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

{"title":"Psychosocial concerns in burn survivors and their families: A narrative review","authors":"Beylin Dmitry ,&nbsp;Rachel Kornhaber ,&nbsp;Michelle Cleary","doi":"10.1016/j.injury.2025.112626","DOIUrl":"10.1016/j.injury.2025.112626","url":null,"abstract":"<div><div>Burn injuries result in profound and enduring consequences that extend well beyond the initial physical trauma. Although survival rates have significantly improved in recent decades, particularly in high-income countries, many survivors continue to experience complex psychological and social challenges that persist long after discharge from hospital care. This review outlines the current understanding of the psychological and social impacts of burn injuries and highlights key strategies to support survivors and their families through each stage of recovery. Common psychological concerns include post-traumatic stress, anxiety, depression, and disruptions to self-perception. These issues frequently emerge early in the recovery process and may endure for several years, influencing daily functioning, interpersonal relationships, and the ability to return to work. Caregivers are also affected, often experiencing emotional fatigue and psychological strain, particularly when access to support services is limited. Reintegration into everyday life is frequently marked by social stigma and exclusion, with children and adolescents being especially vulnerable due to ongoing identity development. Holistic recovery requires more than physical rehabilitation; it requires a coordinated, multidisciplinary approach that incorporates psychological support, social reintegration, and long-term follow-up. Interventions such as cognitive-behavioural therapy, peer and family support programs, and digital health platforms have shown promise in addressing these needs. While some individuals report personal growth following burn trauma, outcomes are influenced by various factors, including mental health history, community context and available support. Psychosocial care must be responsive to cultural and developmental differences and accessible across diverse settings. Innovations such as virtual reality and telehealth are increasingly valuable in bridging service gaps, particularly for individuals in rural or underserved areas.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112626"},"PeriodicalIF":2.0,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757777","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":"Amputation trends in military personnel during the israel-hamas war in 2023-24","authors":"Yigal Chechik ,&nbsp;Ofer Almog ,&nbsp;Yoav Jordan Gutterman ,&nbsp;Shlomi Abuhasira","doi":"10.1016/j.injury.2025.112611","DOIUrl":"10.1016/j.injury.2025.112611","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the mechanisms, distribution, and outcomes of traumatic limb amputations among military casualties during the Israel-Hamas War, and to evaluate the association between life-saving interventions and survival.</div></div><div><h3>Design, Setting, and Participants</h3><div>This retrospective observational study analyzed data from the Israel Defense Forces Trauma Registry. The cohort included 3253 urgent battlefield casualties who sustained limb injuries and were treated by IDF medical forces between October 27th, 2023 and October 31st, 2024.</div></div><div><h3>Main Outcomes and Measures</h3><div>The primary outcomes were anatomical distribution of amputations, mechanism of injury, application of life-saving interventions (tourniquet, whole blood, freeze-dried plasma), and survival on the way to hospital admission and during hospitalization.</div></div><div><h3>Results</h3><div>Of 3253 casualties, 135 (4.2 %) were initially recorded as having amputations. After review, 112 cases were confirmed to involve at least one amputated limb. Explosive devices were the leading cause of injury among amputees (88.9 %). Among the 112 confirmed cases, 50 (44.6 %) survived until hospital admission, and 62 (55.4 %) were pronounced dead prior to hospital arrival; 4 of the survivors died during hospitalization. Tourniquets were applied in 90 % of survivors compared to 24.2 % of deceased (<em>p</em> &lt; 0.001). Whole blood and FDP were administered more frequently in survivors (60 % and 40 %, respectively) than in deceased casualties (9.7 % and 4.8 %, respectively; <em>p</em> &lt; 0.001 for both). Above-knee amputations were the most common anatomical level in both groups.