The FFP-classification: from eminence to evidence
Fragility fractures of the pelvis (FFP) are a clinical entity with a rapidly growing incidence among elderly women. The characteristics of these fractures are different from those appearing after high-energy trauma. In 2013, the comprehensive FFP-classification provided a new framework for analysis of these fractures. It is based on the estimation of loss of stability in the pelvic ring. It is connected with recommendations for surgical treatment, justified by the fact that higher instabilities will need surgical stabilization. (Source: Injury)
Source: Injury - September 21, 2021 Category: Orthopaedics Authors: Rommens Pol Maria, Hofmann Alexander Source Type: research

Hip Arthroplasty For Acute Hip Fracture In Patients With Neurological Disorders: A Report Of 9,702 Cases From The Swedish Arthroplasty Register
Hip fractures resulting from falls are a major concern for patients and healthcare providers and represent a major public health problem in terms of morbidity and mortality. Total deaths and disability adjusted life years as a result of hip fractures, have steadily increased since 1990 [1]. Due to longer life expectancy, the absolute number of hip fractures is expected to increase, even if better identification and treatment of osteoporosis may lower the incidence of hip fractures [2, 3]. Neurological disorders affecting motor and/or cognitive function are also becoming more common [4]. (Source: Injury)
Source: Injury - September 20, 2021 Category: Orthopaedics Authors: Alex L. Wojtowicz, Waheeb Al-Azzani, Jonatan N åtman, Ola Rolfson, Cecilia Rogmark, Peter H.J. Cnudde Source Type: research

Peroneal artery safe zone in the posterolateral approach to the distal tibia: A CT angiogram based anatomical study
Posterior malleolar (PM) fractures can sometimes be inadvertently overlooked though they account for up to 44% of all ankle fractures.1, 2 The advantages in fixing a PM fracture are to assist fibular length restoration, improve articular congruency, and restoration of stability of the syndesmosis.2 Distal tibial plafond (or pilon type) fractures can occur due to a combination of axial compressive and torsional forces. High energy fracture pattern involves predominantly axial force, whilst a low energy pilon fracture predominantly involves rotational or torsional forces. (Source: Injury)
Source: Injury - September 18, 2021 Category: Orthopaedics Authors: Adham Mousa, Mohamed Mousa, Kiran Singisetti Source Type: research

Roadblocks in the Medial surgical approach to the hip joint
We read with interest, the article published by Boonperm et al (1), defining a new medial approach to fix femoral head fractures. The authors have effectively tried to define a new approach in a corridor which is avoided by orthopedicians due to the high risk of neurovascular injury. (Source: Injury)
Source: Injury - September 18, 2021 Category: Orthopaedics Authors: Jitendra Kumar, Pulak Vatsya, Samarth Mittal, Tanya Trikha, Vivek Trikha Source Type: research

The Value of Megaprostheses in non-oncological fractures in Elderly Patients: a short-term results
The management of both hip and distal femur fractures as well as periprosthetic fractures can be challenging for orthopaedic surgeons. (Source: Injury)
Source: Injury - September 18, 2021 Category: Orthopaedics Authors: Raffaele Vitiello, Antonio Ziranu, Maria Serena Oliva, Maria Concetta Meluzio, Michele Cauteruccio, Giulio Maccauro, Francesco Liuzza, Maristella Francesca Saccomanno Source Type: research

An evaluation of the association between fault attribution and healthcare costs and trajectories in the first three years after transport injury
Road traffic injury is a global public health problem [1] and leads to a significant economic impact exceeding A$33 billion per year in Australia [2]. Transport-related injuries lead to long-term disability and premature mortality for many people, especially for people with serious injuries that require treatment in hospital [3, 4]. Common disabling problems after injury include reduced health-related quality of life and the development of persistent pain, mental health concerns, and other functional impairments [3, 5, 6]. (Source: Injury)
Source: Injury - September 18, 2021 Category: Orthopaedics Authors: Giummarra Melita J, Dipnall Joanna F, Collie Alex, Ponsford Jennie, Ameratunga Shanthi, Gabbe Belinda J Source Type: research

Outcomes following Traumatic Inhalational Airway Injury – Predictors of Mortality and Effect of Procedural Intervention
Burn injury represents an important yet underappreciated cause of substantial morbidity and mortality. In fact, a recent report estimates that, in 2017, over 480,000 people suffered from burn injuries requiring medical treatment [1, 2]. Smoke inhalation airway injury (IAI) often occurs concomitantly with burn injury and can contribute significantly to increasing morbidity and mortality [3]. Historically, a lack of consensus on how to define IAI made it difficult to accurately measure the incidence of IAI among burn patients with studies suggesting rates between 10% to 47% [4]. (Source: Injury)
Source: Injury - September 17, 2021 Category: Orthopaedics Authors: Neil N. Luu, Harman S. Parhar, Louis-Xavier Barrette, Kevin Chorath, Alvaro Moreira, Karthik Rajasekaran Source Type: research

