Autologous fat graft in foot calcaneal postsurgical chronic ulcer
Post-traumatic injury of talus ’s posterior area and ankle joint with consequent scar formation is often complicated by an unhealing trophic ulcer. Aim of this paper is to evaluate the autologous fat graft effectiveness in treating Achilles tendon area wounds. (Source: Injury)
Source: Injury - August 16, 2019 Category: Orthopaedics Authors: Luca Maione, Andrea Lisa, Valeriano Vinci, Valeria Bandi, Francesco Klinger, Marco Klinger Source Type: research

Introduction of a Mobile Device Based Tertiary Survey Application Reduces Missed Injuries: A Multi-Center Prospective Study
Trauma resuscitation is internationally standardized according to the American College of Surgeons Committee on Trauma (ACS-COT) Advanced Trauma Life Support (ATLS) course. The principles of ATLS are to identify and treat any life threatening injuries – the primary survey; and then to perform a full head-to-toe physical exam to identify all other injuries – the secondary survey (1). (Source: Injury)
Source: Injury - August 16, 2019 Category: Orthopaedics Authors: B Moffat, KN Vogt, K Inaba, D Demetriades, C Martin, R Malthaner, DK Gray, NG Parry Source Type: research

Acute Shortening versus Bone Transport for the Treatment of Infected Femur Non-Unions with Bone Defects
Definitive treatment of chronic osteomyelitis of the long bones typically includes radical debridement of infected areas, and such patients generally received several surgical interferences, leading to serious bone and soft tissue damages and eventually considerable bone defects [1]. Although a multitude of treatment options are employed to eradicate long-lasting bone infections and to reconstruct defects of long bones, the treatment of osteomyelitis of the long bones remains a considerable challenge, even in the best hands [2]. (Source: Injury)
Source: Injury - August 16, 2019 Category: Orthopaedics Authors: Cengiz Sen, Mehmet Demirel, Yavuz Sa ğlam, Halil I. Balcı, Levent Eralp, Mehmet Kocaoğlu Source Type: research

A new small animal model for simulating a two-stage-revision procedure in implant-related methicillin-resistant Staphylococcus aureus bone infection
Orthopedic implant-related infections such as periprosthetic joint infections (PJI) and osteosynthesis related infections are a devastating problem for both patients and surgeons. Besides being potentially life-threatening, implant related infections are a socioeconomic burden due to increasing health-care expenditures, functional impairment and long-lasting disabilities 1. While Staphylococcus aureus, methicillin-resistant Staphylococcus epidermidis (MRSE), methicillin-resistant Staphylococcus aureus (MRSA), coagulase-negative Staphylococcus (CoNS), Streptococcus, and Enterococcus are mainly responsible for PJI, an increa...
Source: Injury - August 15, 2019 Category: Orthopaedics Authors: Maximilian Brunotte, Markus Rupp, Sabine St ötzel, Ursula Sommer, Walid Mohammed, Ulrich Thormann, Christian Heiss, Katrin S. Lips, Eugen Domann, Volker Alt Source Type: research

Hook plating in patella fractures
The goals of treatment for displaced patella fractures are anatomical reduction of the articular surface and restoration of the extensor mechanism of the knee. Tension band wiring (TBW) has long been the standard method for such fractures [1,2]. However, Smith et al. [3] reported that 22% of patella fractures treated with TBW were significantly displaced in the perioperative period. Particularly, comminuted patella fractures in elderly patients are difficult to treat since their osteopenic bone often lacks the strength to support TBW and/or cerclage, resulting in fixation failure prior to bone union [4]. (Source: Injury)
Source: Injury - August 15, 2019 Category: Orthopaedics Authors: Jae-Hoon Jang, Seung-Joon Rhee, Ji Wan Kim Source Type: research

Reconstruction of traumatic tubular bone defects using vascularized fibular graft
Reconstruction of segmental bony defects of the appendicular skeleton has always been a challenge for orthopedic surgeons. These defects may occur primarily due to high energy trauma, or may result secondarily due to excision of pathological bone (ie: infected nonunions, chronic osteomyelitis, or resection of bone tumors). Additional soft tissue defects of the injury site and failed previous surgical attempts for bony reconstruction further complicate the ongoing trouble, leading to atrophic bone ends, scarred soft tissues with poor vascularity and possibly infection at the injury zone; ending up with loss of function, lim...
Source: Injury - August 14, 2019 Category: Orthopaedics Authors: Tulgar Toros, Kemal Ozaksar Source Type: research

