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

{"title":"Efficacy of intranasal ketamine in controlling pain caused by bone fractures: A single-center double blind randomized controlled trial","authors":"Morteza Zavvar ,&nbsp;Mahboub Pouraghaei ,&nbsp;Saeid Safiri ,&nbsp;Gholamreza Faridaalaee","doi":"10.1016/j.injury.2025.112328","DOIUrl":"10.1016/j.injury.2025.112328","url":null,"abstract":"<div><h3>Introduction</h3><div>Bone fractures are recognized as the second most prevalent cause of pain for patients seeking treatment in medical facilities. This study aims to evaluate the efficacy of intranasal and intravenous ketamine in comparison to intravenous morphine in alleviating severe pain in patients presenting to emergency departments with various bone fractures.</div></div><div><h3>Method &amp; material</h3><div>The clinical trial was conducted on patients over the age of 18 who presented at the emergency department of Imam Reza Educational and Medical Center with bone fractures. These patients were divided into three groups for treatment: intranasal ketamine at a dose of 1 mg/kg body weight, intravenous ketamine at a dose of 0.5 mg/kg body weight, and intravenous morphine at a dose of 0.1 mg/kg body weight. The severity of pain experienced by patients was documented using the numerical pain rating scale at the time of admission, and then at 15 min, 30 min, and 60 min after drug administration.</div></div><div><h3>Results</h3><div>The results of the study revealed that there was no statistically significant difference in the efficacy of pain relief among the three study groups (<em>p</em>=0.77). The interaction of (time*type of drug) had no significant effect on pain intensity (<em>p</em>=0.58). There was no statistically significant difference in side effects reported by patients between the three study groups, with the intranasal ketamine group reporting only minor side effects.</div></div><div><h3>Conclusion</h3><div>The results of this study showed significant effects of intranasal ketamine and intravenous ketamine in reducing pain in patients with bone fractures. The findings further suggest that the analgesic effect of intranasal ketamine is comparable to that of intravenous ketamine and morphine, with no significant adverse effects observed.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112328"},"PeriodicalIF":2.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850473","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":"Comparing the effects of curvilinear position and micromovement on prevention of intraoperative acquired pressure injuries among patients undergoing surgery in the supine position: A randomized controlled trial","authors":"Nasim Jamshid Malekara ,&nbsp;Negin Larti ,&nbsp;Alireza Shirzadi ,&nbsp;Ramin Bozorgmehr","doi":"10.1016/j.injury.2025.112327","DOIUrl":"10.1016/j.injury.2025.112327","url":null,"abstract":"<div><h3>Background</h3><div>Patients undergoing surgery are at significant risk of developing pressure injuries due to immobility and fixed positioning on the operating table, particularly during lengthy procedures. Therefore, implementing effective prevention strategies for pressure injuries should begin as early as the surgical phase. This study aims to compare the two methods of curvilinear position and micromovement in preventing pressure injuries among patients undergoing general surgery in the supine position.</div></div><div><h3>Method</h3><div>This was a double-blind, prospective, randomized, controlled trial conducted from October 2024 to January 2025. The study included a sample size of 120 patients randomly divided into three groups: control (<em>n</em> = 40), micromovement (<em>n</em> = 40), and curvilinear (<em>n</em> = 40). Skin assessments were conducted using the National Pressure Ulcer Scale immediately after surgery and again one day later.</div></div><div><h3>Results</h3><div>A total of 114 patients were included in the analysis: 39 in the control group, 38 in the micromovement group, and 37 in the curvilinear group. A significant difference was found between the three groups regarding the incidence of pressure injuries (<em>p</em> &lt; 0.05). However, there was no considerable difference regarding the location and stage of the pressure injury between groups (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Micromovement and curvilinear supine position can significantly reduce the incidence of intraoperative acquired pressure injuries. Therefore, it is recommended that these methods be utilized as an effective intervention by the surgical team, especially for high-risk patients and those undergoing prolonged surgeries.