Injury-International Journal of the Care of the Injured最新文献

{"title":"The role of the physiotherapist in the assessment and management of blunt mechanism chest wall injury: A systematic integrative review and narrative synthesis","authors":"Edward Baker ,&nbsp;Jane Barnett ,&nbsp;Timothy Driscoll ,&nbsp;Hayley Hutchings ,&nbsp;Claire O’Neill ,&nbsp;Michelle Price ,&nbsp;Hannah Toghill ,&nbsp;Rhys Whelan ,&nbsp;Ceri Battle","doi":"10.1016/j.injury.2025.112355","DOIUrl":"10.1016/j.injury.2025.112355","url":null,"abstract":"<div><h3>Background</h3><div>Blunt mechanism chest wall injury (CWI) is a common traumatic presentation to acute hospitals globally and it is associated with high levels of mortality and morbidity. The role of the physiotherapist in the management of this injured population needs clearer definition.</div></div><div><h3>Aim</h3><div>To synthesise existing evidence relating to the ‘work’ of physiotherapists in the assessment, management and evaluation of patients with blunt mechanism CWI.</div></div><div><h3>Design</h3><div>A systematic integrative review of relevant literature with a narrative synthesis.</div></div><div><h3>Data sources</h3><div>Embase (Ovid), MEDLINE (Ovid), CINAHL Plus with Full Text (EBSCO), Cochrane Central Register of Controlled Trials (Wiley), PEDro (Physiotherapy Evidence Database), AMED (Ovid). Further searches for grey literature and hand searches were applied. Databases were searched from their inception to December 2024. Analysis and data integration was undertaken through narrative synthesis following a process of thematic coding.</div></div><div><h3>Results</h3><div>From 7433 identified papers, 92 were included in the final evidence synthesis. Fifty were full published empirical studies, 14 were evidence reviews, 19 were conference abstracts, three were case presentations and six were opinion pieces. Analysis identified the broad scope of clinical care provided by physiotherapists covering (i) initial assessment and emergency care; (ii) acute care priorities and care planning; (iii) patient education and optimising patient self-management; and (iv) post-acute care and follow-up.</div></div><div><h3>Conclusion</h3><div>There is a need for a more standardised approach to the care provided to this patient group. Clinicians need to acquire and develop formal competencies and capacities and knowledge in a more structured approach.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112355"},"PeriodicalIF":2.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antegrade ESIN technique via the Kocher interval reduces radiation exposure and accelerates recovery in pediatric DRDMJ fractures: A comparative study with cadaveric validation","authors":"Zhan Dong ,&nbsp;Wang Guo ,&nbsp;Zhuqing Kong ,&nbsp;Liukun Xu ,&nbsp;Zhiqun Zhang","doi":"10.1016/j.injury.2025.112348","DOIUrl":"10.1016/j.injury.2025.112348","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Distal radius diaphyseal-metaphyseal junction (DRDMJ) fractures in children often require surgical intervention due to the unique anatomical characteristics and high failure rate of nonoperative treatment. However, the choice of internal fixation remains a challenge for pediatric orthopedic surgeons. Traditional fixation methods, including plate and screw fixation, crossed Kirschner wires (K-wires), and external fixators, have drawbacks such as extensive local trauma and the risk of physeal injury. This study evaluates the clinical efficacy of antegrade elastic stable intramedullary nailing (ESIN) for DRDMJ fractures in children, comparing it with the crossed K-wire technique.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A retrospective analysis was conducted on 47 pediatric patients with DRDMJ fractures treated between June 2018 and January 2023. Patients were divided into an antegrade ESIN group (&lt;em&gt;n&lt;/em&gt; = 20) and a crossed K-wire group (&lt;em&gt;n&lt;/em&gt; = 27). Demographic data, perioperative parameters (operative time, radiation exposure), and postoperative recovery indicators (duration of internal/external fixation, radiographic healing time, wrist function recovery) were collected. All patients were followed up for at least 12 months, and complications were recorded. The Garland-Werley score was used to assess wrist function. Additionally, a cadaveric study was performed to validate the neurovascular safety of antegrade ESIN insertion via the middle third of the radial head–radial tuberosity axis within the Kocher interval.