Operative versus nonoperative treatment of multiple simple rib fractures: a systematic review and meta-analysis
Rib fractures are common injuries in both trauma- and non-trauma centers and occur in up to 10-35% of patients after sustaining blunt chest trauma [1,2]. Rib fractures are associated with pulmonary morbidity such as pneumonia in 17-77% of patients and a mortality rate around 10%, with increased rates in the elderly and those with a higher number of rib fractures [1,3-9]. Multiple rib fractures can result in a flail chest, which is defined as fracture of three or more consecutive ribs, in two or more places, creating a unstable or flail segment [8,10]. (Source: Injury)
Source: Injury - July 3, 2020 Category: Orthopaedics Authors: Mathieu M.E Wijffels, Jonne T.H. Prins, Eva J. Perpetua Alvino, Esther M.M Van Lieshout Source Type: research

Biomechanical comparison of fixation techniques for transverse acetabular fractures – single-leg stance vs. sit-to-stand loading
Biomechanical testing constitutes an integral part of the scientific assessment of fracture fixation techniques [1]. The definition of loading conditions is one of the major challenges in the context of providing clinically relevant data. The loads applied should best possibly mimic physiological loads that occur during daily life [2]. These everyday loads, however, compromise innumerable force vectors with different amplitudes and directions. As a consequence, it is reasonable and well-accepted to use predefined loading protocols for improving comparability of biomechanical studies [3]. (Source: Injury)
Source: Injury - July 3, 2020 Category: Orthopaedics Authors: Huy Le Quang, Werner Schmoelz, Richard A. Lindtner, Peter Schwendinger, Michael Blauth, Dietmar Krappinger Source Type: research

Health and return to work in the first two years following road traffic injury: A comparison of outcomes between compensation claimants in Victoria and New South Wales, Australia
The health outcomes of people with road traffic injuries are influenced by many factors beyond the type and severity of the injuries sustained. In particular, social, demographic and economic factors have been identified to play a key role in injury recovery [1-6]. One key factor includes the intent to claim compensation [7, 8], or having a claim for compensation [9, 10], and compensation-related effects are worse for claimants in fault-based schemes than in no-fault schemes [11]. It is possible that compensation-related harms, especially in fault-based schemes, are a proxy for other causal factors, such as financial incen...
Source: Injury - July 2, 2020 Category: Orthopaedics Authors: Melita J Giummarra, Darnel Murgatroyd, Yvonne Tran, Sam Adie, Rajat Mittal, Jennie Ponsford, Peter Cameron, Belinda Gabbe, Ian A Harris, Ian D Cameron Source Type: research

Plate versus sacroiliac screw fixation for treating posterior pelvic ring fracture: A Systematic review and meta-analysis
The choice between plate and sacroiliac (SI) screw fixation methods for the treatment of posterior pelvic ring disruption is a controversial subject. The SI screw fixation technique has become popular and has shown excellent results over the past few decades [1-3]. The advantages of percutaneous screw fixation include the fact that the patient can be in the supine position; a shorter operation time; the ease of combined anterior fixation; the requirement of only a small incision, which results in minimal blood loss; and low concerns of soft tissue injuries or deep infections [4,5]. (Source: Injury)
Source: Injury - July 2, 2020 Category: Orthopaedics Authors: Chul-Ho Kim, Ji Wan Kim Source Type: research

Validating injury-related diagnoses by physicians: An analysis of 62,269 hospitalizations from a large hospital in Changsha, China
Clinical diagnoses and relevant International Classification of Disease (ICD) codes in hospital records form the basis of official health statistics. In many countries, case-based diagnoses and codes are summarized into aggregate statistics for official release and are generally assumed by researchers, policy-makers and other stakeholders to be accurate. (Source: Injury)
Source: Injury - July 2, 2020 Category: Orthopaedics Authors: Qiong He, Jin Tong, Min Jin, Junjie Hua, David C. Schwebel, Jing Zhang, Guoqing Hu Source Type: research

Esmolol reduces myocardial injury induced by resuscitative endovascular balloon occlusion of the aorta (REBOA) in a porcine model of hemorrhagic shock
The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for the management of non-compressible torso hemorrhage is growing due to its ability to control hemorrhage and augment blood flow to the heart and brain. However, in addition to the profound ischemic injury to tissues below the level of aortic occlusion, recent evidence suggests that REBOA can cause injury to tissue beds proximal to the point of occlusion. Recent translational data has demonstrated direct myocardial injury as a result of complete aortic occlusion in a large animal model of hemorrhagic shock [1]. (Source: Injury)
Source: Injury - July 2, 2020 Category: Orthopaedics Authors: Guillaume L Hoareau, Carl A Beyer, Connor M Caples, Marguerite W Spruce, Zachary Gilbert, J Kevin Grayson, Lucas P Neff, Timothy K Williams, M Austin Johnson Source Type: research

