Towards a Learning Trauma System: Aligning Quality Improvement and Research Strategies
In 2016, the National Academies of Science, Engineering, and Medicine advocated for learning trauma systems in their publication: “A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury”.[1] Learning trauma systems leverage health information technology to rapidly implement evidence gained from both traditional research as well as from clinical practi ce, thus continuously improving and innovating. While multiple characteristics are necessary for a learning trauma system, a key component is the coordination of quality improvement (QI) and research...
Source: Injury - March 27, 2024 Category: Orthopaedics Authors: Lillian S. Kao Tags: Editorial Source Type: research

Is intramedullary nailing of femoral diaphyseal fractures in the lateral decubitus position as safe and effective as on a traction table?
The aim of this study was to compare the radiological and clinical results of femoral diaphyseal fractures operated in the lateral decubitus position with those operated in the supine position on a traction table and to detail the perioperative surgical technique. (Source: Injury)
Source: Injury - March 27, 2024 Category: Orthopaedics Authors: Emir Sholla, Cemil Ert ürk, Necati Doğan, Halil Büyükdoğan, Gürkan Çalışkan, Adem Şahin Source Type: research

Revealing Digital Nerve Lesions- a Comprehensive Analysis of 2084 Cases of a Specialized Center
Finger nerve injuries exert a considerable impact on hand function and force production, necessitating a scientific exploration of their consequences. The digital peripheral nerves play a crucial role in providing sensory feedback for muscles involved in fine motor movements and grip strength (e.g. mm. lumbricales). Any form of nerve damage or injury can lead to reduced sensation, muscle weakness, painful neuroma and impaired coordination in the fingers, thereby diminishing the ability to perform fine motor tasks such as writing and typing, as well as compromising grip strength [1]. (Source: Injury)
Source: Injury - March 24, 2024 Category: Orthopaedics Authors: Martin Aman, Kim S. Zimmermann, Julia J. Glaser, Simeon C. Daeschler, Arne H. Boecker, Leila Harhaus Source Type: research

Leveraging Transportation Providers to Deploy Lay First Responder (LFR) Programs in Three sub-Saharan African Countries without Formal Emergency Medical Services: Evaluating Longitudinal Impact and Cost-Effectiveness
Injury is the leading cause of death for people aged 15-45, accounting for 32% more mortality than malaria, tuberculosis, and HIV/AIDS combined.[1] Road traffic injuries (RTIs) are the largest contributor to global injuries and among the five leading causes of disability-adjusted life years (DALYs).[2] RTIs disproportionately affect low- and middle-income countries (LMICs), comprising 96% of the 25 countries with the greatest RTI-related DALY burden, and decreasing GDP by an estimated 6%.[3] Motorcycle taxis are the fastest-growing form of informal transportation due to a lack of affordable publicly-funded alternatives, be...
Source: Injury - March 20, 2024 Category: Orthopaedics Authors: Peter G. Delaney, Zachary J. Eisner, Haleigh Pine, Max Klapow, Alfred Harun Thullah, Richard Bamuleke, Issa Mohamet Nuur, Krishnan Raghavendran Source Type: research

Comparative Biomechanical Analysis of Reconstruction and Cephalomedullary Nails in the Treatment of Osteoporotic Subtrochanteric Fractures
Subtrochanteric femoral fractures present a notable challenge because of their distinct mechanical and biological properties [1]. These fractures are complicated by factors such as a wide medullary canal, opposing forces on the proximal fragment, risk of improper alignment due to adduction forces, and distal fragment medialization since they are located in high compressive and tensile stress areas [2,3]. Consequently, complications such as malunion, delayed union, non-union, limb shortening, limited joint motion, and mechanical failure may arise [4]. (Source: Injury)
Source: Injury - March 20, 2024 Category: Orthopaedics Authors: Yong-Cheol Yoon, Joon-Woo Kim, Tae-Kong Kim, Chang-Wug Oh, Kyeong-Hyeon Park, Jin-Han Lee Source Type: research

