Journal of Trauma and Injury最新文献

{"title":"An obstinate intracranial bullet: a case report.","authors":"Simon Tomala, Bernardo Bollen Pinto","doi":"10.20408/jti.2025.0139","DOIUrl":"https://doi.org/10.20408/jti.2025.0139","url":null,"abstract":"<p><p>We report the case of a 52-year-old man with a history of psychiatric illness who sustained an intracranial gunshot wound. Within 20 hours, the bullet spontaneously migrated from the right to the left frontal lobe, as confirmed by two computed tomography scans, which led to a failed extraction in the operating theater. A decision was ultimately made not to reoperate. The patient is therefore currently living with a retained intracranial bullet and a decompensated psychiatric state. This case emphasizes the importance of perioperative imaging to adapt surgical planning and highlights the critical impact of bullet migration on prognosis and management.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iatrogenic cardiac injury following prehospital needle decompression: a case report.","authors":"Khalid Ahmed, Rabab Abdelrahman, Murad Alahmad, Ammara Bint I Bilal, Al-Jouhara Albaloshi, Mohamed H Ahmed, Husham Abdelrahman, Hafeez Ulla Lone, Sankar Balasubramanian, Ayman El-Menyar, Sandro Rizoli, Hassan Al-Thani, Talat Chughtai","doi":"10.20408/jti.2025.0136","DOIUrl":"https://doi.org/10.20408/jti.2025.0136","url":null,"abstract":"<p><p>Tension pneumothorax is a life-threatening condition that necessitates prompt intervention, typically via prehospital needle thoracostomy. However, this procedure carries risks such as cardiac injury. We report the case of a 20-year-old man involved in an all-terrain vehicle accident who presented with a low Glasgow Coma Scale (GCS) score, respiratory distress, and hypotension. Prehospital intubation and left-sided needle thoracostomy were performed for suspected pneumothorax and depressed GCS score. Pulsatile bleeding from the catheter was noted. Imaging in the trauma bay revealed catheter penetration into the left ventricle. Pan computed tomography confirmed the cardiac injury and identified a severe traumatic brain injury. The patient underwent surgical repair of the heart via median sternotomy. He recovered well and was subsequently transferred for rehabilitation. This case highlights the risks associated with emergent, blind needle thoracostomy in the prehospital setting. Improved outcomes depend on refined technique, accurate anatomical identification, and appropriate needle selection.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A large foreign body removal from the anterior mediastinum using a minimally invasive method after a shrapnel wound to the neck: a case report.","authors":"Igor Lurin, Eduard Khoroshun, Vitaliy Makarov, Volodymyr Nehoduyko, Hannah B Wild, Serhiy Tertishny, Yuriy Bunin","doi":"10.20408/jti.2025.0077","DOIUrl":"https://doi.org/10.20408/jti.2025.0077","url":null,"abstract":"<p><p>This case report describes the diagnosis and surgical management of a shrapnel wound to the neck with a retained foreign body (metal fragment) in the anterior mediastinum. A 44-year-old male service member was wounded in the neck during an air raid. Thirty minutes after sustaining the injury, the patient reached a forward surgical team, exhibiting hemodynamic instability responsive to resuscitation. After initial stabilization, the forward team performed primary surgical treatment of the wound, including hemostasis, irrigation and debridement, and drainage. Twelve hours later, the patient was transported by ground to the Military Medical Clinical Center of the Northern Region of the Military Medical Center of the Armed Forces of Ukraine and hospitalized in the surgical department. Diagnostic evaluation included computed tomography of the head, chest, abdomen, and pelvis along with esophagogastroduodenoscopy, which demonstrated fracture of left ribs 1 and 2, a 40×15-mm metal fragment in the anterior superior mediastinum with pneumomediastinum and hemomediastinum, and metal fragments in the soft tissues of the neck without contrast extravasation. Esophagogastroduodenoscopy revealed no evidence of esophageal injury. Surgical management included left video-assisted thoracoscopic surgery with opening of the anterior mediastinum and removal of the foreign body (metal shrapnel fragment) using a magnetic surgical instrument. The patient was discharged 2 weeks postoperatively. Gunshot wounds of the neck with a large foreign body in the anterior mediastinum are rare. The use of minimally invasive surgical techniques and modern magnetic surgical instruments can reduce surgical morbidity and may be used at tertiary care centers.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequential bilateral hip fractures after conservative treatment of femoral neck fracture: a case report.","authors":"Panagiotis Karampinas, Athanasios Galanis, Evangelos Sakellariou, Evangelia Argyropoulou, Michail Vavourakis, Spyridon Karampitianis, Vasileios Marougklianis, Angelos Kaspiris, John Vlamis, Spiros Pneumaticos","doi":"10.20408/jti.2025.0067","DOIUrl":"https://doi.org/10.20408/jti.2025.0067","url":null,"abstract":"<p><p>Conservative treatment for valgus-impacted fractures can yield a high union rate; however, determining the ideal indications for this approach remains challenging. Older adults may sustain bilateral hip fractures from low-impact falls, typically presenting a symmetric fracture pattern. Nonetheless, asymmetric bilateral hip fractures, though extremely rare, have been documented. This report describes a case of a 78-year-old woman who presented after a low-impact