</div></div><div><h3>Conclusion and Relevance</h3><div>Combat-related limb amputations during the Israel-Hamas War were primarily caused by explosions and were associated with high mortality. Prompt application of life-saving interventions, particularly tourniquets and early blood resuscitation, was strongly associated with survival. These findings emphasize the critical need for rapid hemorrhage control and trauma care readiness in modern military conflict settings.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112611"},"PeriodicalIF":2.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722921","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":"Comparative study on the efficacy of femoral neck system, FNS with anti-rotation screws, and multiple cancellous screws in treating femoral neck fractures in young and middle-aged patients","authors":"Yixin Huang ,&nbsp;Dongze Lin ,&nbsp;Jiaqi Lan ,&nbsp;Rongxin Zeng ,&nbsp;Fengfei Lin","doi":"10.1016/j.injury.2025.112621","DOIUrl":"10.1016/j.injury.2025.112621","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate and compare the medium- to long-term outcomes of the Femoral Neck System (FNS), FNS combined with the Anti-Rotation Screw (ARS), and Multiple Cancellous Screws (MCS) in the treatment of femoral neck fractures in young and middle-aged patients.</div></div><div><h3>Methods</h3><div>A retrospective, multi-group comparative cohort study was conducted on 731 young and middle-aged patients with femoral neck fractures treated at Level I Trauma Center between September 2019 and January 2024. Patients were divided into three groups based on the surgical method: FNS group (327 cases), FNS+ARS group (120 cases), and MCS group (284 cases). Postoperative follow-up assessments included fracture healing time, functional scores (Harris Hip Score [HHS], Oxford Hip Score [OHS], Hip Outcome Score [HOS]), and complication rates (femoral neck shortening, femoral head necrosis, nonunion, and implant-related complications).</div></div><div><h3>Results</h3><div>Key findings demonstrated the FNS+ARS group achieved significantly faster fracture healing (10.21 ± 1.33 weeks) versus FNS (12.52 ± 1.91) and MCS (13.57 ± 2.13 weeks; <em>P</em> = 0.036). Functional outcomes consistently favored FNS+ARS across all timepoints:3 months: HHS (61.54 ± 2.98 vs 58.15 ± 2.34 vs 54.43 ± 2.79, <em>P</em> &lt; 0.001), OHS (37.19 ± 2.35 vs 43.20 ± 2.91 vs 42.89 ± 3.00, <em>P</em> &lt; 0.001), HOS (33.59 ± 2.39 vs 32.21 ± 2.32 vs 30.39 ± 2.72, <em>P</em> &lt; 0.001);6 months: HHS (87.35 ± 5.58 vs 81.95 ± 5.99 vs 76.54 ± 5.45, <em>P</em> &lt; 0.001), OHS (22.66 ± 2.78 vs 25.96 ± 3.64 vs 27.66 ± 4.81, <em>P</em> &lt; 0.001), HOS (76.02 ± 5.47 vs 75.42 ± 7.63 vs 73.38 ± 6.75, <em>P</em> &lt; 0.001);Final follow-up: HHS (91.95 ± 9.06 vs 90.38 ± 11.21 vs 87.67 ± 11.71, <em>P</em> &lt; 0.001), OHS (21.04 ± 8.71 vs 20.41 ± 7.88 vs 23.40 ± 10.18, <em>P</em> &lt; 0.001), HOS (87.51 ± 12.93 vs 85.84 ± 16.22 vs 85.98 ± 15.00, <em>P</em> &lt; 0.001);Complication rates were significantly lower with FNS+ARS, particularly for femoral neck shortening (2.50 % vs 8.87 % vs 5.28 %; <em>P</em> = 0.031) and avascular necrosis (6.67 % vs 10.92 %; <em>P</em> = 0.040).</div></div><div><h3>Conclusion</h3><div>FNS combined with ARS outperformed FNS and MCS in promoting fracture healing, reducing postoperative complication rates, and accelerating functional recovery.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112621"},"PeriodicalIF":2.