Injury
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The use of multiple small flaps linked in a "chain-linked" flap microanastomosed chimeric system is recommended in distal hand and digital defects reconstruction. The aim of this study is to demonstrates our experience utilizing microsurgical fabrication, multi-lobed and linking combined flaps for the reconstruction of hand degloving injuries with complex multidigit soft tissue defects. ⋯ Level IV, therapeutic study.
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Tibial plateau fractures are complex and the current evidence for postoperative rehabilitation is weak, especially related to the recommended postoperative weight bearing. The primary aim of this study was to investigate if loading in the first 12 weeks of recovery is associated with patient reported outcome measures at 26 and 52 weeks postoperative. We hypothesized that there would be no association between loading and patient reported outcome measures. ⋯ Significant associations were identified between the loading ratio at 2 weeks and knee-related quality of life at six months (R2=0.392), and between the loading ratio at 6 weeks combined with injury severity and knee-related quality of life at 26 weeks (R2=0.441). In summary, weight bearing as tolerated does not negatively affect the results of tibial plateau fracture and may therefore be safe for postoperative management. These findings should be taken in context of the sample size, which was not sufficient for sub-group analysis to investigate the role of impaction grafting.
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Accidents are common in the agricultural industry, particularly among dairy farmers. How said farmers get hurt is well established, but far less is known about how distal, socio-environmental factors influence injuries. This study examined associations between medically-attended agricultural injuries and: (1) personal sociodemographic characteristics, and (2) farm environment features and general safety practices. ⋯ Dairy farmers in this analysis who did not live at their dairy operation, did not provide safety training to all their workers, or had individually-purchased health insurance were more apt to get injured, but more research is needed to confirm these findings in prospectively designed studies. How these factors can be directly addressed or otherwise used to better focus farm injury prevention initiatives should also be explored.
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The treatment of limb threatening trauma on the distal tibia or hindfoot often results in posttraumatic osteoarthritis requiring tibiotalocalcaneal (TTC) arthrodesis. The purpose of this study was to present a case series of patients undergoing various techniques of joint fusion after bone reconstruction and deformity correction as a salvage procedure. The study should help trauma surgeons making decisions in limb salvage and deformity correction in complex lower leg and foot injuries by presenting options and treatment strategies. ⋯ IV, Case series.
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To determine whether the anterior talofibular ligament injury will influence the Hook test result. ⋯ When the inferior tibiofibular joint injury was associated with an anterior talofibular ligament injury, the Hook test indicated about 3.19mm of displacement of the distal end of the fibula, and obvious external rotation occurred due to increased activity of the anterior border of the fibula. In the other groups, a single inferior tibiofibular joint injury or a single anterior talofibular ligament injury did not increase displacement or rotation of the distal end of the fibula.