Euthyroid Sick Syndrome in Hip Fractures: evaluation of postoperative anemia
With the aging of the world population, the incidence of hip fractures is increasing with upward estimates representing one of the most current health problems [1,2]. (Source: Injury)
Source: Injury - July 2, 2020 Category: Orthopaedics Authors: Cauteruccio M, Vitiello R, Perisano C, Covino M, Sircana G, Piccirillo N, Pesare E, A. Ziranu, Maccauro G Source Type: research

Prognostic factors and outcomes of secondary surgery after plate fixation for midshaft clavicle fracture: Comparison of traditional DCP and pre-contoured locking plate
Midshaft clavicle fracture is a common injury in adults, involved in 70 –80% of clavicle fractures [1]. Traditionally, several studies advocated a low nonunion rate without operation [2,3], while conservative management was the mainstay of treatment for middle-third clavicle fractures. This concept was challenged by recent publications indicating that the nonunion rat e of displaced midshaft clavicle fracture without operative treatment reached 15% or more [4,5]. A recent meta-analysis indicated that the surgically treated group had only a 1.4% nonunion rate [4]. (Source: Injury)
Source: Injury - June 29, 2020 Category: Orthopaedics Authors: Yung-Chuan Hsiao, Tung-Yi Lin, Ying-Chih Wang, Chia-Wei Chang, Hao-Che Tang, Chien-Hao Chen, Chun- Yi Su Source Type: research

Concerns regarding “Dynamic limited axial compression yields favorable functional outcomes in the fixation of Pauwels type-3 femoral neck fractures: A retrospective cohort study”
The outcomes of femoral neck fractures are difficult to predict. An anatomical reduction and appropriate fixation may not always result in favorable outcomes. The fixation strategies for the fixation of femoral neck fractures keep on evolving. The article by Liu JF, et  al. [1] provides an interesting description of the two non-conventional but promising methods of fixation of femoral neck fractures. The medial buttress plate without fixation of the femoral head seems to be an attractive augmentation to prevent varus failure. (Source: Injury)
Source: Injury - June 29, 2020 Category: Orthopaedics Authors: Arvind Kumar, Rizwan Khan, Javed Jameel, Owais Ahmed Qureshi, Mukesh Kumar Tags: Letter to the Editor Source Type: research

Concerns regarding one-bone forearm reconstruction and distal radioulnar joint fusion for emergency one-stage operation in traumatic major bone defect of forearm
The article by Wang Y et al [1] on the one-bone forearm (OBF) reconstruction and distal radioulnar joint fusion as an emergency one-stage operation in traumatic major bone defects of the forearm, provides a piece of interesting evidence concerning the salvage options for such complex trauma. Although, there are some shortcomings of this procedure considering the loss of rotatory motion of the forearm, shortening and cosmetic issues, the limb preservation and a satisfactory functional restoration are of paramount importance to the patients. (Source: Injury)
Source: Injury - June 29, 2020 Category: Orthopaedics Authors: Arvind Kumar, Yawar haider, Sandeep Kumar, Javed Jameel Source Type: research

Predicting Tibia Shaft Nonunions at Initial Fixation: An External Validation of the Nonunion Risk Determination (NURD) Score in the SPRINT Trial Data
The risk of a nonunion following a tibial shaft fracture is estimated to be between 5 – 15% [1,2]. A tibial shaft nonunion bears a substantial negative impact on the patients’ quality of life and is costly to treat [3]. Clinicians have previously attempted to develop a tool that would enable the identification of tibial shaft fracture patients at high and low risk for nonunion [3 -5]. Prognostic information at the time of fixation could guide secondary prevention strategies in the management of the injury and allow clinicians and patients to better anticipate the likely treatment course. (Source: Injury)
Source: Injury - June 28, 2020 Category: Orthopaedics Authors: Nathan N. O'Hara, Gerard P. Slobogean, Kevin O'Halloran, Renan Castillo, Sheila Sprague, Mohit Bhandari, Robert V. O'Toole Source Type: research

