Pub Date : 2021-10-19DOI: 10.30491/TM.2021.262005.1211
M. Sajjadi, R. Zandi, A. Manafi, M. K. E. Meibodi, Heydar Darabi
Introduction: This study was conducted to determine the imaging criteria (dimensions) of the anterior pelvis in patients referred to Taleghani Hospital in Tehran, Iran.Methods: The present study was performed as a retrospective cross-sectional study from 2018 to 2020 in the orthopedic clinic of Taleghani Hospital. The target population of this study included all hospitalized patients with a diagnosis of pelvic fracture (unstable acetabular fracture). For sampling, the census method was used, which according to the inclusion criteria, only 102 files were selected for inclusion in the study. In this study, a two-part checklist was used. Results: the angle of coronal cut and sagittal cut at variable levels, the dimensions of the anterior pelvis in three areas of stenosis at variable levels and BMI, the distance from the bladder to the posterior border at the variable levels of BMI, the posterior border at the anterior column to venous at variable levels of BMI, posterior border distance in the anterior column to the artery at variable levels of age and BMI, and lateral ileum to three narrowing zones at varying levels of gender, age, and BMI are significantly different. The results also showed that age had a significant negative correlation with posterior border distance in the anterior column with artery, vein, and BMI index had a significant positive correlation with pelvic anterior column dimensions and lateral ileum distance.Conclusion: To determine the imaging criteria of the anterior pelvic column, variables such as age, gender, and body mass index must be considered.Keywords: Anterior Pelvis, BMI, Imaging, Acetabular Fractures
{"title":"Anatomical Dimensions of the Anterior Column of the Acetabulum with Imaging Criteria in Patients with Surgical Acetabular Fractures","authors":"M. Sajjadi, R. Zandi, A. Manafi, M. K. E. Meibodi, Heydar Darabi","doi":"10.30491/TM.2021.262005.1211","DOIUrl":"https://doi.org/10.30491/TM.2021.262005.1211","url":null,"abstract":"Introduction: This study was conducted to determine the imaging criteria (dimensions) of the anterior pelvis in patients referred to Taleghani Hospital in Tehran, Iran.Methods: The present study was performed as a retrospective cross-sectional study from 2018 to 2020 in the orthopedic clinic of Taleghani Hospital. The target population of this study included all hospitalized patients with a diagnosis of pelvic fracture (unstable acetabular fracture). For sampling, the census method was used, which according to the inclusion criteria, only 102 files were selected for inclusion in the study. In this study, a two-part checklist was used. Results: the angle of coronal cut and sagittal cut at variable levels, the dimensions of the anterior pelvis in three areas of stenosis at variable levels and BMI, the distance from the bladder to the posterior border at the variable levels of BMI, the posterior border at the anterior column to venous at variable levels of BMI, posterior border distance in the anterior column to the artery at variable levels of age and BMI, and lateral ileum to three narrowing zones at varying levels of gender, age, and BMI are significantly different. The results also showed that age had a significant negative correlation with posterior border distance in the anterior column with artery, vein, and BMI index had a significant positive correlation with pelvic anterior column dimensions and lateral ileum distance.Conclusion: To determine the imaging criteria of the anterior pelvic column, variables such as age, gender, and body mass index must be considered.Keywords: Anterior Pelvis, BMI, Imaging, Acetabular Fractures","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"54 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80130564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-19DOI: 10.30491/TM.2021.262592.1212
K. Amini, Soheila Abolghasemi Fakhri, Haniyeh Salehi, H. Bakhtavar, F. Rahmani
Background: There are several models for the prognosis of trauma patients and the present study aims to evaluate age, systolic blood pressure (GAP), revised trauma score (RTS), and new trauma score (NTS) to predict mortality rate in multiple trauma patients referring to Imam Reza Hospital, Tabriz, Iran.Methods: The present descriptive-analytical study was carried out on 544 multiple trauma patients during July 2018 to Aug 2019. GAP, RTS and NTS models were adopted to collect data on the variables. The GAP, RTS and NTS scores were calculated and their relationship with hospital outcome was then assessed.Result: During this study, 31 patients out of the selected sample died. The cut-off point (sensitivity and specificity) of RTS, NTS, and GAP models for hospital survival rates was equal to 6.07 (0.97 and 0.98), 5.59 (0.94 and 0.99), and 15.5 (0.97 and 0.97), respectively. Logistic regression test was run to determine the effects of GCS, GAP, RTS, and NTS models. The results showed that the RTS and NTS scores had the highest value in determining the chances of survival, with the respective odds ratios (OR) of 13.74 and 10.207.Conclusion: Considering the high sensitivity and specificity of RTS, GAP, and NTS models in determining patient survival rates, these models have good predictive value in determining hospital outcome. With regard to the effect of these models on the patient outcome based on OR values, RTS and NTS model showed high values.