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;All patients achieved radiographic union, with no cases of dorsal interosseous nerve injury, tendon rupture, or refracture. There were no significant differences between the two groups in terms of radiographic healing time or wrist function scores at 12 months postoperatively (&lt;em&gt;P&lt;/em&gt; &gt; 0.05). However, compared to the crossed K-wire group, the antegrade ESIN group demonstrated a significantly shorter operative time by 10.71 min (&lt;em&gt;P&lt;/em&gt; = 0.002), reduced fluoroscopy use by 2.74 exposures (&lt;em&gt;P&lt;/em&gt; = 0.001), and a shorter postoperative cast immobilization duration by 9.11 days (&lt;em&gt;P&lt;/em&gt; &lt; 0.001). Additionally, the antegrade ESIN group exhibited a higher rate of excellent wrist function scores at the 3-month follow-up. The cadaveric study confirmed that needle insertion through the middle third of the Kocher interval safely avoided the dorsal interosseous nerve, with no risk of nerve injury in either pronation or supination positions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Antegrade ESIN and crossed K-wire fixation provide comparable long-term functional and radiographic outcomes for pediatric DRDMJ fractures. The antegrade ESIN technique, performed through the middle third of the radial head–radial tuberosity axis within the Kocher interval, effectively avoids dorsal interosseous nerve injury while significantly reducing operative time, minimizing intr","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112348"},"PeriodicalIF":2.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the mini-open surgical technique as good as nonoperative care for acute Achilles tendon injuries?","authors":"Mansur Halai ,&nbsp;Peter Dryden ,&nbsp;Richard Buckley","doi":"10.1016/j.injury.2025.112354","DOIUrl":"10.1016/j.injury.2025.112354","url":null,"abstract":"<div><div>History – A 38yo man was injured in a rugby match. He suffered an isolated, Achilles tendon rupture. He immediately went to his local emergency department. He was keen on the best treatment so that he could get back into playing rugby with his community team.</div><div>Past Medical History and Social History – He was a married man and lived with his wife. He was a nonsmoker. He had no medical problems that he saw a physician about. He worked as an executive with an oil company and was also involved in many sports year-round. He had had surgery for previous sports related broken bones with no complications. He had no allergies and took no medications. He was a regular beer drinker after sports matches.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112354"},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation outcomes and prognostic factors of nerve grafting combined with exercise therapy for high-level radial nerve injury: Results of a retrospective study","authors":"Yifang Cen ,&nbsp;Hongbo Zhao ,&nbsp;Liaozhang Wu","doi":"10.1016/j.injury.2025.112349","DOIUrl":"10.1016/j.injury.2025.112349","url":null,"abstract":"<div><h3>Background</h3><div>Radial nerve injury is one of the most common peripheral nerve injuries and can be effectively treated with nerve grafting. However, the efficacy of nerve grafting combined with exercise therapy for the treatment of radial nerve injury remains unclear.</div></div><div><h3>Methods</h3><div>In this study, we conducted a follow-up of at least one year in 40 patients with radial nerve injuries who received nerve grafting combined with exercise therapy, to evaluate their rehabilitation outcomes and identify the prognostic factors influencing the combined treatment.