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

{"title":"Bird beak-related ocular injuries in southern India: Factors and visual implications","authors":"Prerana A Shetty ,&nbsp;Sze Ing Tan ,&nbsp;Rupesh Agrawal ,&nbsp;Sushank Ashok Bhalerao ,&nbsp;Sowjanya Vuyyuru","doi":"10.1016/j.injury.2024.112003","DOIUrl":"10.1016/j.injury.2024.112003","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the visual outcomes and identify prognostic factors in patients with ocular bird beak injuries treated at a tertiary eye care center in South India.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive analysis of patients with bird beak injuries, considering factors such as age, gender, mode of injury, and size of laceration. The affected eyes underwent detailed examinations using slit-lamp biomicroscopy, and B-scan ultrasonography was performed to assess the status of the posterior segment. Postoperatively, the best-corrected visual acuity (BCVA) was measured at the last follow-up visit.</div></div><div><h3>Results</h3><div>Our findings demonstrated significant improvements in visual outcomes, including BCVA and uncorrected visual acuity (UCVA), over a follow-up period ranging from 1 week to 3 years (<em>p</em> &lt; 0.05). No significant changes were observed in endophthalmitis, intraocular pressure (IOP), lens status, or retinal abnormalities during the study duration.</div></div><div><h3>Conclusion</h3><div>This retrospective study highlight the potential for favorable long-term visual improvement in patients with ocular injuries caused by bird beaks and emphasize the importance of timely intervention. Delayed surgical treatment and the requirement for multiple surgeries within the first week were found to negatively impact visual acuity. Hence, it is crucial to raise public awareness, particularly in rural areas, to prevent these potentially devastating injuries and ensure early intervention for optimal visual recovery.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 12","pages":"Article 112003"},"PeriodicalIF":2.2,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635202","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 deep learning algorithm that aids visualization of femoral neck fractures and improves physician training","authors":"Pengyi Xing ,&nbsp;Li Zhang ,&nbsp;Tiegong Wang ,&nbsp;Lipeng Wang ,&nbsp;Wanting Xing ,&nbsp;Wei Wang","doi":"10.1016/j.injury.2024.111997","DOIUrl":"10.1016/j.injury.2024.111997","url":null,"abstract":"<div><h3>Purpose</h3><div>Missed fractures are the most common radiologic error in clinical practice, and erroneous classification could lead to inappropriate treatment and unfavorable prognosis. Here, we developed a fully automated deep learning model to detect and classify femoral neck fractures using plain radiographs, and evaluated its utility for diagnostic assistance and physician training.</div></div><div><h3>Methods</h3><div>1527 plain pelvic and hip radiographs obtained between April 2014 and July 2023 at our Hospital were selected for the model training and evaluation. Faster R-CNN was used to locate the femoral neck. DenseNet-121 was used for Garden classification of the femoral neck fracture, while an additional segmentation method used to visualize the probable fracture area. The model was assessed by the area under the receiver operating characteristic curve (AUC). The accuracy, sensitivity, and specificity for clinicians fracture detection in the diagnostic assistance and physician training experiments were determined.</div></div><div><h3>Results</h3><div>The accuracy of the model for fracture detection was 94.1 %. The model achieved AUCs of 0.99 for no femoral neck fractures, 0.94 for Garden I/II fractures, and 0.99 for Garden III/IV fractures. In the diagnostic assistance study, the emergency physicians had an average accuracy of 86.33 % unaided and 92.03 % aided, sensitivity of 85.94 % unaided and 91.78 % aided, and specificity of 87.88 % unaided and 93.13 % aided in detecting fractures. In the physician training study, the accuracy, sensitivity, and specificity of the trainees for fracture classification were 81.83 %, 77.28 %, and 84.85 %, respectively, before training, compared with 90.65 %, 88.31 %, and 92.21 %, respectively, after training.</div></div><div><h3>Conclusions</h3><div>The model represents a valuable tool for physicians to better visualize fractures and improve training outcomes, indicating deep learning algorithms as a promising approach to improve clinical practice and medical education.