Open tendoachilles injuries due to squatting type of toilet seats: Five-year prospective observational study from a tertiary care center in India.
Achilles tendon is considered to be one of the strongest and longest tendons in human body [1]. It is a subcutaneous tough structure and its posterior position safeguards it against any anterior assault/ injury due to any falling object [2]. However, the impact against the posterior overhanging lip of the squatting toilet seat while withdrawing the slipped foot makes it vulnerable to severe open injuries [3]. Most of the injuries reported worldwide are closed ruptures related to sports activities or seen following occasional strenuous activities in steroid users [4 –7]. (Source: Injury)
Source: Injury - June 28, 2020 Category: Orthopaedics Authors: Mir Mohsin, Haroon Rashid Zargar, Tanveer Ahmed Bhat, Hilal Ahmed Bhat, Farooq Ahmed Mir, Adil Hafeez Wani Source Type: research

The Influence of Biomechanical Stability on Bone Healing and Fracture-Related Infection: The Legacy of Stephan Perren.
For many centuries, fracture care consisted almost exclusively of conservative treatment options, limited to casting or skeletal traction (1). The concept of open reduction and stable internal fixation (ORIF), heavily influenced by the Association for Internal Fixation (AO/ASIF, "Arbeitsgemeinschaft f ür osteosynthesefragen, later in 1984 to become the AO Foundation), gained popularity in the 1960s as a means to restore anatomical alignment and allow early functional mobilization (2, 3). By minimizing the sequelae of extended immobilization, such as joint stiffness and muscle atrophy, internal f ixation of fractu...
Source: Injury - June 26, 2020 Category: Orthopaedics Authors: Andrew L. Foster, T. Fintan Moriarty, Charalampos Zalavras, Mario Morgenstern, Anjali Jaiprakash, Ross Crawford, Marc-Antoine Burch, Willemijn Boot, Kevin Tetsworth, Theodore Miclau, Peter Ochsner, Michael A. Schuetz, R. Geoff Richards, Willem-Jan Metsema Source Type: research

Surgical approaches to intramedullary nailing of the tibia: Comparative analysis of knee pain and functional outcomes
Dear Editor (Source: Injury)
Source: Injury - June 25, 2020 Category: Orthopaedics Authors: Chong Li, Yi-jun Gao, Ke Lu Tags: Letter to the Editor Source Type: research

Letter to the editor on the outcomes in fracture patients infected with COVID-19.
Dear editor, (Source: Injury)
Source: Injury - June 25, 2020 Category: Orthopaedics Authors: Maroun Rizkallah, Elias Melhem, Mansour Sadeqi, Jean Meyblum, Pomme Jouffroy, Guillaume Riouallon Source Type: research

Combined medial patellofemoral and patellotibial reconstruction with soft tissue fixation in recurrent patellar dislocation: Some concerns
We have read with great interest the recent article on combined medial patellofemoral and patellotibial reconstruction with soft tissue fixation in recurrent patellar dislocation by Maffulli N, et al[1]. The article describes a simple and effective technique for the two ligamentous reconstructions using the Gracilis tendon graft with preserved insertion. Although the authors are able to convey the basic methodology and the effectiveness of this reconstruction in form of their results, there are few concerns regarding the completeness of the methodology and the interpretation of the results provided. (Source: Injury)
Source: Injury - June 25, 2020 Category: Orthopaedics Authors: Dr. Arvind Kumar, Dr. Yawer Haider, Dr. Javed Jameel, Dr. Owais Ahmed Qureshi Source Type: research

Response to comments on “Interlocking nailing of femoral shaft fractures with an extremely narrow medullary canal is associated with iatrogenic fractures.”
We appreciate the constructive comments regarding our study “Interlocking nailing of femoral shaft fractures with an extremely narrow medullary canal is associated with iatrogenic fractures”[1, 2]. After carefully considering your comments, we offer the following explanations: (Source: Injury)
Source: Injury - June 25, 2020 Category: Orthopaedics Authors: Kai-Lan Hsu, Fa-Chuan Kuan, Hao-Chun Chuang, Ming-Long Yeh, Wei-Ren Su Source Type: research

Comments On “Comparison of Extended Lateral Approaches to the Tibial Plateau: The Articular Exposure of Lateral Epicondyle Osteotomy With and Without Popliteus Tendon vs. Fibula Osteotomy”
Dear Editor, (Source: Injury)
Source: Injury - June 25, 2020 Category: Orthopaedics Authors: Devendra K Chouhan, Udit K Jayant Source Type: research

Development of an enhanced acute care surgery service in response to the COVID-19 global pandemic
The COVID-19 pandemic has provided humanity with enormous healthcare and economic challenges. The epicentre has shifted from China to Europe and the United States with over 3 million people infected and 200,000 deaths. The Singapore government escalated its ‘Disease outbreak response system condition (DORCSCON) level to Orange on February 7 instigating containment strategies of isolating infected cases, aggressive contact tracing and widespread testing [1]. Despite mitigation efforts such as border closures, travel restrictions, enforced social dista ncing and a virtual lockdown on April 7, the number of infected cas...
Source: Injury - June 24, 2020 Category: Orthopaedics Authors: Sachin Mathur, Chung Fai Jeremy Ng, Fangju Koh, Mingzhe Cai, Gautham Palaniappan, Yun Le Linn, Huiling Linda Lim, Ramu Lakshman, Xiao Shuang Ling, Sock Teng Chin, Hiang Khoon Tan Source Type: research