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112327"},"PeriodicalIF":2.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785593","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":"Rib fixation in severe isolated chest trauma with pulmonary contusion","authors":"Emanuele Lagazzi ,&nbsp;Vahe S. Panossian ,&nbsp;Dias Argandykov ,&nbsp;Amory de Roulet ,&nbsp;Ikemsinachi C. Nzenwa ,&nbsp;Wardah Rafaqat ,&nbsp;Casey Luckhurst ,&nbsp;Charudutt N. Paranjape ,&nbsp;John O. Hwabejire ,&nbsp;Haytham Kaafarani ,&nbsp;George C. Velmahos ,&nbsp;Katherine H. Albutt","doi":"10.1016/j.injury.2025.112292","DOIUrl":"10.1016/j.injury.2025.112292","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary contusion (PC) is considered a relative contraindication to surgical stabilization of rib fractures (SSRF). This study compared outcomes in patients undergoing SSRF vs. non-operative management (NOM).</div></div><div><h3>Methods</h3><div>ACS-TQIP 2017–2020 was queried to identify patients with PC and severe chest wall injuries admitted to the intensive care unit (ICU). Outcomes included mortality, length of stay (LOS), and in-hospital complications. Subgroup analyses stratifying patients according to PC severity and institutional SSRF volume were performed. Multivariable logistic regression was used to adjust for confounders.</div></div><div><h3>Results</h3><div>A total of 17,344 were included; 1789 (10.3 %) underwent SSRF, and 15,555 (89.7 %) did not. SSRF was associated with lower mortality (OR: 0.47, 95 % CI: 0.33–0.68, <em>p</em> &lt; 0.001) but increased ventilator-associated pneumonia, tracheostomy, unplanned ICU admissions, and intubations. It was also associated with increased hospital LOS by 3.46 days (95 % CI: 2.94–3.98) and ICU LOS by 2.33 days (95 % CI: 1.99–2.68). Institutional volume above the median level of 7 SSRF cases was associated with reduced ventilator days by 1.3 days (95 % CI:2.54 to -0.05), hospital LOS by 1.7 days (95 % CI:2.58 to -0.82), and ICU LOS by 1.4 days (95 % CI:2.11 to -0.64), with no significant effects on other outcomes.</div></div><div><h3>Conclusions</h3><div>In patients with severe chest wall injury and PC, SSRF is associated with lower mortality at the expense of longer LOS.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112292"},"PeriodicalIF":2.2,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784064","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 motion at 8 weeks predict nonunion in nonoperatively managed humeral shaft fractures: A prospective multicenter evaluation","authors":"Francesca Simeone ,&nbsp;Robert A. Hymes ,&nbsp;Dirk William Kiner ,&nbsp;Andrew J. Marcantonio ,&nbsp;Brian H. Mullis ,&nbsp;Lauren Nelson ,&nbsp;David C. Teague ,&nbsp;Lisa Cannada ,&nbsp;Paul Tornetta III","doi":"10.1016/j.injury.2025.112281","DOIUrl":"10.1016/j.injury.2025.112281","url":null,"abstract":"<div><div>Management with a functional brace results in successful union in the majority of patients with a humeral shaft fracture. An important factor in a patient's decision for operative vs. nonoperative management is how long it will take to know if the fracture will unite if treated nonoperatively. In this prospective multicenter evaluation subset analysis, we sought to address the following: (1) What is the positive and negative predictive value of gross motion at the fracture site on physical exam at 8 weeks post-injury for union in patients with humeral shaft fractures treated nonoperatively? (2) does callus present on radiographs correlate with clinical exam findings in terms of gross motion?</div></div><div><h3>Methods</h3><div>We performed a prospective multicenter observational trial to evaluate the PPV and NPV of gross motion at 8 weeks on the outcome of union. There was a proscription against surgery for a minimum of 12 weeks. We additionally evaluated the presence of callus on each cortex for those with gross motion.</div></div><div><h3>Results</h3><div>Of those available from the enrolled 101 patients, 62 (77 %) had no gross motion at 8 weeks following injury and went on to union (PPV=100 %). and 18 (23 %) patients had gross motion at the fracture site and 9 went on to nonunion (NPV =56 %), Callus was present on 3 of 4 cortices in 6 of the 7 patients with gross motion who went on to union and only 3 of the 9 who went on to nonunion (<em>p</em> = 0.06).