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

{"title":"Trends in hemiarthroplasty and total hip arthroplasty for femoral neck fractures: Surgeon or patient driven?","authors":"Christina Liu ,&nbsp;Stephen Moye ,&nbsp;Austin T. Gregg ,&nbsp;Thirushan Wignakumar ,&nbsp;Adriana Liimakka ,&nbsp;Yibin Zhang ,&nbsp;Alex Farid ,&nbsp;Antonia F. Chen ,&nbsp;Nishant Suneja","doi":"10.1016/j.injury.2025.112662","DOIUrl":"10.1016/j.injury.2025.112662","url":null,"abstract":"<div><h3>Introduction</h3><div>The primary objective was to analyze the trends in hemiarthroplasty (HA) and total hip arthroplasty (THA) for adult patients with fractures (FNFs), with a focus on geriatric population, over the past two decades. The secondary objectives were to compare outcomes between HA and THA and evaluate its association with patient- and surgeon- specific factors.</div></div><div><h3>Methods and materials</h3><div><em>Design:</em> Retrospective cohort.</div><div><em>Setting:</em> Two Level 1 Trauma Centers.</div><div><em>Patient Selection Criteria:</em> Adult patients with FNFs between 2001 and 2023.</div></div><div><h3>Results</h3><div>A total of 3180 cases of FNF treated with arthroplasty were included in the study, comprising 2497 patients who received HA and 683 patients who received THA. There was an overall increase in both THA and HA performed for geriatric FNFs with THA increasing at a faster rate (223 % vs. 172 %, respectively). Patients receiving THA were younger (70.8 vs. 81.4 years, <em>p</em> &lt; 0.001) and more likely to be female (70.9 % vs. 65.1 %, <em>p</em> = 0.006). Patients receiving HA had lower BMI (24.6 vs. 25.4kg/m², <em>p</em> = 0.002), higher Charlson Comorbidity Index (7.5 vs. 4.6, <em>p</em> &lt; 0.001), and higher rates of dementia (29.9 % vs. 7.8 %, <em>p</em> &lt; 0.001).Factors associated with selection of THA over HA included arthroplasty fellowship training (21.5 % vs. 10.4 %, <em>p</em> &lt; 0.001) and greater surgical experience, as measured by years in practice (15.1 vs. 12.5 years, <em>p</em> &lt; 0.001).. Patients receiving THA had shorter hospitalizations (6.3 vs. 7.9 days, <em>p</em> &lt; 0.001) and were more likely to be discharged home (24.3 % vs. 5.5 %, <em>p</em> &lt; 0.001). Despite similar reoperation rates (4.5 % vs. 5.1 %, <em>p</em> = 0.58), THA resulted in a higher complication rate (9.2 % vs. 6.1 %, <em>p</em> = 0.006). HA had higher 90-day (11.1 % vs. 1.6 %, <em>p</em> &lt; 0.001) and 1 year (21.1 % vs. 3.8 %, <em>p</em> &lt; 0.001) mortality rates.</div></div><div><h3>Conclusions</h3><div>There has been a rising trend in THA for the treatment of FNFs over the past two decades, and factors affecting treatment decision are both patient and surgeon driven.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112662"},"PeriodicalIF":2.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878871","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":"Futility indications in resuscitative thoracotomy: A retrospective observational study evaluating practice guidelines","authors":"Gabriella H. Kalantar ,&nbsp;Cynthia I. Villalta ,&nbsp;Michael West ,&nbsp;Mason Ragsdale ,&nbsp;Heather M. Grossman Verner ,&nbsp;Rachel M. Krezczowski ,&nbsp;Joseph D. Amos ,&nbsp;Vanessa Shifflette","doi":"10.1016/j.injury.2025.112673","DOIUrl":"10.1016/j.injury.2025.112673","url":null,"abstract":"<div><h3>Background</h3><div>Resuscitative thoracotomies (RTs) are controversial interventions that heavily consume resources and can pose risks for the surgical team. Increasingly limited resources and risk to healthcare teams have encouraged the continued refinement of RT guidelines. We evaluated RT futility indicators amid institutional RT practice guideline changes.</div></div><div><h3>Methods</h3><div>Thoracotomies conducted at our Level 1 Trauma Center from January 2017 to July 2023 were reviewed and classified as either RT or non-resuscitative (non-RT). Injury characteristics, patient demographics, procedure details, and mortality outcomes were collected through chart review.</div></div><div><h3>Results</h3><div>Of 78 thoracotomies, 56 (71.8 %) were RTs, predominantly on patients with penetrating injuries (55.4 %), specifically gunshot wounds (46.4 %). Most RTs (87.5 %) complied with Eastern Association for the Surgery of Trauma guidelines. The procedure mortality rate was 4.6 % for non-RT and 67.9 % for RT, and hospital mortality was 13.6 % for non-RT and 89.3 % for RT. Thus, 10.7 % of RT patients survived to discharge, including 5 (16.2 %) with penetrating injuries and 1 (4.0 %) with blunt injuries. Ten (17.8 %) RT patients arrived with fixed and dilated pupils, 11 (19.6 %) arrived with no signs of life, and 4 (10.7 %) received pre-hospital CPR, all of whom did not survive to discharge. Changes in institutional practice guidelines decreased the frequency of total thoracotomies, but not RT numbers.