Journal of Trauma and Injury最新文献

{"title":"Changes in the clinical features and demographics of donors after brain death, before and after the establishment of a regional trauma center: 20 years of experience at a single center in Korea.","authors":"Myung Jin Jang, Sang Tae Choi, Gil Jae Lee, Doo Jin Kim, Won Suk Lee","doi":"10.20408/jti.2024.0068","DOIUrl":"10.20408/jti.2024.0068","url":null,"abstract":"<p><strong>Purpose: </strong>Organ transplantation is considered the definitive treatment for end-stage organ disease. However, the scarcity of donor organs compared to the number of patients awaiting transplants is a major barrier. This study aimed to assess the impact of a regional trauma center on organ procurement and to provide a basis for future collaboration between regional trauma centers and transplant centers.</p><p><strong>Methods: </strong>This retrospective study analyzed organ donors after brain death over a 20-year period from January 1, 2003, to December 31, 2022. It compared patients before and after the establishment of the regional trauma center, as well as trauma and nontrauma patients. The study investigated general patient characteristics and the number and types of donated organs.</p><p><strong>Results: </strong>The average age of patients significantly increased from 37.75 years before the trauma center was established to 46.72 years after (t=-4.32, P<0.001). The organ acquisition rate significantly increased from 3.03 before to 3.47 after (t=-2.96, P=0.003). Suicide (t=6.52, P=0.011) and cardiopulmonary resuscitation cases were more common among nontrauma patients than among trauma patients (t=8.34, P=0.004). However, the organ acquisition rate was significantly higher among trauma patients than among nontrauma patients (3.53 vs. 3.21; t=2.04, P=0.004).</p><p><strong>Conclusions: </strong>This study identified changes in the characteristics and donor organs of patients diagnosed with brain death after the establishment of a regional trauma center. Given the increase in the proportion of trauma patients and the rate of organ acquisition per capita post-establishment, efforts should be made to encourage organ donation from patients diagnosed with brain death through close collaboration between regional trauma centers and organ transplant centers.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"38 1","pages":"14-21"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774860","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 remarkable growth and international recognition of the Journal of Trauma and Injury.","authors":"Gil Jae Lee","doi":"10.20408/jti.2025.0058","DOIUrl":"10.20408/jti.2025.0058","url":null,"abstract":"","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"38 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774866","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":"Patients with intentional punch injuries in the emergency department: a retrospective cohort study.","authors":"İbrahim Toker, Ömer Salt, Taner Şahin, Mükerrem Altuntaş, İrfan Gökçek, Murat Eşlik, İbrahim Tüysüz, Baycan Kuş, Muhammed İslam Özer","doi":"10.20408/jti.2025.0022","DOIUrl":"10.20408/jti.2025.0022","url":null,"abstract":"<p><strong>Purpose: </strong>Hand and wrist injuries represent some of the most common traumatic conditions encountered in the emergency department (ED). Our study aimed to elucidate the demographic and clinical characteristics of patients sustaining intentional punch injuries.</p><p><strong>Methods: </strong>This single-center retrospective study involved patients aged 16 years and older who presented to the ED with intentional punch injuries in 2023.</p><p><strong>Results: </strong>A total of 405 patients were included in the study. The median patient age was 30 years (interquartile range, 22-40 years), and 363 (89.6%) were male. Among the patients, a total of 389 fractures were identified in 362 patients (89.4%). Metacarpal bone fractures were the most common, with 372 fractures (95.6%). The fifth metacarpal was the most frequently injured (67.4%), followed by the fourth (10.0%) and third (7.7%) metacarpals. Although the most common base fracture occurred in the first metacarpal, shaft fractures were most prevalent in the second, third, fourth, and fifth metacarpals. Overall, 259 patients (71.5%) had nondisplaced fractures. Additionally, 31 patients (7.7%) had previously been admitted to the ED for punching, 17 (4.2%) had prior ED visits for trauma resulting in a fracture, and 63 (15.6%) reported a history of psychiatric drug use.</p><p><strong>Conclusions: </strong>Young men represent the majority of intentional punch injury patients. The fifth metacarpal and its shaft fractures were most commonly observed. A history of prior ED visits for punching or trauma, as well as psychiatric medication use, may serve as potential risk factors.