The use of knee mega-prosthesis for the management of distal femoral fractures: a systematic review
Distal femur fractures (DFFs) are unusual and difficult to deal. Their incidence range from 0.3 to 2.5% and are prevalent in female gender with a ratio of M:F  = 1:3. Young as well as elderly patients can undergo a distal femur fracture by different mechanisms. An high energy trauma is usually the leading cause in the young population, whereas direct or indirect low energy traumatic mechanisms are the main responsible of this type of fractures in elde rly [1]. Main risk factors are: female gender, rheumatoid arthritis, presence of large osteolytic lesions, osteoporosis, previous surgical treatments of that bo...
Source: Injury - August 13, 2019 Category: Orthopaedics Authors: MC Meluzio, MS Oliva, F Minutillo, A Ziranu, MF Saccomanno, G Maccauro Source Type: research

Epidemiological state, predictive model for mortality, and optimal management strategy for pancreatic injury: A multicentre nationwide cohort study
Although pancreatic injury is rare, it is associated with significant mortality; it only accounts for 0.21% –0.32% of all trauma patients but has an overall mortality of 3%–70%1–9. (Source: Injury)
Source: Injury - August 12, 2019 Category: Orthopaedics Authors: Keita Shibahashi, Kazuhiro Sugiyama, Yusuke Kuwahara, Takuto Ishida, Yoshihiro Okura, Yuichi Hamabe Source Type: research

The worldwide variation in epidemiology of pancreatic injuries
Due to the relative rarity of trauma to the pancreas, experience with pancreatic injury is highly variable among surgeons. Considerable differences exist in epidemiology, aetiology, management and outcomes around the globe1. Higher rates of penetrating injuries have traditionally been reported from regions with excessive access to and frequent use of handguns in civilian populations, most notably in South Africa and the United States2 –6. Audits on pancreatic trauma done outside regions of high prevalence of penetrating injuries have been rare to come across, although some have been reported7,8. (Source: Injury)
Source: Injury - August 12, 2019 Category: Orthopaedics Authors: Johannes Wiik Larsen, Kjetil S øreide Source Type: research

Effects of a Proposal to Alter the Statistical Significance Threshold on Previously Published Orthopaedic Trauma Randomized Controlled Trials
A common misconception in clinical research is that statistical significance equates to clinical significance [1 –3]. R.A Fisher’s original idea on the use and interpretation of significance testing remains a long-standing debate because of the increasing reliance on significant P (probability) values [4–8]. Relying solely on P values for interpreting significant data can be misleading [9–12]; however, their use in research is not necessarily a problem [13]. The primary purpose of using a P value is to minimize type I errors — erroneous conclusions made about differences between groups when no...
Source: Injury - August 12, 2019 Category: Orthopaedics Authors: Austin L. Johnson, Sheridan Evans, Jake X. Checketts, Jared T. Scott, Cole Wayant, Mark Johnson, Brent Norris, Matt Vassar Source Type: research

Effect of Fracture Levels on the Strength of Bone-Implant Constructs in Subtrochanteric Fracture Models fixed using Short Cephalomedullary Nails: a Finite Element Analysis
It is challenging to achieve anatomical reduction and stable fixation of subtrochanteric (ST) fracture by surgical means. Intense medial compression and lateral tensile forces are concentrated in the fracture region, and these deforming forces make reduction and fixation difficult. These obstacles and the low vascularity in the fracture region have challenged orthopedic surgeons with problems of malunion, nonunion, and implant failures [1]. (Source: Injury)
Source: Injury - August 12, 2019 Category: Orthopaedics Authors: Chul-Young Jang, Sun-Hee Bang, Won-Hyeon Kim, Sung-Jae Lee, Hyung-Min Lee, Dae-Kyung Kwak, Je-Hyun Yoo Source Type: research

Does arrival time affect outcomes among severely injured blunt trauma patients at a tertiary trauma centre?
Trauma occurs unexpectedly, often at night and at the weekend. Severe trauma patients arriving at hospital warrant rapid diagnostics, the marked utilisation of resources including both personnel and infrastructure, and effective coordination and decision-making. Given that the number and experience of personnel in the emergency, radiology, and interventional radiology departments as well as operating theatres are usually highest during standard office hours, the question arises whether a severely injured patient arriving at hospital during out-of-office hours has a worse prognosis compared with those arriving when resource...
Source: Injury - August 12, 2019 Category: Orthopaedics Authors: Tuomas Brinck, Mikko Hein änen, Tim Söderlund, Rolf Lefering, Lauri Handolin Source Type: research

