J Trauma
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Multicenter Study Comparative Study
Volar locking plates versus K-wire fixation of dorsally displaced distal radius fractures--a functional outcome study.
Fractures of the distal radius are common. As the population of the western world ages, their incidence is set to increase further. There are various methods of treating these fractures, but optimal management remains controversial. In the United Kingdom, the most common surgical treatment of closed distal radius fractures is by Kirschner-wires (K-wires) or volar locking plate. In this study, we compared long-term functional outcomes of volar locking plates with those of K-wires. ⋯ We have been unable to demonstrate a clinically relevant advantage of using volar locking plates over K-wires at 1 year to 2 years postoperatively.
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Screening for mental illness in a trauma center: rooting out a risk factor for unintentional injury.
Injury prevention and screening efforts have long targeted risk factors for injury recurrence. In a retrospective study, our group found that mental illness is an independent risk factor for unintentional injury and reinjury. The purpose of this study was to administer a standard validated screening instrument and psychosocial needs assessment to admitted patients who suffer unintentional injury. We aimed to prospectively measure the prevalence of mental illness. We hypothesize that systematic screening for psychiatric disorders in trauma patients is feasible and identifies people with preexisting mental illness as a high-risk group for unintentional injury. ⋯ This inpatient pilot screening program prospectively identified preexisting mental illness as a risk factor for unintentional injury. Implementation of validated psychosocial and mental health screening instruments is feasible and efficient in the acute trauma setting. Administration of a validated mental health screening instrument can be achieved by training college-level research assistants. This system of screening can lead to identification and treatment of mental illness as a strategy for unintentional injury prevention.
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Most Brazilian hospitals have no medical radiologists for emergencies. The radiologic evaluation is provided by doctors with heterogeneous generalist training. The objective is to demonstrate the need for systematization in the care of trauma in the interpretation of cervical spine and chest radiographs. Is it possible that, through a continuing education program, generalist doctors could be trained in the evaluation of these radiographs? ⋯ The systematized training, through the advanced trauma life support protocol, significantly increased the success rate of the evaluation of cervical spine and chest radiographs.
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To investigate the diagnostic and clinical value of multiplanar reconstruction (MPR) with spiral computed tomography for sacral nerve injury during sacral fracture. ⋯ Sacral MPR at double-oblique position can be used as a routine examination for patient with sacral fracture, which is of great significance in determining the cause of injury to sacral nerve. Furthermore, it can also provide radiologic evidences to analyze the need for surgical therapy.