{"title":"Mortality Prediction in Multiple Trauma Patients Using GAP, RTS and NTS Models","authors":"K. Amini, Soheila Abolghasemi Fakhri, Haniyeh Salehi, H. Bakhtavar, F. Rahmani","doi":"10.30491/TM.2021.262592.1212","DOIUrl":"https://doi.org/10.30491/TM.2021.262592.1212","url":null,"abstract":"Background: There are several models for the prognosis of trauma patients and the present study aims to evaluate age, systolic blood pressure (GAP), revised trauma score (RTS), and new trauma score (NTS) to predict mortality rate in multiple trauma patients referring to Imam Reza Hospital, Tabriz, Iran.Methods: The present descriptive-analytical study was carried out on 544 multiple trauma patients during July 2018 to Aug 2019. GAP, RTS and NTS models were adopted to collect data on the variables. The GAP, RTS and NTS scores were calculated and their relationship with hospital outcome was then assessed.Result: During this study, 31 patients out of the selected sample died. The cut-off point (sensitivity and specificity) of RTS, NTS, and GAP models for hospital survival rates was equal to 6.07 (0.97 and 0.98), 5.59 (0.94 and 0.99), and 15.5 (0.97 and 0.97), respectively. Logistic regression test was run to determine the effects of GCS, GAP, RTS, and NTS models. The results showed that the RTS and NTS scores had the highest value in determining the chances of survival, with the respective odds ratios (OR) of 13.74 and 10.207.Conclusion: Considering the high sensitivity and specificity of RTS, GAP, and NTS models in determining patient survival rates, these models have good predictive value in determining hospital outcome. With regard to the effect of these models on the patient outcome based on OR values, RTS and NTS model showed high values.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84988944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-18DOI: 10.30491/TM.2021.303273.1360
A. Taheri, Fatemeh Arjmandnia, H. Majedi, A. Kazemeini, Fardin Yousefshahi, M. Rahimi
Introduction Pregabalin is a co-analgesia to improve the pain control after colorectal cancer surgeries. But, the effect of Pregabalin on the sleep and ability to change position of patients in postoperative period is less well known. This study aimed to assess the effect of Pregabalin on postoperative morphine consumption, and effect of pain on sleep, mood and ability to change position after colorectal cancer surgery. Methods This double-blind, randomized, controlled, single-center clinical trial was conducted in Imam Khomeini hospital, Tehran, Iran from June 2017 to June 2018. Seventy patients were included for colorectal cancer surgery randomly divided into two groups. Group A received two doses of 150 mg Pregabalin preoperatively and postoperatively and group B placebo was administered at the same scheme. The two groups had same analgesia and anesthesia regimens otherwise. The pain score by a numerical rating scale (NRS); disturbance in sleep, mood and daily activity scores based on a scoring system like the BPI questionnaires; and, nausea- vomiting, fatigue headache, and morphine consumption were assessed 48 hours post-operatively. Results Morphine consumption was lower in the Pregabalin group 24 h postoperatively (P=0.01). The two groups were similar in terms of sleep interference scores and side effects (P>0.05). But, Mood and actions interference scores in the Pregabalin group showed a significant improvement in 48 h postoperative (P<0.05) (Table 3). Conclusion The results showed that Pregabalin could reduce postoperative morphine consumption and improve mood and actions interference scores after colorectal cancer surgery. However, there was no difference between Pregabalin and placebo in postoperative pain management and sleep interference scores after colorectal cancer surgery.
