J Trauma
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In previous studies, mild hypothermia (34 degrees C) during uncontrolled hemorrhagic shock (HS) increased survival. Hypothermia also increased mean arterial pressure (MAP), which may have contributed to its beneficial effect. We hypothesized that hypothermia would improve survival in a pressure-controlled HS model and that prolonged hypothermia would further improve survival. ⋯ Brief hypothermia had physiologic benefit and a trend toward improved survival. Prolonged mild hypothermia significantly increased survival after severe HS even with controlled MAP. Extending the duration of hypothermia beyond the acute phases of shock and resuscitation may be needed to ensure improved outcome after prolonged HS.
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This study examined crash severity and injury patterns between helmeted and unhelmeted adolescent motorcycle riders. ⋯ Crashes involving unhelmeted riders were not more severe but more frequently involved face and head injuries than crashes involving helmeted riders.
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Falls are a well-known source of morbidity and mortality in the elderly. Fall-related injury severity in this group, however, is less clear, particularly as it relates to type of fall. Our purpose is to explore the relationship between mechanism of fall and both pattern and severity of injury in geriatric patients as compared with a younger cohort. ⋯ Falls among the elderly, including same-level falls, are a common source of both high injury severity and mortality, much more so than in younger patients. A different pattern of injury between older and younger fall patients also exists.
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Reamed nailing gives better fracture healing than unreamed nailing in operative treatment of fractures and nonunions. This study investigates the effect of isolated reaming debris on fracture healing in an animal model. ⋯ This study shows that isolated reaming debris supports callus building as much as conventional bone grafting, which might explain why fractures heal with more callus formation when treated with reamed nailing compared with unreamed nailing.
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Little is known about the impact of major in-hospital complications on functional outcome in the short- and long-term period after serious injury. The Trauma Recovery Project (TRP) is a large, prospective, epidemiologic study designed to examine multiple outcomes after major trauma, including quality of life and functional limitation. Patient outcomes were assessed at discharge and at 6, 12, and 18 months after discharge. The specific objectives of the present report are to examine the effect of postinjury complications on functional outcomes at discharge and at 6-, 12-, and 18-month follow-up time points in the TRP population. ⋯ These results provide new evidence that major in-hospital complications may have an important impact on functional outcomes after major trauma.