Chinese Journal of Traumatology最新文献

{"title":"Flexible intramedullary nails for the treatment of metacarpal fractures: A systematic review","authors":"Oliver Scott Brown ,&nbsp;Toby Oliver Smith ,&nbsp;Ravi Kanth Mallina","doi":"10.1016/j.cjtee.2024.08.013","DOIUrl":"10.1016/j.cjtee.2024.08.013","url":null,"abstract":"<div><h3>Purpose</h3><div>Flexible intramedullary nails (FIN) enable minimally invasive and immediate fracture stabilisation, while facilitating early active movement in metacarpal fractures. This systematic review aims to compare locked, non-locked, single, and double FIN and their post-operative outcomes in metacarpal fractures.</div></div><div><h3>Methods</h3><div>A primary literature search was performed on July 15, 2024. English-language studies investigating acute metacarpal fractures, treated with FIN were included. Analyses included: the 5th metacarpal neck fractures locked <em>vs.</em> non-locked FIN; 5th metacarpal neck fractures non-locked single <em>vs.</em> dual FIN; and the 2nd–5th metacarpal fractures locked <em>vs.</em> non-locked FIN. The National Institute for Health tool and the JBI tool were used to assess study quality for controlled trials and case series, respectively.</div></div><div><h3>Results</h3><div>Thirteen studies (<em>n</em>=649 fractures) were eligible, with 12 low risks of bias. There was no difference in overall complication rates between locked and non-locked, and single and double non-locked FIN. Non-locked FIN demonstrated reduced metacarpophalangeal joint penetration (<em>odds ratio</em> (<em>OR</em>): 3.30 (95% <em>confidence interval</em> (<em>CI</em>): 1.23–8.80; <em>p</em>=0.017 and delayed union (<em>OR</em>: 6.95; 95% <em>CI</em>: 1.86–25.97; <em>p</em>=0.004), but increased tendon irritation (<em>OR</em>: 0.19; 95% <em>CI</em>: 0.05–0.83; <em>p</em>=0.027 <em>vs</em>. locked FIN. Overall operative times were lower for single <em>vs</em>. double non-locked nails (mean difference: 9.17; 95% <em>CI</em>: 6.12–12.22; <em>p</em>&lt;0.001).</div></div><div><h3>Conclusions</h3><div>These findings demonstrate low complication rates and excellent functional results using FIN to fix displaced metacarpal fractures. Although complication profiles are contrasting, there is no clear benefit in using locked or double nails compared to a single non-locked FIN.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 6","pages":"Pages 427-435"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The observational chart for traumatic limb swelling enhances diagnostic accuracy for osteofascial compartment syndrome","authors":"Zhi-Wei Yang ,&nbsp;Zhao-Di Wang ,&nbsp;Jun-Sheng Yang ,&nbsp;Liang-Cheng Tong ,&nbsp;Lei Zhao ,&nbsp;Wei Dai ,&nbsp;Kun Pang ,&nbsp;Ying Li","doi":"10.1016/j.cjtee.2025.08.004","DOIUrl":"10.1016/j.cjtee.2025.08.004","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To evaluate the diagnostic accuracy of the observational chart for traumatic limb swelling (OCTLS) for osteofascial compartment syndrome (OCS).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This was a descriptive-longitudinal study. Data of 316 patients who underwent surgical treatment for tibial fractures in our department from January 2015 to December 2023 were collected. Patients with Gustilo type II or higher open fractures, vascular injury, or bilateral fractures were excluded from the study. Two groups of double-blinded investigators independently assessed patients for the presence of OCS using 2 distinct diagnostic methods. Three senior orthopedic trauma surgeons evaluated patients with post-fracture calf swelling for OCS and the need for fasciotomy based on clinical signs and their extensive clinical experience. Subsequently, fasciotomy was performed according to their judgment, followed by postoperative examination of muscle and soft tissue conditions. Additionally, a follow-up evaluation was conducted to assess for complications such as ischemic muscle contracture. Another 3 trained researchers used OCTLS to grade swelling severity and determine the need for fasciotomy. The final diagnostic gold standard of OCS was determined by referring to whether there was escape of muscles at fasciotomy and/or color change in the muscles or muscle necrosis intraoperatively, and neurological abnormality or contracture at the last follow-up. The results of the 2 diagnostic methods were compared with the final diagnostic result. Kappa consistency test, paired χ&lt;sup&gt;2&lt;/sup&gt; test (McNemar test), and receiver operating characteristic curve were used to evaluate the diagnostic efficacy of the 2 diagnostic methods.