Pub Date : 2025-12-04DOI: 10.1016/j.injury.2025.112934
Yi Gou , Dan-dan Li , Xin Li , Xin Yuan , Yi-han Wang , Jian-zhong Yang , Ke Feng
Background
Venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), is a leading cause of trauma-related mortality within 30 days in severe trauma patients. Current diagnostic methods have limitations, leading to an urgent need to identify early diagnostic biomarkers of VTE.
Objective
To screen early diagnostic biomarkers of VTE following severe trauma by integrating metabolomics and proteomics.
Method
The existing plasma metabolomics and proteomics data from 72 severe trauma patients with (22 cases) and without (49 cases) VTE were retrospectively analyzed. By comparing two groups, early diagnostic biomarkers of VTE in severe trauma patients were identified.
Results
210 differentially expressed metabolites (DEMs) and 11 DEPs (DEPs) were identified. We screened the top 10 DEMs and 11 DEPs as early diagnostic biomarkers for VTE after severe trauma, then developed two panels using top 10 DEMs (AUC=0.952) and 11 DEPs (AUC=0.955), respectively. By integrating metabolomics and proteomics, we developed a diagnostic panel consisting of LPC16:0 and FA7, which demonstrated superior diagnostic efficacy (AUC = 0.937).
Conclusion
This study identified potential biomarkers of VTE after severe trauma, providing a novel strategy for early precision diagnosis, providing new insights into the pathogenesis of VTE after severe trauma, and establishing a translational framework for developing early diagnostic biomarker panels.
{"title":"Integrated metabolomics and proteomics to screen early diagnostic biomarkers of venous thromboembolism following severe trauma: A retrospective study","authors":"Yi Gou , Dan-dan Li , Xin Li , Xin Yuan , Yi-han Wang , Jian-zhong Yang , Ke Feng","doi":"10.1016/j.injury.2025.112934","DOIUrl":"10.1016/j.injury.2025.112934","url":null,"abstract":"<div><h3>Background</h3><div>Venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), is a leading cause of trauma-related mortality within 30 days in severe trauma patients. Current diagnostic methods have limitations, leading to an urgent need to identify early diagnostic biomarkers of VTE.</div></div><div><h3>Objective</h3><div>To screen early diagnostic biomarkers of VTE following severe trauma by integrating metabolomics and proteomics.</div></div><div><h3>Method</h3><div>The existing plasma metabolomics and proteomics data from 72 severe trauma patients with (22 cases) and without (49 cases) VTE were retrospectively analyzed. By comparing two groups, early diagnostic biomarkers of VTE in severe trauma patients were identified.</div></div><div><h3>Results</h3><div>210 differentially expressed metabolites (DEMs) and 11 DEPs (DEPs) were identified. We screened the top 10 DEMs and 11 DEPs as early diagnostic biomarkers for VTE after severe trauma, then developed two panels using top 10 DEMs (AUC=0.952) and 11 DEPs (AUC=0.955), respectively. By integrating metabolomics and proteomics, we developed a diagnostic panel consisting of LPC16:0 and FA7, which demonstrated superior diagnostic efficacy (AUC = 0.937).</div></div><div><h3>Conclusion</h3><div>This study identified potential biomarkers of VTE after severe trauma, providing a novel strategy for early precision diagnosis, providing new insights into the pathogenesis of VTE after severe trauma, and establishing a translational framework for developing early diagnostic biomarker panels.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112934"},"PeriodicalIF":2.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716910","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}
Pub Date : 2025-12-04DOI: 10.1016/j.injury.2025.112942
Francois Stapelberg , Carl Lisec
{"title":"Beyond collisions: Addressing fire related hazards in micromobility devices","authors":"Francois Stapelberg , Carl Lisec","doi":"10.1016/j.injury.2025.112942","DOIUrl":"10.1016/j.injury.2025.112942","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 1","pages":"Article 112942"},"PeriodicalIF":2.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776858","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}
Pub Date : 2025-12-04DOI: 10.1016/j.injury.2025.112927
Harmya Bhatt , Souvik Das , Yi (Jade) Han , Mohsen Moghaddam , Gaurav Nanda
Background
Safety is a critical aspect of consumer products. However, there are millions of product related injuries reported each year. Traditional injury surveillance efforts led by public health agencies involve product related injury data collection from hospitals and subsequent injury causation analysis. This approach often requires long processing time and leads to delays in identifying emergent consumer product-related injury patterns and preventive intervention steps such as product recalls, which causes continued product related injuries.
