J Trauma
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Marginal posterior wall fractures are often fixed by lag screws, which may be technically difficult and risks articular penetration. Spring plates are used to avoid articular penetration. Both lag screws and spring plates are usually buttressed by reconstruction plates. ⋯ The marginal fracture is fixed using monocortical locking head screws. This technique has been performed on three patients; none had secondary displacement or nonunion. Fixing marginal posterior acetabular wall fractures using locking reconstruction plates and monocortical screws saves additional lag screws or spring plates without risking articular penetration.
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The aim of this study was to evaluate the relationship of age to the injury types, distribution, and severity in motorcycle crash (MCC) victims admitted to Los Angeles County emergency hospitals in California. ⋯ Injuries related to MCCs show age-related injury distribution, severity, and mortality rates. Older patients are significantly more likely to suffer severe trauma, severe head and chest injuries, and spinal fractures. Adaptation of trauma team activation criteria and more aggressive triage of older victims of motorcycle trauma should be considered.
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Multicenter Study
A critical assessment of the out-of-hospital trauma triage guidelines for physiologic abnormality.
It remains unclear whether the American College of Surgeons Committee on Trauma (ACSCOT) "step 1" field physiologic criteria could be further restricted without substantially sacrificing sensitivity. We assessed whether more restrictive physiologic criteria would improve the specificity of this triage step without missing high-risk patients. ⋯ We were unable to omit or further restrict any ACSCOT step 1 physiologic measures in a decision rule practical for field use without missing high-risk trauma patients.