{"title":"The effect of Pregabalin on morphine consumption, sleep, mood and ability to change position after colorectal cancer surgery","authors":"A. Taheri, Fatemeh Arjmandnia, H. Majedi, A. Kazemeini, Fardin Yousefshahi, M. Rahimi","doi":"10.30491/TM.2021.303273.1360","DOIUrl":"https://doi.org/10.30491/TM.2021.303273.1360","url":null,"abstract":"Introduction\u0000Pregabalin is a co-analgesia to improve the pain control after colorectal cancer surgeries. But, the effect of Pregabalin on the sleep and ability to change position of patients in postoperative period is less well known. This study aimed to assess the effect of Pregabalin on postoperative morphine consumption, and effect of pain on sleep, mood and ability to change position after colorectal cancer surgery.\u0000Methods\u0000This double-blind, randomized, controlled, single-center clinical trial was conducted in Imam Khomeini hospital, Tehran, Iran from June 2017 to June 2018. Seventy patients were included for colorectal cancer surgery randomly divided into two groups. Group A received two doses of 150 mg Pregabalin preoperatively and postoperatively and group B placebo was administered at the same scheme. The two groups had same analgesia and anesthesia regimens otherwise. The pain score by a numerical rating scale (NRS); disturbance in sleep, mood and daily activity scores based on a scoring system like the BPI questionnaires; and, nausea- vomiting, fatigue headache, and morphine consumption were assessed 48 hours post-operatively. \u0000Results\u0000Morphine consumption was lower in the Pregabalin group 24 h postoperatively (P=0.01). The two groups were similar in terms of sleep interference scores and side effects (P>0.05). But, Mood and actions interference scores in the Pregabalin group showed a significant improvement in 48 h postoperative (P<0.05) (Table 3).\u0000Conclusion\u0000The results showed that Pregabalin could reduce postoperative morphine consumption and improve mood and actions interference scores after colorectal cancer surgery. However, there was no difference between Pregabalin and placebo in postoperative pain management and sleep interference scores after colorectal cancer surgery.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"53 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80426210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.30491/TM.2021.303355.1368
S. Bhat, Surendra Kumar, L. Pathak, A. Upadhyay, S. Goel, Ritika Girdhar
Introduction- Pediatric both bone forearm fracture commonly encountered in orthopedic emergency, their treatment varies widely from simple sling and cast to operative fixation with nailing and plating with no definitive consensus on one treatment modality. Although most of cases are satisfactorily managed with conservative measure, current innovation in elastic nailing, instrumentation and poor compliance to cast and frequent revisits to check the adequacy of reduction makes treatment with elastic titanium nailing an excellent means of intervention in unstable both bones fractures in children.Materials methods- The study was conducted at Dept of orthopedics, SHKM Govt medical college Nuh , India, which included 30 patients, 18 male, 12 female with age from 6 to 15years, with mean age of 10 years. Twenty patients had middle third fractures, 6 proximal 1/3rd and 3 distal 1/3rd fractures. Closed reduction was done in 24 (80%) patients and 6(20%) patients needed open reduction at # site.The transverse fractures were seen in 17 patients, oblique fractures in 6 patients, communicated in 4patients and spiral fractures in 3 patients. Results- The functional Outcome as per Price et al Criteria (7) was Excellent in 28 patients, good in 2 patients. None of the patients showed poor function at the final follow up at 1 year. Discussion and conclusion- Tens allows micro motion at fracture site due to elasticity of nails elastic deformation within the medullary canal creates a bending moment within the long bone that is not rigid, but that is stable enough to reduce and fix the fracture, and favors callous formation and bone healing. The treatment of pediatric both bones fractures with TENS continue to be the unparallel success and reliable treatment method with predictable outcome and minimal complication. We certainly recommend this type of treatment in angulated and unstable forearm fractures in children.
{"title":"Titanium Elastic Nailing System, An Effective Way Of Pediatric Forearm Fracture Management","authors":"S. Bhat, Surendra Kumar, L. Pathak, A. Upadhyay, S. Goel, Ritika Girdhar","doi":"10.30491/TM.2021.303355.1368","DOIUrl":"https://doi.org/10.30491/TM.2021.303355.1368","url":null,"abstract":"Introduction- Pediatric both bone forearm fracture commonly encountered in orthopedic emergency, their treatment varies widely from simple sling and cast to operative fixation with nailing and plating with no definitive consensus on one treatment modality. Although most of cases are satisfactorily managed with conservative measure, current innovation in elastic nailing, instrumentation and poor compliance to cast and frequent revisits to check the adequacy of reduction makes treatment with elastic titanium nailing an excellent means of intervention in unstable both bones fractures in children.Materials methods- The study was conducted at Dept of orthopedics, SHKM Govt medical college Nuh , India, which included 30 patients, 18 male, 12 female with age from 6 to 15years, with mean age of 10 years. Twenty patients had middle third fractures, 6 proximal 1/3rd and 3 distal 1/3rd fractures. Closed reduction was done in 24 (80%) patients and 6(20%) patients needed open reduction at # site.The transverse fractures were seen in 17 patients, oblique fractures in 6 patients, communicated in 4patients and spiral fractures in 3 patients. Results- The functional Outcome as per Price et al Criteria (7) was Excellent in 28 patients, good in 2 patients. None of the patients showed poor function at the final follow up at 1 year. Discussion and conclusion- Tens allows micro motion at fracture site due to elasticity of nails elastic deformation within the medullary canal creates a bending moment within the long bone that is not rigid, but that is stable enough to reduce and fix the fracture, and favors callous formation and bone healing. The treatment of pediatric both bones fractures with TENS continue to be the unparallel success and reliable treatment method with predictable outcome and minimal complication. We certainly recommend this type of treatment in angulated and unstable forearm fractures in children.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"39 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78960252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.30491/TM.2021.304534.1370
