Articles

Knee injuries in severe trauma patients: a trauma registry study in 3.458 patients

Purpose of the presented study is to answer the following questions: Are knee injuries associated with trauma mechanisms or concomitant injuries? Do injuries of the knee region aggravate treatment costs or pro...

Authors: Hagen Andruszkow, Emmanouil Liodakis, Rolf Lefering, Christian Krettek, Frank Hildebrand and Carl Haasper

Implant removal of osteosynthesis: the Dutch practice. Results of a survey

The aim of this survey study was to evaluate the current opinion and practice of trauma and orthopaedic surgeons in the Netherlands in the removal of implants after fracture healing.

Authors: Dagmar Vos, Beate Hanson and Michiel Verhofstad

No difference in the long term final functional outcome after nailing or cast bracing of high energy displaced tibial shaft fractures

Cast bracing (CB) has been a well established method of treating tibial shaft fractures. Majority of the recent literature on treatment of tibial shaft fractures have upheld intramedullary nailing (IMN) as the...

Authors: Vineet Batta, Amitabh J Dwyer, Aashish Gulati, Jeevan Prakash, Maharaj K Mam and Bobby John

The song remains the same although the instruments are changing: complications following selective non-operative management of blunt spleen trauma: a retrospective review of patients at a level I trauma centre from 1996 to 2007

Despite a widespread shift to selective non-operative management (SNOM) for blunt splenic trauma, there remains uncertainty regarding the role of adjuncts such as interventional radiological techniques, the ne...

Authors: Aisling A Clancy, Corina Tiruta, Dianne Ashman, Chad G Ball and Andrew W Kirkpatrick

Association of changes in the use of board-certified critical care intensivists with mortality outcomes for trauma patients at a well-established level I urban trauma center

An intensivist-directed Intensive Care Unit is a closed-model unit in which a physician formally trained in critical care plays a leadership role in patient management. In the last decade, there has been a mov...

Authors: Diana Petitti, Vicki Bennett and Charles Kung Chao Hu

Clinical profiles and risk factors for outcomes in older patients with cervical and trochanteric hip fracture: similarities and differences

Data on clinical characteristics and outcomes in regard to hip fracture (HF) type are controversial. This study aimed to evaluate whether clinical and laboratory predictors of poorer outcomes differ by HF type.

Authors: Alexander A Fisher, Wichat Srikusalanukul, Michael W Davis and Paul N Smith

Injury characteristics and outcome of road traffic crash victims at Bugando Medical Centre in Northwestern Tanzania

Road traffic crash is of growing public health importance worldwide contributing significantly to the global disease burden. There is paucity of published data on road traffic crashes in our local environment....

Authors: Phillipo L Chalya, Joseph B Mabula, Ramesh M Dass, Nkinda Mbelenge, Isdori H Ngayomela, Alphonce B Chandika and Japhet M Gilyoma

Trauma center accessibility for road traffic injuries in Hanoi, Vietnam

Rapid economic growth in Vietnam over the last decade has led to an increased frequency of road traffic injury (RTI), which now represents one of the leading causes of death in the nation. Various efforts towa...

Authors: Takashi Nagata, Ayako Takamori, Yoshinari Kimura, Akio Kimura, Makoto Hashizume and Shinji Nakahara

International benchmarking of tertiary trauma centers: productivity and throughput approach

Care process in tertiary trauma centers consists of a chain of care phases in different departments from the emergency department (ED) to post-operative rehabilitation. The historical evolution of healthcare s...

Authors: Antti Peltokorpi, Lauri Handolin, Matthias Frank, Paulus Torkki, Gerrit Matthes, Axel Ekkernkamp and Eero Hirvensalo

Patients Referred to a Norwegian Trauma Centre: effect of transfer distance on injury patterns, use of resources and outcomes

Triage and interhospital transfer are central to trauma systems. Few studies have addressed transferred trauma patients. This study investigated transfers of variable distances to OUH (Oslo University Hospital...

