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

{"title":"Supraclavicular brachial plexus exploration and centralisation of services: An opinion from a national peripheral nerve injury referral unit","authors":"Ashley I. Simpson,&nbsp;Kapil Sugand,&nbsp;Anna Panagiotidou,&nbsp;Mike Fox,&nbsp;Marco Sinisi","doi":"10.1016/j.injury.2024.112002","DOIUrl":"10.1016/j.injury.2024.112002","url":null,"abstract":"<div><div>Centralising complex surgeries in specialised UK hospitals improves patient outcomes by leveraging high-volume expertise and optimising resources. Supraclavicular brachial plexus exploration, a complex and high-risk procedure, requires centralisation to enhance care standards.</div><div>This approach ensures experienced teams, advanced diagnostics, and a multidisciplinary framework for preoperative, surgical, and postoperative care. Early intervention is crucial for optimal results. Centralised centres also support comprehensive rehabilitation and systematic research, promoting evidence-based practices and specialist collaboration.</div><div>By adopting this approach, the UK healthcare system can ensure that patients with brachial plexus injuries receive the highest quality of care, paving the way for better health outcomes and innovations in surgical practice.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 8","pages":"Article 112002"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591906","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":"Preliminary results of stabilization of far distal tibial fractures with the distal tibial nail: A prospective, multicenter case series study","authors":"Mehmet Subasi","doi":"10.1016/j.injury.2024.112051","DOIUrl":"10.1016/j.injury.2024.112051","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 8","pages":"Article 112051"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756065","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 the letter to the editor – An additional anterior support screw (AS2) besides cephalomedullary nailing","authors":"Takashi Maehara","doi":"10.1016/j.injury.2025.112585","DOIUrl":"10.1016/j.injury.2025.112585","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 8","pages":"Article 112585"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644392","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":"Whether or not practicing early weight-bearing makes the differences in the risk of reoperation after cephalomedullary nailing","authors":"Shuang Li ,&nbsp;Zhen-Hai Wang ,&nbsp;Shi-Min Chang","doi":"10.1016/j.injury.2024.112006","DOIUrl":"10.1016/j.injury.2024.112006","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 8","pages":"Article 112006"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635125","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":"Comment on “Injury patterns and outcomes in motorcycle driver crashes in the United States: The effect of helmet use”","authors":"Gurdeep Gambhir","doi":"10.1016/j.injury.2024.112009","DOIUrl":"10.1016/j.injury.2024.112009","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 8","pages":"Article 112009"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741767","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 editor on: Stabilisation of AO OTA 31-A unstable proximal femoral fractures: Does the choice of intramedullary nail affect the incidence of post-operative complications? A systematic literature review and meta-analysis","authors":"M. Quartley,&nbsp;C. Saunders","doi":"10.1016/j.injury.2025.112586","DOIUrl":"10.1016/j.injury.2025.112586","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 8","pages":"Article 112586"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669167","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 the letter to the editor on : Preliminary results of stabilization of far distal tibial fractures with the distal tibial nail: a prospective, multicenter case series study.\"","authors":"","doi":"10.1016/j.injury.2025.112587","DOIUrl":"10.1016/j.injury.2025.112587","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 8","pages":"Article 112587"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621558","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":"Quantitative analysis of radial torsion angle according to location with CT scan","authors":"Eic Ju Lim ,&nbsp;Seungyeob Sakong ,&nbsp;Jeong Seok Choi ,&nbsp;Wonseok Choi ,&nbsp;Jong-Keon Oh ,&nbsp;Jae-Woo Cho","doi":"10.1016/j.injury.2025.112634","DOIUrl":"10.1016/j.injury.2025.112634","url":null,"abstract":"<div><h3>Purpose</h3><div>Malrotation of the radius following a shaft fracture can lead to persistent pain, limited motion, and adjacent joint instability. This study aimed to evaluate radial torsion patterns by specific location.</div></div><div><h3>Methods</h3><div>We included 50 patients with uninjured radii on computed tomography (CT). The torsion measuring zone (TMZ), defined along the longitudinal axis from just proximal to the watershed line to the distal end of the radial tuberosity, was divided into 3 mm intervals, generating cross-sectional images for torsion evaluation. Distal and proximal 30 mm segments were defined as distal end zone (DEZ) and proximal end zone (PEZ), respectively. The area with the largest 30 mm angular difference in distal half was designated the distal shaft torsion zone (DSTZ). The area between the proximal end of DSTZ and distal end of PEZ was the mid-shaft zone (MSZ). Angle change rate was evaluated in each zone, with the DSTZ compared to DEZ, MSZ, and PEZ.</div></div><div><h3>Results</h3><div>The cohort included 27 men and 23 women, mean age of 54.8 ± 19.6 years. TMZ length was 160.5 ± 16.3 mm, with torsion angle of 49.8 ± 13.3° The angle change rate was 4.6 ± 1.9°/cm in the DEZ and 5.1 ± 3.3°/cm in the PEZ. The centre of the DSTZ was 4.8 ± 1.4 cm from distal end, with an angle change rate of 6.5 ± 1.8°/cm. The MSZ length was 6.7 ± 1.7 cm, with angle change rate of 0.3 ± 1.6°/cm. DSTZ showed significantly higher angle change rates compared to DEZ (<em>P</em> &lt; 0.001) and MSZ (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The DSTZ, located about 5 cm from the distal end, exhibited the most significant torsion, while the MSZ showed minimal torsion. Recognising these torsion patterns will guide proper plate positioning and prevent iatrogenic malrotation during plate osteosynthesis for radius shaft fracture.