Comparison of injury severity scores derived from ICD-10-AM codes with trauma registry derived scores: a study from New Zealand
Trauma registries play a key role in trauma systems, providing useful information on patterns of injury and outcomes, monitoring of the quality of care, and informing injury prevention and control actions [1]. Injury severity is an important measure in trauma research, with the Injury Severity Score (ISS) one of the most commonly used indices [2]. The ISS is an anatomically based score used to rate the overall severity of multiple injuries, and is calculated using the Abbreviated Injury Scale (AIS) [3]. (Source: Injury)
Source: Injury - March 17, 2024 Category: Orthopaedics Authors: Luisa Montoya, Gabrielle Davie, Rebbecca Lilley, Bridget Dicker, Bridget Kool Source Type: research

A Comparison of the Psychometric Properties of a Person-Administered vs. Automated Screening Tool for Posttraumatic Stress Disorder (PTSD) in Traumatically Injured Patients
Poor mental health outcomes, including posttraumatic stress disorder (PTSD), affect greater than 20% of trauma patients 12 months post-injury.[1,2] PTSD after traumatic injury is associated with poor physical recovery, social functioning, and quality of life.[3,4] Despite the known effects that adverse mental health outcomes have on trauma patient recovery, only a small portion of trauma centers have protocols in place to address PTSD.[5] For these reasons, the American College of Surgeons Committee on Trauma (ACS-CoT) has required that trauma centers have mental health screening and referral protocols in place by 2023. (Source: Injury)
Source: Injury - March 15, 2024 Category: Orthopaedics Authors: Amber Brandolino, Elise A. Biesboer, Morgan Leissring, Rachel Weber, Sydney Timmer-Murillo, Terri A. deRoon-Cassini, Mary E. Schroeder Source Type: research

The Relationship Between Patient Volume And Mortality In NSW Major Trauma Service Hospitals
Trauma is the most common cause of death in first world jurisdictions for people under 45 years of age. In Australia road trauma and self-harm were both amongst the top ten causes of years of life lost in 2013 [1]. Systems of trauma care which decrease mortality are therefore important public health measures. Based on systems originally developed in the United States in the 1970s and 1980s modern trauma systems designate specialist centres for the management of severely injured patients as this has been associated with lower mortality [2]. (Source: Injury)
Source: Injury - March 15, 2024 Category: Orthopaedics Authors: Alan A Garner, Leela Sai Krishna Suryadevara, Charlie Sewalt, Stuart Lane, Rajneesh Kaur Source Type: research

Mechanism and Outcomes of Recreational and Sports-Related Open Globe Injuries
Open globe injury (OGI) is defined as a full-thickness wound that typically occurs near the limbus and insertion of the rectus muscles due to blunt trauma or penetrating objects [1]. These injuries are divided into three different zones, with zone 1 defined as an injury of the whole cornea and corneoscleral limbus, zone 2 as an injury from the corneoscleral limbus to a point 5 mm posterior into the sclera, and zone 3 as an injury posterior to the anterior 5 mm of the sclera [2]. Notably, while the association of blunt trauma with increased zone 3 OGIs is well documented, OGIs caused by penetrating mechanisms have also been...
Source: Injury - March 14, 2024 Category: Orthopaedics Authors: Bronson M. Ciavarra, Emma C. Stenz, Matthew R. Barke, Andrew W. Gross, Alice Z. Chuang, Eric L. Crowell Source Type: research

Physiologic Parameters and Radiologic Findings can Predict Pulmonary Complications and Guide Management in Traumatic Rib Fractures
Traumatic rib fracture is associated with a high morbidity rate and identifying patients at risk of developing pulmonary complications (PC) can guide management and potentially decrease unnecessary intensive care admissions. Therefore, we sought to assess and compare the utility of a physiologic parameter, vital capacity (VC), with the admission radiologic findings (RibScore) in predicting PC in patients with rib fractures. (Source: Injury)
Source: Injury - March 13, 2024 Category: Orthopaedics Authors: Abdul Hafiz Al Tannir, Courtney J. Pokrzywa, Christopher Dodgion, Kelly A. Boyle, Savo Bou Zein Eddine, Elise A. Biesboer, David J. Milia, Marc A. de Moya, Thomas W. Carver Source Type: research

