Injury-International Journal of the Care of the Injured最新文献

{"title":"Gait assessment in patients with intra-articular calcaneal fractures after treatment with the Ilizarov method","authors":"Marcin Pelc ,&nbsp;Władysław Hryniuk ,&nbsp;Andrzej Bobiński ,&nbsp;Joanna Kochańska-Bieri ,&nbsp;Łukasz Tomczyk ,&nbsp;Daniele Pili ,&nbsp;Piotr Morasiewicz","doi":"10.1016/j.injury.2024.112070","DOIUrl":"10.1016/j.injury.2024.112070","url":null,"abstract":"<div><h3>Background</h3><div>Intra-articular and comminuted fractures of the calcaneus constitute a significant orthopedic challenge. Calcaneal fracture management should primarily aim to achieve good clinical and biomechanical outcomes, pain reduction, and normal function following treatment.</div></div><div><h3>Research question</h3><div>How does Ilizarov treatment of calcaneal fractures affect gait parameters?</div></div><div><h3>Methods</h3><div>This retrospective study included 21patients (7 women, 14 men) who were treated for intra-articular calcaneal fractures with the Ilizarov method in the period 2021–2022. Nineteen healthy volunteers constituted the control group. Gait assessments were conducted with a BTS G-SENSOR device (BTS Bioengineering Corp., Quincy, MA, USA). The gait assessment evaluated the following parameters: assessment duration expressed in seconds (s), cadence expressed as the number of steps per minute (steps/min), gait velocity (m/s), stride length (m), stance phase (%), swing phase (%), double support phase (%), and single support phase (%).The study assessed pain intensity in the VAS scale, <em>Böhler</em>'s angle and <em>Gissane's</em> angle.</div></div><div><h3>Results and Significance</h3><div>We observed no significant differences between the experimental group and the healthy control group in terms of cadence, gait velocity, or stride length. Patients in experimental group showed significantly shortened stance and single support phases in the treated limb in comparison with those in the intact limb; the remaining gait parameters were similar in the treated and intact limb. We observed no significant differences between the treated limbs in the patient group and the nondominant limbs in the control group in terms of any gait parameters. In the follow-up, the average pain value on the VAS scale was 2.3. The median Böhler angle changed from 5.5° preoperatively to 28.5° postoperatively, <em>p</em> &lt; 0.001. The median Gissane's angle was 119° before surgery and 143° after surgery, <em>p</em> &lt; 0.001.The use of the Ilizarov method in the treatment of calcaneal fractures helps achieve sufficient normalization of most gait parameters, with their values similar to those observed in healthy volunteers. After treatment of calcaneal fractures using the Ilizarov method, radiological parameters improved. The biomechanical outcomes of calcaneal fracture treatment with the Ilizarov method are good.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 2","pages":"Article 112070"},"PeriodicalIF":2.2,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated posterior stabilization of the pelvic ring in type III/IV fragility fractures of the pelvis are beneficial compared to 360° antero-posterior surgical approaches. A dual-center cohort analysis","authors":"Christopher Lampert ,&nbsp;Florian Pachmann ,&nbsp;Johannes Rieger ,&nbsp;Yunjie Zhang ,&nbsp;Johannes Gleich ,&nbsp;Markus Stumpf ,&nbsp;Johannes Beckmann ,&nbsp;Wolfgang Böcker ,&nbsp;Carl Neuerburg ,&nbsp;Christoph Linhart","doi":"10.1016/j.injury.2024.112043","DOIUrl":"10.1016/j.injury.2024.112043","url":null,"abstract":"<div><h3>Background</h3><div>Fragility fractures of the pelvis (FFP) in elderly patients are an increasing concern due to their association with osteoporosis and the aging population. These fractures significantly affect patients’ mobility and quality of life. This study evaluates different surgical techniques in patients suffering from FFP to provide standardized recommendations for treatment strategies. In addition, we compared therapeutic concepts and their outcome between two major trauma centers in Germany.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 882 patients aged over 65 years who suffered from FFP between 2003 and 2020 at a level I and level III trauma center in a german metropolis. Fractures were classified according to Rommens and Hofmann. Data collection included patient demographics, fracture type, treatment strategy, and length of hospital stay.</div></div><div><h3>Results</h3><div>FFP I fractures were predominantly treated conservatively at both centers. Significant variability was noted in the treatment of type II and III fractures, with level III trauma center having a higher surgical intervention rate for FFP II in 27.6 % compared to the level I trauma center in 9.9 % of the cases. The most common procedure at both hospitals was the stabilization of the posterior pelvic ring. Patients who underwent less invasive posterior-only stabilization had shorter length of hospital stay than those who received combined anterior and posterior stabilization.