Shahideh Rostami, Fatemeh Heidarzadeh, S. Fallah, Seyed Alireza Rahimi, M. Mehrizi, F. Sadeghi, Seyed Morteza Hosseiniara, Mohammad Shahrabadi, Marziyeh Hajizadeh, Reza Hosseiniara, Jennifer Swann, A. Farahani
Traumatic brain injury (TBI) is a common cause of disability and mortality worldwide. TBI is an acquired brain injury that may be open (penetrating) or closed (non-penetrating) and is be categorized as mild, moderate, or severe, depending on the clinical presentation. Accurate diagnosis at the earliest stages can significantly affect patient discomfort, prognosis, therapeutic intervention, survival rates, and recurrence. Whereas traditional CT and MRI techniques for diagnosis are dominant in clinical situations, a promising direction for clinical diagnosis is the use of fluid biomarkers like blood, CSF, urine, and saliva. Fluid biomarkers that may track these injuries and inflammatory processes have been explored for their potential to provide objective measures in TBI assessment. At present, there are limited clinical guidelines available regarding the use of fluid biomarkers in following TBI. In recent years, saliva has received significant attention as a biomarker for TBI in clinical practice due to the non-invasive accessibility, cost-effective collection, and consistent relationship with serum. This review examines the utility of saliva biomarkers such as S100B, noncoding RNAs (ncRNAs), extracellular vesicles (EVs), miRNAs levels, microtubule-associated protein tau, alpha-amylase, cortisol, and oxidative stress in TBI. The study highlights the current state of salivary diagnostics, future aspirations, and their potential as the preferred route of TBI detection. The newly developed techniques for salivary analysis of these molecules may help to improve outcomes for TBI through rapid detection current unavailable with serum samples Future studies employing salivary biomarkers will certainly help to establish consistent strategies for early diagnosis of TBI and improve treatment outcomes of TBI patients.
{"title":"Diagnostic Salivary Biomarkers in Traumatic Brain Injury","authors":"Shahideh Rostami, Fatemeh Heidarzadeh, S. Fallah, Seyed Alireza Rahimi, M. Mehrizi, F. Sadeghi, Seyed Morteza Hosseiniara, Mohammad Shahrabadi, Marziyeh Hajizadeh, Reza Hosseiniara, Jennifer Swann, A. Farahani","doi":"10.30491/TM.2021.304534.1370","DOIUrl":"https://doi.org/10.30491/TM.2021.304534.1370","url":null,"abstract":"Traumatic brain injury (TBI) is a common cause of disability and mortality worldwide. TBI is an acquired brain injury that may be open (penetrating) or closed (non-penetrating) and is be categorized as mild, moderate, or severe, depending on the clinical presentation. Accurate diagnosis at the earliest stages can significantly affect patient discomfort, prognosis, therapeutic intervention, survival rates, and recurrence. Whereas traditional CT and MRI techniques for diagnosis are dominant in clinical situations, a promising direction for clinical diagnosis is the use of fluid biomarkers like blood, CSF, urine, and saliva. Fluid biomarkers that may track these injuries and inflammatory processes have been explored for their potential to provide objective measures in TBI assessment. At present, there are limited clinical guidelines available regarding the use of fluid biomarkers in following TBI. In recent years, saliva has received significant attention as a biomarker for TBI in clinical practice due to the non-invasive accessibility, cost-effective collection, and consistent relationship with serum. This review examines the utility of saliva biomarkers such as S100B, noncoding RNAs (ncRNAs), extracellular vesicles (EVs), miRNAs levels, microtubule-associated protein tau, alpha-amylase, cortisol, and oxidative stress in TBI. The study highlights the current state of salivary diagnostics, future aspirations, and their potential as the preferred route of TBI detection. The newly developed techniques for salivary analysis of these molecules may help to improve outcomes for TBI through rapid detection current unavailable with serum samples Future studies employing salivary biomarkers will certainly help to establish consistent strategies for early diagnosis of TBI and improve treatment outcomes of TBI patients.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"8 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86126274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-30DOI: 10.30491/TM.2021.295070.1330
J. Ogunlusi, M. Yusuf, S. Hailu, S. Popoola, O. Esan, K. Oluwadiya
