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

{"title":"Prevalence and predictors of bone mineral density testing after distal radius fracture in menopausal women","authors":"Jessica M Welch ,&nbsp;Christopher S Klifto ,&nbsp;Kevin M Klifto ,&nbsp;Kiera N Lunn ,&nbsp;Kwabena Adu-Kwarteng ,&nbsp;Warren C Hammert ,&nbsp;Christian A Pean ,&nbsp;Tyler S Pidgeon","doi":"10.1016/j.injury.2025.112219","DOIUrl":"10.1016/j.injury.2025.112219","url":null,"abstract":"<div><h3>Background</h3><div>Osteoporosis screening guidelines recommend bone mineral density (BMD) testing following fragility fractures. Nevertheless, previous studies have demonstrated low rates of osteoporosis screening. Diagnosis and treatment of osteoporosis is essential for prevention of future fractures, however not much is known about the factors associated with receiving BMD testing in this patient population. The purpose of this study was to evaluate the prevalence, timing, and predictors of BMD testing following distal radius fractures (DRF) in menopausal women.</div></div><div><h3>Methods</h3><div>We queried a national insurance database to identify menopausal women aged 45–64 years with a DRF between years 2013 and 2020. The rate of BMD testing within 1 year of injury was calculated. Multivariable logistic regression analysis was used to evaluate the effect of patient- and injury-related variables on the likelihood of undergoing BMD testing following DRF.</div></div><div><h3>Results</h3><div>Among 31,728 patients meeting inclusion criteria (mean ± SD age: 57.5 ± 4.3), 3,886 (12.2 %) received a BMD test within 1 year following DRF. The rate of BMD tests decreased with the highest rate of 14.5 % in 2015 and the lowest rate of 10.5 % in 2020. Mean time from DRF to BMD testing was 143 ± 102 days. Patients aged 60–64 had the highest adjusted odds of receiving BMD testing (OR 2.85 [95 % CI: 2.26 to 3.64]). Factors associated with increased likelihood of BMD testing included surgical intervention (OR 1.38 [1.28–1.48]), rheumatoid arthritis (OR 1.22 [1.06–1.40]), osteoarthritis (OR 1.28 [1.19–1.37]), breast cancer (OR 1.35 [1.16–1.56]), and vitamin D deficiency (OR 1.29 [1.17–1.43]). Factors associated with decreased likelihood of testing included tobacco use (OR 0.90 [0.84–0.97]), patients with Medicaid (OR 0.73 [0.61–0.86]) or Medicare (OR 0.76 [0.65–0.88]) insurance, and living in Southern (OR 0.67 [0.62–0.73]) or Western (OR 0.69 [0.62–0.77]) regions of the United States. Obesity, diabetes, renal disease, and early menopause were not associated with BMD testing.</div></div><div><h3>Conclusions</h3><div>Despite guidelines recommending BMD testing after low-energy fractures, rates of BMD testing were low and decreased among menopausal women with DRF. Mean time to BMD testing was 4.7 months, indicating substantial delays in workup. Known risk factors for osteoporosis did not reliably predict likelihood of BMD testing.</div></div><div><h3>Level of Evidence</h3><div>Level III, prognostic</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112219"},"PeriodicalIF":2.2,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445385","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":"A nurse-led approach to enhancing foot and ankle tissue repair: A study using fibroblast growth factor and skin flap technique","authors":"Fan Yang ,&nbsp;Jing Dong ,&nbsp;Jing Hu,&nbsp;Zhezhen Jiang,&nbsp;Regis Ernest Mendame Ehya","doi":"10.1016/j.injury.2025.112213","DOIUrl":"10.1016/j.injury.2025.112213","url":null,"abstract":"<div><h3>Introduction</h3><div>Foot and ankle soft tissue defects with exposed bone pose significant challenges in wound healing and patient satisfaction</div></div><div><h3>Objective</h3><div>The study aims to assess the impact of nursing care quality and patient satisfaction on optimizing outcomes for complex foot and ankles injuries, focusing on the timing of rh-FGF administration after reconstructive surgery</div></div><div><h3>Methods</h3><div>This study included eighteen patients (15 males and 3 females) with traumatic foot and ankle soft tissue defects and exposed bone wounds, treated between January 2021 and December 2022. Patients were randomly assigned to three groups, underwent reconstructive surgery, and received rh-bFGF at varying times postoperatively. Key outcomes included wound healing time, hospital stay duration, satisfaction with nursing care scale, American Orthopedic Foot and Ankle Society (AOFAS) score, and Visual Analogue Scale for pain. All patients were followed for at least three