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 12","pages":"Article 111997"},"PeriodicalIF":2.2,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591907","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":"Letter to Editor","authors":"Natasha Shaukat,&nbsp;Sharika Ferdous,&nbsp;Gladys Ibanez","doi":"10.1016/j.injury.2024.112010","DOIUrl":"10.1016/j.injury.2024.112010","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 12","pages":"Article 112010"},"PeriodicalIF":2.2,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593507","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 study of the incidence of the corona mortis within a South African patient sample using computerized tomographic angiography","authors":"Jade Naicker ,&nbsp;Zithulele Nkosinathi Tshabalala ,&nbsp;Jacques Janse van Rensburg ,&nbsp;Andries Masenge ,&nbsp;Obakeng Modisane ,&nbsp;Steven Matshidza ,&nbsp;Nkhensani Mogale","doi":"10.1016/j.injury.2024.112000","DOIUrl":"10.1016/j.injury.2024.112000","url":null,"abstract":"<div><h3>Introduction</h3><div>Retropubic hematomas are a common development in cases of pelvic ring trauma and post- operative repair of fractures to the anterior column of the pelvis. Early detection and diagnosis of such events using computed tomography angiography (CTA) are critical for successful intervention and patient recovery, especially when bleeding is a result of injury to the corona mortis (CM). The CM is the communication between the obturator vessels and the external iliac vessels typically via an accessory obturator vessel. This communication of vessels is identified as a major hindrance in anterior approaches to the pelvis.</div></div><div><h3>Materials and Methods</h3><div>This study investigated the incidence of CM and mapped out safe zones for the anastomosis in a South African sample using 73 adult angiograms from the Department of Diagnostic Radiology, Universitas Academic Hospital. After careful observation of the iliac system, the incidence of CM was documented. The distance from the CM to clinically relevant bony landmarks were recorded to formulate safe zones.</div></div><div><h3>Results</h3><div>The incidence of CM was observed in 33.1 % of the sample, with 20 % being venous and 13.1 % being arterial anastomoses. Statistically significant differences between the sexes were noted for safe zones between all landmarks except for the pubic tubercle (<em>p</em> ≥ 0.26). The safe zone between the CM and the pubic tubercle were documented as 46.88 mm and the average diameter for all anastomotic vessels was noted as 2.83 mm (Range: 1.75 - 4.61 mm).</div></div><div><h3>Conclusion</h3><div>The inconsistencies presented in angiogram studies compared to cadaver studies suggest that angiograms should be limited to a diagnostic and therapeutic role of identifying the CM or injury thereof in the retropubic region. However, measurements concerning safe zones should rather be extracted from cadaveric studies.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 12","pages":"Article 112000"},"PeriodicalIF":2.2,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593508","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":"Association between adolescent lifestyle factors and high-energy traumas in early adulthood: A longitudinal study","authors":"Matias Vaajala ,&nbsp;Alisa Teuho ,&nbsp;Rasmus Liukkonen ,&nbsp;Ville Ponkilainen ,&nbsp;Arja Rimpelä ,&nbsp;Leena K. Koivusilta ,&nbsp;Ville M. Mattila","doi":"10.1016/j.injury.2024.112008","DOIUrl":"10.1016/j.injury.2024.112008","url":null,"abstract":"<div><h3>Introduction</h3><div>Longitudinal studies investigating lifestyle factors as risk factors for high-energy traumas from adolescence to adulthood are lacking. The aim of this study was to investigate the influence of 14 to 18-year old adolescent health-related behaviours, overweight, chronic disease, family socioeconomic status (SES), and adulthood education level on the risk of high-energy traumas during the average 27-year follow-up in Finland.</div></div><div><h3>Materials and methods</h3><div>The baseline data were surveys gathered biennially from 1981 to 1997 (the Adolescent Health and Lifestyle Survey) and individually linked with outcome data on high-energy traumas retrieved from the Care Register for Health Care until the year 2018. A logistic regression model was used to analyse the associations between the exposure variables in adolescence (frequent physical activity, overweight, smoking, monthly drunkenness, chronic disease, family SES, adulthood education level) and the overall risk for high-energy traumas. Adjusted odds ratios (aOR) with 95 % confidence intervals (CIs) were computed.