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

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Risk factors for fracture-related infections after low-velocity gunshot fractures to the pelvis 骨盆低速枪击骨折后发生骨折相关感染的风险因素
IF 2.2 3区 医学
Injury-International Journal of the Care of the Injured Pub Date : 2024-09-24 DOI: 10.1016/j.injury.2024.111918
Madelyn Coleman, Carisa Bergner, Thomas W. Carver
{"title":"Risk factors for fracture-related infections after low-velocity gunshot fractures to the pelvis","authors":"Madelyn Coleman,&nbsp;Carisa Bergner,&nbsp;Thomas W. Carver","doi":"10.1016/j.injury.2024.111918","DOIUrl":"10.1016/j.injury.2024.111918","url":null,"abstract":"<div><h3>Background</h3><div>Although treatments have improved dramatically in recent years, mortality following gunshot wounds (GSW) to the pelvis continue to range between 3 and 20 %. This project was designed to determine the incidence and risk factors associated with pelvic fracture-related infection (FRI) following GSWs to the pelvis given the paucity of evidence regarding this complication.</div></div><div><h3>Methods</h3><div>A retrospective review of 13 years (1/2010–12/2022) of patients with GSW to the pelvis was performed. Patients meeting inclusion criteria underwent chart review for the development of pelvic FRI and the following additional data elements were extracted: demographics, presence and type of bowel injury, operations performed, complications, use of postoperative antibiotics (≤24 h vs. &gt;24 h), surgical osseous debridement, presence of retained bullet fragments, and bullet trajectory. Discrete variables were analyzed using Wilcoxon rank-sum test, chi-square, and Fischer's exact test. Pearson correlation coefficients were calculated for continuous variables.</div></div><div><h3>Results</h3><div>242 patients were included in the study. Concomitant bowel injury was present in 108 patients (45 %). Eleven patients (4.5 %) developed FRI, all of whom had a concomitant bowel injury (<em>p</em> &lt; 0.001). Neither the presence of retained bullet fragments nor the bullet trajectory (through bowel before the bone) was associated with FRI. Antibiotic duration &gt;24 h was not associated with a lower rate of pelvic FRI.</div></div><div><h3>Conclusion</h3><div>Development of FRI after a GSW to the pelvis occurs in 4.5 % of patients and is significantly associated with concomitant bowel injury, specifically colonic injury. These findings can be used to help guide further studies on the role of prophylactic antibiotics or other strategies to prevent pelvic FRI.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 11","pages":"Article 111918"},"PeriodicalIF":2.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327468","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}
引用次数: 0
The ‘AfterBurn’ Longitudinal Exploratory (ABLE) study: Cohort profile 烧伤后 "纵向探索(ABLE)研究:队列概况。
IF 2.2 3区 医学
Injury-International Journal of the Care of the Injured Pub Date : 2024-09-24 DOI: 10.1016/j.injury.2024.111908
Martha Druery , Arpita Das , Jacelle Warren , Peter A Newcombe , Jeffrey Lipman , Cate M Cameron
{"title":"The ‘AfterBurn’ Longitudinal Exploratory (ABLE) study: Cohort profile","authors":"Martha Druery ,&nbsp;Arpita Das ,&nbsp;Jacelle Warren ,&nbsp;Peter A Newcombe ,&nbsp;Jeffrey Lipman ,&nbsp;Cate M Cameron","doi":"10.1016/j.injury.2024.111908","DOIUrl":"10.1016/j.injury.2024.111908","url":null,"abstract":"<div><div>With advanced medical treatments more burns patients survive their injuries, requiring a better understanding of the quality-of-life outcomes experienced after the burn. The aims of the ABLE study cohort profile are to describe the baseline characteristics. The study included participants aged 18 years or over, admitted to a single state-wide burns centre in Queensland, Australia with a ‘major burn injury’. Baseline survey data were collected either in person or by telephone within 28 days of the injury and participants were followed up with in-person, or telephone interviews at 3-, 6- and 12-months post-burn. Injury and burns treatment information were collected from medical records