</div></div><div><h3>Results</h3><div>62.5 % (<em>n</em> = 25) patients achieved M3+ extension strength. Shorter defect length and delayed repair time and more cables of nerve graft were significantly associated with the recovery of finger extension. Moreover, multivariate analysis showed that defect length and delay in repair were the independent predictors of extensor digitorum communis reinnervation. Additionally, receiver operating characteristic (ROC) curve suggested that both delay in repair (AUC = 0.808) and cables of nerve graft (AUC = 0.837) had a high accuracy in predicting the prognosis of nerve graft combined with exercise therapy, while delay in repair+cables of nerve graft (AUC = 0.960) had the highest accuracy. The optimal time for transplantation is 6.89 months (sensitivity = 86.7 %, specificity = 58.7 %) post-injury, and the optimal number of nerve grafts is 2.5 (sensitivity = 80 %, specificity = 53.3 %).</div></div><div><h3>Conclusion</h3><div>We demonstrated that the effectiveness of nerve grafting combined with exercise therapy in treating radial nerve injury, and delay in repair and cables of nerve graft may act as the prognostic predictors of nerve graft combined with exercise therapy. These findings may provide a novel therapeutic method for radial nerve injury.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112349"},"PeriodicalIF":2.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of ankle fracture surgical wounds: the development and testing of the Wound after Osteosynthesis Kolding (WOK) score","authors":"Niels Martin Jensen ,&nbsp;Alice Ørts Hansen ,&nbsp;Simon Thonsgaard ,&nbsp;Ane Simony ,&nbsp;Christian Cavallius ,&nbsp;Rikke Serritslev Østergaard ,&nbsp;Lars Bo Rottwitt ,&nbsp;Charlotte Abrahamsen","doi":"10.1016/j.injury.2025.112345","DOIUrl":"10.1016/j.injury.2025.112345","url":null,"abstract":"<div><h3>Introduction</h3><div>Describing surgical wounds accurately poses challenges due to the diverse terminology used for complications. Existing evaluation methods do not cater specifically to surgical wounds from post-ankle fracture surgery with osteosynthesis. Given the unique anatomical challenges and treatment considerations (limited tissue coverage and blood supply as well as the surgical treatment with osteosynthesis), a targeted wound score is essential for ensuring consistent evaluation and high-quality care and thereby optimizing patient outcomes and satisfaction. The study aimed to develop a wound score specifically for evaluating surgical wounds following ankle fracture surgery.</div></div><div><h3>Method</h3><div>Development of the <em>Wound after Osteosynthesis Kolding</em> score (WOK) proceeded through three phases: 1) identifying WOK domains, 2) developing item and response options, and 3) pilot testing the WOK score.</div></div><div><h3>Results</h3><div>Five domains were identified: <em>erythema, swelling, dehiscence, exudate</em> and <em>warmth</em>. Response options were derived from literature and clinical insights. Content validity was assessed with an S-CVI/Ave of 0.93 for nurses and 0.82 for orthopedic surgeons. Orthopedic surgeons perceived <em>erythema</em> and <em>warmth</em> as less relevant, while nurses considered all five domains to be fairly or very relevant. High agreement between scores was found, but varying kappa scores were observed when assessing intra-rater reliability. Inter-rater reliability was acceptable across all domains (κ = 0.44 to 1.00). <em>Warmth</em> was omitted from the final WOK score due to low content validity among orthopedic surgeons and poor inter-rater reliability. Additionally, assessing <em>warmth</em> in a clinical setting was challenging because ankle brace stabilization affects overall skin humidity and warmth.</div></div><div><h3>Conclusions</h3><div>The Wound after Osteosynthesis Kolding score (WOK) has proven to be a content-valid and reliable tool for assessing minor complications in surgical wounds following ankle fracture surgery.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112345"},"PeriodicalIF":2.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Infection rates and complications following fasciotomy in mass casualty events: Lessons learned from the 2023 Turkey-Syria earthquake\"","authors":"Saygin Kamaci,&nbsp;Engin Turkay Yilmaz ,&nbsp;Ozan Tuncay,&nbsp;Ulas Can Kolac,&nbsp;Gazi Huri,&nbsp;Omur Caglar,&nbsp;Ahmet Mazhar Tokgozoglu","doi":"10.1016/j.injury.2025.112338","DOIUrl":"10.1016/j.injury.2025.112338","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate the outcomes of fasciotomy, including infection, amputation, and complications, in patients with crush injuries from the 2023 Turkey-Syria earthquake.