</div></div><div><h3>Conclusions</h3><div>The study reveals substantial differences in the treatment approaches for FFP between two major trauma centers. Less invasive surgical methods, particularly posterior-only stabilization, are associated with shorter hospital stays and potentially better outcomes for elderly patients with unstable FFP.</div></div><div><h3>Clinical Relevance</h3><div>This study underscores the importance of minimally invasive surgical techniques in managing FFP in elderly patients, highlighting their potential to reduce the length of hospital stay and improve recovery.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 2","pages":"Article 112043"},"PeriodicalIF":2.2,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An endpoint adjudication committee for the assessment of computed tomography scans in fracture healing","authors":"Chloe Elliott ,&nbsp;Ethan D. Patterson ,&nbsp;Adina Tarcea ,&nbsp;Brenna Mattiello ,&nbsp;Bevan Frizzell ,&nbsp;Richard E.A. Walker ,&nbsp;Kevin A. Hildebrand ,&nbsp;Neil J. White","doi":"10.1016/j.injury.2024.112067","DOIUrl":"10.1016/j.injury.2024.112067","url":null,"abstract":"<div><h3>Introduction</h3><div>Endpoint Adjudication Committees (EACs) benefit the quality of randomized control trials (RCTs) where outcomes depend on subjective interpretations. However, assembling a committee to adjudicate large datasets is cumbersome. In a recent RCT, the primary outcome was time to union following operative fixation of scaphoid non-union, with real or placebo adjunctive ultrasound treatment. Union status was determined with computed tomography (CT) scans interpreted by treating surgeons and radiologists. An EAC was established to deliberate discrepancies between radiologists’ and surgeons’ interpretations of union status.</div></div><div><h3>Methods</h3><div>Three hundred sixty-four CT scans from 142 participants were collected in the RCT. The treating surgeon and an MSK radiologist categorized images by percent-union (0 %, 1–24 %, 25–49 %, 50–74 %, 75–99 %, 100 %). Union was defined as at least 50 % trabecular bridging. The EAC adjudicated those images that were deemed major discrepancies. The committee was composed of three members assembled by the committee chair, an MSK radiologist. A charter was established to guide the adjudication process. Ten minutes were allotted to each scan, including 2–3 min of an independent adjudicator's review, followed by 5–7 min of committee discussion to reach a diagnosis.</div></div><div><h3>Results</h3><div>Adjudicators spent an average of seven minutes on each scan. The EAC assessed 101 CT scans from 69 patients collected across five study sites: four scans from the agreed upon group as practice interpretations, 75 major discrepancies, and 22 missing interpretations from either the initial MSK radiologist, the treating orthopaedic surgeon, or both. These were adjudicated for final union status. Twenty-eight of the images with major discrepancies were adjudicated to union, and 47 to non-union. Adjudication changed the primary outcome of time to union in 40/142 (28 %) of study participants.</div></div><div><h3>Conclusion</h3><div>This adjudication process provides a valuable research tool for reference by other clinical investigators whose RCTs’ outcomes are dependent on interpretation of radiographic images.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 2","pages":"Article 112067"},"PeriodicalIF":2.2,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal injuries from gender-based violence at a tertiary hospital orthopaedic centre, central South Africa","authors":"Kenneth T. Leslie ,&nbsp;Steven T. Matshidza ,&nbsp;Omololu Aluko","doi":"10.1016/j.injury.2024.112061","DOIUrl":"10.1016/j.injury.2024.112061","url":null,"abstract":"<div><h3>Introduction</h3><div>Limited research describing the pattern of orthopaedic musculoskeletal injuries among gender-based violence (GBV) victims has been conducted in South Africa. With the high prevalence of GBV in our locality, there is a need for healthcare workers to identify this vulnerable population for early management, intervention, and prevention of subsequent assaults. This study aimed to describe the pattern of musculoskeletal injuries resulting from physical assaults due to GBV.</div></div><div><h3>Methods</h3><div>This retrospective analysis was conducted in the orthopaedic department of a tertiary hospital in South Africa. Medical records of GBV victims between 01 January 2021 and 31 December 2021, including adult males and females with acute musculoskeletal injuries, were analysed.