Authors: Thomas Kristiansen, Hans M Lossius, Kjetil Søreide, Petter A Steen, Christine Gaarder and Pål A Næss

HIV seroprevalence and its effect on outcome of moderate to severe burn injuries: A Ugandan experience

HIV infection in a patient with burn injuries complicates the care of both the patient and the treating burn team. This study was conducted to establish the prevalence of HIV among burn patients in our setting...

Authors: Phillipo L Chalya, Robert Ssentongo and Ignatius Kakande

Etiological spectrum, injury characteristics and treatment outcome of maxillofacial injuries in a Tanzanian teaching hospital

Maxillofacial injuries pose a therapeutic challenges to trauma, maxillofacial and plastic surgeons practicing in developing countries. This study was carried out to determine the etiology, injury characteristi...

Authors: Phillipo L Chalya, Mabula Mchembe, Joseph B Mabula, Emanuel S Kanumba and Japhet M Gilyoma

Intraoperative angioembolization in the management of pelvic-fracture related hemodynamic instability

This case series report discusses patients presenting with hemorrhage and hemodymanic compromise due to severe pelvic fractures and undergoing intraoperative angioembolization (IAE) with other resuscitative pr...

Authors: Robert A Cherry, David C Goodspeed, Frank C Lynch, John Delgado and Spence J Reid

Improving prehospital trauma management for skiers and snowboarders - need for on-slope triage?

Injuries from skiing and snowboarding became a major challenge for emergency care providers in Switzerland. In the alpine setting, early assessment of injury and health status is essential for the initiation o...

Authors: Rebecca M Hasler, Uli Schmucker, Dimitrios S Evangelopoulos, Ron E Hirschberg, Heinz Zimmermann and Aristomenis K Exadaktylos

Protective and risk factors in amateur equestrians and description of injury patterns: A retrospective data analysis and a case - control survey

In Switzerland there are about 150,000 equestrians. Horse related injuries, including head and spinal injuries, are frequently treated at our level I trauma centre.

Authors: Rebecca M Hasler, Lena Gyssler, Lorin Benneker, Luca Martinolli, Andreas Schötzau, Heinz Zimmermann and Aristomenis K Exadaktylos

Treatment course and outcomes following drug and alcohol-related traumatic injuries

Alcohol and drug use is known to be a major factor affecting the incidence of traumatic injury. However, the ways in which immediate pre-injury substance use affects patients' clinical care and outcomes remain...

Authors: Matthew C Cowperthwaite and Mark G Burnett

Patients with pelvic fractures due to falls: A paradigm that contributed to autopsy-based audit of trauma in Greece

Evaluation of the pelvic fractures (PFx) population in auditing effective components of trauma care is the subject of this study.

Authors: Iordanis N Papadopoulos, Nikolaos K Kanakaris, Stefanos Bonovas, George Konstantoudakis, Konstantina Petropoulou, Spyridon Christodoulou, Olympia Kotsilianou and Christos Leukidis

The efficacy of four-slice helical CT in evaluating pancreatic trauma: a single institution experience

To assess the efficacy of computed tomography (CT) in evaluating patients with pancreatic trauma.

Authors: Wei-Jing Lee, Ning-Ping Foo, Hung-Jung Lin, Yen-Chang Huang and Kuo-Tai Chen

Antithrombotic therapy and outcomes of cervical arterial dissection in the trauma patient: a case series

The use of antithrombotic therapy (anticoagulants and/or antiplatelets) in the setting of traumatic cervical arterial dissection (CAD) for the prevention of stroke remains controversial. This issue is further ...

Authors: Holly E Hinson, M JB Stallmeyer, Jon P Furuno, Karen L Yarbrough and John W Cole

Occult pneumothorax, revisited

Pneumothorax is a recognized cause of preventable death following chest wall trauma where a simple intervention can be life saving. In cases of trauma patients where cervical spine immobilization is mandatory,...

Authors: Hesham R Omar, Hany Abdelmalak, Devanand Mangar, Rania Rashad, Engy Helal and Enrico M Camporesi

Mind your hand during the energy crunch: Functional Outcome of Circular Saw Hand Injuries

Although injuries due to circular saws are very common all over the world, there is surprisingly little information available about their functional outcomes. As the socioeconomic impact of these injuries is i...