Absolute or relative stability in plate fixation for simple humeral shaft fractures.
Humeral shaft fractures represent 1% –3% of all fractures [1]. Classically these fractures have been treated conservatively. Due to a more demanding society, surgical fixation is becoming more popular in high income countries [2]. Both nail and plate fixation may be used. However, plate fixation is becoming the preferred method since the last decades [2]. This is likely caused by emerging evidence demonstrating shoulder pain, rotator cuff damage and periprosthetic fractures secondary to nailing [3]. (Source: Injury)
Source: Injury - August 11, 2019 Category: Orthopaedics Authors: BJM van de Wall, C Theus, BC Link, N van Veelen, RJH van de Leeuwen, C Ganzert, R Babst, FJP Beeres Source Type: research

Biomechanical properties of off-axis screw in Pauwels III femoral neck fracture fixation: bicortical screw construct is superior to unicortical screw construct
The optimal treatment of femoral neck fractures has been developing for several decades. The disease is characterized by a bimodal distribution based on age. In a younger population, the fracture tends to extend in a vertical fashion secondary to a high-energy mechanism. To preserve the femoral head, anatomic reduction with stable internal fixation is the best treatment choice [1,2]. However, it is challenging to withstand the shear force yielded from the vertically oriented fracture, and one clinical study showed that neck shortening and varus collapse of the head would have some negative effect on functional outcome [3]. (Source: Injury)
Source: Injury - August 10, 2019 Category: Orthopaedics Authors: Fa-Chuan Kuan, Kai-Lan Hsu, Cheng-Li Lin, Chih-Kai Hong, Ming-Long Yeh, Wei-Ren Su Source Type: research

Haemodynamics as a Determinant of Need for Pre-Hospital Application of a Pelvic Circumferential Compression Device in Adult Trauma Patients
Fractures to the pelvic ring are common following high energy blunt trauma, occurring in 8% of major trauma patients and 15.7% of patients with an injury severity score>15 ( [1]). These injuries can cause substantial haemorrhage [2 –4], with overall mortality reported at 14-18% [1,3,5,6]. In patients with unstable fractures, mortality can be as high as 42% [5]. (Source: Injury)
Source: Injury - August 10, 2019 Category: Orthopaedics Authors: D. McCreary, C. Cheng, Z.C. Lin, Z. Nehme, M. Fitzgerald, B. Mitra Source Type: research

Chinese Expert Consensus on Diagnosis and Treatment of Infection after Fracture Fixation
Currently, accurate diagnosis and successful treatment of infection after fracture fixation (IAFF) still impose great challenges. According to the onset of infection symptoms after implantation, IAFF is classified as early infection ( < 2 weeks), delayed infection (2~10 weeks) and late infection (>10 weeks). Confirmation of IAFF should be supported by histopathological tests of intraoperative specimens which confirm infection, cultures from at least two suspected infection sites which reveal the same pathogen, a definite si nus or fistula which connects directly the bone or the implant, and purulent drainage from the...
Source: Injury - August 6, 2019 Category: Orthopaedics Authors: Nan Jiang, Bo-wei Wang, Yi-min Chai, Xin-bao Wu, Pei-fu Tang, Ying-ze Zhang, Bin Yu, Traumatic Orthopaedics Group, Society of Orthopaedics, Chinese Medical Association, Group of External Fixation and Limb Reconstruction, Society of Orthopaedics, Chinese M Source Type: research

Size and stabilization of the dorsoulnar fragment in AO C3-type distal radius fractures
Recently, volar locking plate (VLP) fixation has become the gold-standard treatment for distal radius fractures (DRFs). Although 80% of all DRFs are complete intra-articular fractures, simple intra-articular DRFs have been successfully treated with a single VLP without loss of reduction [1]. However, comminuted intra-articular DRFs, such as AO C3-type, are still the most challenging to surgically treat with the VLP [2]. (Source: Injury)
Source: Injury - August 6, 2019 Category: Orthopaedics Authors: Y. Miyashima, Y. Kaneshiro, K. Yano, H. Teraura, H. Sakanaka, T. Uemura Source Type: research

Internal Fixation of Unstable Radial Head Fracture: A Comparison of Metallic and Biodegradable Implants
Radial head fractures are common injuries in sports or daily activity accounting for about one-third of all elbow fractures, with an estimated incidence of 2.5 to 2.9 per 10,000 people per year [1]. Radial head fractures are usually classified according to the original Mason classification: type I, fissure fractures or marginal sector fractures without displacement; type II, partial articular fractures with displacement; and type III, comminuted fractures involving the whole head of the radius [2,3]. (Source: Injury)
Source: Injury - August 6, 2019 Category: Orthopaedics Authors: Young Hak Roh, Sangwoo Kim, Hyun Sik Gong, Goo Hyun Baek Source Type: research