</div></div><div><h3>Results</h3><div>Of the 138 GBV victims, 92.7 % were female, with a median age of 32 (range 19–80). Most (66.7 %) were unemployed, while 63.8 % of cases occurred within intimate partner relationships. The predominant mechanism of injury was blunt force trauma (35.5 %), stab injuries (22.4 %), and fall from standing height (19.5 %). Men predominantly sustained soft tissue injuries (60.0 %), while women sustained upper limb fractures (53.9 %). Soft tissue injuries were noted in 34.1 % of victims, of which 23.3 % were lacerations. Just over half (51.5 %) of victims had upper limb fractures, and 19.6 % had lower limb fractures. A significant difference was found between gender and upper limb fractures (<em>p</em> = 0.0328). Isolated ulnar fracture was the predominant upper limb fracture (18.8 %). Males (70.0 %) and females (60.9 %) were predominantly injured between 16:00 and 00:00; 50.7 % of assaults occurred over weekends. Overall, 47.1 % reported alcohol use, which was strongly associated with female gender as 48.4 % of females reported its use either by themselves or their assailant, compared to 30.0 % of male victims (<em>p</em> = 0.026).</div></div><div><h3>Conclusion</h3><div>The pattern of musculoskeletal injuries in our study may be due to defensive manoeuvres from assaults, especially among female victims. This is worsened by the association between alcohol use and GBV and, therefore, underlines the importance of interventions to identify and protect this vulnerable population.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 2","pages":"Article 112061"},"PeriodicalIF":2.2,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of head & facial skin wound healing complications with GLUBRAN® Tiss 2 skin adhesive Vs Non-absorbable nylon suture","authors":"Pouneh Hamian Roumiani,&nbsp;Samad Shams Vahdati,&nbsp;Alireza Ala","doi":"10.1016/j.injury.2024.112042","DOIUrl":"10.1016/j.injury.2024.112042","url":null,"abstract":"<div><h3>Background</h3><div>Wound healing is an essential process for the body to repair damaged tissue and restore normal function. Over the years, there have been advancements in wound closure techniques, with skin adhesive and sutures being two common methods. In this article, we will evaluate the healing complications associated with GLUBRAN® Tiss 2 (2-cyanoacrylate<strong>)</strong> skin adhesive in comparison to traditional sutures.</div></div><div><h3>Method</h3><div>The study was a randomized control trial. In the control group, sutures were used with six zero nylon threads. In the intervention group, GLUBRAN® Tiss 2 skin adhesive was applied using a special applicator. Both groups underwent the same wound preparation and cleansing procedure. Patient data including demographics, wound location, and size were recorded. After closing the wound, patients were followed up after 1 month.</div></div><div><h3>Results</h3><div>Overall, the study found that while there was no significant difference between the two groups in terms of age, gender distribution, laceration location, or length,(p-value= 0.946, 0.812, 0.721 and 0.539 respectively) there were significant differences in terms of complications, scarring, and pain scores (p-value= 0.072, &lt;0.001 and &lt;0.001 respectively).</div></div><div><h3>Conclusion</h3><div>The use of GLUBRAN® Tiss 2 skin adhesive in patients with head or face lacerations may provide a less painful and complication-free alternative to traditional wound healing with sutures.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 2","pages":"Article 112042"},"PeriodicalIF":2.2,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does injury type influence patient preference, response rates, and data completeness for online or telephone follow-up following injury?","authors":"Lincoln M. Tracy ,&nbsp;Heather J. Cleland ,&nbsp;Richard N. de Steiger ,&nbsp;Warwick J. Teague ,&nbsp;Peter A. Cameron ,&nbsp;Belinda J. Gabbe","doi":"10.1016/j.injury.2024.112060","DOIUrl":"10.1016/j.injury.2024.112060","url":null,"abstract":"<div><h3>Introduction</h3><div>Collecting patient-reported outcomes in a systematic fashion is important to understand recovery trajectories and compare performance between different services and fields of care. These outcomes can be collected through a variety of means, but studies comparing different follow-up methods in patients with a variety of injury types are scarce. This study aimed to compare follow-up data from three injury registries to quantify patient preference for telephone versus online follow-up, determine factors associated with choosing online follow-up, and compare response rates based on the patient's preferred follow-up method.