Authors: Matthias Frank, Juliane Hecht, Matthias Napp, Joern Lange, Rico Grossjohann, Dirk Stengel, Uli Schmucker, Axel Ekkernkamp and Peter Hinz

Editorial Commentary: Resource utilization and outcomes of intoxicated drivers: does evidence of alcohol-impaired driving affect road traffic crash injury outcomes?

Authors: Uli Schmucker

Resource utilization and outcomes of intoxicated drivers

The high risk behavior of intoxicated drivers, impaired reaction time, lack of seat belt use, and increased incidence of head injury raises questions of whether pre-hospital use of alcohol leads to a higher in...

Authors: Robert A Cherry, Pamela A Nichols, Theresa M Snavely, Lindsay J Camera and David T Mauger

Measuring attitudes, behaviours, and influences in inner city victims of interpersonal violence (VIVs) - a Swiss emergency room pilot study

Switzerland is confronted with the problem of interpersonal violence. Violence is in the increase and the potential for aggression seems to be rising. Observations by hospitals discern an appalling increase of...

Authors: Aristomenis K Exadaktylos, Anja Evangelisti, Fiorenzo Anghern, Ursula Keller, Kathrin Dopke, Annette Ringger, Victor Jeger, Heinz Zimmermann, Urs Laffer and Allan Guggenbühl

Psychometric properties of questionnaires evaluating health-related quality of life and functional status in polytrauma patients with lower extremity injury

Long term disability is common among polytrauma patients. However, as yet little information exists on how to adequately measure functional status and health-related quality of life following polytrauma.

Authors: Lian Jansen, Martijn PM Steultjens, Herman R Holtslag, Gert Kwakkel and Joost Dekker

Effects of acute substance use and pre-injury substance abuse on traumatic brain injury severity in adults admitted to a trauma centre

The aims of this study were to describe the occurrence of substance use at the time of injury and pre-injury substance abuse in patients with moderate-to-severe traumatic brain injury (TBI). Effects of acute s...

Authors: Nada Andelic, Tone Jerstad, Solrun Sigurdardottir, Anne-Kristine Schanke, Leiv Sandvik and Cecilie Roe

500 ml of blood loss does not decrease non-invasive tissue oxygen saturation (StO₂) as measured by near infrared spectroscopy - A hypothesis generating pilot study in healthy adult women

The goal when resuscitating trauma patients is to achieve adequate tissue perfusion. One parameter of tissue perfusion is tissue oxygen saturation (StO₂), as measured by near infrared spectroscopy. Using a commer...

Authors: Victor Jeger, Stephan M Jakob, Stefano Fontana, Martin Wolf, Heinz Zimmermann and Aristomenis K Exadaktylos

Trauma management incorporating focused assessment with computed tomography in trauma (FACTT) - potential effect on survival

Immediate recognition of life-threatening conditions and injuries is the key to trauma management. To date, the impact of focused assessment with computed tomography in trauma (FACTT) has not been formally ass...

Authors: Karl-Georg Kanz, April O Paul, Rolf Lefering, Mike V Kay, Uwe Kreimeier, Ulrich Linsenmaier, Wolf Mutschler and Stefan Huber-Wagner

A decade of experience with injuries to the gallbladder

Considering that injuries to the gallbladder are rare, the purpose of this study was to evaluate injury patterns, operative procedures and outcomes in patients with trauma to the gallbladder. A retrospective r...

Authors: Chad G Ball, Elijah Dixon, Andrew W Kirkpatrick, Francis R Sutherland, Kevin B Laupland and David V Feliciano

Real-world car-to-pedestrian-crash data from an urban centre

Pedestrians are at a high risk for crash and injury. This study aims at comparing data from real world crashes with data gathered from experimental settings.

Authors: Uli Schmucker, Melissa Beirau, Matthias Frank, Dirk Stengel, Gerrit Matthes, Axel Ekkernkamp and Julia Seifert

Complications related to deep venous thrombosis prophylaxis in trauma: a systematic review of the literature

Deep venous thrombosis prophylaxis is essential to the appropriate management of multisystem trauma patients. Without thromboprophylaxis, the rate of venous thrombosis and subsequent pulmonary embolism is subs...