Methods
We propose a machine learning (ML) based framework for improving injury surveillance by extracting crucial product injury related details from real-time social media posts to quickly identify emerging trends of product injuries and potentially facilitate timely interventions. We evaluated the efficacy of the proposed framework by analyzing injuries related to skateboard from the Redditt platform. The framework has two stages. In stage1, the social media posts scrapped based on product-related keywords were classified whether they were injury related or not using ML models trained on non-injury related data of Amazon product reviews and injury-related data obtained from the National Electronic Injury Surveillance System (NEISS) database. In stage2, the posts identified as injury related were further analyzed by another ML model trained on NEISS dataset to predict the body-part injured and the injury diagnosis code based on the content of Redditt post.
Results
In stage1 for classifying whether social media posts are injury related or not the deep learning models LSTM and GRU yielded an F-1 score of 72 %. In stage2, for the posts that were classified as injury related, the SGD model yielded an F-1 score of 86 % for predicting the body-part-injured and 76 % for injury diagnosis-code.
Conclusions
The results of the study indicate that the proposed machine learning framework yielded decent accuracy levels for injury surveillance purposes. Therefore, the framework can be used for analyzing social media data for identifying emerging trends in product-related injuries and can bolster the existing injury surveillance efforts.
{"title":"A machine learning based framework for identifying consumer product injuries from social media data","authors":"Harmya Bhatt , Souvik Das , Yi (Jade) Han , Mohsen Moghaddam , Gaurav Nanda","doi":"10.1016/j.injury.2025.112927","DOIUrl":"10.1016/j.injury.2025.112927","url":null,"abstract":"<div><h3>Background</h3><div>Safety is a critical aspect of consumer products. However, there are millions of product related injuries reported each year. Traditional injury surveillance efforts led by public health agencies involve product related injury data collection from hospitals and subsequent injury causation analysis. This approach often requires long processing time and leads to delays in identifying emergent consumer product-related injury patterns and preventive intervention steps such as product recalls, which causes continued product related injuries.</div></div><div><h3>Methods</h3><div>We propose a machine learning (ML) based framework for improving injury surveillance by extracting crucial product injury related details from real-time social media posts to quickly identify emerging trends of product injuries and potentially facilitate timely interventions. We evaluated the efficacy of the proposed framework by analyzing injuries related to skateboard from the Redditt platform. The framework has two stages. In stage1, the social media posts scrapped based on product-related keywords were classified whether they were injury related or not using ML models trained on non-injury related data of Amazon product reviews and injury-related data obtained from the National Electronic Injury Surveillance System (NEISS) database. In stage2, the posts identified as injury related were further analyzed by another ML model trained on NEISS dataset to predict the body-part injured and the injury diagnosis code based on the content of Redditt post.</div></div><div><h3>Results</h3><div>In stage1 for classifying whether social media posts are injury related or not the deep learning models LSTM and GRU yielded an F-1 score of 72 %. In stage2, for the posts that were classified as injury related, the SGD model yielded an F-1 score of 86 % for predicting the body-part-injured and 76 % for injury diagnosis-code.</div></div><div><h3>Conclusions</h3><div>The results of the study indicate that the proposed machine learning framework yielded decent accuracy levels for injury surveillance purposes. Therefore, the framework can be used for analyzing social media data for identifying emerging trends in product-related injuries and can bolster the existing injury surveillance efforts.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112927"},"PeriodicalIF":2.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716660","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}
Pub Date : 2025-12-04DOI: 10.1016/j.injury.2025.112937
Evan Avraham Alpert , Maximilian P. Nerlander , Sharon Alter , Ahmad Nama , Jacob Assaf , Aliza Goldman , Ruchama Pliner , Eli Jaffe
Introduction
For 20 years, Israel has experienced periods where it has been attacked by missile fire from Gaza resulting in civilian deaths and injuries. The Iron Dome air defense system detects incoming missiles and then triggers an air-raid siren that can result in physical injuries and emotional distress as civilians seek shelter. The objective of this study was to compare the epidemiology of responses by Magen David Adom, Israel’s National Emergency Medical System (EMS) during the 2021 Gaza War and the 2023 Israel-Hamas War, that were associated with injuries during air-raid sirens but not directly related to the missiles.
Methods
This is a retrospective comparative study of all EMS responses during air-raid sirens which occurred during the 2021 Gaza War (May 10 –21, 2021) and the 2023 Israel-Hamas War (data from October 7- November 3, 2023).
