Injury
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The ideal resuscitation strategy for multiply injured patients remains a topic of ongoing debate. At present, no consensus has been reached on the ideal fluid for early resuscitation and on the threshold for blood product transfusions. ⋯ Finally, postinjury coagulopathy is a poorly defined entity, and current resuscitation strategies lack strong evidence-based scientific support. This review article provides a brief overview of the existing resuscitation protocols for multiply injured patients, including ATLS and "damage control", and will address developing controversies in the field.
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The Canadian Orthopaedic Trauma Society has been a promoter of multicentre research studies for more than a decade. From its modest beginnings, the group has grown to over 50 members who meet twice a year. The following article is a review of how the group developed to become a leader in level-one orthopaedic research. ⋯ The group has completed a number of prospective randomised trials over the years and has received numerous awards. These awards are highlighted along with recent publications by the group. These accomplishments have led to recognition as a leader in successful randomised orthopaedic trials and have helped us to obtain funding for our ongoing and future research.
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Polytrauma patients represent the ultimate challenge to trauma care and the optimisation of their care is a major focus of clinical and basic science research. A universally accepted definition for polytrauma is vital for comparing datasets and conducting multicentre trials. The purpose of this review is to identify and evaluate the published definitions of the term "polytrauma". ⋯ This review identified the lack of a validated or consensus definition of the term polytrauma. The international trauma community should consider establishing a consensus definition for polytrauma, which could be validated prospectively and serve as a basis for future research.
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The term "biker couple" is becoming an increasingly common site in emergency departments. The purpose of this study was to identify orthopaedic and non-orthopaedic injury patterns among this unique patient group. A 14-year (1993-2006) retrospective review of a Level I Trauma Institute Registry was performed. ⋯ Unhelmeted drivers were more likely to sustain head injury than passengers. When a scapular fracture was present both drivers and passengers had a greater incidence of head injuries. Prospective investigations are needed to better delineate the precise mechanisms for these injury patterns.
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Case Reports
Management of infected femoral nonunions with a single-staged protocol utilizing internal fixation.
There are no reported series that specifically deal with repair of infected nonunions of the femur with revision internal fixation. We sought to determine whether a standardised treatment protocol we have used for 13 patients since 1992 results in a high union rate, resolution of infection, and a good functional outcome. ⋯ The results of this study indicate that our standard protocol for treatment of infected nonunion of the shaft of the femur is reliable at obtaining fracture union with a good functional result, while resolving infection despite the reliance upon internal fixation.