months</div></div><div><h3>Results</h3><div>The study population had an average age of 41.1 years, with a range from 16 to 74 years. Findings indicated an average hospital stay of 17 days and a corresponding wound healing time of 17 days. At three months post-operation, the average American Orthopedic Foot and Ankle Society (AOFAS) score was 88. A notable 88.9 % of patients expressed satisfaction with the attentiveness of nursing staff and the privacy afforded to them. Furthermore, 84.3 % rated the nurses’ competence positively, and 83.3 % appreciated the support provided to family and friends, along with personalized care and nurses’ expertise in patient management. The results demonstrated a consistent trend of improvement in all assessed outcomes across the three treatment groups. Patients in Group 1, who received rh-bFGF one day after surgery, demonstrated the most favorable outcomes. This was followed by Group 3, which received rh-bFGF until ischemic changes were noted. In contrast, Group 2, which received rh-bFGF once inflammatory granulation had subsided, exhibited the least improvement</div></div><div><h3>Conclusion</h3><div>The results of this study highlight the crucial role of timing in the administration of rh-bFGF for optimizing soft tissue repair in patients with foot and ankle defects. Timely application of rh-bFGF post-surgery is essential for achieving favorable patient outcomes, improving patient satisfaction with nursing care, and facilitating faster recovery.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112213"},"PeriodicalIF":2.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418875","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":"Incidence of venous thromboembolism following achilles tendon rupture. Data from the UK foot and ankle thrombo-embolism (UK-FATE) audit","authors":"Matthew Solan ,&nbsp;Samuel Briggs-Price ,&nbsp;Linzy Houchen-Wolloff ,&nbsp;Karan Malhotra ,&nbsp;Lyndon Mason ,&nbsp;Jitendra Mangwani ,&nbsp;UK FATE Collaborative","doi":"10.1016/j.injury.2025.112212","DOIUrl":"10.1016/j.injury.2025.112212","url":null,"abstract":"<div><h3>Introduction</h3><div>Achilles tendon rupture (ATR) carries a high risk of venous thrombo-embolism (VTE) whether the injury is managed surgically or non-operatively. This study reports symptomatic VTE rate following ATR. The influence of patient demographics, treatment type and use of chemical thromboprophylaxis is examined.</div></div><div><h3>Materials and Methods</h3><div>Observational cohort study. The data is from a multi-centre, prospective, national audit of patients from 68 participating United Kingdom centres. Data was prospectively collected from hospital records. The study was conducted between June and November 2022, with a 3-month follow up.</div></div><div><h3>Results</h3><div>Of 11,363 participants in the National Audit, 9.5 % (<em>n</em> = 1084) had experienced an ATR. Management strategies included both non-surgical (74 %) and surgical (26 %). Following ATR, the VTE rate was 3.69 % (<em>n</em> = 40) compared to 0.57 % (<em>n</em> = 59) for other foot and ankle surgeries.</div><div>Participants who developed symptomatic VTE after ATR were older than those who did not (mean age 54 years (95 %CI 50.5 - 54.7) vs 48 years (95 %CI 47.3 - 49.1)). There was no significant difference in VTE events due to participant sex, ethnicity or number of comorbidities. Differences in treatment regimen, such as weight-bearing status and immobilisation strategy, showed no significant difference in symptomatic VTE events between groups.</div></div><div><h3>Conclusion</h3><div>After ATR, patients are 6.5-times more likely to experience symptomatic VTE than those recovering from surgery for other foot and ankle pathology. There was no significant difference in symptomatic VTE rate after ATR with specific chemical prophylaxis or early mobilisation strategies.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112212"},"PeriodicalIF":2.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classifications and treatment management of fragility fracture of the pelvis: A scoping review","authors":"Kaori Endo ,&nbsp;Norio Yamamoto ,&nbsp;Shunsuke Taito ,&nbsp;Takahiro Tsuge ,&nbsp;Yuki Nakashima ,&nbsp;Kosuke Suzuki ,&nbsp;Takao Kaneko ,&nbsp;Kae Okoshi","doi":"10.1016/j.injury.2025.112206","DOIUrl":"10.1016/j.injury.2025.112206","url":null,"abstract":"<div><h3>Background</h3><div>Fragility fractures of the pelvis (FFP) present a growing challenge in aging populations. However, standardized classifications and treatment guidelines remain scarce.