Results
The study included a total of 1155 EMS responses. Across both conflicts, physical injuries and anxiety-related responses were more common in women than in men (71.8 % vs. 28.2 %; p ≤ 0.05) and 63.5 % vs. 36.5 %; p ≤ 0.05). Comparative analysis between the two conflicts demonstrated that the odds of a response being for an elderly patient (age >75) was higher in the 2023 Israel-Hamas War compared to the 2021 Gaza War (OR 1.83, 95 % CI 1.35–2.48). In addition, there were more EMS responses for injuries in the 2023 Israel-Hamas War compared to the 2021 Gaza War, whether orthopedic (OR 1.66, 95 % CI 1.22–2.25), light injuries (OR 1.35, 95 % CI 0.98–1.86), or head injury (OR 3.31, 95 % CI 1.74–6.30). Additionally, the mean ratio of responses per air-raid siren was higher in the 2023 Israel-Hamas War compared to the 2021 Gaza War (M = 0.15, SD = 0.08 vs M = 0.06, SD = 0.03; p < 0.0001).
Conclusion
Air-raid sirens are important in reducing civilian injuries and deaths from missiles. However, the siren itself may cause significant anxiety and can lead to injury as civilians try to seek shelter. Increased public messaging about staying calm and carefully moving to shelter could help prevent injuries.
导言：20年来，以色列多次遭受来自加沙的导弹袭击，造成平民伤亡。“铁穹”防空系统探测到来袭导弹，然后触发空袭警报，在平民寻求庇护时造成身体伤害和精神困扰。本研究的目的是比较以色列国家紧急医疗系统（EMS）在2021年加沙战争和2023年以色列-哈马斯战争期间的反应流行病学，这些反应与空袭警报期间的伤害有关，但与导弹没有直接关系。方法：这是对2021年加沙战争（2021年5月10日至21日）和2023年以色列-哈马斯战争（2023年10月7日至11月3日）期间发生的空袭警报期间所有EMS反应的回顾性比较研究。结果：本研究共纳入1155例EMS应答。在这两种冲突中，身体伤害和焦虑相关反应在女性中比在男性中更常见（71.8%比28.2%,p≤0.05），63.5%比36.5%；P≤0.05)。两种冲突之间的比较分析表明，2023年以色列-哈马斯战争中老年患者（年龄在75岁以下）的反应几率高于2021年加沙战争（OR 1.83, 95% CI 1.35-2.48）。此外，与2021年加沙战争相比，2023年以色列-哈马斯战争中受伤的EMS反应更多，无论是骨科（OR 1.66, 95% CI 1.22-2.25），轻伤（OR 1.35, 95% CI 0.98-1.86）还是头部损伤（OR 3.31, 95% CI 1.74-6.30）。此外，与2021年加沙战争相比，2023年以色列-哈马斯战争中每个空袭警报器的平均响应率更高（M = 0.15, SD = 0.08 vs M = 0.06, SD = 0.03; p < 0.0001）。结论：防空警报器在减少导弹造成的平民伤亡方面很重要。然而，警笛本身可能会引起严重的焦虑，并可能导致平民在寻求庇护时受伤。增加关于保持冷静和小心转移到避难所的公众信息有助于防止受伤。
{"title":"Injuries while seeking shelter during air-raid sirens: A retrospective comparative study from two armed conflicts in Israel","authors":"Evan Avraham Alpert , Maximilian P. Nerlander , Sharon Alter , Ahmad Nama , Jacob Assaf , Aliza Goldman , Ruchama Pliner , Eli Jaffe","doi":"10.1016/j.injury.2025.112937","DOIUrl":"10.1016/j.injury.2025.112937","url":null,"abstract":"<div><h3>Introduction</h3><div>For 20 years, Israel has experienced periods where it has been attacked by missile fire from Gaza resulting in civilian deaths and injuries. The Iron Dome air defense system detects incoming missiles and then triggers an air-raid siren that can result in physical injuries and emotional distress as civilians seek shelter. The objective of this study was to compare the epidemiology of responses by Magen David Adom, Israel’s National Emergency Medical System (EMS) during the 2021 Gaza War and the 2023 Israel-Hamas War, that were associated with injuries during air-raid sirens but not directly related to the missiles.</div></div><div><h3>Methods</h3><div>This is a retrospective comparative study of all EMS responses during air-raid sirens which occurred during the 2021 Gaza War (May 10 –21, 2021) and the 2023 Israel-Hamas War (data from October 7- November 3, 2023).