Editorial Board/Publication Information
(Source: Injury)
Source: Injury - August 1, 2019 Category: Orthopaedics Source Type: research

We only see what we know: Structures at risk during the anterior intrapelvic approach
The classification, radiographic analysis, and surgical treatment of acetabular fractures described by Judet and Letournel in the 1960 ’s laid the groundwork for current management of these difficult injuries [1]. The ilioinguinal approach, described in 1963, was the first intrapelvic approach that allowed for visualization of the medial wall of the acetabulum [2]. While this approach served as the workhorse for anterior open red uction of acetabular fractures, dissection through the inguinal canal is technically demanding, with mobilization of the iliac vessels and lymphatic system, risking thrombosis and lymphedema...
Source: Injury - August 1, 2019 Category: Orthopaedics Authors: Theerachai Apivatthakakul, Michael Maher, Allison Tetreault, Thanawat Buranaphatthana, Sutiwat Luangsod, Motasem Salameh, Joshua A. Parry, Cyril Mauffrey Tags: Editorial Source Type: research

Comparison between conventional MRI and MR arthrography in the diagnosis of triangular fibrocartilage tears and correlation with arthroscopic findings
The triangular fibrocartilage complex is one of the most important stabilizers of the wrist and a defect in its anatomical structure is a possible cause of ulnar sided wrist pain. The aim of this study is to compare the diagnostic accuracy between conventional MRI and MR arthrography (MRA) in the depiction of triangular fibrocartilage complex (TFCC) tears. (Source: Injury)
Source: Injury - August 1, 2019 Category: Orthopaedics Authors: Evangelos Petsatodis, Mayia Pilavaki, Anna Kalogera, Antonios Drevelegas, Filon Agathangelidis, Konstantinos Ditsios Source Type: research

Use of Masquelet technique in treatment of septic and atrophic nonunion
Treatment of atrophic non-unions and large bone defects or infections remains a challenging task for the treating surgeon. In the herein study, we present our experience of the 'Masquelet technique' according to the 'diamond concept' for the treatment of complex long bone reconstruction procedures. (Source: Injury)
Source: Injury - August 1, 2019 Category: Orthopaedics Authors: T.F. Raven, A. Moghaddam, C. Ermisch, F. Westhauser, R. Heller, T. Bruckner, G. Schmidmaier Source Type: research

Intraoperative customization of intramedullary nails – First results
Intramedullary nailing is a valuable treatment option for many types of fractures. Furthermore nailing is applicable for osteosynthesis following osteotomy in deformity correction. For intraoperative fine-tuning of alignment in intramedullary (IM) nailing procedures, a bending device for customization of IM nails under sterile conditions was developed. We have performed a retrospective clinical study to analyze and describe the technical requirements, indications and limitations for intraoperative customization of IM nails. (Source: Injury)
Source: Injury - August 1, 2019 Category: Orthopaedics Authors: P.H. Thaller, J. F ürmetz, N. Degen, T. Eilers, E. Euler, F. Wolf Source Type: research

Nailing of lower extremity fractures
The Gerhard Kuentscher Society was founded from surgeons convinced and dedicated to the ideas of intramedullary fixation of fractures. Kuentscher was not the first to try the intramedullary fixation but he brought it to the level of a general scientific discussion and wide application. However, if we think at the technical standards then, lack of fluoroscopy, lack of nail locking options and the need of wide reaming for self-blocking of the nail in the medullary canal, one could argue that it was still an experimental therapy compared with the current state of the art of intramedullary nailing for long bone fracture fixation. (Source: Injury)
Source: Injury - August 1, 2019 Category: Orthopaedics Authors: Wilhelm Friedl, Georg Gradl Tags: Editorial Source Type: research

Locking plate fixation versus antegrade intramedullary nailing for the treatment of extra-articular distal femoral fractures
Less than 1% of all reported fractures are distal femur fractures; however, distal femur fractures account for 3% –6% of all femoral fractures [1]. There is a bimodal distribution of the incidence of distal femur fractures with age [2]. These fractures often occur in young adults after high energy trauma and in older adults following low energy trauma. Epidemiologic studies have confirmed these injury pattern s, showing peaks in incidence in elderly women and in young males [2,3]. (Source: Injury)
Source: Injury - August 1, 2019 Category: Orthopaedics Authors: E. Ocalan, C.C. Ustun, K. Aktuglu Source Type: research

