J Trauma
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The original Trauma and Injury Severity Score (TRISS) methodology from the Major Trauma Outcome Study (MTOS) is the most widely used outcome prediction model. The coefficients from the MTOS cohorts are still used in the Japan Trauma Data Bank for evaluating the quality of patient care. The purposes are to determine whether the database of this institution is well matched to the MTOS study and whether the original TRISS coefficients are accurate predictors of the patient outcome in Japan. ⋯ The trauma populations in this study differed significantly from the MTOS. The Modified TRISS coefficients should be adapted for outcome assessment based on the location of the injured population. This is the first report of an M-study from Japan to be published in the English literature.
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Fractures of the talar neck are relatively uncommon. The reported rates of avascular necrosis in Hawkins type II fractures vary from 34% to 50%. Various strategies have been adapted to prevent the occurrence of avascular necrosis. ⋯ The use of a vascularized cuboid pedicle bone graft and combined internal and external fixation can effectively prevent avascular necrosis of the talus in preliminary study. Further randomized control research is necessary to clarify the effectiveness of this technique.
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Our goal was to analyze whether radiographic fracture pattern correlates with mortality of patients with lateral compression type 1 (LC1) fractures. ⋯ Sacral fracture pattern does not seem to be predictive of mortality for patients with LC1 pelvic fractures The presence of associated injuries seems to be the key driver of mortality.
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Specific information about the supervision of young children with injuries related to falls is limited. In this study, we describe the supervision and physical environment of falls resulting in medical care in the emergency department. ⋯ Many children were supervised at the time of their fall. Most caretakers had visual contact, and up to a third were touching or within reach of the child. The strategies used in these apparently low-risk situations were insufficient to prevent the falls we report.
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The challenge of closing extremity fasciotomy wounds is well known to every trauma and orthopedic surgeon. We developed a new, easy, and inexpensive dermatotraction technique based on the simple use of Ty-Raps and report on the first pilot study using this novel technique for the closure of 23 extremity fasciotomy wounds. The Ty-Rap system consists of several combinations of two Ty-Raps and four surgical staples. ⋯ We regard the use of Ty-Raps a good alternative for the current closing techniques of extremity fasciotomy wounds. We value its low cost, general availability, effectiveness, and the fact that, in this pilot study, both the application and the tightening of the Ty-Raps were well tolerated by our patients with a minimal need for secondary procedures. Knowledge of this technique is a useful adjunct to the existing surgical array for every trauma and orthopedic surgeon for the closure of extremity fasciotomy wounds, especially in austere or military environments.