Journal of Trauma and Injury最新文献

{"title":"The Last Temptation of Christ as terminal hallucination: a trauma surgeon's interpretation of hypovolemic shock in literature and film.","authors":"Kun Hwang, Chan Yong Park","doi":"10.20408/jti.2025.0113","DOIUrl":"10.20408/jti.2025.0113","url":null,"abstract":"","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"38 3","pages":"165-167"},"PeriodicalIF":0.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blunt abdominal trauma: a retrospective study on clinical insights and treatment outcomes.","authors":"Anurag Kumar, Rachith Sridhar, Harendra Kumar, Abdul Hakeem S, Abdul Vakil Khan, Majid Anwer","doi":"10.20408/jti.2025.0045","DOIUrl":"10.20408/jti.2025.0045","url":null,"abstract":"<p><strong>Purpose: </strong>Blunt abdominal trauma is a significant cause of morbidity and mortality, predominantly affecting younger male patients. Therefore, a study examining the mechanisms of injury, injury patterns, and outcomes in these cases is essential. The aim of this study was to evaluate demographics, injury mechanisms, treatments provided, and outcomes in cases of blunt abdominal trauma at a level I trauma center in Eastern India.</p><p><strong>Methods: </strong>A descriptive retrospective study was conducted at a level I trauma center using departmental audit data spanning 18 months (July 2022-December 2023). Data from 118 patients diagnosed with blunt abdominal trauma were analyzed.</p><p><strong>Results: </strong>The study revealed a pronounced male predominance (6.35:1), with a mean age of 30.2 years. Road traffic accidents were the most frequent cause of injury (56.8%). Only six patients (5.1%) presented within the \"golden hour,\" resulting in delayed interventions. Surgical intervention was necessary in 78 cases (66.1%), with hollow viscus perforation being the most common indication. The mean hospital stay was 10.6 days, and the overall mortality rate was 12.7%. The presence of shock upon admission significantly correlated with mortality (P<0.001).</p><p><strong>Conclusions: </strong>Blunt abdominal trauma continues to represent a critical healthcare challenge, particularly affecting younger males. Improved healthcare accessibility, adherence to Advanced Trauma Life Support protocols, and timely interventions could improve survival rates.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"38 3","pages":"221-231"},"PeriodicalIF":0.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated blood storage requirements for a North Korean invasion of South Korea and South Korea's preparedness.","authors":"Kun Hwang, Chan Yong Park","doi":"10.20408/jti.2025.0061","DOIUrl":"10.20408/jti.2025.0061","url":null,"abstract":"<p><strong>Purpose: </strong>Hemorrhage is the leading cause of preventable battlefield deaths, and up to 30% of casualties could survive with timely transfusions. In a potential North Korea-South Korea conflict, ensuring adequate blood supply would be crucial for military medical readiness. This study estimated the 2-week blood demand in such a conflict and evaluated South Korea's preparedness to meet it.</p><p><strong>Methods: </strong>A multifaceted approach was employed, incorporating historical casualty data, medical literature on battlefield transfusions, South Korean blood supply reports, and military blood logistics models. Projections indicate 80,000 to 150,000 casualties within the first 2 weeks, with 30% of military and 15% of civilian casualties requiring transfusions. The estimated total blood demand ranges from 360,000 to 600,000 L, surpassing current South Korean reserves.</p><p><strong>Results: </strong>Despite a 100,000-L prewar storage goal, weekly replenishment needs could reach 150,000 to 300,000 L, placing immense strain on collection, storage, and distribution systems. Key shortages include packed red blood cells, fresh frozen plasma, and platelets, with projected deficits of up to 120,000, 70,000, and 30,000 units, respectively. The logistical challenges of storing and transporting platelets, given their 5-day shelf life, make them particularly vulnerable to depletion. To address these shortages, a multipronged strategy is required, including pre-war stockpiling, mobile blood banks, rapid military-civilian coordination, international cooperation with US and other allies, and prioritization of whole blood over component therapy.</p><p><strong>Conclusions: </strong>South Korea's current blood reserves are insufficient for a large-scale war. A combination of strategic stockpiling, military-civilian coordination, and alternative blood sources (synthetic oxygen carriers, prewar autologous donation programs) is essential to sustaining medical operations and improving survival rates.