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of the 316 patients, 211 were finally included in the study, including 160 males and 51 females, with an average follow-up time of (14.5 ± 2.7) months. Among the 211 patients with tibial fracture-associated swelling, 42 were definitively diagnosed with OCS. Based on clinical symptoms and signs judgment, among the 65 fasciotomy patients, 38 were confirmed as correct, while among the 146 non-fasciotomy patients, 4 developed ischemic muscle contractures. Based on the OCTLS for assessment, fasciotomy was correctly recommended in 36 out of 43 cases, while 6 out of 168 non-fasciotomy patients developed OCS. Compared to the use of the gold standard, clinical signs judgment showed moderate consistency (McNemar's test &lt;em&gt;p&lt;/em&gt; &lt; 0.001, Kappa = 0.618, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), whereas OCTLS demonstrated strong agreement (McNemar's test &lt;em&gt;p&lt;/em&gt; = 1.000, Kappa = 0.808, &lt;em&gt;p&lt;/em&gt; &lt; 0.001). Receiver operating characteristic analysis revealed higher diagnostic accuracy for OCTLS (area under curve = 0.908, 95% &lt;em&gt;CI&lt;/em&gt;: 0.843 – 0.972) compared to clinical signs judgment (area under curve = 0.872, 95% &lt;em&gt;CI&lt;/em&gt;: 0.812 – 0.933). OCTLS achieved superior accuracy (93.8% &lt;em&gt;vs&lt;/em&gt;. 85.3%, χ&lt;sup&gt;2&lt;","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 6","pages":"Pages 454-461"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment of a nomogram for early risk prediction of severe trauma in primary medical institutions: A multi-center study","authors":"Wang Bo ,&nbsp;Ming-Rui Zhang ,&nbsp;Gui-Yan Ma ,&nbsp;Zhan-Fu Yang ,&nbsp;Rui-Ning Lu ,&nbsp;Xu-Sheng Zhang ,&nbsp;Shao-Guang Liu","doi":"10.1016/j.cjtee.2025.10.001","DOIUrl":"10.1016/j.cjtee.2025.10.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze risk factors for severe trauma and establish a nomogram for early risk prediction, to improve the early identification of severe trauma.</div></div><div><h3>Methods</h3><div>This study was conducted on the patients treated in 81 trauma treatment institutions in Gansu province from 2020 to 2022. Patients were grouped by year, with 5364 patients from 2020 to 2021 as the training set and 1094 newly admitted patients in 2020 as the external validation set. Based on the injury severity score (ISS), patients in the training set were classified into 2 subgroups of the severe trauma group (<em>n</em> = 478, ISS scores ≥25) and the non-severe trauma group (<em>n</em> = 4886, ISS scores &lt;25). Univariate and binary logistic regression analyses were employed to identify independent risk factors for severe trauma. Subsequently, a predictive model was developed using the R software environment. Furthermore, the model was subjected to internal and external validation via the Hosmer–Lemeshow test and receiver operating characteristic curve analysis.</div></div><div><h3>Results</h3><div>In total, 6458 trauma patients were included in this study. Initially, this study identified several independent risk factors for severe trauma, including multiple traumatic injuries (polytrauma), external hemorrhage, elevated shock index, elevated respiratory rate, decreased peripheral oxygen saturation, and decreased Glasgow coma scale score (all <em>p</em> &lt; 0.05). For internal validation, the area under the receiver operating characteristic curve was 0.914, with the sensitivity and specificity of 88.4% and 87.6%, respectively; while for external validation, the area under the receiver operating characteristic curve was 0.936, with the sensitivity and specificity of 84.6% and 93.7%, respectively. In addition, a good model fitting was observed through the Hosmer–Lemeshow test and calibration curve analysis (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>This study establishes a nomogram for early risk prediction of severe trauma, which is suitable for primary healthcare institutions in underdeveloped western China. It facilitates early triage and quantitative assessment of trauma severity by clinicians prior to clinical interventions.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 6","pages":"Pages 418-426"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The surveillance and assessment of acute injuries in different age categories in national wrestling championships","authors":"Sema Can ,&nbsp;Erkan Demirkan ,&nbsp;Mustafa Arıcı ,&nbsp;Mehmet İsmail Tosun ,&nbsp;Halil İbrahim Cicioğlu","doi":"10.1016/j.cjtee.2024.09.001","DOIUrl":"10.1016/j.cjtee.2024.09.001","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study is to surveil the injuries in wrestling according to the different age categories and wrestling styles throughout the competition season.