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

{"title":"Modified Masquelet technique using free vascularized fibula grafting for reconstruction of large bone defects after bone infection","authors":"Huhu Wang , Hongying He , Jianwen Zhao , Li Han , Weidong Shi , Zhuo Wu , Lin Yang , Wenxing Han , Hao Wang , Shaoguang Li , Xiaowei Zhang , Jianzheng Zhang","doi":"10.1016/j.injury.2026.113036","DOIUrl":"10.1016/j.injury.2026.113036","url":null,"abstract":"<div><h3>Background</h3><div>Bone infection with large bone defects presents a significant challenge for orthopedic surgeons. Free vascularized fibula grafting (FVFG) and the Masquelet technique have proven to be a practical reconstructive approach for addressing large bone defects. Although various strategies have been utilized to manage bone infection with large bone defects, there remains debate concerning the optimal treatment approach. The aim of this study was to observe the outcomes of a new surgical procedure of the modified Masquelet technique for bone infection with large bone defects.</div></div><div><h3>Methods</h3><div>From October 2021 to October 2023, 10 patients of bone infection with large bone defects underwent the surgery of the modified Masquelet technique. A large bone defect was defined as bone defects >6 cm. Among the 10 cases, 8 were male, and 2 were female, with a mean age of 54.7 ± 11.1 years. The median and interquartile range of the infection history was 6 (2, 66) months. The infected skeletal sites included 7 cases in the tibia and 3 in the femur. All cases underwent the modified Masquelet technique, which included two-stage surgical approaches: the first-stage surgery (FSS) involved debridement, bone cement filling, soft tissue coverage, and external fixation; the second-stage surgery (SSS) included removal of the bone cement, FVFG, iliac bone grafting, and external fixation. The bone defect sizes ranging from 9.7 to 22.4 cm (16.4 ± 4.1 cm). The median and quartile of the bone defect volume were 70.1 (52.1, 139.9) cm<sup>3</sup>. The size of the vascularized fibula varied from 11.3 to 21.0 cm (17.2 ± 3.7 cm). Postoperatively, patients were followed for a duration ranging from 12 to 31 (19.7 ± 6.4) months. Bone graft fusion was assessed according to the radiographic union score (RUS), with scores greater than 8 indicating successful bone fusion. The pain was measured by the visual analogue scale (VAS), limb function was assessed with the lower extremity functional scale (LEFS), and anxiety levels were evaluated using the self-rating anxiety scale (SAS).</div></div><div><h3>Results</h3><div>All patients achieved complete resolution of their infections, resulting in an infection cure rate of 100%, with no recurrences observed during the follow-up period. All patients achieved osseous fusion, resulting in an overall bony union rate of 100%. The average RUS recorded was 10.6 ± 1.5, and no instances of re-fracture were observed during the follow-up period. There were no wound-related complications at the donor site of the fibula graft, nor were there any issues such as toe flexion weakness, ankle instability, or pain. Compared with the preoperative scores, the last follow-up VAS scores (0.6 ± 0.5 vs. 5.8 ± 1.0, <em>p</em> < 0.001) and SAS scores (33.3 ± 2.3 vs. 59.7 ± 4.1, <em>p</em> < 0.001) were significantly lower. Compared with the preoperative scores, the last follow-up LEFS scores (63.3 ± 7.8 vs. 20.8 ± 3.8,","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113036"},"PeriodicalIF":2.0,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950138","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":"Ischemic skin flap viability: in vivo study of alginate-ZIF-8 hydrogel systems with Rhizophora mangle and tannic acid","authors":"Bianca Rocha da Silva Barreto ,&nbsp;Eduardo Carvalho Lira ,&nbsp;Severino Alves Júnior ,&nbsp;Luzia Abilio da Silva ,&nbsp;Yuri José de Albuquerque Silva ,&nbsp;Widarlane Ângela da Silva Alves ,&nbsp;Madson Manoel Nunes da Silva ,&nbsp;Rosallyne Hosana Vanderlei das Chagas ,&nbsp;Larissa Cardeal da Rocha Carvalho ,&nbsp;Jasmine Martins Vieira Cunha ,&nbsp;Jamily Isabel Viana de Lima ,&nbsp;Ester Francisca Gomes de Lima ,&nbsp;Ícaro Mota Oliveira ,&nbsp;Jeymesson Raphael Cardoso Vieira","doi":"10.1016/j.injury.2026.113043","DOIUrl":"10.1016/j.injury.2026.113043","url":null,"abstract":"<div><div>Skin flaps are widely used in plastic and reconstructive surgery. However, inadequate blood perfusion during flap mobilization can trigger an ischemic process that may lead to tissue necrosis in the absence