J Trauma
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: Treatment of odontoid fractures remains controversial. There are conflicting data in the literature with regard to timing of operative fixation (OP), as well as whether OP should be performed. Within our own institution, treatment is variable depending largely on surgeon preference. This study was undertaken in an attempt to develop management consensus by examining outcomes in elderly patients with odontoid fractures and comparing OP to a nonoperative (non-OP) approach. ⋯ : Despite being an older population, elderly patients with odontoid fracture who were managed non-OP had similar mortality, UTI, and pneumonia rates compared with their younger counterparts who underwent OP. The need for tracheostomy and PEG and discharge disposition was similar among all three groups. Elderly patients with odontoid fracture managed non-OP had a reduction in HLOS and ventilator days compared with either operative group and less DVT compared with the early operative group. Based on these results, non-OP management should be given strong consideration in elderly patients with traumatic odontoid fractures.
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: Motor vehicle crashes are the leading cause of death among teenagers because of higher crash rates per mile driven and low seat belt use rates. ⋯ : Social pressure and poor comprehension of the risks of injury were identified as barriers to seat belt usage among teenage high school students. A friendly, competitive approach to openly discussing and educating teens about these risks led to a 20% increase in seat belt usage among teen drivers and their passengers.
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: Angiographic embolization (AE) is used to control hemorrhage in adult blunt liver, spleen, and kidney (ASO) injuries. Pediatric experience with AE for blunt ASO injuries is limited. We reviewed our use of AE to control bleeding pediatric blunt ASO injuries for efficacy and safety. ⋯ : AE is a safe and an effective technique for controlling hemorrhage from blunt ASO injuries in select pediatric patients.
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: The fluoroscopic imaging technique that has been used in the dorsal percutaneous screw fixation of scaphoid fracture was modified for more consistent central screw placement according to the different fracture locations. ⋯ : The fluoroscopic images should be individualized according to the fracture planes for more consistent and accurate central guide wire placement in the dorsal percutaneous screw fixation of scaphoid fracture.
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: We report microvascular free tissue transfers in pediatric patients in a retrospective series. ⋯ : In cases of severe tissue defects in pediatric patients, microvascular free flap reconstruction is a treatment of choice. A multicenter study for guidelines on preoperative assessment and antitrombotic therapy in pediatric microsurgery is warranted.