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

{"title":"Evaluation of children applying to emergency service after motor vehicle trauma","authors":"","doi":"10.1016/j.injury.2024.111925","DOIUrl":"10.1016/j.injury.2024.111925","url":null,"abstract":"<div><h3>Background</h3><div>Traffic accidents are significant causes of death and serious injury in children. Children's clinical findings are more subtle and there is a risk of faster deterioration. On the other hand, radiation sensitivity due to imaging is also high. These challenging factors highlight the importance of approaching pediatric trauma cases. In our study, we aimed to contribute to current approaches by examining the clinical course and profiles of children involved in traffic accidents. This study aimed to analyze the profiles and clinical courses of children involved in road traffic accidents.</div></div><div><h3>Methods</h3><div>Pediatric patients brought to our hospital due injuries from traffic accidents were retrospectively investigated.</div></div><div><h3>Results</h3><div>During the two-year period analyzed in the study, 605 child patients applied due to traffic accidents, accounting for 5.4 % of pediatric trauma cases. The majority of the children were between the ages of 12–17, with most accidents occurring in the summer. In total, 56.9 % were from in-vehicle traffic accidents, 36.7 % were from extra-vehicular traffic accidents, and 6.4 % were from motorcycle accidents. The imaging rate among the patients was 89 %, and 50.6 % had more than one tomography. More than half of the cases had no pathological findings, and only 6 % required hospitalization. Most cases were treated successfully with medical care, while 21.4 % needed interventional procedures, and 10 % received no treatment. The most common injuries were superficial skin lesions (11.1 %) and extremity fractures (10.2 %), with orthopedics being the most consulted department. Fractures were most common in the tibia and were more likely in motorcycle accidents than in-car accidents.</div></div><div><h3>Conclusion</h3><div>In-vehicle accidents were the most frequent type of accident, and children under 4 years old had a higher incidence of in-car accidents than other age groups. Males made up 60 % of the cases, with boys having higher rates of motorcycle and extra-vehicular accidents compared to girls. While most children had no injuries from the accidents, those who did generally recovered well with outpatient monitoring. On the other hand, 89 % of patients underwent imaging at a high rate.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432486","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":"The Impact of Early Axial Interfragmentary Motion on the Fracture Healing Environment: A Scoping Review","authors":"","doi":"10.1016/j.injury.2024.111917","DOIUrl":"10.1016/j.injury.2024.111917","url":null,"abstract":"<div><h3>Purpose</h3><div>The initial interfragmentary motion (IFM) at a fracture site determines the mode of fracture healing. Understanding the impact of orthopaedic interventions on the fracture environment is essential to advancing our knowledge of fracture healing. The purpose of this scoping review is to analyze the orthopaedic literature to assess our understanding of the effects of early axial IFM on fracture healing outcomes.</div></div><div><h3>Methods</h3><div>PubMed, OVID, and Scopus databases were queried to identify all studies from inception until June 2023 assessing axial IFM on fracture healing outcomes in animal and human subjects. We collected information regarding the amount of IFM, osteotomy/fracture location, experimental methodology, and outcomes (histologic, biomechanical, and radiographic evidence of fracture healing) for each study. Data synthesis is presented as a narrative review of our findings.</div></div><div><h3>Results</h3><div>In total, 4,972 studies were identified. Fifteen studies were included, totaling 605 fractures/osteotomies. Of the included studies, 423 animal and 182 human subjects were examined. Nine studies investigated IFM at the tibia, four at the metatarsus, and two at the femur. The median time to analysis was nine weeks. The fracture gap size did not exceed 6 mm in any study. The range of IFM in tibias, metatarsi, and femurs was 0.3-2.0 mm, 0.1-2.4 mm, and 0.03-1.0 mm, respectively. No experiment using a femur model identified an association between early axial IFM and healing outcomes. All studies at the level of the tibia exhibited positive effects on callus formation with small-to-moderate axial IFM (mean 0.54, SD 0.30; range 0.2-0.9 mm). Most studies (9/13, 69.2%) found that early micromovement produced superior stiffness and biomechanical rigidity at the fracture site compared to absolute stability. While larger IFMs (mean 1.28, SD 0.70; range 0.25-2.4 mm) frequently led to a larger callus area, the callus quality and biomechanical strength of the callus was compromised.