Background: Pelvic-acetabular fractures are markers of high energy trauma and are associated with significant morbidity, mortality and management could be challenging. The inability to surgically manage these fractures appropriately in our centre and few publications on pelvic-acetabular fractures in Nigeria stimulated this study.Objectives: to find out how pelvic and acetabular fractures are managed and availability of investigating tools in Nigeria.Materials and methods: A questionnaire was uploaded for 7 weeks on the National orthopaedics and trauma surgeons’ forum. Questions on pelvic fractures management, knowledge and classification of pelvic fractures, preferred methods of pelvic fractures management- surgical or non-surgical, availability of advanced investigating tools and desire to acquire more skills /training were asked. Results: Eighty-five (33.2%) of the 256 members participated in the study. Preferred classification were Tile and Young-Burgess 46 (56.8%) and 29 (35.8 %) respectively. Thirty-six (43.9%) had Computerize Tomography scan (CT) while 19 (23.2%) had Magnetic Resonance Imaging (MRI) available in their place of practice. Twenty-eight (34.6%) would manage operatively, 8 (9.9%) would either operate or refer, while 23 (28.48%) would either manage non-operative or refer and outright non-operative in 7 (8.6%) of pelvic-acetabular fractures that require Open Reduction Internal Fixation (ORIF). Forty-six (56.8%) would refer patients; because of non-availability of skilled surgeon in 30(65.2%) and non-availability of operating tools in 32(69.6 %). Seventy-four (90.2%) would like to acquire skills in pelvic surgery.Conclusion: The health facilities were not adequately equipped with advanced imaging tools. Twenty-three percent of the respondents would consider managing pelvic fracture that requires ORIF non-operatively, while more than half would refer because of either non-availability of skilled pelvic surgeon or non-availably of operating tools. Majority of the respondents are interested in acquiring skills in pelvic surgery
{"title":"Knowledge and Practice of Pelvic and Acetabular Fractures Management Among Orthopaedics and Trauma Surgeons in Nigeria","authors":"J. Ogunlusi, M. Yusuf, S. Hailu, S. Popoola, O. Esan, K. Oluwadiya","doi":"10.30491/TM.2021.295070.1330","DOIUrl":"https://doi.org/10.30491/TM.2021.295070.1330","url":null,"abstract":"Background: Pelvic-acetabular fractures are markers of high energy trauma and are associated with significant morbidity, mortality and management could be challenging. The inability to surgically manage these fractures appropriately in our centre and few publications on pelvic-acetabular fractures in Nigeria stimulated this study.Objectives: to find out how pelvic and acetabular fractures are managed and availability of investigating tools in Nigeria.Materials and methods: A questionnaire was uploaded for 7 weeks on the National orthopaedics and trauma surgeons’ forum. Questions on pelvic fractures management, knowledge and classification of pelvic fractures, preferred methods of pelvic fractures management- surgical or non-surgical, availability of advanced investigating tools and desire to acquire more skills /training were asked. Results: Eighty-five (33.2%) of the 256 members participated in the study. Preferred classification were Tile and Young-Burgess 46 (56.8%) and 29 (35.8 %) respectively. Thirty-six (43.9%) had Computerize Tomography scan (CT) while 19 (23.2%) had Magnetic Resonance Imaging (MRI) available in their place of practice. Twenty-eight (34.6%) would manage operatively, 8 (9.9%) would either operate or refer, while 23 (28.48%) would either manage non-operative or refer and outright non-operative in 7 (8.6%) of pelvic-acetabular fractures that require Open Reduction Internal Fixation (ORIF). Forty-six (56.8%) would refer patients; because of non-availability of skilled surgeon in 30(65.2%) and non-availability of operating tools in 32(69.6 %). Seventy-four (90.2%) would like to acquire skills in pelvic surgery.Conclusion: The health facilities were not adequately equipped with advanced imaging tools. Twenty-three percent of the respondents would consider managing pelvic fracture that requires ORIF non-operatively, while more than half would refer because of either non-availability of skilled pelvic surgeon or non-availably of operating tools. Majority of the respondents are interested in acquiring skills in pelvic surgery","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"77 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74196091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-30DOI: 10.30491/TM.2021.271571.1234
Avtar Singh, D. Patel, Rajeev Vohra, S. Chauhan, Babaji Thorat
Introduction: Displaced fractures of the femoral neck in the elderly are best treated with arthroplasty. The type of arthroplasty to be used, either hemi- or total hip arthroplasty, remains controversial as total hip replacements potentially have a higher rate of dislocation.Hypothesis: Dual mobility cups have a low dislocation rate when used to manage fractures of the femoral neck with posterior approach.Patients and methods: In our center prospective study conducted in Amritsar (Punjab) India over an inclusion time of 2 years, all displaced fractures of the femoral neck treated with arthroplasty were operated on with insertion of a dual mobility cup with posterior approach. Patients had clinical and radiological assessment at immediate post op, 3 and 6 months, 1 year and 3 year after surgery.Results: Among these 240 patients, The right hip was operated on 121 (50.4%) patients and left hip on 119 (49.6%) patients. There was a male preponderance seen and 101 (42.1%) out of 240 patients were female. None of the patients was lost to follow-up. All patients were operated through a posterior approach. The mean Harris hip score improved from 16.62 ± 6.34 preoperative to 92.86 ± 2.28 at the time of 1 year follow up and 95.20 ± 1.82 at the time of 3 years follow up We had three dislocation occurred and Open Reduction was performed through posterior approach under regional anesthesia for 2 patients and close reduction done in one patient . There was no recurrence of dislocation.CONCLUSIONS: Our experience with Dual mobility cup is an effective solution for the management of treatment for displaced fracture of the femoral neck in the elderly undergoing total hip replacement to reduce the incidence of postoperative instability even after using posterior approach.
