Injury
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Resuscitative thoracotomy (RT) is a salvage procedure following traumatic cardiac arrest. We aim to evaluate RT trends and outcomes in adults with cardiac arrest following penetrating trauma to determine the effect on mortality in this population. Further, we aim to estimate the effect of hospital teaching status on the performance of resuscitative thoracotomies and mortality. ⋯ Despite up-trending rates, a resuscitative thoracotomy may not improve mortality in adults with penetrating, traumatic cardiac arrest. University teaching hospitals are nearly twice as likely to perform a RT than non-teaching hospitals, with no subsequent improvement in mortality.
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Tendon injury accounts for 30% of musculoskeletal diseases and often leads to disability, pain, healthcare cost, and lost productivity. Following injury to tendon, tendon healing proceeds via three overlapping healing processes. However, due to the structural defects of the tendon itself, the tendon healing process is characterized by the formation of excessive fibrotic scar tissue, and injured tendons rarely return to native tendons, which can easily contribute to tendon reinjury. ⋯ However, blockage TGF-β1 fails to effectively enhance tendon healing. A detailed understanding of real abilities of TGF-β1 involved in tendon healing can bring promising perspectives for therapeutic value that improve the tendon healing process. Thus, in this review, we describe recent efforts to identify and characterize the roles and mechanisms of TGF-β1 involved at each stage of the tendon healing and highlight potential roles of TGF-β1 leading to the fibrotic response to tendon injury.
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Fractures in children and adolescents are a public health issue. However, reliable epidemiological descriptions of the South American population must be improved. This study aims to present epidemiological data on fractures from a children's orthopedic hospital in one of the five largest cities in Latin America. ⋯ Level III - retrospective cohort study.
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To evaluate the clinical outcomes using the PRECICE magnetic limb lengthening intramedullary nail for the correction of lower limb length discrepancies (LLD) in adults with posttraumatic nonunion or malunion defects in a Latin American center. ⋯ The results of this study demonstrated that the PRECICE nail is an effective device for the management of posttraumatic LLD during the treatment of nonunion or malunion bone defects of femur and tibia, offering a reasonable quality of life, despite its postoperative complication risk.
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Vertically unstable pelvic injuries associated with sacroiliac disruption are challenging. Although percutaneous iliosacral fixation using two screws at S1 vertebral body has been shown beneficial, the use of two transiliac screws at S1 has been proposed to increase the fixation strength of the construct. In the herein study, the finite element method (FEM) was performed to analyse the biomechanical behaviour of five different constructions using iliosacral screws only, transiliac screws only, and combining an iliosacral and a transiliac screw. ⋯ In our FEM study, the construct using two transiliac screws in S1 is biomechanically superior for stabilizing the sacroiliac joint in vertically unstable pelvic ring injuries compared to the other configurations. Lateral displacement, posterior displacement, and von Mises stress were reduced with this construct. A good option can be the use of one iliosacral screw and one transiliac screw in S1.