of effective management of the inflammatory process. In this context, the search for new biocompatible strategies to ensure the viability of ischemic skin flaps (ISFs) remains necessary. Therefore, this study evaluated novel alginate-ZIF-8 (ALG-ZIF-8) hydrogel systems with <em>Rhizophora mangle</em> (<em>R. mangle</em>) extract and tannic acid (TA) to assess their potential in preventing necrosis in ISF. Twenty-two male Wistar rats underwent the surgical creation of ISF and were divided into four groups: 0.9% saline (negative control - NegC), placebo alginate hydrogel (pALGgel), ALG-ZIF-8 hydrogel system with 5% TA (ALGzTA), and finally, ALG-ZIF-8 hydrogel system with 5% <em>R. mangle</em> (ALGzRm). Flap outcomes were evaluated through macroscopic observation, followed by morphometric analysis of viable and necrotic areas, and histomorphometric analysis of fibroblasts, blood vessels, and leukocytes, using ImageJ and PrimeCam 5.1 software. Statistical analysis was performed using IBM SPSS software (version 27). The results suggest that the formulations produced divergent outcomes by differentially modulating inflammatory and angiogenic responses. The ALGzRm formulation tended to show a protective profile, associated with a significant reduction in leukocyte infiltration (<em>p</em> &lt; 0.001), while the ALGzTA formulation was linked to a detrimental response, including exacerbated inflammation and a pathologically high blood vessel count (<em>p</em> = 0.015). In conclusion, findings suggest that the ALGzRm-gel has a potential for tissue repair, mediated by the modulation of inflammatory and angiogenic responses.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113043"},"PeriodicalIF":2.0,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981493","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":"Impact of Psychosocial intervention on Quality of life in patients with post- traumatic limb amputation/s: a randomized controlled trial","authors":"Milandeep ,&nbsp;Rajesh Sagar ,&nbsp;Sushma Sagar ,&nbsp;Pratyusha Priyadarshini ,&nbsp;Abhinav Kumar ,&nbsp;Junaid Alam ,&nbsp;Dinesh Bagaria ,&nbsp;Narendra Chaudhary ,&nbsp;Amit Gupta ,&nbsp;Biplab Mishra ,&nbsp;Anamika Sahu ,&nbsp;Shivam Pandey ,&nbsp;Subodh Kumar","doi":"10.1016/j.injury.2026.113027","DOIUrl":"10.1016/j.injury.2026.113027","url":null,"abstract":"<div><h3>Introduction</h3><div>Trauma results in approximately 1.19 million deaths and 20–50 million disabilities globally each year. With increasing industrialization, road traffic injuries have become a leading cause of Disability Adjusted Life Years and traumatic amputations. These sudden amputations often lead to significant psychological distress. This study aims to assess the effectiveness of psychosocial interventions in enhancing the Quality of Life of post-traumatic amputees.</div></div><div><h3>Material and Methods</h3><div>This randomized controlled trial enrolled 74 post-traumatic extremity amputees aged over 18 years, who were cognitively coherent, had adequate social support, and no prior psychological illness. Following baseline psychosocial assessment, participants were randomly assigned to two groups: Group A (<em>n</em> = 39) received conventional care, while Group B (<em>n</em> = 35) received both psychosocial intervention and conventional care for seven weeks. Psychosocial outcomes were reassessed in both groups at the eighth week post-intervention.</div></div><div><h3>Results</h3><div>Quality of life showed significant improvement in both the groups. However, there was no significant difference between the groups. Level of depression, anxiety and stress significantly decreased in both the groups at 8 weeks, but the difference was not significant between the groups. However, body image showed a significant improvement in Group B as compared to Group A (<em>p</em> = 0.023).</div></div><div><h3>Conclusion</h3><div>Our study did not show any observable positive effects of psychosocial intervention over conventional care on quality of life, depression, stress, or anxiety except on body image. We hypothesize that positive results might be seen in quality of life of amputees if a larger study with longer duration of psychosocial intervention is conducted.