The Early Effects of Social Distancing Resultant From COVID-19 on Admissions To a Level I Trauma Center
Trauma imposes a major burden on the healthcare system. The US has a well-developed public health program and trauma systems. Despite that, trauma is still responsible for a sizable number of hospital admissions. Besides, it's a prominent cause of death of young adults. Multiple elements dictate the number and pattern of trauma admission to the emergency department (ED), such as location, population density and size, economy, weather, social factors, and others. These factors can be unique to each region; therefore, it can lead to different patterns. (Source: Injury)
Source: Injury - June 24, 2020 Category: Orthopaedics Authors: Zaid Aljuboori, Emily Sieg Source Type: research

Living settings and cognitive impairment are stronger predictors of nursing home admission after hip fracture surgery than physical comorbidities A nationwide Danish cohort study
What preoccupies the patient's mind when sustaining a hip fracture? The risk of dying, fear of going through surgery? No, they fear to lose their independence. Not to be able to walk their dog and play with the grandchildren or in worse case being admitted to nursing home seem to be predominant worries [1,2]. (Source: Injury)
Source: Injury - June 24, 2020 Category: Orthopaedics Authors: Liv Riisager Wahlsten, L ærke Smedegaard, Stig Brorson, Gunnar Gislason, Henrik Palm Source Type: research

A protocol for the management of Maxillofacial Injuries in the wake of the COVID-19 Pandemic
The oral& maxillofacial region and by that virtue surgery of the same is correlated to an increased risk of the transfer of the SARS CoV-2. In times of a pandemic it is imperative to institute a protocol based management of maxillofacial injuries based on currently available literature which is suggestive, simplistic, executable and amenable to modifications should the rapidly changing situation demand the same. The author, in the present study conducted a review of literature to undertake the task of forming a simplistic protocol which is readily applicable for the management of maxillofacial injuries which would not ...
Source: Injury - June 24, 2020 Category: Orthopaedics Authors: Dr Vaibhav Sahni Tags: Letter to the Editor Source Type: research

Are emergency surgical patients “collateral victims” of COVID-19 outbreak?
To the editor: (Source: Injury)
Source: Injury - June 24, 2020 Category: Orthopaedics Authors: Pietro Fransvea, Marta Di Grezia, Antonio La Greca, Valerio Cozza, Gabriele Sganga Tags: Letter to the Editor Source Type: research

Development of an enhanced Acute Care Surgery service in response to the COVID-19 global pandemic: Assessment of clinical patient outcomes and staff psychological well-being
The COVID-19 pandemic has provided humanity with enormous healthcare and economic challenges. The epicentre has shifted from China to Europe and the United States with over 3 million people infected and 200,000 deaths. The Singapore government escalated its ‘Disease outbreak response system condition (DORCSCON) level to Orange on February 7 instigating containment strategies of isolating infected cases, aggressive contact tracing and widespread testing [1]. Despite mitigation efforts such as border closures, travel restrictions, enforced social dista ncing and a virtual lockdown on April 7, the number of infected cas...
Source: Injury - June 24, 2020 Category: Orthopaedics Authors: Sachin Mathur, Chung Fai Jeremy Ng, Fangju Koh, Mingzhe Cai, Gautham Palaniappan, Yun Le Linn, Huiling Linda Lim, Ramu Lakshman, Xiao Shuang Ling, Sock Teng Chin, Hiang Khoon Tan Source Type: research

The Impact of Historical Racism on Modern Gun Violence: Redlining in the City of Louisville, KY
Gun violence is a significant public health problem in America. Nearly 13,000 people are the victims of gun homicide and approximately 75,000 are injured in non-fatal gun assaults per year in the United States [1]. The problem of gun violence, particularly intentional injuries, disproportionately affects individuals based on race. Black men are 14 times more likely than white men to die from firearm violence [1] and homicide by firearm is the leading cause of death for Black males aged 15-35 in the United States [1]. (Source: Injury)
Source: Injury - June 24, 2020 Category: Orthopaedics Authors: Matthew Benns, Matthew Ruther, Nicholas Nash, Matthew Bozeman, Brian Harbrecht, Keith Miller Source Type: research

