OTA international : the open access journal of orthopaedic trauma最新文献

{"title":"Hospital episode-of-care costs for hip fractures: an activity-based costing analysis.","authors":"Antoine Denis, Julien Montreuil, Yasser Bouklouch, Rudolf Reindl, Gregory K Berry, Edward J Harvey, Mitchell Bernstein","doi":"10.1097/OI9.0000000000000295","DOIUrl":"10.1097/OI9.0000000000000295","url":null,"abstract":"<p><strong>Background: </strong>Despite the large impact of hip fracture care on hospital budgets, accurate episode-of-care costs (EOCC) calculations for this injury remains a challenge. The objective of this article was to assess EOCC for geriatric patients with hip fractures using an activity-based costing methodology and identify intraoperative, perioperative, and patient-specific factors associated with higher EOCC.</p><p><strong>Material and methods: </strong>This is a retrospective cohort study involving a total of 109 consecutive patients with hip fracture treated surgically at a Canadian level-1 trauma center from April 2018 to February 2019. Clinical and demographic data were extracted through the institution's centralized data warehouse. Data acquisition also included direct and indirect costs per episode of care, adverse events, and precise temporal data.</p><p><strong>Results: </strong>The median total EOCC was $13,113 (interquartile range 6658), excluding physician fees. Out of the total cost, 75% was attributed to direct costs, which represented a median expenditure of $9941. The median indirect cost of the EOCC was $3322. Based on the multivariate analysis, patients not operated within the 48 hours guidelines had an increased length of stay by 5.7 days (<i>P</i> = 0.003), representing an increase in EOCC of close to 5000$. Higher American Society of Anesthesiology (ASA) scores were associated with elevated EOCC.</p><p><strong>Conclusion: </strong>The cost of managing a patient with geriatric hip fracture from arrival in the emergency department to discharge from surgical ward represented $13,113. Main factors influencing the EOCC included adherence to the 48-hour benchmark surgical delay and ASA score. High-quality costing data are vital in assessing health care spending, conducting cost effectiveness analyses, and ultimately in guiding policy decisions.</p><p><strong>Level of evidence: </strong>Level III (3), retrospective cohort study.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 4","pages":"e295"},"PeriodicalIF":0.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10695580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138489231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MELD score predicts short-term outcomes after surgical management of proximal humerus fractures: a matched analysis.","authors":"Brendan Y Shi, Alexander Upfill-Brown, Alan Li, Shannon Y Wu, Seth Ahlquist, Christopher M Hart, Thomas J Kremen, Christopher Lee, Alexandra I Stavrakis","doi":"10.1097/OI9.0000000000000289","DOIUrl":"10.1097/OI9.0000000000000289","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to evaluate the difference in 30-day outcomes after surgical management of proximal humerus fractures (PHFs) between patients with and without chronic liver disease as defined by a MELD score greater than 10.</p><p><strong>Design: </strong>This was a retrospective database review.</p><p><strong>Setting: </strong>All centers participating in the American College of Surgeons National Surgical Quality Improvement Program database were included.</p><p><strong>Patients/participants: </strong>Patients with proximal humerus fractures who (1) underwent ORIF, HA, or SA and (2) had calculable MELD scores were included.</p><p><strong>Intervention: </strong>Open reduction and internal fixation, hemiarthroplasty, or shoulder arthroplasty was used for treatment.</p><p><strong>Main outcome measurements: </strong>Thirty-day complications, mortality, readmission, and reoperation rates were measured.</p><p><strong>Results: </strong>Of the total 1732 PHF patients identified, 300 had a MELD score higher than 10. After propensity matching by significant covariates, MELD score higher than 10 was found to be significantly associated with higher rates of 30-day mortality, 30-day readmission, transfusion within 72 hours, and systemic complications. Among patients with a MELD score higher than 10, treatment with SA or HA instead of ORIF was associated with a higher rate of transfusion and longer operative time. There were no significant differences between treatment cohorts regarding mortality, reoperation, readmission, or complications.</p><p><strong>Conclusions: </strong>A MELD score higher than 10 is associated with higher risk of surgical complications, transfusion, and death in patients undergoing surgery for proximal humerus fractures. Among patients with a MELD score higher than 10, ORIF was associated with a lower transfusion rate and shorter operative time than arthroplasty or hemiarthroplasty.</p><p><strong>Level of evidence: </strong>Prognostic Level III.