</div></div><div><h3>Results</h3><div>The study included a total of 1155 EMS responses. Across both conflicts, physical injuries and anxiety-related responses were more common in women than in men (71.8 % vs. 28.2 %; <em>p</em> ≤ 0.05) and 63.5 % vs. 36.5 %; <em>p</em> ≤ 0.05). Comparative analysis between the two conflicts demonstrated that the odds of a response being for an elderly patient (age >75) was higher in the 2023 Israel-Hamas War compared to the 2021 Gaza War (OR 1.83, 95 % CI 1.35–2.48). In addition, there were more EMS responses for injuries in the 2023 Israel-Hamas War compared to the 2021 Gaza War, whether orthopedic (OR 1.66, 95 % CI 1.22–2.25), light injuries (OR 1.35, 95 % CI 0.98–1.86), or head injury (OR 3.31, 95 % CI 1.74–6.30). Additionally, the mean ratio of responses per air-raid siren was higher in the 2023 Israel-Hamas War compared to the 2021 Gaza War (<em>M</em> = 0.15, SD = 0.08 vs <em>M</em> = 0.06, SD = 0.03; <em>p</em> < 0.0001).</div></div><div><h3>Conclusion</h3><div>Air-raid sirens are important in reducing civilian injuries and deaths from missiles. However, the siren itself may cause significant anxiety and can lead to injury as civilians try to seek shelter. Increased public messaging about staying calm and carefully moving to shelter could help prevent injuries.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112937"},"PeriodicalIF":2.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835693","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}
Pub Date : 2025-12-04DOI: 10.1016/j.injury.2025.112941
Rachel E. Manhertz , Shelbie D. Waddle , Arielle Thomas-Jonasson , Joseph Shilati , Deysi Paniagua-Perez , Ying Shan , Tiannan Zhan , John D. Slocum , Angie Jang , Kaithlyn Tesorero , Gio Manguerra , Jesus Ramirez , Grace Chang , Andrew Dennis , Lisa Azu-Popow , Joseph Feinglass , Anne M Stey
Introduction
Revised Trauma Quality of Life (RT-QOL) measurement among violence survivors is challenging because of loss to follow-up. This study evaluated RT-QOL instrument completion during follow-up phone calls after hospital discharge and assessed if time to follow-up call was associated with instrument completion.
Materials and Methods
This was an observational cohort study of intentional interpersonal violence survivors treated at a Level 1 urban trauma center from March 2018-April 2024. Depression (Beck’s Depression Inventory II), Post-Traumatic Stress Disorder (Breslau Post Traumatic Stress Disorder Scale 7-item), and Revised Trauma-specific Quality of Life (RT-QOL) instruments were phone administered after discharge in English or Spanish. Multivariable regression tested if time to follow-up call was associated with instrument completion while controlling for survivors’ demographic, injury, hospital course and follow-up characteristics.
Results
A total of 566 intentional interpersonal violence survivors were eligible. Survivors were mostly male (82.0 %), 25–64 years old (77.9 %), Black (65.2 %), and injured by firearm (44.7 %). Among the 566 eligible survivors, 115 survivors (20.3 %) had an inaccurate phone number in the medical record, and 32 (5.7 %) died after hospital discharge. Two survivors (0.4 %) partially completed and 51 (9 %) completed instruments. Survivors who completed instruments were called fewer times, 2 calls (IQR: 1–2.5) versus 3 calls (IQR: 1–3). Approximately 43 % of survivors who completed instruments, completed them on the first call. Time to follow-up call was not associated with instrument completion. Females had 2.45 higher adjusted odds of instrument completion after controlling for time to follow-up call, age, race, ethnicity and injury mechanism (p = 0.008). Among survivors who completed instruments, 21(41.1 %) screened positive on Beck’s Depression Inventory II, 31 (60.8 %) screened positive on Breslau Post Traumatic Stress Disorder Scale 7-item, and 39 (76.5 %) reported RT-QOL symptoms impairing work.
Conclusions
Only female sex, not time to follow-up call, was associated with increased instrument completion among violence survivors.