</div></div><div><h3>Results</h3><div>A total of 876 persons (1.8 %) had a high-energy trauma during the follow-up. High-energy trauma diagnoses overall were more common among males than among females (2.8 % vs 1.0 %). Follow-up showed that those who smoked (aOR 1.49, CI 1.40–1.58), were drunk monthly (aOR 1.49, CI 1.39–1.59), had a chronic disease (aOR 1.22, CI 1.12–1.34) in adolescence or had attained only low education level in adulthood (aOR 1.39, CI 1.30–1.48) had higher odds for high-energy traumas. Frequent physical activity or overweight in adolescence were not related to the higher odds for high-energy traumas.</div></div><div><h3>Conclusion</h3><div>Smoking, monthly drunkenness, self-reported chronic diseases in adolescence, and low educational level in adulthood increased the risk of high-energy traumas during the mean follow-up of 27-years. Frequent physical activity and overweight in adolescence did not predict the occurrence of high-energy traumas. Intervention programs should also focus on the long-term consequences of these risk factors.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 12","pages":"Article 112008"},"PeriodicalIF":2.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593506","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":"Should we reconsider age classification of ISO ski binding settings for children?","authors":"Gerhard Ruedl,&nbsp;Martin Burtscher","doi":"10.1016/j.injury.2024.112007","DOIUrl":"10.1016/j.injury.2024.112007","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 12","pages":"Article 112007"},"PeriodicalIF":2.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586296","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":"Hyperextension tibial plateau fractures: An increasingly recognised injury in need of consensus.","authors":"Daniel W.R. Seng ,&nbsp;Peter V. Giannoudis","doi":"10.1016/j.injury.2024.112001","DOIUrl":"10.1016/j.injury.2024.112001","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 12","pages":"Article 112001"},"PeriodicalIF":2.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635244","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":"Firearm violence and the 'reopening phenomenon' in Turkey","authors":"Abuzer Özkan ,&nbsp;Enes Ferhatlar ,&nbsp;Abdullah Algin","doi":"10.1016/j.injury.2024.111962","DOIUrl":"10.1016/j.injury.2024.111962","url":null,"abstract":"<div><h3>Aim</h3><div>The COVID-19 pandemic has affected many habits and social reactions. During the lifting of COVID-19 lockdown measures in the USA, there was a notable surge in firearm violence, which became known as “the reopening phenomenon”. This study evaluated the impact of a similarly proposed phenomenon on individuals living in a center of Türkiye.</div></div><div><h3>Method</h3><div>This retrospective observational study involved the evaluation of firearm injuries in three periods of 455 days each surrounding the COVID-19 pandemic: the pre-pandemic period (January 1, 2018-April 1, 2019) the pandemic lockdown period (March 2, 2020-May 31, 2021), and the reopening period (June 4, 2021-September 2, 2022).</div></div><div><h3>Results</h3><div>The incidents analyzed predominantly involved the use of pistols (<em>n</em> = 371, 96 %). Long-barreled pistols caused injury in only 16 (4.1 %) cases. Most injuries (<em>n</em> = 275, 71 %) were located in the lower extremity. The comparison of the pre-pandemic, Pandemic lockdown and Reopening periods did not reveal a significant difference in the rate of firearm violence (<em>p</em> = 0.266, x² goodness of fit)</div></div><div><h3>Conclusion</h3><div>We did not observe the reopening phenomena around the COVID-19 pandemic period in a center of Türkiye. However, firearm violence remains a significant societal issue for both Türkiye and the world.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 12","pages":"Article 111962"},"PeriodicalIF":2.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565361","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":"Biomechanical effects of different miniplate use on bone and miniplate systems in multiple mandible fracture: A finite element study","authors":"Erdinç Sulukan ,&nbsp;Zeynep Gümrükçü","doi":"10.1016/j.injury.2024.111983","DOIUrl":"10.1016/j.injury.2024.111983","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study is to evaluate the biomechanical efficiency of different miniplates in the treatment of multiple mandibula fractures.