Authors: Indraneel Datta, Chad G Ball, Lucas Rudmik, S Morad Hameed and John B Kortbeek

Autologous bone graft versus demineralized bone matrix in internal fixation of ununited long bones

Non-unions are severe complications in orthopaedic trauma care and occur in 10% of all fractures. The golden standard for the treatment of ununited fractures includes open reduction and internal fixation (ORIF...

Authors: Oliver Pieske, Alexandra Wittmann, Johannes Zaspel, Thomas Löffler, Bianka Rubenbauer, Heiko Trentzsch and Stefan Piltz

Free abdominal fluid without obvious solid organ injury upon CT imaging: an actual problem or simply over-diagnosing?

Whereas a non-operative approach for hemodynamically stable patients with free intraabdominal fluid in the presence of solid organ injury is generally accepted, the presence of free fluid in the abdomen withou...

Authors: Vanessa M Banz, Muhammad U Butt, Heinz Zimmermann, Victor Jeger and Aristomenis K Exadaktylos

Impact of falls on early mortality from severe traumatic brain injury

The causes of severe traumatic brain injury (TBI) vary by age and other demographic characteristics. Mortality after trauma is higher for elderly than younger patients. This study is based on 2779 patients wit...

Authors: Linda M Gerber, Quanhong Ni, Roger Härtl and Jamshid Ghajar

Hospital mortality among major trauma victims admitted on weekends and evenings: a cohort study

Patient care may be inconsistent during off hours. We sought to determine whether victims of major trauma admitted to hospital on evenings, nights, and weekends suffer increased mortality rates. All victims of...

Authors: Kevin B Laupland, Chad G Ball and Andrew W Kirkpatrick

A multicenter review of deep venous thrombosis prophylaxis practice patterns for blunt hepatic trauma

Non-operative management of blunt hepatic trauma is successful in the majority of hemodynamically stable patients. Due to the risk of recurrent hemorrhage, pharmacologic deep venous thrombosis (DVT) prophylaxi...

Authors: Indraneel Datta, Chad G Ball, Lucas R Rudmik, Damian Paton-Gay, Deepak Bhayana, Peter Salat, Colin Schieman, Dean F Smith, Mary vanWijngaarden-Stephens and John B Kortbeek

Advocating "spine damage control" as a safe and effective treatment modality for unstable thoracolumbar fractures in polytrauma patients: a hypothesis

The "ideal" timing and modality of fracture fixation for unstable thoracolumbar spine fractures in multiply injured patients remains controversial. The concept of "damage control orthopedics" (DCO), which has ...

Authors: Philip F Stahel, Michael A Flierl, Ernest E Moore, Wade R Smith, Kathryn M Beauchamp and Anthony Dwyer

Outcome after severe head injury: focal surgical lesions do not imply a better Glasgow Outcome Score than diffuse injuries at 3 months

Historically neurosurgeons have accepted head injured patients only in the presence of a mass lesion requiring surgical decompression. Underpinning this is an assumption that these patients have a better outco...

Authors: Paul Leach, Omar N Pathmanaban, Hiren C Patel, Julian Evans, Raphael Sacho, Richard Protheroe and Andrew T King

Severe traumatic injury during long duration spaceflight: Light years beyond ATLS

Traumatic injury strikes unexpectedly among the healthiest members of the human population, and has been an inevitable companion of exploration throughout history. In space flight beyond the Earth's orbit, NAS...

Authors: Andrew W Kirkpatrick, Chad G Ball, Mark Campbell, David R Williams, Scott E Parazynski, Kenneth L Mattox and Timothy J Broderick

Alcohol-positive multiple trauma patients with and without blood transfusion: an outcome analysis

Blood transfusion is a common therapy for multiple trauma patients, and is often performed soon after hospital admission. It is unclear whether the need for a blood transfusion in multiply injured patients pre...

Authors: Manuel F Struck, Thomas Schmidt, Ralph Stuttmann and Peter Hilbert

Ten years of major equestrian injury: are we addressing functional outcomes?