Diagnosing Penetrating Diaphragmatic Injuries: CT scan is Valuable but not Reliable
Though diaphragmatic injuries (DI) can occur after either blunt or penetrating trauma, the latter is known to be the more common mechanism of injury [1,2]. The incidence of DI after penetrating thoraco-abdominal trauma is quite high, ranging from 11 to 48%, according to recent series in the literature [3-6]. Untreated DI may result in late diaphragmatic hernias, which are associated with significant morbidity and mortality [7]. (Source: Injury)
Source: Injury - September 17, 2021 Category: Orthopaedics Authors: Camilla Cremonini, Meghan R. Lewis, Dominik Jakob, Elizabeth R. Benjamin, Massimo Chiarugi, Demetrios Demetriades Source Type: research

A high fraction of inspired oxygen may increase mortality in intubated trauma patients – A retrospective cohort study
Tracheal intubation and mechanical ventilation of trauma patients may be life-saving interventions, as many trauma patients are unable to protect their airway and require an increased fraction of inspired oxygen (FiO2) to avoid hypoxaemia. However, exposure to a high FiO2 carries a risk of hyperoxia, which has been associated with an increased production of reactive oxygen species, cerebral and coronary vasoconstriction, deleterious effects on lung function, and mortality. [1 –5] (Source: Injury)
Source: Injury - September 17, 2021 Category: Orthopaedics Authors: Josefine S. Baekgaard, Volkert Siersma, Rasmus Ejlersgaard Christensen, Camilla Ikast Ottosen, Katrine  Bennett Gyldenkærne, Jasmin Garoussian, Emilie S. Baekgaard, Jacob Steinmetz, Lars S. Rasmussen Source Type: research

Reply to Editorial, Death of the Trauma Centre
Despite the somewhat melodramatic and provocative title, the content of Professor Cameron's editorial [1] contains considered points worthy of discussion. Although I feel it is a little early to call time on the Major Trauma Centre, it is a reminder that any clinical service must adapt to the changing needs of the population they serve, and as highlighted, two areas stand out as targets for improvement, the fate of the elderly trauma patient, and the role of inter-hospital transfer in trauma. (Source: Injury)
Source: Injury - September 17, 2021 Category: Orthopaedics Authors: David J. Read Source Type: research

Acetylation of histone 3 promotes miR-29a expression and downregulates STAT3 in sepsis
Sepsis is a severe inflammatory disease with great incidence [1]. There are around 18 million cases of severe sepsis worldwide and 750,000 cases of sepsis in the United States each year. Sepsis can be caused by infection and its clinical symptoms commonly include pneumonia, peritonitis, cholangitis, urinary system infection, cellulitis, meningitis, abscess and so on. The underlying mechanisms of sepsis are not fully elucidated. Complex systemic inflammation, gene polymorphisms, immune dysfunction, abnormal blood coagulation, tissue damage, and the abnormal host response to different infectious pathogens and toxins have bee...
Source: Injury - September 17, 2021 Category: Orthopaedics Authors: Yun Zheng, Jun Cheng, AFang Zhang, YuYang Wang, ChengCai Dai, JiaBin Li Source Type: research

Gluteal Compartment Syndrome: A systematic review and meta-analysis
Gluteal compartment syndrome is a rare but devastating orthopaedic and medical emergency, which can be associated with significant morbidity and mortality if misdiagnosed and inappropriately treated. Acute compartment syndrome occurs when intracompartmental pressure within myofascial compartments exceeds capillary perfusion pressure, leading to tissue ischemia and necrosis [1]. Rhabdomyolysis can be a consequence, often leading to acute renal failure (ARF) requiring hemodialysis (HD). Furthermore, muscle edema may compress nearby nerves, resulting in compressive or ischemic neuropathies [2]. (Source: Injury)
Source: Injury - September 17, 2021 Category: Orthopaedics Authors: Farshad Adib, Andrew D. Posner, Nathan N. O'Hara, Robert V. O'Toole Source Type: research

Immune function and the role of vaccination after splenic artery embolisation for blunt splenic injury.
The spleen is the most commonly injured solid organ as a result of blunt abdominal trauma. Over recent decades, splenic artery embolisation (SAE) has become the mainstay treatment for haemodynamically stable patients with high-grade blunt splenic trauma, with splenectomy the mainstay of treatment for unstable patients. Splenic function is complex but the spleen has an important role in immune function, particularly in protection against encapsulated bacteria. Established evidence suggests that following splenectomy immune function is impaired resulting in increased susceptibility to overwhelming post-splenectomy infection,...
Source: Injury - September 17, 2021 Category: Orthopaedics Authors: Samuel J Slater, Matthew Lukies, Helen Kavnoudias, Adil Zia, Robin Lee, Julian J Bosco, Tim Joseph, Warren Clements Source Type: research