Evaluation of the clinical use of the ETN PROtect ® in non-union therapy
Non-union of a long bone fracture remains a challenge in orthopaedic and trauma surgery. In the current study, we sought to determine the clinical effectiveness of tibial non-union treatment utilizing an antibiotic-coated intramedullary nail (Expert Tibia Nail (ETN) PROtect ®) regarding prevention and treatment of infection and the clinical outcome. (Source: Injury)
Source: Injury - August 1, 2019 Category: Orthopaedics Authors: Arash Moghaddam, Johanna Weis, Patrick Haubruck, Tim Friedrich Raven, Fabian Westhauser, Ayoub Addali, Gerhard Schmidmaier Source Type: research

The circular arc shaped nail for fixing the tibiotalocalcaneal arthrodesis. Concept and clinical results
Tibiotalocalcaneal arthrodesis is commonly considered a salvage option for a variety of hindfoot disorders involving the ankle and subtalar joint mostly with concomitant deformity. Retrograde interlocking nailing represents one of the biomechanically most stable fixation modes after reduction of hindfoot geometry. The considerable complications, non-union and revision rates at a moderate outcome reported even with modern retrograde nails underscore the idea that the development of an optimized retrograde may be warranted. (Source: Injury)
Source: Injury - August 1, 2019 Category: Orthopaedics Authors: Kaj Klaue, Alice Wichelhaus, Paulina Maik, Thomas Mittlmeier Source Type: research

Calcaneal fracture fixation using a new interlocking nail reduces complications compared to standard locking plates – Preliminary results after 1.6 years
Surgical treatment of displaced intra-articular calcaneal fractures using a standard extended lateral approach for plate fixation is frequently associated with substantial wound healing complications and infections. This matched pairs analysis compares the new minimally-invasive calcaneal interlocking nailing technique to standard locking plate fixation in terms of reduction capacity, complication rates, and functional outcomes. (Source: Injury)
Source: Injury - August 1, 2019 Category: Orthopaedics Authors: Anica Herlyn, Anna Brakelmann, Philipp KE Herlyn, Georg Gradl, Thomas Mittlmeier Source Type: research

Impacted Steel Sleeves for a Minimally Invasive Approach in Intramedullary Nailing
A custom-made instrument set of Steel Sleeves was developed to assist the insertion of reamers and intramedullary devices for fixation of long bone fractures or lengthening procedures. By use of the Steel Sleeves, migration of the entry point is prevented and protection of the bone and soft tissue at the entry point is guaranteed. In addition, the principle of a closed working channel for trans-articular approaches can be provided.In this article, a description of properties and clinical appliance custom-made, steel sleeve instrument set is given. (Source: Injury)
Source: Injury - August 1, 2019 Category: Orthopaedics Authors: F. Wolf, S. B ösl, N. Degen, J. Fürmetz, P.H. Thaller Source Type: research

Developing a blueprint for a civilian-military collaborative program in trauma training for Northern European countries: A South African experience
The current global geo-political situation is characterized by political instability and manifests itself in ongoing military conflicts, which are often described as being asymmetrical in nature. An asymmetrical conflict implies that often the combatants are not members of formal military structures and that the concept of a frontline or combat zone needs to be rethought. [1 –3] Recent terrorist attacks and mass shooting incidents in major European and North American cities are examples of this new era of asymmetrical warfare. (Source: Injury)
Source: Injury - August 1, 2019 Category: Orthopaedics Authors: Henk van der Wal, Thijs TCF van Dongen, Christine FW Vermeulen, John L Bruce, Wanda Bekker, Vassil Manchev, Victor Kong, Oscar van Waes, Damian L Clarke, Rigo Hoencamp Source Type: research

Rehabilitation of the multiple injured patient with spinal cord injury: A systematic review of the literature
Patients with multiple injuries including spinal cord injury (SCI) have low survivability. Little is known for the effect of SCI in their rehabilitation process. (Source: Injury)
Source: Injury - July 30, 2019 Category: Orthopaedics Authors: V.N. Christodoulou, D. Varvarousis, A. Theodorou, S. Voulgaris, A. Beris, S. Doulgeri, I. Gelalis, A. Ploumis Source Type: research

