MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Injury' source. Thu, 09 Feb 2012 00:02:29 +0100 http://www.medworm.com/index.php?rid=5585481&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311005134%2Fabstract%3Frss%3Dyes Olecranon fracture dislocations often create complex fractures of the proximal ulna including fragmented coronoid fractures. Olecranon fracture dislocations can occur in an anterior or a posterior direction. In an anterior olecranon (transolecranon) fracture dislocation, the radius and ulna both dislocate anteriorly, the forearm relationships remain intact and the coronoid fracture is usually simple. Posterior olecranon fracture dislocations and varus posteromedial rotational injuries can have greater coronoid fragmentation. Coronoid fragmentation can be difficult to repair with a posterior plate and screws alone. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5585481 Sat, 14 Jan 2012 14:37:34 +0100 5585481 http://www.medworm.com/index.php?rid=5585480&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311004645%2Fabstract%3Frss%3Dyes A Bosworth ankle fracture-dislocation is a dislocation of the distal fibular shaft posterior to the posterior tibial tubercle held fixed by an intact interosseous membrane. Approximately 60 cases have been reported in the literature since 1947, either as case reports or as small case series. Variants of this injury pattern include an intact fibula, associated ruptured deltoid ligaments, fractured medial malleolus, fractured posterior tibial tubercle, associated compartment syndrome and vascular injury. In most cases, there is a need to perform an open reduction as closed reduction methods often fail. Rarely, the fibula shaft fragment interposes between the posterior tibial lip fragments necessitating an open reduction and the exertion of ‘considerable force’ in order to achieve reducti... Injury journals http://www.medworm.com/rss/comments.php?id=5585480 Sat, 14 Jan 2012 14:37:33 +0100 5585480 http://www.medworm.com/index.php?rid=5585479&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311005316%2Fabstract%3Frss%3Dyes Abstract: The purpose of this study was to describe the results of extra-articular and intra-articular fractures, at the base of the first metacarpal, treated with closed reduction and percutaneous fixation with intermetacarpal Kirschner wires. Outcome was evaluated by experienced pain, functional outcome and radiographic indications for arthritis. In total, 25 patients with unstable fractures at the base of the first metacarpal underwent closed reduction and percutaneous fixation of the fracture. Prospectively collected data of 25 consecutive patients were evaluated retrospectively, assessing stability of fixation, operation time and the occurrence of fracture dislocation during and after treatment.All patients were assessed at 1, 3, 6 and 24months. Follow-up included questionnaires: func... Injury journals http://www.medworm.com/rss/comments.php?id=5585479 Sat, 14 Jan 2012 14:37:32 +0100 5585479 http://www.medworm.com/index.php?rid=5585478&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311005298%2Fabstract%3Frss%3Dyes Abstract: The purpose of this study was to report the medium-term results in 28 patients affected by closed displaced fractures of the neck of the fifth metacarpal bone (boxer's fracture) with an associated severe swelling of the hand, who were treated with percutaneous transverse K-wire pinning, to verify the effectiveness of this surgical treatment. We opted for this treatment in all cases in which malrotation of the fifth finger and volar angulation of the metacarpal head greater than 30° were associated with a severe swelling of the hand. All the patients were reviewed clinically and radiologically at an average of 25 months after surgery. At the final follow-up, no patient reported residual pain. All patients had full extension of the fifth finger, except two in whom we observed a li... Injury journals http://www.medworm.com/rss/comments.php?id=5585478 Sat, 14 Jan 2012 14:37:31 +0100 5585478 http://www.medworm.com/index.php?rid=5585477&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311005158%2Fabstract%3Frss%3Dyes Abstract: Introduction: The purpose of this study was to investigate serum levels of vitamin D in post-menopausal Korean women with a distal radius fracture (DRF) and to determine if there is any association between vitamin D levels and bone-related variables such as bone mineral densities (BMDs), serum parathyroid hormone (PTH) levels and several bone turnover markers.Materials and methods: The data of 104 postmenopausal women surgically treated for a distal radius fracture (DRF group) and 107 age-matched control patients without a fracture (control group) were compared. Serum vitamin D levels (25-hydroxycholecalciferol, 25(OH)D3) were compared between the groups with consideration of age and seasonal variations. BMDs, serum PTH and several bone turnover markers, including serum osteocalc... Injury journals http://www.medworm.com/rss/comments.php?id=5585477 Sat, 14 Jan 2012 14:37:30 +0100 5585477 http://www.medworm.com/index.php?rid=5585476&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS002013831100502X%2Fabstract%3Frss%3Dyes Conclusion: It might be concluded that PHC exhibit anti-inflammatory and protective effects in traumatic lung injury via the inhibition of the TLR4 pathway. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5585476 Sat, 14 Jan 2012 14:37:29 +0100 5585476 http://www.medworm.com/index.php?rid=5585475&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311004712%2Fabstract%3Frss%3Dyes Conclusion: The data show that the combination of angular stability with the possibility of variable polyaxial screw direction is a good concept for reduction and fixation of displaced proximal humeral fractures, but anatomical reduction and medial support remain important preconditions for a good outcome. However, a significantly lower rate of complications or better clinical outcome than that reported in the literature could not be found. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5585475 Sat, 14 Jan 2012 14:37:29 +0100 5585475 http://www.medworm.com/index.php?rid=5585474&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311004001%2Fabstract%3Frss%3Dyes Abstract: Introduction: Fracture management in polytrauma patients has favoured early definitive fracture fixation with some authors advocating a staged management approach in these potentially unstable patients. We aimed to investigate the timing of surgical fracture stabilisation in polytrauma patients with significant orthopaedic injuries in a Level 1 trauma unit in South Africa (RSA) and to compare its performance with Level 1 trauma units in the USA and Europe.Materials and methods: A retrospective review was performed extracting polytrauma patients with a New Injury Severity Score (NISS)≥15, with significant pelvic or long bone fractures managed surgically. We compared these data with recently published data from the USA and Europe.Results: Over a 3 year period pedestrian (46.3%) a... Injury journals http://www.medworm.com/rss/comments.php?id=5585474 Sat, 14 Jan 2012 14:37:29 +0100 5585474 http://www.medworm.com/index.php?rid=5585473&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311003809%2Fabstract%3Frss%3Dyes Abstract: Background: Numerous surgical methods are used to treat acromioclavicular (AC) joint dislocations, and an anatomical reconstruction using a free tendon graft has attracted considerable attention, particularly for chronic cases. The purpose of this study was to introduce the results of lateral half conjoined tendon (LHCT) and coracoacromial ligament (CAL) transfer for chronic type V injuries.Materials and methods: A retrospective evaluation was performed on the clinical and radiographic outcomes of the 12 patients who underwent LHCT and CAL transfer for chronic type V AC injuries and had been followed for 2 years postoperatively. All 12 patients were males with a mean age of 37.3±7.7 years (range: 26–49 years) at surgery. The causes of the injury were traffic accidents (five), ... Injury journals http://www.medworm.com/rss/comments.php?id=5585473 Sat, 14 Jan 2012 14:37:28 +0100 5585473 http://www.medworm.com/index.php?rid=5585472&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311003597%2Fabstract%3Frss%3Dyes We present a cadaveric study and a technical tip to assist in the accurate and reproducible placement of one such plate.Study: We placed 25-g needles in the distal radioulnar joint and radiocarpal joint and measured the distance from these needles to a DVR plate in its optimal position. This distance measured 5mm, corresponding to the width of the depth gauge handle. Placing this next to needles in these joints can help pre-plan the most distal and ulnar extent of the plate allowing for reproducible optimal positioning of the DVR plate.Technique: The technique developed uses the existing kit and is simple and easy to build into one's existing fixation technique. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5585472 Sat, 14 Jan 2012 14:37:27 +0100 5585472 http://www.medworm.com/index.php?rid=5585471&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311003512%2Fabstract%3Frss%3Dyes Conclusions: There is variation in compression along the length of the standard Acutrak 2 screw and the maximum compression was obtained at the mid-point of the screw. From this study, we would recommend when using an Acutrak 2 screw for internal fixation of scaphoid fractures, to attain maximum compressive force, place the fracture at the mid-point of the Acutrak screw. If this is not possible, then place the fracture towards the proximal half of the screw. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5585471 Sat, 14 Jan 2012 14:37:27 +0100 5585471 http://www.medworm.com/index.php?rid=5585470&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311003469%2Fabstract%3Frss%3Dyes Abstract: Introduction: Pronator quadratus (PQ) is an important contributor to forearm pronation, and there is concern that volar plating of a distal radius fracture (DRF) may damage the PQ function. The purpose of this study was to determine whether isokinetic pronation strength would decrease considerably after volar locking plating of a DRF, and whether clinical outcomes would be affected by any pronation strength decrease.Materials and methods: Thirty-four patients of mean age of 55 years (range, 21–74 years) underwent bilateral isokinetic testing at 6 months and 1 year after open reduction and internal fixation using volar plating. Isokinetic pronation and supination strengths were compared between the operated and normal sides. Clinical outcomes such as grip strengths, range of mot... Injury journals http://www.medworm.com/rss/comments.php?id=5585470 Sat, 14 Jan 2012 14:37:26 +0100 5585470 http://www.medworm.com/index.php?rid=5585469&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002786%2Fabstract%3Frss%3Dyes Conclusion: 2×AIS>2 captured the greatest percentage of the worst outcomes and significantly larger % of the clinically defined polytrauma patients. 2×AIS>2 has higher accuracy and precision in defining polytrauma than ISS>15 and ISS>17. This simple, retrospectively also reproducible criteria warrants larger scale validation. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5585469 Sat, 14 Jan 2012 14:37:25 +0100 5585469 http://www.medworm.com/index.php?rid=5585468&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002312%2Fabstract%3Frss%3Dyes Abstract: Alveolar IL-8 has been reported to early identify patients at-risk to develop ARDS. However, it remains unknown how alveolar IL-8 is related to pulmonary and systemic inflammation in patients predisposed for ARDS. We studied 24 patients 2–6h after multiple trauma. Patients with IL-8 >200pg/ml in bronchoalveolar lavage (BAL) were assigned to the group at high risk for ARDS (H, n=8) and patients with BAL IL-8 (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5585468 Sat, 14 Jan 2012 14:37:25 +0100 5585468 http://www.medworm.com/index.php?rid=5585467&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002269%2Fabstract%3Frss%3Dyes Conclusions: There is a significant correlation between obesity, underweight, and increased mortality in polytraumatized patients. Efforts to promote optimal body weight may reduce not only the risk of chronic diseases but also the risk of polytrauma mortality amongst obese and underweight individuals. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5585467 Sat, 14 Jan 2012 14:37:24 +0100 5585467 http://www.medworm.com/index.php?rid=5585466&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002257%2Fabstract%3Frss%3Dyes Conclusion: Splenic embolisation does not alter the measured immunologic parameters. The absence of sensitive markers for splenic immune function limits the ability to assess the impact of embolisation for trauma. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5585466 Sat, 14 Jan 2012 14:37:23 +0100 5585466 http://www.medworm.com/index.php?rid=5585465&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002142%2Fabstract%3Frss%3Dyes Abstract: The traditional treatment of severely impacted fractures of the distal radius involves bridging external fixation and maintaining reduction by applying continuous traction. The recent technique using fixed-angle screws within volar plates is reported restore the radial length and the articular profile whilst avoiding joint distraction. It is also believed to produce better and quicker clinical results. To test these claims, we carried out a randomised controlled comparison of the efficiency of external fixation (EF) ‘versus’ open reduction and internal fixation (ORIF) in treating severely impacted fractures of the distal radius. A total of 39 patients were treated with EF, eventually associated with percutaneous pinning, whereas 36 underwent ORIF with a locked volar plate. Th... Injury journals http://www.medworm.com/rss/comments.php?id=5585465 Sat, 14 Jan 2012 14:37:23 +0100 5585465 http://www.medworm.com/index.php?rid=5585464&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001756%2Fabstract%3Frss%3Dyes Conclusions: The AWE can vary amongst species. This study determined the relationship to allow the comparison of rabbit and human IAP. The proposed mathematical function is important for the advancement of interpretation and understanding of animal research into IAH and ACS. We recommend developing model-specific functions comparing individual animal models’ IAP and that of humans. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5585464 Sat, 14 Jan 2012 14:37:22 +0100 5585464 http://www.medworm.com/index.php?rid=5585463&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001732%2Fabstract%3Frss%3Dyes This article aims to present 15 patients with a fracture of the capitulum humeri treated with the same implant, fine-threaded Kirschner wires (FFS). Besides range of motion and grip strength, outcome measurements include the following scores: the Mayo Elbow Performance index (MEPI); the American Shoulder and Elbow Surgeons’ Elbow Assessment (ASES) Form; the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire; and the Broberg–Morrey score.Using the modified Bryan and Morrey classification, there were seven type-I injuries, three type-II, two type-III and three type-IV fractures. In addition to fractures of the capitellum, five patients were diagnosed with a complex ligamentous injury and three had suffered radial head fractures. After a minimum follow-up of 12 months, we obt... Injury journals http://www.medworm.com/rss/comments.php?id=5585463 Sat, 14 Jan 2012 14:37:21 +0100 5585463 http://www.medworm.com/index.php?rid=5585462&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001720%2Fabstract%3Frss%3Dyes This article evaluates the prevalence of clavicular fractures, estimates the number of cases requiring operative treatment, evaluates whether removal of implant is a frequent necessity and compares the final functional outcome of the operative and non-operative groups.Patients and methods: Between November 2005 and November 2007, patients with clavicular fractures were eligible for participation. Patients below 18 years of age and those with pathological fractures were excluded. Demographic details, mechanism of injury, operative versus non-operative treatment, radiographic classification (Allman system), complications, implant removal and functional outcome using the University of California, Los Angeles (UCLA) shoulder-rating score were documented and analysed.Results: Out of 16,280 frac... Injury journals http://www.medworm.com/rss/comments.php?id=5585462 Sat, 14 Jan 2012 14:37:21 +0100 5585462 http://www.medworm.com/index.php?rid=5585461&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001586%2Fabstract%3Frss%3Dyes Abstract: Introduction: Angular stable osteosynthesis has become the gold standard in the operative treatment of proximal humeral fractures. The aim of this article is to determine the indications for osteosynthesis versus primary arthroplasty based on clinical and radiological parameters.Methods: A total of 368 surgically treated proximal humeral fractures were reviewed. Preoperative X-rays were used to evaluate the displacement and vascularity of the humeral head (according to the Hertel criteria) and the AO (Arbeitsgemeinschaft für Osteosynthesefragen) fracture type. Postoperative X-rays were analysed to assess the quality of the reduction, the reconstruction of the medial hinge and the displacement of the tuberosities. Follow-up X-rays were used to evaluate healing progress, the occur... Injury journals http://www.medworm.com/rss/comments.php?id=5585461 Sat, 14 Jan 2012 14:37:20 +0100 5585461 http://www.medworm.com/index.php?rid=5585460&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001574%2Fabstract%3Frss%3Dyes Conclusion: An AC plate is a useful technique in acromio-clavicular dislocations because it is easy to implant, requires mini-invasive access and results in early resumption of normal activity. MRI can be used to evaluate healing of coraco-clavicular ligaments. A long-term follow-up study is, however, warranted to assess the likelihood of recurrence.Level of evidence: Level IV, therapeutic cases series. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5585460 Sat, 14 Jan 2012 14:37:19 +0100 5585460 http://www.medworm.com/index.php?rid=5585459&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001422%2Fabstract%3Frss%3Dyes Conclusion: A displaced dorsal rim fracture does not appear to affect outcomes adversely after volar locking plate fixation of dorsally displaced DRFs. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5585459 Sat, 14 Jan 2012 14:37:18 +0100 5585459 http://www.medworm.com/index.php?rid=5585458&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001379%2Fabstract%3Frss%3Dyes Abstract: Today multiple trauma still is associated with a high mortality. Although severe open fractures and wounds can give rise to local infections and sepsis, the overall infection rate of multiply injured patients is surprisingly low. We have investigated serum of multiply injured patients with respect to antibacterial properties and screened for host defence peptides (HDP) that constitute a class of fast acting and rapidly available molecules preventing bacterial infection.Serum specimens were obtained from multiply injured patients. Radial diffusion assays were performed to investigate antimicrobial properties. Ultrafiltration and heat-inactivation were used to rule out antimicrobial activity of large proteins i.e. complement factors. ELISA was performed to analyse serum concentrati... Injury journals http://www.medworm.com/rss/comments.php?id=5585458 Sat, 14 Jan 2012 14:37:17 +0100 5585458 http://www.medworm.com/index.php?rid=5585457&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002294%2Fabstract%3Frss%3Dyes Abstract: Haemorrhagic shock and resuscitation (HS/R) following major trauma results in a global ischaemia and reperfusion injury that may lead to multiple organ dysfunction syndrome (MODS). Systemic activation of the immune system is fundamental to the development of MODS in this context, and shares many features in common with the systemic inflammatory response syndrome (SIRS) that complicates sepsis. An important advancement in the understanding of the innate response to infection involved the identification of mammalian toll-like receptors (TLRs) expressed on cells of the immune system. Ten TLR homologues have been identified in humans and toll-like receptor-4 (TLR4) has been studied most intensively. Initially found to recognise bacterial lipopolysaccharide (LPS), it has also recently... Injury journals http://www.medworm.com/rss/comments.php?id=5585457 Sat, 14 Jan 2012 14:37:16 +0100 5585457 http://www.medworm.com/index.php?rid=5585456&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311005857%2Fabstract%3Frss%3Dyes The face of trauma in Europe continues to be mainly represented by patients with blunt injuries. Even in 2012, multiply injured patients are usually younger and male gender is prevailing. Scoring of these patients is an important factor for clinicians and for reimbursement of care. Anatomic scoring systems continue to be used as gold standard. Despite well described shortcomings, the abbreviated injury scale and the injury severity score continue to be the most relevant scales to assess injury severity. However, since the initial descriptions of the AIS/ISS, there have been significant developments in trauma management techniques, both in the preventive and acute-care phases of trauma management. Since the development of the score, mortality rates dropped from 30% and more to less than 15%... Injury journals http://www.medworm.com/rss/comments.php?id=5585456 Sat, 14 Jan 2012 14:37:16 +0100 5585456 http://www.medworm.com/index.php?rid=5585455&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311005997%2Fabstract%3Frss%3Dyes (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5585455 Sat, 14 Jan 2012 14:37:15 +0100 5585455 http://www.medworm.com/index.php?rid=5390805&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000726%2Fabstract%3Frss%3Dyes In this study the authors do not recommend the utilisation of CPc in case of severe A3.1, A3.2 and A3.3 fractures, but propose to utilise PMMA. At the same time they recommend to associate posterior instrumentation with kyphoplasty for A3.3 fractures. This correlates with our findings, because we also recommend adding further techniques like posterior instrumentation for the treatment of A3.2 and A3.3 fractures. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390805 Thu, 10 Nov 2011 17:55:25 +0100 5390805 http://www.medworm.com/index.php?rid=5390804&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS002013831000851X%2Fabstract%3Frss%3Dyes Abstract: We studied 80 patients (56 females) with an average age of 84 years (range: 80–94). All patients were suffering from osteoporosis (1 or 2 Singh score) and had an unstable intertrochanteric fracture, defined as a fracture with three fragments or more. Patients were divided into group A (40 patients), treated by a cement augmentation technique, and group B (40 patients) treated by Gamma Nail conventional technique. Augmentation was performed with MetilMetacrilate (Mendec Spine, Tecres) inserted through the cannulated cephalic screw at its apex. Parameters such as the length of operating time, early functional recovery using the Harris hip score, assessment with radiography of the TAD index, and development of implant-related complications were evaluated. The Health and Human Serv... Injury journals http://www.medworm.com/rss/comments.php?id=5390804 Thu, 10 Nov 2011 17:55:25 +0100 5390804 http://www.medworm.com/index.php?rid=5390803&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310007680%2Fabstract%3Frss%3Dyes We read the article dealing with cement augmentation of the gamma nail with great interest. The authors compared two groups each with 40 patients in a prospective randomised setting. One group received 2–3ml of a vertebroplasty-cement which was injected through the cannulated screw. Apart from one case of cement leakage within the hip joint there were no more complications reported and almost both groups had a similar outcome. We would like to congratulate the authors to this work. However, a few questions and remarks remain. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390803 Thu, 10 Nov 2011 17:55:25 +0100 5390803 http://www.medworm.com/index.php?rid=5390802&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS002013831000762X%2Fabstract%3Frss%3Dyes This article may give unintended wrong messages about performing kyphoplasty is safe in Magerl type A3.3 fractures which would be actually dangerous. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390802 Thu, 10 Nov 2011 17:55:25 +0100 5390802 http://www.medworm.com/index.php?rid=5390801&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310003761%2Fabstract%3Frss%3Dyes It is now established that surgical intervention for hip fracture should be performed without delay to decrease mortality and improve outcome. This remains essential in the elderly population, the most commonly encountered population presenting with this type of fracture. With such need for rapid intervention, several concerns emerge regarding elderly patients who suffer from various co-morbidities and receive several long-term treatment modalities. One such concern is the concurrent use of clopidogrel for various cardiovascular indications, as this creates a dilemma that we wish to herein review, describe, and reflect upon. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390801 Thu, 10 Nov 2011 17:55:25 +0100 5390801 http://www.medworm.com/index.php?rid=5390800&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001173%2Fabstract%3Frss%3Dyes A 44-year-old Caucasian male was treated with external fixation to stabilise a proximal tibia fracture with an articular split. Postoperatively, the patient became hypersensitive to pain in both the injured and uninjured legs. Intramuscular pressures (IMPs) were measured in all four compartments of the injured extremity resulting in 40-mmHg perfusion pressure in all four compartments. (Perfusion pressure was defined as diastolic blood pressure minus IMP.) (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390800 Thu, 10 Nov 2011 17:55:25 +0100 5390800 http://www.medworm.com/index.php?rid=5390799&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001835%2Fabstract%3Frss%3Dyes Although intramedullary nailing has been the treatment of choice for diaphyseal tibial fractures, its role in the management of fractures occurring at the proximal tibial metaphysis remains controversial, as high complication rates that mostly refer to unsuccessful reduction and malalignment have been reported. To overcome these problems and improve outcomes, certain modifications to the standard operative technique have been proposed, such as the use of blocking screws, additional buttress plate, different patient positioning, and extended parapatellar or retropatellar approaches. Remarkably, the role of location of the entry portal for the nail in the coronal plane in achieving and maintaining fracture reduction has not been thoroughly investigated. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390799 Thu, 10 Nov 2011 17:55:25 +0100 5390799 http://www.medworm.com/index.php?rid=5390798&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311004517%2Fabstract%3Frss%3Dyes Conclusion: Hoffa fractures are intra-articular and are best treated by anatomical reduction and rigid fixation followed by early mobilisation. Open reduction increases the chances of achieving anatomical reduction and gives satisfactory functional results when coupled with aggressive rehabilitation. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390798 Thu, 10 Nov 2011 17:55:25 +0100 5390798 http://www.medworm.com/index.php?rid=5390797&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311003962%2Fabstract%3Frss%3Dyes Conclusion: We conclude that although bone quality may be diminished in the elderly this does not influence the occurrence of nonunion. These results indicate that the use of BMD measurements preoperatively to identify osteoporosis as a possible risk factor of nonunion has no clinical value. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390797 Thu, 10 Nov 2011 17:55:25 +0100 5390797 http://www.medworm.com/index.php?rid=5390796&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311003500%2Fabstract%3Frss%3Dyes Summary: Pertrochanteric fractures are a rising major health-care problem in the elderly and their operative stabilisation techniques are still under discussion. Furthermore, complications like cut-out are reported to be high and implant failure often is associated with poor bone quality. The PFNA® with perforated blade offers a possibility for standardised cement augmentation using a polymethylmethacrylate (PMMA) cement which is injected through the perforated blade to enlarge the load-bearing surface and to diminish the stresses on the trabecular bone. The current prospective multicentre study was undertaken to evaluate the technical performance and the early clinical results of this new device.In nine European clinics, 59 patients (45 female, mean age 84.5 years) suffering from an oste... Injury journals http://www.medworm.com/rss/comments.php?id=5390796 Thu, 10 Nov 2011 17:55:25 +0100 5390796 http://www.medworm.com/index.php?rid=5390795&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311003482%2Fabstract%3Frss%3Dyes Conclusions: The low rate of performance metric reporting could have an impact on the reader's ability to determine the reproducibility of the results published. We propose a new section on performance metrics reporting for editors to include in their instructions to authors. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390795 Thu, 10 Nov 2011 17:55:25 +0100 5390795 http://www.medworm.com/index.php?rid=5390794&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311003457%2Fabstract%3Frss%3Dyes Conclusion: This study describes the impact of LLA of different levels on patients’ lives. The results indicate that patients with a TKA have a better physical quality of life than those with an AKA and, therefore, support the surgical strategy of maintaining maximum length and performing TKA in preference to AKA, where possible. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390794 Thu, 10 Nov 2011 17:55:25 +0100 5390794 http://www.medworm.com/index.php?rid=5390793&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002397%2Fabstract%3Frss%3Dyes Abstract: Distraction osteogenesis (DO) has been accepted as an effective technique for bone lengthening. However, the long treatment period and possible fibrous union or nonunion hampers its further clinical application. Bone regeneration in DO involves multiple stages of repair and coordinated action of multiple cell types. Consequently, it may be possible to enhance bone regeneration through treatment strategies that target more than one repair process or cell types. The goal of this study was to determine the combined effects of recombinant human bone morephogenetic protein 2 (rhBMP-2) and NEL-like molecule-1 (NELL-1) on bone formation in DO. Unilateral tibiae in 48 rabbits were lengthened for 7days at a rate of 2mm/day after 3-day lag. At the end of distraction, the animals were rando... Injury journals http://www.medworm.com/rss/comments.php?id=5390793 Thu, 10 Nov 2011 17:55:25 +0100 5390793 http://www.medworm.com/index.php?rid=5390792&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002361%2Fabstract%3Frss%3Dyes Abstract: We asked whether locally applied recombinant-Bone Morphogenic Protein-2 (rh-BMP-2) with an absorbable Type I collagen sponge (ACS) carrier could enhance the consolidation phase in a callotasis model. We performed unilateral transverse osteotomy of the tibia in 21 immature male rabbits. After a latency period of 7 days, a 3-weeks distraction was begun at a rate of 0.5mm/12h. At the end of the distraction period (Day 28) animals were randomly divided into three groups and underwent a second surgical procedure: 6 rabbits in Group I (Control group; the callus was exposed and nothing was added), 6 rabbits in Group II (ACS group; receiving the absorbable collagen sponge soaked with saline) and 9 rabbits in Group III (rh-BMP-2/ACS group; receiving the ACS soaked with 100μg/kg of rh-BMP... Injury journals http://www.medworm.com/rss/comments.php?id=5390792 Thu, 10 Nov 2011 17:55:25 +0100 5390792 http://www.medworm.com/index.php?rid=5390791&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002270%2Fabstract%3Frss%3Dyes Abstract: Introduction: Despite the lack of robust evidence, numerous different “track and trigger” warning systems have been implemented. These have only been validated in an emergency medical admissions setting. The Modified Early Warning Score (MEWS) is the chosen track and trigger system used in the University Hospitals of Leicester trauma unit, but has not been validated in trauma patients. A considerable proportion of all trauma admissions are elderly patients with proximal femoral fractures and significant co-morbidities. Early recognition of physiological deterioration and prompt action could therefore be lifesaving in this patient group.Aim: To identify whether the implementation of the MEWS system coupled with a critical care outreach service resulted in a reduction in mortal... Injury journals http://www.medworm.com/rss/comments.php?id=5390791 Thu, 10 Nov 2011 17:55:25 +0100 5390791 http://www.medworm.com/index.php?rid=5390790&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS002013831100221X%2Fabstract%3Frss%3Dyes Abstract: Introduction: External fixation is the primary choice of temporary fracture stabilisation for specific polytrauma patients. Adequate initial fracture healing requires sufficient stability at the fracture site. The purpose of this study was to compare the rigidity of the Dynafix DFS® Standard Fixator (4 joints) with the Orthofix ProCallus Fixator® (2 joints), which differ in possibilities for adapting the configuration for clinical needs.Materials and methods: Both devices were tested 10 times in a standardised model. In steps of 10N, loading was increased to a maximum of 160N in parallel, transversal and axial direction (distraction and compression). Translation resultant and rotation resultant were calculated.Results: With a force of 100N in parallel direction the mean transla... Injury journals http://www.medworm.com/rss/comments.php?id=5390790 Thu, 10 Nov 2011 17:55:25 +0100 5390790 http://www.medworm.com/index.php?rid=5390789&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002191%2Fabstract%3Frss%3Dyes Conclusions: For large population-based surveillance research into orthopaedic injury the SF-12 provides a valid and versatile tool. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390789 Thu, 10 Nov 2011 17:55:25 +0100 5390789 http://www.medworm.com/index.php?rid=5390788&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001914%2Fabstract%3Frss%3Dyes We examined 85 patients, including 61 men and 24 women, with a collective mean age of 46 years (range: 18–84 years). Thirty-nine patients had never smoked (G1) and 45 patients were current or previous smokers (G2).The G2 group displayed a significantly increased risk for delayed union or nonunion (G1=3 patients, G2=18 patients; P=0.0007) and increased time required for fracture healing (mean times: G1=11.9 weeks, G2=17.4 weeks; p=0.003) and a markedly increased time out of work (mean times: G1=16.1 weeks, G2=21.5 weeks; p=0.1177 (not significant)). The 18 negatively affected patients in G2 displayed a significant increase in the time required for fracture healing and time out of work (26 weeks (p=0.02) and 31 weeks (p=0.03), respectively). G2 group members had a 3- to 18-fold higher risk... Injury journals http://www.medworm.com/rss/comments.php?id=5390788 Thu, 10 Nov 2011 17:55:25 +0100 5390788 http://www.medworm.com/index.php?rid=5390787&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001380%2Fabstract%3Frss%3Dyes Abstract: Non-union occurs in 5–10% of all fractures and is caused by a variety of mechanical and biological factors. Stable fixation is essential and many authors recommend the addition of bone graft. Our aim was to evaluate the results of internal fixation using Judet decortication and compression plating for long bone fractures and assess the impact of bone grafting on union rates. Our study group comprised all the patients undergoing compression plate fixation under a single surgeon over a fourteen year period (n=96). AO principles were used and the standard technique involved Judet decortication, compression plating and lag screws. Autologous bone graft was harvested from the iliac crest. The mean age was 45 years and 62% were male. The fracture site was the clavicle (n=20); humerus... Injury journals http://www.medworm.com/rss/comments.php?id=5390787 Thu, 10 Nov 2011 17:55:25 +0100 5390787 http://www.medworm.com/index.php?rid=5390786&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001215%2Fabstract%3Frss%3Dyes Conclusion: Muscle strength improves after multiple ligament reconstruction. There is no difference in outcomes for different muscle groups at 2 years. Deficits persist in comparison with the uninjured limb. A proportion of patients will be unable to return to the pre-injury occupation or sporting ability. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390786 Thu, 10 Nov 2011 17:55:25 +0100 5390786 http://www.medworm.com/index.php?rid=5390785&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001203%2Fabstract%3Frss%3Dyes Conclusions: The added value of 3D CT after 2D CT is limited and does not significantly improve reliability of characterisation and classification of tibial plateau fractures. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390785 Thu, 10 Nov 2011 17:55:25 +0100 5390785 http://www.medworm.com/index.php?rid=5390784&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311005092%2Fabstract%3Frss%3Dyes Abstract: The aim of the present study was to comparatively analyse certain outcome measures of open tibial fractures, stratified per grade of open injury and method of treatment. For this purpose, a systematic review of the English literature from 1990 until 2010 was undertaken, comprising 32 eligible articles reporting on 3060 open tibial fractures. Outcome measures included rates of union progress (early union, delayed union, late union and non-union rates) and certain complication rates (deep infection, compartment syndrome and amputation rates). Statistical heterogeneity across component studies was detected with the use of Cochran chi-square and I2 tests. In the absence of significant statistical heterogeneity a pooled estimate of effect size for each outcome/complication of interest... Injury journals http://www.medworm.com/rss/comments.php?id=5390784 Thu, 10 Nov 2011 17:55:24 +0100 5390784 http://www.medworm.com/index.php?rid=5390783&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311004542%2Fabstract%3Frss%3Dyes Abstract: Acute compartment syndrome (ACS) in tibial diaphyseal fractures has been associated with such complications as infection, delayed fracture healing or non-union, sensory and motor deficits, deformities, and poor functional outcome. Essential condition of an uncomplicated recovery is early diagnosis with prompt decompression. A comprehensive review of the literature was performed to evaluate the impact of compartment syndrome and leg fasciotomies on the time to fracture union and the incidence of delayed union and non-union in tibial diaphyseal fractures. A total of 16 articles, which included 245 tibial fractures complicated with compartment syndrome were analysed. There were statistically significant differences in the time to healing, being longer by 4.90 weeks (p (Source: Injur... Injury journals http://www.medworm.com/rss/comments.php?id=5390783 Thu, 10 Nov 2011 17:55:24 +0100 5390783 http://www.medworm.com/index.php?rid=5390782&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311005067%2Fabstract%3Frss%3Dyes Fractures of the pelvis continue to be challenging cases for most trauma surgeons. Disruption of the pelvic ring due to severe pelvic trauma may result in distortion of pelvic symmetry and pelvic instability. Complications, which are related to suboptimal bone healing and to various degrees of inability of load transfer from the trunk to the lower limbs, render the anatomical restoration and operative stabilisation of the pelvic ring an imperative aim. It has been shown that following pelvic injuries the long term functional outcome is closely associated with the anatomical reduction of the pelvic ring. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390782 Thu, 10 Nov 2011 17:55:24 +0100 5390782 http://www.medworm.com/index.php?rid=5390781&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311004682%2Fabstract%3Frss%3Dyes Peter Templeton, consultant trauma and children's orthopaedic surgeon at Leeds General Infirmary, a great colleague and family friend died suddenly and unexpectedly on 21st May 2011. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390781 Thu, 10 Nov 2011 17:55:24 +0100 5390781 http://www.medworm.com/index.php?rid=5390780&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311004852%2Fabstract%3Frss%3Dyes (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5390780 Thu, 10 Nov 2011 17:55:24 +0100 5390780 http://www.medworm.com/index.php?rid=5276536&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002245%2Fabstract%3Frss%3Dyes We thank the authors for pointing out the differences in pre-hospital management within Australia. The article, ‘Pre-hospital and in-hospital parameters and outcomes in patients with traumatic brain injury: A comparison between German and Australian trauma registries’, published in Injury last year (Int. J. Care Injured 41 (2010) 901–906) used data solely from the Australian state of Victoria. We are aware of the differences between Australian states in management of trauma and apologise for calling the Victorian model a unified Australian model. Nonetheless, because Australian states act rather autonomously in pre-hospital management, a state can be interpreted as a closed population and compared with other populations, such as Germany. A comparison between Germany and populations f... Injury journals http://www.medworm.com/rss/comments.php?id=5276536 Mon, 03 Oct 2011 16:03:48 +0100 5276536 http://www.medworm.com/index.php?rid=5276535&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002233%2Fabstract%3Frss%3Dyes We read with interest the article “The invisible nail: A technique report of treatment of a pathological humerus fracture a radiolucent intra medullary nail”. We would like to highlight certain shortcomings of this nail. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276535 Mon, 03 Oct 2011 16:03:48 +0100 5276535 http://www.medworm.com/index.php?rid=5276534&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001537%2Fabstract%3Frss%3Dyes Dear Editor, Recently in Your journal a global expert panel was convened to develop evidence-based recommendations describing the use of negative pressure wound therapy in traumatic wounds and reconstructive procedures. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276534 Mon, 03 Oct 2011 16:03:48 +0100 5276534 http://www.medworm.com/index.php?rid=5276533&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001410%2Fabstract%3Frss%3Dyes Adequate preparation of the nerve stumps prior to nerve coaptation or grafting is vital for obtaining satisfactory results in secondary peripheral nerve repairs. Resection of the post-traumatic neuroma is needed in order to get rid of the blocking fibrosis and reaproximate axonal tubes. Freshing the nerve edges and resection of the neuroma must be performed with precision in order to minimize the nerve gap and to reach healthy axonal tubes (preinjury segment). Well trained surgeon familiar to peripheral nerve structure and adequate magnification is needed for this purpose. As a secondary aid and a novel approach we are using vital methylene blue staining in order to confirm and documentize that we have reached the healthy nerve structure. Vital staining of nerves by methylene blue was firs... Injury journals http://www.medworm.com/rss/comments.php?id=5276533 Mon, 03 Oct 2011 16:03:48 +0100 5276533 http://www.medworm.com/index.php?rid=5276532&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000271%2Fabstract%3Frss%3Dyes There are around 76,000 cases of hip fractures a year in the United Kingdom, with the majority being managed operatively. This case reports the migration of the entire lag screw into the pelvis. Although medial migration of the screw has been reported as a rare complication of the Intramedullary Hip Screw®, it has never before been reported to travel entirely into the pelvis. The patient and the next of kin have consented to the case report and the radiographs being published (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276532 Mon, 03 Oct 2011 16:03:48 +0100 5276532 http://www.medworm.com/index.php?rid=5276531&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310005899%2Fabstract%3Frss%3Dyes The all-terrain vehicle (ATV) is a recreational object that has achieved enormous popularity over the past few years and has contributed greatly to the number of injuries in children. ATVs are three-wheeled or four-wheeled motorised vehicles that were originally designed for farming, logging and other off-road rural applications. They are made with low-pressure tyres, with seats designed for straddling, handlebars and motorcycle-type engines. They weigh between 100 and 600 pounds and can reach speeds of 30–50milesh−1. As a result of their design, they have a high centre of gravity and poor or no suspension system. The ATV is designed for one person in order for the driver to make quick weight distribution adjustments to maintain balance and control. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276531 Mon, 03 Oct 2011 16:03:48 +0100 5276531 http://www.medworm.com/index.php?rid=5276530&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310008545%2Fabstract%3Frss%3Dyes Titanium locking plates are commonly used for periarticular fracture fixation. Early clinical results have been encouraging in their use in treating distal femur and proximal tibia fractures, particularly with the advent of instrumentation for submuscular insertion and percutaneous fixation. A unique feature of titanium locking plates is the phenomenon of cold-welded screws due to titanium being a softer metal. The removal of cold-welded screws in clinical practice can be frustrating. However, it is not commonly reported, as it is often viewed as an insignificant surgical event. Manufacturers promote a strict adherence to using a torque-limiting screwdriver to decrease the risk of cold-welding. Failure to be able to remove titanium screws can be attributed to fracturing or deforming the sc... Injury journals http://www.medworm.com/rss/comments.php?id=5276530 Mon, 03 Oct 2011 16:03:48 +0100 5276530 http://www.medworm.com/index.php?rid=5276529&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311003445%2Fabstract%3Frss%3Dyes This study aims to test, compare and evaluate the bone–screw interface strengths, the fatigue strengths, and the stabilities of our newly designed expansive cannulated screw (ECS) and the common cannulated compression screw (CCS) in the fixation of femoral neck fracture, which is a summary of recent research.Methods: Twenty-four pairs (48) of fresh femur specimens were randomly divided into four groups with six pairs (12) in each. To simulate one-legged standing, the maximum compressive strength and the single-screw axial pull-out force were compared between the fixed femoral necks treated with two ECSs and two CCSs, two ECSs and three CCSs or three ECSs and three CCSs, respectively. The screws were also subjected to 1000000 cycles of a loaded fatigue test and the results were recorded.F... Injury journals http://www.medworm.com/rss/comments.php?id=5276529 Mon, 03 Oct 2011 16:03:48 +0100 5276529 http://www.medworm.com/index.php?rid=5276528&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311003019%2Fabstract%3Frss%3Dyes We present a series of 15 proximal tibial and 11 distal femoral fractures treated with total knee arthroplasty at over mean follow-up period of 38.8 months. The mean age of the patients was 80 years. The choice of the implant and level of constraint was determined as per the nature of injury and preference of the surgeon dealing with the fracture. Patients were allowed rapid mobilisation with immediate full weight-bearing. Good clinical results were achieved with fracture healing, sound fixation and well-aligned flexible knees. Mean Knee Society knee score was 90.2; Knee Society function score was 35.5; Oxford Knee score was 39.5; and Short Form (SF)-36 physical function score was 37.3 and mental score 50.6. Good correlation was noted between Knee society knee score and SF-36 physical func... Injury journals http://www.medworm.com/rss/comments.php?id=5276528 Mon, 03 Oct 2011 16:03:48 +0100 5276528 http://www.medworm.com/index.php?rid=5276527&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002774%2Fabstract%3Frss%3Dyes Abstract: Background: The study aim was to determine the outcome, in relation to military service in UK military combat amputees.Patients and methods: Casualties were assessed at mean 2.4 years after injury and graded by a Functional Activity Assessment (FAA) ranging from 1 (fully fit) to 5 (unfit all duties) to score vocational functional outcome. ISS were calculated and the patients were categorised as having unilateral or multiple amputations. The Short Form-36 Health Survey (SF-36) was completed.Results: Of the 52, 8 patients had left the forces by medical discharge, with 44 continuing to serve. 33 of the 44 had returned to work. 50 patients had FAA grades and were at least 7.6 months post-injury. No patients were graded as FAA1, 8 as FAA2, 18 as FAA3, 19 as FAA4 and 5 as FAA5. There w... Injury journals http://www.medworm.com/rss/comments.php?id=5276527 Mon, 03 Oct 2011 16:03:48 +0100 5276527 http://www.medworm.com/index.php?rid=5276526&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002610%2Fabstract%3Frss%3Dyes Abstract: Dynamisation of a previously interlocked intramedullary nail is believed to stimulate an osteogenic response due to increased load across the fracture site. The purpose of this study was to retrospectively investigate fracture patterns that could tolerate dynamisation without the risk of major complications. Thirty patients (24 males) with an average age of 33 years (17–90) were studied. As many as 21 suffered from a fresh femoral fracture, whereas the remaining nine patients suffered from femoral nonunions. Four patterns of osseous lesion were recognised in terms of mechanical stability under a dynamic nail and biological activity at the fracture/nonunion site: stable/hypertrophic, stable/atrophic, unstable/hypertrophic and unstable/atrophic osseous lesions. Complete union (wi... Injury journals http://www.medworm.com/rss/comments.php?id=5276526 Mon, 03 Oct 2011 16:03:48 +0100 5276526 http://www.medworm.com/index.php?rid=5276525&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002609%2Fabstract%3Frss%3Dyes Conclusions: The use of a navigation system to align axis, length and rotation led to a secure way of avoiding any relevant malalignment in complex femur-shaft fractures whilst exposing patients to an acceptable amount of additional procedure sequences.Malalignment can be avoided by using a navigation system in the operative treatment of femoral-shaft fractures and may be integrated into clinical routine in specialised centres. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276525 Mon, 03 Oct 2011 16:03:48 +0100 5276525 http://www.medworm.com/index.php?rid=5276524&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002415%2Fabstract%3Frss%3Dyes Abstract: Background: Rotational malalignment is a well-known complication following intramedullary nailing of femoral shaft fractures. The hypothesis of this study is that various modifiable factors, such as position on the surgical table or nailing technique, influence the incidence of torsional abnormalities.Methods: For this retrospective study, we analysed the data of 220 consecutive patients with femoral shaft fractures and postoperative torsion-difference computed tomographies (CTs), performed from 2001 to 2009 in our institution. Mean age of the patients was 33±15 years. Average delay to surgery was 8±11 days. The average postoperative neck anteversion difference between both sides was 11±8°. A p value (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276524 Mon, 03 Oct 2011 16:03:48 +0100 5276524 http://www.medworm.com/index.php?rid=5276523&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001926%2Fabstract%3Frss%3Dyes Conclusion: Appreciation of these appearances and an understanding of how these fractures may progress are important in the current diagnosis and management of delayed presentations, neglected or inadequately fixed subcapital fractures of the femoral neck. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276523 Mon, 03 Oct 2011 16:03:48 +0100 5276523 http://www.medworm.com/index.php?rid=5276522&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001823%2Fabstract%3Frss%3Dyes Conclusion: If circumstances and time constrains allow, a conventional amputation technique carried out by a trained medical practitioner would be preferable to the use of the fire service hydraulic cutting equipment. However, we feel that this technique could be used to perform emergent amputation under trained medical supervision, if it is felt that a standard amputation technique would take too long or the environment is too restrictive to perform a standard amputation safely. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276522 Mon, 03 Oct 2011 16:03:48 +0100 5276522 http://www.medworm.com/index.php?rid=5276521&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001781%2Fabstract%3Frss%3Dyes This study was conducted to evaluate baseline cerebral tissue regional oxygen saturation (rSO2) values and identify risk factors related to severe rSO2 reductions in elderly patients with hip fractures.Patients and methods: This was a prospective observational single-centre study on patients undergoing scheduled or urgent operation for isolated hip fracture. The study was approved by the Institution Ethics Committee, and all patients signed informed consent before entering the study. Data were collected on factors potentially related to baseline cerebral rSO2. Data were analysed with Student's t-test, Pearson's correlation or multiple regression analysis as appropriate.Results: Sixty-nine patients, aged (mean±standard deviation (SD)) 74±13 years participated. Left baseline rSO2 was 60.09... Injury journals http://www.medworm.com/rss/comments.php?id=5276521 Mon, 03 Oct 2011 16:03:48 +0100 5276521 http://www.medworm.com/index.php?rid=5276520&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001744%2Fabstract%3Frss%3Dyes Discussion: Augmentation of femoral heads yielded a significantly superior rotational stability, as well as an enhanced pull-out resistance, compared to the non-augmented state. However, the higher the BMD of the specimens, the lower was the effect of augmentation on the rotational stability. Therefore, augmentation can be a good clinical tool to enhance implant anchorage in osteoporotic bone. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276520 Mon, 03 Oct 2011 16:03:48 +0100 5276520 http://www.medworm.com/index.php?rid=5276519&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001185%2Fabstract%3Frss%3Dyes Conclusions: The results demonstrate that judicious use of cerclage cables to augment fixation of subtrochanteric femur fractures does not have a deleterious effect on healing. One should endeavour, however, to minimise the number of cables used. The basic science literature underpinning our approach to these unstable fractures is also discussed. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276519 Mon, 03 Oct 2011 16:03:48 +0100 5276519 http://www.medworm.com/index.php?rid=5276518&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001161%2Fabstract%3Frss%3Dyes Abstract: Introduction: Diabetes mellitus, and especially type II diabetes, is a widespread and increasing problem in the western world due to the high rates of obesity. It has also been shown in previous studies that diabetics have impaired fracture healing. The aim of this study was to see exactly what role diabetes plays in hip fracture because it is a partially modifiable disease, and to see whether there are any changes that we could make to our practice to improve patient outcome.Methods: We analysed the characteristics and outcomes for 477 hip fracture patients who were known to be diabetic at the time of admission, against 5489 non-diabetic hip fracture patients.Results: At the time of admission the diabetic patients were more likely to be using walking aids [268/477 (56%) versus 2... Injury journals http://www.medworm.com/rss/comments.php?id=5276518 Mon, 03 Oct 2011 16:03:48 +0100 5276518 http://www.medworm.com/index.php?rid=5276517&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001136%2Fabstract%3Frss%3Dyes Discussion: The results of our study suggest that there is a correlation between the effect of AS and the quicker and better recuperation and rehabilitation observed in group A. Nonetheless, these results must be interpreted with caution, and further in vivo research is needed to confirm these findings. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276517 Mon, 03 Oct 2011 16:03:48 +0100 5276517 http://www.medworm.com/index.php?rid=5276516&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000842%2Fabstract%3Frss%3Dyes Conclusion: Bone bruising detected on MRI without fracture is an important entity, and can lead to occult fracture (2%). It can take anywhere up to 8weeks to declare. Treatment for bone bruising should be with a scaphoid cast and follow-up X-ray. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276516 Mon, 03 Oct 2011 16:03:48 +0100 5276516 http://www.medworm.com/index.php?rid=5276515&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000660%2Fabstract%3Frss%3Dyes Summary: Introduction: All previous experimental and clinical repairs of flexor tendons in zone II have used either a grasping or a locking technique. In this article, a combined (grasping and locking) repair was compared biomechanically to its grasping and locking components.Methods: Using fresh flexor profundus adult sheep tendons, three techniques of tendon repair were tested biomechanically: the ‘three figure-of-eight sutures’ (a six-strand grasping technique), the ‘locked cruciate repair’ (a four-strand locked technique) and the ‘combined technique’ (a 10-strand repair using both the figure-of-eight and cruciate sutures). All repairs were tested to single-cycle tensile failure using a computerised tensometer. For each repair, the 2-mm gap force and the ultimate breaking (f... Injury journals http://www.medworm.com/rss/comments.php?id=5276515 Mon, 03 Oct 2011 16:03:48 +0100 5276515 http://www.medworm.com/index.php?rid=5276514&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000465%2Fabstract%3Frss%3Dyes Conclusion: The PFLCP can be a feasible alternative to the treatment of pertrochanteric fractures. Treatment with a PFLCP can provide good-to-excellent healing for pertrochanteric fractures, with a limited occurrence of complications. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276514 Mon, 03 Oct 2011 16:03:48 +0100 5276514 http://www.medworm.com/index.php?rid=5276512&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000283%2Fabstract%3Frss%3Dyes Conclusions: The outcome of the radial nerve palsy following humeral fractures is associated to the initial trauma. Palsies that are part of a low energy fracture uniformly recover and therefore primary surgical exploration seems unnecessary. In high energy fractures, neurotmesis or severe contusion must be expected. In this case nerve recovery is unfavourable and the patients should be informed of the poor prognosis and the need of tendon transfers. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276512 Mon, 03 Oct 2011 16:03:48 +0100 5276512 http://www.medworm.com/index.php?rid=5276511&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS002013831100026X%2Fabstract%3Frss%3Dyes Conclusion: Preoperative assessment of the local BMD and the patients’ biological age as well as intraoperative anatomic reduction and restoration of the medial cortical support are the essentials for successful surgical fixation of proximal humerus fractures. Multifragmentary fracture patterns in old patients with low local BMD are prone for fixation failure. If the surgeon is not able to achieve anatomic reduction and restoration of the medial cortical support intraoperatively in this situation, adjustments such as augmentation or primary arthroplasty should be considered. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276511 Mon, 03 Oct 2011 16:03:48 +0100 5276511 http://www.medworm.com/index.php?rid=5276510&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000118%2Fabstract%3Frss%3Dyes Conclusions: Patients receiving anti-platelet drugs can safely undergo hip fracture surgery without delay, regardless of greater perioperative blood loss and possible thrombo-embolic/postoperative bleeding events. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276510 Mon, 03 Oct 2011 16:03:48 +0100 5276510 http://www.medworm.com/index.php?rid=5276509&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000088%2Fabstract%3Frss%3Dyes This study highlights a specific fracture pattern that occurs with cemented well-fixed polished, tapered, collarless (PTC) stems. We reviewed a consecutive series of 21 PPF around well fixed PTC stems. The majority of the fractures were classified pre-operatively as Vancouver B2 (14/21), but there were also B1 (6/21) and A type fractures. The B2 fractures had common radiological and intra-operative findings: a spiral fracture with extensive fragmentation of bone and cement, debonding of cement from the implant, cement fracture, and a well-fixed cement–bone interface. Reconstruction of these fractures was more difficult than suggested by the radiographs. Two of the six patients who were considered to have a Vancouver B1 fracture underwent open reduction and internal fixation (ORIF), and h... Injury journals http://www.medworm.com/rss/comments.php?id=5276509 Mon, 03 Oct 2011 16:03:48 +0100 5276509 http://www.medworm.com/index.php?rid=5276508&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000064%2Fabstract%3Frss%3Dyes Conclusion: Early use of the wrist after volar plating was not found to reduce depressive symptoms as compared with cast immobilisation in the early treatment period following a distal radius fracture. Pain was found to be an important predictor of depression, suggesting that caution is needed to address pain during the early rehabilitation period. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276508 Mon, 03 Oct 2011 16:03:48 +0100 5276508 http://www.medworm.com/index.php?rid=5276507&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000040%2Fabstract%3Frss%3Dyes Conclusion: Our six-strand technique is an alternative technique for zone II flexor-tendon repair in children younger than 2 years of age, but the bulky repair site requires a ‘profundus only’ repair and ‘venting’ of the pulley system. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276507 Mon, 03 Oct 2011 16:03:48 +0100 5276507 http://www.medworm.com/index.php?rid=5276506&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000027%2Fabstract%3Frss%3Dyes This study examines whether implementing prehospital preoperative procedures might lead to reduced waiting times, less postoperative pain, fewer complications and shorter length of care for this patient group. To “fast-track” care for hip fracture patients, the ambulance nurse starts the preoperative procedure (usually performed in the accident and emergency department [A&E]) and transfers patients directly to radiology, bypassing A&E. Results from the fast-track care group were compared to results from a control group, who had been admitted to A&E in the usual way. The study group experienced fewer complications and shorter hospital stays compared to the control group. This finding suggests that fast-track care for hip fracture patients can minimise complications, heighten priorities,... Injury journals http://www.medworm.com/rss/comments.php?id=5276506 Mon, 03 Oct 2011 16:03:48 +0100 5276506 http://www.medworm.com/index.php?rid=5276505&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310008259%2Fabstract%3Frss%3Dyes This study aims to assess the mortality associated with hip fracture at 5 years in a geriatric population, and evaluate the influence of age, cognitive state, mobility and residential status on long term survival after hip fracture.Methods: A prospective audit was carried out of all patients with a hip fracture admitted to a university hospital over a 4 year period. Data from 2640 patients were analysed and multivariate analysis used to indicate the important variables predicting mortality. Patients fulfilling the criteria of age (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276505 Mon, 03 Oct 2011 16:03:48 +0100 5276505 http://www.medworm.com/index.php?rid=5276504&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310008235%2Fabstract%3Frss%3Dyes Conclusion: The polyaxial two-column plate tested in this study provides a biomechanically sound construct for the management of intra-articular fractures of the distal radius. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276504 Mon, 03 Oct 2011 16:03:48 +0100 5276504 http://www.medworm.com/index.php?rid=5276503&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310008223%2Fabstract%3Frss%3Dyes Conclusion: Snowboarding and skiing are sports with increased risk of glenohumeral dislocation compared with the general population, and the injury pattern differs between them. In snowboarding, injury patterns seem to be influenced by performance style. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276503 Mon, 03 Oct 2011 16:03:48 +0100 5276503 http://www.medworm.com/index.php?rid=5276502&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310007886%2Fabstract%3Frss%3Dyes Abstract: The Pauwels classification for the femoral neck fracture is still broadly used in literature and clinical practise. However, this classification has never been tested for its reliability in terms of inter-observer agreement. We assessed whether or not it is reliable to use the Pauwels classification in pre-operative planning.Ten observers classified 100 intra-capsular femur fractures. The inter-observer agreement was calculated using the multi-rater Fleiss’ kappa.The Pauwels classification showed an inter-observer agreement of κ0.31 (0.01).Classification of intra-capsular hip fractures according to the Pauwels classification using the Pauwels angle is unreliable and its use should be avoided. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276502 Mon, 03 Oct 2011 16:03:48 +0100 5276502 http://www.medworm.com/index.php?rid=5276501&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310007618%2Fabstract%3Frss%3Dyes We present our experience in the management of hip fracture patients after the application of a value-stream approach, the Lean framework, in our trust. This system uses available resources in an efficient manner whilst eliminating waste. A statistically significant reduction of 5% and 9.3% was noted in the 30-day and overall mortality, respectively, after implementing ‘Lean thinking’. Further improvements were also noted in door-to-theatre time, use of trauma beds and early discharge from hospitals. To our knowledge, this is the largest study in the literature where the Lean framework has been successfully employed for the management of a very challenging health-care issue faced by the National Health Service. Future prospective studies are, however, needed to reconfirm these results ... Injury journals http://www.medworm.com/rss/comments.php?id=5276501 Mon, 03 Oct 2011 16:03:48 +0100 5276501 http://www.medworm.com/index.php?rid=5276500&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310007473%2Fabstract%3Frss%3Dyes Conclusions: The evaluation and implementation of cost-effective preventive and therapeutic strategies in the short term may help to ameliorate the future financial burden of PFF, and, more importantly, improve the outcome and quality of life for the elderly after fracture. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276500 Mon, 03 Oct 2011 16:03:48 +0100 5276500 http://www.medworm.com/index.php?rid=5276499&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310006352%2Fabstract%3Frss%3Dyes Conclusions: The results highlight the considerable hospital costs associated with the surgical fixation of an ankle fracture, thus providing valuable information for resource planners. Future research should broaden the perspective of the economic analysis to include rehabilitation costs and assess the cost-effectiveness of potential cost-saving strategies. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276499 Mon, 03 Oct 2011 16:03:48 +0100 5276499 http://www.medworm.com/index.php?rid=5276498&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310006327%2Fabstract%3Frss%3Dyes Conclusion: We had a satisfactory outcome following individualised treatment of interprosthetic femoral fractures following ipsilateral hip and knee joint replacement. Compared to the rare data in current literature, we had promising functional result and high rate of bony fusion. Regarding the complexity and challenges in many of these cases, interprosthetic fractures require an adequate analysis of the fracture aetiology and a suitable transfer into the best possible treatment concept. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276498 Mon, 03 Oct 2011 16:03:48 +0100 5276498 http://www.medworm.com/index.php?rid=5276497&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310005772%2Fabstract%3Frss%3Dyes Abstract: Psychological factors are capable of influencing an individual's perception of pain and may mediate the evolution from acute to chronic pain. Personality characteristics, such as alexithymia and anxiety sensitivity, can also influence perception of pain by somatising psychological distress associated with acute pain. The aim of this study was to understand if alexithymia and anxiety sensitivity interact with psychological distress at an early stage of recovery from orthopaedic injury, to accentuate perception of pain intensity and potentially mediate the development of chronic pain disorder. 62 patients who had recently suffered orthopaedic injury completed the British Pain Society Pain Rating Scale plus the Hospital Anxiety and Depression Scale, as well as measures of alexithymi... Injury journals http://www.medworm.com/rss/comments.php?id=5276497 Mon, 03 Oct 2011 16:03:48 +0100 5276497 http://www.medworm.com/index.php?rid=5276496&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310008454%2Fabstract%3Frss%3Dyes Conclusion: There is no single unifying scale in widespread use for proximal femoral fracture patients. We would recommend the validation of commonly used scales for this population, and would advise the use of scales from more than one category to assess outcome. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276496 Mon, 03 Oct 2011 16:03:48 +0100 5276496 http://www.medworm.com/index.php?rid=5276495&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310007552%2Fabstract%3Frss%3Dyes Abstract: Traumatic knee dislocations are uncommon yet serious injuries that historically have had variable prognosis. The evaluation and management of traumatic knee dislocations remains controversial. Appropriate early management has been shown to have a significant impact on long term functional outcome. A comprehensive review of the recent literature is presented alongside our current approach to management.The dislocated knee is an under diagnosed injury which relies on a high index of clinical suspicion on presentation of any knee injury. There is now a degree of consensus regarding need for surgery, timing of surgery, vascular investigations, surgical techniques and rehabilitation protocols.Vigilant monitoring for neurovascular complications, appropriate investigations and early inv... Injury journals http://www.medworm.com/rss/comments.php?id=5276495 Mon, 03 Oct 2011 16:03:48 +0100 5276495 http://www.medworm.com/index.php?rid=5276494&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310002846%2Fabstract%3Frss%3Dyes Abstract: This meta-analysis evaluates the quality of life in post-traumatic amputees in comparison with limb salvage. Studies included in this meta-analysis had a minimum of 24 months of follow-up and used a validated quality-of-life outcome assessment scale (Short Form-36 or Sickness Impact Profile) for physical and psychological outcomes. Two reviewers performed the search and data extraction independent of each other.A total of 214 studies were identified; 11 fulfilled the inclusion criteria; thus, 1138 patients were available for meta-analysis (769 amputees and 369 cases of reconstruction).The meta-analysis demonstrated that lower limb reconstruction is more acceptable psychologically to patients with severe lower limb trauma compared with amputation, even though the physical outcome ... Injury journals http://www.medworm.com/rss/comments.php?id=5276494 Mon, 03 Oct 2011 16:03:48 +0100 5276494 http://www.medworm.com/index.php?rid=5276493&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001793%2Fabstract%3Frss%3Dyes Abstract: Bone regeneration presents a unique challenge to both clinicians and scientists. Recently, a vast amount of knowledge has been attained with regard to the molecular mediators, cell populations and the overall cascade of events participating in the bone repair processes. For the treatment of bone non-unions or bone defects, the ‘diamond concept’ for biological enhancement supports the implantation of mesenchymal stem cells, a scaffold and a growth factor. Prior to the implantation of any or all of these materials however, the surgeon must develop the ideal biological environment (non-union bed) where molecular and physiological processes will evolve facilitating an early and successful osteogenesis leading to bone continuity and functional restoration of the affected limb. At ... Injury journals http://www.medworm.com/rss/comments.php?id=5276493 Mon, 03 Oct 2011 16:03:48 +0100 5276493 http://www.medworm.com/index.php?rid=5276492&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311004323%2Fabstract%3Frss%3Dyes (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5276492 Mon, 03 Oct 2011 16:03:48 +0100 5276492 http://www.medworm.com/index.php?rid=5186235&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000854%2Fabstract%3Frss%3Dyes Please note that the authors’ names we ordered incorrectly in the published version of this article, with surnames appearing before first initial. This has been rectified above. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186235 Sat, 03 Sep 2011 19:22:22 +0100 5186235 http://www.medworm.com/index.php?rid=5186234&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310006765%2Fabstract%3Frss%3Dyes Injury to the sciatic nerve is a well recognised complication of fractures of the pelvic ring and acetabulum, occurring either at the time of injury or as an iatrogenic injury secondary to treatment. The prevalence of sciatic nerve in injury has been reported to be 10–13% after acetabular fracture or fracture-dislocation of the hip. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186234 Sat, 03 Sep 2011 19:22:22 +0100 5186234 http://www.medworm.com/index.php?rid=5186233&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001860%2Fabstract%3Frss%3Dyes Osteogenesis imperfecta (OI) is an inherited disease characterised by abnormal collagen formation leading to increased risk of fracture. Depending on the sub-type, modes of inheritance largely occur via an autosomal dominant fashion and clinical manifestations vary from very mild disease to lethal forms, which can involve intrauterine death. In addition to concerns regarding suitable bone stock, increased risk of intraoperative fracture, and soft tissue considerations, the operative surgeon should also be aware of hemorrhagic diathesis found in OI patients. Patients with OI often have an inherent coagulation defect due to abnormal collagen within endothelial capillary beds. Postoperatively, hypertrophic callus or heterotopic ossification (HO) can also be expected in OI patients, and can be... Injury journals http://www.medworm.com/rss/comments.php?id=5186233 Sat, 03 Sep 2011 19:22:22 +0100 5186233 http://www.medworm.com/index.php?rid=5186232&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310003414%2Fabstract%3Frss%3Dyes We present a patient with such an unstable injury pattern and the surgical treatment in one stage procedure he underwent. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186232 Sat, 03 Sep 2011 19:22:22 +0100 5186232 http://www.medworm.com/index.php?rid=5186231&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310005759%2Fabstract%3Frss%3Dyes Abstract: Background: Compartment syndrome is a devastating complication after trauma to the extremities. Prompt fasciotomy is essential for avoiding disability and limb loss. The purpose of this study was to determine the incidence and predictors for the need for fasciotomy after extremity trauma.Methods: All trauma patients sustaining extremity injuries admitted to the LAC+USC Medical Centre during a 10-year period ending in December 2007 were identified. Demographics, clinical data, blood requirements and outcomes were abstracted. Patients who required an extremity fasciotomy were compared with those who did not. Stepwise logistic regression analysis was used to identify independent predictors of the need for fasciotomy.Results: During the study period, 288 (2.8%) of a total of 10,315 p... Injury journals http://www.medworm.com/rss/comments.php?id=5186231 Sat, 03 Sep 2011 19:22:21 +0100 5186231 http://www.medworm.com/index.php?rid=5186230&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310006303%2Fabstract%3Frss%3Dyes Discussion: Compression did not enhance fracture healing in terms of mineralization, bending strength, or stiffness at the time of union, compared with the control condition. The compression and control groups exhibited improved healing in terms of mechanical strength and stiffness and a more mature callus mineralization compared with the distraction group. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186230 Sat, 03 Sep 2011 19:22:21 +0100 5186230 http://www.medworm.com/index.php?rid=5186229&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310006479%2Fabstract%3Frss%3Dyes Abstract: Our purpose was to examine survivorship of the native hip joint in patients ages 60 and over who underwent percutaneous reduction and fixation of acetabular fractures. A retrospective review at a University Level I Trauma Center was performed. Our institutional trauma database was reviewed. Patients aged 60 or older treated with percutaneous reduction and fixation of acetabular fractures between 1994 and 2007 were selected. 79 consecutive patients with 80 fractures were identified. Rate of conversion to total hip arthroplasty were used to construct a Kaplan–Meier curve showing survivorship of the native hip joint after treatment. 75 fractures had adequate clinical follow-up with a mean of 3.9 years (range 0.5–11.9 years). Average blood loss was 69cc and there were no postoper... Injury journals http://www.medworm.com/rss/comments.php?id=5186229 Sat, 03 Sep 2011 19:22:21 +0100 5186229 http://www.medworm.com/index.php?rid=5186228&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310006947%2Fabstract%3Frss%3Dyes Abstract: Fractures of the calcaneus are often associated with serious permanent disability, a considerable reduction in quality of life, and high socio-economic cost. Although some studies have already reported changes in plantar pressure distribution after calcaneal fracture, no investigation has yet focused on the patient‘s strength and postural control.Method: 60 patients with unilateral, operatively treated, intra-articular calcaneal fractures were clinically and biomechanically evaluated >1 year postoperatively (physical examination, SF-36, AOFAS score, lower leg isokinetic strength, postural control and gait analysis including plantar pressure distribution). Results were correlated to clinical outcome and preoperative radiological findings (Böhler angle, Zwipp and Sanders Score).... Injury journals http://www.medworm.com/rss/comments.php?id=5186228 Sat, 03 Sep 2011 19:22:21 +0100 5186228 http://www.medworm.com/index.php?rid=5186227&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310008089%2Fabstract%3Frss%3Dyes Conclusion: Internal fixation using the modified Stoppa approach to buttress the quadrilateral plate should be considered a viable alternative to total hip arthroplasty for the initial treatment of acetabular fractures in the elderly. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186227 Sat, 03 Sep 2011 19:22:21 +0100 5186227 http://www.medworm.com/index.php?rid=5186226&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS002013831100009X%2Fabstract%3Frss%3Dyes Conclusion: There is a significant increase in wound complications in distal fibular fractures treated with a locking compression plate. In light of the current study, we would caution against the application of the currently used locking compression plates in the treatment of distal fibular fractures. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186226 Sat, 03 Sep 2011 19:22:21 +0100 5186226 http://www.medworm.com/index.php?rid=5186225&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000234%2Fabstract%3Frss%3Dyes Conclusion: The virtual surgical procedure for acetabular fractures is feasible and useful clinically for surgeons to determine surgical planning. It may be a valuable tool for surgeons in learning about the nature of the fracture and in formulating an appropriate surgical plan. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186225 Sat, 03 Sep 2011 19:22:20 +0100 5186225 http://www.medworm.com/index.php?rid=5186224&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000301%2Fabstract%3Frss%3Dyes Conclusion: This new double fixation technique using bioabsorbable cannulated lag screws and braided polyester suture tension bands resulted in satisfactory outcomes for patella fractures without any obvious complications. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186224 Sat, 03 Sep 2011 19:22:19 +0100 5186224 http://www.medworm.com/index.php?rid=5186223&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000337%2Fabstract%3Frss%3Dyes Abstract: The use of ring fixators in lower limb reconstruction and deformity correction both for trauma and elective procedures is now widespread. The long course of treatment requires regular outpatient review with frequent radiological imaging to assess the progression of treatment and plan correctional adjustment.Following publication of a technique using a frame mounted spirit-level to aid radiographers in accurately aligning the limb for optimal imaging we implemented a similar technique in our department and carried out a two part prospective comparative study to assess the impact on radiograph quality.Comparison was made of radiograph quality, X-rays taken, patient trips to the radiology department and X-ray exposure before and after implementation of the spirit-level guide techniq... Injury journals http://www.medworm.com/rss/comments.php?id=5186223 Sat, 03 Sep 2011 19:22:18 +0100 5186223 http://www.medworm.com/index.php?rid=5186222&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000659%2Fabstract%3Frss%3Dyes Conclusion: There is a substantial change in the biomechanical characteristics of the Ilizarov ring fixator when mobilising a patient with a weight-bearing platform. The considerable higher mechanical stress on the wires needs to be considered when patients are mobilised with a weight-bearing platform. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186222 Sat, 03 Sep 2011 19:22:18 +0100 5186222 http://www.medworm.com/index.php?rid=5186221&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000702%2Fabstract%3Frss%3Dyes This study was motivated by the treatment demands encountered by orthopaedic surgeons providing medical treatment in several different LMIC and their need for access to basic osteosynthesis devices. The rigorous decontamination protocol and generalized inspection criteria proved useful for efficiently screening a large volume of devices. Given that re-used osteosynthesis devices can yield satisfactory results, this study addresses potential complications of re-used devices and valid concerns that relate to patient safety. Implementing this defined reprocessing protocol into existing re-use practises in LMIC helps to limit the risks of inadequate sterilization and structural failure without adding additional risks to patients receiving re-used devices. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186221 Sat, 03 Sep 2011 19:22:18 +0100 5186221 http://www.medworm.com/index.php?rid=5186220&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000763%2Fabstract%3Frss%3Dyes Conclusion: Fracture compression can be improved either using multiple eccentrically placed screws alternated between the two sides of the plate in LCP and DCP, or by the use of a universal drill guide in DCP. Although the compression hole in the LCP is shorter, it generates compression comparable to the DCP. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186220 Sat, 03 Sep 2011 19:22:18 +0100 5186220 http://www.medworm.com/index.php?rid=5186219&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000775%2Fabstract%3Frss%3Dyes Abstract: Background and context: Helicopter Emergency Medical Services (HEMS) have been incorporated into modern health systems for their speed and coverage. In the state of New South Wales (NSW), nine HEMS operate from various locations around the state and currently there is no clear picture of their resource implications. The aim of this study was to assess the cost of HEMS in NSW and investigate the factors linked with the variation in the costs, coverage and activities of HEMS.Methods: We undertook a survey of HEMS costs, structures and operations in NSW for the 2008/2009 financial year. Costs were estimated from annual reports and contractual agreements. Data related to the structure and operation of services was obtained by face-to-face interviews, from operational data extracted f... Injury journals http://www.medworm.com/rss/comments.php?id=5186219 Sat, 03 Sep 2011 19:22:17 +0100 5186219 http://www.medworm.com/index.php?rid=5186218&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000830%2Fabstract%3Frss%3Dyes Conclusions: Injuries related to direct contact with cattle are common. We noted an as yet unreported common pattern of injury to the hands of workers kicked whilst handling cattle at milking time. We also noted the previously recognized potential for serious injury due to more proximal body trauma whilst working with large animals. Whilst there is some work available pertaining to injury prevention in this industry, our study demonstrates a need for further work to be done to minimize and prevent future injuries. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186218 Sat, 03 Sep 2011 19:22:17 +0100 5186218 http://www.medworm.com/index.php?rid=5186217&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001100%2Fabstract%3Frss%3Dyes Abstract: Aim: To establish whether the modified anatomic plate (MAP) performs as well as the anatomic plate (AP), dynamic hip screw (DHS) and proximal femoral nail (PFN) from a biomechanical perspective.Materials and methods: The, AP, MAP, DHS and PFN were assessed using finite element (FE) methods and biomechanical tests. A solid model was created based on the fracture lines and results were assessed using analyses of variance.Main outcome measurements: Independent variables were the implants (n=4) and axial loads: 0–1000 Newton (N) in 100N increments. Dependent variables were loads at the intertrochanteric fracture line as measured by load cells.Results: Axial loads ≤400N generated significantly (p0.5) lower forces (almost 50% less) compared with the MAP and PFN. At 1000N, the DHS g... Injury journals http://www.medworm.com/rss/comments.php?id=5186217 Sat, 03 Sep 2011 19:22:17 +0100 5186217 http://www.medworm.com/index.php?rid=5186216&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001148%2Fabstract%3Frss%3Dyes Abstract: Previous studies have demonstrated the need for accurate reduction of ankle syndesmosis. Measurement of syndesmosis is difficult on plain radiographs. A computed tomography (CT) scan allows better visualisation of the transverse relationship between the fibula and incisura fibularis. The difference (‘G’ a term we coined for ease of description) between the fibula and the anterior and posterior facets of the incisura fibularis was compared between normal and injured ankles following syndesmotic fixation in 19 patients. The mean diastasis (MD) was also calculated, representing the average measurement between the fibula and the anterior and posterior incisura. When compared with the normal side, eight out of 19 (42%) cases were found to have a residual diastasis even after fixat... Injury journals http://www.medworm.com/rss/comments.php?id=5186216 Sat, 03 Sep 2011 19:22:17 +0100 5186216 http://www.medworm.com/index.php?rid=5186215&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001197%2Fabstract%3Frss%3Dyes Conclusions: The management of selected osteoporotic complex intra-articular fractures of the proximal tibia with compression bolts and intramedullary nailing offers specific advantages and, in the present pilot study, provided promising results. These results should be validated and confirmed with larger case series and comparison studies in the future. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186215 Sat, 03 Sep 2011 19:22:17 +0100 5186215 http://www.medworm.com/index.php?rid=5186214&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001343%2Fabstract%3Frss%3Dyes Conclusion: In our view, it is crucial to recognise the different components of the injury in the typical postero-medial fracture dislocation of the proximal tibia. The described larger medial approach for this type of medial fracture dislocation allows repairing most of the injured aspects of the tibial head, namely the medial condyle with postero-medial buttressing, the distal insertion of the ACL and the posterolateral impaction of the plateau. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186214 Sat, 03 Sep 2011 19:22:17 +0100 5186214 http://www.medworm.com/index.php?rid=5186213&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001471%2Fabstract%3Frss%3Dyes We describe the experience of the orthopaedic department in a field hospital operating in an extreme mass casualty situation.The hospital contained 4 operating table and 72 hospitalization beds. The orthopaedic department included 8 orthopaedic surgeons and 3 residents.1111 patients were treated in the hospital, 1041 of them had adequate records for inclusion. 684 patients were admitted due to trauma with a total of 841 injuries. 320 patients sustained 360 fractures, 18 had joint dislocations and 22 patients were admitted after amputations. 207 patients suffered 315 soft tissue injuries. 221 patients were operated on under general or regional anaesthesia. External fixation was used for stabilization of 48 adult femoral shaft fractures, 24 open tibial fractures and 1 open humeral fracture. ... Injury journals http://www.medworm.com/rss/comments.php?id=5186213 Sat, 03 Sep 2011 19:22:16 +0100 5186213 http://www.medworm.com/index.php?rid=5186212&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001495%2Fabstract%3Frss%3Dyes Conclusion: The use of an aiming device for distal locking of a tibia nail lengthens operation time rather than reducing it. Fluoroscopy was still needed in about half of the cases. No difference was seen in clinical outcomes. The use of a distal aiming device to lock a tibial nail appears to have no benefit. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186212 Sat, 03 Sep 2011 19:22:16 +0100 5186212 http://www.medworm.com/index.php?rid=5186211&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001513%2Fabstract%3Frss%3Dyes Abstract: We reviewed 77 patients with an acetabular fracture, treated operatively through a non-extensile approach after an average time of 45 months. The ilioinguinal approach was chosen in 41, the Kocher–Langenbeck approach in 36 patients. Following the Letournel classification, the most frequent lesions were posterior wall (26%), two-column (22.1%) and anterior column (14.3%) fractures. Subchondral impaction, intra-articular fracture fragments and fracture comminution, called modifiers, could be identified in the preoperative CT-data of 38 patients (49.4%). Patients were operated after an average of 4 days. Average hospital stay was 19 days. Sciatic nerve and peroneal nerve palsy were registered in 5.6%. Deep venous thrombosis was seen in 10.4%, peri-articular ossifications in 7.8%. ... Injury journals http://www.medworm.com/rss/comments.php?id=5186211 Sat, 03 Sep 2011 19:22:16 +0100 5186211 http://www.medworm.com/index.php?rid=5186210&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001616%2Fabstract%3Frss%3Dyes Conclusion: Vertebral body stenting leads to satisfactory improvement in pain, function and kyphosis correction in the treatment of osteoporotic and traumatic fractures. Anterior spinal column, especially the fragmented superior endplate is nicely reconstructed by the stent provided it is inserted accurately. With addition of posterior transpedicular instrumentation, indications for this technique may be wider covering some Type B and C fractures with similar vertebral body damage. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186210 Sat, 03 Sep 2011 19:22:16 +0100 5186210 http://www.medworm.com/index.php?rid=5186209&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001902%2Fabstract%3Frss%3Dyes Conclusion: Though interfragmentary screws seem to block necessary interfragmentary movement, we see callus formation as a sign of secondary fracture healing. The osteosynthesis construct with interfragmentary screw seems to be more stable and less flexible than sole bridge plating, leading to faster fracture healing. Interfragmentary screws might help to control and limit interfragmentary movement in certain cases. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186209 Sat, 03 Sep 2011 19:22:16 +0100 5186209 http://www.medworm.com/index.php?rid=5186208&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310006042%2Fabstract%3Frss%3Dyes Conclusion: Paediatric pelvic fractures differ from their adult counterpart in aetiology, fracture type, and associated injury pattern. They represent a reliable marker for severe trauma. Prospective studies are required to define optimal treatment guidelines, particularly in older children. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186208 Sat, 03 Sep 2011 19:22:15 +0100 5186208 http://www.medworm.com/index.php?rid=5186207&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310006662%2Fabstract%3Frss%3Dyes Conclusion: The results of this randomised clinical trial in healthy volunteers showed that patients with pelvic fractures, temporarily stabilised with a PCCD, are at risk for developing pressure sores. The pressure on the skin exceeded the tissue damaging threshold and is, besides PCCD type, influenced by BMI, waist size and age. Regardless with which PCCD trauma patients are stabilised, early transfer from the spine board is of key importance to reduce the pressure to a level below the tissue damaging threshold. Clinicians should be aware of the potential deleterious effects associated with the application of a PCCD, and every effort must be made to remove the PCCD once haemodynamic resuscitation has been established. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186207 Sat, 03 Sep 2011 19:22:15 +0100 5186207 http://www.medworm.com/index.php?rid=5186206&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310007928%2Fabstract%3Frss%3Dyes Conclusion: Functional outcome after surgical treatment of open book pelvic lesions is good. External rotation and accompanying inferior displacement of the ipsilateral hemipelvis may be a sign of partial lesion of the posterior sacroiliac complex. Identification of patients who need additional posterior stabilization remains difficult. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186206 Sat, 03 Sep 2011 19:22:15 +0100 5186206 http://www.medworm.com/index.php?rid=5186205&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310008168%2Fabstract%3Frss%3Dyes Conclusions: With appropriately targeted training it is likely that the care of patients with pelvic fractures can be significantly improved. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186205 Sat, 03 Sep 2011 19:22:15 +0100 5186205 http://www.medworm.com/index.php?rid=5186204&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000489%2Fabstract%3Frss%3Dyes Conclusion: Despite treatment advances, mortality rates remain high in patients with open pelvic fractures. The urogenital and/or intra-abdominal injuries are not associated with mortality. RTS≤8 might be a predictor of poor outcome in open pelvic fractures patients. Open reduction and internal fixation might be used in those unstable pelvic fractures without gross contamination in the fracture region after extensive cleansing and lavage. More emphasis needs to be placed on this injury complex. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186204 Sat, 03 Sep 2011 19:22:15 +0100 5186204 http://www.medworm.com/index.php?rid=5186203&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS002013831100146X%2Fabstract%3Frss%3Dyes Conclusion: In contrast to an overall decline in trauma mortality, complex pelvic ring injuries remain associated with a significant risk of death. Awareness of this potentially life-threatening condition should be increased amongst trauma care professionals, and early management protocols need to be implemented to improve the survival prognosis. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186203 Sat, 03 Sep 2011 19:22:14 +0100 5186203 http://www.medworm.com/index.php?rid=5186202&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001604%2Fabstract%3Frss%3Dyes Conclusions: Percutanous iliosacral screw fixation alone is a sufficient technique for the stabilisation of rotationally unstable pelvic fractures with low rates of complications or non-unions. It allows for a minimally invasive treatment thus being a useful option in patients who do not qualify for open anterior fixation. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186202 Sat, 03 Sep 2011 19:22:14 +0100 5186202 http://www.medworm.com/index.php?rid=5186201&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002403%2Fabstract%3Frss%3Dyes Conclusions: The findings highlight the importance of effective control of haemodynamic instability for reducing the risk of mortality. As most patients survive these injuries, further research should focus on long term morbidity and the impact of different treatment approaches. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186201 Sat, 03 Sep 2011 19:22:14 +0100 5186201 http://www.medworm.com/index.php?rid=5186200&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002920%2Fabstract%3Frss%3Dyes The purpose of the study was to evaluate if the quality of post operative radiographs improved once the surgeons involved knew that all operative radiographs would be peer reviewed by the by the whole department on weekly basis, using the tip apex distance of DHS cases as a surrogate marker. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186200 Sat, 03 Sep 2011 19:22:14 +0100 5186200 http://www.medworm.com/index.php?rid=5186199&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002907%2Fabstract%3Frss%3Dyes We performed a pragmatic, randomised, pilot trial to compare intramedullary nailing with ‘locking-plate’ fixation for extra-articular fracture of the distal tibia. Methods: Patients presenting with a closed or Gustillo1, extra-articular fracture of the distal tibia were offered the opportunity to participate. Consenting patients were randomised to either intramedullary nailing or ‘locking-plate’ fixation. Fractures too distal to achieve four cortex fixation with distal locking screws (IM nailing) or patients with other serious injuries were excluded from the study. The primary outcome measure was the patient-reported Disability Rating Index (DRI). EuroQol (EQ-5D), and the Olerud and Molander Ankle score (OMA), were also recorded at 3, 6 and 12 months post operatively. Mal-union, i... Injury journals http://www.medworm.com/rss/comments.php?id=5186199 Sat, 03 Sep 2011 19:22:14 +0100 5186199 http://www.medworm.com/index.php?rid=5186198&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002890%2Fabstract%3Frss%3Dyes Study Aims: An audit to change practice and decrease the remanipulation rate of paediatric forearm fractures. Background: Forearm fractures represent approximately 20 – 30% of all fractures in children. Re-displacement or re-angulation is the most commonly reported complication in fractures treated in plaster and invariably needs re-manipulation. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186198 Sat, 03 Sep 2011 19:22:14 +0100 5186198 http://www.medworm.com/index.php?rid=5186197&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002889%2Fabstract%3Frss%3Dyes The aim of this study is to describe how patients perceive their recovery following open tibial fractures using a phenomenological approach. Ten adult patients with a diagnosis of “healed” open tibial fracture were recruited after completion of their surgical treatment at Morriston Hospital. All patients were between 6 months and 1 year post-injury. A purposive sampling method was employed to ensure that a range of injuries as well as clinical outcomes were included. All patients underwent an in-depth semi-structured interview, exploring all aspects of their injury, treatment, rehabilitation, psycho-social and financial situations. Interviews were completed with 2 interviewers present and continued until thematic saturation had been completed. Interview transcripts were analysed indep... Injury journals http://www.medworm.com/rss/comments.php?id=5186197 Sat, 03 Sep 2011 19:22:14 +0100 5186197 http://www.medworm.com/index.php?rid=5186196&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002877%2Fabstract%3Frss%3Dyes Purpose: To assess whether acellular porcine derived xenogenic osteochondral grafts are non-cytotoxic to cells and therefore capable of allowing cellular in-growth and proliferation. A natural acellular scaffold may provide advantages over synthetic grafts in having pre-fabricated extra-cellular matrix which more closely recreates the normal cellular micro-environment. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186196 Sat, 03 Sep 2011 19:22:13 +0100 5186196 http://www.medworm.com/index.php?rid=5186195&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002865%2Fabstract%3Frss%3Dyes Introduction: The value of dynamisation of statically locked intramedullary (IM) nails in the treatment of delayed-union of the tibia has been poorly documented. Many authors report no effect on the speed of fracture union. We performed a biomechanical study using cadaveric bones to measure the forces required to compress and distract the interfragmentary gap in a tibial shaft fracture model fixed by IM nailing in dynamisation mode. We also measured interfragmentary movements that occur under physiological loading conditions with the IM nails statically locked. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186195 Sat, 03 Sep 2011 19:22:13 +0100 5186195 http://www.medworm.com/index.php?rid=5186194&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311002853%2Fabstract%3Frss%3Dyes The purpose of the study was to elucidate the ideal syndesmosis drill hole direction that would not displace the fibula relative to the tibia at 20mm proximal to the ankle joint. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186194 Sat, 03 Sep 2011 19:22:13 +0100 5186194 http://www.medworm.com/index.php?rid=5186193&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311003627%2Fabstract%3Frss%3Dyes Historically, open long bone fractures were considered life threatening and primary treatment with amputation was encouraged, due to the high incidence of both early and late infection. With the advent of aseptic technique and antibiotics from the early 20th Century, the rate of successful salvage increased. Vascularised soft tissue coverage of fractured long bones was shown to be reliable and to provide a barrier to ingress of bacteria, allowing uneventful fracture healing. The specialties of both plastic surgery and orthopaedic trauma surgery developed techniques to deal with both soft tissue and bone injury. This culminated in Godina's landmark publication in 1986. His large personal series of patients demonstrated the major advantages of early soft tissue cover of extremity trauma in t... Injury journals http://www.medworm.com/rss/comments.php?id=5186193 Sat, 03 Sep 2011 19:22:13 +0100 5186193 http://www.medworm.com/index.php?rid=5186192&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311003706%2Fabstract%3Frss%3Dyes (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5186192 Sat, 03 Sep 2011 19:22:13 +0100 5186192 http://www.medworm.com/index.php?rid=5148846&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001355%2Fabstract%3Frss%3Dyes Road traffic injuries are a common problem in the world which is the aetiology of 1.2 million deaths and 50 million non-fatal injuries per year. We read the article entitled “Factors affecting anatomical region of injury, severity, and mortality for road trauma in a high-income developing country: Lessons for prevention” with great interest. We aimed to report our experience in our referral trauma centre and also to evaluate epidemiological factors of car accidents to propose some preventional strategies to reduce the rate of accidents and/or morbidities and mortalities. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5148846 Wed, 24 Aug 2011 19:56:39 +0100 5148846 http://www.medworm.com/index.php?rid=5148845&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000969%2Fabstract%3Frss%3Dyes In this study the authors used an haemofiltration prescription with an high-flux dialyzer that efficiently removed molecules up to 30kDa; replacement fluid was administered at the pre-philtre site. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5148845 Wed, 24 Aug 2011 19:56:36 +0100 5148845 http://www.medworm.com/index.php?rid=5148844&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311000878%2Fabstract%3Frss%3Dyes We bring your attention to the statement in the introduction of the above article: “In contrast, in Anglo-American emergency medical systems such as Australia, an alternative EMS has developed in which highly trained paramedics are deployed on road and air for acute trauma care at the scene and for transport. Within, this system, emergency physicians rarely leave the hospital for patient care at the scene and if so, only on very special occasion or upon specific request.” Later on in the introduction the authors state the German data is being compared to the “Australian State of Victoria”. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5148844 Wed, 24 Aug 2011 19:56:35 +0100 5148844 http://www.medworm.com/index.php?rid=5148843&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310005991%2Fabstract%3Frss%3Dyes I read the recent report by Chong et al. with a great interest. Chong et al. concluded that “Cardiac injury is an important complication after orthopaedic surgery. Studies have found that troponin testing can detect asymptomatic cardiac injury.” I have some comments on this work. First, the problem of troponin in laboratory medicine should be mentioned. Tate mentioned that “Current second generation cTnI and fourth generation cTnT assays generally have an imprecision of around 20% coefficient of variation (CV) at the 99th percentile of the reference population, which is greater than the recommended imprecision of 10% CV.” Thus, the reliability of the test in the report is still questionable. Second, there are many other causes of elevation of troponin including systemic diseases an... Injury journals http://www.medworm.com/rss/comments.php?id=5148843 Wed, 24 Aug 2011 19:56:33 +0100 5148843 http://www.medworm.com/index.php?rid=5148842&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310005875%2Fabstract%3Frss%3Dyes As the corresponding author of the above manuscript it is my pleasure to respond to the letter of Drs. Alain and Olivier Reinberg. We wish to thank them for the interest in our manuscript. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5148842 Wed, 24 Aug 2011 19:56:32 +0100 5148842 http://www.medworm.com/index.php?rid=5148841&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310003785%2Fabstract%3Frss%3Dyes The recent article in Injury drew our interest as we have a strong involvement in chronobiology with a research program dealing with 24h, weekly as well as annual rhythms in accidents of children dating back to 1994. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5148841 Wed, 24 Aug 2011 19:56:31 +0100 5148841 http://www.medworm.com/index.php?rid=5148840&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138311001872%2Fabstract%3Frss%3Dyes Iatrogenic and non-iatrogenic causes may contribute to intercostal vessel injury; the most common iatrogenic aetiology is thoracostomy and thoracentesis, especially for patients having coagulation disorders (e.g., hepatocirrhosis, liver transplantation and haematopathy). Non-iatrogenic injuries include secondary intercostal vessel injury, such as chest-wall sharp-instrument injury, autogenous haemorrhage of angioma and costal fracture. There are a variety of manoeuvres that can be used in the management of intercostal vessel bleeding. These include chest tube drainage, thoracotomy and endovascular embolisation. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5148840 Wed, 24 Aug 2011 19:56:29 +0100 5148840 http://www.medworm.com/index.php?rid=5148839&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310006741%2Fabstract%3Frss%3Dyes Conclusion: The results of this study indicate that the 3 fundamental elements comprising the Glasgow coma scale, E, M, and V individually, and in certain combinations are predictive of the survival of TBI patients. This observation is clinically useful when evaluating TBI patients in whom a complete GCS score cannot be obtained. (Source: Injury) Injury journals http://www.medworm.com/rss/comments.php?id=5148839 Wed, 24 Aug 2011 19:56:27 +0100 5148839 http://www.medworm.com/index.php?rid=5148838&cid=s_35629_31_f&fid=35629&url=http%3A%2F%2Fwww.injuryjournal.com%2Farticle%2FPIIS0020138310003293%2Fabstract%3Frss%3Dyes This study evaluated changes from AIS 98 to AIS 05, the changes’ effect on ISS distributions, and presents an application of the results.Methods: Injury descriptions from medical records of 137 randomly selected patients in the Oklahoma Trauma Registry (OTR) were obtained. A single trained coder used AIS 98 and AIS 05 to code each injury. ISS values were calculated and grouped into 4 categories: 1–8, 9–14, 16–24, >24. Paired ISS was compared using Kappa statistics and tests of symmetry. We identified common injury diagnoses for which AIS severity changed between versions. Estimates of the proportion of patients changing ISS groups were applied to the entire OTR to assess the impact on reporting and on a model for reimbursement.Results: OTR AIS 98 and manual AIS 98-based ISS values ... Injury journals http://www.medworm.com/rss/comments.php?id=5148838 Wed, 24 Aug 2011 19:56:25 +0100 5148838