J Trauma
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Explosions cause more complex and multiple forms of damage than any other wounding agent, are the leading cause of death on the battlefield, and are often used by terrorists. Because explosion-related injuries are infrequently seen in civilian practice, a broader base of knowledge is needed in the medical community to address acute needs of patients with explosion-related injuries and to broaden mitigation-focused research efforts. The objective of this review is to provide insight into the complexities of explosion-related injury to help more precisely target research efforts to the most pressing areas of need in primary prevention, mitigation, and consequence management. ⋯ A comprehensive approach to injury from explosions should include not only primary prevention, but also injury mitigation and consequence management. Recalibration of medical research focus will improve management of injuries from explosions, with profound implications in both civilian and military healthcare systems.
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Injuries represent an important and growing global burden of disease. The availability of evidence-based injury control interventions is unknown. We aimed to assess trends with respect to the number, content, and methodologic quality of reports of randomized controlled trials (RCTs) in the prevention and care of injuries. ⋯ The number of RCTs specific to the prevention and care of injuries is small, but increasing. The reporting of injury-related RCTs has important deficiencies including inadequate allocation concealment; failure to blind patients, investigators, and assessors; and per protocol analyses. In addition, many interventions studied are not available in low-income countries where the majority of the world's population resides and injury rates are highest.
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The aim of this study was to review the evidence regarding the use of low intensity pulsed ultrasound (LIPUS) in the management of acute long bone fractures. ⋯ The literature supports the use of LIPUS in the treatment of acute fractures treated with plaster immobilization.
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The role of endovascular techniques in the treatment of traumatic vascular injuries, including injury to the internal carotid artery, continues to evolve. Despite growing experience with the usage of these techniques in the setting of artherosclerotic disease, published results in traumatic carotid injuries remain sporadic and confined to case reports and case series. ⋯ Endovascular treatment of traumatic internal carotid artery injury continues to evolve. Early results are encouraging, but experience with this modality and data on late follow-up are still very limited. A large prospective randomized trial is warranted to further define the role of this treatment modality in the setting of trauma.