{"title":"Dual mobility cups hip arthroplasty as a treatment for displaced fracture of the femoral neck in the elderly patients: A prospective, systematic study with specific focus on postoperative dislocation using posterior approach.","authors":"Avtar Singh, D. Patel, Rajeev Vohra, S. Chauhan, Babaji Thorat","doi":"10.30491/TM.2021.271571.1234","DOIUrl":"https://doi.org/10.30491/TM.2021.271571.1234","url":null,"abstract":"Introduction: Displaced fractures of the femoral neck in the elderly are best treated with arthroplasty. The type of arthroplasty to be used, either hemi- or total hip arthroplasty, remains controversial as total hip replacements potentially have a higher rate of dislocation.Hypothesis: Dual mobility cups have a low dislocation rate when used to manage fractures of the femoral neck with posterior approach.Patients and methods: In our center prospective study conducted in Amritsar (Punjab) India over an inclusion time of 2 years, all displaced fractures of the femoral neck treated with arthroplasty were operated on with insertion of a dual mobility cup with posterior approach. Patients had clinical and radiological assessment at immediate post op, 3 and 6 months, 1 year and 3 year after surgery.Results: Among these 240 patients, The right hip was operated on 121 (50.4%) patients and left hip on 119 (49.6%) patients. There was a male preponderance seen and 101 (42.1%) out of 240 patients were female. None of the patients was lost to follow-up. All patients were operated through a posterior approach. The mean Harris hip score improved from 16.62 ± 6.34 preoperative to 92.86 ± 2.28 at the time of 1 year follow up and 95.20 ± 1.82 at the time of 3 years follow up We had three dislocation occurred and Open Reduction was performed through posterior approach under regional anesthesia for 2 patients and close reduction done in one patient . There was no recurrence of dislocation.CONCLUSIONS: Our experience with Dual mobility cup is an effective solution for the management of treatment for displaced fracture of the femoral neck in the elderly undergoing total hip replacement to reduce the incidence of postoperative instability even after using posterior approach.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"112 6 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79960176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-30DOI: 10.30491/TM.2021.301333.1358
Myrzatay A. Buleshov, A. Buleshova, A. Ilimova, B. Ashirov, G. Kausova, D. M. Buleshov
Studying the issues of improving the outpatient surgery in a megalopolis based on standardization is essential both for practical healthcare and medical science. In order to increase the quality and accessibility of surgical treatment, as well as to reduce the cost of treatment and post-operative rehabilitation, medical and economic standards were introduced at Shymkent Municipal Center of Outpatient Surgery in 2016, as a part of the National Healthcare Program. Also, day hospitals were organized for treatment and post-operative rehabilitation of surgical ambulatory patients. The training to increase the doctors’ qualification and their knowledge of medical and economic standards was carried out at South Kazakhstan Medical Academy. The efficiency of using medical and economic standards at day hospitals was assessed with indices based on medical, social and economic criteria. The data was taken from statistical records of attendance and clinical protocols of treatment. Respondents’ opinions were studied with a poll. The research showed that after introduction of the medical and economic standards the doctors’ payment increased depending on the medical efficiency and quality of treatment and post-operative rehabilitation of surgical ambulatory patients; the levels of incidence with temporary and permanent disability decreased, and the time of patients’ staying in hospital reduced.
