Injury
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Bicycle accidents account for the majority of traffic-related accidents in Sweden. Despite the widespread everyday use of bicycles, little is known about the fracture panorama resulting from bicycle accidents. This study analysed the fracture patterns of bicycle accidents in Sweden in regard to fracture type, sex, age, and type of bicycle. ⋯ The main finding is that bicyclists predominantly sustained fractures of the upper limb via low energy mechanisms. The fracture panorama differed by age, sex, and type of bicycle.
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Paediatric tibial shaft fractures are commonly treated nonoperatively and followed-up in the clinic setting. Loss of position has traditionally been managed with wedging of the cast or admission and manipulation in the operaing theatre. The authors present a technique to aid in the wedging of plasters for paediatric tibia and forearm fractures that reduces time requirement, hospital costs and emotional distress on the part of the patient and family.
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Retropubic hematomas are a common development in cases of pelvic ring trauma and post- operative repair of fractures to the anterior column of the pelvis. Early detection and diagnosis of such events using computed tomography angiography (CTA) are critical for successful intervention and patient recovery, especially when bleeding is a result of injury to the corona mortis (CM). The CM is the communication between the obturator vessels and the external iliac vessels typically via an accessory obturator vessel. This communication of vessels is identified as a major hindrance in anterior approaches to the pelvis. ⋯ The inconsistencies presented in angiogram studies compared to cadaver studies suggest that angiograms should be limited to a diagnostic and therapeutic role of identifying the CM or injury thereof in the retropubic region. However, measurements concerning safe zones should rather be extracted from cadaveric studies.
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Geriatricians are increasingly involved in the treatment of fragility fractures. In Germany, hospitals that meet specific standards for orthogeriatric co-management (OGCM) are additionally certified as 'geriatric trauma centers.' One responsibility of OGCM is the appropriate management of osteoporosis through medication. We aimed to analyse the association between prescription frequencies of anti-osteoporotic drugs in hospitals with certified OGCM, those with non-certified OGCM, and those with no OGCM at all. ⋯ OGCM, especially when coupled with certification as a 'Geriatric Trauma Center,' is associated with higher prescription rates of specific anti-osteoporotic drugs and vitamin D after fragility fractures in Germany.
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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.