{"title":"Violence survivors’ quality of life assessment: An observational cohort study","authors":"Rachel E. Manhertz , Shelbie D. Waddle , Arielle Thomas-Jonasson , Joseph Shilati , Deysi Paniagua-Perez , Ying Shan , Tiannan Zhan , John D. Slocum , Angie Jang , Kaithlyn Tesorero , Gio Manguerra , Jesus Ramirez , Grace Chang , Andrew Dennis , Lisa Azu-Popow , Joseph Feinglass , Anne M Stey","doi":"10.1016/j.injury.2025.112941","DOIUrl":"10.1016/j.injury.2025.112941","url":null,"abstract":"<div><h3>Introduction</h3><div>Revised Trauma Quality of Life (RT-QOL) measurement among violence survivors is challenging because of loss to follow-up. This study evaluated RT-QOL instrument completion during follow-up phone calls after hospital discharge and assessed if time to follow-up call was associated with instrument completion.</div></div><div><h3>Materials and Methods</h3><div>This was an observational cohort study of intentional interpersonal violence survivors treated at a Level 1 urban trauma center from March 2018-April 2024. Depression (Beck’s Depression Inventory II), Post-Traumatic Stress Disorder (Breslau Post Traumatic Stress Disorder Scale 7-item), and Revised Trauma-specific Quality of Life (RT-QOL) instruments were phone administered after discharge in English or Spanish. Multivariable regression tested if time to follow-up call was associated with instrument completion while controlling for survivors’ demographic, injury, hospital course and follow-up characteristics.</div></div><div><h3>Results</h3><div>A total of 566 intentional interpersonal violence survivors were eligible. Survivors were mostly male (82.0 %), 25–64 years old (77.9 %), Black (65.2 %), and injured by firearm (44.7 %). Among the 566 eligible survivors, 115 survivors (20.3 %) had an inaccurate phone number in the medical record, and 32 (5.7 %) died after hospital discharge. Two survivors (0.4 %) partially completed and 51 (9 %) completed instruments. Survivors who completed instruments were called fewer times, 2 calls (IQR: 1–2.5) versus 3 calls (IQR: 1–3). Approximately 43 % of survivors who completed instruments, completed them on the first call. Time to follow-up call was not associated with instrument completion. Females had 2.45 higher adjusted odds of instrument completion after controlling for time to follow-up call, age, race, ethnicity and injury mechanism (<em>p</em> = 0.008). Among survivors who completed instruments, 21(41.1 %) screened positive on Beck’s Depression Inventory II, 31 (60.8 %) screened positive on Breslau Post Traumatic Stress Disorder Scale 7-item, and 39 (76.5 %) reported RT-QOL symptoms impairing work.</div></div><div><h3>Conclusions</h3><div>Only female sex, not time to follow-up call, was associated with increased instrument completion among violence survivors.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112941"},"PeriodicalIF":2.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829384","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}
Pub Date : 2025-12-04DOI: 10.1016/j.injury.2025.112943
Anna Schiefer, Nora Renz, Gernot Steiner, Sven Märdian, Ulrich Stöckle, Andrej Trampuz, Sebastian Meller
Introduction
Infection is one of the major complications associated with intramedullary nailing. Aim of this study is to analyze the outcome of infection after fixation of tibia and femur with intramedullary nailing and to compare the outcome in patients treated with nail retention versus removal.
Patients and methods
This is a retrospective cohort study including consecutive adult patients treated at our institution between 01/2015 and 03/2022 for infection involving the intramedullary nail used for fixation of femur or tibia fractures. Characteristics of infection and outcome data were evaluated by actively contacting the patients with a standardized questionnaire. Uniform predetermined definitions were used. The probability of infection-free survival was estimated using the Kaplan–Meier method and compared between the groups using log-rank test.
Results
Fifty-one patients (37 males, 14 females) with infection associated with femur (n = 37) or tibia (n = 14) nail were included. The pathogen was identified in 45 (88 %) episodes, including 30 monomicrobial and 15 polymicrobial infections. The predominant pathogens in monomicrobial infections were coagulase-negative staphylococci (n = 11) and in polymicrobial infections gram-negative bacteria. The intramedullary nail was removed in 35 (69 %) patients and retained in 16 (31 %) patients. At follow-up (median follow-up 28 months; IQR 21–38 months), 19 of 31 (61 %) evaluable patients were infection-free. In patients with nail removal, 14 of 22 (64 %) were infection-free, whereas those with nail retention, 5 of 9 (56 %) were infection free.
