Injury
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Little is known about the long-term outcomes of injured older adults cared for in trauma systems. We sought to describe mortality and causes of death over time, and the independent association of injury severity, comorbidities, and other factors on 12-month mortality among injured older adults transported by emergency medical services (EMS). ⋯ Injury requiring EMS transport is a sentinel event among older adults, with death typically occurring months later, often due to cardiovascular causes and dementia. A heavy comorbidity burden had an adjusted mortality risk comparable to severe injury.
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Social deprivation is associated with many adult fractures including distal radius fractures but the mechanisms for this are unclear. The aim of this study was to identify if social deprivation was associated with falls risk, mechanism of injury or osteoporosis in patients with a fragility fracture of the distal radius. ⋯ We have identified increased falls risk as an important reason for DRF in socially deprived patients. Knowing which patients are at highest risk allows interventions to be efficiently targeted. We would recommend resources should be targeted towards patients from socially deprived areas and focused on specific falls prevention strategies.
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Great vessel trauma (GVT), which is defined as trauma to the aorta or vena cava, remains one of the most challenging injuries to treat and has a high mortality rate despite advances in modern medicine. Additionally, the optimal management of GVT is controversial. In this study, we review the incidence, management, and outcome of GVT, identify the current status and prognostic factors of GVT, and compare treatment outcomes. ⋯ In conclusion, GVT is relatively rare but often lethal in clinical practice. Patient survival depends on injury severity and the shock status grade. Aggressive resuscitation and treatment play important roles in survival. The coordination of different levels of surgical expertise and the application of novel treatment methods are required to improve clinical outcomes for patients with vena caval injuries.
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In the pediatric population supracondylar humerus fracture (SHF) is one of the most common injuries. Diagnosis is based on inspection and conventional radiography. SHFs should be classified according to the modified Gartland classification, which guides treatment. ⋯ In both cases, K-wires should be removed 3-6 weeks after surgery with consolidation of the fracture. Clinical and radiological follow-up should be carried out at 3 weeks post fracture fixation to rule out loss of reduction. If this should occur, early revision surgery has been demonstrated beneficial.
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This study aimed to assess the tibiofibular relationships of normal syndesmosis on axial computed tomography (CT) images and evaluate the measurement differences by gender, age, and body sides. ⋯ Level IV, case series.