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"38 1","pages":"32-37"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774865","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":"Acute irreducible anterior shoulder dislocation due to interposition of the subscapularis muscle and the lesser tuberosity: a case report.","authors":"Nazim Sifi, Ahmad Madani, Mahdi Zeghdoud","doi":"10.20408/jti.2024.0044","DOIUrl":"10.20408/jti.2024.0044","url":null,"abstract":"<p><p>Efforts to reduce an anterior shoulder dislocation can fail due to numerous mechanical obstructions caused by soft tissue interposition (long head of the biceps, rotator cuff muscles, labrum, musculocutaneous nerve) and/or bony elements (displaced fragment of a greater tuberosity or glenoid fracture, bone impaction such as a Hill-Sachs lesion fixed on the glenoid rim, a bony Bankart lesion). Herein, we report the case of a 35-year-old man who sustained an anterior shoulder fracture-dislocation of his left shoulder after a fall. Despite a postreduction radiological examination that appeared misleadingly reassuring, subtle signs of persistent subluxation raised concerns. A computed tomography (CT) scan revealed subscapularis muscle entrapment along with avulsion of its bony insertion from the lesser tuberosity of the humerus, and a comminuted avulsion fracture of the greater tuberosity of the humerus. The patient underwent surgery using a deltopectoral approach. This involved releasing the entrapped subscapularis muscle and fixing the two fractured fragments. The lesser tuberosity was reduced and secured with two cannulated screws, and the comminuted fragment of the greater tuberosity was reattached using transosseous sutures. At 12-month follow-up, the patient achieved a Constant-Murley score of 85 of 100, with limitation in internal rotation at L3 but no signs of instability or new dislocation episode. This case underscores the importance of confirming shoulder reduction on at least two orthogonal views and paying close attention to the patient's feedback about sensation in their shoulder. Additionally, it highlights the utility of CT or magnetic resonance imaging scans if doubt exists about the integrity of the reduction.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"38-43"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512786","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":"Minimally invasive surgery for concomitant pericardial and diaphragmatic rupture after blunt trauma: a case report.","authors":"Ranti Kenny Maila, Kenny Nyiko Mongwe, Mirza Mohamod Zahir Uddin Bhuiyan","doi":"10.20408/jti.2024.0045","DOIUrl":"10.20408/jti.2024.0045","url":null,"abstract":"<p><p>Pericardial rupture with cardiac herniation is a rare injury that occurs following blunt trauma. It is even more unusual to find a pericardial tear associated with diaphragmatic injury after such trauma. Diagnosing this condition through radiologic imaging is challenging. A 51-year-old man was admitted to the emergency department after a wall collapsed on him. He reported overall body discomfort, breathlessness, chest pain, and abdominal discomfort. A plain x-ray revealed haziness in the left thoracic cavity and elevation of the left hemidiaphragm with collapse of the left lung. Additionally, a gastric shadow was seen within the left hemithorax, accompanied by a mediastinal shift to the right. An x-ray of the pelvis displayed fractures at the right sacroiliac joint, left superior pubic ramus, left inferior pubic ramus, and left anterior acetabular with displacement. A computed tomography scan indicated herniation of the stomach, splenic flexure, and spleen, but there was no clear evidence of pericardial laceration. The patient underwent emergency exploratory laparoscopy and thoracoscopy. During the laparoscopy, a significant defect was found in the left hemidiaphragm, along with a pericardial rupture that had led to cardiac herniation and visceral herniation of the stomach, splenic flexure, and spleen through the diaphragmatic tear. The abdominal visceral organs were repositioned into the abdomen, and the diaphragm was repaired. The heart was repositioned, and the pericardial defect was closed using thoracoscopic techniques. Pericardial rupture can be effectively managed using minimally invasive surgery.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"38 1","pages":"51-55"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774863","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":"Clinical profile, management, and outcome of pediatric neurotrauma: a multicentric observational study.","authors":"Sanat Kumar Khanna, Anil Kumar, Anand Kumar Katiyar, Kundan Mishra","doi":"10.20408/jti.2024.0080","DOIUrl":"10.20408/jti.2024.0080","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric neurotrauma (pNT) includes pediatric traumatic brain injury and spinal cord injury. The incidence and distribution of pNT by age and sex remain understudied, with several gaps in both epidemiological and clinical data. This study aimed to estimate the epidemiological parameters, clinical presentations, surgical interventions, and outcomes in our patient population with pNT.