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"38 3","pages":"232-236"},"PeriodicalIF":0.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal fat embolism syndrome in a young trauma patient with a stable initial presentation: time to define predictive criteria? A case report.","authors":"Nebojsa Brezic, Strahinja Gligorevic, Tatjana Atanasijevic, Vladimir Zivkovic, Bojan Jovanovic","doi":"10.20408/jti.2024.0072","DOIUrl":"10.20408/jti.2024.0072","url":null,"abstract":"<p><p>Fat embolism syndrome (FES) is a rare but serious complication most commonly associated with trauma, particularly long bone fractures. However, symptomatic FES remains a significant diagnostic and therapeutic challenge. We present the case of a 20-year-old man who, after sustaining multiple long bone fractures in a motorcycle accident and initially appearing stable, experienced a rapid and fatal progression of FES. This case underscores the unpredictable course of FES even in young, previously healthy individuals and highlights the critical need for early recognition and intervention. It also emphasizes the importance of identifying risk factors that may predict severe outcomes and mortality.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"273-279"},"PeriodicalIF":0.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preperitoneal pelvic packing as a salvage operation for postoperative retroperitoneal bleeding with hemodynamic instability after the Kocher-Langenbeck approach to the acetabulum: a case report.","authors":"Doo-Hun Kim, Maru Kim, Dae-Sang Lee, Tae Hwa Hong, Hangjoo Cho","doi":"10.20408/jti.2024.0087","DOIUrl":"10.20408/jti.2024.0087","url":null,"abstract":"<p><p>Pelvic fractures result from high-energy trauma, and when accompanied by hemorrhagic shock, the mortality rate increases to 40%. Pelvic fractures are anatomically categorized as pelvic ring disruptions and acetabular fractures, each requiring different treatment methods and approaches. Acetabular fractures, which also result from high-energy injuries, may be accompanied by hemorrhagic shock. Treatment options for pelvic fractures with hemorrhagic shock include angioembolization, preperitoneal pelvic packing (PPP), and emergency laparotomy. In hemodynamically stable patients, early total care may be attempted, and for acetabular fractures (posterior column), the Kocher-Langenbeck approach is the treatment of choice. This case report describes the use of PPP as a salvage operation for postoperative retroperitoneal bleeding with hemodynamic instability following a Kocher-Langenbeck approach for an acetabular fracture with pelvic ring injury. The patient was discharged without postoperative complications such as bone displacement or surgical site infection. While PPP is commonly employed as an initial treatment modality for pelvic fractures with hemorrhagic shock, it may also be valuable in managing postoperative retroperitoneal bleeding with hemorrhagic shock.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"285-289"},"PeriodicalIF":0.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The SPAIRE (saving piriformis and internus, repair of externus) posterolateral approach in bipolar hemiarthroplasty for femoral neck fractures: a case report.","authors":"Nazim Sifi, Sorin Suba","doi":"10.20408/jti.2024.0099","DOIUrl":"10.20408/jti.2024.0099","url":null,"abstract":"<p><p>Femoral neck fractures commonly occur in older patients and typically require surgical intervention to promptly restore mobility and minimize complications. While the anterior, lateral, and posterior approaches are frequently employed for hemiarthroplasty, each has its own benefits and drawbacks. Notably, the posterior approach has been linked to a higher risk of dislocation in some studies. The SPAIRE (saving piriformis and internus, repair of externus) technique is a modern adaptation of the traditional posterolateral approach. This less invasive, anatomically considerate method preserves the piriformis muscle tendon and the conjoint tendon of the superior gemellus, obturator internus, and inferior gemellus muscles. However, it involves sectioning the tendon of the obturator externus muscle. The technique is designed to maintain stabilizing muscular structures, decrease dislocation risk, and hasten functional recovery, including in patients with neurological conditions. This case report describes the treatment of a 79-year-old woman with a transcervical fracture of the right femoral neck. A bipolar hemiarthroplasty was performed using the SPAIRE technique. The procedure effectively preserved the functional synergistic unit of the piriformis-conjoint tendon (quadriceps coxa) and included meticulous capsular and tendinous repair. The patient's postoperative recovery was characterized by an excellent functional outcome at the 3-month follow-up. This case highlights the advantages of the SPAIRE technique in enhancing joint stability and facilitating rapid recovery, especially in geriatric patients.