J Trauma
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Comparative Study
Helicopters and the civilian trauma system: national utilization patterns demonstrate improved outcomes after traumatic injury.
The role of helicopter transport (HT) in civilian trauma care remains controversial. The objective of this study was to compare patient outcomes after transport from the scene of injury by HT and ground transport using a national patient sample. ⋯ Trauma patients transported by helicopter were more severely injured, had longer transport times, and required more hospital resources than those transported by ground. Despite this, HT patients were more likely to survive and were more likely to be discharged home after treatment when compared with those transported by ground. Despite concerns regarding helicopter utilization in the civilian setting, this study shows that HT has merit and impacts outcome.
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Comparative Study
The pattern of thoracic trauma after suicide terrorist bombing attacks.
The worldwide escalation in the volume of suicide terrorist bombing attacks warrants special attention to the specific pattern of injury associated with such attacks. The goal of this study was to characterize thoracic injuries inflicted by terrorist-related explosions and compare pattern of injury to penetrating and blunt thoracic trauma. ⋯ Injury inflicted by terrorist bombings causes a unique pattern of thoracic wounds. Victims are exposed to a combination of lung injury caused by the blast wave and penetrating injury caused by metallic objects.
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Comparative Study
Hips can lie: impact of excluding isolated hip fractures on external benchmarking of trauma center performance.
Trauma centers (TCs) vary in the inclusion of patients with isolated hip fractures (IHFs) in their registries. This inconsistent case ascertainment may have significant implications on the assessment of TC performance and external benchmarking efforts. ⋯ Given the fact that IHFs in the elderly significantly influence risk-adjusted outcomes and are variably reported by TCs, these patients should be excluded from subsequent benchmarking efforts.
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Comparative Study
New intramedullary locking nail for olecranon fracture fixation--an in vitro biomechanical comparison with tension band wiring.
The aim of this study was to determine the difference in displacement of a newly designed intramedullary olecranon fracture fixation device compared with multifilament tension band wiring after 4 cycles and 300 cycles of dynamic continuous loading. ⋯ The newly designed interlocking nailing system showed higher stability in comparison with multifilament tension band wiring after continuous dynamic loading.
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Reported iatrogenic injury to the proximal femoral vascular structures is rare after retrograde femoral nailing. Previous cadaveric dissections have recommended placement of proximal interlocking screws above the level of the lesser trochanter. ⋯ No true safe zone corridor exists anteriorly for placement of AP interlocking screws in this region. Surgical technique modifications are suggested to minimize the potential risks of iatrogenic arterial injury during retrograde femoral nail AP proximal interlocking.