</div></div><div><h3>Material and Methods</h3><div>Out of 210 patients presenting from the earthquake zone, 46 patients (23 male-23 female, mean age: 21 years) who underwent 52 extremity fasciotomies were included. Data collected included infection rates, need for grafts/flaps, amputation rates, creatinine, CK levels, need for dialysis, and neurologic injuries. Early fasciotomy was defined as ≤12 h and late as &gt;12 h after the earthquake. Patients were categorized by fasciotomy timing and location (earthquake-zone or university hospital). Time to first debridement was also evaluated.</div></div><div><h3>Results</h3><div>The median time to fasciotomy was 24 h (2–97 h, (IQR 12.5–65)). Fasciotomies performed in the earthquake zone had a higher infection rate (68 % vs. 25 %, <em>p</em> = 0.061), though this difference was not statistically significant, likely due to the small sample size. There was no significant difference in infection rates between patients who underwent early fasciotomy (8/13, 62 %) and those who underwent late fasciotomy (20/33, 61 %) (<em>p</em> = 1.0).Amputation was required in 7/46 patients (15 %), with 1/13 patient (8 %) in the early fasciotomy group and 6/33 patients (18 %) in the late fasciotomy group (<em>p</em> = 0.698). Skin grafting was performed for wound closure in 19 patients (42 %). In patients undergoing early fasciotomy, 75 % (9/12) required skin grafts for wound closure, whereas the rate in the late fasciotomy group was significantly lower at 30 % (10/33) (<em>p</em> = 0.019). The mean time to first debridement was significantly higher in infected patients [65.5 (SD 11.8) vs 57.8 (SD 11.4 h), <em>p</em> = 0034]. For wounds that required skin grafts, the average duration between the fasciotomy and initial debridement was significantly higher (68.5 vs 54 h), <em>p</em> = 0.001.</div></div><div><h3>Conclusion</h3><div>Fasciotomies performed in earthquake zones had higher infection rates compared to hospitals, though not statistically significant. Infections with potentially multi-drug resistant bacterias may increase the risk of complications like amputations. Timely debridement and efficient patient transfer remain essential to minimizing risks and improving outcomes.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112338"},"PeriodicalIF":2.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of age on major trauma profile and characterisation: Analysis from the national major trauma audit in Ireland","authors":"Olga Brych ,&nbsp;Seif El Hadidi ,&nbsp;Pamela Hickey ,&nbsp;Rachael Doyle ,&nbsp;Conor Deasy ,&nbsp;Louise Brent","doi":"10.1016/j.injury.2025.112343","DOIUrl":"10.1016/j.injury.2025.112343","url":null,"abstract":"<div><h3>Background</h3><div>Major trauma (MT) is a significant cause of morbidity and mortality worldwide, with older adult patients facing unique challenges due to age-related vulnerabilities and higher risks of falls. This study aimed to investigate differences in trauma characteristics, injury mechanisms, and outcomes of older adults compared to all younger patients with MT on a national level.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analysed the national Major Trauma Audit data from 23,765 eligible patients with MT in Ireland of all ages and stratified into two age groups: those under 65 years (<em>n</em> = 12,620) and those aged 65 years or older (<em>n</em> = 11,145). The Major Trauma Audit follows the methodology of National Major Trauma Registry in the UK. Variables assessed included injury severity, comorbidities, length of stay (LOS), and mortality rates. Statistical comparisons were made between the two age groups.</div></div><div><h3>Results</h3><div>Older adults represent 47 % of the total Irish patient population with MT, with a significantly higher proportion of females (56 %) compared to younger patients (31 %) (<em>P</em> <em>&lt;</em> <em>0.001</em>)<em>.</em> Falls of less than two meters were the leading mechanism of injury for older adults (82 %), while road traffic accidents (RTA) were more common among younger patients (25 %). Severe injuries were observed in 34 % of both age groups, but &lt;10 % of older adults were received by a trauma team. Comorbidities were significantly more prevalent in older adults (75 %) compared to 39 % in younger patients, (<em>P</em> <em>&lt;</em> <em>0.001</em>). Median hospital LOS was twelve days for older adults, compared to seven days for younger patients. Mortality rates were significantly higher among the older patient population, who were also more likely to be discharged to long-term care, (<em>P</em> <em>&lt;</em> <em>0.001)</em>.