or the hospital database and surveys collected demographic and psychosocial data. Health-Related Quality of Life (HRQoL) data were collected using the 12-item Short Form Survey – version 1 (SF-12v1) and the Burn Specific Health Scale – Brief version (BSHS-B). Of the 274 participants recruited, 71.5 % (<em>N</em> = 196) remained enrolled in the study at 12 months post-burn. The median age for the cohort was 41.5 years (range 18 to 87 years) and the majority were male (72 %) as well as non-Indigenous Australians (76 %). The median Total Body Surface Area (TBSA) burned was 4.75 % (IQR=1.5–10.13) with a range of 0.1 % to 79.75 %. The largest percentage of participants sustained a flame burn (<em>N</em> = 129, 47.1 %) followed by scald (<em>N</em> = 56, 20.4 %) then contact burn (<em>N</em> = 54, 19.7 %). Fewer participants were injured by chemical (<em>N</em> = 14, 5.1 %), friction (<em>N</em> = 11, 4 %), and electrical burns (<em>N</em> = 6, 2.2 %). There were 37.9 % participants who reported having been diagnosed with a psychological condition prior to their burn injury. These findings provide an overview of baseline characteristics with a greater understanding of personal, environmental, burn injury and burn treatment factors in a state-wide burn centre.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 12","pages":"Article 111908"},"PeriodicalIF":2.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376403","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}
引用次数: 0
Scientometric analysis of global research on delayed and nonunion of fractures (2004–2023): Insights from the Web of Science core collections 全球骨折延迟和不愈合研究的科学计量分析(2004-2023 年):从科学网核心数据库中获得的启示
IF 2.2 3区 医学
Injury-International Journal of the Care of the Injured Pub Date : 2024-09-21 DOI: 10.1016/j.injury.2024.111882
Raju Vaishya , Brij Mohan Gupta , Mallikarjun M. Kappi , Ghouse Modin N. Mamdapur , K. S Ali , Abhishek Vaish
{"title":"Scientometric analysis of global research on delayed and nonunion of fractures (2004–2023): Insights from the Web of Science core collections","authors":"Raju Vaishya ,&nbsp;Brij Mohan Gupta ,&nbsp;Mallikarjun M. Kappi ,&nbsp;Ghouse Modin N. Mamdapur ,&nbsp;K. S Ali ,&nbsp;Abhishek Vaish","doi":"10.1016/j.injury.2024.111882","DOIUrl":"10.1016/j.injury.2024.111882","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Nonunion of fractures continue to be the most challenging complication. The increased interest in this area has been anecdotally recognized through published research. The study aimed to conduct a comprehensive bibliometric analysis of global research on nonunion and delayed union of fractures to identify key trends, hotspots, and potential areas for future research development.</div></div><div><h3>Methods</h3><div>Using a pre-defined search strategy, articles related to “Nonunion and Delayed Union of Fractures” that were published from January 1st, 2004 to December 31st, 2023, were retrieved from the Web of Science Core Collection for scientometric analysis. The bibliometrics method was used to analyze the publication dates, countries, institutions, journals, authors, highly cited literature and research hotspots.</div></div><div><h3>Results</h3><div>A total of 1997 publications were identified, which registered an average of 21.42 citations per paper (CPP). The 30.39 % and 3.55 % of the 1997 global publications have received external funding support and were highly-cited papers, respectively. The USA, China and UK, were the most productive countries, while Canada, Scotland, and Belgium registered the highest citation impact. University Leeds, Shanghai Jiao Tong University and Kobe University were the most productive organizations, while Vanderbilt University, University of Edinburgh and University Leeds registered the highest citation impact. Giannoudis PV, Egol KA, and Konda SR were the most productive authors, while Bhandari M, Mehta S, and Schemitsch EH registered the highest citation impact. <em>Injury, Journal of Orthopaedic Trauma and Archives of Orthopaedic and Trauma Surgery</em> contributed the most papers, while <em>Journal of Bone and Joint Surgery-American, Injury and Clinical Orthopaedics and Related Research</em> registered the highest citation impact per paper.</div></div><div><h3>Conclusion</h3><div>The present bibliometric analysis shows the characteristics and trends of non-union fracture research and illuminates the current research situation and developmental trends.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 11","pages":"Article 111882"},"PeriodicalIF":2.2,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142323429","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}