“Early results after initiation of a rib fixation programme: A propensity score matched analysis”
Chest wall injuries are a common occurrence in blunt trauma and can be seen in up to 20% of all injured patients[1]. The resulting rib fractures have been estimated to occur in the hundreds of thousands of patients per year in the United States[2,3]. These injuries have been correlated to significant analgesia challenges, early pulmonary complications, and mortality, as well as to prolonged pain and disability [4 –7]. (Source: Injury)
Source: Injury - September 16, 2021 Category: Orthopaedics Authors: Grace Niziolek, Michael D. Goodman, Amy Makley, D Anderson Millar, Victor Heh, Timothy A. Pritts, Christopher Janowak Source Type: research

Reversal of Direct Oral Anticoagulants in adult Hip Fracture patients. A Systematic Review and Meta-analysis.
Approximately 70 –75,000 hip fractures occur annually in the UK, with similar incidences occurring in other high-income countries. 1 Hip fractures are the commonest cause of admission to an orthopaedic ward in the UK, with an estimated £2 billion cost to social care.1An ageing population has also resulted in more patients requiring long-term anticoagulation therapy. 2 Traditionally warfarin or Vitamin-K Antagonists (VKAs) were the drug of choice, however Direct Oral Anticoagulants (DOACs) have gained increasing popularity in the last decade. (Source: Injury)
Source: Injury - September 12, 2021 Category: Orthopaedics Authors: H.M.F Alcock, S.K. Nayar, I.K. Moppett Source Type: research

The percutaneous oval forceps suture-guiding method with anchor nails for Achilles tendon repair
The Achilles tendon (AT) is the thickest and strongest tendon in the human body, which is a combination of the tendons of gastrocnemius and soleus and inserts at calcaneal tuberosity [1,2]. The most common rupture of AT is located 2 to 6 cm proximally to the calcaneal tuberosity, where the tendon is weakest and avascular [3,4]. In addition, the tendon's lack of soft tissue coverage alters the healing process and can lead to soft tissue complications [3]. The incidence of acute Achilles tendon rupture (AATR) is on the rise, which is related to the emphasis on physical activity in recent years. (Source: Injury)
Source: Injury - September 11, 2021 Category: Orthopaedics Authors: Gaole Dai, Yijing Zheng, Xiaolang Lu, Yang Liu, Qihao Weng, Jianjun Hong Source Type: research

Definition of long-bone nonunion: A scoping review of prospective clinical trials to evaluate current practice
Development of nonunion after long-bone fractures is one of the most serious complications in musculoskeletal trauma surgery with an important socioeconomic impact [1]. Nonunions are often associated with prolonged treatment, including multiple surgical revisions. Outcomes may be poor, resulting in permanent disability and an inability to return to work. Healthcare costs for patients diagnosed with nonunion are estimated to be more than double the cost of those with uneventful fracture healing [2]. (Source: Injury)
Source: Injury - September 9, 2021 Category: Orthopaedics Authors: Matthias Wittauer, Marc-Antoine Burch, Martin McNally, Thomas Vandendriessche, Martin Clauss, Gregory J. Della Rocca, Peter V. Giannoudis, Willem-Jan Metsemakers, Mario Morgenstern Source Type: research

A comparison of acute mouse hindlimb injuries between tourniquet- and femoral artery ligation-induced ischemia-reperfusion
Ischemia-reperfusion (IR) is a well-known phenomenon in a wide range of organs, including the heart, lung, kidney, gut, skeletal muscle, and brain [1]. Although reperfusion, reestablishment of blood flow, is essential to salvage ischemic tissues or organs, it can cause further damage, threatening function and viability of the organ following the ischemic event, often referred to as IR injury [2,3]. In the skeletal muscle, IR injury due to tourniquet or femoral artery constriction has been reported in many debilitating diseases and some clinical procedures [2,3], further leading to systemic damage to distant organs [2,4,5],...
Source: Injury - September 8, 2021 Category: Orthopaedics Authors: Huiyin Tu, Dongze Zhang, Junliang Qian, Aaron N. Barksdale, Iraklis I. Pipinos, Kaushik P. Patel, Michael C. Wadman, Yu-Long Li Source Type: research

Adult Trauma Patients with Autism Spectrum Disorder: A Case-Control Study to Evaluate Disparities After Injury
The prevalence of Autism Spectrum Disorder (ASD) has increased 178% in the United States between 2000 and 2016.[1] Autism Spectrum Disorder is defined as a developmental disability characterized by persistent impairments in social interaction, as well as the presence of restricted, repetitive patterns of behaviors, interests, or activities.[2] The severity of ASD can vary widely based on the degree of cognitive and verbal impairments that patients experience.[3,4] Previous work has shown that males are more frequently diagnosed with ASD at a 4:1 ratio when compared to females. (Source: Injury)
Source: Injury - September 8, 2021 Category: Orthopaedics Authors: Christopher J. McLaughlin, Patra Childress, Scott B. Armen, Steven R. Allen Source Type: research