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 4","pages":"e289"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10611337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The “Human Emotions” and the new “Perrotta Human Emotions Model” (PHEM-2): Structural and functional updates to the first model","authors":"Perrotta Giulio, Basiletti Vanessa, Eleuteri Stefano","doi":"10.17352/ojt.000043","DOIUrl":"https://doi.org/10.17352/ojt.000043","url":null,"abstract":"Background: The first version of the Perrotta Human Emotions Model (PHEM) responded to the need for better structuring, in a functional framework, of emotions and sentiments, giving the proper role to anxiety, according to a neurobiological perspective, in a strategic scheme, but needs structural and functional corrections. Methods: Clinical interview, based on narrative-anamnestic and documentary evidence, and battery of psychometric tests. Results: Statistical comparison of data obtained by administering PHEM-1 versus data obtained by administering PHEM-2 reported an R = 0.999, with p = ≤0.001, as is the case when testing clinical utility by assessing it using MMPI-2-RF and PICI-2. Conclusion: This research confirms the clinical usefulness of administering the PHEM-2, compared with the previous version, during psychotherapeutic encounters conducted according to the brief or otherwise integrated strategic approach.","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136265823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of nonunion for transverse femoral shaft fractures treated with intramedullary nailing: a SIGN database study.","authors":"Brett Jones,&nbsp;Blake Cohoe,&nbsp;Kelsey Brown,&nbsp;Michael Flores,&nbsp;Kevin Peurrung,&nbsp;Terry Smith,&nbsp;David Shearer,&nbsp;Lewis Zirkle","doi":"10.1097/OI9.0000000000000281","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000281","url":null,"abstract":"<p><strong>Introduction: </strong>Nonunion is a common postfracture complication resulting in decreased quality of life for patients in resource-limited settings. This study aims to determine how age, sex, injury mechanism, and surgical intervention affect the rate of nonunion in transverse femur fractures treated with a SIGN intramedullary nail (IMN).</p><p><strong>Methods: </strong>A retrospective study was conducted using the SIGN online surgical database. All patients older than 16 years with simple transverse (<30 degrees), open or closed, femur fractures treated using a SIGN IMN between 2007 and 2021 were included. Our primary outcome of nonunion was measured with the modified Radiographic Union Scale for Tibial fractures (mRUST); scores ≤9 of 16 defined nonunion. The secondary outcome was squat depth. Outcomes were evaluated at follow-up appointments between 240 and 365 days postoperatively. Univariate and multivariate analysis were used for statistical comparison.</p><p><strong>Results: </strong>Inclusion criteria were met for 182 patients. The overall radiographic union rate was 61.0%, and a high proportion (84.4%) of patients could squat with their hips at or below the level of their knees. Older age, retrograde approach, and fracture distraction were associated with nonunion, but sex, injury mechanism, and other surgical variables were not.</p><p><strong>Conclusion: </strong>Poor reduction with fracture distraction was associated with a higher rate of nonunion. Loss of follow-up may have contributed to our overall union rate; however, we observed high rates of functional healing using the SIGN IMN.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 3","pages":"e281"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/58/oi9-6-e281.PMC10368386.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9883059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of a 2.7-mm and 3.5-mm locking compression plate for ulnar fractures: a biomechanical evaluation.","authors":"Jenna M Wahbeh,&nbsp;Benjamin V Kelley,&nbsp;Cyrus Shokoohi,&nbsp;Sang-Hyun Park,&nbsp;Sai K Devana,&nbsp;Edward Ebramzadeh,&nbsp;Sophia N Sangiorio,&nbsp;Devon M Jeffcoat","doi":"10.1097/OI9.0000000000000278","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000278","url":null,"abstract":"<p><strong>Objectives: </strong>Implant prominence after ulnar fracture fixation may be mitigated by the use of lower profile plates. The biomechanical strength and stability of 2.7-mm and 3.5-mm locking compression plates for fixation were compared.</p><p><strong>Methods: </strong>Two fracture conditions, transverse (N = 10) and oblique (N = 10), were evaluated in an in vitro study. Half of the specimens for each condition were fixed with 2.7-mm plates and the other half with 3.5-mm plates, all fixed with conventional dynamic compression mechanisms. Specimens were loaded under ±2 Nm of cyclic axial torsion, then under 10 Nm of cyclic cantilever bending, and bending to failure. Interfragmentary motion and strain were analyzed to determine construct stability as a function of fracture pattern and plate size.</p><p><strong>Results: </strong>Interfragmentary motion was significantly larger in all constructs fixed with 2.7-mm plates, compared with 3.5-mm plates (<i>P</i> < 0.01). The 2.7-mm constructs with transverse fractures had the greatest motion, ranging between 5° and 10° under axial rotation and 5.0-6.0 mm under bending. Motions were the lowest for 3.5-mm constructs with oblique fractures, ranging between 3.2 and 4.2 mm under bending and 2°-3.5° for axial rotation. For oblique fractures, the bending moment at ultimate failure was 31.4 ± 3.6 Nm for the 2.7-mm constructs and 10.0 ± 1.9 Nm for 3.5-mm constructs (<i>P</i> < 0.01). Similarly, for transverse fractures, the bending moment was 17.9 ± 4.0 Nm for the 2.7-mm constructs and 9.7 ± 1.3 Nm for the 3.5-mm constructs (<i>P</i> < 0.01).