</div></div><div><h3>Conclusion</h3><div>The definitive range of axial IFM conducive to a favorable healing environment remains elusive. However, preliminary evidence suggests an association between small-to-moderate (mean 0.41, SD 0.32; range: 0.03- 1.0 mm) initial axial IFM for stimulating successful fracture healing. This review found that the cumulative evidence present in the literature is insufficient to determine a definite correlation between the early axial IFM and outcomes.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444742","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":"The CLIPS Protocol: Cast re-aLignment In Paediatric patients using Stationery","authors":"","doi":"10.1016/j.injury.2024.111932","DOIUrl":"10.1016/j.injury.2024.111932","url":null,"abstract":"<div><div>Paediatric tibial shaft fractures are commonly treated nonoperatively and followed-up in the clinic setting. Loss of position has traditionally been managed with wedging of the cast or admission and manipulation in the operaing theatre. The authors present a technique to aid in the wedging of plasters for paediatric tibia and forearm fractures that reduces time requirement, hospital costs and emotional distress on the part of the patient and family.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532278","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":"Classification of fracture-related infections: The FRI classification","authors":"","doi":"10.1016/j.injury.2024.111934","DOIUrl":"10.1016/j.injury.2024.111934","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376402","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":"Early surgical care of the anticoagulated hip fracture patient within 24 hours","authors":"","doi":"10.1016/j.injury.2024.111924","DOIUrl":"10.1016/j.injury.2024.111924","url":null,"abstract":"<div><h3>Introduction</h3><div>Hip fractures are still associated with high morbidity and mortality. Despite international guidelines advocating for urgent surgical treatment, delays often occur, particularly for patients on long-term antithrombotic therapy. We hypothesised that urgent surgical care for the anticoagulated hip fracture patient is not associated with severe bleeding complications.</div></div><div><h3>Material and Methods</h3><div>For the period from 2015 to 2021, we retrospectively reviewed clinical records of 1142 patients with proximal femur fractures treated within 24 h of admission to our trauma centre (mean age 80.4 ± 12.4 years; 761 females, 381 males). The cohort comprised 409 femoral neck and 733 trochanteric fractures, managed with either arthroplasty (<em>n</em> = 297), hip-preserving techniques (<em>n</em> = 147), or intramedullary nailing (<em>n</em> = 698). Of these, 583 patients (51.1 %) were on long-term antithrombotic therapy. The primary endpoints included transfusion rate and the difference in haemoglobin (Hb) levels from pre- to postoperative. Secondary endpoints were in-patient mortality and occurrence of postoperative haematomas requiring surgical revision. A regression analysis was performed.</div></div><div><h3>Results</h3><div>The mean time to surgery was 10.3 h, with delays observed in patients on direct oral anticoagulants (DOACs). Overall, 25.9 % (<em>n</em> = 296) of the patients required blood transfusions. The transfusion rate was dependent on duration of the surgery, preoperative Hb level, and anticoagulation with DOACs. Similarly, the Hb difference was found to be dependent on the duration of surgery, preoperative Hb level, and anticoagulation with DOACs. In-patient mortality was 5.3 % (<em>n</em> = 60). Regression analysis indicated that mortality was dependent on a high ASA classification of 4 and the time to surgery, but not on the type of antithrombotic therapy. 3.1 % of the patients needed surgical revision due to postoperative haematoma with prolonged duration of surgery and antithrombotic therapy (PAI [OR = 3.7, 95 % CI: 1.1–12.7], DOACs [OR = 3.4, 95 % CI: 1.3–8.8], and VKA [OR = 5.5, 95 % CI: 1.8–17.1], <em>p</em> &lt; 0.05) as independent risk factors.