Rehabilitation of the multiple injured patient with spinal cord injury; a systematic review of the literature
Patients with multiple injuries including spinal cord injury (SCI) have low survivability. Little is known for the effect of SCI in their rehabilitation process. (Source: Injury)
Source: Injury - July 30, 2019 Category: Orthopaedics Authors: V. Christodoulou, D. Varvarousis, A. Theodorou, S. Voulgaris, A. Beris, S. Doulgeri, I. Gelalis, A. Ploumis Source Type: research

An audit of the polytrauma fracture detection rate of clinicians evaluating Lodox Statscan bodygrams in two South African public sector Trauma Units
There is growing global demand for specialized emergency radiological examinations, and an expectation that all such examinations will be reported timeously [1,2]. The trend is exemplified by the burgeoning use of computerized tomography (CT) in trauma [3]. The increase in trauma-related CT has contributed to delayed or non-reporting of plain trauma radiographs internationally. This is particularly true in resource-limited environments, where patient management is largely determined by the radiographic interpretive skills of referring clinicians [1,2,4]. (Source: Injury)
Source: Injury - July 30, 2019 Category: Orthopaedics Authors: FC Holdt, RD Pitcher Source Type: research

Intramedullary nailing of displaced four-part fractures of the proximal humerus
Consensus on the treatment strategy of displaced 4-part proximal humeral fractures is still in the focus of the interest. Current strategy prefers individual approach according to biological age and fracture patterns. In younger patients, reduction and stable fixation with locking plates is recommended in all fractures capable for reconstruction, in active elderly patients, reverse shoulder arthroplasty is more frequent because of shorter physiotherapy and one-shot surgery. Results of the studies are influenced by inclusion criteria for reconstruction strategy and quality of surgery performance, especially appropriate redu...
Source: Injury - July 29, 2019 Category: Orthopaedics Authors: Martin Kloub, Karel Holub, Jiri Urban, Pavel Latal, Marek Peml, Martin Krivohlavek Source Type: research

Does Fracture Obliquity in Weber B Fibula Fractures Correlate with Mortise Instability?
The diagnosis of instability in the apparent, isolated Weber B fibula fracture presenting with an anatomic mortise can be challenging and often necessitates stress radiography. Whether gravity or external rotation stress testing is performed, issues such as patient discomfort, increased radiation exposure, cost, additional time and delayed office throughput are not insignificant. Recently, Nortunen et al. examined radiographic characteristics of non-stress radiographs and concluded that patients with noncomminuted lateral malleolar fractures could be diagnosed with a stable mortise without stress testing when fracture disp...
Source: Injury - July 27, 2019 Category: Orthopaedics Authors: Brian Velasco, Christopher P. Miller, Michael Y. Ye, John Y. Kwon Source Type: research

How effective is Skyline View for Avoiding Dorsal Cortex Penetration in Volar Plate Fixation of Intra-articular and Dorsal Cortex Comminuted Distal Radius Fractures
The incidence of osteosynthesis is increased by volar anatomic plate used for treatment of distal radius fractures and this increases the incidence of wrist extensor tendon irritation, a postoperative complication of the aforementioned surgical technique. The purpose of this study; was to evaluate the intraoperative skyline view which is commonly used to prevent dorsal cortex penetration of distal screws during the surgical treatment of intra-articular distal radius fractures with comminuted dorsal cortex with CT(computed tomography) scanning to determine its effectiveness. (Source: Injury)
Source: Injury - July 26, 2019 Category: Orthopaedics Authors: Emre An ıl Özbek, Tacettin Ayanoğlu, Mehmet Armangil Source Type: research

Eye Injury Registries – A systematic review
Registries are integral to monitoring, surveying, treating, preventing and prognosticating trauma. The quantity and quality of data must justify a change or intervention in treatment and/or preventive strategies and must be collected while balancing the cost and time invested in the registry. This review documents the quality, completeness and operational and funding models for ocular trauma registries worldwide. (Source: Injury)
Source: Injury - July 26, 2019 Category: Orthopaedics Authors: Annette Hoskin, Stephanie Watson, David Mackey, Rupesh Agrawal, Lisa Keay Tags: Review Source Type: research

Effectiveness of distally slotted proximal femoral nails on prevention of femur fractures during and after intertrochanteric femur fracture surgery
Slotted devices are used to stabilize the intramedullary cavities of the proximal femora and reduce stress at nail tips, to mitigate later complications such as periprosthetic fractures and thigh pain [1]. In patients receiving either nails or endoprostheses, implant-related femoral fractures occurring after hip fracture surgery develop principally at implant tips [2]. Distally slotted femoral stems were initially introduced for use during hip arthroplasty. Musgrave et al. showed that use of such stems reduced the fracture risk during stem insertion [1]. (Source: Injury)
Source: Injury - July 26, 2019 Category: Orthopaedics Authors: Mehmet Salih Soylemez, Esat Uygur, Oguz Poyanli Source Type: research