</p><p><strong>Methods: </strong>A multicentric, ambispective study was conducted at five tertiary care pediatric neurosurgical centers in Northern India from January 2011 to December 2022. The study included children under 16 years of age admitted with a history of head injury. Data on demographics, radiological findings, management, and outcomes were recorded.</p><p><strong>Results: </strong>A total of 2,250 children were admitted; 77.5% were male and 22.5% were female. The most common age group was 6 months to 2 years (37.3%). The primary mechanism of injury was fall from height (64.6%), followed by road traffic accidents (26.1%). Overall, 84.6% of children had mild head injury, 14.2% moderate, and 1.2% severe. The most common abnormality on computed tomography brain was contusion (9.2%). Surgical interventions were required in only 0.8% of children. A favorable outcome, as measured by Glasgow Outcome Scale, was achieved in 99.2% of patients, and the mortality rate was 0.1%.</p><p><strong>Conclusions: </strong>Our findings indicate that pNT is most common in children aged 6 months to 2 years and predominantly affects boys. The most frequent cause was a fall from height, and the majority of patients sustained mild head injuries requiring only observation, which led to excellent outcomes. Surgical intervention was necessary in only a few cases, and mortality was rare. This study highlights the epidemiological pattern of pNT in our population and delineates various causes of such trauma.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"38 1","pages":"22-31"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774861","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":"Infection prevention and treatment following dog bites: a systematic review of randomized controlled trials.","authors":"Yongsik Yoon, Dukho Kim, Dongwuk Lee, Hyeongyu Min, Junhyuk Choi","doi":"10.20408/jti.2024.0069","DOIUrl":"10.20408/jti.2024.0069","url":null,"abstract":"<p><strong>Purpose: </strong>Dog bites pose a significant global public health challenge, with outcomes that range from minor injuries to fatalities. Despite their prevalence, no consensus has been established regarding the most effective prevention and treatment strategies. This systematic review aimed to consolidate and evaluate randomized controlled trials (RCTs) examining the effectiveness of interventions in preventing and treating dog bites.</p><p><strong>Methods: </strong>A comprehensive search was conducted across the CINAHL, Embase, MEDLINE, Web of Science, and PubMed databases for RCTs published within the last 10 years. Studies were included if they focused on interventions to prevent or treat dog bites. Primary outcomes included the infection rate and recovery time of dog bites, the effectiveness of interventions in preventing or reducing bite severity, and associated health outcomes. The risk of bias was assessed using the Cochrane Collaboration tool.</p><p><strong>Results: </strong>Five RCTs met the eligibility criteria, with a total of 1,148 participants. These studies examined various interventions, including medical techniques (medical glue, negative pressure wound therapy, and hyperbaric oxygen therapy), wound management strategies (primary suturing versus non-suturing), and educational interventions. A meta-analysis of four studies revealed no significant difference in infection rates between the intervention and control groups (risk ratio, 0.69; 95% confidence interval [CI], 0.27-1.77; I2=62%; P=0.44). However, the interventions examined in each study demonstrated shorter recovery times (mean difference, 11.25 days; 95% CI, 8.44-14.07 days; I2=99%; P<0.001).</p><p><strong>Conclusions: </strong>Although the included studies suggest potential benefits of certain interventions in treating dog bites, particularly in reducing recovery time, the evidence regarding infection prevention remains inconclusive. The limited number of high-quality RCTs in this field highlights the need for further research to establish evidence-based guidelines for dog bite prevention and treatment.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"38 1","pages":"3-13"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774862","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":"Injuries from blank cartridge shots in suicide attempts within the South Korean military: a case series of five patients.","authors":"Jeong Il Joo, Changsin Lee, Kyungwon Lee","doi":"10.20408/jti.2024.0037","DOIUrl":"10.20408/jti.2024.0037","url":null,"abstract":"<p><strong>Purpose: </strong>Blank cartridges are designed to produce the sound and gas flare of a gunshot without firing a bullet. However, blank cartridge shots (BCS) can still cause injuries ranging from minor to life-threatening. Within the South Korean military, most BCS-related injuries have occurred during suicide attempts. This study documents a case series of patients who sustained injuries from BCS during such attempts.</p><p><strong>Methods: </strong>We examined the medical records of Korean soldiers at a military trauma center between April 2022 and April 2024 who had sustained injuries from BCS during suicide attempts. The analyzed data included general characteristics, injury site, surgical and psychiatric interventions, and length of hospitalization.