fall at home. Her medical history included a previous fall 3 months earlier, resulting in a Garden I right femoral neck fracture treated conservatively in another department of our institution. Radiological examination revealed a left peritrochanteric fracture and a displaced (Garden IV) subcapital fracture of the right hip. Both fractures were treated surgically on the same day, with cephalomedullary nailing of the left femur followed by cemented bipolar hemiarthroplasty of the right femur. The postoperative course was uneventful, and the 1-year follow-up was satisfactory. The surgical sequence was chosen to facilitate intraoperative positioning, minimize the risk of prosthetic dislocation, and allow accurate restoration of leg length using the fixation as a reference point for hemiarthroplasty. This case highlights the importance of individualized treatment planning and careful consideration of surgical fixation for older adults with valgus-impacted femoral neck fractures who are at high risk of subsequent falls and hip fractures.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Walking on the blade: Frank C. Spencer and the courage to defy dogma in the Korean War.","authors":"Kun Hwang","doi":"10.20408/jti.2025.0239","DOIUrl":"10.20408/jti.2025.0239","url":null,"abstract":"","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"1-3"},"PeriodicalIF":0.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576565","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":"Bridging the gap: a successful interhospital transfer of a bleeding pelvic fracture patient using REBOA and the \"doctor car\" system: a case report.","authors":"Hanbyol Song, Gil Jae Lee, Byungchul Yu, Seung Hwan Lee, Min A Lee, Myung Jin Jang, Jeong Ho Kim, Kang Kook Choi","doi":"10.20408/jti.2025.0059","DOIUrl":"10.20408/jti.2025.0059","url":null,"abstract":"<p><p>Severe traumatic injuries, particularly unstable pelvic fractures, frequently result in life-threatening hemorrhagic shock, necessitating urgent transfer to specialized trauma centers. However, interhospital transport of hemodynamically unstable patients poses a significant risk of clinical deterioration. Resuscitative endovascular balloon occlusion of the aorta (REBOA) offers effective temporary hemodynamic stabilization before definitive care. Here, we describe the successful use of zone III REBOA by a surgeon-staffed emergency medical service (\"doctor car\") to rapidly stabilize and safely transfer a 62-year-old man with a severe bleeding pelvic fracture. Upon arrival at the trauma center, the patient underwent immediate definitive treatments, including preperitoneal pelvic packing and transarterial embolization. This case highlights the potential for integrating REBOA with physician-staffed emergency transport systems as a strategy to bridge critical gaps in regional trauma care networks and improve patient outcomes.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"80-84"},"PeriodicalIF":0.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558424","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":"Prognostic role of serum interleukin-6 levels in polytrauma patients: a comprehensive narrative review.","authors":"Nicola Madani, Sereen Halayqeh, Hebah Almahariq, Ahmad Al-Badawi, Mohammad Alomari, Bassem Haddad","doi":"10.20408/jti.2025.0081","DOIUrl":"10.20408/jti.2025.0081","url":null,"abstract":"<p><p>Polytrauma triggers a complex systemic inflammatory response, and early identification of high-risk patients is essential for guiding timely interventions and improving outcomes. Interleukin-6 (IL-6), a rapidly induced proinflammatory cytokine, has emerged as a potential biomarker for prognosis in the trauma setting. This narrative review summarizes current evidence on the prognostic role of IL-6 in polytrauma patients, addressing its biological functions, kinetics after injury, and associations with clinical outcomes such as acute respiratory distress syndrome, multiple organ dysfunction syndrome, intensive care unit admission, and mortality. IL-6 levels have been shown to correlate with injury severity scores and to predict complications more reliably than many other inflammatory markers, largely due to its early elevation and sustained presence in circulation. Furthermore, IL-6 measurement may inform surgical decision-making, particularly in selecting candidates for damage control strategies versus definitive care. Compared to other cytokines and acute-phase reactants, IL-6 demonstrates superior temporal responsiveness and prognostic accuracy in the early postinjury phase. Despite variability in measurement methods and the influence of external confounding factors, IL-6 holds significant promise as a clinical tool for early triage, risk stratification, and potentially therapeutic targeting in trauma care. Standardized protocols and larger multicenter studies are needed to facilitate broader adoption and integration of IL-6 into clinical algorithms.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"4-13"},"PeriodicalIF":0.