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750583","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":"A retrospective case control study of the impact of a dedicated service to increase retrieval rates of IVC filters in a Level 1 Trauma centre","authors":"Abhishekh Srinivas ,&nbsp;Nico Ng ,&nbsp;Warren Clements ,&nbsp;Gerard Goh ,&nbsp;Chris Groombridge ,&nbsp;Mark Fitzgerald ,&nbsp;Joseph Mathew","doi":"10.1016/j.injury.2025.112623","DOIUrl":"10.1016/j.injury.2025.112623","url":null,"abstract":"<div><h3>Purpose</h3><div>Inferior vena cava (IVC) filters are considered for preventing fatal pulmonary embolism (PE) in patients unable to undergo anticoagulant therapy. Trauma patients face a heightened risk of PE due to immobility and hypercoagulability. Although effective, IVC filters have long-term risks and should be removed when no longer indicated. A dedicated follow-up clinic can improve IVC filter retrieval rates and minimize complications. This study evaluates the impact of a dedicated clinic on retrieval rates, complications, and follow-up.</div></div><div><h3>Methods and Materials</h3><div>A retrospective analysis was conducted on trauma patients with IVC filters inserted between October 2011 and October 2021. A dedicated trauma clinic, established in January 2018, followed discharged patients with inserted IVC filters. Inclusion criteria included prophylactic and therapeutic indications and emergent presentations. Patients who died during hospitalization or had filters retrieved at other hospitals were excluded.</div></div><div><h3>Results</h3><div>During the pre-clinic period, 639 IVC filters were inserted, and 380 (59.5 %) were retrieved, with an average dwell time of 200 days. In the post-clinic period, 332 filters were inserted, and 278 (83.8 %) were retrieved, with a reduced average dwell time of 150 days. Complications decreased from 37 cases (average dwell time: 303 days) pre-clinic to 10 cases (average dwell time: 187 days) post-clinic.</div></div><div><h3>Conclusion</h3><div>The establishment of a dedicated follow-up clinic significantly improved IVC filter retrieval rates and reduced dwell times at this trauma center. This study highlights the value of follow-up clinics in ensuring timely IVC filter retrieval and minimizing complications when filters are no longer clinically required.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 9","pages":"Article 112623"},"PeriodicalIF":2.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755503","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":"Mortality following fragility fractures of the pelvis: Systematic review and meta-analysis","authors":"Norio Yamamoto ,&nbsp;Hidehiro Someko ,&nbsp;Yuki Nakashima ,&nbsp;Shuri Nakao ,&nbsp;Takao Kaneko ,&nbsp;Takahiro Tsuge","doi":"10.1016/j.injury.2025.112618","DOIUrl":"10.1016/j.injury.2025.112618","url":null,"abstract":"<div><h3>Background</h3><div>Fragility fractures of the pelvis (FFPs) in older adults are increasingly recognized as serious injuries with substantial morbidity. However, mortality after FFP has not been comprehensively quantified across timepoints or patient subgroups, limiting the ability to inform prognosis and guide clinical strategies. This systematic review and meta-analysis aimed to assess the 1-year mortality following FFP in patients aged ≥60 years. We also assessed the mortality at 30 days, 3 months, 6 months, 2 years, and 5 years after FFP, and the differences in mortality by geographic region, sex, fracture classification, or treatment modality.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of studies published from inception to May 2024 in MEDLINE, Embase, and CENTRAL databases. Eligible studies reported mortality outcomes in patients aged ≥60 years with FFP. A random-effects model was used to estimate pooled mortality at prespecified time points. We assessed the risk of bias using the Joanna Briggs Institute (JBI) Prevalence Critical Appraisal Tool. Subgroup analyses were conducted to assess differences by region, sex, fracture classification, and treatment modality. We conducted a sensitivity analysis including only the high-quality studies according to the JBI assessment. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach.</div></div><div><h3>Results</h3><div>The pooled 1-year mortality was 17 % (95 % confidence interval, 14 %–19 %). The certainty of this evidence was rated as low because of publication bias and heterogeneity. The mortality at 30 days, 3 months, 6 months, 2 years, and 5 years were 5 %, 10 %, 14 %, 26 %, and 46 %, respectively. Mortality was lower in studies from Asia than in those from Europe or North America. Male sex, lower-grade FFPs, and nonoperative management showed numerically higher mortality, though not statistically significant.