</p><p><strong>Conclusions: </strong>Although 3.5-mm plates were more effective at reducing fracture motion, they were consistently associated with refracture at the distal-most screw hole under load to failure. By contrast, 2.7-mm plates plastically deformed despite excessive loads, potentially avoiding a subsequent fracture.</p><p><strong>Level of evidence: </strong>Level V.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 3","pages":"e278"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/65/9c/oi9-6-e278.PMC10368380.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9937125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of restrictive fluid management on outcomes among geriatric hip fractures: a retrospective cohort study at five level I trauma centers.","authors":"Jordan Willis,&nbsp;Stephanie Jarvis,&nbsp;Gina M Berg,&nbsp;Chad Corrigan,&nbsp;Robert Madayag,&nbsp;Cassandra Reynolds,&nbsp;Allen Tanner,&nbsp;Gary Marshall,&nbsp;Carlos Palacio Lascano,&nbsp;David Bar-Or","doi":"10.1097/OI9.0000000000000279","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000279","url":null,"abstract":"<p><p>Restrictive fluid management (RFM) for hemodynamically unstable trauma patients has reduced mortality rates. The objective was to determine whether RFM benefits geriatric hip fracture patients, who are usually hemodynamically stable.</p><p><strong>Design: </strong>Retrospective propensity-matched study.</p><p><strong>Setting: </strong>Five Level I trauma centers (January 1, 2018-December 12, 2018).</p><p><strong>Patients: </strong>Geriatric patients (65 years or older) with hip fractures were included in this study. Patients with multiple injuries, nonoperative management, and preoperative blood products were excluded.</p><p><strong>Intervention: </strong>Patients were grouped by fluid volume (normal saline, lactated Ringer, dextrose, electrolytes, and medications) received preoperatively or ≤24 hours of arrival; patients with standard fluid management (SFM) received ≥150 mL and RFM <150 mL of fluids.</p><p><strong>Main outcome measurements: </strong>The primary outcomes were length of stay (LOS), delayed ambulation (>2 days postoperatively), and mortality. Paired Student t-tests, Wilcoxon paired rank sum tests, and McNemar tests were used; an α value of < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>There were 523 patients (40% RFM, 60% SFM); after matching, there were 95 patients per arm. The matched patients were well-balanced, including no difference in time from arrival to surgery. RFM and SFM patients received a median of 80 mL and 1250 mL of preoperative fluids, respectively (<i>P</i> < 0.001). Postoperative fluid volumes were 1550 versus 2000 mL, respectively, (<i>P</i> = 0.73), and LOSs were similar between the two groups (5 versus 5 days, <i>P</i> = 0.83). Mortality and complications, including acute kidney injuries, were similar. Delayed ambulation rates were similar overall. When stratified by preinjury ambulation status, SFM was associated with delayed ambulation for patients not walking independently before injury (<i>P</i> = 0.01), but RFM was not (<i>P</i> = 0.09).</p><p><strong>Conclusions: </strong>RFM seems to be safe in terms of laboratory results, complications, and disposition. SFM may lead to delayed ambulation for patients who are not walking independently before injury.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 3","pages":"e279"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/01/oi9-6-e279.PMC10356122.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9840274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of computed tomography in the detection of traumatic arthrotomies of the elbow: a cadaveric study.","authors":"Vinicius Ladeira Craveiro,&nbsp;Shasta Henderson,&nbsp;Henry Boateng,&nbsp;Matthew R Garner","doi":"10.1097/OI9.0000000000000275","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000275","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the use of computed tomography (CT) imaging as a diagnostic tool for elbow arthrotomies using a standardized cadaveric arthrotomy model.</p><p><strong>Method: </strong>Nineteen intact fresh frozen cadaver elbows were CT scanned using 2 mm cuts with sagittal and coronal reformats in the plane of the joint and used as controls. An elbow arthrotomy at the posterocentral arthroscopic portal site was performed in all specimens using a 4.5 millimeter trocar. After arthrotomy, all elbows underwent a second CT scan followed by a standard saline load test (SLT). Images were randomized and reviewed by 2 blinded, independent reviewers. Bimodal scoring was performed for each specimen with regard to the presence of an arthrotomy indicated by presence of air in the joint. Regarding the SLT, saline exiting the arthrotomy wound was considered a positive test.</p><p><strong>Results: </strong>CT scans were found to have 100% sensitivity and 86% specificity for diagnosing elbow arthrotomies. Interrater reliability calculated with Cohen kappa statistic was near perfect at r = 0.89. The SLT had a sensitivity of 79% when 20 mL was injected. A total of 25 mL of saline was required to be injected for a sensitivity greater than 95%.</p><p><strong>Conclusion: </strong>This study demonstrates that CT scan is a reliable and less technically demanding method of diagnosis arthrotomies with high interrater reliability and high sensitivity and with results comparable with SLT. This technique may be useful in centers where trained providers are not readily available to perform SLT. Clinical study is required to validate our results.