Discussion
The fact that patients in the nail retention group were of higher age, experienced earlier infection after surgery, and were mainly caused by high virulent pathogens suggest a potential selection bias. Nevertheless, it appears that certain infections may be treated successfully with nail retention, reducing the number of interventions for the patient, and increasing cost effectiveness.
Conclusions
Overall cure of infected intramedullary nails was 61 %. No significant difference in the infection eradication of infected intramedullary nails were observed, irrespective of the time of occurrence after nail implantation. These results should be confirmed in a larger prospective cohort.
{"title":"Infection after intramedullary nailing for femur and tibia fractures – characteristics and outcome analysis","authors":"Anna Schiefer, Nora Renz, Gernot Steiner, Sven Märdian, Ulrich Stöckle, Andrej Trampuz, Sebastian Meller","doi":"10.1016/j.injury.2025.112943","DOIUrl":"10.1016/j.injury.2025.112943","url":null,"abstract":"<div><h3>Introduction</h3><div>Infection is one of the major complications associated with intramedullary nailing. Aim of this study is to analyze the outcome of infection after fixation of tibia and femur with intramedullary nailing and to compare the outcome in patients treated with nail retention versus removal.</div></div><div><h3>Patients and methods</h3><div>This is a retrospective cohort study including consecutive adult patients treated at our institution between 01/2015 and 03/2022 for infection involving the intramedullary nail used for fixation of femur or tibia fractures. Characteristics of infection and outcome data were evaluated by actively contacting the patients with a standardized questionnaire. Uniform predetermined definitions were used. The probability of infection-free survival was estimated using the Kaplan–Meier method and compared between the groups using log-rank test.</div></div><div><h3>Results</h3><div>Fifty-one patients (37 males, 14 females) with infection associated with femur (<em>n</em> = 37) or tibia (<em>n</em> = 14) nail were included. The pathogen was identified in 45 (88 %) episodes, including 30 monomicrobial and 15 polymicrobial infections. The predominant pathogens in monomicrobial infections were coagulase-negative staphylococci (<em>n</em> = 11) and in polymicrobial infections gram-negative bacteria. The intramedullary nail was removed in 35 (69 %) patients and retained in 16 (31 %) patients. At follow-up (median follow-up 28 months; IQR 21–38 months), 19 of 31 (61 %) evaluable patients were infection-free. In patients with nail removal, 14 of 22 (64 %) were infection-free, whereas those with nail retention, 5 of 9 (56 %) were infection free.</div></div><div><h3>Discussion</h3><div>The fact that patients in the nail retention group were of higher age, experienced earlier infection after surgery, and were mainly caused by high virulent pathogens suggest a potential selection bias. Nevertheless, it appears that certain infections may be treated successfully with nail retention, reducing the number of interventions for the patient, and increasing cost effectiveness.</div></div><div><h3>Conclusions</h3><div>Overall cure of infected intramedullary nails was 61 %. No significant difference in the infection eradication of infected intramedullary nails were observed, irrespective of the time of occurrence after nail implantation. These results should be confirmed in a larger prospective cohort.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112943"},"PeriodicalIF":2.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746154","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}
Pub Date : 2025-12-04DOI: 10.1016/j.injury.2025.112915
Zhan Dong , Wang Guo , Zhuqing Kong , Liukun Xu , Zhiqun Zhang
{"title":"Corrigendum to ‘Antegrade ESIN technique via the Kocher interval reduces radiation exposure and accelerates recovery in pediatric DRDMJ fractures: A comparative study with cadaveric validation’","authors":"Zhan Dong , Wang Guo , Zhuqing Kong , Liukun Xu , Zhiqun Zhang","doi":"10.1016/j.injury.2025.112915","DOIUrl":"10.1016/j.injury.2025.112915","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112915"},"PeriodicalIF":2.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688857","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}
Pub Date : 2025-12-04DOI: 10.1016/j.injury.2025.112947
Jan Siad El Barbari, Benedict James Swartman, Alma Aubert, Paul Alfred Grützner, Sven Yves Vetter, Jonas Armbruster
Introduction
While radiographic reduction quality is considered a key determinant of outcome in intraarticular calcaneal fractures, its quantification remains inconsistent and often unidimensional. Existing radiographic parameters only partially reflect the complex joint surface restoration while gradings often lack correlation to clinical outcomes. This study introduces the Calcaneal Fracture Outcome Score (CFOS), a composite score integrating joint-specific deformities and patient-level prognosticators to improve outcome prediction.