What's old is best again Is anterior plating best for fixation of type-C pelvic fractures? A systematic review and meta-analysis
Pelvic fractures are relatively rare but present a significant management challenge. The incidence is between 20-37 per 100,000 people [1]. However, pelvic fractures have a mortality rate of 5-30%, which can increase to 27-60% in haemodynamically unstable patients [2]. Therefore, pelvic fractures pose a significant problem for trauma units. (Source: Injury)
Source: Injury - September 8, 2021 Category: Orthopaedics Authors: Dr. Joshua Booth, Assoc. Prof. Diana M. Perriman, Dr. Jason Szczepanski, Ms Dianne Walton-Sonda, Prof. Paul N. Smith Source Type: research

Implant Failure after Externally Magnetic-controlled Nail Lengthening
Leg length discrepancy (LLD) has variable causes, such as congenital malformations, posttraumatic growth arrest, fracture, malunion, malignancies or infections. Besides aesthetic issues, significant LLD may cause an asymmetry of weight distribution [1] that leads to joint pain over time. Hip, knee and the lower back are affected particularly [2]. A first approach with external devices had acceptable results but showed a variety of complications, e.g. pin-tract infections, pin side pain and scarring [3, 4]. (Source: Injury)
Source: Injury - September 8, 2021 Category: Orthopaedics Authors: Colleen Rentenberger, Thomas Haider, Lukas Zak, Gerald E. Wozasek Source Type: research

Masquelet technique in post-traumatic infected femoral and tibial segmental bone defects. Union and reoperation rates with high proportions (up to 64%) of allograft in the second stage.
Introduction: The aim of this study was to describe union, reoperation and failure rates after using the induced membrane (IM) technique with ≥50% allograft over autograft to treat infected femoral and tibial segmental bone defects (SBD).Materials and Methods: We retrospectively analyzed patients with femoral and tibial SBD treated in our center between 2012 and 2019 using ≥50% allograft over autograft during the second stage of the M asquelet technique. We analyzed the affected bone, defect size, osteosynthesis technique used, time elapsed between the first and second stage of the technique, graft proportions, union...
Source: Injury - September 6, 2021 Category: Orthopaedics Authors: Cesar Angel PESCIALLO, Germ án GARABANO, Tamara DAINOTTO, Glenda ERNST Source Type: research

Musculoskeletal injuries and management of victims from collapsed buildings in the 2016 Taiwan earthquake: Experiences in a tertiary medical center
Earthquakes are devastating natural disasters that cause numerous deaths and injuries in a short period of time. Previous studies have investigated injury profiles and have revealed that earthquakes can cause various injury patterns, including intra-cranial hemorrhaging, fractures, dislocations, crush injuries, etc.[1 –4] In addition, building collapse during earthquake can cause severe physical or psychological trauma and is the most common cause of earthquake-related mortality.[5,6] (Source: Injury)
Source: Injury - September 4, 2021 Category: Orthopaedics Authors: Chun-Yi Li, Chih-Hao Lin, Chih-Wei Chang, Chang-Han Chuang, Yu-Hsuan Chung, Ming-Hsien Hu, Cheng-Li Lin Tags: Original Article Source Type: research

Response to the Letter to the Editor by Ratnayake et  al.
We want to thank Ratnayake et  al. for their interest in our recent study and their comments on lower extremity vascular trauma. There are some aspects, we would like to respond to. (Source: Injury)
Source: Injury - September 3, 2021 Category: Orthopaedics Authors: Michaela Kluckner Tags: Author ’s Reply Source Type: research

Rib fractures in blunt chest trauma: factors that influence daily patient controlled opiate use during acute care.
Traumatic injury continues to be a burden to health services with over 400,000 presentations per year to Queensland Emergency Departments, comprising almost 30% of the total workload.[1] Most presentations are related to blunt trauma, commonly presenting following a motor vehicle crash or fall. Rib fractures in the setting of blunt chest wall injury occur in upwards of 10-20% of trauma presentations. [2-4] Blunt chest wall injury leads to impairment of the ventilatory function by firstly, altering respiratory mechanics due to the deformed chest wall and secondly, by an increased shunt fraction due to associated pulmonary c...
Source: Injury - September 3, 2021 Category: Orthopaedics Authors: Dr Frances Williamson, Ms Jacelle Warren, A/Prof Cate M Cameron Source Type: research