</div></div><div><h3>Conclusion</h3><div>FFPs are associated with substantial short- and long-term mortality, warranting their recognition as high-risk injuries in older adults. Regional and treatment-related variation highlights the need for individualized management. Future research should clarify causal mechanisms and assess targeted interventions to reduce mortality risk.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112618"},"PeriodicalIF":2.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704029","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":"Hemiarthroplasty versus nonoperative treatment of comminuted proximal humeral fractures: results of the ProCon multicenter randomized clinical trial","authors":"Dennis Den Hartog ,&nbsp;Leendert HT Nugteren ,&nbsp;Kiran C Mahabier ,&nbsp;Aron JM De Zwart ,&nbsp;Stella CM Heemskerk ,&nbsp;Stefaan Nijs ,&nbsp;Michael HJ Verhofstad ,&nbsp;Niels WL Schep ,&nbsp;Esther MM Van Lieshout ,&nbsp;ProCon trial investigators","doi":"10.1016/j.injury.2025.112620","DOIUrl":"10.1016/j.injury.2025.112620","url":null,"abstract":"<div><h3>Background/aim</h3><div>The best treatment of comminuted, proximal humeral fractures in the elderly population is an unresolved clinical problem. This study aimed to compare the outcome of hemiarthroplasty (HA) and nonoperative treatment in the elderly population patients with a comminuted proximal humeral fracture.</div></div><div><h3>Method</h3><div>From October 6, 2009 to April 26, 2017, 57 elderly patients with a comminuted proximal humeral fracture were enrolled in the multicenter randomized controlled trial (RCT). Patients were randomized to HA or nonoperative treatment. Outcome measures were the Constant-Murley score (primary outcome), Disabilities of the Arm, Shoulder, and Hand, pain (Visual Analog Score), quality of life (Short Form-36 and EuroQoL-5D-3 L), complications, revision operation, health care consumption, and costs. Patients were followed for two years.</div></div><div><h3>Result</h3><div>Of the 57 patients included, 30 underwent treatment with HA and 27 were treated nonoperatively. Patients had a median age of 77 years, and 89 % was female. According to the Hertel classification, most fractures were type 7 (47 %) or type 12 (42 %). The median Constant-Murley score increased from 23 (95 % CI 17–29) at six weeks to 48 (95 % CI 41–53) at 24 months in the HA group, and from 24 (95 % CI 17–31) to 59 (95 % CI 52–65) in the nonoperative group. Throughout follow-up, scores were similar in both groups. The DASH score consistently decreased over time in both groups. At 24 months, median DASH scores were 24.0 (95 % CI 17.4–30.8) and 23.4 (95 % CI 16.5–30.4) in the HA and nonoperative group, respectively. Pain levels, SF-36, and EQ-5D were similar in both groups throughout follow-up. Eleven patients, of which seven in the HA group, developed one or more complications, of which six patients required surgical interventions. Total costs were higher for HA, although not statistically significant.</div></div><div><h3>Conclusion</h3><div>Based on results of this RCT, primary hemiarthroplasty cannot be considered superior to nonoperative treatment for comminuted proximal humeral fractures in the elderly population. A trend favoring nonoperative treatment is observed in outcomes and in costs.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112620"},"PeriodicalIF":2.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852792","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":"Perspectives of a newly developed UK major trauma and plastics psychology service: A qualitative service evaluation","authors":"Alice Balfe ,&nbsp;Megan Powell ,&nbsp;Dr. Mattia Monastra ,&nbsp;Dr. Joanna Latham","doi":"10.1016/j.injury.2025.112619","DOIUrl":"10.1016/j.injury.2025.112619","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite evidence of frequent adverse psychological reactions including PTSD in major trauma survivors, psychological support represents a frequent gap in UK major trauma care pathways. North Bristol Trust Major Trauma and Plastics Psychology Service has been newly developed in response at an NHS Major Trauma Centre (MTC). The service aims to address patients’ psychological needs early on and throughout recovery from major trauma, alongside physical and functional recovery. Thus, a qualitative service evaluation was conducted. It aimed to explore major trauma clinicians’ perspectives and experiences of the psychology service and to identify areas of strength and opportunity for development.