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"268-272"},"PeriodicalIF":0.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inferior vena cava injuries at a level I trauma center: a case series.","authors":"Rachith Sridhar, Abdul Vakil Khan, Harendra Kumar, Abdul Hakeem, Deepak Kumar, Majid Anwer","doi":"10.20408/jti.2025.0054","DOIUrl":"10.20408/jti.2025.0054","url":null,"abstract":"<p><p>Inferior vena cava (IVC) injuries are rare but deadly. Depending on the mechanism of injury, patient status, and type of injury, intervention may be surgical or endovascular. These injuries typically pose challenges in identification and treatment. During surgical intervention, rapid access and timely control of the bleeding site may be difficult. In this series, we aim to describe various IVC injuries presented at our center, detailing challenges and outcomes in their management. The study aims to characterize the presentation, interventions, and outcomes of IVC injury cases at a level I trauma center over a period of 30 months. In this report, a total of six cases of IVC injury were treated at our center. All patients underwent surgical intervention. Each patient experienced a high-energy trauma mechanism, with three patients sustaining blunt trauma and three sustaining penetrating trauma. Of the six patients, three survived while three died. Mortality was attributed to delayed presentation, complexity of injuries, and technical difficulties. Adherence to Advanced Trauma Life Support (ATLS) protocols, timely diagnosis and resuscitation, and rapid decision-making can reduce mortality associated with IVC injuries. Nonetheless, surgeons must remain cognizant of the inherent challenges and pitfalls in managing these injuries.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"299-306"},"PeriodicalIF":0.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is dorsal cortex drilling necessary for distal radius fractures treated with a volar locking plate? A comparative study of near-cortex-only and far-cortex drilling.","authors":"Chul Hong Kim, Sung Yoon Jung, Hyeon Jun Kim, Si-Hyun Park","doi":"10.20408/jti.2025.0018","DOIUrl":"10.20408/jti.2025.0018","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare and analyze the effectiveness of near-cortex-only drilling for the surgical treatment of distal radius fractures using a volar locking plate.</p><p><strong>Methods: </strong>From January 2010 to December 2022, a total of 185 patients aged 60 years or older with AO type C distal radius fractures who were treated with a volar locking plate at our hospital were enrolled. Of these, 59 patients were excluded according to the study criteria, resulting in a final cohort of 126 subjects. Without differentiating between left and right sides, group A (n=60) underwent distal locking screw fixation with screws of 12-mm length (except for the most radial screw) using near-cortex-only drilling. In group B (n=66), drilling was performed through to the dorsal cortex, and the length was measured using a depth gauge; distal screws were then fixed at a length 2 mm shorter than the measured depth. The degree of fracture reduction on postoperative radiographs was assessed using the modified Lidstrom scoring system by measuring radial inclination, radial height, and volar tilt. In addition, the visual analog scale, the Korean Disabilities of the Arm, Shoulder, and Hand (DASH) score, and the incidence of extensor tendon rupture and tenosynovitis were evaluated at the final follow-up and compared between groups.</p><p><strong>Results: </strong>Bone union was achieved in all cases, with no significant radiographic differences observed between the two groups (P>0.05). In contrast, two cases of extensor tenosynovitis were noted in group A, whereas group B experienced one extensor tendon rupture and five cases of extensor tenosynovitis, representing a significant difference (P<0.05).</p><p><strong>Conclusions: </strong>In patients aged 60 years or older with AO type C distal radius fractures, the technique of near-cortex-only drilling with short distal locking screws yielded satisfactory results for fracture reduction and clinical indices. This approach may offer a new alternative for preventing extensor tendon rupture or tenosynovitis.