</div></div><div><h3>Methods</h3><div>A registry-based cohort study of adult (≥16 years) patients registered one of three registries from January 2021 to December 2021 was undertaken. Patients who survived to discharge were contacted by telephone and offered the option of telephone or online self-completion at six- and 12-months post-injury using the EQ-5D-5L. The three injury cohorts and telephone/online groups were compared for differences in characteristics, follow-up rates, and data completeness. Multivariable logistic regression models were used to identify predictors of choosing online completion in the three cohorts.</div></div><div><h3>Results</h3><div>Data were retrieved for 8,049 patients. A greater proportion of orthopaedic trauma patients initially opted for online follow-up (41.0 %) compared to major trauma (31.0 %) and burns (24.1 %) patients. Orthopaedic and major trauma patients had increased odds of choosing online follow-up compared to burns patients (adjusted odds ratio [95 % confidence interval] 2.9 [2.2–3.7] and 2.1 [1.6–2.7], respectively). A greater proportion of major trauma patients (69.3 %) and burns patients (64.3 %) completed both follow-ups compared to orthopaedic trauma patients (52.4 %). The overall completion rates for the EQ-5D-5L were high.</div></div><div><h3>Conclusions</h3><div>While follow-up preference and completion were higher for telephone-based follow-ups, the findings suggest a patient's preference for completing post-injury follow-ups differs according to the type of injury they sustained, and that allowing patients a choice of their preferred follow-up method is important. The variety of follow-up methods offered should therefore reflect the needs of different patient groups, which may allow for the development of algorithms or workflow processes. Directing certain patients towards a particular follow-up method could deliver higher and more efficient follow-up rates.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 2","pages":"Article 112060"},"PeriodicalIF":2.2,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology, classification, and treatment of 2084 Lisfranc injuries: An observational study from the Swedish fracture register","authors":"Hans Juto ,&nbsp;Sebastian Mukka ,&nbsp;Olof Wolf ,&nbsp;Michael Möller","doi":"10.1016/j.injury.2024.112036","DOIUrl":"10.1016/j.injury.2024.112036","url":null,"abstract":"<div><h3>Background</h3><div>Lisfranc injuries are potentially severe but relatively uncommon. Limited epidemiological data regarding Lisfranc injuries of the midfoot are available. This study aimed to describe the injury's epidemiology, injury mechanism, and primary treatment.</div></div><div><h3>Methods</h3><div>An observational register study examined all Lisfranc injuries registered in the Swedish Fracture Register from 2013 to 2022. Data on sex, age, date of injury, injury type, injury mechanism, and primary treatment were analysed.</div></div><div><h3>Results</h3><div>Some 2084 Lisfranc injuries in 2079 patients (54 % men) were included in the study. The mean age at injury was 43 (18–92, SD 17.3) years for men and 49 (18–96, SD 17.4) for women. One of five cases were caused by high-energy trauma, and the most common injury mechanism was a simple fall - tripping (31 %). Approximately 39 % of patients underwent operative treatment, with fixation using plates (51 %) being the prevailing choice of treatment. Primary arthrodesis was performed in 11 % of the operatively treated cases.</div></div><div><h3>Conclusions</h3><div>Lisfranc injuries are the consequence of a broad spectrum of injury mechanisms, are primarily induced by low-energy trauma and found in all age groups in adults. The majority of Lisfranc injuries are treated non-operatively. This comprehension can aid in accurate diagnosis and management in everyday clinical practice.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 2","pages":"Article 112036"},"PeriodicalIF":2.2,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can trauma scores predict the length of hospital stay of patients with fractures after earthquake-related blunt injury?","authors":"Akif Mirioğlu ,&nbsp;Veli Can Kıran ,&nbsp;Kaan Ali Dalkir ,&nbsp;Melih Bağır ,&nbsp;Buğra Kundakçı ,&nbsp;Ömer Sunkar Biçer ,&nbsp;Mustafa Tekin ,&nbsp;Cenk Özkan","doi":"10.1016/j.injury.2024.112041","DOIUrl":"10.1016/j.injury.2024.112041","url":null,"abstract":"<div><h3>Objective</h3><div>The number of patients during disastrous conditions was high, and triage is essential. In chaotic circumstances, orthopedic surgeons can also struggle with patient selection, not only for surgical selection but also for the necessity of hospitalization. So, the performance of the Injury Severity Score, New Injury Severity Score, and Trauma and Injury Severity Score was compared in victims who were struck under the wreckage and had fractures due to the Kahramanmaras Earthquake.