High Acuity Polytrauma Centers in Orthopaedic Trauma: Decreasing Patient Mortality With Effective Resource Utilization
Regionalization of health care is a structured way of delivering high-quality, cost-efficient medical care. Regionalization is designed to offer improved patient outcomes through two mechanisms: 1) improved patient outcomes at specialized, experienced centers and 2) improved care coordination within a given geographic region. Within emergency care, regionalization of trauma, interventional cardiology, neurology, critical care medicine, and pediatric emergency medicine has become increasingly common as a means of concentrating integrated, interspecialty expertise to provide high-value care. (Source: Injury)
Source: Injury - June 24, 2020 Category: Orthopaedics Authors: Andrew M. Schwartz, Christopher Staley, Jacob M. Wilson, William M. Reisman, Mara L. Schenker Source Type: research

Surgical Management of Acetabular Fractures – A Contemporary Literature Review
Surgical management of acetabular fractures is now commonplace for almost all displaced or unstable fractures. Over the last 20 years however, the patient population has aged, and there have been significant changes to safety in motor vehicles and the work-place, and people's activity types and levels have changed. The surgical specialty has also developed with time, and as a result acetabular fracture surgery today is different to 20 years ago.We have repeated a meta-analysis originally published by Giannoudis et al in 2005, to evaluate contemporary aspects of acetabular fracture patients, injury mechanisms, management, c...
Source: Injury - June 24, 2020 Category: Orthopaedics Authors: J. Kelly, A. Ladurner, M. Rickman Source Type: research

The single visit treatment of pediatric distal radius buckle fractures –A center's experience with the treatment algorithm
The buckle fracture, also interchangeably termed a torus fracture, is a unique type of fracture commonly involving the distal radius in the pediatric population [1]. It is a fracture through the metaphyseal-diaphyseal zone from a compressive force, resulting in a “buckling” or protuberance of one cortex while the opposite cortex remains intact [2]. These fractures are inherently stable with little to no risk of displacement [3]. (Source: Injury)
Source: Injury - June 22, 2020 Category: Orthopaedics Authors: Chin Yee Woo, Pak Leung Kenneth Wong, Arjandas Mahadev Source Type: research

The Single Visit Treatment of Pediatric Distal Radius Buckle Fractures – A Center's Experience with the Treatment Algorithm
The buckle fracture, also interchangeably termed a torus fracture, is a unique type of fracture commonly involving the distal radius in the pediatric population (1). It is a fracture through the metaphyseal-diaphyseal zone from a compressive force, resulting in a “buckling” or protuberance of one cortex while the opposite cortex remains intact (2). These fractures are inherently stable with little to no risk of displacement (3). (Source: Injury)
Source: Injury - June 22, 2020 Category: Orthopaedics Authors: Chin Yee WOO, Pak Leung Kenneth WONG, Mahadev Arjandas Source Type: research

A Pilot Biomechanical Study Comparing a Novel, Intramedullary Nail/Plate Construct to Standard Dual-Plate Fixation of Intra-Articular C2.3 Distal Humerus Fractures
Comminuted and displaced distal humerus fractures continue to represent a significant challenge for upper extremity and trauma surgeons [1 –3]. Intra-articular distal humerus fractures typically result from either high-energy trauma, such as motor vehicle collisions, in younger patients or low-energy trauma, such as falls, in osteoporotic elderly individuals [2,4,5]. For intra-articular distal humerus fractures, the treatment of choi ce is open reduction and internal fixation, with a goal of stable, anatomic bone and articular reconstruction that can enable early mobilization – critical to achieving successful ...
Source: Injury - June 22, 2020 Category: Orthopaedics Authors: Neil V. Shah, Westley T. Hayes, Hanbin Wang, John C. Hordines, Jonathan E. Karakostas, Odysseas Paxinos, Steven M. Koehler Source Type: research

Bilateral flaps based on the dorsal branches of digital artery for one-stage repairing the multiple defects in one finger
The flap based on the dorsal branch of the proper digital artery (PDA) is commonly used to repair the skin soft tissue defect of finger, including dorsal or palmar defect of the finger, particularly for fingertip, and the outcomes are satisfactory, associating with the properties of reliable and rich blood supply, easy technique, texture and hairless, and the dorsal branch of the proper digital nerve can also be included in the flap, if necessary.[1-9] Coverage of the multiple skin soft tissue defects of one finger represents a challenging problem, including multiple defects without adjacent edge and the limitation of flap...
Source: Injury - June 22, 2020 Category: Orthopaedics Authors: Wenlong Zhang, Jie Fang, Yun Lu, Fei Ma, Jian Wang Source Type: research