</div></div><div><h3>Discussion</h3><div>RT utilization and mortality rates remained consistent after implementing stricter institutional guideline policies. Improving odds of survival may require further refinement to RT practice guidelines regarding patient selection criteria. We recommend adding witnessed cardiac arrest and prioritizing pupillary response to RT futility guidelines regardless of injury pattern.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112673"},"PeriodicalIF":2.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829469","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 predictive scoring system for late displacement and deformity following non-operative treatment of Young-Burgess lateral compression type 1 (OTA 61-B1/B2) pelvic ring injuries","authors":"Wayne Hoskins ,&nbsp;Rown Parola ,&nbsp;Charles Gusho ,&nbsp;Daniel Bravin ,&nbsp;Brett Crist ,&nbsp;Josh Milby ,&nbsp;Gregory J.Della Rocca ,&nbsp;Kyle Schweser ,&nbsp;James P. Stannard ,&nbsp;Jaime Bellamy ,&nbsp;Douglas Haase","doi":"10.1016/j.injury.2025.112670","DOIUrl":"10.1016/j.injury.2025.112670","url":null,"abstract":"<div><h3>Objective</h3><div>To identify risk factors and develop a scoring system based on static x-rays that can predict late displacement and deformity of non-operatively treated Young-Burgess lateral compression type 1 (LC1) pelvic ring injuries</div></div><div><h3>Methods</h3><div>A retrospective review of all non-operatively treated low-energy LC1 (AO/OTA 61-B2/B3) pelvic ring injuries in patients aged ≥50 associated with incomplete zone 1 sacral fractures and minimum three-month follow-up between January 2019 through January 2024 from two academic level 1 trauma centers. Exclusion criteria were non-acute presentations, nonunions, pathological fractures and non-ambulatory patients. Anterior-posterior, inlet and outlet radiographic imaging at initial, post-operative and final follow-up were assessed.The primary outcome measure was greater than 1 cm of pelvic ring displacement from initial to final radiographs showing fracture healing. Patient demographic and radiographic factors were described with univariate analyses. Statistically significant variables (<em>P</em> &lt; 0.05) entered a multivariable logarithmic regression to develop a scoring system through stepwise elimination, which was assessed via receiver operator characteristic (ROC) curve analysis.</div></div><div><h3>Results</h3><div>A total of 197 LC1 injuries in patients managed non-operatively (mean age 75.6 (50–103) years, <em>n</em>= 147 (74.6 %) female) were included for analyses. Variables correlated with pelvic deformity development on univariate analysis included, increasing age (<em>p</em> = 0.038), whether the anterior ring had initial displacement present (<em>p</em> &lt; 0.001), bilateral anterior ring involvement (<em>p</em> = 0.027), unstable superior ramus fracture angle (<em>p</em> &lt; 0.001), superior ramus comminution (<em>p</em> &lt; 0.001), Nakatani zone 1 of ipsilateral fracture (<em>p</em> &lt; 0.001), and Nakatani zone 1 of contralateral fracture (if bilateral) (<em>p</em> = 0.031). After multivariate analysis with stepwise elimination, only superior ramus fracture angle (oblique OR 4.88, 95 % CI 2.09–12.25; longitudinal OR 15.55, 95 % CI 4.81–56.42), anterior ring initial displacement present (OR 5.05, 95 % CI 1.93–14.29) and superior ramus comminution (OR 4.43 95 % CI 1.99–10.15) remained significant as variables correlating with the development of pelvic deformity (all <em>p</em> ≤ 0.001).</div></div><div><h3>Conclusions</h3><div>The statistically significant variables that correlated with late displacement and deformity of LC1 fracture patterns were superior ramus fracture angle, comminution, and initial anterior ring displacement. A combination of these factors increased the risk of displacement.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112670"},"PeriodicalIF":2.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809328","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":"The impact of individual and regional socioeconomic identity on pediatric extremity fracture management: A scoping review","authors":"Devika A. Shenoy ,&nbsp;Summer Shabana ,&nbsp;Evelyn Hunter ,&nbsp;Christian Zirbes ,&nbsp;Simran Khanna ,&nbsp;Sofiu Ogunbiyi ,&nbsp;Muhamed Sanneh ,&nbsp;Steph Hendren ,&nbsp;Kathryn Radulovacki ,&nbsp;Aaron D. Therien ,&nbsp;Sanjeev Sabharwal ,&nbsp;Anthony A. Catanzano","doi":"10.1016/j.injury.2025.112674","DOIUrl":"10.1016/j.injury.2025.112674","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric extremity fractures represent a frequent cause of emergency department visits, with inequity in care linked to socioeconomic status, race, and insurance type. Despite standardized treatment algorithms, currently available evidence indicates that socially disadvantaged children experience delays in surgical fixation and pain management. This scoping review aims to evaluate the impact of socioeconomic factors on multiple elements of pediatric extremity fracture management.