Response to the Letter to the Editor by Ratnayake et al.:
We want to thank Ratnayake et al. for their interest in our recent study and their comments on lower extremity vascular trauma. There are some aspects, we would like to respond to. (Source: Injury)
Source: Injury - September 3, 2021 Category: Orthopaedics Authors: Michaela Kluckner Source Type: research

Intra-wound vancomycin and tobramycin powder for infection prophylaxis in orthopaedic trauma surgery: Economically justifiable?
Deep surgical site infection (SSI) following orthopedic trauma surgery remains a common complication. While infection rates have decreased with refined surgical and medical management of orthopedic trauma patients, recent studies cite infection rates ranging from 4.3% for general orthopedic trauma to 16% for high-risk fractures [1,2]. This not only represents a medical and surgical challenge, but deep SSIs result in significant resource and cost burdens for patients and health systems alike. On average, fracture patients who develop SSI accrue approximately twice the total cost of treatment compared to uninfected controls ...
Source: Injury - September 2, 2021 Category: Orthopaedics Authors: Gregory J. Kirchner, Nathan P. Smith, Matthew R. Garner Tags: Author ’s Reply Source Type: research

Intrawound vancomycin and tobramycin powder for infection prophylaxis in orthopaedic trauma surgery: Economically justifiable?
Deep surgical site infection (SSI) following orthopaedic trauma surgery remains a common complication. While infection rates have decreased with refined surgical and medical management of orthopaedic trauma patients, recent studies cite infection rates ranging from 4.3% for general orthopaedic trauma to 16% for high-risk fractures.[1, 2] This not only represents a medical and surgical challenge, but deep SSIs result in significant resource and cost burdens for patients and health systems alike. On average, fracture patients who develop SSI accrue approximately twice the total cost of treatment compared to uninfected controls. (Source: Injury)
Source: Injury - September 2, 2021 Category: Orthopaedics Authors: Gregory J. Kirchner, Nathan P. Smith, Matthew R. Garner Source Type: research

Resetting the compass for research on trauma education
Performing applied research in any field of study is difficult. In this sense, medical education research is no different to clinical research in terms of the existence of a number and wide range of barriers and challenges faced in the planning, execution and analysis. Participants in medical education research are frequently students of one variety or other rather than patients. But, just like patients, learner participants can be every bit as complex, demonstrate varying degrees of cooperation with the research protocol and subject to numerous influencing factors occurring before, during and after the research takes place. (Source: Injury)
Source: Injury - September 1, 2021 Category: Orthopaedics Authors: Mary Lawson Source Type: research

Editorial Board/Publication Information
(Source: Injury)
Source: Injury - September 1, 2021 Category: Orthopaedics Source Type: research

A novel inflatable device for perihepatic packing and hepatic hemorrhage control: a proof-of-concept study.
The liver is the most commonly injured solid organ in the abdominal cavity in both blunt and penetrating trauma mechanisms [1 –3]. Uncontrolled bleeding is a major cause of death in complex liver injuries with mortality rate exceeding 50% [4–7]. The acute management of traumatic liver injuries is dependent on multiple factors, most importantly, the hemodynamic status of the patient [2,8,9]. Non-operative management (NO M) of hepatic trauma is the treatment modality of choice in hemodynamically stable patients without associated injuries that would require operative treatment; irrespective of the trauma mechanis...
Source: Injury - August 28, 2021 Category: Orthopaedics Authors: Joao Rezende-Neto, Sachin Doshi, David Gomez, Bruna Camilotti, Dan Marcuzzi, Andrew Beckett Source Type: research

Fracture morphology and biomechanical characteristics of Pauwels III femoral neck fractures in young adults
Femoral neck fractures include injuries involving the area between the femoral head and the intertrochanteric line. Fractures occurring in physiologically young adults are relatively uncommon and are typically the result of high-energy trauma. Management of young adult femoral neck fractures remains one of the most challenging problems in orthopaedic trauma surgery. Previous reports indicate that the frequency for major complications, such as implant failure rates, reoperation rates, and non-union rates, are as high as 9.7%, 34%, and 45%, respectively [1-7]. (Source: Injury)
Source: Injury - August 27, 2021 Category: Orthopaedics Authors: Kaiyang Wang, Ming Ni, Peng Liao, Bang Dou, Xu Yan, Lin Lv, Fangfang Zhang, Jiong Mei Source Type: research

Numerical evaluation of the mechanical properties of a novel expandable intramedullary nailing: a new alternative to standard interlocking nailing
Intramedullary nailing has an important manner in the treatment of long bone fractures. Although the primal fixations like intramedullary nailing were seen in Aztecs ’ records [1], the first successful intramedullary nailing was introduced by Smith-Petersen and colleagues in 1931 [2]. The first modern intramedullary nail design [3] was introduced in 1940 by Gerhard Küntscher who is accepted as the father of the intramedullary nailing by some. Although his stu dies [3,4] have been quite criticized by other surgeons at the beginning, the intramedullary nailing has become the gold standard in the treatment of long ...
Source: Injury - August 26, 2021 Category: Orthopaedics Authors: Mustafa Özkaya, Teyfik Demir Source Type: research