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"38 3","pages":"248-254"},"PeriodicalIF":0.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual plating in the management of nonunion complex distal femur fractures following lateral locked plate fixation: radiological and functional outcomes of a prospective study.","authors":"Nilesh Barwar, Gypsy Gargi, Ankit Rai, Abhay Elhence, Sumit Banerjee, Nitesh Gahlot","doi":"10.20408/jti.2024.0054","DOIUrl":"10.20408/jti.2024.0054","url":null,"abstract":"<p><strong>Purpose: </strong>Managing complex distal femur fractures presents technical challenges. Although the lateral locked plate has become standard for these fractures, failures are not uncommon when this device is used alone. Patients with nonunion of distal femur fractures following treatment with a single lateral locked plate were examined. Revision surgery was performed by applying dual plates, and their efficiency was evaluated.</p><p><strong>Methods: </strong>This study investigated 24 aseptic and 3 septic nonunions of distal femur fractures, classified as AO/OTA type C, that were previously managed with open reduction and internal fixation using only a lateral locked plate. Revision surgery involved replacing the broken 5.0-mm lateral locked plate, supplementing the medial side with a 4.5-mm T-plate, and applying bone grafting at the fracture site. Septic cases were managed using a staged approach with dual implant application.</p><p><strong>Results: </strong>Following revision surgery, bony union was achieved in 83.3% of aseptic nonunions, with a mean bone healing time of 22.5 weeks (range, 15-27 weeks). Additional surgery was required for the remaining 16.6%. Using staged management, the septic nonunions were united in a mean of 30.25 weeks (range, 27-32 weeks). Significant improvements were noted in the Tegner Lysholm Knee Scoring Scale, with median preoperative and postoperative scores of 30 (range, 12-67) and 80 (range, 66-90), respectively (P<0.001). Limb pain, as measured by the visual analog scale for knee pain, improved significantly from a preoperative median of 6 (range, 4-8) to 3 (range, 1-6) postoperatively (P<0.001). All patients were ambulatory without supportive devices. However, the mean knee range of motion was 80° (range, 40°-120°). Limb shortening was observed in six cases (22.2%; average shortening, 2.3±1.0 cm).</p><p><strong>Conclusions: </strong>Dual plating appears to be an effective approach for managing failed complex distal femur fractures following initial treatment with a single lateral locked plate.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"125-136"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical site infections: a comprehensive review.","authors":"Ahmad Reza Rezaei, Damian Zienkiewicz, Amir Reza Rezaei","doi":"10.20408/jti.2025.0019","DOIUrl":"10.20408/jti.2025.0019","url":null,"abstract":"<p><p>Surgical site infections (SSIs) represent a major public health challenge, contributing to increased morbidity, mortality, and healthcare costs worldwide. This paper presents a comprehensive review of the epidemiology, classification, risk factors, microbiological aspects, treatment modalities, and prevention strategies for SSIs, based on contemporary research and evidence-based practice protocols. An extensive literature review was conducted, synthesizing existing studies on SSIs. A comprehensive search was performed in PubMed, Embase, Cochrane Library, and guidelines from leading organizations such as the American College of Surgeons, the US Centers for Disease Control and Prevention, the World Health Organization, and the Infectious Diseases Society of America. Inclusion criteria encompassed peer-reviewed articles as well as American and European medical guidelines focusing on the epidemiology, risk factors, microbiology, treatment, and prevention of SSIs. The review adhered to the PECO (population, exposure, comparator, outcome) framework. Some of the most significant global concerns related to SSIs include antibiotic resistance and the contamination of surgical instruments, particularly in resource-poor settings. Trauma patients, especially those undergoing emergency procedures or sustaining open fractures, are at increased risk for SSIs due to the severity of their injuries and higher contamination risks. These findings underscore the importance of preventive measures, such as appropriate preoperative interventions, strict aseptic techniques, and proper antibiotic prophylaxis, in reducing SSI incidence and improving patient outcomes.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"71-81"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}