Introduction.
Introduction: Fractured scapula is rare because the scapula is mobile and well protected. We report the first prospective study in the literature of scapular fractures caused by
Background /Methods: Abbreviated Injury Scale based systems; the ISS, NISS, and AISmax, are used to assess trauma patients. The merits of each in predicting outcome are controversial. A large prospective database was used to assess their predictive capacity using receiver operator characteristic curves. Results: 13,301 adult patients met the inclusion criteria. All systems were significant outcome predictors for sepsis, multiple organ failure (MOF), length of hospital stay, length of ICU admission and mortality (p 0.0001). NISS was a significantly better predictor than the ISS for mortality (p 0.0001). NISS was equivalent to the AISmax for mortality prediction and superior in patients with orthopaedic injuries. NISS was significantly better for sepsis, MOF, ICU stay and total hospital stay (p 0.0001). Analysis of the ROC curves revealed that the traditional ISS cut-offs for severity of 16, 25 and 50 should be increased to 20, 30 and 55 to provide patients with equivalent outcome. Conclusions: NISS is superior or equivalent to the ISS and AISmax for prediction of all investigated outcomes in a population of
Background: We aimed to study the relationship between the number of fractured scapular regions, and the severity and distribution of associated injuries in
Cervical extrication collars are frequently used in pre hospital stabilization and in the definitive treatment for lesions of the cervical spine. The control of extensionflexion, lateral bending, and rotation given to individual segments is variable with different designs.
There is evidence that fracture healing is delayed in severely injured patients. We recently demonstrated that a
Background. Thoracolumbar fractures are the most common spinal injuries resulting from
Aim. The knee radiograph is a commonly requested investigation as the knee joint is commonly injured. Each radiograph exposes 0.01mSv of radiation to the patient that is equivalent to 1.5 days of natural background radiation. Also, each knee radiograph costs approximately £37.16 to produce. The aim of the clinical audit was to use the Pittsburgh knee rules to attempt to reduce the number of knee radiographs taken in patients with acute knee injuries and hence reduce the dose of ionising radiation the patient receives. Method. A retrospective audit was undertaken. 149 knee requests and radiographs taken during October 2016 were evaluated. Each knee radiograph request including patient history and clinical examination was graded against the Pittsburgh knee rules to give a qualifying score. The Pittsburgh knee rules assigns 1 point for each of the following;
Cryotherapy is often applied after injuries of synovial joints. Although positive clinical effects on periarticular swelling and pain are well known, the effects on molecular processes of cartilage and synovial cells remained largely unknown so far. Therefore, the hypothesis was tested that hypothermia alleviates the synovial reaction and prevents chondrocyte death as well as cartilage destructive processes after
Introduction: Road side accidents resulting in polytrauma with an associated fracture of femur is a common pattern of injury in asian countries. We hypothesised that the use of unreamed nailing in the management of such fractures has better outcome than reamed nailing. Material and Methods: We retrospectively reviewed 116 cases of polytrauma with associated fracture of shaft of femur admitted in our tertiary teaching hospital in North India bewteen Jan 1996 to Dec 2001. The patients were initially resuscitated according to the advanced trauma life support protocol. They were randomally managed by interlocking nail using reamed (n=48) and unreamed (n=68) technique after being haemodynamically stabilized. Five intraoperative parameters were recorded – the surgical time, fluoroscopy time, the intraoperative blood loss, intraoperative oxygen saturation, and any intraoperative complications. The patients were assessed postoperatively for ninety six hours for features of adult respiratory distress syndrome. All patients were clinically and radiologically assessed at 6 weekly intervals till union. The follow-up reassessments were performed by a single surgeon (AG). Results: There were 80 males, 30 females (6 were bilateral), with an average age of 26 years (range 19 to 64 years). The fractures were closed in 74 and open in 42 (Gustillo Grade 1;n=28, Grade 2;n=9, Grade 3;n=5). 48 were managed by reamed interlock nailing (Group 1) and 68 by unreamed interlock nailing (Group 2). 58 patients had an associated
Rib fractures (RF) represent the most common bone fracture after
Introduction:. South Africa has a very sports orientated population and a high
Guidelines for cervical trauma x-rays highlight the necessity for visualization of the C7-T1 junction. However, despite 15% of thoracolumbar fractures involving the T12 vertebra, less emphasis has been placed on ensuring the thoracolumbar junction or T12 vertebra is included on lumbar trauma radiographs. This may be due to an assumption that the lower thoracic spine will routinely be seen on lumbar x-rays. We aimed to determine the proportion of lumbar trauma x-rays that allowed adequate visualisation for fracture diagnosis. We retrospectively reviewed all lumbar spine radiographs for patients presenting with
The early diagnosis of the suprascapular nerve (SSN) entrapment in overhead athletes with simultaneous shoulder injuries and its arthroscopic release plays an important role for their appropriate treatment and recovery. SSN release at suprascapular and spinoglenoid notches, seems very helpful for increasing their performance. 21 Elite overhead athletes were treated from Jan 2005–May 2009. From 16 to 34 years old, mean 26 years, 4 Javelin throwers (Olympic and National level thrower), 4 Weightlifters (International level), 8 Volleyball Players, 3 Kick Boxer, 2 Water Polo Players. Extreme ROM of arm creates large torques about the shoulder cycle of repetitive microtrauma to the SSN, Direct trauma: fracture, dislocation,
The conflict in Iraq has evolved from a conventional war in April 2003 to a guerrilla-based insurgency. We investigated whether this change altered the pattern of wounding and types of injuries seen in casualties presenting to a military field hospital. From January 2006 – October 2006, data was collected on all casualties who presented to the sole British field hospital in the region following injury from hostile action (HA). 86 casualties presented with injuries from hostile action (HA). 3 subsequently died of wounds (DOW – 3.5%). 46 (53.5%) casualties had their initial surgery performed by British military surgeons. 20 casualties (23.2%) sustained gunshot wounds, 63 (73.3%) suffered injuries from fragmentation weapons and 3 (3.5%) casualties sustained injury from
Traumatic disruption of the pelvic ring has a high risk of mortality. These injuries are predominantly due to high-energy,
Our aim was to investigate the incidence and outcome of chest injuries after
Study objective: To validate the Ottawa Ankle Rules (OAR) to predict significant fractures in a Danish clinical setting. Methods: We designed an interventional clinical study in the emergency department, Kolding Hospital. The intervention and control groups consisted of all patients presenting with a
Background: Neutrophil (PMN) infiltration of the lung is characteristic of ARDS. Interleukin-8 (IL-8) plays a central role in the recruitment of PMN to the lung and their subsequent activation. This study examines PMN migratory activity in response to IL-8, over the first 24 hours of admissions following major trauma. Methodology: Study Population: Adult
Introduction Open calcaneal fractures are high-energy compression injuries that commonly result in dismal outcomes, despite appropriate care. Fracture pattern associated with these compound injuries have never been documented in detail. Plain radiographic studies and CT are imaging modalities commonly utilized to assess the fracture patterns. Methods The roentgenographic studies of thirty-nine consectutive compound fractures treated at our University Hospital were retrospectively reviewed to evaluate fracture subtypes and incidence. Hindfoot roentgenograms were performed in all individuals; more than three-fourths of the fractures were also assessed with CT. Results A vast array of fracture patterns was noted with variable incidence. Over 90% were intra-articular fractures. Eighty-seven percent resulted from