</div></div><div><h3>Conclusion</h3><div>As postoperative haematoma and the need for transfusion are manageable situations, we conclude that immediate surgical treatment of hip fracture patients on long-term antithrombotic therapy within 24 h is feasible and patients may benefit.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432593","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":"Injury surveillance in Spanish professional female soccer players: A three-season retrospective study","authors":"","doi":"10.1016/j.injury.2024.111922","DOIUrl":"10.1016/j.injury.2024.111922","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the popularity of soccer at the male elite level, data on the incidence of injuries in female players are limited. The study aimed to evaluate the injury incidence and rates in female soccer players in a professional setting over 3 consecutive seasons.</div></div><div><h3>Methods</h3><div>Data compiled from 71 elite female players with different playing positions and belonging to the same team were analyzed. The location and severity of injuries were reported according to international consensus statements on the process of conducting epidemiological studies in professional soccer. The injury incidence rate (IIR) for matches and practices and the rate ratio (RR) were calculated, and time-loss injuries during the season were also recorded.</div></div><div><h3>Results</h3><div>A total of 53 injuries were documented, with an overall IIR of 1.08 injuries per 1000 h and an overall rate ratio of 0.61. The lower limbs were the most affected region (86,8 %). The majority of these injuries occurred around the thigh and knee and were predominantly traumatic, with markedly higher rates of injury during match play (2.78 injuries per 1000 h) when compared to injury incidence during training (0.79 injuries per 1000 h). Traumatic injuries accounted for 48 (91 %) and 24 (45,3 %) were indirect contact injuries. Reinjuries amounted to 15 % of total injuries and August was the predominant month for injury, being goalkeepers the least injured players (13.2 %).</div></div><div><h3>Conclusions</h3><div>Female professional soccer players displayed injury incidence rates and patterns comparable to those of male players. This study provides epidemiological information that will help to inform future injury surveillance studies and the development of prevention strategies to reduce the number of injuries in elite female soccer players, focusing specifically on thigh and knee regions. All match involvements should be considered when exploring associations between the type of exposure and injury risk.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432592","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 surgical fixation timing on in-hospital mortality and morbidity of distal femur fractures","authors":"","doi":"10.1016/j.injury.2024.111927","DOIUrl":"10.1016/j.injury.2024.111927","url":null,"abstract":"<div><h3>Introduction</h3><div>The literature lacks a large-scale study investigating the effect of surgical fixation timing on early mortality and morbidity outcomes in distal femur fractures. The aims of this study were to determine the effect of fixation timing on in-hospital mortality and morbidity outcomes for operatively treated distal femur fractures retrospectively using large database data.</div></div><div><h3>Methods</h3><div>This study is a retrospective analysis using data from the National Trauma Data Bank. Patients were stratified into a fragility cohort (age <span><math><mo>≥</mo></math></span> 60, ISS <span><math><mo>&lt;</mo></math></span> 16) and polytrauma cohort (age <span><math><mo>&lt;</mo></math></span> 60, ISS <span><math><mo>≥</mo></math></span>16), with both cohorts analyzed separately. Within each cohort, patients were split into three fixation timing groups: within 24 h, between 24 and 48 h, and greater than 48 h from presentation to the hospital. Fixation-timing groups were compared based on the primary outcome of in-hospital mortality rate. Secondary outcomes included hospital length of stay (LOS), ICU length of stay (ICU LOS), days on a ventilator, and complications.