</div></div><div><h3>Conclusion</h3><div>In comparison to younger patients, the present study highlights that older adults who experience major trauma are frequently under-triaged as suspected MT, leading to delays in care, inadequate treatment, or worse clinical outcomes.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112343"},"PeriodicalIF":2.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional outcomes and complication rates of the SPAIRE approach compared to the direct lateral approach in hemiarthroplasty for displaced femoral neck fractures","authors":"Maren Paus ,&nbsp;Ulf Sundin ,&nbsp;Kristian Sydnes ,&nbsp;Mette Martinsen ,&nbsp;Haldor Valland ,&nbsp;Sylvia Sunde ,&nbsp;Joseph Sexton ,&nbsp;Siri Lillegraven ,&nbsp;Mads Sundet","doi":"10.1016/j.injury.2025.112339","DOIUrl":"10.1016/j.injury.2025.112339","url":null,"abstract":"<div><h3>Aims</h3><div>A soft-tissue sparing posterior surgical approach (SPAIRE) for hip hemiarthroplasty after femoral neck fractures is hypothesized to provide better functional results than the standard direct lateral approach, while maintaining a low dislocation rate. The aim of this study was to compare rate of complications and functional results between these approaches in a clinical cohort.</div></div><div><h3>Methods</h3><div>Prospectively collected registry data on all femoral neck fracture cases treated with hemiarthroplasty between September 2018 and November 2022 in a single Norwegian hospital were analyzed grouped by SPAIRE versus direct lateral approach. Outcomes were prosthesis dislocation, surgical site infection, 30-day mortality, and tests of function three months postoperatively. Linear regression was used for continuous outcomes, and dichotomous outcomes were analyzed by logistic regression and contingency tables.</div></div><div><h3>Results</h3><div>Of 858 cases, 430 were operated using SPAIRE, and 428 using direct lateral approach. There were no group differences in prosthesis dislocation rate (SPAIRE 0.7 % vs direct lateral 0.9 %, <em>p</em> = 0.725), and no differences in surgical site infections or 30-day mortality. In the patients with three months follow-up (total <em>n</em> = 372; SPAIRE <em>n</em> = 192; direct lateral <em>n</em> = 180) the SPAIRE group had better functional outcomes; New Mobility Score: 6.1 vs 5.0 (difference 1.1, <em>p</em> &lt; 0.001), New Mobility Score change from preoperative: −1.3 vs −1.8 (difference 0.5, <em>p</em> = 0.024), Short Physical Performance Battery: 7.3 vs. 5.9 (difference 1.4, <em>p</em> &lt; 0.001), Walking speed: 0.8 vs 0.7 m/s (difference 0.1, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>We found no differences in the rate of prosthesis dislocations, infections, or mortality between the SPAIRE and the direct lateral approach. Functional outcomes were better in patients operated with the SPAIRE approach.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112339"},"PeriodicalIF":2.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Employment outcomes following thoracic and lumbar fractures in wales: Long term follow up greater than 5 years","authors":"Elliot J. Kimber ,&nbsp;Jacob J. Allman ,&nbsp;Davor Dasic ,&nbsp;Fabian Wong ,&nbsp;Michael J H. McCarthy","doi":"10.1016/j.injury.2025.112326","DOIUrl":"10.1016/j.injury.2025.112326","url":null,"abstract":"<div><h3>Study design</h3><div>Retrospective study.</div></div><div><h3>Objectives</h3><div>To identify outcomes, in particular employment, &gt;5 years following traumatic thoracic and/or lumbar fracture/s.</div></div><div><h3>Methods</h3><div>235 patients between the ages of 18 and 65 were identified from hospital radiology databases having sustained a traumatic thoracic and/or lumbar fracture on CT and/or MRI between 01/01/2013 and 31/12/2017. Questionnaires were sent via post and available emails, with a reminder letter and phone calls. Retrospective data was gathered about employment status pre-fracture and &gt; 5 years post-injury.