Prevalence of chronic pain after severe lower limb injury (SLLI): a systematic review and meta-analysis
Globally, severe lower limb injuries (SLLIs) are the predominant cause of long-term injury related disability and poor functional outcomes. Chronic pain is a major source of this morbidity, but the magnitude of the contribution is not clearly understood. The aim of this systematic review and meta-analysis was to determine the prevalence of chronic pain following SLLIs in civilian and military patients. (Source: Injury)
Source: Injury - March 11, 2024 Category: Orthopaedics Authors: Shareef Mahdi, Rebecca Stoner, James Wyatt, Henry De'Ath, Zane Perkins Source Type: research

Effect of trauma quality improvement initiatives on outcomes and costs at community hospitals: A scoping review
Traumatic injury is a major cause of death and disability worldwide. An estimated 5.8 million people die from trauma annually, with many more experiencing substantial ongoing disability [1]. A disproportionate proportion of major trauma affect individuals in developing countries, with low socioeconomic status, certain racial and ethnic groups, and rural inhabitants [2,3,4,5]. The organization of trauma systems has been associated with a decrease in trauma-related mortality when implemented [6,7]. (Source: Injury)
Source: Injury - March 11, 2024 Category: Orthopaedics Authors: Reba McIver, Mete Erdogan, Robin Parker, Allyson Evans, Robert Green, David Gomez, Tyler Johnston Source Type: research

The paediatric polytrauma CT-indication (PePCI)-score –Development of a prognostic model to reduce unnecessary CT scans in paediatric trauma patients
Whole-Body CT (WBCT) is frequently used in emergency situations for promptly diagnosing paediatric polytrauma patients, given the challenges associated with obtaining precise details about the mechanism and progression of trauma. However, WBCT does not lead to reduced mortality in paediatric patients, but is associated with high radiation exposure. We therefore wanted to develop a screening tool for CT demand-driven emergency room (ER)-trauma diagnostic to reduce radiation exposure in paediatric patients. (Source: Injury)
Source: Injury - March 9, 2024 Category: Orthopaedics Authors: Strahl Andr é, Willemsen Jan Fritjof, Schoof Benjamin, Reinshagen Konrad, Frosch Karl-Heinz, Wintges Kristofer Source Type: research

The Paediatric polytrauma CT-Indication (PePCI)-Score - Development of a prognostic model to reduce unnecessary CT scans in paediatric trauma patients
Whole-Body CT (WBCT) is frequently used in emergency situations for promptly diagnosing paediatric polytrauma patients, given the challenges associated with obtaining precise details about the mechanism and progression of trauma. However, WBCT does not lead to reduced mortality in paediatric patients, but is associated with high radiation exposure. We therefore wanted to develop a screening tool for CT demand-driven emergency room (ER)-trauma diagnostic to reduce radiation exposure in paediatric patients. (Source: Injury)
Source: Injury - March 9, 2024 Category: Orthopaedics Authors: Strahl Andr é, Willemsen Jan Fritjof, Schoof Benjamin, Reinshagen Konrad, Frosch Karl-Heinz, Wintges Kristofer Source Type: research

The Economic and Resource Burden of E-Scooter-Related Orthopaedic Injuries: A District General Hospital's Experience
Electric scooters (e-scooters) are becoming an increasingly popular and convenient method of transportation in major urban cities across the world. There is existing evidence that there is an increasing frequency of significant orthopaedic injuries associated with e-scooters and that they incur a financial burden to our healthcare system.[1 –3] (Source: Injury)
Source: Injury - March 9, 2024 Category: Orthopaedics Authors: M. Antonik, S Sankar, J Shepherd, S Hassan Source Type: research