Injury
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The influence of wound age on the risk of infection in simple lacerations repaired in the emergency department (ED) has not been well studied. It has traditionally been taught that there is a "golden period" beyond which lacerations are at higher risk of infection and therefore should not be closed primarily. The proposed cutoff for this golden period has been highly variable (3-24h in surgical textbooks). Our objective is to answer the following research question: are wounds closed via primary repair after the golden period at increased risk for infection? ⋯ The existing evidence does not support the existence of a golden period nor does it support the role of wound age on infection rate in simple lacerations.
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The use of an intramedullary fibular allograft together with a locking plate fixation has been recently described in biomechanical studies to provide additional medial support and prevent varus malalignment for displaced proximal humeral fractures with promising results. The aim of this study was to evaluate the clinical and radiographic outcome of a locking plate with fibular allograft augmentation in unstable humeral fractures. ⋯ Locking plate with fibular graft augmentation is a safe and promising technique to support the humeral head and maintain reduction in the proximal humeral fracture with medial comminution.
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Comparative Study
Mental disorder as a risk factor for dog bites and post-bite cellulitis.
Patients with mental disorders are at an increased risk for sustaining traumatic injury. No study has evaluated the association between mental disorders and the injury of dog bite. We conducted case-control studies to investigate whether people with mental disorders are at elevated risks of dog bite and post-bite cellulitis. ⋯ Individuals with mental disorders are likely at an elevated risk for serious dog bites and post-bite cellulitis.
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In an attempt to explore new tools for constructing a model of blast injuries to the human mandible, a finite element method was used. This model allowed us to perform dynamic simulations and analyse the injury processes and severity of trauma to the human mandible from an explosion striking at the middle mandibular angle. ⋯ The finite element model was able to dynamically simulate the blast-initiated trauma processes to a human mandible, which allowed for investigation of the severity of damage to the mandible under different injury conditions. This model and the simulation method are conducive for applications in basic studies and clinical investigations of blast-initiated injury mechanisms of bone tissues.
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Review Multicenter Study
Traumatic brain injury in older adults: characteristics, causes and consequences.
Traumatic brain injury is of particular concern in the older population. We aimed to examine the trends in hospitalisations, causes and consequences of TBI in older adults in New South Wales, Australia. ⋯ The rapid increase in hospitalised TBI is being predominantly driven by falls in the oldest old and the greatest increase predominantly in intracranial haemorrhages, highlighting the need for future research to quantify the risk versus benefit of anticoagulant therapies.