</div></div><div><h3>Methods</h3><div>This scoping review followed PRISMA standards. Eligible studies included pediatric patients (&lt;18 years) with extremity fractures, incorporated measures of social or economic status, and evaluated pre-defined management outcomes. Studies conducted before 2010 or outside of the United States were excluded. Abstracts and full texts were screened independently by multiple reviewers using Covidence software.</div></div><div><h3>Results</h3><div>After duplicate removal, 9,671 articles were screened, with 78 undergoing full-text review; 33 articles met all inclusion criteria. The 33 eligible studies predominantly consisted of retrospective cohort analyses, with sample sizes ranging from fewer than 500 to over 9 million patients. Major outcomes evaluated included type of treatment offered (n=10), pain management (n=10), time to care (n=8), post-discharge care (n=4), imaging (n=3), and pre-hospital care (n=1). Inequities were identified across multiple domains, commonly associated with insurance status, race, family income, and primary language. Children with public insurance consistently experienced higher rates of nonoperative management and longer delays to definitive treatment. Racial/ethnic minority children had lower odds of receiving opioid analgesics despite equivalent pain levels.</div></div><div><h3>Discussion and conclusion</h3><div>Socioeconomic disadvantage, measured at both the individual and regional level, is strongly associated with differences in pediatric extremity fracture management, including inequitable access to timely imaging, operative care, and adequate pain control. These findings underscore the critical need for targeted policy interventions, standardized clinical protocols, and improved care coordination to reduce disparities and ensure equitable pediatric fracture care for all children.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112674"},"PeriodicalIF":2.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826352","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 evaluation of external chest wall fixator treatment effectiveness in patients with rib fractures","authors":"Gizem Kececi Ozgur ,&nbsp;Tevfik Ilker Akcam ,&nbsp;Kutay Arkoc ,&nbsp;Ahmet Kayahan Tekneci ,&nbsp;Ayse Gul Ergonul ,&nbsp;Ali Ozdil ,&nbsp;Kutsal Turhan ,&nbsp;Alpaslan Cakan ,&nbsp;Ufuk Cagirici","doi":"10.1016/j.injury.2025.112675","DOIUrl":"10.1016/j.injury.2025.112675","url":null,"abstract":"<div><h3>Objective</h3><div>External chest wall fixators may provide a new approach as part of multimodal treatment. This study aimed to investigate the effect of external chest wall fixator on patients' pain level, complication development and hospital stay in patients with rib fractures.</div></div><div><h3>Material and method</h3><div>Patients who were admitted due to trauma and had serial rib fractures between December 2020 and December 2021 were evaluated. There were 14 patients in case group and 20 in control group. External chest wall fixator was applied to the case group in addition to standard treatment. Pain levels, development of complications and duration of hospitalization were recorded.</div></div><div><h3>Results</h3><div>Pain levels in first and third months were lower in case group than control group. Mean pain levels in the first month were 1.79 (SD 0.80) in case group and 2.85 (SD 1.53) in control group, in the third-month were 0.43 (SD 0.64) in case group and 1.34 (SD 1.59) in control group, and the difference was significant (<em>p</em> = 0.022 and 0.032, respectively). Complications were more common in patients with more rib fractures (<em>p</em> = 0.002). While complications developed in 2 patients in the case group and 8 patients in the control group, the difference was not statistically significant (<em>p</em> = 0.216). Duration of hospital stay was shorter in the case group and the difference was significant (2.7 (SD 0.9) days versus 2.0 (SD 0.7) days, <em>p</em> = 0.049).</div></div><div><h3>Conclusion</h3><div>It has been shown in our study that external fixator can be an effective method in reducing patients' pain and hospital stay. This method can be included as part of multimodal treatment in patients with rib fractures.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112675"},"PeriodicalIF":2.