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113027"},"PeriodicalIF":2.0,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000146","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":"Preoperative malnutrition is associated with increased infectious, vascular, and wound complications after distal femur fracture fixation","authors":"Muaaz Wajahath ,&nbsp;Jawad Saad ,&nbsp;Noah Hodson ,&nbsp;Ameen Suhrawardy ,&nbsp;Ali Mehaidli ,&nbsp;Amir Ghafarian ,&nbsp;Tyler Forbes ,&nbsp;Stuart Guthrie","doi":"10.1016/j.injury.2026.113031","DOIUrl":"10.1016/j.injury.2026.113031","url":null,"abstract":"<div><h3>Objectives</h3><div>Distal femur fractures (DFF) are serious injuries that frequently affect older, medically complex patients. Malnutrition worsens outcomes in elective orthopaedic surgery, but its impact in urgent DFF fixation, where preoperative optimization time is limited, remains unclear. This study evaluated whether preoperative malnutrition predicts 90-day morbidity after DFF fixation and whether implant choice modifies risk among malnourished patients.</div></div><div><h3>Methods</h3><div>Adults undergoing operative DFF fixation from 2005 to 2025 were identified in the TriNetX US Collaborative Network. Malnutrition was defined as serum albumin ≤3.5 g/dL or leukocyte count ≤1.5 × 10³/µL within one year before surgery. After 1:1 propensity matching for demographics and comorbidities, outcomes were compared between 13,924 malnourished and 13,924 non-malnourished patients. A secondary matched analysis compared plate versus intramedullary nail fixation in malnourished patients (<em>n</em> = 662). Ninety-day postoperative complications, readmission, and opioid-related outcomes were assessed.</div></div><div><h3>Results</h3><div>Malnourished patients had significantly higher rates of nearly all 90-day complications, including sepsis (risk ratio [RR] 3.55), surgical site infection (RR 3.05), wound disruption (RR 3.38), pulmonary embolism (RR 2.09), pneumonia (RR 2.45), renal failure (RR 2.53), anemia (RR 1.97), and transfusion (RR 2.52) (all <em>p</em> &lt; 0.001). Ninety-day readmission and opioid-related outcomes were also substantially increased. Among malnourished patients, overall complication rates were similar between plate and nail fixation, with the exception of lower pneumonia rates in the plate cohort (<em>p</em> = 0.045).</div></div><div><h3>Conclusions</h3><div>Preoperative malnutrition is a strong, independent predictor of postoperative morbidity after DFF fixation, and complication risk remains high regardless of implant choice. Routine nutritional screening with simple laboratory markers and targeted perioperative optimization should be integrated into trauma workflows to improve outcomes in this vulnerable population.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113031"},"PeriodicalIF":2.0,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038911","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":"Prehospital spinal immobilization and motion restriction strategies: A scoping review of the literature","authors":"Federico Cucci ,&nbsp;Dario Marasciulo ,&nbsp;Roberto Lupo ,&nbsp;Luana Conte ,&nbsp;Giovanni Soldano ,&nbsp;Cosimo Caldararo ,&nbsp;Leonardo Zizzi ,&nbsp;Emanuele Lagazzi ,&nbsp;Michele Bonetti","doi":"10.1016/j.injury.2026.113024","DOIUrl":"10.1016/j.injury.2026.113024","url":null,"abstract":"<div><h3>Background</h3><div>Prehospital management of suspected spinal injury has long relied on routine full immobilization. In recent years, several studies have questioned its benefit and highlighted possible adverse effects. The aim of this scoping review is to describe the evidence on the management of patients with suspected spinal injury, focusing on models based on full immobilization with rigid devices and a cervical collar, and on strategies of selective spinal motion restriction (SMR).</div></div><div><h3>Methods</h3><div>A scoping review was conducted according to JBI methodology and PRISMA-ScR guidance, with a protocol registered on the Open Science Framework. The literature search was carried out in the PubMed, Scopus and Web of Science databases. Studies on adults or children with suspected traumatic spinal injury managed in the out-of-hospital setting were included when strategies of full immobilization, selective SMR or no immobilization were described or compared.</div></div><div><h3>Results</h3><div>Twenty-seven studies met the inclusion criteria, including observational cohorts, experimental studies on volunteers, simulation studies and qualitative research. Overall, no clear advantage of routine full immobilization over more selective strategies emerges. Selective SMR based on clinical assessment and decision rules appears to reduce the use of rigid devices without evidence of increased missed unstable injuries. Prolonged immobilization is instead associated with pain, discomfort, alterations in tissue perfusion and greater use of imaging examinations. The overall body of evidence is heterogeneous and largely based on observational studies, in which the influence of confounding factors cannot be fully ruled out.