引用次数: 0
Closed reduction by robot with different modes: Experimental study on tibial fracture specimen 采用不同模式的机器人闭合复位:胫骨骨折标本的实验研究
IF 2.2 3区 医学
Injury-International Journal of the Care of the Injured Pub Date : 2024-09-21 DOI: 10.1016/j.injury.2024.111874
Jiingtao Lei , Suchi Qiao , Yuyang Wang , Zhuangzhuang Wang , Guangqing Song , Chaohao Cai
{"title":"Closed reduction by robot with different modes: Experimental study on tibial fracture specimen","authors":"Jiingtao Lei ,&nbsp;Suchi Qiao ,&nbsp;Yuyang Wang ,&nbsp;Zhuangzhuang Wang ,&nbsp;Guangqing Song ,&nbsp;Chaohao Cai","doi":"10.1016/j.injury.2024.111874","DOIUrl":"10.1016/j.injury.2024.111874","url":null,"abstract":"<div><h3>Purpose</h3><div>This paper evaluates the accuracy and safety of a long bone fracture reduction robot under different surgical modes.</div></div><div><h3>Methods</h3><div>A long bone fracture reduction robot system was developed, which can be controlled via an autonomous surgical mode or a master-slave surgical mode. Reduction experiments were conducted on a long bone cadaver specimen. The accuracy and safety of the robotic reduction were compared across the different surgical modes.</div></div><div><h3>Results</h3><div>When the fracture reduction was completed by the robot, the translational deviation was less than 2 mm, and the angular deviation was less than 3° The autonomous reduction time was 140 s, while the master-slave reduction time was 200 s.</div></div><div><h3>Conclusions</h3><div>Based on CT imaging verification, the accuracy of the robot in both autonomous and master-slave surgical modes meets clinical requirements. Future work will focus on further optimizing the robot system.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 11","pages":"Article 111874"},"PeriodicalIF":2.2,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142323458","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}
引用次数: 0
Wound infection rate after skin closure of damage control laparotomy with wicks or incisional negative wound therapy: An EAST multi-center trial. 使用灯芯或切口负性伤口疗法进行损伤控制开腹手术皮肤闭合后的伤口感染率:EAST多中心试验。
IF 2.2 3区 医学
Injury-International Journal of the Care of the Injured Pub Date : 2024-09-19 DOI: 10.1016/j.injury.2024.111906
John Cull , Katherine Pellizzeri , Daniel C. Cullinane , Meghan Cochran-Yu , Eric Trevizo , Anna Goldenberg-Sandau , Ryan Field , Jordan M. Kirsch , Jessica K. Staszak , Jeffrey J. Skubic , Raul Barreda , William M. Brigode , Faran Bokhari , Christopher A. Guidry , Jordan Basham
{"title":"Wound infection rate after skin closure of damage control laparotomy with wicks or incisional negative wound therapy: An EAST multi-center trial.","authors":"John Cull ,&nbsp;Katherine Pellizzeri ,&nbsp;Daniel C. Cullinane ,&nbsp;Meghan Cochran-Yu ,&nbsp;Eric Trevizo ,&nbsp;Anna Goldenberg-Sandau ,&nbsp;Ryan Field ,&nbsp;Jordan M. Kirsch ,&nbsp;Jessica K. Staszak ,&nbsp;Jeffrey J. Skubic ,&nbsp;Raul Barreda ,&nbsp;William M. Brigode ,&nbsp;Faran Bokhari ,&nbsp;Christopher A. Guidry ,&nbsp;Jordan Basham","doi":"10.1016/j.injury.2024.111906","DOIUrl":"10.1016/j.injury.2024.111906","url":null,"abstract":"<div><div>Damage control laparotomy (DCL) has a high risk of SSI and as an attempt to mitigate this, surgeons often leave the skin open to heal by secondary intention. A recent retrospective study showed that DCL wounds could be closed with the addition of wicks or incisional wound vacs with acceptable rates of wound infection. The aim of this prospective trial was to corroborate these results.