</div></div><div><h3>Methods</h3><div>The study was designed as a descriptive study. The study was conducted during the wrestling competition season in 2023 (from January 2023 to July 2023), which includes 5 different age categories: U-15, U-17, U-20, U-23, and seniors, along with the Turkey National Wrestling Championships. The data of injuries was recorded immediately after the acute injury was treated by the medical expert during the competitions and evaluated according to the parameters that were obtained. In the statistical analysis, the frequency and percentage values were presented as descriptive statistics and the Chi-square test was used.</div></div><div><h3>Results</h3><div>The study incorporated a total of 6214 wrestlers and a total of 7151 wrestling bouts were performed during these competitions. The analyses indicated that the rate of injury incidence was 42.65‰ in all wrestling styles. When taking account of the injured body parts in all wrestlers’ exposures, the occurrence of injuries to the head-face, neck, trunk, upper extremity, and lower extremity, rates of 17.6‰, 1.3‰, 3.6‰, 13.5‰, and 6.6‰, respectively, were observed. According to the pre-diagnosis based on freestyle, Greco-Roman, and female wrestling styles, injuries with bleeding (39.6%, 46.3%, and 14.6%, respectively) and muscle strain (37.9%, 28.7 %, and 52.6%, respectively) most often occurred.</div></div><div><h3>Conclusion</h3><div>The study findings indicate that most cases of injury appeared to occur in bleeding and muscle strain in all wrestling styles. We suggest that medical experts should set up their health equipment with consideration to the injuries that occur most frequently.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 6","pages":"Pages 485-490"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Dexmedetomidine reduces hippocampal microglia inflammatory response induced by surgical injury through inhibiting NLRP3” [Chinese J Traumatol 22 (2019) 161–165]","authors":"Ji Peng,&nbsp;Peng Zhang,&nbsp;Han Zheng,&nbsp;Yun-Qin Ren,&nbsp;Hong Yan","doi":"10.1016/j.cjtee.2024.12.001","DOIUrl":"10.1016/j.cjtee.2024.12.001","url":null,"abstract":"","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 6","pages":"Page 516"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications among patients undergoing orthopedic surgery after infection with the SARS-CoV-2 Omicron strain and a preliminary nomogram for predicting patient outcomes","authors":"Liang Zhang ,&nbsp;Wen-Long Gou ,&nbsp;Ke-Yu Luo ,&nbsp;Jun Zhu ,&nbsp;Yi-Bo Gan ,&nbsp;Xiang Yin ,&nbsp;Jun-Gang Pu ,&nbsp;Huai-Jian Jin ,&nbsp;Xian-Qing Zhang ,&nbsp;Wan-Fei Wu ,&nbsp;Zi-Ming Wang ,&nbsp;Yao-Yao Liu ,&nbsp;Yang Li ,&nbsp;Peng Liu","doi":"10.1016/j.cjtee.2025.02.003","DOIUrl":"10.1016/j.cjtee.2025.02.003","url":null,"abstract":"<div><h3>Purpose</h3><div>The rate of complications among patients undergoing surgery has increased due to infection with SARS-CoV-2 and other variants of concern. However, Omicron has shown decreased pathogenicity, raising questions about the risk of postoperative complications among patients who are infected with this variant. This study aimed to investigate complications and related factors among patients with recent Omicron infection prior to undergoing orthopedic surgery.</div></div><div><h3>Methods</h3><div>A historical control study was conducted. Data were collected from all patients who underwent surgery during 2 distinct periods: (1) between Dec 12, 2022 and Jan 31, 2023 (COVID-19 positive group), (2) between Dec 12, 2021 and Jan 31, 2022 (COVID-19 negative control group). The patients were at least 18 years old. Patients who received conservative treatment after admission or had high-risk diseases or special circumstances (use of anticoagulants before surgery) were excluded from the study. The study outcomes were the total complication rate and related factors. Binary logistic regression analysis was used to identify related factors, and odds ratio (<em>OR</em>) and 95% confidence interval (<em>CI</em>) were calculated to assess the impact of COVID-19 infection on complications.