Hyperglycemia as a Risk Factor for Postoperative Early Wound Infection after Bicondylar Tibial Plateau Fractures: Determining a Predictive Model Based on Four Methods
Tibial plateau fractures are common injuries of the lower extremity with reported wound complications rates as high as 88% and infection rates that range from 5% to 15% [1 –4]. Known risk factors for developing an infection are: smoking status, diagnosis of diabetes, open fracture, presence of compartment syndrome, prolonged operative times, and high energy fractures (i.e. Schatzker IV-VI) [3,5–7]. Hyperglycemia is common after high-stress events. Stress-induced h yperglycemia has been widely studied in other medical fields (e.g. (Source: Injury)
Source: Injury - July 25, 2019 Category: Orthopaedics Authors: Andres Rodriguez-Buitrago, Attum Basem, Ebubechi Okwumabua, Nichelle Enata, Adam Evans, Jacquelyn Pennings, Bernes Karacay, Mark John Rice, William Obremskey Source Type: research

Management of post-traumatic long bone defects: A comparative study based on long-term results
Reconstruction of post-traumatic long bone defects is a formidable problem. To date, the approaches for bony reconstruction remain controversial. Thus, we aimed to compare the different methods in the treatment of patients with post-traumatic long bone defects, based on the long-term functional and self-evaluation results. (Source: Injury)
Source: Injury - July 25, 2019 Category: Orthopaedics Authors: Gen Wen, Runhua Zhou, Yanmao Wang, Shengdi Lu, Yimin Chai, Huilin Yang Source Type: research

Timing and methods of frailty assessments in geriatric trauma patients: A Systematic Review
The trauma population is aging and in older trauma patients, innocuous mechanisms such as a fall from standing height, can result in severe injury and poor outcomes (1,2). Triage measures such as systolic blood pressure and age poorly identify older patients at risk of adverse outcome and better prognostic measures for older trauma patients are required (3 –5). Frailty, described by Rockwood as “an evolving concept” without consensus definition, is an age-related vulnerable state in which the individual is at risk of adverse health outcomes (6,7). (Source: Injury)
Source: Injury - July 24, 2019 Category: Orthopaedics Authors: Mya Cubitt, Emma Downie, Rose Shakerian, Peter W. Lange, Elaine Cole Source Type: research

The reliability of the ICD-AIS map in identifying serious road traffic injuries from the Helsinki Trauma Registry
To monitor and reduce serious road traffic injuries, the EU has recommended that its member countries compile statistics on the number of serious road traffic injuries according to a common definition known as MAIS 3+ (1). MAIS 3+ is based on the Abbreviated Injury Scale (AIS ©) (2), which is a widely accepted injury severity rating method developed by the Association for the Advancement of Automotive Medicine (AAAM). The ideal use of AIS classification is to conduct the injury severity rating by a trained expert on the basis of the full medical records of a patient. (Source: Injury)
Source: Injury - July 24, 2019 Category: Orthopaedics Authors: Noora K. Airaksinen, Mikko T. Hein änen, Lauri E. Handolin Source Type: research

Early Clinical and Radiographic Outcomes of a Mini-Fragment, Low Profile Plating System in Tibial Plafond Fractures
Tibial plafond or “pilon” fractures are commonly associated with significant high energy forces which can result in severe soft tissue injury and challenging fracture patterns. In such instances, it is important for soft tissue handling to be minimal in order to avoid infection, nonunion, or wound complications [ 1–3]. Extensive articular comminution or bony segmentation can also complicate fracture reduction after a traumatic injury. (Source: Injury)
Source: Injury - July 23, 2019 Category: Orthopaedics Authors: Khang H. Dang, Samuel S. Ornell, Rose Ann Huynh, Jorge C. DeLeon, Rachel Pesek, Ravi A. Karia Source Type: research

Routine postoperative radiographs after tibia plateau fixation have minimal impact on patient care
Tibia plateau fractures constitute approximately 1% of all fractures, with an annual incidence of 10.3 per 100,000 [1,2]. These fractures tend to occur more commonly with high energy mechanisms such as motor vehicle collision before the 6th decade, while low energy impacts causing tibial plateau fractures are more common after the 6th decade. These fractures are commonly treated with open reduction and internal fixation, especially for displaced or unstable fractures [3]. Implants commonly used for tibia plateau internal fixation includes 3.5  mm and 4.5 mm proximal tibia locking compression plates (LCP), 3.5...
Source: Injury - July 23, 2019 Category: Orthopaedics Authors: B. Jennewine, D. Fiorino, M. Kew, A. Byrne, S. Yarboro Source Type: research

