Injury
-
To assess the association between Injury Severity Score (ISS) and subsequent risk of early retirement. ⋯ The risk of early retirement is 2.6 times higher in severely injured patients (ISS 16-75) than the risk in low to moderately injured patients (ISS 1-15) and they have a high absolute 5-year risk as well. Early, targeted interventions to assist with return to work might be able to reduce this risk.
-
Volar locking plates are an increasingly popular treatment for distal radius fractures. We reviewed complications observed after volar locking plate fixation in a busy teaching hospital. The purpose of the study was to assess whether complication rates after volar locking plate use in general, routine trauma practice were higher than published literature from expert users. ⋯ This study provides information which can be used to counsel patients about risks, including those of tendon and metalwork problems. This allows patients to make an informed decision. Surgeons must have specific strategies to avoid these complications and remain vigilant so that these can be identified and managed early.
-
To report the surgical anatomy of the perforator arteries at the lower leg, analyse clinical outcomes in previous studies, and forward methodological recommendations for future studies of post-traumatic perforator flap reconstructions. ⋯ Fasciocutaneous perforator flaps seem to have high survival rates and represent a feasible approach to post-traumatic reconstructions, especially in low-resource settings. A template for data gathering is recommended for higher accuracy in future comparative studies, and for scientific analysis of success and risk factors. New imaging techniques indicate a promising potential of micro-circular angiogenesis during the first two weeks after flap transpose.
-
Trauma registries are used worldwide to coordinate patient care as well as provide data for audit and research purposes. National registries collect this data, producing research opportunities, outcome standards and a means by which to benchmark trauma centre performance. The Trauma Audit and Research Network (TARN) is the UK national registry, with data upload being mandatory from all major trauma centres (MTCs), a process which is manual and time and resource intensive. ⋯ The wide range of software options and their lack of integration with the hospital electronic patient records results in the duplication of data as well as requiring time and resources. This may also be due to the difference in data required for coordinating on-going patient care and that required for upload to the TARN. Whilst some of these programmes do have the capabilities for automatic data upload, further efforts must be made to provide a cohesive system that provides the required integration and customisability in order to improve efficiency and ultimately trauma care.
-
Published studies investigating the role of driver sleepiness in road crashes in low and middle-income countries have largely focused on heavy vehicles. We investigated the contribution of driver sleepiness to four-wheel motor vehicle crashes in Fiji, a middle-income Pacific Island country. ⋯ Driver sleepiness is an important contributor to injury-involved four-wheel motor vehicle crashes in Fiji, highlighting the need for evidence-based strategies to address this poorly characterised risk factor for car crashes in less resourced settings.