</div></div><div><h3>Results</h3><div>The fragility and polytrauma cohorts included 22,045 and 5,905 patients, respectively. The in-hospital mortality rate was 1.23 % in the fragility cohort and 2.56 % in the polytrauma cohort. Multivariate analysis of the fragility cohort showed that fixation greater than 48 h from time of presentation was associated with increased mortality compared to fixation within 24 h (OR 1.89, CI: 1.26–2.83, <strong><em>p</em></strong> <strong>=</strong> <strong>0.002</strong>) and between 24 and 48 h (OR 1.63, CI: 1.23–2.15, <strong><em>p</em></strong> <strong>&lt;</strong> <strong>0.001</strong>). In the polytrauma cohort, multivariate analysis showed no significant mortality differences between fixation timing groups. Multivariate analysis of morbidity outcomes in both cohorts showed that fixation greater than 48 h was associated with increased LOS, ICU LOS, ventilator days, and complications compared to fixation within 24 h. In the polytrauma cohort, fixation between 24 and 48 h was associated with decreased LOS, ICU LOS, and complications compared to the other two timing groups.</div></div><div><h3>Conclusions</h3><div>Fixation of distal femur fractures before 48 h from presentation may lead to improved mortality and morbidity in older, lower injury severity patients. No significant mortality benefit was observed in younger, polytrauma fractures. Further prospective work is needed to validate these findings.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367964","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":"Clinical and radiological outcome of extended lateral approach via epicondyle osteotomy in complex lateral tibia plateau fractures involving the central and postero-lateral segments","authors":"","doi":"10.1016/j.injury.2024.111876","DOIUrl":"10.1016/j.injury.2024.111876","url":null,"abstract":"<div><h3>Introduction</h3><div>The purpose of this study was to evaluate the clinical and radiological results of complex lateral tibial plateau fractures involving the central segments of the lateral tibial plateau. It was hypothesized that an extended lateral approach by using the lateral epicondyle osteotomy improves the rate of malreduction and yields to good and excellent clinical results at a mid-term follow-up.</div></div><div><h3>Methods</h3><div>This retrospective case series conducted at two centers evaluated complex lateral tibial plateau fractures treated with an extended lateral approach by lateral epicondyle osteotomy. Fractures were classified according to the AO/OTA and 10-segment classification, with only B/C type fractures involving the antero-latero-central (ALC) and postero-latero-central (PLC)/postero-latero-lateral (PLL) segments. Postoperative computer tomography scans were used to assess the quality of reduction. Clinical outcomes and postoperative complications were evaluated with a minimum follow-up of 2 years.</div></div><div><h3>Results</h3><div>Sixty-five patients (mean age: 47.7 ± 11.5 years) were included, with an average follow-up of 51.9 ± 3.6 months. Radiological outcomes revealed a postoperative fracture step at the ALC/PLC crossing of 0.8 ± 1.1 mm, at the PLC/PLL crossing of 0.4 ± 1.1 mm, and a fracture gap of 1.8 ± 4.0 mm, yielding a Rasmussen Score of 15.1 ± 3.2. No significant differences among type B and C fractures were identified. No case of nonunion of the lateral epicondyle osteotomy was recorded. The mean Knee injury and Osteoarthritis Outcome Score was 80.4 ± 16.2 (type B 85.6 ± 11.9 vs. type C 76.1 ± 18.4, <em>p</em> &lt; 0.05), Lysholm score was 83.4 ± 17.1 (B 89 ± 11.3 vs. C 78.7 ± 20.1, <em>p</em> &lt; 0.05) and International Knee Documentation Committee score was 69.9 ± 18.8 (type B 76.5 ± 15.7 vs. type C 64.3 ± 20.1, <em>p</em> &lt; 0.05). Early complication rate requiring surgical revision due to malreduction or infection were 7 %. None of the patients reported about subjective lateral knee instability at the time of clinical follow-up.</div></div><div><h3>Conclusion</h3><div>The extended lateral approach with lateral epicondyle osteotomy demonstrated excellent radiological alignment and favorable mid-term clinical outcomes. An overall low complication rate was recorded. Notably, long-term revisions due to lateral instability were absent, indicating the safety and efficacy of lateral epicondyle osteotomy as an operative technique.