Horseback riding is considered more dangerous than motorcycle riding, skiing, automobile racing, football and rugby. The integral role of rehabilitation therapy in the recovery of patients who have sustained a...

Authors: Jill E Ball, Chad G Ball, Robert H Mulloy, Indraneel Datta and Andrew W Kirkpatrick

Cost-effectiveness of an integrated 'fast track' rehabilitation service for multi-trauma patients involving dedicated early rehabilitation intervention programs: design of a prospective, multi-centre, non-randomised clinical trial

In conventional multi-trauma care service (CTCS), patients are admitted to hospital via the accident & emergency room. After surgery they are transferred to the IC-unit followed by the general surgery ward. En...

Authors: Sevginur Kosar, Henk AM Seelen, Bena Hemmen, Silvia MAA Evers and Peter RG Brink

Strategic emergency department design: An approach to capacity planning in healthcare provision in overcrowded emergency rooms

Healthcare professionals and the public have increasing concerns about the ability of emergency departments to meet current demands. Increased demand for emergency services, mainly caused by a growing number o...

Authors: Aristomenis K Exadaktylos, Dimitrios S Evangelopoulos, Marcel Wullschleger, Leo Bürki and Heinz Zimmermann

A new approach and first steps to strengthen trauma management and road safety in North Vietnam

In Vietnam, the number of road traffic accidents increased dramatically which is a major threat for the national health system. Reliable data on the magnitude of traffic accidents as well as the current manage...

Authors: Uli Schmucker, Caspar Ottersbach, Matthias Frank, Luong Xuan Hien, Lajos Bogar, Axel Ekkernkamp, Dirk Stengel and Gerrit Matthes

Red blood cell transfusion within the first 24 hours of admission is associated with increased mortality in the pediatric trauma population: a retrospective cohort study

Allogeneic red blood cell transfusion is associated with increased morbidity and mortality in adult trauma patients. Although studies have suggested that the adoption of a more restrictive transfusion strategy...

Authors: Taylor J Stone, Paul J Riesenman and Anthony G Charles

Evaluation of the safety of high-frequency chest wall oscillation (HFCWO) therapy in blunt thoracic trauma patients

Airway clearance is frequently needed by patients suffering from blunt chest wall trauma. High Frequency Chest Wall Oscillation (HFCWO) has been shown to be effective in helping to clear secretions from the lu...

Authors: Casandra A Anderson, Cassandra A Palmer, Arthur L Ney, Brian Becker, Steven D Schaffel and Robert R Quickel

The BHU bicentric bipolar prosthesis in fracture neck femur in active elderly

55 BHU bicentric bipolar hemiarthroplasties were reviewed after a mean follow up of 4 years (range 1–5 years). Patients with displaced subcapital fractures were selected for operation on the basis of good mobi...

Authors: Anil K Rai, Rakesh Agarwal, Saurabh Singh and Ratnav Ratan

Outcomes of Ilizarov ring fixation in recalcitrant infected tibial non-unions – a prospective study

Infected non-union of long bones is a problem in the developing countries. Persistent infection, deformity, shortening, bone loss, joint stiffness and disability complicate the non-union. Secondary procedures ...

Authors: Thayur R Madhusudhan, Balasundaram Ramesh, KS Manjunath, Harshad M Shah, Dabir C Sundaresh and N Krishnappa

The profile of head injuries and traumatic brain injury deaths in Kashmir

This study was conducted on patients of head injury admitted through Accident & Emergency Department of Sher-i-Kashmir Institute of Medical Sciences during the year 2004 to determine the number of head injury ...

Authors: GH Yattoo and Amin Tabish

MRI efficacy in diagnosing internal lesions of the knee: a retrospective analysis

Many surgeons tend to believe that MRI is an accurate, non invasive diagnostic method, enough to lead to decisions for conservative treatment and save a patient from unnecessary arthroscopy. We conducted a ret...

Authors: Vassilios S Nikolaou, Efstathios Chronopoulos, Christianna Savvidou, Spyros Plessas, Peter Giannoudis, Nicolas Efstathopoulos and Georgios Papachristou