</div></div><div><h3>Conclusions</h3><div>The available evidence supports moving away from routine full immobilization towards selective SMR in the prehospital setting. Emergency medical services should update protocols and training accordingly and promote prospective studies focused on clinical outcomes and patient experience.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113024"},"PeriodicalIF":2.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981573","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":"Wiring fixation for acetabular column fractures: Mid-term outcomes and survival according to reduction quality and fracture pattern","authors":"Chan Young Lee,&nbsp;Taek-Rim Yoon,&nbsp;Kyung-Soon Park","doi":"10.1016/j.injury.2026.113016","DOIUrl":"10.1016/j.injury.2026.113016","url":null,"abstract":"<div><h3>Background</h3><div>Acetabular column fractures remain among the most complex injuries in orthopedic trauma. Conventional plating techniques require extensive soft-tissue dissection and are associated with high complication rates. The wiring technique, which achieves compression across both acetabular columns through the greater and lesser sciatic notches, was developed to minimize surgical morbidity. This study aimed to evaluate the mid-term clinical and radiologic outcomes of this technique and to analyze factors affecting hip joint preservation.</div></div><div><h3>Methods</h3><div>This retrospective study included 41 patients who underwent fixation of acetabular column fractures using the wiring technique between 1994 and 2018 at a single tertiary referral center. A dual approach combining the Kocher–Langenbeck and mini-iliofemoral incisions was used. Clinical outcomes were evaluated using the Harris Hip Score (HHS) and Visual Analog Scale (VAS), and radiologic reduction was graded according to Matta’s criteria. Survivorship was analyzed using Kaplan–Meier methods with conversion to total hip arthroplasty (THA) as the endpoint.</div></div><div><h3>Results</h3><div>The cohort included 29 men and 12 women, with a mean age of 51.2 years and a mean follow-up duration of 11.4 years. The mean operation time was 139.8 minutes. Intraoperative complications included one case each of superior gluteal artery injury, sciatic nerve palsy, and lateral femoral cutaneous nerve injury. Postoperative complications were rare. Anatomical or near-anatomical reduction was achieved in 97.5% of patients. The mean HHS and VAS at final follow-up showed satisfactory functional outcomes. Eight patients (19.5%) required conversion to THA during follow-up, resulting in an overall THA-free survival rate of 85%. Survival analysis demonstrated 100% survivorship for anatomical reductions, 75% for imperfect reductions, and 0% for poor reductions. Fracture classification did not influence clinical outcomes but significantly affected long-term survivorship, with anterior column fractures showing 100% survival and transverse with posterior wall fractures showing the lowest at 50%.</div></div><div><h3>Conclusion</h3><div>The wiring technique offers a reliable and biologically favorable method for treating acetabular column fractures. It provides stable reduction with limited soft-tissue disruption, resulting in durable mid-term hip preservation and low complication rates. These findings emphasize the importance of achieving anatomical reduction and support the wiring technique as an effective option for managing acetabular column fractures.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113016"},"PeriodicalIF":2.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981492","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":"Application of the posterolateral approach in the surgical treatment of ankle fractures","authors":"Heng Zhang,&nbsp;Yue Wang,&nbsp;Zhiliang Guo,&nbsp;Minhui Zhang,&nbsp;Ruojie Bi","doi":"10.1016/j.injury.2026.113021","DOIUrl":"10.1016/j.injury.2026.113021","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to compare the efficacy of the posterolateral and posteromedial approaches in the surgical treatment of trimalleolar ankle fractures involving the posterior malleolus.