J Trauma
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: The objective was to evaluate the newly developed Radiographic Union Score for Tibial fractures (RUST). Because there is no "gold standard," it was hypothesized that the RUST score would provide substantial improvements compared with previous scores presented in the literature. ⋯ : The RUST score exhibits substantial improvements in reliability from previously published scores and produces equally reproducible results among a variety of orthopedic specialties and experience levels. Because no "gold standards" currently exist against which RUST can be compared, this study provides only the initial step in the score's full validation for use in a clinical context.
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: The fluoroscopic imaging technique that has been used in the dorsal percutaneous screw fixation of scaphoid fracture was modified for more consistent central screw placement according to the different fracture locations. ⋯ : The fluoroscopic images should be individualized according to the fracture planes for more consistent and accurate central guide wire placement in the dorsal percutaneous screw fixation of scaphoid fracture.
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: Angiographic embolization (AE) is used to control hemorrhage in adult blunt liver, spleen, and kidney (ASO) injuries. Pediatric experience with AE for blunt ASO injuries is limited. We reviewed our use of AE to control bleeding pediatric blunt ASO injuries for efficacy and safety. ⋯ : AE is a safe and an effective technique for controlling hemorrhage from blunt ASO injuries in select pediatric patients.
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: We report microvascular free tissue transfers in pediatric patients in a retrospective series. ⋯ : In cases of severe tissue defects in pediatric patients, microvascular free flap reconstruction is a treatment of choice. A multicenter study for guidelines on preoperative assessment and antitrombotic therapy in pediatric microsurgery is warranted.
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: As the population continues to age, the number of patients undergoing traumatic injury while on antiplatelet or anticoagulation therapies is increasing. Mortality has been shown to increase in traumatic brain injury patients on warfarin therapy. Whether this increased mortality is seen in trauma patients without traumatic brain injury remains controversial. We investigated whether patients on antiplatelet and/or anticoagulation therapy were at increased risk of death from blunt traumatic injury in the absence of head injury. ⋯ : In the absence of traumatic brain injury, the use of preinjury antiplatelet and/or anticoagulation therapy does not significantly increase the risk of mortality in the trauma patient. As the number of active seniors rises, this patient population will continue to present to the trauma service. To the best of our knowledge, this study is one of the largest addressing this question, and the only study examining the addition of antiplatelet therapy.