</div></div><div><h3>Material and Methods</h3><div>The study included 147 patients. Patients younger than 18, lacking information that prevents calculation of trauma scores, having a history of fracture other than struck injury, and those who didn't survive the follow up were not included in the study. Fractures were classified as anatomic regions. The relationship between the trauma scores, fracture regions, entrapment durations, and length of hospital stay was evaluated. Other risk factors related to length of stay were also determined.</div></div><div><h3>Results</h3><div>The age and gender of the patients did not affect the length of hospital stay. There was no relationship between the fracture region and length of stay. Even the proximal fractures of the upper extremities had significantly shorter hospitalization duration. Entrapment duration was correlated considerably with length of stay (<em>p</em> &lt; 0.001). NISS, ISS, and NISS were correlated with length of stay (<em>p</em> &lt; 0.001, <em>p</em> &lt; 0.001, <em>p</em> = 0.033), and the AUC values of the trauma scores were 0.70, 0.66, and 0.59, respectively. Multiple regression analysis showed that only NISS and entrapment duration was related to length of stay, while ISS and TRISS were not.</div></div><div><h3>Conclusion</h3><div>All the trauma scores can assess expected length of hospital stay for patients with fractures; however, NISS shows better predicting performance. Additionally, the fracture location is not associated with the length of stay.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 2","pages":"Article 112041"},"PeriodicalIF":2.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-operative periprosthetic femoral fractures in England: patient profiles and short-term outcomes","authors":"Mohammad Aryaie ,&nbsp;Jonathan Thomas Evans ,&nbsp;Mike Reed ,&nbsp;Cliff L Shelton ,&nbsp;Antony Johansen ,&nbsp;Toby O Smith ,&nbsp;Jonathan Benn ,&nbsp;Mark Baxter ,&nbsp;Paul Aylin ,&nbsp;Michael R Whitehouse ,&nbsp;Alex Bottle ,&nbsp;PROFOUND study team","doi":"10.1016/j.injury.2024.112026","DOIUrl":"10.1016/j.injury.2024.112026","url":null,"abstract":"<div><h3>Background and objective</h3><div>Post-operative periprosthetic femoral fractures (POPFF) present a growing challenge for healthcare services, but there are limited national data on patient profiles, short-term outcomes, and post-discharge follow-up. We aimed to fill these gaps.</div></div><div><h3>Methods</h3><div>Using Hospital Episode Statistics (HES), we identified POPFF discharges from hospitals in England for patients aged 18 and above between April 2016 and December 2022. We flagged prior admissions for hip fracture and elective hip or knee replacement surgery (primary, revision or re-revision) between April 2000 and the day of the POPFF admission date. We extracted information on patient factors, treatment modes for POPFF (nonoperative, fixation, revision), and outcomes (in-hospital mortality, length of stay, unplanned readmission). We used outpatient data to summarise post-hospitalisation follow-up.</div></div><div><h3>Results</h3><div>Of 39,035 cases, 65.9% were female; the median age was 82 years. HES data identified that 34.0% had previously undergone elective hip replacement, 26.2% elective knee replacement, and 22.8% surgery for hip fracture. Those with a prior hip fracture were more likely to have delirium during the index POPFF admission, and, compared with those with a prior elective hip or knee replacement, they faced higher in-hospital mortality (5.1% vs 3.2% and 3.6%, respectively), rates of readmission (15.4% vs 13.1% and 12.8%, respectively), and hip re-fracture after POPFF (2.9% vs 1.2% and 1.6%, respectively). Their median length of stay was longer (16 vs 14 days, p&lt;0.001). The most common reason for hospital readmission following POPFF was another fracture (11.3% of all readmissions). Overall, 74% of patients were discharged from outpatient follow-up within 12 months.</div></div><div><h3>Conclusion</h3><div>This is the first national description of the burden of adverse outcomes for people with POPFF in England, of whom a large proportion require ongoing specialist support. Fewer POPFF cases follow prior hip fracture surgery than elective joint replacement, but these patients face higher risks of worse outcomes. With an expected increasing incidence of POPFF, this may have considerable health service implications.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 2","pages":"Article 112026"},"PeriodicalIF":2.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreaticoduodenectomy in high-grade pancreatic and duodenal trauma","authors":"Jake E Krige ,&nbsp;Eduard G Jonas ,&nbsp;Andrew J Nicol ,&nbsp;Pradeep H Navsaria","doi":"10.1016/j.injury.2024.112048","DOIUrl":"10.1016/j.injury.2024.112048","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 2","pages":"Article 112048"},"PeriodicalIF":2.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}