</div></div><div><h3>Methods</h3><div>A total of 120 patients with trimalleolar ankle fractures (Haraguchi type II posterior malleolar fractures confirmed by computed tomography scans involving &gt;30% of the tibial articular surface) admitted to our hospital were separated into two subgroups according to different intervention methods. The posterolateral approach subgroup had 60 patients (finally, 58 patients were included), and the posteromedial approach subgroup had 60 patients (finally, 57 patients were included). Open reduction and internal fixation (ORIF) were conducted in all patients, addressing the fibula through the same posterolateral incision or through a separate lateral incision in the posteromedial group. The general operation, fracture healing and complication rate of the two subgroups were compared.</div></div><div><h3>Results</h3><div>The operation time, intraoperative bleeding, incision length and postoperative hospitalisation time of the posterolateral approach subgroup were significantly shorter than those of the posteromedial approach subgroup. The fracture healing time in the posterolateral approach subgroup was significantly shorter than that in the posteromedial approach subgroup, and the complication rate was significantly less than that in the posteromedial approach subgroup. At a mean follow-up of 14.3 months (range: 12–18 months), there was no notable distinction in the excellent and good rates for the posterolateral approach subgroup (94.83%) and the posteromedial approach subgroup (87.72%).</div></div><div><h3>Conclusion</h3><div>The posterolateral approach for the treatment of trimalleolar ankle fractures shortens the operation time, promotes fracture healing through improved visualisation and reduction quality, lessens the incidence of complications and, compared with posteromedial ORIF, does not affect the functional recovery of the ankle joint.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113021"},"PeriodicalIF":2.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032472","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 comparison of triangular osteosynthesis and triangular minimally invasive spinopelvic stabilization technique for pelvic fragility fractures","authors":"Hans-Joachim Riesner ,&nbsp;Jason DePhillips ,&nbsp;Amber R. Witt ,&nbsp;Jonathan M. Mahoney ,&nbsp;Brandon S. Bucklen","doi":"10.1016/j.injury.2026.113022","DOIUrl":"10.1016/j.injury.2026.113022","url":null,"abstract":"<div><h3>Objectives</h3><div>To biomechanically compare triangular osteosynthesis (TOS) and a minimally invasive triangular spinopelvic stabilization (TMSS) technique for Type IV fragility fractures of the pelvis (FFP) in a cadaveric model.</div></div><div><h3>Methods</h3><div>Six fresh-frozen lumbopelvic specimens (L3–pelvis; mean age 61.5 ± 11.5 yrs) with simulated Type IV U-shaped sacral fractures were sequentially instrumented with TOS (bilateral iliosacral screws + lumbopelvic fixation) and TMSS (bilateral iliac screws with transverse connecting rod + lumbopelvic fixation). Constructs were cyclically loaded (200–430 N; 25,000 cycles or 1 cm axial displacement) to simulate postoperative single-leg stance loading. Fracture displacement was quantified using a motion capture system.</div></div><div><h3>Results</h3><div>All but one TOS specimen completed 25,000 cycles. Bone mineral density had no effect on displacement. TMSS showed lower maximum fracture displacement (6.05 mm) than TOS (12.12 mm; <em>p</em>= 0.071). Displacement after 1000 cycles averaged 56% (TOS) and 62% (TMSS) of the maximum.</div></div><div><h3>Conclusions</h3><div>TMSS provided comparable or improved stability versus TOS and, with its minimally invasive design, may offer a viable alternative for FFP Type IV treatment. Further clinical validation is warranted.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113022"},"PeriodicalIF":2.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981494","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":"Scoping review on motorcycle crashes patterns, risk factors, and potential in setting policy priorities in the gulf cooperation council countries (GCC)","authors":"Simple Sibi Joseph ,&nbsp;Layth Al-Jarrah ,&nbsp;Mohamed H. Ahmed ,&nbsp;Ayman El-Menyar ,&nbsp;Naushad Ahmad Khan ,&nbsp;Husham Abdelrahman ,&nbsp;Rafael Consunji ,&nbsp;Yassir Abdulrahman ,&nbsp;Sandro Rizoli ,&nbsp;Hassan Al-Thani","doi":"10.1016/j.injury.2026.113017","DOIUrl":"10.1016/j.injury.2026.113017","url":null,"abstract":"<div><h3>Background</h3><div>Although road traffic injuries (RTIs) pose a significant public health burden in the Gulf Cooperation Council countries (GCC), the true extent of motorcycle crash injuries (MCCIs) remains unclear because of limited published data from this region. Emerging evidence suggests that MCCIs are on the rise because of the growing use of motorcycles for transport and delivery services, even though road safety overall has improved. We sought to review regional evidence on MCCIs' patterns, key risk factors, and temporal trends to inform policy interventions and research priorities for effective prevention.