J Trauma
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To compare the stability of a novel, nonspanning external fixator with a standard volar locked plate for treatment of unstable distal radius fractures. ⋯ This study demonstrated no significant difference in the mechanical stiffness of the CPX nonspanning external fixator and volar locked plate in a cadaveric fracture model. Both constructs appear to be biomechanically equivalent in this experimental model; however, this is only one factor in the choice of fixation device for the management of unstable distal radius fractures.
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Some recent studies have suggested that certain types of orthopedic trauma result in ongoing disability and that factors other than injury severity or location may influence outcome. This study aimed to evaluate outcome 12 months and 2 years after severe orthopedic trauma, as measured on the Short Form (SF)-36 Health Survey, relative to a control group, to examine change over time and to examine which demographic, injury-related and psychological factors are associated with persisting disability. ⋯ This study has highlighted pain and PTSD symptoms as frequent and disabling factors after othropedic trauma. There is clearly a need to focus on alleviating these problems as part of the rehabilitation process.
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Serum albumin level is correlated with outcome in various clinical situations. Albumin has multiple physiologic properties that could be beneficial in brain injury. The Lund therapy for elevated intracranial pressure uses albumin as part of its protocol and demonstrates favorable outcome. We sought to find out if albumin is associated with outcome after traumatic brain injury to justify conducting a randomized trial. ⋯ Serum albumin level seems to be an independent predictor of poor outcome. The model also identified classic predictors of poor outcome that tends to strengthen its adequacy. Because albumin level is the only modifiable factor influencing outcome, it seems justified to carry out a randomized trial of the use of albumin in the treatment of brain injury.
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Deep vein thrombosis (DVT) has been identified as a marker of quality of care by various governmental and consumer groups. However, the lack of standardized DVT screening systems across trauma centers may introduce surveillance bias in the rates of DVT reported. We hypothesize that trauma centers with higher rates of duplex ultrasound detect more DVTs and subsequently report higher DVT rates to the National Trauma Data Bank. ⋯ More aggressive screening procedures may be associated with higher DVT rates. Trauma centers that screen more and report higher DVT rates may be falsely labeled as having decreased quality of care. Using DVT rate alone as an independent quality measure should be reevaluated because of the potential for surveillance bias.