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112634"},"PeriodicalIF":2.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780283","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":"Minimally invasive plate osteosynthesis for humeral shaft fractures with the far cortical locking system: A matched comparison with the standard locked plating construct","authors":"Joon-Woo Kim,&nbsp;Chang-Wug Oh,&nbsp;Sang-Roc Han,&nbsp;Hee-June Kim","doi":"10.1016/j.injury.2025.112635","DOIUrl":"10.1016/j.injury.2025.112635","url":null,"abstract":"<div><h3>Introduction</h3><div>The far cortical locking (FCL) system reduces axial stiffness in locked plating constructs while maintaining construct strength, thereby promoting secondary bone healing following fracture fixation. However, studies evaluating its efficacy compared with standard locked plating (LP) systems for upper extremity fractures remain limited. This study compared humeral shaft fractures treated with minimally invasive plate osteosynthesis (MIPO) using either the FCL or LP system.</div></div><div><h3>Materials and Methods</h3><div>We analyzed 40 patients with diaphyseal humeral fractures treated with MIPO using either FCL or LP and conducted a matched-pair comparative analysis. Prospective data were collected from 20 consecutive patients who underwent MIPO with FCL. A matched case-control cohort was constructed by pairing MIPO cases using LP with the most closely matched FCL cases. The primary outcome was a comparison of radiographic and clinical fracture healing, as well as complications, between the two groups using statistical analysis. Statistical significance was set at <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Union was achieved in 18 of 20 cases (90 %) in the FCL group at a mean of 13.6 weeks. All 20 cases in the LP group achieved union after a mean of 20.1 weeks. Time to union was significantly shorter in the FCL group (<em>p</em> &lt; 0.05), though the union rate did not differ significantly (<em>p</em> = 0.49). Near cortex healing occurred at a mean of 11.2 weeks in the FCL group and 18.8 weeks in the LP group (<em>p</em> &lt; 0.01). Two FCL cases required revision surgery due to screw breakage or pull-out at the proximal fracture segment. Mean coronal and sagittal angulations were 2.9° and 4.8° in the FCL group, and 2.4° and 3.3° in the LP group, with no significant differences (<em>p</em> = 0.60 and 0.24). No significant differences in functional outcomes were observed between the groups.</div></div><div><h3>Conclusions</h3><div>The FCL group showed significantly faster union compared to the LP group, but no significant differences in union rate, alignment, or functional outcomes. Although not statistically significant, a 10 % complication rate was observed in the FCL group. Caution is warranted, as FCL screws may fail at the proximal fracture segment, either by breakage due to mechanical overload or by pull-out.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112635"},"PeriodicalIF":2.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757778","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":"Acute reverse total shoulder arthroplasty versus internal fixation for 3- and 4- part proximal humerus fractures: A propensity matched analysis of 5466 elderly patients","authors":"Margaret A. Sinkler,&nbsp;Andrew J. Moyal,&nbsp;Jeremy M. Adelstein,&nbsp;Robert J. Burkhart,&nbsp;Raymond Chen,&nbsp;Robert J. Wetzel,&nbsp;George Ochenjele,&nbsp;John K. Sontich,&nbsp;Jacob G. Calcei,&nbsp;Joshua K. Napora","doi":"10.1016/j.injury.2025.112624","DOIUrl":"10.1016/j.injury.2025.112624","url":null,"abstract":"<div><h3>Introduction</h3><div>The purpose of this study was to utilize a large national database to evaluate short- and long-term outcomes of acute management of proximal humerus fractures (PHF) with reverse total shoulder arthroplasty (RSA) compared to open reduction internal fixation (ORIF).</div></div><div><h3>Methods</h3><div>The TriNetX platform was utilized to perform a retrospective review of patients who sustained PHFs treated within three weeks of injury. Patients were identified using Current Procedural Terminology codes and the International Classification of Disease diagnosis codes. The cohorts were 1:1 propensity matched. Patients who received RSA were propensity matched to patients who underwent ORIF. Short-term and long-term outcomes were compared across the cohorts across various post operative periods. Kaplan Meier survival analysis was used to analyze implant survival rate and Cox hazard ratio was used to identify risk factors of re-operation.</div></div><div><h3>Results</h3><div>Following propensity matching, each cohort included 2733 patients with an average age of 71±9.5. Patients treated with ORIF were more likely to have a re-operation or hospital admission than patients who underwent RSA at both 1 and 2 year follow up (5.5 % vs 2.1 %; <em>p</em> &lt; 0.001; 6.9 % vs 2.6 %, <em>p</em> &lt; 0.001 and 13.7 % vs 11.3 %, <em>p</em> = 0.01; 19.6 % vs 16.4 %, <em>p</em> = 0.003). At two year follow up, 173 patients treated with ORIF had a re-operation of which 60 (35 %) were converted to arthroplasty. On Kaplan Meier survival analysis for re-operation, both implants had satisfactory survival rates at both one and two year time point with survival rates over 90 %. However, there was a difference between survival rates at both one and two years between the ORIF and RSA groups (94 % vs 98 %, <em>p</em> &lt; 0.0001; 91 % vs 97 %, <em>p</em> &lt; 0.0001). For ORIF, patients with four part PHF and osteoporosis had a 39 % and 19 % increased risk of re-operation (<em>p</em> &lt; 0.001; <em>p</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>While both ORIF and RSA have been shown to be acceptable techniques for managing PHFs in the elderly, ORIF had a significantly higher re-operation and hospital readmission rate at mid- and long-term follow up. Additionally, a large portion of patients undergoing re-operation following ORIF were converted to shoulder arthroplasty although acute RSA has superior outcomes compared to delayed RSA. Therefore, for operative elderly candidates we advocate for the use of RSA in three- and four-part PHFs.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 10","pages":"Article 112624"},"PeriodicalIF":2.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144766948","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}