Injury
-
Randomized Controlled Trial
The impact of hemocoagulase for improvement of coagulation and reduction of bleeding in fracture-related hip hemiarthroplasty geriatric patients: A prospective, single-blinded, randomized, controlled study.
Uncontrolled bleeding is associated with poor outcomes and mortality in geriatric patients undergoing hemiarthroplasty. Hemocoagulase agkistrodon is a hemocoagulative, anti-hemorrhagic enzyme complex from Deinagkistrodon acutus snake venom. This study aimed to investigate the efficacy of hemocoagulase agkistrodon on coagulation and bleeding outcomes in fracture-related hemiarthroplasty. ⋯ Hemocoagulase reduced blood loss and transfusion in fracture-related hip hemiarthroplasty without increasing short-term adverse event rates. In geriatric populations, hemocoagulase could be used for limiting bleeding and related complications.
-
The Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) find increasingly widespread use to assess trauma burden and to perform interhospital benchmarking through trauma registries. Since 2015, public resource allocation in Switzerland shall even be derived from such data. As every trauma centre is responsible for its own coding and data input, this study aims at evaluating interobserver reliability of AIS and ISS coding. ⋯ Injury severity all too often is neither identified correctly nor consistently when using the AIS. This leads to wrong identification of severely injured patients using the ISS. Improving consistency of coding through centralisation is recommended before scores based on the AIS are to be used for interhospital benchmarking and resource allocation in the treatment of severely injured patients.
-
Injuries of the hand can cause significant functional impairment, diminished quality of life and delayed return to work. However, the incidence and functional outcome of hand injuries in polytrauma patients is currently unknown. The aim of this study was to determine the incidence, distribution and functional outcome of fractures and dislocation of the hand in polytrauma patients. ⋯ The incidence of hand injuries in polytrauma patients is 3.5%, which is relatively low compared to a general trauma population. Metacarpal and carpal bones were most frequently affected. The functional extremity specific outcome scores are highly influenced by concomitant injuries (upper extremity injuries, neurological injuries and higher ISS).
-
Observational Study
Patient reported health related quality of life early outcomes at 12 months after surgically managed tibial plafond fracture.
Tibial plafond fractures represent a small but complex subset of fractures of the lower limb. The aim of this study was to describe the health related quality of life, pain and return to work outcomes 12 months following surgically managed tibial plafond fracture. ⋯ The presence of persistent pain, loss of physical health and a low return to work rate highlights the profound impact of tibial plafond fractures on patients' lives. Although this study looked at the early 12 month results, it is expected these outcomes will continue to improve over time. Further studies, with larger patient numbers, must focus on how to improve not only the operative management of these fractures, but also patient's mental and overall physical health in the long term. Improved management techniques and early identification of injury patterns known to perform poorly may help long-term outcomes.
-
Comparative Study
Does intra-articular load distribution change after lateral malleolar fractures? An in vivo study comparing operative and non-operative treatment.
The impact of isolated malleolar fractures on the intra-articular load distribution within the ankle joint has been studied in several biomechanical cadaver studies during the last decades. Recently, computed tomography osteoabsorptiometry (CT-OAM) has been proposed as a valuable tool to assess intra-articular joint load distribution in vivo. The purpose of this retrospective matched pair analysis was to apply CT-OAM to evaluate in vivo changes of talar load distribution after lateral malleolar fractures in patients treated with open anatomic reduction and internal fixation (ORIF) compared to patients treated non-operatively. ⋯ Level III, retrospective cohort study.