J Trauma
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To predict the severity of nerve traction injury by skin biopsy with quantification of intraepidermal nerve fibers density (IENFD). ⋯ With the ability to classify the nerve traction injury into a mild, moderate, or severe injury, correlations can be made between skin biopsy with IENFD and the severity of nerve traction injury. However, the extent of nerve injury cannot be differentiated within group of moderate injury with the use of three different traction weights.
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Comparative Study
Application of electronic surveillance and global information system mapping to track the epidemiology of pediatric pedestrian injury.
To compare the epidemiology of pediatric pedestrian injury in Jacksonville, FL to national trends, to analyze geographic distribution of these injuries, and to analyze pedestrian injury severity trends over time. ⋯ Although Jacksonville is similar to national trends in terms of gender, hour, day, and location of pedestrian injury, it differs from previous reports in terms of seasonality and the high proportion of adolescents struck. The effect of enhanced education appears to have diminished injury severity, although comparison of GIS plots clearly demonstrates that effective control will require changing environmental factors. Moreover, this report mandates further investigation and prevention efforts specifically targeting adolescents in urban areas.
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To improve utilization of scarce surgical resources, we changed from a single tier trauma paging system (TPS) to a three tiered TPS at a tertiary pediatric trauma center. We investigated if patients were appropriately classified into the three levels of trauma team activation. ⋯ Our results suggest that a three tiered TPS more efficiently utilizes limited surgical resources without leading to major misclassifications.
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Current data on the association between surgeon and hospital volumes and patient outcomes after hip fracture surgery is inconclusive. We hypothesized that surgeons and hospitals with higher caseloads of hip fracture care have better outcomes as measured by decreased postoperative complications and mortality, shorter length of stay in the hospital, routine disposition of patients on discharge, and decreased cost of care. ⋯ This study provides evidence that surgeon volume, but not hospital volume, is associated with decreased mortality in the treatment of hip fractures. Both surgeon and hospital volume seem to be associated with nonfatal morbidity and length of stay.
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The surgical reduction of distal femoral fractures with minimally invasive plate osteosynthesis is difficult and the maintenance of the reduction can involve high exposures to radiation. We designed an effective fracture reduction method involving a percutaneous temporal wiring technique for the reduction of distal femoral fractures with oblique or spiral fracture components during surgery with minimally invasive plate osteosynthesis. Our method consistently reduced these fractures satisfactorily. The maintenance of reduction and plate fixation were easy with our method and the radiation exposure during the operation was reduced.