</div></div><div><h3>Methods</h3><div>A scoping review was conducted in accordance with the PRISMA-ScR guidelines. Articles on GCC MCCIs published from July 2008 to October 2025, examining injury patterns, mortality, and safety practices, were included in the review. Search was conducted across PubMed, Scopus, Google Scholar, and grey literature sources. The GCC consists of six countries: Saudi Arabia (KSA), Qatar, Kuwait, the United Arab Emirates (UAE), Bahrain, and Oman.</div></div><div><h3>Results</h3><div>Of 1344 studies identified, 9 met the inclusion criteria and were analyzed. The GCC has seen an increase in the number of motorcycles registered, resulting in higher MCC rates over time. During the COVID-19 pandemic, these rates surged again as the delivery sector grew. MCCI victims were mainly young males (mean age of 29 years). Extremity injuries were the most frequent (two-thirds), followed by head injuries (20–41%), often associated with poor helmet use compliance (range 13–17%). Delivery riders represented a high-risk subgroup, reflecting occupational exposure, fatigue, and time pressure. Despite advances in trauma care, geographic gaps persist. Helmet use non-compliance, alcohol use, and inadequate documentation remain significant risk factors. Extremity injuries were the most common in the GCC.</div></div><div><h3>Conclusion</h3><div>MCCIs in the GCC are on the rise with high rates of extremity and head trauma. Poor helmet use compliance is a significant factor. Therefore, we suggest strengthening helmet use laws and safety standards, increasing community efforts, and establishing motorcycle lanes with lower speed limits. Protection for riders at work should be enhanced. Road infrastructure and robust data systems also need improvement.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113017"},"PeriodicalIF":2.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021237","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":"Accelerating the healing of infected full thickness excision wounds through the topical use of Pluronic F127 copolymer and Polyglutamic acid","authors":"Ali Edalat Irani ,&nbsp;Mohammad Reza Farahpour ,&nbsp;Mohammad Reza Valilou ,&nbsp;Zohreh Ghazi Tabatabaei","doi":"10.1016/j.injury.2026.113028","DOIUrl":"10.1016/j.injury.2026.113028","url":null,"abstract":"<div><div>Hydrogels have emerged as effective tools in medication delivery and tissue engineering due to their adjustable characteristics and water retention capabilities. The purpose of this work was to investigate the potential of a novel thermosensitive hydrogel composed of Pluronic F127 and polyglutamic acid (PGA) to enhance the treatment of MRSA-infected full-thickness excision wounds. The viscosity and gelation temperature of the hydrogels were evaluated using viscometry and rheometry, while their injectability was assessed with a texture analyzer. Swelling and biodegradation were measured in PBS at 37 °C, and antibacterial and antioxidant activity was determined using MIC/MBC tests and DPPH radical scavenging. In mouse infected wound healing investigations, hydrogels were applied to wounds, and tissue examination was done with Masson's Trichrome staining and biochemical assays for TAC and MDA. The F127/PGA hydrogel converted from a liquid to a gel at body temperature more efficiently than F127 alone, with lower gelation temperatures and improved mechanical characteristics. F127/PGA had higher swelling capacity and a slower degradation rate than F127. In antibacterial assays, the F127/PGA hydrogel showed stronger inhibitory and bactericidal activity against MRSA, as reflected by its lower MIC and higher MBC values. In addition, the hydrogel showed increased antioxidant activity and lower oxidative stress during wound healing, resulting in much better wound contraction and tissue regeneration than F127 and control treatments. These characteristics make F127/PGA an attractive choice for improved drug delivery systems and wound healing applications.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 3","pages":"Article 113028"},"PeriodicalIF":2.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121349","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}