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865819","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":"Outcomes of immediate full weight bearing protocol for incomplete intertrochanteric occult hip fractures","authors":"Davidson Amit ,&nbsp;Silver Natan ,&nbsp;Mohammed Abu tair ,&nbsp;Levi Yadin ,&nbsp;Katz Alan ,&nbsp;Yaakov Applbaum ,&nbsp;Peyser Amos","doi":"10.1016/j.injury.2025.112649","DOIUrl":"10.1016/j.injury.2025.112649","url":null,"abstract":"<div><h3>Introduction</h3><div>Occult hip fractures are femoral neck fractures diagnosed by MRI or CT scan following negative plain radiographs. Incomplete intertrochanteric occult hip fractures (IIOHFs) do not involve the medial cortex. These fractures can be isolated but can also occur in the presence of greater trochanter (GT) fractures. Many authors recommend further imaging to exclude IIOHFs in cases where a GT fracture is present on plain radiograph, in order to evaluate the intertrochanteric region fracture extension. There is no consensus on the optimal treatment for IIOHFs, with approaches ranging from surgical fixation to full weight bearing. At our institution a protocol of immediate full weight bearing for patients diagnosed with IIOHFs was implemented. This study retrospectively evaluates the outcomes of this treatment protocol.</div></div><div><h3>Methods</h3><div>The medical records of patients who underwent MRI for suspected occult hip fractures were retrospectively analyzed. Inclusion criteria included: (1) patients with no findings on plain radiographs who were diagnosed by MRI with intertrochanteric fractures not involving the medial cortex, and (2) patients with isolated GT fractures diagnosed by plain radiographs and fracture extension greater than one-third of the intertrochanteric width seen on MRI. Data regarding initial hospitalization, diagnostic timing and findings, and follow-up outcomes were collected.</div></div><div><h3>Results</h3><div>Of 196 MRI scans performed during the study period, 45 patients met the inclusion criteria. None of these patients experienced secondary displacement of the fracture despite immediate full weight bearing. The average age was 81.1 years, and 21(10.7%) patients were male. The mean time from admission to MRI was 30 h, and the average length of hospitalization was 6.3 days. The 45 intertrochanteric fractures that were included in this study include nine isolated incomplete intertrochanteric fractures and 36 GT fractures with extension greater than one third of the intertrochanteric width. None of the GT fractures had involvement of the medial cortex.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that immediate full weight bearing is a safe treatment approach for IIOHFs. Operative fixation or immobilization may be unnecessary for these fractures. Our findings also challenge the clinical necessity of routine MRI scans in patients with GT fractures to assess for fracture progression.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112649"},"PeriodicalIF":2.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829470","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":"The use of the anterior lateral flap as a stage of orthopedic treatment for post-traumatic deformation of the tibia in children","authors":"Vitaliy Trofimchuk ,&nbsp;Agabek Chikinayev ,&nbsp;Serik Balgazarov ,&nbsp;Vasiliy Lozovoy ,&nbsp;Deniza Suleimenova ,&nbsp;Alexandr Kriklivyy ,&nbsp;Ruslan Abilov ,&nbsp;Roman Sokolov ,&nbsp;Bakhtiyar Jumabekov","doi":"10.1016/j.injury.2025.112646","DOIUrl":"10.1016/j.injury.2025.112646","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Complex open tibial fractures with soft tissue defects in children represent a major clinical challenge due to high risks of infection, osteomyelitis, and long-term functional impairment. This study aimed to evaluate the effectiveness of a combined orthopedic and reconstructive approach using external fixation and free anterolateral thigh (ALT) flaps in pediatric patients.</div></div><div><h3>Methods</h3><div>In this prospective, controlled clinical trial, 78 children (mean age 12.4 ± 3.1 years) with open tibial fractures and extensive soft tissue loss from road traffic accidents were enrolled. Patients were randomized into two groups: the experimental group (<em>n</em> = 40) received Ilizarov external fixation with microsurgical ALT flap reconstruction; the control group (<em>n</em> = 38) underwent conventional internal fixation with standard wound management. Renal function markers (creatinine, urea, GFR) were monitored to assess the impact of trauma, systemic inflammation, and nephrotoxic antibiotic exposure. Healing was evaluated using the Zygo-Scale at 7, 30, 60, 90 days, and 12 months. Incidence of osteomyelitis, joint ankylosis, flap complications, and revision surgeries was recorded.