</div></div><div><h3>Results</h3><div>In the analysis, a total of 847 patients who underwent surgery were included, with 275 of these patients testing positive for COVID-19 and 572 testing negative. The COVID-19-positive group had a significantly higher rate of total complications (11.27%) than the control group (4.90%, <em>p</em> &lt; 0.001). After adjusting for relevant factors, the <em>OR</em> was 3.08 (95% <em>CI</em>: 1.45–6.53). Patients who were diagnosed with COVID-19 at 3–4 weeks (<em>OR</em> = 0.20 (95% <em>CI</em>: 0.06–0.59), <em>p</em> = 0.005), 5–6 weeks (<em>OR</em> = 0.16 (95% <em>CI</em>: 0.04–0.59), <em>p</em> = 0.010), or ≥7 weeks (<em>OR</em> = 0.26 (95% <em>CI</em>: 0.06–1.02), <em>p</em> = 0.069) prior to surgery had a lower risk of complications than those who were diagnosed at 0–2 weeks prior to surgery. Seven factors (age, indications for surgery, time of operation, time of COVID-19 diagnosis prior to surgery, C-reactive protein levels, alanine transaminase levels, and aspartate aminotransferase levels) were found to be associated with complications; thus, these factors were used to create a nomogram.</div></div><div><h3>Conclusion</h3><div>Omicron continues to be a significant factor in the incidence of postoperative complications among patients undergoing orthopedic surgery. By identifying the factors associated with these complications, we can determine the optimal surgical timing, provide more accurate prognostic information, and offer appropriate consultation for orthopedic surgery patients who have been infected with Omicron.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 6","pages":"Pages 445-453"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early prediction and warning of MODS following major trauma via identification of cytokine storm: A prospective cohort study","authors":"Panpan Chang ,&nbsp;Rui Li ,&nbsp;Jiahe Wen ,&nbsp;Guanjun Liu ,&nbsp;Feifei Jin ,&nbsp;Yongpei Yu ,&nbsp;Yongzheng Li ,&nbsp;Guang Zhang ,&nbsp;Tianbing Wang","doi":"10.1016/j.cjtee.2025.05.001","DOIUrl":"10.1016/j.cjtee.2025.05.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Early mortality in major trauma has decreased, but MODS remains a leading cause of poor outcomes, driven by trauma-induced cytokine storms that exacerbate injuries and organ damage.</div></div><div><h3>Methods</h3><div>This prospective cohort study included 79 major trauma patients (ISS &gt;15) treated in the National Center for Trauma Medicine, Peking University People's Hospital, from September 1, 2021, to July 31, 2023. Patients (1) with ISS &gt;15 (according to AIS 2015), (2) aged 15–80 years, (3) admitted within 6 h of injury, (4) having no prior treatment before admission, were included. Exclusion criteria were (1) GCS score &lt;9 or AIS score ≥3 for TBI, (2) confirmed infection, infectious disease, or high infection risk, (3) pregnancy, (4) severe primary diseases affecting survival, (5) recent use of immunosuppressive or cytotoxic drugs within the past 6 months, (6) psychiatric patients, (7) participation in other clinical trials within the past 30 days, (8) patients with incomplete data or missing blood samples. Admission serum inflammatory cytokines and pathophysiological data were analyzed to develop machine learning models predicting MODS within 7 days. LR, DR, RF, SVM, NB, and XGBoost were evaluated based on the area under the AUROC. The SHAP method was used to interpret results.</div></div><div><h3>Results</h3><div>This study enrolled 79 patients with major trauma, and the median (Q₁, Q₃) age was 51 (35, 59) years (52 males, 65.8%). The inflammatory cytokine data were collected for all participants. Among these patients, 35 (44.3%) developed MODS, and 44 (55.7%) did not. Additionally, 2 patients (2.5%) from the MODS group succumbed. The logistic regression model showed strong performance in predicting MODS. Ten key cytokines, IL-18, Eotaxin, MCP-4, IP-10, CXCL12, MIP-3α, MCP-1, IL-1RA, Cystatin C, and MRP8/14 were identified as critical to the trauma-induced cytokine storm and MODS development. Early elevation of these cytokines achieved high predictive accuracy, with an AUROC of 0.887 (95% <em>CI</em> 0.813–0.976).</div></div><div><h3>Conclusion</h3><div>Trauma-induced cytokine storms are strongly associated with MODS. Early identification of inflammatory cytokine changes enables better prediction and timely interventions to improve outcomes.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 6","pages":"Pages 391-398"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The positioning of cephalon medullary nailing correlated with hidden blood loss during the perioperative period in patients with intertrochanteric fractures: A retrospective study","authors":"Yao Chen,&nbsp;Shaobo Zhang,&nbsp;Zhiqi Liu,&nbsp;Jiashan Li","doi":"10.1016/j.cjtee.2025.03.002","DOIUrl":"10.1016/j.cjtee.2025.03.