Bear attack pattern and behavior in the Himalayan region: A study from a tertiary care center
Human-wildlife conflict is an essential cause of injury to people in rural communities. With increased urbanization and encroachment into natural wildlife territory, humans are more at risk of being injured by wild animals [1]. Although bear attacks constitute only 0.1% of all animal attacks in India, they are the most common injuries inflicted by wild animals [2]. (Source: Injury)
Source: Injury - June 20, 2020 Category: Orthopaedics Authors: Amborish Nath, Nikhilesh Kumar Gaur, Madhubari Vathulya, Akshay Kapoor, Md Altaf Mir, Vishal Mago, Debarati Chattopadhyay Source Type: research

Submental Nalbuphine Exhibits Improved Efficacy in Ameliorating Acute Pain in Prehospital emergent conditions; A Comparative Study with Conventional Intramuscular using Gamma Scintigraphy.
Pain is an obnoxious stimulus and according to the International Association of study of Pain, it is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage (1). It is a complex phenomenon comprising physiological, emotional and behavioral components. Relief from pain is a major issue concerning practical and humanitarian reasons. Pain control is desirable for assessment of injuries, helps to reduce rescue and extrication times, ease off medical interventions. (Source: Injury)
Source: Injury - June 20, 2020 Category: Orthopaedics Authors: Kushagra Khanna, Ritu Karwasra, Sandeep Choudhary, Deeksha Sharma, Nitin Sharma, Puja Nagpal, Varsha Chorsiya, Dhruv Kumar Nishad, Harvinder Popli, Aseem Bhatnagar Source Type: research

Bear attack pattern and behavior in the Himalayan region: a study from a tertiary care center.
Human-wildlife conflict is an essential cause of injury to people in rural communities. With increased urbanization and encroachment into natural wildlife territory, humans are more at risk of being injured by wild animals.[1] Although bear attacks constitute only 0.1% of all animal attacks in India, they are the most common injuries inflicted by wild animals [2]. (Source: Injury)
Source: Injury - June 20, 2020 Category: Orthopaedics Authors: Amborish Nath, Nikhilesh Kumar Gaur, Madhubari Vathulya, Akshay Kapoor, Md Altaf Mir, Vishal Mago, Debarati Chattopadhyay Source Type: research

Pleiotropic Actions of Vitamin D in Composite Musculoskeletal Trauma
Composite tissue injuries (CTI) are complex and devastating wounds usually caused by high energy impacts such as motor vehicle accidents or within the military context, blasts. CTI's are characterized by severe trauma and wide-spread damage or ablation of several tissue types, most commonly: muscle, bone, vasculature, nerve and dermal tissues.[1] These types of injuries are extensive and often time's treatments are confounded by persistent complications as a result of poor wound healing, costing the health care system and the Department of Defense healthcare system billions of dollars. (Source: Injury)
Source: Injury - June 17, 2020 Category: Orthopaedics Authors: Michael S. Valerio, Naveena B. Janakiram, Stephen M. Goldman, Christopher L. Dearth Source Type: research

One-Bone Forearm Reconstruction and Distal Radioulnar Joint Fusion for Emergency One-stage Operation in Traumatic Major Bone Defect of Forearm
The bony structure of the forearm consists of the ulna, radius and associated articulations radius. The length of the ulna and radius is critical to the proper function of the forearm [1] [2]. Due to the unique rotation function of the forearm, the treatment of ulnar and radius fractures should be considered as an intra-articular fracture, which requires anatomic reduction to restore normal function. Despite advances in microsurgical technology, the treatment of major bone defects in forearm caused by severe trauma remains a real challenge. (Source: Injury)
Source: Injury - June 17, 2020 Category: Orthopaedics Authors: Yapeng Wang, Ming Zhou, Yongwei Wu, Yunhong Ma, Jun Liu, Yongjun Rui Source Type: research

Geriatric ATV and Snowmobile Trauma at a Rural Level 1 Trauma Center: A Blow to the Chest
It is predicted that by 2030 1 out of 5 people in the United States will be over 65 years old1. As life expectancy continues to increase, trauma centers will see more injured older adults. In the past, the definition of geriatric trauma patients has been debated, with studies using anywhere from 55-80 years old as a cuffoff2. However, currently both the American Association for the Surgery of Trauma (AAST) geriatric trauma committee, the American College of Surgeons and the Eastern Association for the Surgery of Trauma (EAST) geriatric trauma triage guidelines all use 65 years and older to define geriatric trauma patients3,4. (Source: Injury)
Source: Injury - June 17, 2020 Category: Orthopaedics Authors: Jenaya L. Goldwag, Eleah D. Porter, Allison R. Wilcox, Eric D. Martin, Andrea B. Wolffing, D. Joshua Mancini, Alexandra Briggs Source Type: research