</div><div>This is a prospective multicenter observational trial performed by 7 institutions from July 2020 to April 2022. Adult patients who underwent DCL and fascia/skin closure with the addition of wicks or an incisional wound vac were included. Patients who died within seven days of DCL were excluded. Demographics, mechanism of initial presentation, wound classification, antibiotics given, surgical site infections, procedures performed, and mortality data was collected. Fisher's Exact test was used for categorical data and Wilcoxon Rank Sum test for continuous data. Mean days to closure was assessed using Student's <em>t</em>-test for independent groups. P-values &lt;0.05 were considered indicative of statistical significance.</div><div>Over the 21-month period, a total of 119 patients analyzed. Most patients were male (<em>n</em> = 66, 63 %), and the average age was 51 years. The average number of days the abdomen was kept open was 2.6. A majority of the DCLs were performed on acute care patients (<em>n</em> = 76, 63.8 %) and 92 patients (77.3 %) had a wound classification of contaminated or dirty. Most of the patients’ skin was closed with wicks in place (68.9 %). There was a 9.8 % infection rate in patient's skin closed with wicks versus 16.2 % closed with an incisional wound vac (<em>p</em> = 0.361).</div><div>Although the wick group had a higher proportion of class III and IV wound types, patients primarily treated with wicks had a lower risk of wound infection compared to those treated with incisional wound VACs; however, this difference was not statistically significant.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 11","pages":"Article 111906"},"PeriodicalIF":2.2,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311707","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}
引用次数: 0
The epidemiology of geriatric fractures: A nationwide analysis of 1 million fractures 老年骨折的流行病学:对全国 100 万例骨折的分析
IF 2.2 3区 医学
Injury-International Journal of the Care of the Injured Pub Date : 2024-09-19 DOI: 10.1016/j.injury.2024.111900
Izzet Bingol , Saygin Kamaci , Engin Turkay Yilmaz , Melih Oral , Niyazi Erdem Yasar , Ebru Dumlupinar , Naim Ata , M.Mahir Ulgu , Suayip Birinci , Sinem Bayram , Ahmet Mazhar Tokgozoglu , Huseyin Demirors
{"title":"The epidemiology of geriatric fractures: A nationwide analysis of 1 million fractures","authors":"Izzet Bingol ,&nbsp;Saygin Kamaci ,&nbsp;Engin Turkay Yilmaz ,&nbsp;Melih Oral ,&nbsp;Niyazi Erdem Yasar ,&nbsp;Ebru Dumlupinar ,&nbsp;Naim Ata ,&nbsp;M.Mahir Ulgu ,&nbsp;Suayip Birinci ,&nbsp;Sinem Bayram ,&nbsp;Ahmet Mazhar Tokgozoglu ,&nbsp;Huseyin Demirors","doi":"10.1016/j.injury.2024.111900","DOIUrl":"10.1016/j.injury.2024.111900","url":null,"abstract":"<div><h3>Objective</h3><div>Fractures among the geriatric population impose a substantial burden on healthcare systems. This study aims to investigate the incidence and distribution of fractures among geriatric individuals over seven years, analyzing changes by age and sex. The findings will inform national healthcare strategies for addressing the growing impact of geriatric fractures.</div></div><div><h3>Materials and methods</h3><div>Electronic health records from a nationwide personal health records system were analyzed, focusing on ICD-10 codes for fractures. Recurrent codes for the same patients within three months were excluded. Patients were categorized into three age groups (65–74, 75–84, and 85+ years), and fractures were grouped anatomically. Incidence rates for specific fracture locations were calculated based on the actual population at risk annually. Incidence rates were further stratified by sex and age groups using Turkey's age- and sex-specific populations.</div></div><div><h3>Results</h3><div>A total of 1,004,663 geriatric fractures (66.9 % female, 33.1 % male) were identified over seven years. The overall fracture incidence among the geriatric population was 1.9 % (1910/100,000). Hip fractures were the most common (25.2 %), followed by wrist (15 %) and lumbar-pelvic fractures (11.9 %). Femur fractures were predominant in the 75–84 and 85+ age groups, while wrist fractures were more common in the 65–74 age group. Fracture incidences generally increased with age, except for ankle, foot, and toe fractures, which decreased with age for both sexes (p &lt; 0.05). The male/female ratio was lowest for wrist, elbow, and humeral shaft fractures (1:3.2, 1:2.7, and 1:2.7, respectively). The lowest overall fracture incidence was observed in 2020 (1568/100,000), while the highest was in 2017 (2523/100,000).