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444743","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":"Prosthesis applications and challenges in children with earthquake-related amputations","authors":"","doi":"10.1016/j.injury.2024.111920","DOIUrl":"10.1016/j.injury.2024.111920","url":null,"abstract":"<div><h3>Background</h3><div>Amputations are among the most important traumatic injuries caused by earthquakes. However, data on amputee children and prosthesis application is quite limited in the literature. The aim of the study is to evaluate the injury-related data, stump problems, prosthesis application, difficulties and complications experienced with prosthesis during follow-up of children with 2023 Kahramanmaraş earthquake-related limb loss.</div></div><div><h3>Patients and methods</h3><div>Sociodemographic and injury-related data, pre-amputation and post-amputation interventions, prosthesis application, current prosthetic problems, and revision surgeries of the amputee children were recorded.</div></div><div><h3>Results</h3><div>Median age of patients (<em>n</em> = 102) admitted to our center was 13.0 years. 67.6 % of patients had one or more concomitant injuries. Median time and number of amputations were 4 (0–57) days and 1 (1–4), respectively. Of the total 120 amputations, 67.5 % (<em>n</em> = 81) were lower extremity amputations. Most common amputation levels were transtibial (29.1 %, <em>n</em> = 35), transfemoral (22.5 %, <em>n</em> = 27), and transhumeral (15.8 %, <em>n</em> = 19). Most amputees (56.8 %) underwent revision surgery after initial amputation. Median duration of time from amputation to prosthesis application was 184 (28–314) days. For 25 prostheses, a socket revision was required. Six patients had surgical revision of the stumps to allow prosthetic fit and mobility (due to bone overgrowth, soft tissue failure, heterotopic ossification).</div></div><div><h3>Conclusion</h3><div>Limited healthcare facilities, surgeries performed under emergency conditions, accompanying multiple traumas, inadequate follow-up conditions, and additional difficulties arising from the pediatric patient group lead to difficulties in the care of pediatric amputee patients. Our results will guide the care of this vulnerable patient population in the event of a similar unfortunate disaster.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358429","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":"Risk factors for fracture-related infections after low-velocity gunshot fractures to the pelvis","authors":"","doi":"10.1016/j.injury.2024.111918","DOIUrl":"10.1016/j.injury.2024.111918","url":null,"abstract":"<div><h3>Background</h3><div>Although treatments have improved dramatically in recent years, mortality following gunshot wounds (GSW) to the pelvis continue to range between 3 and 20 %. This project was designed to determine the incidence and risk factors associated with pelvic fracture-related infection (FRI) following GSWs to the pelvis given the paucity of evidence regarding this complication.</div></div><div><h3>Methods</h3><div>A retrospective review of 13 years (1/2010–12/2022) of patients with GSW to the pelvis was performed. Patients meeting inclusion criteria underwent chart review for the development of pelvic FRI and the following additional data elements were extracted: demographics, presence and type of bowel injury, operations performed, complications, use of postoperative antibiotics (≤24 h vs. &gt;24 h), surgical osseous debridement, presence of retained bullet fragments, and bullet trajectory. Discrete variables were analyzed using Wilcoxon rank-sum test, chi-square, and Fischer's exact test. Pearson correlation coefficients were calculated for continuous variables.</div></div><div><h3>Results</h3><div>242 patients were included in the study. Concomitant bowel injury was present in 108 patients (45 %). Eleven patients (4.5 %) developed FRI, all of whom had a concomitant bowel injury (<em>p</em> &lt; 0.001). Neither the presence of retained bullet fragments nor the bullet trajectory (through bowel before the bone) was associated with FRI. Antibiotic duration &gt;24 h was not associated with a lower rate of pelvic FRI.</div></div><div><h3>Conclusion</h3><div>Development of FRI after a GSW to the pelvis occurs in 4.5 % of patients and is significantly associated with concomitant bowel injury, specifically colonic injury. These findings can be used to help guide further studies on the role of prophylactic antibiotics or other strategies to prevent pelvic FRI.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327468","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}