</div></div><div><h3>Material and Method</h3><div>Mandible, miniplates, and screws were modeled using the Solid Works v2015 (Dassault Systèmes, France) program, Subsequently two fracture lines were created on the right parasymphysis and angulus mandible. Models were divided into two main groups according to the plates used in the anterior fracture line: group A, 2 piece 4-hole-bar-I plate, and group B, ellipse plate. Each group was divided into five subgroups according to the plates used in the posterior fracture line (I, X, G, 3D, E) and 10 study models were created in total. Under three different biting forces (anterior, right, left), maximum von-Mises stresses seen on miniplates/screws, and Pmax/Pmin stresses seen in the cortically/cancellous bone were analyzed using the Ansys 16.2 software (ANSYS, Inc., USA). Data was visualized using a color distribution scale and interpreted.</div></div><div><h3>Results</h3><div>The highest von-Mises stress, seen in plates, was found in the I plate (353.82 MPa) at the angulus region of model A1. The highest Pmax and Pmin stresses, revealed in cortical bone, were found respectively in model A1 (181.63 MPa) and model B2 (115.01 MPa). The ideal results on plates were seen in models B3 and B5, in which E plates were used in the parasymphysis and G/E plates were used in the angulus region.</div></div><div><h3>Conclusion</h3><div>Grid and ellipse plates provide successful results and plate geometry is more critical than number in terms of stress distribution.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 12","pages":"Article 111983"},"PeriodicalIF":2.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555046","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":"Schatzker IV tibial plateau fractures involving the posterolateral column: Higher incidence of lateral meniscus and anterior cruciate ligament injuries with suboptimal postoperative outcomes","authors":"Jian Peng ,&nbsp;Weizhi Ren ,&nbsp;Bin Feng,&nbsp;Zhenghui Hu,&nbsp;Wei Xu","doi":"10.1016/j.injury.2024.111921","DOIUrl":"10.1016/j.injury.2024.111921","url":null,"abstract":"<div><h3>Background</h3><div>Current literature offers scant insights into Schatzker IV tibial plateau fractures (TPFs) that affect the posterolateral (PL) column. This study seeks to elucidate the prevalence of meniscal and ligamentous injuries in the knee, as well as the clinical outcomes, in Schatzker IV TPF cases, both with and without PL column involvement.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of clinical and imaging data from patients with Schatzker IV TPFs who received surgical treatment at our institution between January 2018 and January 2022. Patient demographics and surgical details were meticulously documented. The study participants were categorized into two groups based on the involvement of the PL column in the Schatzker IV TPF. Group A comprised patients without PL column fractures, whereas Group B included those with such fractures. We compared soft tissue injuries affecting knee stability, namely meniscal and ligamentous injuries, between two groups using Magnetic Resonance Imaging (MRI) and surgical records. Further, Group B was divided into subgroups based on the presence or absence of knee subluxation. Within Group B, we measured the lateral plateau depression (LPD) and lateral plateau widening (LPW). Additionally, we investigated the frequency of meniscus entrapment in patients with PL column fractures. Clinical outcomes were assessed using The American Hospital for Special Surgery (HSS) and Rasmussen scores.</div></div><div><h3>Results</h3><div>The study comprised 66 patients with Schatzker IV TPFs. Of these, 12 patients had no PL column fracture, while 54 had a PL column fracture. Group B demonstrated a 57.4 % and 64.8 % incidence of lateral meniscus (LM) and anterior cruciate ligament (ACL) injuries, respectively, significantly higher than that in Group A (25 %, 8.3 %) (<em>p</em> = 0.044, <em>p</em> &lt; 0.001). Within Group B, those with knee subluxation showed a marked increase in LPD (14.5 ± 5.3 mm) and LPW (9.3 ± 4.9 mm), correlating with a higher rate of meniscus entrapment (76.0 %) (<em>p</em> &lt; 0.001). Patients in Group B had lower HSS and Rasmussen scores compared to Group A (<em>p</em> = 0.048, <em>p</em> = 0.006).</div></div><div><h3>Conclusion</h3><div>This investigation reveals that Schatzker IV TPFs involving the PL column are highly associated with increased rates of LM and ACL injuries. Additionally, these fractures correlate with a greater likelihood of knee subluxation and meniscus entrapment, ultimately leading to poorer prognostic outcomes.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 12","pages":"Article 111921"},"PeriodicalIF":2.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523964","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}