</div></div><div><h3>Objective</h3><div>This scoping review examines the application of fracture classifications, treatment strategies, and outcome evaluations for FFP, identifying gaps in the literature, and suggesting directions for future research.</div></div><div><h3>Methods</h3><div>A systematic search of multiple electronic databases yielded 117 studies discussing FFP names, classifications, treatment approaches, and outcomes. Data extraction focused on study characteristics, classification systems, treatment details, outcomes, and follow-up periods. Residual analysis using the Chi-square test assessed statistical associations and underrepresentation.</div></div><div><h3>Results</h3><div>The FFP classification was the most common (51.3%), with additional treatment indicators focused on immobility (44.4%) and pain assessment (using the Visual Analog Scale [VAS] or Numeric Rating Scale [NRS], 37.6%), consistent with existing guidelines. In contrast, the sacral insufficient fractures were statistically associated with pain indications but lacked corresponding classification application. Initial management typically involved conservative or observation period. Regarding the management indications and outcomes, surgical interventions were categorized into osteosynthesis and sacroplasty. Outcome evaluations often incorporated mobility and functional status (59.0%), hospitalization length (49.6%), mortality rates (41.0%), and post-treatment living conditions (41.0%). Patient recovery was assessed through VAS scores (59.0%) and Activities of Daily Living Patient-Reported Outcomes (ADL-PROs, 34.2%). However, inconsistencies in standardized outcomes, particularly in sacroplasty studies, hinder comparative analysis.</div></div><div><h3>Conclusion</h3><div>FFP classifications, along with pain and mobility assessments, were frequently applied as management indicators for FFP. Standardizing treatment indications and establishing consistent outcome measures, including the evidenced gap treatments (sacral insufficient fracture and cement augmentation), could significantly improve comparability across studies.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112206"},"PeriodicalIF":2.2,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445384","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":"Effects of acute intermittent hypoxia on muscle strength in individuals with spinal cord injury: A systematic review of randomized trials","authors":"Anas R. Alashram","doi":"10.1016/j.injury.2025.112211","DOIUrl":"10.1016/j.injury.2025.112211","url":null,"abstract":"<div><h3>Introduction</h3><div>Muscle weakness is among the most common motor deficits in individuals with spinal cord injury (SCI). Acute intermittent hypoxia (AIH) has been used to improve motor function by facilitating neuroplasticity. The purpose of this systematic review is to explore the impacts of AIH on muscle strength in individuals with SCI, identify who would most likely respond well to the intervention, and determine the optimal therapeutic protocol.</div></div><div><h3>Methods</h3><div>Relevant literature was explored in “PubMed, MEDLINE, The Cochrane Library, Scopus, PEDro, and Web of Science” databases until October 2024. Randomized trials that involved SCI patients who underwent AIH, compared with controls, and assessed muscle strength were included in this review. The methodological quality was assessed using the “Physiotherapy Evidence Database (PEDro)” scale. The effect sizes were calculated using Cohen's d<em>.</em></div></div><div><h3>Results</h3><div>Of 502 studies, seven studies met the eligibility criteria, and the sample sizes ranged from 12 to 28 participants across the included studies. In total, 146 SCI patients (mean age 46.76 years; 88 % male) were included in this systematic review. The PEDro scores of the studies included varied between 5 and 8, with a median score of 8.</div></div><div><h3>Conclusions</h3><div>AIH is a promising therapeutic modality for enhancing muscle strength post-SCI, specifically in patients with motor-incomplete injuries. Based on good quality studies, delivering AIH independently or in combination with other treatments for 15 short (60–90 s) episodes of hypoxic exposure (Oxygen = 9 %) alternating with 15 (60–90 s) normoxic episodes (Oxygen = 21 %), across one or more sessions, could yield meaningful outcomes. Nevertheless, the evidence is limited by treatment protocol variations, small sample sizes, and a lack of standardization in combining AIH with other treatments. Therefore, further studies with larger sample sizes, more diverse populations, and standardized treatment protocols are strongly needed to verify our findings. Future studies should also address the potential bias, examine the long-term effects, and investigate underlying mechanisms to provide more generalized evidence.