</p><p><strong>Results: </strong>The case series included five patients between 19 and 20 years old (mean age, 19.6±0.55 years). Four of these patients sustained self-inflicted gunshot wounds to the submandibular area, while one targeted the right temporal area. Although initial vital signs and laboratory findings were unremarkable, computed tomography scans revealed injuries from projectile gas and gunpowder, including burns, subcutaneous emphysema, and major structural damage. Cases 1 and 2 required emergency surgery for foreign body removal and debridement. The average length of hospitalization was 35.2±12.11 days. Patients were first admitted to the trauma surgery department for BCS injury management, and then transferred to the psychiatry department for emotional support. The average stay was 15.6±15.87 days in trauma surgery and 19.6±14.99 days in psychiatry.</p><p><strong>Conclusions: </strong>This study highlights the consequences of BCS from suicide attempts in the South Korean military and provides valuable insights for medical personnel who may encounter patients with BCS injuries.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"262-267"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774750","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":"Reperfusion injury or cytokine storm? Utilizing plasmapheresis in severe trauma-induced multiorgan failure: a case report.","authors":"Gun Woo Kim, Suyeong Hwang, Kyoung Hoon Lim, Sung Hoon Cho","doi":"10.20408/jti.2024.0051","DOIUrl":"10.20408/jti.2024.0051","url":null,"abstract":"<p><p>Reperfusion injury can cause tissue damage due to ischemia, with severe cases potentially resulting in multiorgan failure. Cytokine storm, a life-threatening systemic inflammatory state characterized by elevated levels of circulating cytokines and hyperactive immune cells, can also lead to tissue damage and multiorgan failure. Reperfusion injury and cytokine storm sometimes exhibit similar clinical features, necessitating specific treatment in severe cases. A 31-year-old man sustained a stab wound to his left knee. Computed tomography angiography and surgical exploration revealed a transection of the left popliteal artery and vein. Both vessels were revascularized via end-to-end anastomosis approximately 3 hours after the injury. On postoperative day 2, marked increases were observed in levels of aspartate aminotransferase (8,600 U/L), alanine transaminase (6,690 U/L), creatine phosphokinase (26,817 U/L), and lactate dehydrogenase (7,398 U/L) levels. Elevated levels of interleukin 6 (178 pg/mL) and ferritin (41,079 ng/mL) were also noted. Given the possibility of either reperfusion injury or cytokine storm, plasmapheresis was initiated. Following two rounds of plasmapheresis, the patient's condition rapidly improved, and he was discharged without complications. Reperfusion injury can arise when a target blood vessel is revascularized, particularly during severe stages of ischemia. Cytokine storm represents a life-threatening systemic inflammatory state characterized by high levels of circulating cytokines and overactive immune cells. Both reperfusion injury and cytokine storm can cause systemic inflammation and multiorgan failure. These two conditions may exhibit similar clinical features, necessitating supportive care primarily to prevent organ dysfunction. However, plasmapheresis may represent an effective treatment option in cases of severe progression.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"295-299"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774751","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":"Splenic artery embolization for trauma: a narrative review.","authors":"Simon Roh","doi":"10.20408/jti.2024.0056","DOIUrl":"10.20408/jti.2024.0056","url":null,"abstract":"<p><p>The management of traumatic splenic injuries has evolved significantly over the past several decades, with the majority of these injuries now being treated nonoperatively. Patients who exhibit hemodynamic instability upon initial evaluation typically require surgical intervention, while the remainder are managed conservatively. Conservative treatment for traumatic splenic injuries encompasses both medical management and splenic artery angiography, followed by embolization in cases where patients exhibit clinical signs of ongoing splenic hemorrhage. Splenic artery embolization is generally divided into two categories: proximal and distal embolization. The choice of embolization technique is determined by the severity and location of the splenic injury. Patients who retain functioning splenic tissue after trauma do not routinely need immunization. This is in contrast to post-splenectomy patients, who are at increased risk for opportunistic infections.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"37 4","pages":"252-261"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907940","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}