</div></div><div><h3>Conclusion</h3><div>With Turkey's aging population, the socioeconomic impact of geriatric fractures is anticipated to rise. Fracture patterns and incidence vary by age and sex among geriatric individuals. These findings provide valuable insights for healthcare planning and the development of community-based preventive measures tailored to specific fracture locations and demographics.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 11","pages":"Article 111900"},"PeriodicalIF":2.2,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142323459","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}
引用次数: 0
The use of amniotic tissue-derived products in orthopedic surgery: A narrative review 在骨科手术中使用羊膜组织衍生产品:叙述性综述
IF 2.2 3区 医学
Injury-International Journal of the Care of the Injured Pub Date : 2024-09-19 DOI: 10.1016/j.injury.2024.111901
Jessica Forbes , Garrett R. Jackson , Derrick M. Knapik , Justin T. Childers , Connor Donley , Nino Coutelle , Vani J. Sabesan
{"title":"The use of amniotic tissue-derived products in orthopedic surgery: A narrative review","authors":"Jessica Forbes ,&nbsp;Garrett R. Jackson ,&nbsp;Derrick M. Knapik ,&nbsp;Justin T. Childers ,&nbsp;Connor Donley ,&nbsp;Nino Coutelle ,&nbsp;Vani J. Sabesan","doi":"10.1016/j.injury.2024.111901","DOIUrl":"10.1016/j.injury.2024.111901","url":null,"abstract":"<div><div>Amniotic-derived products have been used for decades in various medical subspecialties and have proven to be a safe method of allograft tissue transplantation. These products have shown promising preclinical and early clinical results in the treatment of tendon/ligament injuries, cartilage defects, and osteoarthritis.</div><div>The therapeutic benefits of amniotic-derived products are likely due to intrinsic properties, such as their structure as an extracellular matrix and concentration of growth factors, as well as anti-inflammatory, antifibrotic, and antimicrobial molecules. We performed a narrative review, evaluating the pre-clinical and clinical use of amniotic-derived products in musculoskeletal injuries such as osteoarthritis, Achilles tendinopathy, plantar fasciitis, lateral epicondylitis, chronic stenosing tenosynovitis, and nerve, cartilage and tendon repair or reconstruction, along with fracture healing treatment.</div><div>In vitro and pre-clinical studies using amniotic-derived products for orthopedic treatments have shown promising results and provide the foundation for further human trials to be conducted. With the rise of commercially available biologics, incorporating amniotic products into orthopedic practice is becoming more accessible, while further studies investigating long-term outcomes and potential adverse events are necessary.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 11","pages":"Article 111901"},"PeriodicalIF":2.2,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327467","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}
引用次数: 0
Risk factors for adverse events after clavicle fracture open reduction and internal fixation: A NSQIP study 锁骨骨折切开复位内固定术后不良事件的风险因素:一项 NSQIP 研究
IF 2.2 3区 医学
Injury-International Journal of the Care of the Injured Pub Date : 2024-09-18 DOI: 10.1016/j.injury.2024.111883
Aadi Sharma , Isabel Shaffrey , Charles R. Reiter , James R. Satalich , Brady Ernst , Conor N. O'Neill , Carl Edge , Jennifer L. Vanderbeck