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112211"},"PeriodicalIF":2.2,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143402422","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":"Damage control orthopedics versus early total care of femur fracture in a national cohort of pediatric patients with traumatic brain injury","authors":"Cailan L. Feingold ,&nbsp;Jose Dominguez ,&nbsp;Michael Jacoby ,&nbsp;Harshadkumar A. Patel ,&nbsp;Damon Delbello ,&nbsp;Irim Salik","doi":"10.1016/j.injury.2025.112210","DOIUrl":"10.1016/j.injury.2025.112210","url":null,"abstract":"<div><h3>Background</h3><div>Long bone fracture is one of the most common concomitant injuries in pediatric traumatic brain injury (TBI) patients, requiring surgical intervention in the form of intramedullary nailing (IMN), open reduction and internal fixation (ORIF), or temporary external fixation, otherwise known as damage control orthopedics (DCO), for transient stabilization before definitive repair. There are no definitive guidelines for femur fracture management in polytrauma TBI pediatric patients. This study investigates the outcomes of patients with TBI and femur fractures who underwent DCO versus early total care (ETC), hypothesizing that delayed fracture fixation is associated with worse outcomes.</div></div><div><h3>Methods</h3><div>Pediatric patients admitted with TBI who underwent femur fracture repair between 2016 and 2020 were investigated using the National Inpatient Sample database. Clinical outcomes, healthcare utilization data, baseline demographics, and comorbidities were collected. All Patient Refined Diagnosis Related Groups (APR-DRG) severity was defined for each case. The injury severity scale (ISS) was developed using ICD-10-CM codes for injury. High ISS was defined as greater than 75th percentile. DCO patients were compared with ETC patients. Inpatient death, prolonged LOS, and high total charges were the primary outcomes evaluated. Multivariate binary logistic regression analysis was used to evaluate for independent predictors of primary outcomes.</div></div><div><h3>Results</h3><div>A total of 6,775 pediatric TBI patients under the age of 21 who underwent repair of femur fracture were identified. The average age was 15.5 years (range: 0–21 years) and there were 2,065 (30.5 %) females. DCO to treat femur fractures was employed in 1,010 (14.9 % of patients). Patients undergoing DCO were significantly more likely to have extreme illness severity (OR = 3.049), early trauma complications (OR = 2.273), and respiratory complications (OR = 2.255). DCO was independently associated with prolonged length of stay (LOS) (OR = 1.263), high total charges (OR = 1.786), and inpatient death (OR = 2.796).</div></div><div><h3>Conclusion</h3><div>This study found that DCO is associated with worse outcomes, likely secondary to injury severity and underlying neurologic injury of patients undergoing DCO. These findings suggest it is time to definitively outline the timing and modality of femur fracture repair for the polytrauma pediatric patient with TBI.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112210"},"PeriodicalIF":2.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387119","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":"Operatively treated high-energy blunt pelvic ring injuries and surgical site infections – A retrospective assessment based on a prospective registry","authors":"Elvin Gurbanov ,&nbsp;Ulysse Coneys ,&nbsp;Elisabeth Andereggen ,&nbsp;Alexandre Ansorge ,&nbsp;Vanessa Morello ,&nbsp;Axel Gamulin","doi":"10.1016/j.injury.2025.112209","DOIUrl":"10.1016/j.injury.2025.112209","url":null,"abstract":"<div><h3>Introduction</h3><div>High-energy pelvic ring injuries (PRI) are severe, life-threatening trauma conditions which might require complex surgical management. One of the major complications associated with these injuries is the development of surgical site infections (SSI) which significantly impact patient outcomes. This study aimed to evaluate the rate of SSI in patients undergoing surgical fixation of high-energy blunt PRI and identify the key predisposing factors.