J Trauma
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Comparative Study
The association between occupant restraint systems and risk of injury in frontal motor vehicle collisions.
An evaluation of seat belt use and airbag deployment, either alone or in combination, on risk of injury to specific body regions has yet to be completed. ⋯ Airbag deployment does not appear to significantly reduce the risk of injury either alone or in combination with seat belts. Airbag deployment without associated seat belt use may increase the risk of lower extremity injury.
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The pattern and severity of crash injury depends on a complex interaction of biomechanical factors such as deceleration velocity at impact (delta-V), seat-belt and airbag use, and type of impact. Human body characteristics such as height and weight may play an important role. We hypothesized that body mass index (BMI) will influence crash injury patterns. ⋯ Although no difference in ISS was identified between the lean and obese cohorts, there was an increase in mortality with the obese cohort. The severity of lower extremity injuries increased with increasing BMI. The overweight cohort was associated with lower ISS and abdominal mAIS score compared with the lean cohort. This protection may be attributable to an increase in insulating tissue, or a "cushion effect," without a significant increase in mass and momentum.
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Traumatic coagulopathy is thought to be caused primarily by fluid administration and hypothermia. ⋯ There is a common and clinically important acute traumatic coagulopathy that is not related to fluid administration. This is a marker of injury severity and is related to mortality. A coagulation screen is an important early test in severely injured patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Early functional treatment versus early immobilization in tension of the musculotendinous unit after Achilles rupture repair: a prospective, randomized, clinical study.
The aim of our prospective, randomized, clinical study was to compare two postoperative regimens after Achilles rupture repair and determine whether early functional treatment will give a better result than early immobilization in tension of the musculotendinous unit. ⋯ The isokinetic calf muscle strength results were somewhat better in the early motion group, whereas the other outcome results obtained in the two groups of patients were very similar. We recommend early functional postoperative treatment after Achilles rupture repair for athletes and well-motivated patients and for less-motivated patients and nonathletes.