Injury
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Intra-articular and comminuted fractures of the calcaneus constitute a significant orthopedic challenge. Calcaneal fracture management should primarily aim to achieve good clinical and biomechanical outcomes, pain reduction, and normal function following treatment. ⋯ We observed no significant differences between the experimental group and the healthy control group in terms of cadence, gait velocity, or stride length. Patients in experimental group showed significantly shortened stance and single support phases in the treated limb in comparison with those in the intact limb; the remaining gait parameters were similar in the treated and intact limb. We observed no significant differences between the treated limbs in the patient group and the nondominant limbs in the control group in terms of any gait parameters. In the follow-up, the average pain value on the VAS scale was 2.3. The median Böhler angle changed from 5.5° preoperatively to 28.5° postoperatively, p < 0.001. The median Gissane's angle was 119° before surgery and 143° after surgery, p < 0.001.The use of the Ilizarov method in the treatment of calcaneal fractures helps achieve sufficient normalization of most gait parameters, with their values similar to those observed in healthy volunteers. After treatment of calcaneal fractures using the Ilizarov method, radiological parameters improved. The biomechanical outcomes of calcaneal fracture treatment with the Ilizarov method are good.
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Observational Study
Epidemiology and outcomes of severe injury patients related to suicide attempt or self-harm in Korea: Nationwide community-based study, 2016-2020.
Suicide is a major social issue in Korea. Suicide attempt or self-harm (SA/SH)-a risk factor for suicides-is in itself a major public health problem. Investigating vulnerable populations is the first step for designing an effective prevention program. This study aimed to investigate the epidemiology and outcomes of patients with severe injuries related to suicide attempts or self-harm (SA/SH) by age groups, using a nationwide database. ⋯ More than 20 % of EMS treated patients with severe injury were SA/SH-related, and the mortality was over 20 %. Although poisoning was the most common mechanism, the high proportions of jumping and hanging with high mortality, resulted in adolescents and the older adults groups having high mortality. Therefore, designing target-specific SA/SH prevention programs based on age, sex, and common SA/SH mechanisms are necessary.
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Work-related musculoskeletal (MSK) injuries pose significant challenges to workers' health, productivity, and healthcare systems. Increased working from home since the onset of the COVID-19 pandemic may have affected the incidence and prevalence of work-related MSK injuries. Despite workers' compensation systems providing valuable data, underreporting remains a concern, necessitating additional data sources such as hospital admissions to better understand the burden of MSK injuries. ⋯ The study observed a gradual decrease in the overall incidence rate of hospital admissions for cumulative work-related MSK injuries over the last decade. Despite expectations of disruptions, no significant deviations in MSK injury trends were observed following the onset of the COVID-19 pandemic in Victoria, Australia.
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The number of patients during disastrous conditions was high, and triage is essential. In chaotic circumstances, orthopedic surgeons can also struggle with patient selection, not only for surgical selection but also for the necessity of hospitalization. So, the performance of the Injury Severity Score, New Injury Severity Score, and Trauma and Injury Severity Score was compared in victims who were struck under the wreckage and had fractures due to the Kahramanmaras Earthquake. ⋯ All the trauma scores can assess expected length of hospital stay for patients with fractures; however, NISS shows better predicting performance. Additionally, the fracture location is not associated with the length of stay.
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Intraosseous (IO) access is a commonly used procedure in pediatric emergencies for establishingvascular access when alternative means, such as intravenous access, cannot be obtained. Likealternative routes, IO can be administered quickly and provides a route for medications, blood products,and fluids to be infused in emergency circumstances. While the use of IO is generally considered safewith minimal risks, potential complications can include compartment syndrome, infection, thrombosis, and fracture. ⋯ This review supports the rarity of fracture as a complication following the use of an IO needle in pediatric age group, emphasizing the need for additional research to elucidate the underlying risk factors associated with fracture in these cases. Additionally, it underscores the importance of conducting further pathological investigations to gain insight into bone histology that may be indicative of IO access and/or fracture occurrence.