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Hidden blood loss (HBL) during the perioperative period significantly impacts postoperative recovery and complications, yet it is frequently disregarded. This study aimed to investigate the effects of tip-apex distance (TAD) and calcar-referenced tip-apex distance (calTAD) on HBL in the treatment of intertrochanteric fractures utilizing proximal femoral nail antirotation (PFNA). The study also seeks to evaluate the possible decrease in HBL subsequent to PFNA treatment by optimizing nail positioning.</div></div><div><h3>Method</h3><div>A historical cohort study was conducted from January 2020 to December 2022. Patients diagnosed with unilateral acute closed femoral intertrochanteric fracture and who underwent PFNA internal fixation surgery met the inclusion criteria, and were grouped according to the value of calTAD and TAD. The participants were divided into low TAD group (TAD&lt;20 mm) and high TAD group (TAD≥20 mm); low calTAD group (calTAD&lt;7.625 mm) and high calTAD group (calTAD≥7.625 mm), respectively. The primary outcome measures were intraoperative blood loss (including HBL, overt blood loss, and total blood loss). Continuous data were analyzed using an independent sample <em>t</em>-test or Mann-Whitney <em>U</em> test, and categorical data were analyzed using the Pearson Chi-square test. Univariate analysis was used to evaluate the association between various indicators and perioperative HBL. A stepwise multiple linear regression analysis model was used to determine the independent factors affecting perioperative HBL. A <em>p</em> value less than 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>A total of 131 patients were initially included, of which 80 were assigned to the calTAD group (with 61 in the high calTAD group and 19 in the low calTAD group), and 80 were assigned to the TAD group (with 34 in the high TAD group and 46 in the low TAD group). The average HBL for the low TAD group was 772.85 mL, whereas for the high TAD group it was 919.68 mL (<em>p</em>&gt;0.05). The average HBL for the low calTAD group was 611.42 mL, whereas for the high calTAD group it was 904.97 mL (<em>p</em>&lt;0.05). Subsequent analysis revealed that the patient's height, preoperative hemoglobin levels, changes in hemoglobin and hematocrit levels from pre- to post-surgery, and calTAD are independent risk factors influencing HBL.</div></div><div><h3>Conclusion</h3><div>In summary, our investigation revealed a significant correlation between the positioning of nails in PFNA and HBL during the perioperative period. By optimizing the placement of the cephalic nail, specifically by ensuring a calTAD of less than 7.625 mm, a significant decrease in HBL can be attained. Additionally, we identified that height, preoperative hemoglobin, differences in preoperative and postoperative hemoglobin and hematocrit, and the positioning of the cephalic nail were independent risk factors for HBL.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 6","pages":"Pages 503-508"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective effect of sub-hypothermic mechanical perfusion combined with membrane lung oxygenation on a yorkshire model of brain injury after traumatic blood loss","authors":"Xiang-Yu Song ,&nbsp;Yang-Hui Dong ,&nbsp;Zhi-Bo Jia ,&nbsp;Lei-Jia Chen ,&nbsp;Meng-Yi Cui ,&nbsp;Yan-Jun Guan ,&nbsp;Bo-Yao Yang ,&nbsp;Si-Ce Wang ,&nbsp;Sheng-Feng Chen ,&nbsp;Peng-Kai Li ,&nbsp;Heng Chen ,&nbsp;Hao-Chen Zuo ,&nbsp;Zhan-Cheng Yang ,&nbsp;Wen-Jing Xu ,&nbsp;Ya-Qun Zhao ,&nbsp;Jiang Peng","doi":"10.1016/j.cjtee.2024.10.003","DOIUrl":"10.1016/j.cjtee.2024.10.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To investigate the protective effect of sub-hypothermic mechanical perfusion combined with membrane lung oxygenation on ischemic hypoxic injury of yorkshire brain tissue caused by traumatic blood loss.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This article performed a random controlled trial. Brain tissue of 7 yorkshire was selected and divided into the sub-low temperature anterograde machine perfusion group (&lt;em&gt;n&lt;/em&gt; = 4) and the blank control group (&lt;em&gt;n&lt;/em&gt; = 3) using the random number table method. A yorkshire model of brain tissue injury induced by traumatic blood loss was established. Firstly, the perfusion temperature and blood oxygen saturation were monitored in real-time during the perfusion process. The number of red blood cells, hemoglobin content, NA&lt;sup&gt;+&lt;/sup&gt;, K&lt;sup&gt;+&lt;/sup&gt;, and Ca&lt;sup&gt;2+&lt;/sup&gt; ions concentrations and pH of the perfusate were detected. Following perfusion, we