Fracture-related infection in long bone fractures: a comprehensive analysis of the economic impact and influence on quality of life
Fracture-related infection (FRI) is a serious complication that has an important impact on patients and healthcare systems (1). The risk of developing an FRI is largely dependent on the degree of soft tissue injury, and can be as high as 30% for Gustilo-Anderson type III open injuries (1,2). These numbers will continue to rise due to the increasing number of fracture-related surgeries, especially in the elderly (3). (Source: Injury)
Source: Injury - August 25, 2021 Category: Orthopaedics Authors: Jorien Iliaens, Jolien Onsea, Harm Hoekstra, Stefaan Nijs, Willy E. Peetermans, Willem-Jan Metsemakers Source Type: research

Radiological assessments and clinical results of intra-articular osteotomy for traumatic osteoarthritis of the ankle
The incidence of degenerative osteoarthritis of the ankle with aging has been reported to be lower than that for the hip, the knee and the wrist [1]. However, compared with other countries, incidence of degenerative ankle osteoarthritis is higher in Japan due to culture and lifestyle factors peculiar to the Japanese such as the Japanese custom of sitting erect on their knees. Orthopedists in Japan have more opportunities for treating patients with degenerative ankle arthritis than those in western countries. (Source: Injury)
Source: Injury - August 21, 2021 Category: Orthopaedics Authors: Shota Harada, Tsukasa Teramoto, Motoyuki Takaki, Tomohiko Asahara, Narutaka Katoh, Nobuyuki Takenaka, Takashi Matsushita, Takahiro Inui, Yoshinobu Watanabe, Yukinobu Nishii, Kiyoto Kinugasa, Kazutaka Otsuka Source Type: research

Resveratrol ameliorates thoracic blast exposure-induced inflammation, endoplasmic reticulum stress and apoptosis in the brain through the Nrf2/Keap1 and NF- κB signaling pathway
Blast injury is the damage of body organs and tissues caused by impact force of high speed blast waves. Since both internal and external injuries can be caused by blast injuries, they can manifest in a variety of ways. For example, while the clinical features of an observed body surface trauma may be relatively mild, a serious general visceral injury may be present [1]. Peak time for these injuries is also rapid, generally within 48 hours, which means that the consequences of blast injuries are often unpredictable and can be fatal if they are not treated in time. (Source: Injury)
Source: Injury - August 19, 2021 Category: Orthopaedics Authors: Peifang Cong, Teng Wang, Changci Tong, Ying Liu, Lin Shi, Shun Mao, Xiuyun Shi, Hongxu Jin, Yunen Liu, Mingxiao Hou Source Type: research

Finite element study on whether posterior upper wall fracture is a risk factor for the failure of short-segment pedicle screw fixation in the treatment of L1 burst fracture
Surgical treatment is often required for thoracolumbar burst factures. The typical imaging features of burst fractures include compression of the anterior column and comminution of the middle column (namely, burst facture of the posterior wall of VB), and bone fragments retropulsed into the vertebral canal (VC). In severe cases, the interpedicular distance (IPD) may increase (such as accompanied pedicle fracture) [1]. Posterior short-segment conventional pedicle screw fixation for thoracolumbar burst fractures has been widely used clinically [2-4], but in type A fractures [5] with loading shear classification (LSC) LSC [6]...
Source: Injury - August 18, 2021 Category: Orthopaedics Authors: Chunyang Xia, Sheng Yang, Jifeng Liu, Jianmin Lu, Depeng Shang, Dapeng Fu, Zhenhua Zhao, Xiahua Wang Source Type: research

High grade renal trauma: does the mechanism of penetrating injury influence renal salvage rate?
Over the last half century there has been a move towards conservatism in trauma care in general and in the management of renal trauma in particular [1,2]. This trend has been underpinned by a philosophy of selective nonoperative management (SNOM) and the rapid development, and increasing availability of imaging, especially Computed Tomography [1,3] and minimally invasive endourological approaches [1,4]. Traumatic renal injuries (TRI) are present in up to 5% of all trauma cases [5,6] and between 80-95% of TRI's have other associated organ injuries [7,8]. (Source: Injury)
Source: Injury - August 18, 2021 Category: Orthopaedics Authors: Willem Meyer du Plessis, Danelo Estienne du Plessis, John Lambert Bruce, Michelle TD Smith, Damian Luiz Clarke Source Type: research