{"title":"Assessing the efficiency of using medical and economic standards when treating surgical patients in day hospitals","authors":"Myrzatay A. Buleshov, A. Buleshova, A. Ilimova, B. Ashirov, G. Kausova, D. M. Buleshov","doi":"10.30491/TM.2021.301333.1358","DOIUrl":"https://doi.org/10.30491/TM.2021.301333.1358","url":null,"abstract":"Studying the issues of improving the outpatient surgery in a megalopolis based on standardization is essential both for practical healthcare and medical science. In order to increase the quality and accessibility of surgical treatment, as well as to reduce the cost of treatment and post-operative rehabilitation, medical and economic standards were introduced at Shymkent Municipal Center of Outpatient Surgery in 2016, as a part of the National Healthcare Program. Also, day hospitals were organized for treatment and post-operative rehabilitation of surgical ambulatory patients. The training to increase the doctors’ qualification and their knowledge of medical and economic standards was carried out at South Kazakhstan Medical Academy. The efficiency of using medical and economic standards at day hospitals was assessed with indices based on medical, social and economic criteria. The data was taken from statistical records of attendance and clinical protocols of treatment. Respondents’ opinions were studied with a poll. The research showed that after introduction of the medical and economic standards the doctors’ payment increased depending on the medical efficiency and quality of treatment and post-operative rehabilitation of surgical ambulatory patients; the levels of incidence with temporary and permanent disability decreased, and the time of patients’ staying in hospital reduced.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"62 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78175962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-07DOI: 10.30491/TM.2021.278138.1264
A. Ebrahimi, B. Behzadi, M. H. Motamedi, H. Rasouli
Background: Maxillofacial trauma and fractures are among the most common reasons for referral to ER. Epidemiologic features and fracture patterns are widely dependent on cultural, environmental, and socio-economic parameters. In this study we aimed to assess epidemiology and patterns of facial fractures in Iran.Materials and Methods: This cross-sectional study was conducted at a Trauma research center. In this study, medical records of patients with maxillofacial fractures from 2010 to 2015 were reviewed. Age, gender, GCS at admission, hospital stay, fracture cause, site fractured bones, ocular injuries, brain injuries, trigeminal involvement, facial involvement, soft tissue injuries, upper limb fractures and open fractures were evaluated. Treatment plans were also reviewed. Data analysis was performed using SPSS version 22. Results: 283 patients with mean age of 32.48 years and male-to-female ratio of 4.43:1 were assessed. The most common age group was the third decade of life (38.2%). The most common causes of fracture were MVA (66.4%), falls (13.1%) and assault (9.2%). The most common fractured bones were mandibles (42.04%), orbit (39.57%) and maxilla (37.1%). Most patients underwent open reduction (94%). The most common treatment was open reduction and internal fixation with miniplates (49.5%). The hospital stay duration was 3.44 days (on average).Conclusion: In maxillofacial fractures, males in the third decade of life were the most prone to facial fractures. risk. Associated injuries were common and must not be neglected on physical examination. The profession, culture and social differences are influential in facial fractures and thus vary in different nations.
{"title":"Epidemiologic patterns of maxillofacial fractures: A 5-year study in a referral hospital in Iran","authors":"A. Ebrahimi, B. Behzadi, M. H. Motamedi, H. Rasouli","doi":"10.30491/TM.2021.278138.1264","DOIUrl":"https://doi.org/10.30491/TM.2021.278138.1264","url":null,"abstract":"Background: Maxillofacial trauma and fractures are among the most common reasons for referral to ER. Epidemiologic features and fracture patterns are widely dependent on cultural, environmental, and socio-economic parameters. In this study we aimed to assess epidemiology and patterns of facial fractures in Iran.Materials and Methods: This cross-sectional study was conducted at a Trauma research center. In this study, medical records of patients with maxillofacial fractures from 2010 to 2015 were reviewed. Age, gender, GCS at admission, hospital stay, fracture cause, site fractured bones, ocular injuries, brain injuries, trigeminal involvement, facial involvement, soft tissue injuries, upper limb fractures and open fractures were evaluated. Treatment plans were also reviewed. Data analysis was performed using SPSS version 22. Results: 283 patients with mean age of 32.48 years and male-to-female ratio of 4.43:1 were assessed. The most common age group was the third decade of life (38.2%). The most common causes of fracture were MVA (66.4%), falls (13.1%) and assault (9.2%). The most common fractured bones were mandibles (42.04%), orbit (39.57%) and maxilla (37.1%). Most patients underwent open reduction (94%). The most common treatment was open reduction and internal fixation with miniplates (49.5%). The hospital stay duration was 3.44 days (on average).Conclusion: In maxillofacial fractures, males in the third decade of life were the most prone to facial fractures. risk. Associated injuries were common and must not be neglected on physical examination. The profession, culture and social differences are influential in facial fractures and thus vary in different nations.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89849725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-07DOI: 10.30491/TM.2021.283199.1283
