Injury
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Venous thromboembolism (VTE) is a common and in some instances life-threatening complication following severe traumatic injury. Owing to a lack of high-quality evidence in VTE risk prediction and prevention in this cohort, major trauma patients receive variable VTE preventative care. The aim of this systematic review was to determine the reported rates of VTE in major trauma patients, and associated risk factors. ⋯ There exists significant variation in the reported rates of VTE in major trauma patients globally. Operative procedure, delays to prophylaxis and pelvic injury were the most consistently reported associated variables for DVT. Lower extremity injury followed by male sex and increased age were the most frequently reported associated variables for PE. Although studies indicate possible differences in risk factors for DVT and PE, heterogeneity in study characteristics and outcome reporting impedes any meaningful conclusions. Reconciliation of VTE rates in major trauma patients is necessary when comparing populations.
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The anatomical study of the modified medial approach for addressing fractures of the distal third of the humeral shaft aimed to elucidate the benefits of this method in providing optimal exposure for surgical intervention. ⋯ The modified medial approach, as revealed by anatomical studies, focuses on the fracture site with a straight skin incision aligned between the most prominent point of the medial epicondyle and the midpoint of the axilla, positioned one transverse finger from the radial side. Using the basilic vein as a reference, major vessels and nerves remain undisturbed, ensuring a safe operative zone. This technique allows for significant exposure of both the anterior and external humeral shaft fracture site and the ulnar side butterfly fragment while minimizing tissue damage and facilitating rapid recovery. The approach offers notable clinical value due to its reduced invasiveness and accelerated postoperative rehabilitation.
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The fractures in the condylar area are a challenge for every surgeon, for the treatment of which trapezoidal condylar plate is used in most cases. However, it is not possible to position the plate in the ideal osteosynthesis lines according to Meyer et al. in every clinical situation. In many cases, the fracture line is also not in the centre of the trapezoidal plate. ⋯ The results have shown that an inferior position of the fracture line leads to greater mobility of the fragments if the position of the osteosynthesis material is the same. With a deep fracture line, a more cranial positioning of the plate leads to better stabilisation. This study needs to be experimentally validated.
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Missed fractures are the most common radiologic error in clinical practice, and erroneous classification could lead to inappropriate treatment and unfavorable prognosis. Here, we developed a fully automated deep learning model to detect and classify femoral neck fractures using plain radiographs, and evaluated its utility for diagnostic assistance and physician training. ⋯ The model represents a valuable tool for physicians to better visualize fractures and improve training outcomes, indicating deep learning algorithms as a promising approach to improve clinical practice and medical education.
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The COVID-19 pandemic has affected many habits and social reactions. During the lifting of COVID-19 lockdown measures in the USA, there was a notable surge in firearm violence, which became known as "the reopening phenomenon". This study evaluated the impact of a similarly proposed phenomenon on individuals living in a center of Türkiye. ⋯ The incidents analyzed predominantly involved the use of pistols (n = 371, 96 %). Long-barreled pistols caused injury in only 16 (4.1 %) cases. Most injuries (n = 275, 71 %) were located in the lower extremity. The comparison of the pre-pandemic, Pandemic lockdown and Reopening periods did not reveal a significant difference in the rate of firearm violence (p = 0.266, x2 goodness of fit) CONCLUSION: We did not observe the reopening phenomena around the COVID-19 pandemic period in a center of Türkiye. However, firearm violence remains a significant societal issue for both Türkiye and the world.