</div></div><div><h3>Method</h3><div>Semi-structured interviews were conducted with a purposive sample of seven major trauma clinicians working at the MTC who make referrals to, and interact with, the psychology service. Data were thematically analysed using a codebook approach.</div></div><div><h3>Results</h3><div>Thematic analysis of qualitative data revealed five themes: (1) Necessity of specialist psychology for major trauma patients; (2) Psychological involvement facilitates patients’ recovery; (3) Psychologists have an important role in supporting clinicians; (4) Requirement for service expansion; (5) Importance of psychologists’ integration within a multidisciplinary team. Overall, the importance of the psychology service in facilitating patients’ holistic recovery was emphasised, as well as its role in emotionally and professionally supporting major trauma clinicians. Service expansion was suggested to better meet patients’ needs by permitting increased provision of training and formalised support sessions for clinicians, greater involvement of psychologists in rehabilitation, and psychological support for patients’ families.</div></div><div><h3>Conclusions</h3><div>Findings highlighted a perceived positive impact of integrated, specialist psychological support on the recovery of major trauma patients and the psychological wellbeing of major trauma clinicians. A need for future service expansion to overcome current capacity pressures and permit suggested developments was also emphasised. Replication of the psychology service in additional NHS MTCs to reach patients in other regions offers a potential solution to current inequities in post-major trauma psychological care in the UK.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 9","pages":"Article 112619"},"PeriodicalIF":2.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719284","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":"Deriving shock index pediatric age-adjusted thresholds to predict need for emergent intervention","authors":"Zachary T. Sheff ,&nbsp;Brett W. Engbrecht","doi":"10.1016/j.injury.2025.112612","DOIUrl":"10.1016/j.injury.2025.112612","url":null,"abstract":"<div><h3>Background</h3><div>Shock index (SI) has been used to identify patients at risk for severe injury and predict those who require an emergent intervention. In adults, SI &gt; 0.9 is considered elevated. Shock index pediatric age-adjusted (SIPA) modifies this threshold based on patients’ age. This analysis leverages a large dataset to empirically identify threshold values of SI using a composite outcome capturing patients’ need for emergent intervention.</div></div><div><h3>Methods</h3><div>Pediatric patient data was abstracted from the Trauma Quality Improvement Program Participant Use Files from 2013 – 2020. 484,586 patients were included in the analysis. Area under the receiver-operator characteristic curve (AUROC) was used to empirically derive optimal cutoffs by age group. Need for emergent intervention included craniotomy, thoracotomy, laparotomy, chest tube, angioembolization, endotracheal intubation, and blood transfusion within 24 h of arrival or use of mechanical ventilation or admission to an intensive care unit.</div></div><div><h3>Results</h3><div>Empirically derived SIPA-E cutoffs (1.23, 1.05, 0.95, and 0.85 for ages 1–3, 4–6, 7–12, and 13–17 years, respectively) were similar to established SIPA-L cutoffs (1.22, 1.22, 1.00, and 0.90). Overall accuracy was consistent between the two cutoffs with nearly equal trades of sensitivity for specificity but remain low overall (empirical cutoff sensitivity = 33.8 %, specificity = 79.5 %; established cutoff sensitivity = 26.5 %, specificity = 86.8 %).</div></div><div><h3>Conclusions</h3><div>Empirically derived cutoffs agreed with established cutoffs for SIPA, but overall accuracy is low. Rather than predicting broad outcomes, SIPA seems better suited to narrow cases where it has shown greater accuracy, such as the need for urgent blood transfusion.