</div></div><div><h3>Conclusions</h3><div>The lack of gross motion at the fracture site in patients treated nonoperatively for a humeral shaft fracture is highly predictive of union. The presence of gross motion does not predict nonunion as well, especially if callus is present on at least 3 of the 4 cortices. This information can be used to counsel patients at the inception of treatment and at 8 weeks.</div></div><div><h3>Level of Evidence</h3><div>II</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112281"},"PeriodicalIF":2.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876912","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":"Repurposing of activating transcription factor 3 (ATF3) activator molecules with potential wound-healing effects","authors":"Yolanda M. Jacobo-Delgado ,&nbsp;Valentin Trujillo-Paez ,&nbsp;Alan Santos-Mena ,&nbsp;Camelia Felix-Arellano ,&nbsp;Irma Gonzalez-Curiel ,&nbsp;Luis A. De Jesus-González ,&nbsp;Bruno Rivas-Santiago","doi":"10.1016/j.injury.2025.112314","DOIUrl":"10.1016/j.injury.2025.112314","url":null,"abstract":"<div><div>Background: Wound healing is a complex and regulated process that involves the coordinated action of key signaling pathways. Activating transcription factor 3 (ATF3) is a stress-inducible protein that has recently emerged as a critical modulator of cellular responses to injury, including those involved in wound healing. Aim: The aim of this study was to explore the repurposing of existing pharmacological agents to activate ATF3 and evaluate their potential to enhance wound healing factors. Methods: We selected three compounds: retin-A, furosemide, and acrivastine based on their ability to modulate ATF3 expression and assessed their effects on wound healing processes in primary cell cultures. We evaluated wound healing-related genes such as LL-37, HBD-2, HBD-3, and VEGFA by qPCR, and a wound healing scratch assay using keratinocytes was conducted to evaluate cell migration. Results: Interestingly, retin-A induced the expression of key wound healing-related genes, including HBD-2, HBD-3, LL-37, and VEGF. Also, retin-A was the only compound showing wound healing effects, while furosemide and acrivastine did not exhibit any noticeable activity. Conclusion: Our research highlights the potential of retin-A as therapeutic agents to improve wound healing, particularly in chronic wound models.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112314"},"PeriodicalIF":2.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816585","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":"Weightbearing instructions after orthopaedic injury or surgery","authors":"Alex Trompeter","doi":"10.1016/j.injury.2025.112329","DOIUrl":"10.1016/j.injury.2025.112329","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112329"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839644","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":"Screw fixation of superior pubic ramus fractures using a modified technique with a pre-bent guidewire in curved transpubic corridors – A non-inferiority pilot study","authors":"Nico Hinz ,&nbsp;Alena Seffert ,&nbsp;Darius Thiesen ,&nbsp;Esko Meine ,&nbsp;Mohamad Hadi Nasri ,&nbsp;Karl-Heinz Frosch ,&nbsp;Maximilian Hartel","doi":"10.1016/j.injury.2025.112318","DOIUrl":"10.1016/j.injury.2025.112318","url":null,"abstract":"<div><h3>Introduction</h3><div>Transpubic screw fixation is a valuable option for stabilization of superior pubic ramus fractures. However, insertion of a transpubic screw can be challenging or sometimes even impossible due to a narrow or curved transpubic screw corridor, which is present in 38 % of cases. To overcome this problem, a modified technique for insertion of a transpubic screw by advancing a pre-bent guidewire in an ESIN-like fashion is described.</div></div><div><h3>Materials and Methods</h3><div>A retrospective, non-inferiority pilot study with patients, who received a transpubic screw, was performed to investigate potential procedure-associated complications as well as short-term radiological and clinical outcomes of the modified technique in comparison to the classical technique for insertion.