</div></div><div><h3>Results</h3><div>The experimental group demonstrated significantly faster and more complete soft tissue healing (<em>p</em> ≤ 0.05), with lower rates of osteomyelitis at 6 and 12 months (2.5 % and 0 % vs. 10.5 % and 5.25 %, respectively; <em>p</em> &lt; 0.05). Joint ankylosis scores were also significantly reduced (<em>p</em> = 0.02 and <em>p</em> = 0.01). Flap survival rate was 95 %, with no cases of total necrosis. Donor site morbidity was minimal. While renal function improved in both groups, a modest but significant difference in creatinine levels at 12 months favored the experimental group (<em>p</em> = 0.03). The combined approach was associated with shorter healing times and fewer complications.</div></div><div><h3>Conclusion</h3><div>The integration of Ilizarov fixation with ALT flap reconstruction is a safe and effective strategy for managing severe pediatric lower limb injuries, enhancing healing, reducing infections, and improving functional outcomes. Monitoring renal markers provides insight into systemic stress and antibiotic safety in trauma care.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112646"},"PeriodicalIF":2.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890372","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":"Long hindfoot nail fixation using standard tibial nails for elderly ankle and distal tibia fractures","authors":"Mr Ghiath Ismayl ,&nbsp;Miss Sadia Afzal ,&nbsp;Mr Majed Al Najjar ,&nbsp;Mr Mohamed Said Ammar ,&nbsp;Mr Aiman Khunda ,&nbsp;Mr Dominic Sprott ,&nbsp;Mr Asan Rafee ,&nbsp;Mr Peyman Bakhshayesh ,&nbsp;Mr Patrick Foster","doi":"10.1016/j.injury.2025.112648","DOIUrl":"10.1016/j.injury.2025.112648","url":null,"abstract":"<div><h3>Introduction</h3><div>Fragility ankle and distal tibia fractures in the elderly population present a complex clinical situation, due to the poor bone quality, soft tissue condition and medical comorbidities in this age group. This study aims to assess the outcome of long hindfoot nail fixation using standard tibial nails in managing these injuries. This is the largest and possibly first study to date of this implant used in ankle trauma hindfoot fixation.</div></div><div><h3>Methods</h3><div>This was a retrospective observational study across two level 1 major trauma centres in the United Kingdom, from January 2019 to December 2024. Patients included were above the age of 60 years, with acute ankle or distal tibia fractures and underwent long hindfoot nail fixation with standard tibial nails. Postoperative complications, early weightbearing and mortality rates were assessed.</div></div><div><h3>Results</h3><div>A total of 36 patients were included, of which 44.4 % were malleolar fractures, 38.9 % distal tibia extra-articular fractures, and 16.7 % distal tibia intra-articular fractures. Half of the cases were open fractures. There were no cases of periprosthetic fracture, re-fracture, fixation or implant failure. There were six (16.7 %) postoperative complication cases, of which only one (2.8 %) was deemed a major complication; re-operation for removal of proximal locking bolt due to infection. 88.9 % were able to full weightbear within 30 days after surgery. The mortality rate was 8.3 % at 30 days and 16.7 % at 1 year.</div></div><div><h3>Conclusion</h3><div>The use of standard tibial nails, a universally available and feasible implant, for long hindfoot nail fixation in fragility ankle and distal tibia fractures is a safe and reliable treatment option, with a success rate of 97.2 % without major complications. They permit early weightbearing and provide a stable construct with reduced risk of periprosthetic fractures and fixation failure. The mortality rate was comparable to fragility hip fractures, highlighting the medical complexity of patients with these injuries.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112648"},"PeriodicalIF":2.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809390","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":"An additional anterior support screw (AS2) besides cephalomedullary nailing","authors":"Shi-Yi Chen ,&nbsp;Shi-Min Chang","doi":"10.1016/j.injury.2024.111786","DOIUrl":"10.1016/j.injury.2024.111786","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 8","pages":"Article 111786"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908638","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":"Response to letter to the editor on “Injury patterns and outcomes in motorcycle driver crashes in the United States: The effect of helmet use”","authors":"Lara A. Brockhus ,&nbsp;Panagiotis Liasidis ,&nbsp;Meghan Lewis ,&nbsp;Dominik A. Jakob ,&nbsp;Demetrios Demetriades","doi":"10.1016/j.injury.2025.112583","DOIUrl":"10.1016/j.injury.2025.112583","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 8","pages":"Article 112583"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621557","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}