Material and Methods
Postoperative CT scans from 80 patients with surgically treated calcaneal fractures were evaluated for residual step, gap, and angulation at the posterior facet (PF) and calcaneocuboid (CC) joint. Additional parameters included Boehler’s angle, Gissane’s angle, Sanders classification, smoking status, and comorbidity burden. All variables were z-standardized and entered into a LASSO regression with 5-fold cross-validation. A weighted score (CFOS) was computed per patient and correlated with PROMS (VAS-FA; SF-12).
Results
Higher CFOS grades were associated with significantly worse outcomes, i.e. posttraumatic osteoarthritis (p<0.001), VAS-FA (p=0.035) and SF-12 PCS (p=0.010), outperforming the traditional grading established by Kurozumi et al and adapted by Nosewicz et al. with a mean positive predictive value of 90 %.
Conclusions
The CFOS offers a clinically intuitive, multidimensional assessment of reduction quality and provides robust predictive value for postoperative functional outcome.
{"title":"Calcaneal fracture outcome score (CFOS): A novel outcome-based prognostic CT grading for calcaneal fracture reduction","authors":"Jan Siad El Barbari, Benedict James Swartman, Alma Aubert, Paul Alfred Grützner, Sven Yves Vetter, Jonas Armbruster","doi":"10.1016/j.injury.2025.112947","DOIUrl":"10.1016/j.injury.2025.112947","url":null,"abstract":"<div><h3>Introduction</h3><div>While radiographic reduction quality is considered a key determinant of outcome in intraarticular calcaneal fractures, its quantification remains inconsistent and often unidimensional. Existing radiographic parameters only partially reflect the complex joint surface restoration while gradings often lack correlation to clinical outcomes. This study introduces the Calcaneal Fracture Outcome Score (CFOS), a composite score integrating joint-specific deformities and patient-level prognosticators to improve outcome prediction.</div></div><div><h3>Material and Methods</h3><div>Postoperative CT scans from 80 patients with surgically treated calcaneal fractures were evaluated for residual step, gap, and angulation at the posterior facet (PF) and calcaneocuboid (CC) joint. Additional parameters included Boehler’s angle, Gissane’s angle, Sanders classification, smoking status, and comorbidity burden. All variables were z-standardized and entered into a LASSO regression with 5-fold cross-validation. A weighted score (CFOS) was computed per patient and correlated with PROMS (VAS-FA; SF-12).</div></div><div><h3>Results</h3><div>Higher CFOS grades were associated with significantly worse outcomes, i.e. posttraumatic osteoarthritis (p<0.001), VAS-FA (p=0.035) and SF-12 PCS (p=0.010), outperforming the traditional grading established by Kurozumi et al and adapted by Nosewicz et al. with a mean positive predictive value of 90 %.</div></div><div><h3>Conclusions</h3><div>The CFOS offers a clinically intuitive, multidimensional assessment of reduction quality and provides robust predictive value for postoperative functional outcome.</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":"57 2","pages":"Article 112947"},"PeriodicalIF":2.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145748255","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}
This study aimed to evaluate the association between hospital arrival time/day and mortality in pediatric patients with severe trauma.
Methods
This retrospective observational study was conducted using data retrieved from the Japan Trauma Data Bank from January 2004 to May 2019. Patients younger than 18 years and with an Injury Severity Score of 16 or higher were included. Patients’ hospital arrival time was categorized into daytime (9:00 am to 4:59 pm) and nighttime (5:00 pm to 8:59 am), and hospital arrival day was categorized into weekdays (Monday to Friday, except for national holidays) and weekends/holidays (Saturday, Sunday, and national holidays). The main outcome was in-hospital mortality. Multiple imputation was used to address missing values. Subsequently, inverse probability of treatment weighting was applied to compare in-hospital mortality rates between the two sets of groups: (1) nighttime and daytime arrival groups and (2) weekend/holiday and weekday arrival groups.
Results
Overall, 6562 patients were included in this study, and the crude in-hospital mortality rate was 6.8%. The odds of in-hospital mortality were significantly higher in the nighttime arrival group than in the daytime arrival group (adjusted odds ratio [aOR], 1.35; 95% confidence interval [CI], 1.09–1.68). In contrast, no significant difference was observed between the weekend/holiday arrival group and the weekday arrival group (aOR, 0.95; 95% CI, 0.79–1.13).
Conclusions
Nighttime hospital arrival was associated with higher odds of in-hospital mortality in pediatric patients with severe trauma but weekend/holiday arrival was not.
