Injury
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Randomized Controlled Trial
Effect of free distribution of safety equipment on usage among motorcycle-taxi drivers in Tanzania-A cluster randomised controlled trial.
Deaths due to road traffic injuries, particularly motorcycle crashes, have increased rapidly in many African nations and context-specific strategies to improve preventative behaviours are needed. Although adhering to conspicuity measures by wearing reflective safety vests is a highly effective crash prevention strategy and mandated by law among motorcycle-taxi drivers in some African countries, actual use is currently low. We aimed to test whether eliminating cost-barriers through the provision of free reflective, fluorescent motorcycle safety vests would lead to increased utilisation among a high-risk population of motorcycle-taxi drivers in Tanzania. ⋯ Although distribution of free reflective vests led to a statistically significant increase in vest usage, the absolute increase was modest. Additional strategies beyond removing economic barriers are important to augment adherence to road safety behaviours for injury prevention.
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Total elbow arthroplasty (TEA) is a viable treatment for elderly patients with distal humerus fracture who frequently present with low-grade open fractures. This purpose of this study was to evaluate the results of a protocol of serial irrigations and debridements (I&Ds) followed by primary TEA for the treatment of open intra-articular distal humerus fractures. ⋯ TEA has become a mainstream option for the treatment of distal humerus fractures which are on occasion open. There is hesitation in using arthroplasty in an open fracture setting due to a potential increased infection risk. The absence of any infectious complications and satisfactory functional outcomes observed in the current series indicates that TEA is a viable treatment modality for complex open fractures of the distal humerus.
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Crevasse accidents can lead to severe injuries and even death, but little is known about their epidemiology and mortality. ⋯ The clinical spectrum of injuries sustained by the 415 patients in this study ranged from benign to life-threatening. Death occurred in 11% of victims and seems to be determined primarily by the depth of the fall.
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Fractures of the olecranon are relatively common injuries in adults and are of great clinical importance. Classification systems have been developed as tools to assist surgeons in grouping different types of fractures, to facilitate communication and to standardise treatment, but none of the systems used today is universally accepted for olecranon fractures. ⋯ The results of this study indicate that the most commonly used classifications for olecranon fractures are associated with low reproducibility.
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Comparative Study
Interlocking screws placed with freehand technique and uni-planar image intensification: the "dip-stick" technique.
To report our experience with a novel alternative method of freehand interlocking of intramedullary nails. This method requires the use of only anterior-posterior image intensification and an intramedullary guide wire to verify screw placement. Our results are compared with historical results in the literature. ⋯ The surgical technique is simple, easy and reproducible. Mean time of surgery and radiation exposure was less than that in the literature. A comparative study should be performed.