</div></div><div><h3>Methods</h3><div>A retrospective review of patients treated for high-energy blunt PRI was conducted using the prospectively filled institutional <em>Severely Injured Patients’ Registry</em>, focusing on the rate of SSI following surgical fixation. The multifactorial nature of infection risk was analyzed, with particular attention to the type of injury, surgical technique, external fixation devices’ usage and the germs encountered.</div></div><div><h3>Results</h3><div>A SSI rate of 10,5 % (12 out of 114 patients) was encountered among the study population. The primary SSI risk factor was PRI complexity; 83.3 % of patients with SSI had an AO/OTA type C fracture and 16.7 % a type B fracture, while 43.1 % of patients without SSI had a type C fracture and 56.9 % a type B fracture (<em>p</em> = 0.008). Additionally, SSI patients had a trend to have higher extremities/pelvis AIS and higher ISS, and to have been more often treated with a transient pelvic fixation device including supra-acetabular external fixator.</div></div><div><h3>Conclusion</h3><div>These findings emphasize the need for a comprehensive infection prevention strategy in high-energy PRI patients, especially in complex cases. A multidisciplinary approach is of outmost importance and should include surgical techniques with meticulous soft tissue handling, proper implant selection and aggressive post-operative wound care. Despite external fixation devices being related to certain cases of SSI, their life-saving potential during the initial management phase should be carefully weighed against this risk.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112209"},"PeriodicalIF":2.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143402424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for cut-throughs in intertrochanteric hip fracture fixation Tip-Apex Distance (TAD) <10 mm and Apex-to-Center <4 mm","authors":"Arielle Richey Levine,&nbsp;Trevan Klug,&nbsp;James Cross,&nbsp;Motasem Salameh,&nbsp;Matthew Riedel,&nbsp;Michael Leslie","doi":"10.1016/j.injury.2025.112205","DOIUrl":"10.1016/j.injury.2025.112205","url":null,"abstract":"<div><h3>Objectives</h3><div>TAD &gt; 25 mm is a risk factor for cut-out in intramedullary nailing. Less attention has been given to the risk factors for central cut-through and the possible outcomes of TAD &lt;10 mm. Furthermore, the risk of cut-through depending on minimum depth on either anterior-posterior (AP) or lateral views has not been explored. The goal of this study is to outline the parameters that increase risk of cut-through in intertrochanteric hip fractures.</div></div><div><h3>Methods</h3><div>A retrospective review of 2128 intertrochanteric hip fractures admitted to a single level 1 academic trauma center from 2014 – 2023 was conducted<strong>.</strong> Variables included patient and operative characteristics, fracture fixation device, fracture type based on OTA/AO 2018 classification, TAD, neck-shaft angle and radiographic and clinical outcomes.</div></div><div><h3>Results</h3><div>TAD &lt;10 millimeters carried a significantly higher risk for lag screw and blade cut-through. Cut-through risk increased significantly when either AP or lateral apex-to-center distance was &lt;4 millimeters, including when comparing fracture reduction quality for a cohort including sliding hip screws, lag screws and blades. Cut-out complications in this cohort only occurred with a TAD &gt;10 mm and was significantly more likely to occur with TAD &gt;25 mm, similar to prior studies.</div></div><div><h3>Conclusion</h3><div>TAD optimization between 10 and 25 mm reduces risk of both cut-out and cut-through and maintenance of 4 mm of distance between apex-to-center distance may help decrease the risk of cut-through complications.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112205"},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143402423","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":"Patient reported outcome scores following traumatic hip dislocations","authors":"Carlo Eikani ,&nbsp;Elizabeth Cho ,&nbsp;Robert Kelly ,&nbsp;Robert Hand ,&nbsp;Joseph Cohen ,&nbsp;Hobie Summers ,&nbsp;Ashley E. Levack","doi":"10.1016/j.injury.2025.112197","DOIUrl":"10.1016/j.injury.2025.112197","url":null,"abstract":"<div><h3>Objective</h3><div>Traumatic native hip dislocations require immediate orthopaedic attention and have been associated with significant long-term morbidity. Previous studies have reported radiographic outcomes and clinical complication rates, however; evidence evaluating the effect of these injuries on patient-reported outcomes (PROs) is limited. The purpose of our study was to evaluate PRO scores among patients with native hip dislocations.