</div></div><div><h3>Results</h3><div>From 01/2021 to 04/2024, 24 transpubic screws were inserted at two major trauma centers, of which nine screws were inserted using the modified technique. Ten patients with a total of eleven transpubic screws (modified technique: 5; classical technique: 6) were available for this pilot study. One patient from the modified technique subgroup experienced a screw migration without affecting fracture healing and without necessitating hardware removal. The complication rate of the modified technique was not significantly inferior to the classical technique (p = 0.50). Residual displacement of the pubic ramus fracture was not significantly inferior using the modified technique compared to the classical technique (modified: 5.0 ± 2.2 mm; classical 4.4 ± 3.3 mm; p = 0.38). The clinical outcome was not significantly inferior using the modified technique compared to the classical technique regarding VAS pain (modified: 2.4 ± 4.3; classical 2.6 ± 2.5; p = 0.47), VAS satisfaction (modified: 8.8 ± 1.8; classical 9.0 ± 1.0; p = 0.42) and Majeed score (modified: 82.0 ± 12.6; classical 90.0 ± 12.5; p = 0.17).</div></div><div><h3>Conclusion</h3><div>The modified technique for insertion of a transpubic screw using a pre-bent guidewire is feasible in narrow and particularly curved transpubic corridors. It was not inferior compared to the classical technique regarding complications as well as short-term radiological and clinical outcomes.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112318"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807135","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":"Increasing incidences of acetabular, pelvic fractures and proximal femur fractures in the Netherlands","authors":"MI Lommerse ,&nbsp;HC Willems ,&nbsp;S van Dieren ,&nbsp;FW Bloemers ,&nbsp;HJ Schuijt ,&nbsp;D van Embden","doi":"10.1016/j.injury.2025.112322","DOIUrl":"10.1016/j.injury.2025.112322","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to investigate incidence rates of acetabular, pelvic, and proximal femur fractures in the Netherlands over a 10-year period (2012-2022). With an aging population, understanding trends in these osteoporotic fractures is essential for improving patient outcomes and guiding healthcare strategies.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using data from two national databases, forming a ‘hospitalised’ and an ‘all patients’ cohort. The study population included patients diagnosed with acetabular, pelvic, and proximal femur fractures in the Netherlands during the study period. Incidence rates were calculated per 100,000 person-years and linear regression was used to assess temporal trends. Age-adjustments were performed using Dutch population data from the Central Bureau of Statistics (CBS). Comparative analyses between the two cohorts were conducted to identify discrepancies.</div></div><div><h3>Results</h3><div>A total of 283,991 patients were identified (12,020 acetabular, 70,595 pelvic and 201,376 proximal femur fractures). Of these patients, 159,563 were hospitalised (7,123 acetabular, 24,192 pelvic, and 128,252 proximal femur fractures). Incidence rates of acetabular fractures increased by 26% (hospitalised) and 98% (all patients), while pelvic fractures showed stagnation in hospitalised patients (-0.13%) but a 44% rise in all patients. Proximal femur fractures increased by 5% (hospitalised) and 15% (all patients). Significant differences between the databases were noted across all fracture types.</div></div><div><h3>Conclusion</h3><div>The incidence of acetabular, pelvic, and proximal femur fractures has significantly increased in the last decade, most notably in acetabular and pelvic fractures. Furthermore, a shift toward out-patient treatment of acetabular and pelvic fractures was found. These findings highlight the need for improved fracture prevention and out-patient management strategies, while also underscoring the need for a nationwide registration for these injuries.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112322"},"PeriodicalIF":2.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792418","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":"Nationwide analysis of pelvic and acetabular fracture surgeries in Japan: The impact of aging and healthcare resources","authors":"Kaori Endo","doi":"10.1016/j.injury.2025.112316","DOIUrl":"10.1016/j.injury.2025.112316","url":null,"abstract":"<div><h3>Purpose</h3><div>This study investigates Japanese trends in Open Reduction and Internal Fixation (ORIF) surgeries for acetabular and pelvic fractures, focusing on age, gender, regional disparities, and how orthopedic surgeon distribution affects surgical volumes, aiming to identify factors contributing to geographic variations.