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The management of open tibial fractures is a challenge to all orthopaedic trauma surgeons. The major goals are fracture union, uncomplicated soft tissue healing and return to pre-injury level of function. The geographical isolation and vastness of the Northern Territory of Australia complicates the management of these injuries by adding a significant delay to treatment. Forty-five patients sustained...
Background: In this prospective study, the TRISS methodology is used to compare trauma care at a university hospital (Lokmanya Tilak Municipal General (LTMG) Hospital) in Mumbai, India, with the standards reported in the Major Trauma Outcome Study (MTOS). Methods: Between 1 August 2001 and 31 May 2002, 1074 severely injured patients were included in the study. Survival analysis was completed for 98...
Admitting patients with fractured neck of femur using fast tracking procedure is well established in over 75% of hospitals in the United Kingdom. A retrospective study on 143 patients admitted using such procedure revealed inadequacies in the system. Although the waiting time in the Accident and Emergency Department (A&E) was reduced, it did not contribute much to the other aspects of patients...
Open pelvic fractures constitute one of the most devastating injuries in musculo-skeletal trauma and must be treated aggressively, incorporating a multidisciplinary approach. Early treatment, focusing on prevention of haemorrhage and sepsis, is essential.The management of associated soft tissue injuries must also be aggressive, including early administration of broad-spectrum antibiotics and repeated,...
Previous studies have suggested that the lower-extremities are among the most frequently injured body regions in polytrauma patients and have a major impact on the functional recovery following polytrauma. In particular, injuries to the distal part of the lower-extremity appear to be associated with a poor functional outcome. Therefore, the goal of this study was to evaluate the impact of injuries...
The purpose of this prospective cohort study was to define indications and analyze the clinical and radiographic results of using interbody cages to surgically treat traumatic cervical spine instability. Patients and methods: 53 patients were treated by monosegmental anterior dis-cectomy and interbody fusion using either autologous tricortical iliac crest bone graft and CSLP (cervical spine locking...
Scapulothoracic dissociation is an infrequent injury with potentially devastating outcomes. Knowledge of this injury is based on small patient series and case reports. The aim of this article is to review the evaluation, management and functional outcomes following scapulothoracic dissociation. Often caused by high traction forces applied to the shoulder girdle, there is a complete loss of the scapulothoracic...
The purpose of the study was to determine the outcome after treatment of transitional fractures of the distal tibia, including growth disturbances, osteoarthritis, and/or restriction of the ability to take part in sports.In a retrospective multicentre study of 72 patients, 50 were evaluated by clinical and 46 by radiographic examination, an average of 7.4 years (standard deviation 5.9) after treatment...
In Brazil, trauma occupies third place among the various causes of death and is the first cause of death among young people. Among the various approaches to the study of trauma, analysis of the organisation and quality of care has been frequently reported in the literature. The objective of the present study was to assess the quality of care for victims of trauma due to traffic accidents provided...
Ruptures of the patellar and/or quadriceps tendon are rare injuries that require immediate repair to re-establish knee extensor continuity and to allow early motion. We evaluated 36 consecutive patients with quadriceps or patellar tendon rupture between 1993 and 2000. There were 37 primary ruptures, 3 reruptures, 21 quadriceps and 19 patellar tendon ruptures. Follow up examination (>24 months postoperatively)...
Pelvic fracture associated with liver trauma is not an uncommon injury combination in multiple trauma and is associated with high morbidity and mortality. The aim of this study was to examine the characteristics of this specific patient group, to describe the diagnostic and treatment protocols and finally to analyse risk factors associated with mortality. Data were collected over a 6-year period,...
We present the results of a retrospective review of 50 Müller straight stem total hip replacements performed for femoral neck fracture over a 10-year period.Between 1992 and 2002, 50 Müller straight stem total hip replacements were performed for femoral neck fracture in 42 female and 8 male patients with a mean age of 74 years.No hips have required revision surgery. Two patients have suffered early...
A consecutive series of patients with all types of cervical hip fracture (both undisplaced and displaced) were randomised to osteosynthesis with Hansson hook-pins (n=98) or AO-screws (n=101). Background parameters, fracture type and reduction of the fracture did not differ significantly between the groups. Fifty-seven percent of the patients were operated on within 6h of admission to hospital, 74%...
This paper assesses the outcomes and complications of Lisfranc joint injuries treated at a regional trauma centre under the care of a single surgeon.We performed a retrospective study of all patients that underwent ORIF of a Lisfranc joint injury over a 5-year period. Case note review, radiology review, and questionnaire assessment were performed. We analysed for correlations between outcome and injury...
Parkinson's disease patients are at increased risk of falls and osteoporosis. They present a challenge to those who treat them for fracture neck of femur. There are conflicting views as to whether they have a worse prognosis, compared to age matched controls.This review discusses their care, including surgical approach and technique, to post-operative management and complications. It highlights the...
Assessing outcomes in the paediatric trauma population is important. Identifying suitable instruments can be problematic. This article highlights the commonly used outcome measures for assessing functional status and health related quality of life in paediatric trauma patients. Child specific characteristics which impact upon instrument development and selection are reviewed.An electronic database...
Prediction of the likely outcome of head injury from the outset would allow early rehabilitation to be targeted at those with most to gain. Clinical evaluation of a head injured patient may be confounded by intoxicants such as alcohol. Imaging modalities are insensitive (CT) or impractical (MR) for screening populations of such patients. A peripheral marker that reflected the extent of brain injury...
Traumatic extradural haematoma (EDH) is a neurosurgical emergency and timely surgical intervention for significant EDH is the gold standard. This study aims to determine the incidence and mortality of consecutive patients with traumatic EDH admitted to the Emergency Department (ED) of Prince of Wales Hospital (PWH), a University Hospital Trauma Centre in Hong Kong.Retrospective analysis of prospectively...
Professional horse riding-related injuries have not been studied before in Hong Kong, although horse racing takes place very regularly in the territory. In addition, the equestrian events of the 2008 Beijing Olympic Games will come to Hong Kong. This study analysed the pattern of horse-related injury among patients who presented to a trauma centre in a teaching hospital in Hong Kong.Information from...
Severe bleeding from liver injury is one of the major causes of mortality in patients with abdominal trauma. The study was undertaken to assess factors that influence outcome following liver trauma.This is a prospective study of patients with liver injury treated in one surgical ward at King Edward VIII Hospital over a 7-year period (from 1998 to 2004). Data collected included demographics, intra-operative...
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