Risk of Alcohol Withdrawal Syndrome in Hospitalized Trauma Patients: A National Data Analysis
Alcohol withdrawal syndrome (AWS) is one of the conditions that occurs in patients, who have a history of chronic alcohol consumption on a regular basis, and suddenly stop or reduce their alcohol consumption [1]. The timing of the manifestation of AWS varies from 6 hours to 48 hours after cessation of alcohol [2]. Common and early symptoms are tremor, confusion, agitation, etc. [3]. Serious conditions of AWS can be delirium tremens and seizures [3-6]. The most commonly used measurement of AWS is the Clinical Institute Withdrawal Assessment for Alcohol –revised (CIWA-AR) scale. (Source: Injury)
Source: Injury - August 18, 2021 Category: Orthopaedics Authors: Nasim Ahmed, YenHong Kuo Source Type: research

The role of low-grade infection in the pathogenesis of apparently aseptic tibial shaft nonunion
Aim of this study was to determine the rate of low-grade infection in patients with primarily as aseptic categorized tibial shaft nonunion and lack of clinical signs of infection. (Source: Injury)
Source: Injury - August 13, 2021 Category: Orthopaedics Authors: Simon Hackl, Lena Keppler, Christian von R üden, Jan Friederichs, Mario Perl, Christian Hierholzer Source Type: research

Crossing Quartiles: Improving time to theatre for patients with hip fractures in a large UK district general hospital; A quality improvement report
Neck of femur or proximal femoral fractures are amongst the most common fractures in the elderly with an incidence of 16.9 per 10,000 person years [1]. This vulnerable group of patients are typically frail with significant co-morbidities; as such, hip fracture patients often suffer a high level of morbidity and mortality [2, 3]. In recognition of this, a formal financial uplift system for meeting agreed key criteria in hip fracture care, the ‘Best Practise Tariff’ (BPT), was introduced by the Department of Health in 2010 [4, 5]. (Source: Injury)
Source: Injury - August 13, 2021 Category: Orthopaedics Authors: Christopher Anthony, Marta Malaj, Prashan Lokanathan, James Murgatroyd, Patrick O'Connor Source Type: research

Comparison of sliding distance of lag screw and nonunion rate according to anteromedial cortical support in intertrochanteric fracture fixation: A systematic review and meta-analysis
With an increase in the elderly population, the growing incidence of intertrochanteric fractures has placed a heavy burden on the healthcare system [1]. Despite efforts to improve hip fracture care, the 1-year mortality rate is reportedly 22% [2] and about half the patients cannot resume their preinjury activities [3]. As part of the effort to enhance the surgical outcome of intertrochanteric fractures, various possible influencing factors have been investigated, including the choice of appropriate implant, the reduction method, stable fixation, and postoperative care. (Source: Injury)
Source: Injury - August 12, 2021 Category: Orthopaedics Authors: Eic Ju Lim, Seungyeob Sakong, Whee Sung Son, Jae-Woo Cho, Jong-Keon Oh, Chul-Ho Kim Source Type: research

Crevasse accidents in the Swiss Alps Epidemiology and mortality of 405 victims of crevasse accidents from 2010 to 2020
Mountaineering, high-altitude hiking, and ski touring have become increasingly popular in the past decades in the Swiss Alps, with known inherent risks (1, 2). It is estimated that there are about 200,000 to 300,000 off-piste skiers per year in Switzerland (3), and that more than 40 million people around the world partake in leisure activities at an altitude of 2000 meters above mean sea level (4, 5). General Hiking and high-altitude hiking are among the most popular sports in Switzerland during the summer season, both for younger and older (> 60 years) mountaineers. (Source: Injury)
Source: Injury - August 12, 2021 Category: Orthopaedics Authors: Eva Klocker, Lorenz Meuli, Simon Rauch, Alexandre Kottmann, Ueli Mosimann, Mathieu Pasquier, Pierre M étrailler, Pascal Doppman, Roland Albrecht, Urs Pietsch Source Type: research

Single Sterile Silicon Ring Technique for Utilization of Upper Limb Intravenous Regional Anesthesia: A Prospective Study of Patients with Operated Distal Radius Fractures.
Bier's block, or intravenous regional anesthesia (IVRA), is an effective method of providing adequate analgesia in upper extremity surgery [1]. The method includes application of a double tourniquet device to the arm followed by exsanguination of upper extremity with an Esmarch bandage and inflation of the proximal tourniquet [2]. Anesthesia and analgesia are achieved by injecting the local anesthetic solution into a peripheral vein [3]. When the patient complains of pain at tourniquet site, the distal tourniquet is inflated and the proximal is deflated to provide pain relief. (Source: Injury)
Source: Injury - August 12, 2021 Category: Orthopaedics Authors: Dimitrios Kitridis, Byron Chalidis, Irene Asouhidou, Eleni Koraki, Panagiotis Givissis Source Type: research