A qualitative study of patients ’ experience of recovery after a distal femoral fracture
Fragility fractures are significant injuries that occur in a vulnerable group of patients, causing considerable morbidity and mortality [1]. The incidence of fragility fractures is increasing and the spectrum of fractures presenting in the older population is changing [2]. An increase in fractures around the knee is evident and predicted to continue [3]. Distal femoral fractures (just above the knee) account for between 4 –6% of all fractures of the femur [4]. Occurring predominantly in older people with osteoporotic bone [2], these fractures can be devastating with a high rate of mortality (18–30% mortality at...
Source: Injury - July 22, 2019 Category: Orthopaedics Authors: Emma Elizabeth Phelps, Elizabeth Tutton, Xavier Griffin, Janis Baird, On behalf of the TrAFFix research collaborators Source Type: research

A reliable method for intraoperative detection of lateral malleolar malrotation using conventional fluoroscopy
To introduce a new method for intraoperative detection of rotational malreduction of the lateral malleolus using conventional fluoroscopy. (Source: Injury)
Source: Injury - July 22, 2019 Category: Orthopaedics Authors: Shi-Min Chang, Hai-Feng Li, Sun-Jun Hu, Shou-Chao Du, Li-Zhi Zhang, Wen-Feng Xiong Tags: Technical Note Source Type: research

A qualitative study of patients ’ experience of recovery after a distal femur fracture
Fragility fractures are significant injuries that occur in a vulnerable group of patients, causing considerable morbidity and mortality [1]. The incidence of fragility fractures is increasing and the spectrum of fractures presenting in the older population is changing [2]. An increase in fractures around the knee is evident and predicted to continue [3]. Distal femoral fractures (just above the knee) account for between 4 to 6% of all fractures of the femur [4]. Occurring predominantly in older people with osteoporotic bone [2], these fractures can be devastating with a high rate of mortality (18 – 30% mortality at o...
Source: Injury - July 22, 2019 Category: Orthopaedics Authors: Emma Elizabeth Phelps, Elizabeth Tutton, Xavier Griffin, Janis Baird, On behalf of the TrAFFix research collaborators Source Type: research

Flexible Fixation for Ligamentous Lisfranc Injuries
We describe a novel technique that provides flexible fixation that is simple, cost-effective and that may offer certain advantages over more traditional techniques.Level of Evidence: Level V, Expert Opinion (Source: Injury)
Source: Injury - July 22, 2019 Category: Orthopaedics Authors: Jorge Briceno, Kristen L. Stupay, Bruno Moura, Brian Velasco, John Y. Kwon Tags: Technical Note Source Type: research

The relationship between geographic location and outcomes following injury: A scoping review
Globally, injury incidence and injury-fatality rates are higher in regional and remote areas. Recovery following serious injury is complex and requires a multi-disciplinary approach to management and community re-integration to optimise outcomes. A significant knowledge gap exists in understanding the regional variations in hospital and post-discharge outcomes following serious injury. The aim of this study was to review the evidence exploring the association between the geographic location, including both location of the event and place of residence, and outcomes following injury. (Source: Injury)
Source: Injury - July 17, 2019 Category: Orthopaedics Authors: Jemma Keeves, Christina L. Ekegren, Ben Beck, Belinda J. Gabbe Source Type: research

Greater trochanteric versus piriformis fossa entry nails for femur shaft fractures: Resolving the controversy
The management of femur fractures has evolved since the introduction of intramedullary nailing technique by Kuntscher in the 1940 ’s [1]. Close reduction and internal fixation with an intramedullary nail is the preferable and widely acceptable treatment for femur shaft fractures [2–5]. The nailing technique, along with the nail design and configuration have also been improvised over past few decades. Although the piriformi s fossa and the greater trochanter (GT) are the two recognised entry points for antegrade nails, the debate for optimal entry point and the superiority of one over the other is not settled [6...
Source: Injury - July 14, 2019 Category: Orthopaedics Authors: Prasoon Kumar, Deepak Neradi, Rohit Kansal, Sameer Aggarwal, Vishal Kumar, Mandeep Singh Dhillon Source Type: research