Injury
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Road traffic injuries (RTIs) pose a significant health burden with 1.35 million individuals dying on the world's roads annually. Nearly a decade ago, based on agreed road safety indicators, global commitments were encouraged to dramatically reduce this burden as part of the United Nation's Decade of Action for Road Safety 2011-2020. ⋯ Despite global efforts during the past decade, road traffic deaths remain disproportionally high in LMICs and African countries as shown by global reports, and progress in achieving global road safety indicators is slow. Countries need to greatly accelerate the implementation of interventions proven to reduce RTIs in order to meet the goals of the second Decade of Action for Road Safety.
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Review Meta Analysis
Comparison of different segments in the fixation of thoracolumbar fractures: a Bayesian network meta-analysis.
Posterior internal fixation (PIF) is commonly used in the treatment of thoracolumbar fracture (TLF), but there is still no standard for the number of fixed segments. The objective of this meta-analysis was to evaluate the efficacy and safety of short segment (SS), intermediate segment (IS) and long segment (LS) in the fixation of TLF. ⋯ IS may be the most desirable treatment option for TLF in reducing SCA, implant failure rate, VAS, and improving AVHR. However, more randomized controlled trials are needed to verify these results.
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The impact of concurrent upper limb and fragility hip fractures has not been well defined. A greater understanding of this can guide decision making in the early peri-operative period and subsequent rehabilitation of such patients. ⋯ Concurrent fragility hip and upper limb fractures are associated with increased length of hospital stay. We recommend early, aggressive, individualised rehabilitation to help improve outcomes and early hospital discharge in this highly vulnerable patient group.
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There remain gaps in knowledge regarding the pathophysiology, initial diagnosis, treatment, and outcome of acute compartment syndrome (ACS). Most reported clinical outcomes are from smaller studies of heterogeneous patients. For a disease associated with a financial burden to society that represents billions of dollars worldwide the literature does not currently establish baseline diagnostic parameters and risk factors that may serve to predict treatment and outcomes. ⋯ This big data approach shows us that ACS is primarily linked to the extent of soft tissue damage. However, newfound effect of some comorbidities like cirrhosis and hypertension on the risk of ACS imply other mechanisms.