</div></div><div><h3>Methods</h3><div>Surgical volumes for acetabular (K124–2) and pelvic (K125) fractures were categorized by age, gender, and prefecture in the National Database of Health Insurance Claims and Specific Health Checkups of Japan (2016–2022). Correlation analyses assessed relationships between surgical volumes, aging populations, and orthopedic surgeon availability.</div></div><div><h3>Results</h3><div>Surgical volumes of the elderly increased among individuals over 65, with a notable rise in female pelvic fractures. Acetabular fractures were more prevalent in younger males. Urban areas with more orthopedic surgeons showed higher surgical volumes (<em>p</em> &lt; 0.0001), while aging population rates correlated negatively (<em>p</em> &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>ORIF for acetabular and pelvic fractures is increasing in Japan's aging population. Surgeon distribution influences surgical volumes, highlighting the need for treatment guidelines in primary care and telemedicine-based strategies.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112316"},"PeriodicalIF":2.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800142","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":"Description and prognostic factors of a cohort of polytraumatized patients with spinal injury in a level I trauma center","authors":"B. Unger ,&nbsp;A. Sarfati ,&nbsp;T. Botrel ,&nbsp;H. Pascal-Moussellard ,&nbsp;M. Raux ,&nbsp;A. James ,&nbsp;L. Marie-Hardy","doi":"10.1016/j.injury.2025.112319","DOIUrl":"10.1016/j.injury.2025.112319","url":null,"abstract":"<div><h3>Introduction</h3><div>Traumatic spinal injuries are a significant public health issue due to their high frequency and severity, impacting the entire healthcare system, especially when neurological sequelae are involved. These injuries require comprehensive resuscitative management, prioritizing spinal injuries within the context of associated injuries. Understanding the epidemiology of spinal fractures in polytraumatized patients is essential for improving care planning, primary prevention methods, and hospital management.</div></div><div><h3>Methods</h3><div>This retrospective, single-center, observational study used the TRAUMABASE database from 2018 to 2022 to provide an epidemiological overview of polytraumatized patients with spinal fractures treated in a level I trauma center. Patients admitted to the Post-Anesthesia Care Unit (PACU) with at least one spinal fracture were included, excluding those with isolated transverse process fractures or incomplete clinical files. Data collected included demographics, injury mechanism, Injury Severity Score (ISS), type of spinal lesion, Glasgow Coma Scale (GCS), surgical management, length of hospital stay, and mortality.</div></div><div><h3>Results</h3><div>From 2018 to 2022, 561 patients with spinal fractures in the context of polytrauma were treated, with 386 patient records analyzed after exclusions. The mean age was 43 years, with a majority being male (75.1 %). The main injury mechanisms were falls from height (47.7 %) and traffic road accidents (46.4 %). Spinal surgery was performed on 53 % of patients, with a mean delay of 2.8 days from trauma to surgery. The overall mortality rate was 14.8 %, with neurological impairment, higher age, higher ISS score, lower GCS score, and absence of spinal surgery as unfavorable prognostic factors. The mean cost of hospitalization per patients was 76.854 ± 53.719 euros [3.502; 65.6623].</div></div><div><h3>Discussion</h3><div>This study highlights the severity of polytraumatized patients with spinal lesions, with a mean ISS score of 24.4 and frequent associated severe traumatic brain injuries. The main injury mechanisms were falls from height and traffic road accidents, with a high representation of self-inflicted injuries. Overall, the study provides valuable insights into the management and outcomes of polytraumatized patients with spinal injuries.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112319"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792293","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}