</div></div><div><h3>Level of evidence</h3><div>Prognostic/epidemiological; Level III</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 9","pages":"Article 112612"},"PeriodicalIF":2.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719283","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":"Expeditious femoral nailing prior to vascular repair in fractures associated with vascular injury: A series of four cases","authors":"Austin M. Cronen ,&nbsp;Richard L. Auran ,&nbsp;Jeromy S. Brink ,&nbsp;Michael D. McKee","doi":"10.1016/j.injury.2025.112613","DOIUrl":"10.1016/j.injury.2025.112613","url":null,"abstract":"<div><h3>Case</h3><div>Femoral shaft fractures with concomitant vascular injury requiring limb revascularization, although rare, are a limb-threatening condition. Historically, emergent external fixation of the femur fracture followed by vascular repair has been considered the standard of care. We discuss four cases of femoral fracture with an associated vascular injury amenable to nail fixation stabilized by expeditious intramedullary nailing (IMN), followed by limb revascularization. We discuss the timeline and duration of the procedure for this technique.</div></div><div><h3>Conclusion</h3><div>Expeditious femoral IMN prior to limb revascularization has multiple clinical advantages and has become our standard protocol for these injuries.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 8","pages":"Article 112613"},"PeriodicalIF":2.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656878","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":"High-risk electrical burn injuries associated with illicit copper wire theft","authors":"Reza Vaghardoost ,&nbsp;Abolfazl Abbaszadeh ,&nbsp;Seyedalireza Seyed Siamdoust ,&nbsp;Yaser Ghavami","doi":"10.1016/j.injury.2025.112617","DOIUrl":"10.1016/j.injury.2025.112617","url":null,"abstract":"<div><h3>Objective</h3><div>Electrical burn injuries associated with copper wire theft represent a unique and dangerous subset of injuries observed in clinical practice. Economic hardship and the high value of copper wires drive some individuals to engage in the risky act of scavenging wires, often cutting them directly from live electrical poles. This study aims to investigate the prevalence and clinical outcomes of electrical burn injuries resulting from copper wire theft.</div></div><div><h3>Methods</h3><div>This retrospective analysis reviewed medical records of patients presenting with electrical burns caused by contact with live electrical wires in urban settings. Cases were included if patient histories, eyewitness accounts, or police reports confirmed illegal wire cutting as the cause of injury. Data collected included demographic information, total body surface area (TBSA) burned, associated injuries such as fractures and amputations, creatine kinase (CK) levels, and mortality outcomes.</div></div><div><h3>Results</h3><div>Thirty-six patients were included, with an average age of 27.72 (14.58) years, the majority of whom were male (97 %). The mean TBSA burned was 16.19 %. Fractures were reported in 22 patients (61 %), and 10 patients (28 %) underwent amputations of digits or limbs. Eight individuals (22 %) did not survive their injuries. Statistical analysis revealed a significant relationship between mortality and factors such as TBSA (<em>P</em> = 0.0001), amputation (<em>P</em> = 0.0001), CK levels, and ICU length of stay (<em>P</em> = 0.0001). Additionally, elevated CK levels were strongly correlated with longer ICU stays (<em>P</em> = 0.0001).</div></div><div><h3>Conclusion</h3><div>Electrical burn injuries linked to copper wire theft are severe and frequently lead to debilitating outcomes such as amputations, fractures, and high mortality rates. These injuries highlight the intersection of economic desperation and public health risk. Preventive efforts should prioritize educational campaigns, socio-economic interventions, and stringent measures to deter copper wire theft.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 9","pages":"Article 112617"},"PeriodicalIF":2.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762785","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}