Naderali Nazemyanyazdi, A. Delavari, Masood Saghafinia, M. Emami
Background: Post-operative pain management following total knee replacement (TKA) is very crucial. There is a need to introduce some available, inexpensive, and effective methods for postoperative pain management. This randomized clinical trial was done for comparing the analgesic effect of an oral inexpensive drug (oxycodone) and saphenous nerve blocko study the better method for postoperative pain management after TKA surgery.Methods: This single-blind, randomized, controlled, single-center clinical trial was performed in Baghiatallah Hospital from June 2017 to June 2018. Eighty patients were included for TKA randomly divided into two groups. Group A received a single shot ultrasound-guided saphenous nerve block and group B had an oral intake of oxycodone started before and continued every 6 hours after surgery to control post-operative pain. The pain score by visual analog scale (VAS), nausea- vomiting and diclofenac consumption were assessed postoperatively at 2, 6, 12 and 24 hours post-spinal anesthesia administration. Data were analyzed by SPSS-21 and Chi2, Fishers' exact test, and Mann-Whitney were used for comparing data between the two groups. Result: The pain intensity according to the visual analog scale at 2, 6, 12, and 24 h post-operative was 1.25±1.37, 4.12±1.11, 5.25±0.89, and 4.57±095 in group A and 1.10±0.953.77±0.99, 4.05±0.78, and 2.95±0.78 in the group B respectively that was significantly lower in the group B at 12 and 24 hours (p <0.05). The mean diclofenac use was 87.01±68.02 mg in group B and 262.04±92.05 mg in the group A (p <0.001). Also, the incidence of nausea and vomiting was significantly higher in group B compared to the other group (p <0.001). Conclusion: Oral oxycodone can control post-operative pain better than saphenous nerve block in the management of postoperative relief and reducing total additional analgesic drugs consumption. But, adverse effects such as nausea and vomiting were lower in saphenous nerve block than oral oxycodone.
{"title":"Comparison of Saphenous Nerve Block and Oral Oxycodone for Postoperative Pain Management in Total Knee Arthroplasty: A Randomized Clinical Trial","authors":"Naderali Nazemyanyazdi, A. Delavari, Masood Saghafinia, M. Emami","doi":"10.30491/TM.2021.283199.1283","DOIUrl":"https://doi.org/10.30491/TM.2021.283199.1283","url":null,"abstract":"Background: Post-operative pain management following total knee replacement (TKA) is very crucial. There is a need to introduce some available, inexpensive, and effective methods for postoperative pain management. This randomized clinical trial was done for comparing the analgesic effect of an oral inexpensive drug (oxycodone) and saphenous nerve blocko study the better method for postoperative pain management after TKA surgery.Methods: This single-blind, randomized, controlled, single-center clinical trial was performed in Baghiatallah Hospital from June 2017 to June 2018. Eighty patients were included for TKA randomly divided into two groups. Group A received a single shot ultrasound-guided saphenous nerve block and group B had an oral intake of oxycodone started before and continued every 6 hours after surgery to control post-operative pain. The pain score by visual analog scale (VAS), nausea- vomiting and diclofenac consumption were assessed postoperatively at 2, 6, 12 and 24 hours post-spinal anesthesia administration. Data were analyzed by SPSS-21 and Chi2, Fishers' exact test, and Mann-Whitney were used for comparing data between the two groups. Result: The pain intensity according to the visual analog scale at 2, 6, 12, and 24 h post-operative was 1.25±1.37, 4.12±1.11, 5.25±0.89, and 4.57±095 in group A and 1.10±0.953.77±0.99, 4.05±0.78, and 2.95±0.78 in the group B respectively that was significantly lower in the group B at 12 and 24 hours (p <0.05). The mean diclofenac use was 87.01±68.02 mg in group B and 262.04±92.05 mg in the group A (p <0.001). Also, the incidence of nausea and vomiting was significantly higher in group B compared to the other group (p <0.001). Conclusion: Oral oxycodone can control post-operative pain better than saphenous nerve block in the management of postoperative relief and reducing total additional analgesic drugs consumption. But, adverse effects such as nausea and vomiting were lower in saphenous nerve block than oral oxycodone.","PeriodicalId":23249,"journal":{"name":"Trauma monthly","volume":"94 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79637194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：