{"title":"Risk factors for adverse events after clavicle fracture open reduction and internal fixation: A NSQIP study","authors":"Aadi Sharma ,&nbsp;Isabel Shaffrey ,&nbsp;Charles R. Reiter ,&nbsp;James R. Satalich ,&nbsp;Brady Ernst ,&nbsp;Conor N. O'Neill ,&nbsp;Carl Edge ,&nbsp;Jennifer L. Vanderbeck","doi":"10.1016/j.injury.2024.111883","DOIUrl":"10.1016/j.injury.2024.111883","url":null,"abstract":"<div><h3>Background</h3><div>Midshaft clavicle fractures are often subject to increased complications when treated nonoperatively, so surgical treatment with open reduction and internal fixation (ORIF) is a favored alternative. Despite safer outcomes, adverse events such as surgical site infections may still persist, particularly in the presence of certain patient characteristics. The objective of this study was to determine risk factors for and the frequency of adverse events following ORIF for clavicle fractures.</div></div><div><h3>Methods</h3><div>A retrospective review of the National Surgical Quality Improvement Program (NSQIP) database from 2012 to 2021 identified patients undergoing isolated ORIF for clavicle fractures. Patient demographics and 30-day complications were collected. Bivariate analyses with a student's <em>t</em>-test or chi-square test were used to identify possible predictor variables for either AAE or SSI, and demographic metrics with <em>P</em> &lt; 0.2 were included in a multivariable regression model. Multivariable analyses identified significant independent patient risk factors for any adverse event (AAE) or SSI within 30-days of surgery. Adjusted odds ratios were reported for each variable included in the model. Statistical significance was set <em>a prior</em> at <em>P</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>The 6,753 selected patients who underwent ORIF for clavicle fractures between 2012 and 2021 were 38.1 ± 15.3 years of age, BMI 26.2 ± 4.9 kg m<sup>-12</sup>, and 77.3 % male. Of this cohort, 88.4 % received treatment on an outpatient basis. Postoperative adverse events were experienced by 128 (1.9 %) patients within 30 days of surgery, and SSI were prevalent in 0.77 % of patients, followed by wound dehiscence in 0.12 % of patients. After controlling for patient demographics and comorbidities, notable risk factors for adverse events included current smoking status (OR=2.036; <em>P</em> &lt; 0.001) and patient age (OR=1.025; <em>P</em> &lt; 0.001). Outpatient status (OR=0.528; <em>P</em> = 0.004) was protective.</div></div><div><h3>Conclusion</h3><div>The present study noted significantly increased risk of postoperative adverse events in older patients, as well as patients who smoke. Outpatient setting was significantly protective for adverse events. These findings help to provide further clinical context to guide surgical decision making and inform surgeons on current risks and outcomes.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 11","pages":"Article 111883"},"PeriodicalIF":2.2,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315680","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}
引用次数: 0
The known and unknown reality of knee dislocations: A systematic review 膝关节脱位的已知和未知现实:系统回顾。
IF 2.2 3区 医学
Injury-International Journal of the Care of the Injured Pub Date : 2024-09-18 DOI: 10.1016/j.injury.2024.111904
Zachary D. Randall , Matthew J. Strok , Jacob W Mazzola , Ravi Agrawal , Lauren H. Yaeger , Marschall B. Berkes
{"title":"The known and unknown reality of knee dislocations: A systematic review","authors":"Zachary D. Randall ,&nbsp;Matthew J. Strok ,&nbsp;Jacob W Mazzola ,&nbsp;Ravi Agrawal ,&nbsp;Lauren H. Yaeger ,&nbsp;Marschall B. Berkes","doi":"10.1016/j.injury.2024.111904","DOIUrl":"10.1016/j.injury.2024.111904","url":null,"abstract":"<div><h3>Background</h3><div>Knee dislocations (KD) are limb threatening injuries known to cause significant dysfunction and disability. This review aims to summarize KD knowledge and uncover areas where more research is needed.</div></div><div><h3>Methods</h3><div>The published literature was queried according to PRISMA guidelines. Studies eligible for inclusion were clinical studies of knee dislocations. Studies published before 1990, or that focused on patellofemoral dislocation were excluded.