Health related quality of life and mortality 10 years after a femoral neck fracture in patients younger than 70 years
A femoral neck fracture (FNF) in a patient younger than 70 years of age is uncommon but may result in lifetime disability [1,2] and reduced life expectancy [3,4]. The goal of treatment for these patients is to restore function, health related quality of life (HRQoL) and to reduce mortality [5]. The clinical results after a hip fracture have traditionally been evaluated by surgical or general postoperative complications [1,6,7,8]. However, it might be even more relevant for these younger patients with a FNF to evaluate patient ´s HRQoL postoperatively [9] as well as identifying predictors for mortality [4]. (Source: Injury)
Source: Injury - June 17, 2020 Category: Orthopaedics Authors: Pierre Campenfeldt, Wilhelmina Ekstr öm, Amer N. Al-Ani, Emanuel Weibust, Katarina Greve, Margareta Hedström Source Type: research

British Orthopaedic Association's Standards for Trauma (BOAST): Care of the older or frail patient with orthopaedic injuries
Managing elderly, frail patients with orthopaedic injuries, remains a challenge. Their poor bone stock and associated comorbidities makes this special cohort of patients unique in terms of their needs and the risk of developing complications. Published on line in 2019 (www.boa.ac.uk/uploads/assets/04b3091a-5398-4a3c-a01396c8194bfe16/the%20care%20of%20the%20older%20or%20frail%20orthopaedic%20trauma%20patient.pdf) the British Orthopaedic Association's Standards for Trauma focusing on the care of the older or frail patient with orthopaedic injuries, provides a contemporary guide for the holistic management of the spectrum of ...
Source: Injury - June 16, 2020 Category: Orthopaedics Authors: British Orthopaedic Association Trauma Committee Source Type: research

The Evolving COVID-19 Effect on Hip Fracture Patients
Countries around the world have had to implement measures to reduce the spread of COVID-19 in order to stop their health services from becoming overwhelmed and to save life. In the UK, protocols have been put in place to protect staff and patients, often drawing upon the experience of countries already affected. (Source: Injury)
Source: Injury - June 16, 2020 Category: Orthopaedics Authors: James N. Hadfield, Andrew C. Gray Tags: Editorial Source Type: research

Editorial Board/Publication Information
(Source: Injury)
Source: Injury - June 16, 2020 Category: Orthopaedics Source Type: research

Orthoplastics, Tariffs and the Reality of Providing Complex Fracture Care
The advent of the Major Trauma network in the United Kingdom (UK) has been heralded as providing significant improvements to patient care on many levels [1 –4]. This is particularly evident in the realm of orthoplastic care, where orthopaedic trauma surgeons work closely with reconstructive plastic surgeons to combine their knowledge and expertise to provide more timely treatment, reduced complications and better functional outcomes [2]. Within the U nited Kingdom National Health Service (NHS), each patient admission cost is calculated using a complex system of codes based on clinical diagnosis and medical interventi...
Source: Injury - June 16, 2020 Category: Orthopaedics Authors: Ben Strong, Ye Ru Chin, Will Eardley, Keith Allison Source Type: research

Combined medial patellofemoral and patellotibial reconstruction with soft tissue fixation in recurrent patellar dislocation
Stability of the patellofemoral joint results from passive soft tissue tension in the medial and lateral retinacular structures, active muscle tension, trochlear architecture, and the forces acting on the articular surfaces [1]. The medial patellofemoral ligament (MPFL) is the primary passive restraint to lateral patellar translation at 0 ° to 30° of knee flexion [2,3], the angle at which lateral instability often occurs [4]. The MPFL is located in the second layer of the anteromedial aspect of the knee [5]. (Source: Injury)
Source: Injury - June 16, 2020 Category: Orthopaedics Authors: Nicola Maffulli, Rocco Aicale, Alessio D'Addona, David A Young, Deiary F Kader, Francesco Oliva Source Type: research

Operative treatment of 2-part surgical neck type fractures of the proximal humerus in the elderly: Cement augmented locking plate PHILOS ™ vs. proximal humerus nail MultiLoc®
Proximal humeral fractures are the second most common fracture of the upper limb and the third most common fracture in the elderly [1, 2]. In turn, 65% of patients with a proximal humeral fracture are>60 years of age [3]. In the light of demographic change, the incidence of proximal humeral fracture is expected to rise, as Kannus et al. reported an incidence of 298 per 100,000 in the age group of at least 80 year old patients in 2007 [4] and Palvanen et al. predict an increase of fracture incidence of 50 % until 2030 [3]. (Source: Injury)
Source: Injury - June 16, 2020 Category: Orthopaedics Authors: Tobias Helfen, Georg Siebenb ürger, Evi Fleischhacker, Johannes Gleich, Wolfgang Böcker, Ben Ockert Source Type: research