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858874","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 voice of injury: a case report of isolated trauma to the larynx.","authors":"Najeebuddin Mohammed, Ashima Sharma, Alekhya Machani, Sujata Patnaik","doi":"10.20408/jti.2025.0065","DOIUrl":"10.20408/jti.2025.0065","url":null,"abstract":"<p><p>Although uncommon, laryngotracheal injuries carry a significant risk of mortality. This rare case of isolated laryngeal injury underscores the importance of recognizing the various potential presentations of such injuries and highlights the evidence-based management strategies that every emergency physician should consider when treating potential airway trauma. A 45-year-old male motorcyclist was involved in a road traffic accident during the night and presented to the emergency department the following morning. The patient complained of breathlessness, neck pain, hoarseness of voice, and noisy breathing. Examination revealed stridor, swelling in zones 1 and 2 of the neck, tenderness over the thyroid, and subcutaneous emphysema over the neck and anterior chest. A definitive airway was secured, and computed tomography imaging revealed a fracture of the thyroid cartilage. The patient was managed conservatively, extubated after 1 week, and discharged after 2 days of observation. Classification of the type of injury and the use of an algorithmic approach, involving consensus among the emergency department, trauma surgeons, and the critical care team, can help streamline and standardize management of these cases. Furthermore, a thorough understanding of the dos and don'ts in securing the airway in patients with laryngotracheal injuries increases the robustness of the approach to managing this patient population.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"39 1","pages":"85-89"},"PeriodicalIF":0.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583099","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":"Global trends influencing orthopedic surgeons' midshaft clavicle fracture management: a Bullet Health Analysis.","authors":"Arthur P Drouaud, Carolina Stocchi, Christoph Schroen, Kilian T Drouaud, Jan Szatkowski, Derek Moore","doi":"10.20408/jti.2025.0099","DOIUrl":"10.20408/jti.2025.0099","url":null,"abstract":"<p><strong>Purpose: </strong>The management of midshaft clavicle fractures varies depending on fracture characteristics, patient demographics, and surgeon preferences. However, global differences in practice patterns and surgical decision-making for this injury remain poorly characterized.</p><p><strong>Methods: </strong>An international survey was conducted through Orthobullets between March 2021 and September 2024, targeting practicing orthopedic surgeons. Standardized polls, created collaboratively using the best available evidence and a peer-reviewed, evidence-based item list, were designed to capture global treatment preferences. Analyses were then performed to evaluate variation across subspecialties and practice environments. Multivariable regression was applied to examine associations between subspecialty, practice type, the likelihood of selecting operative management, and the preferred surgical techniques.</p><p><strong>Results: </strong>The study included 2,364 surgeons from 76 countries. Overall, 46% (1,076 of 2,337 respondents) selected operative treatment, with notable regional differences. Surgeons from Asia (odds ratio [OR], 1.650), Africa (OR, 1.988), and Latin America (OR, 1.785) were more likely to choose surgery, whereas those from Oceania (OR, 0.464) were less likely. Trauma specialist were 1.45 times more likely to offer operative management. Regarding immobilization, 73.4% preferred a sling, while 23.4% chose a figure-of-eight brace. Among surgeons opting for surgery, 93% (1,479 of 1,590 respondents) selected open reduction and internal fixation with plates and screws.</p><p><strong>Conclusions: </strong>This study demonstrates a notable trend toward operative management of midshaft clavicle fractures, influenced by subspecialty and practice environment. These findings highlight the evolving landscape of fracture care and emphasize the need for standardized approaches and broader understanding across diverse healthcare systems.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"34-41"},"PeriodicalIF":0.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345936","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":"Facial trauma and reconstructive surgery: insights from a case series of severe maxillofacial injuries.","authors":"Harendra Kumar, Abdul Hakeem, Abdul Vakil Khan, Rachith Sridhar, Deepak Kumar, Majid Anwer","doi":"10.20408/jti.2025.0080","DOIUrl":"10.20408/jti.2025.0080","url":null,"abstract":"<p><p>Facial trauma is a complex and important contributor to trauma-related morbidity, often requiring multidisciplinary management due to intricate anatomy and the dual need for functional and aesthetic restoration. This case series describes a spectrum of maxillofacial injuries treated by trauma surgeons, including soft tissue degloving, zygomaticomaxillary complex fractures, mandibular fractures, and airway compromise. All patients were managed in accordance with Advanced Trauma Life Support (ATLS) principles. Surgical interventions included layered wound closure, open reduction and internal fixation, and airway management through endotracheal intubation, cricothyroidotomy, or tracheostomy. The series underscores the critical decision-making required in airway management, the surgical expertise necessary for fracture stabilization, and the importance of early reconstruction in optimizing outcomes. It further emphasizes the role of trauma surgeons in delivering comprehensive care and highlights the value of preventive strategies such as helmet use and road safety enforcement. These cases contribute to the growing evidence that timely, coordinated surgical intervention supports optimal recovery in patients with facial trauma.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"94-103"},"PeriodicalIF":0.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114922","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}