specifically examined the parietal lobe to assess its water content. The prefrontal cortex and hippocampus were then dissected for histological evaluation, allowing us to investigate potential regional differences in tissue injury. The blank control group was sampled directly before perfusion. All statistical analyses and graphs were performed using GraphPad Prism 8.0 Student &lt;em&gt;t&lt;/em&gt;-test. All tests were two-sided, and &lt;em&gt;p&lt;/em&gt; value of less than 0.05 was considered to indicate statistical significance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The contents of red blood cells and hemoglobin during perfusion were maintained at normal levels but more red blood cells were destroyed 3 h after the perfusion. The blood oxygen saturation of the perfusion group was maintained at 95% − 98%. NA&lt;sup&gt;+&lt;/sup&gt; and K&lt;sup&gt;+&lt;/sup&gt; concentrations were normal most of the time during perfusion but increased significantly at about 4 h. The Ca&lt;sup&gt;2+&lt;/sup&gt; concentration remained within the normal range at each period. Glucose levels were slightly higher than the baseline level. The pH of the perfusion solution was slightly lower at the beginning of perfusion, and then gradually increased to the normal level. The water content of brain tissue in the sub-low and docile perfusion group was 78.95% ± 0.39%, which was significantly higher than that in the control group (75.27% ± 0.55%, &lt;em&gt;t&lt;/em&gt; = 10.49, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), and the difference was statistically significant. Compared with the blank control group, the structure and morphology of pyramidal neurons in the prefrontal cortex and CA1 region of the hippocampal gyrus were similar, and their integrity was better. The structural integrity of granulosa neurons was destroyed and cell edema increased in the perfusion group compared with the blank control group. Immunofluorescence staining for glail fibrillary acidic protein and Iba1, markers of glial cells, revealed well-preserved cell structures in the perfusion group. While there were indications of abnormal cellular activity, the analysis showed no sign","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 6","pages":"Pages 469-476"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of CT scoring systems and a simplified prediction model in pediatric moderate-to-severe traumatic brain injury.","authors":"Yangyang Diao, Ping Liang","doi":"10.1016/j.cjtee.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.09.002","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the prognostic performance of 4 CT scoring systems in pediatric patients with moderate-to-severe traumatic brain injury (TBI) and develop a simplified, interpretable predictive model based on machine learning.</p><p><strong>Methods: </strong>This retrospective study included 103 pediatric patients with moderate-to-severe TBI admitted to a tertiary children's hospital in Southwest China from September 2020 to December 2023. CT images were assessed using the Marshall score, Rotterdam score, Helsinki score, and Stockholm score. Clinical outcomes were defined by the Glasgow outcome scale (GOS) and categorized as favorable results (GOS 4-5) or unfavorable results (GOS 1-3). The dataset was divided into a training set (n=83) and a test set (n=20). Class imbalance was corrected using the random over-sampling examples method. Eight classification models were compared through 5-fold cross-validation. The Naive Bayes model showed the best performance and was simplified to include 5 key predictors. An interactive online application was developed to provide individualized prognostic estimation and visualization.</p><p><strong>Results: </strong>The Helsinki score demonstrated the highest predictive accuracy among the 4 CT scores (area under the curve (AUC)=0.906), followed by the Stockholm score (AUC=0.897), Rotterdam score (AUC=0.837), and Marshall score (AUC=0.764). The simplified Naive Bayes model achieved an AUC of 0.930, with 100% sensitivity and 65.9% specificity in the test set. The model enables real-time outcome prediction and visual interpretation of contributing factors.</p><p><strong>Conclusions: </strong>The simplified Naive Bayes model outperforms traditional CT scoring systems in predicting outcomes of pediatric moderate-to-severe TBI. Its easy use, interpretability, and web-based implementation support its potential for clinical application. Further prospective and multicenter studies are needed to validate these findings.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}