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 3","pages":"e275"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0f/f9/oi9-6-e275.PMC10278719.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9709966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transparency films: intraoperative templating to prevent limb deformity.","authors":"Sasha Stine,&nbsp;Jonathan Daniel Joiner,&nbsp;Daniel Andersen,&nbsp;Eric Schweller,&nbsp;Rahul Vaidya","doi":"10.1097/OI9.0000000000000280","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000280","url":null,"abstract":"<p><p>Operative management of fractures and malunions can be challenging when restoring native anatomy is not straightforward. Comminuted fractures and managing deformity correction in the setting of osteolysis, callus, and even complete fracture healing must include careful planning. Preoperative planning has been popularized and taught as an integral part of a surgeon's skill set, with critical evaluation and assessment of the implemented plan being the final step in the process. We present a robust, reproducible, and cost-effective technique for intraoperative fracture fixation assessment with case examples, used routinely at our institution.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 3","pages":"e280"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/56/e5/oi9-6-e280.PMC10438797.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10406196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping crisis intervention course into social work academic curricula in Lebanon","authors":"Mansour Rania","doi":"10.17352/ojt.000042","DOIUrl":"https://doi.org/10.17352/ojt.000042","url":null,"abstract":"Social work is strongly presented to support and decrease the suffering of people living in a crisis. The call to intervene professionally in such cases is highly demanded by government institutions, non-governmental organizations, international organizations, and United Nations agencies, the main umbrella that enfolded practitioner social workers in Lebanon. Although Lebanon has experienced successive crises for more than forty years, there is no national strategy for social work or for intervention during crises that must be developed by the Ministry of Social Affairs in collaboration with relevant institutions such as academia. However, considering that the Lebanese universities that graduate social workers are the most important source for developing that strategy based on evidence-based research, unfortunately, they did not do any action. The purpose of this article is to describe how these universities are preparing students and developing their capacities to deal with the crisis consequences. The focus of this article is the presence of the Crisis Intervention (CI) course in the curricula of universities. Data were collected from all Lebanese universities’ websites and catalogs with undergraduate-level social work majors (N = 6). The data were issued from reviewing the curricula of the six universities that covered the N = 290 course. Data shows that the CI course does not enclose three out of six published curricula as well and results indicate a modest appearance of the crisis and its relevant courses. Accordingly, at the end of the research, a syllabus of the crisis intervention course is proposed and will be shared with the six Lebanese concerned Universities.","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136241433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurofilament light protein as a cerebrospinal fluid marker after whiplash trauma","authors":"Bunketorp Olof, Lindh Malin, Pujol-Calderón Fani, Rosengren Lars, Carlsson Gudrun Silverbåge, Z. Henrik","doi":"10.17352/ojt.000041","DOIUrl":"https://doi.org/10.17352/ojt.000041","url":null,"abstract":"The purpose was to investigate if a whiplash trauma may cause an increased concentration of the Neurofilament Light (NFL) protein, and if so; is this related to the injury severity and the radiological findings? Adult car occupants, with neck problems after rear-end collisions, were investigated in a study on Whiplash-Associated Disorders (WAD) in 1997-2001. The study protocol included a neurological examination, plain radiography and MRT of the cervical spine, and a lumbar puncture for Cerebrospinal Fluid (CSF) within six weeks after the accident. Similar CSF samples were also taken three and twelve months later. All CSF samples were analyzed for NFL. Of 52 subjects who entered the study, 43 completed it. The WAD grade was I in two of the 43 cases, II in 13, and III in 28. No one had radiological signs, indicating injuries to the cervical spine or spinal cord. Six subjects showed an increased NFL concentration at the primary examination. This was judged to be caused by whiplash trauma in three of them (7%). There was no relation between an increased NFL concentration and the number of pathological changes on plain radiographs or MRT. Neither was there a relation between the NFL concentration and the WAD grade. An increased NFL concentration can be found in some WAD patients. It might be difficult to relate such an increase to clinical or radiological findings. Further studies should investigate NFL as a marker for injuries to the central nervous system in whiplash trauma, including minimal traumatic brain injuries.","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73164324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}