One bone forearm with vascularized fibular graft. Clinical experience and literature review
Bone reconstruction of the forearm in severe radius and ulna bone loss is a difficult problem to manage. In 1921 Hey-Groves described a rescue technique for severe forearm instability, defined as one-bone forearm (OBF) in which the proximal stump of the ulna was fixed to the distal stump of the radius [1]. The OBF technique creates a stable bone bridge between the ulnohumeral and radiocarpal joint in which, according to the description given by Vitale, the ulna "makes" the elbow and the radius "makes" the wrist [2]. (Source: Injury)
Source: Injury - June 15, 2020 Category: Orthopaedics Authors: S. Artiaco, D Ciclamini, J. Teodori, E. Dutto, T. Benigno, B. Battiston Source Type: research

Letter regarding “Popere et al. A cross sectional study of outcomes of muscle pedicle grafting in neck of femur fractures and avascular necrosis of femoral head. Injury.2020. Doi.org/10.1016/j.injury.2020.04.026
I read with great interest the article titled “A cross sectional study of outcomes of muscle pedicle grafting in neck of femur fractures and avascular necrosis of femoral head” by Popere et al. [1]. They performed an interesting retrospective study to evaluate the results of the quadratus femoris muscle pedicle (QFMP) bone grafting with ca ncellous screws in the management of avascular necrosis (AVN) of the hip and femoral neck fracture and to study the radiological and functional outcome of the procedure in young patients, and concluded that a femoral head preserving surgery should be treatment of choice ...
Source: Injury - June 15, 2020 Category: Orthopaedics Authors: Tomonori Shigemura Tags: Letter to the Editor Source Type: research

Letter to editor regarding “Injuries associated with the use of ejection seats: a systematic review, meta-analysis and the experience of the Israeli Air Force, 1990-2019”.
We have read with interest the recent systematic review and meta-analysis published by Epstein et al. [1]. We want to congratulate the authors for this successful review article, and make some contributions in relation to the experience in the Spanish Air Force. (Source: Injury)
Source: Injury - June 15, 2020 Category: Orthopaedics Authors: R Garc ía Cañas, C Rodríguez Moro, D Crego Vita, JL Bernácer López, F Álvarez-Sala Walther, FJ Areta Jiménez Source Type: research

Trends of publications during COVID-19 pandemic
We read with interest the recently published editorial on “Research and Publishing in the COVID-19 Pandemic” [1]. We are happy to note that the INJURY is willing to entertain and publish the trauma-related research during this crisis time. It is an irony that the trauma related problems are going to be much lower these days of pandemic, due to extensiv e lockdown globally. Hence, we are likely to see lesser number of submissions related to recent trauma now and in near future too. (Source: Injury)
Source: Injury - June 15, 2020 Category: Orthopaedics Authors: Raju Vaishya, Abhishek Vaish Source Type: research

Letter Regarding “Popere et al. A cross sectional study of outcomes of muscle pedicle grafting in neck of femur fractures and avascular necrosis of femoral head. Injury.2020. Doi.org/10.1016/j.injury.2020.04.026
I read with great interest the article titled “A cross sectional study of outcomes of muscle pedicle grafting in neck of femur fractures and avascular necrosis of femoral head” by Popere et al. [1]. They performed an interesting retrospective study to evaluate the results of the quadratus femoris muscle pedicle (QFMP) bone grafting with can cellous screws in the management of avascular necrosis (AVN) of the hip and femoral neck fracture and to study the radiological and functional outcome of the procedure in young patients, and concluded that a femoral head preserving surgery should be treatment of choice in yo...
Source: Injury - June 15, 2020 Category: Orthopaedics Authors: Tomonori Shigemura Source Type: research

COVID 19: Should we consider universal screening in trauma patients?
The current novel Coronavirus disease (COVID-19) pandemic has overwhelmed healthcare systems worldwide with its exponential spread. Asymptomatic individuals infected with the virus pose the greatest threat, in terms of disease spread. Universal testing to identify such asymptomatic individuals has been the subject of frequent debates. Whereas universal testing could help decrease rates of community transmission; availability of test kits, infrastructure and manpower remain the major challenge, especially in countries with large populations. (Source: Injury)
Source: Injury - June 15, 2020 Category: Orthopaedics Authors: Nirmal Raj Gopinathan, Siddhartha Sharma, Karthick S Rangasamy, Mandeep S Dhillon Source Type: research