Injury
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Non-compressible hemorrhage in the junctional areas and torso could be life-threatening and its prehospital control remains extremely challenging. The aim of this review was to compare commonly used techniques for the control of non-compressible hemorrhage in prehospital settings, and thereby provide evidence for further improvements in emergency care of traumatic injuries. Three techniques were reviewed including external aortic compression (EAC), abdominal aortic junctional tourniquet (AAJT), and resuscitative endovascular balloon occlusion of the aorta (REBOA). ⋯ In comparison, AAJT or REBOA is recommended for better control of the aorta blood flow in prehospital settings. Although these three techniques each have advantages, their use in trauma is not widespread. Future studies are warranted to provide more data about their safety and efficacy.
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Up to 25% of acetabular fractures have poor functional outcomes in short-term follow-up. The aim of our study is to analyze predictors related to poor outcome in surgically treated acetabular fractures. Damage to the femoral head cartilage and poor fracture reduction has been reported as predictors to total hip arthroplasty (THA). ⋯ Femoral head damage and dislocation, fracture reduction, and seagull sign were the strongest predictors related to THA after surgical treatment of acetabular fractures.
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Observational Study
Hip fractures in cyclist - a six-year cohort study at a single large volume trauma centre.
Cycling has gained in popularity as a recreational activity and method or travel, in part due to its recognised health benefits in maintenance of good cardiovascular strength and also for environmental issues. As a consequence of this, there is unfortunately an increased number of cycling related injuries. One particular injury incurred is a proximal femoral fracture, but there is little information in the literature with regarding this and its management. ⋯ One patient continued to complain of pain and subsequently underwent a total hip arthroplasty. The mean follow up for these patients was 1033 days (range 1 year to 7 years). 47 (94%) had full return back to pre-injury levels. Given that cycling is likely to increase in the future, we recommend that early surgical fixation is a viable and functionally positive treatment management in these particular group of patients.
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A pilot study to evaluate the face & construct validity of an orthopaedic virtual reality simulator.
This study aimed to identify the face and construct validity of the Precision OS trauma module proximal femoral nail procedure. Secondary outcomes included perceived use of simulation in surgical training, with structured feedback from participants. ⋯ The proximal femoral nail module on the Precision OS platform demonstrated good face, and construct validity. Further research evaluating use of virtual platform simulation in surgical trauma training is needed.
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Operative fixation of pelvic ring injuries is associated with a high risk of hardware failure and loss of reduction. The purpose of this study was to determine whether preoperative radiographs can predict failure after operative treatment of pelvic ring injuries and if the method of fixation effects their risk. ⋯ Our study demonstrates that both gender and the method of posterior fixation are associated with hardware failure or displacement.