Geographical risk of fatal and non-fatal injuries among adults in Norway
Traumatic injury is a leading cause of death and disability worldwide, accounting for 10% of the global burden of disease [1]. The main causes are road traffic injuries, suicide, falls, and violence. Traffic injuries are ninth among causes of the global burden of disease, and road traffic deaths continue their climb, topping 1.35 million deaths worldwide in 2016 [1, 2]. (Source: Injury)
Source: Injury - August 12, 2021 Category: Orthopaedics Authors: Vegard Andersen, Vilde Ravnsborg Gurigard, June Alette Holter, Torben Wisborg Source Type: research

Prehospital paramedic pleural decompression: A systematic review
Traumatic injuries account for 5.8 million deaths worldwide every year and is the leading cause of death for people aged under 45 years [1]. Many traumatic deaths, resulting from overwhelming injury, do not rely on the quality of prehospital care for survival as death is immediate [2]. Where death is not immediate, timely delivery of adequate care in the immediate aftermath following traumatic injury has been associated with improved survival [2]. (Source: Injury)
Source: Injury - August 11, 2021 Category: Orthopaedics Authors: Ms. Kelsey Sharrock, Mr.Brendan Shannon, Mr. Carlos Garcia Gonzalez, Mr. Toby St Clair, Prof Biswadev Mitra, Dr. Michael Noonan, Prof Mark Fitzgerald, Dr. Alexander Olaussen Source Type: research

Loss of skeletal muscle mass can be predicted by sarcopenia and reflects poor functional recovery at one year after surgery for geriatric hip fractures
In geriatric patients, hip fractures are regarded as “the straw that breaks the camel's back”, with a reported mortality at one year as high as 36% [1]. In addition, functional loss following geriatric hip fracture surgery is a critical concern for caregivers. Only 8.2% of such patients are able to walk unassisted at 1 year after surgery [2]. Moto r impairment after hip fractures is also associated with the increased time required to assist patients with activities of daily living (ADL) in a long-term care insurance system [3]. (Source: Injury)
Source: Injury - August 9, 2021 Category: Orthopaedics Authors: Yu-Pin Chen, Yi-Jie Kuo, Shen-Wu Hung, Tsai-wei Wen, Pei-Chun Chien, Ming-Hsiu Chiang, Nicola Maffulli, Chung-Ying Lin Source Type: research

What is the diagnostic value of the Centers for Disease Control and Prevention criteria for surgical site infection in fracture-related infection?
Fracture-Related Infection (FRI) remains one of the most challenging complications in orthopaedic trauma surgery. If not recognized and treated at an early stage it can lead to permanent loss of function or even amputation of the affected limb. Therefore, early diagnosis and appropriate treatment are of paramount importance [1 –4]. (Source: Injury)
Source: Injury - August 9, 2021 Category: Orthopaedics Authors: Jonathan Sliepen, Jolien Onsea, Charalampos Zalavras, Melissa Depypere, Geertje A.M. Govaert, Mario Morgenstern, Martin A. McNally, Michael H.J. Verhofstad, William T. Obremskey, Frank IJpma, Willem-Jan Metsemakers Source Type: research

Manual Extraction is Superior to Power Tools When Removing Stripped Titanium Locking Screws
Plates with locking screws are commonly used in fracture fixation. In these devices, the threaded head of the screw locks in the plate. Since its introduction in the 90s, this technique has become the preferred method of fixation in several fractures, including periarticular and osteoporotic fractures [1]. Removal of these plates/screws is sometimes indicated after the fracture has healed. Several reports have highlighted difficulties in the removal of locking screws as compared to conventional non-locked screws, especially when using titanium implants. (Source: Injury)
Source: Injury - August 6, 2021 Category: Orthopaedics Authors: N. Nizaj, C. Muhammed Shamseer, A.N. Sukesh, Jacob Varughese, Bipin Theruvil Source Type: research

Biochemical, pathological and ultrastructural investigation of whether lamotrigine has neuroprotective efficacy against spinal cord ischemia reperfusion injury
During the thoracoabdominal aortic surgery, cessation and restoring of spinal cord blood flow can cause initially ischemic and subsequently reperfusion injury on the neuronal structures which is called the ischemia/reperfusion injury of spinal cord (SCIRI) (1). Paraplegia as a result from SCIRI results in physically, socially and financially deprived victims (2). SCIRI is a composite of interwoven pathological pathways result in apoptotic cell death which includes decreases of cellular energy production, mitochondrial dysfunction, alteration of ionic distribution, loss of membrane potential, depolarization of cellular memb...
Source: Injury - August 6, 2021 Category: Orthopaedics Authors: Fatih Ozan Kahveci, Ramazan Kahveci, Emre Cemal Gokce, Aysun Gokce, Üçler Kısa, Mustafa Fevzi Sargon, Ramazan Fesli, Muhammed Fatih Sarı, Bora Gürer Source Type: research