{"title":"Association between hospital arrival time/day and mortality in pediatric patients with severe trauma: a nationwide retrospective observational study in Japan","authors":"Shingo Ohki , Ryu Matsuo , Mitsuaki Nishikimi , Shinichiro Ohshimo , Nobuaki Shime","doi":"10.1016/j.injury.2025.112946","DOIUrl":"10.1016/j.injury.2025.112946","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the association between hospital arrival time/day and mortality in pediatric patients with severe trauma.</div></div><div><h3>Methods</h3><div>This retrospective observational study was conducted using data retrieved from the Japan Trauma Data Bank from January 2004 to May 2019. Patients younger than 18 years and with an Injury Severity Score of 16 or higher were included. Patients’ hospital arrival time was categorized into daytime (9:00 am to 4:59 pm) and nighttime (5:00 pm to 8:59 am), and hospital arrival day was categorized into weekdays (Monday to Friday, except for national holidays) and weekends/holidays (Saturday, Sunday, and national holidays). The main outcome was in-hospital mortality. Multiple imputation was used to address missing values. Subsequently, inverse probability of treatment weighting was applied to compare in-hospital mortality rates between the two sets of groups: (1) nighttime and daytime arrival groups and (2) weekend/holiday and weekday arrival groups.</div></div><div><h3>Results</h3><div>Overall, 6562 patients were included in this study, and the crude in-hospital mortality rate was 6.8%. The odds of in-hospital mortality were significantly higher in the nighttime arrival group than in the daytime arrival group (adjusted odds ratio [aOR], 1.35; 95% confidence interval [CI], 1.09–1.68). In contrast, no significant difference was observed between the weekend/holiday arrival group and the weekday arrival group (aOR, 0.95; 95% CI, 0.79–1.13).</div></div><div><h3>Conclusions</h3><div>Nighttime hospital arrival was associated with higher odds of in-hospital mortality in pediatric patients with severe trauma but weekend/holiday arrival was not.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112946"},"PeriodicalIF":2.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716835","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}
Pub Date : 2025-12-04DOI: 10.1016/j.injury.2025.112932
Matthew J Wood , Talal Al-Jabri , Rayyan S. Mirdad , Yousef S Alqahtani , Rohit Rambani , Peter V Giannoudis
Periprosthetic fracture is a devastating complication of total hip arthroplasty that is associated with significant morbidity and mortality. Cement-in-cement revision of the femoral component is a technique that has been proposed as an efficient revision technique to treat femoral periprosthetic fractures where the femoral stem is loose, but the bone-cement interface is intact. By eliminating the need to remove the existing cement mantle, proposed advantages include shorter operative time, reduced blood loss, easy restoration of pre-fracture version and soft tissue tension, and eliminating the risk of iatrogenic damage from cement removal. However, the technique has not been widely popularised due to concerns over the fixation stability and risk of non-union from cement extrusion into the fracture site. Herein, an up-to-date review of the indications for, surgical technique of, and outcomes of cement-in-cement revision of the femoral component of a total hip arthroplasty for periprosthetic fracture is provided.
{"title":"Cement-in-cement revision of the cemented femoral stem as a treatment for periprosthetic fracture around a total hip arthroplasty: an up-to-date review","authors":"Matthew J Wood , Talal Al-Jabri , Rayyan S. Mirdad , Yousef S Alqahtani , Rohit Rambani , Peter V Giannoudis","doi":"10.1016/j.injury.2025.112932","DOIUrl":"10.1016/j.injury.2025.112932","url":null,"abstract":"<div><div>Periprosthetic fracture is a devastating complication of total hip arthroplasty that is associated with significant morbidity and mortality. Cement-in-cement revision of the femoral component is a technique that has been proposed as an efficient revision technique to treat femoral periprosthetic fractures where the femoral stem is loose, but the bone-cement interface is intact. By eliminating the need to remove the existing cement mantle, proposed advantages include shorter operative time, reduced blood loss, easy restoration of pre-fracture version and soft tissue tension, and eliminating the risk of iatrogenic damage from cement removal. However, the technique has not been widely popularised due to concerns over the fixation stability and risk of non-union from cement extrusion into the fracture site. Herein, an up-to-date review of the indications for, surgical technique of, and outcomes of cement-in-cement revision of the femoral component of a total hip arthroplasty for periprosthetic fracture is provided.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112932"},"PeriodicalIF":2.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829373","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}
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