J Trauma
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Airway compromise secondary to isolated injury at the atlas (C1) and axis (C2) without an associated spinal cord injury is a rare, but recognized phenomenon that results in significant morbidity and mortality. No previous study in the literature has reported the incidence of this potentially lethal complication of these relatively common fractures. ⋯ Approximately 5% of patients with isolated C1 and C2 fractures developed airway compromise. All patients with these injuries should be assessed for the risk of developing this complication and some will require close monitoring to detect this problem at an early stage.
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War-trauma, especially due to blast injury, can be associated with long bone fracture. Immediate external fixation of fractures, followed by internal fixation when the patient is medically stabilized (damage control orthopedics [DCO]), is the U.S. Army policy for war-related fractures. Data on infectious outcomes when DCO is used for war-trauma fractures are scant. ⋯ Infection was associated with 40% of DCO-associated intramedullary nails. Blast injury was a predictor of infection. Despite infection, fracture union and nail retention rates were high, suggesting a good outcome.
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Although infrequent, injury to the common or external iliac artery in association with pelvic fractures can be devastating, and descriptive data are lacking. This study was performed to determine the incidence, injury patterns, and outcomes of blunt iliac artery injuries (BIAIs) in association with moderate or severe pelvic fractures. ⋯ BIAI is a rare diagnosis, but when present it is associated with a higher rate of overall complications and mortality. Vigilance is warranted in the diagnosis and management of this infrequent injury, especially in the setting of severe pelvic fractures.
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Recent studies have suggested that moderate doses of ethanol (ETOH) before traumatic brain injury (TBI) may have a neuroprotective role. ⋯ The results of this study suggest that elevated ETOH serum levels are independently associated with higher survival in patients with severe traumatic brain injuries. Additional research is required to further investigate the mechanism and potential therapeutic implications of this association.