</div></div><div><h3>Results</h3><div>26 (11 %) patients died before follow-up, leaving 209 patients. 108 (52 %) were treated surgically and 101 (48 %) conservatively. 106 replies were received, with 85 (80 %) opting in and 21 (20 %) out. 68 (80 %) patients completed full questionnaires, and 17 (20 %) filled out a shortened questionnaire via phone conversation. Of the 85 enrolled patients, 52 (61 %) had undergone surgery, and 33 (39 %) had been treated conservatively. The mean follow-up time was 7.9 years (range 5–11 years). Prior to injury, 66 patients (78 %) were employed and 19 (22 %) unemployed (6 were full-time students, 8 retired). 49 (74 %) previously employed patients had returned to work at follow-up, with 35 (53 %) working the same or increased hours. Regarding employment, there was no significant difference between the treatment groups (<em>p</em> = 0.355) or the fracture classification (<em>p</em> = 0.303). 16 (19 %) patients reported back pain before their injury, whilst 69 (81 %) did not. There were 58 (68 %) cases of new pain, with the most affected area being the lumbar region in 43 (51 %) patients. 32 (38 %) patients reported neurological deficit post-injury: 19 with subjective symptoms, 9 objective symptoms and 4 suffered paralysis.</div></div><div><h3>Conclusion</h3><div>After 5 years or more following a traumatic thoracic and/or lumbar fracture, most individuals return to employment. There was no significant difference between the severity of the fracture or treatment on their employment outcomes.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112326"},"PeriodicalIF":2.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injury caseload, pattern and time of presentation to emergency services in Mozambique: A pragmatic, multicentre, observational study","authors":"Naisa Manafe ,&nbsp;Simon Stewart ,&nbsp;Olimpio Durão ,&nbsp;Bonifacio Cebola ,&nbsp;Maria Helena Anibal ,&nbsp;Frederico Sebastião ,&nbsp;Nerolie Stickland ,&nbsp;Yhi-Khi Chan ,&nbsp;Ashley Kimberley Keates ,&nbsp;Mário Jacob ,&nbsp;Nino Paichadze ,&nbsp;Ana Olga Mocumbi","doi":"10.1016/j.injury.2025.112332","DOIUrl":"10.1016/j.injury.2025.112332","url":null,"abstract":"<div><h3>Background</h3><div>Rapid population growth and urbanisation raise a critical need to better understand the burden of injuries in sub-Saharan Africa. We assessed the pattern of service demand for injuries at emergency department (ED) in urban areas of Mozambique.</div></div><div><h3>Methods</h3><div>This prospective, multi-centric, observational study was conducted in EDs in southern (Maputo), central (Beira) and northern (Nampula) of Mozambique. We randomly selected 7809 cases (age ≥1 years) during the seasonally distinct months of April/2016–2017 and October/2017. Data on patients’ demographics, nature of injury and clinical outcomes were collected.</div></div><div><h3>Results</h3><div>Overall, 1881/7809 (26.2 %) emergency cases comprising 518 children (58.5 % male, aged 4.6 ± 2.5 years), 324 adolescents (64.8 % male, 14.7 ± 3.0 years) and 10,39 adults (60.8 % male, 34.5 ± 13.0 years) presented with injury. The arms, legs and head were most affected in both children (518 with 795 injuries) and adults (1039 with 1496 injuries). The diversity of injuries increased with older age. Injury cases predominantly presented during daylight hours (from 0900 to 1900) with age-differentials evident. There were proportionately more injury presentations in the hotter and wetter October than in colder and drier April<span>.</span> The most common mechanisms of injury were falls, physical violence and road traffic injuries. Overall, 9.1 % of injury cases were admitted to hospital and 0.2 % died.</div></div><div><h3>Conclusions</h3><div>Injuries corresponded to around one-quarter of all emergency admissions in urban Mozambique, and were predominantly caused by falls, physical violence, and road traffic injuries. Understanding distinctive variations in the pattern and timing of these presentations according to the age, location and season will assist in future planning for more efficient injury prevention and health care services in Mozambique.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112332"},"PeriodicalIF":2.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}