</div></div><div><h3>Methods</h3><div>Adult patients with native hip dislocations between 2005 and 2020 at a single academic Level 1 trauma center were retrospectively reviewed. Radiographs and medical records were reviewed for patient demographics and comorbidities, injury characteristics, details of treatment including time to reduction, and complications. Patients were given the PROMIS Physical Function (PROMIS PF) and Short Form-36 (SF-36) via HIPAA compliant electronic data capture. Outcomes were analyzed using Student <em>t</em>-tests and Mann-Whitney U comparisons of means/medians. Floor and ceiling effects were also characterized for the various outcomes scores.</div></div><div><h3>Results</h3><div>A total of 168 patients with native hip dislocation were identified, 78 (46.4 %) of whom completed all PROs measures. Among responders, mean age was 36.2 years (SD 14.5), mean BMI was 29.2 (SD 6.7), and mean dislocation duration was 8.9 h (SD 5.1). On univariable regression, older age was associated with worse SF-36 Physical scores (<em>p</em> = 0.007). PROMIS PF showed an estimated 2.18 decrease for every one grade increase in Kellgren-Lawrence score (<em>p</em> = 0.01). There were no ceiling or floor effects seen with PROMIS PF, SF-36 Physical Summary, or SF-36 Mental Summary Scores.</div></div><div><h3>Conclusions</h3><div>Patients of older age and higher Kellgren-Lawrence score exhibited worse SF-36 Physical Function and PROMIS PF scores, respectively, highlighting the functional impact that native hip dislocations may have. PROMIS PF, SF-36 Physical and Mental Summary Scores were without floor or ceiling effects, rendering this an important tool in the evaluation of patients with traumatic native hip dislocation.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112197"},"PeriodicalIF":2.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387120","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":"Enhancing pelvic fracture care: The impact of extraperitoneal pelvic packing on definitive Orthopaedic treatment","authors":"Francesco Addevico ,&nbsp;Michele Altomare ,&nbsp;Umberto Mezzadri ,&nbsp;Alberto Nicolò Bergamini ,&nbsp;Sara Gianna Salvadori ,&nbsp;Federico Bove ,&nbsp;Stefania Cimbanassi","doi":"10.1016/j.injury.2025.112207","DOIUrl":"10.1016/j.injury.2025.112207","url":null,"abstract":"<div><div>This study investigates the impact of extraperitoneal pelvic packing (EPP) on the definitive surgical treatment of pelvic fractures (PF) in trauma patients. While EPP is recognized as an effective life-saving technique for controlling non-compressible retroperitoneal bleeding, concerns persist about its potential to complicate subsequent surgical interventions.</div><div>A total of 220 trauma patients treated in a single First Level Trauma Centre from October 2016 to December 2021 were analysed. Demographic data, trauma mechanisms, hemodynamic stability, Injury Severity Scores (ISS), New ISS, PF classification (Tile), surgical timelines, and postoperative complications according to the Clavien-Dindo classification were collected. The study population was divided into two groups: those who underwent EPP (<em>n</em> = 42) and those who did not (<em>n</em> = 178). Statistical analyses included propensity score matching to balance baseline characteristics and reduce selection bias.</div><div>Key findings show that EPP effectively improved survival rates in hemodynamically unstable patients, achieving a survival rate of 71.43 %. However, EPP was associated with delays in definitive surgical treatment and a higher incidence of major postoperative complications (41.67 % vs. 17.65 %, <em>p</em> = 0.014). Despite these delays, EPP did not significantly limit the possibility of achieving definitive surgery or the choice of fixation technique. Patients who underwent both EPP and open reduction internal fixation did not show a higher rate of severe complications compared to those managed without EPP.</div><div>The study concludes that while EPP should be considered a practical emergency intervention for critically unstable PF patients, and even though it may affect the timing of definitive PF treatment, it does not prevent further surgical management.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112207"},"PeriodicalIF":2.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372049","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}