</div></div><div><h3>Results</h3><div>A total of 132 studies involving 43,869 knee dislocations were analyzed. The majority of patients were young adult males, with high-velocity trauma, particularly motor vehicle accidents, being the most common cause. Substance use and alcohol involvement were commonly reported. The predominant KD types were KD III (54.8 %) and KD IV (20.5 %). Meniscal tears were observed in over 50 % of cases, while cartilage injuries were present in 26.7 %. Neurovascular complications were significant, with popliteal artery injuries in 7.8 % and peroneal nerve injuries in 15.3 % of patients. Acute ligament repairs (64.2 %) were more common than delayed repairs (35.8 %), although the average time to repair was 56.1 days. Complications included amputations (2.3 %), fatalities (1.9 %), compartment syndrome (2.7 %), deep infection (5.3 %), and heterotopic ossification (21.6 %). Despite these severe injuries, a substantial loss to follow-up (19 %) and underreporting of functional outcomes were noted, limiting the comprehensive assessment of long-term recovery. A notable percentage of patients did not return to work or sports, with many requiring a change in profession due to their injuries, but these outcomes were only reported in 10 or fewer studies.</div></div><div><h3>Conclusion</h3><div>This study highlights the significant gaps in understanding the treatment strategies, financial burden, and long-term outcomes of knee dislocations. The incomplete data, particularly the high loss to follow-up rates and underreported functional outcomes, hinders the ability to make comprehensive assessments. Available results should thusly be interpreted with an understanding of the gaps in data, however return to sport and prior employment is often not achieved. Additionally, the potential influence of socioeconomic factors and substance abuse on treatment decisions and outcomes remains inadequately explored. Future research should focus on these areas to improve the management and prognosis of patients with knee dislocations, ensuring more accurate and thorough evaluations of long-term recovery and quality of life.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 11","pages":"Article 111904"},"PeriodicalIF":2.2,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367965","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}
引用次数: 0
Proceedings of the United Kingdom Periprosthetic Joint Infection Meeting 2022: Fracture-Related Infection Session 英国 2022 年假体周围关节感染会议记录:骨折相关感染专场。
IF 2.2 3区 医学
Injury-International Journal of the Care of the Injured Pub Date : 2024-09-18 DOI: 10.1016/j.injury.2024.111905
Nima Razii, Alex Hrycaiczuk, John W. Kennedy, David W. Shields, R. M. Dominic Meek, Bilal Jamal
{"title":"Proceedings of the United Kingdom Periprosthetic Joint Infection Meeting 2022: Fracture-Related Infection Session","authors":"Nima Razii,&nbsp;Alex Hrycaiczuk,&nbsp;John W. Kennedy,&nbsp;David W. Shields,&nbsp;R. M. Dominic Meek,&nbsp;Bilal Jamal","doi":"10.1016/j.injury.2024.111905","DOIUrl":"10.1016/j.injury.2024.111905","url":null,"abstract":"<div><div>Implant-related infections represent a relatively common and significant challenge in the surgical management of musculoskeletal trauma patients. The third United Kingdom Periprosthetic Joint Infection (UK PJI) Meeting convened in Glasgow on 1 April 2022, and brought together over 180 delegates, representing orthopaedics, infectious diseases, microbiology, plastic surgery, anaesthetics, and allied health professions, including pharmacy and specialist nurses. The meeting comprised a plenary session for all delegates, and separate breakout sessions for fracture-related infection (FRI) and arthroplasty. The UK PJI working group prepared consensus statements in advance of each session, based upon topics that were discussed at previous meetings, and delegates engaged in an anonymous electronic voting process. This article presents the findings of the FRI session, and examines each consensus topic within the context of the contemporary literature.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 11","pages":"Article 111905"},"PeriodicalIF":2.2,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378724","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}
引用次数: 0
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