Injury
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Due to the orientation of the sacroiliac joint (SIJ), as the symphysis widens in an open-book pelvic ring disruption, it should displace inferiorly. The purposes of this study were to reconfirm this inferior displacement and to evaluate the relative contributions of the pubic symphysis (PS), the sacrotuberous/sacrospinous ligament complex (STL/SSL) and the anterior sacroiliac ligament (ASIL) to pelvic ring stability in a rotationally unstable open-book injury. ⋯ The PS and ASIL are important in maintaining pelvic ring external rotational stability. However, the SSL/STL has little, if any, effect in this regard. Due to the orientation of the SIJ, external rotation of the hemipelvis, as in open-book injury, will show inferior vertical, as well as horizontal, displacement on the AP radiograph, despite the PSIL being intact.
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We evaluated whether the location of a ballistic femoral fracture helps predict the presence of arterial injury. We hypothesized that fractures located in the distal third of the femur are associated with a higher rate of arterial injury. ⋯ A fracture line in the distal third of the femur after ballistic injury is six times more likely to be associated with arterial injury and warrants careful evaluation. Our data show that fracture location can help alert clinicians to possible arterial injury after ballistic femoral fracture.
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To detect whether external factors (time of day, day of week, month and season, lunar phases) influence incidence and outcome of severely injured trauma patients. ⋯ There are clear differences in incidence but not in outcome of the patients due to external factors.
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Knowledge about the functional consequences of lower limb long bone fractures is helpful to inform patients, clinicians and employers about their recovery process and prognosis. This study aims to describe the epidemiology and health outcomes of femoral and tibial shaft fractures treated at two level I trauma centres, by comparing the differences between patients with delayed union or nonunion and patients with union. ⋯ Despite modern treatment, the patient-reported outcomes of lower limb long bone shaft fractures do not return to normal at one year. Patients with delayed union or nonunion can expect poorer outcomes.
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This study assessed the long-term outcome (>6 months, with a mean of 46 months after injury) of the conservatively treated radial head fracture type 1 of the Broberg-Morrey (B-M) modification of the Mason classification. The main aim of this study is to assess the limitations in ADL activities on long term following a conservative treatment for B-M 1 radial head fractures. ⋯ It appears that a B-M type 1 radial head fracture is not always accompanied with regaining full function on long term. To what extent these observed limitations influence patient behaviour and how treatment modalities influence these limitations should be the base of future prospective research.