Injury
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Comparative Study
Can residents be effective trauma team leaders in a major trauma centre?
The overall objective of this study was to compare senior Emergency Department (ED) trainees (residents) with consultant trauma team leaders, assessing their influence on trauma team performance and patient outcomes. We aimed to identify the effect of seniority of leader on time-based performance measures and clinical outcomes. ⋯ Consultant team leaders improve team performance, resulting in shorter times to diagnostic imaging, and faster transfer to haemorrhage control. The greatest benefit seems to be for bleeding patients. Clinical outcomes were similar for trainees and consultants in our major trauma centre.
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Comparative Study
Fresh osteochondral allograft is a suitable alternative for wide cartilage defect in the knee.
There are several surgical options to restore a wide osteochondral defect in the knee. Fresh osteochondral allografts are usually considered a poor alternative due to their difficulties in surgical application. The aim of this work is first to present our experience including the surgical technique and the functional results of patients receiving fresh osteochondral allograft to restore major knee lesions, then, to compare our results with other results presented in literature. ⋯ Therapeutic study, Level IV.
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Comparative Study
Clinical strategies at the docking site of distraction osteogenesis: are open procedures superior to the simple compression of Ilizarov?
This retrospective review reports on forty-five tibial non-unions who underwent docking site treatment for non-union using closed versus open and endoscopic strategies. In this cohort of patients, all but twelve were infected non-unions. Sixteen patients initially treated with single compression were compared to twenty-three patients treated with open revision of the docking site, and six endoscopic procedures. ⋯ Conclusive evidence of superiority of one modality of treatment over the other cannot be drawn from our data. The simple compression procedure requires less invasive surgery and is probably less demanding and more cost-effective in short transports, although the two cases of failure due to recurrence of sepsis were observed after this procedure. Further studies are desirable to investigate the effectiveness of open docking site grating procedures.
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Comparative Study
Comparing ICD-9 and ICD-10: the impact on intentional and unintentional injury mortality statistics in Italy and Norway.
The international classification of diseases (ICD) provides guidelines for the collection, classification and dissemination of official cause-of-death statistics. New revisions of the ICD can potentially disrupt time trends of cause-of-death statistics and affect between-country comparisons. The aim of this study was to measure how switching from ICD-9 to ICD-10 affected mortality statistics for external causes of death, i.e. intentional and unintentional injuries, in Italy and Norway. ⋯ Switching to ICD-10 did not change the overall trends for accidents, homicides and suicides in either country. However, the number of records in some injury subcategories e.g. accidental falls and traffic accidents, decreased. Changing classification can thus affect the ranking of causes of injury mortality, with consequences for public health policy.