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Copyright of Revista de Sanidad Militar is the property of Direccion General de Sanidad Secretaria de la Defensa Nacional and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To assess the clinical outcomes of open calcaneal fractures with medial wounds treated with one‐stage management, including early modern wound care, sequential reduction, and frame structure fixation using percutaneous Kirschner wires. Methods: A total of 19 patients with open calcaneal fractures admitted to our hospital from May 2016 to March 2019 were selected in this study. Twelve type‐II and seven type‐IIIA medial open injuries were identified according to the classification of Gustilo and Anderson. Fractures were stratified by Sanders classification, including nine type‐II fractures, seven type‐III fractures, and three type‐IV fractures. All patients accepted one‐stage irrigation and debridement, sequential reduction of calcaneal fractures through the open medial wound, percutaneous Kirschner wire fixation, and primary closure of wounds covered with vacuum‐assisted closure (VAC) device. The Bohler angle, the Gissane angle, and the width of the calcaneus were compared before and after surgery. The functional results were evaluated according to the Paley and Hall score system, visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score, Maryland Foot Score, and related complications. Results: The follow‐up duration for all patients ranged from 14 to 28 months (mean, 22.7 months). The angle of Bohler and Giasane was increased from (−7.6° ± 15.0°) and (96.6° ± 7.6°) before surgery to (23.7° ± 6.1°) and (124.1° ± 7.1°) postoperatively (P < 0.05), respectively. Three cases of superficial infection and two cases of wound dehiscence were observed in our study, which were then successfully treated with wound debridement, VAC replacement, appropriate use of antibiotics, and delayed closure. The last follow‐up revealed three cases of lateral wall expansion and six cases of mild‐to‐moderate subtalar arthritis based on the Paley and Hall scoring system. According to the AOFAS ankle and hindfoot score, one case showed excellent results, 14 cases exhibited good results, and four cases displayed fair results, with the mean of 80.7 ± 6.7 points (range, 70–90). The Maryland Foot Score revealed one case of excellent outcomes, nine cases of good outcomes, and nine cases of fair outcomes with an average of 76.8 ± 8.6 points (range, 62–90). The mean VAS for pain was 1.8 ± 1.5 (range, 0–5), and a total of 14 patients complained of mild‐to‐moderate pain when walking for a more extended period. Severe complications, such as deep infection, osteomyelitis, and soft tissue necrosis, were not observed during follow‐up. Conclusions: Collectively, one‐stage management allowed the direct restoration of calcaneal morphology with a minimal invasion of soft tissues in most open calcaneal fractures with medial wounds, and the functional outcomes were comparable to previous data. [ABSTRACT FROM AUTHOR]

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this paper is to enable a simulation tool for cardiovascular blood flow in order to better understand normal and hemorrhage conditions. A second order partial differential model for cardiovascular blood flow is employed. The individual components of the model is represented as an RLC circuit representation. Injury behavior is simulated by varying the circuit system parameters for the section representing different arterial levels. Our results show that significant changes in the blood flow inside the cardiovascular system can be observed when different injury conditions are modeled. [ABSTRACT FROM AUTHOR]

Open scapulothoracic dissociation (SD) is a rare injury and an average orthopaedic surgeon might be practically unaware of this entity. To our knowledge, there are hardly any cases of open SD reported in the English literature. We present one such case of open injury associated with total brachial plexus injury, but without any component of vascular injury. The patient was managed by aggressive debridement and fixation of the osseous injury which helped us save the patient from the dreadful complication of sepsis associated with such a severe injury. We briefly review the literature regarding SD and also discuss the management options when encountered with such a severe and rare injury. [ABSTRACT FROM AUTHOR]