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Background: Only a few cases of bilateral traumatic sternoclavicular dislocations have been reported in the literature. This injury is considered one of the rarest injuries of the human musculoskeletal system. Therefore, we present the first documented case of a cyclist with a third-degree open thoracic trauma (Gustilo–Anderson 3a) associated with a dislocated manubrium sterni fracture in the upper thoracic aperture, bilateral anterior dislocations of the sternoclavicular joints, rib fractures, and pleural ruptures. Case presentation: The patient, a 27-year-old Caucasian male, incurred this injury while participating in a professional cycling race at Nürburgring, Germany and received immediate interdisciplinary surgical treatment and has encountered no complications. We conducted a 1-year follow-up and present the clinical findings of this follow up. Additionally, we conducted a comprehensive review of the existing literature on this injury. Conclusions: Immediate interdisciplinary intervention, including surgical repair and meticulous postoperative care, facilitated successful patient recovery. This underscores the critical role of comprehensive trauma management in complex polytrauma cases. In conclusion, this case report highlights the rarity and complexity of a traumatic injury involving bilateral sternoclavicular dislocation, with this case being the first case reported with concomitant open thorax trauma. Our patient benefited greatly from immediate air-bound transportation to an interdisciplinary care provider, which houses both thoracic and trauma surgery departments. [ABSTRACT FROM AUTHOR]

Background/Objectives: osteoarthritis (OA) is a leading cause of disability. With an aging population and rising obesity rates, OA presents a growing challenge to health systems worldwide. Current OA treatments involve a mix of pharmacological and nonpharmacological interventions. Viscosupplementation with hyaluronic acid (HA) has proven effective, especially in knee OA, leading to its recommendation in international guidelines. This study investigates the sustained benefits of a single intra-articular HA injection beyond one year in patients coming from the SOYA trial, considering the EU MDR 2017/745 emphasis on post-market follow-up. Methods: A prospective, observational, open, post-marketing study in a cohort of patients that participated in the SOYA trial. Follow-up was carried out by means of a telephone survey, and the data were anonymized and coded so that patients could not be identified. The study was approved by the Alcorcón Hospital Institutional Review Board (Alcorcón, Madrid, Spain). Results: In the follow-up of the SOYA trial, 81.5% of patients sustained positive effects for over 6 months after the trial ended. This correlated with improved daily functioning, enhanced mood, and high patient satisfaction. Younger age and milder OA grades were associated with prolonged treatment effects. Notably, 82% of patients with >6 months of improvement did not require additional medication. Conclusions: the results of this study support the safety and performance of Adant® Plus as a treatment for patients with mild and moderate knee OA, with results lasting more than one year. Post-marketing studies are particularly relevant to examine the experience gained with the use of the device in routine clinical practice. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusion The prognosis of an avulsed permanent tooth depends on the time elapsed from injury to replantation in the injured socket. Wide variability exists in the terminologies used to describe this period. Hence, the aim of this study was to identify and categorize the terminologies related to this aspect of tooth avulsion, grade the explanations provided by the authors, and develop a consensus about the most appropriate terminology through a Delphi approach.This study involved a scoping review to identify and analyze the terminologies. It was performed according to PRISMA‐ScR with a systematic search performed in PubMed, Scopus, EMBASE, LILACS, and Web of Science. The terminologies were extracted, categorized, and evaluated for correctness. On the basis of the results of the review and expert group discussion, an ideal terminology was proposed. A Delphi study with 20 global experts in dental traumatology was conducted to develop a consensus for the proposed terminology and its description.A total of 92 studies were included. They were distributed into five categories according to the terminology used: (a) dry period alone, (b) total period with dry and/or wet times, (c) extra‐alveolar period, (d) extraoral period, and (e) miscellaneous. The explanations provided were correct in 37.5% of the studies that used an extraoral period. In the Delphi study, the lowest scores were given to the term dry period. There was an agreement of 95% for the proposed terminology.A wide variation in terminologies was observed that could be distributed into five categories. The correctness of explanations was highest in the studies that described total periods with dry and wet times. The Delphi study revealed excellent agreement for the proposed term “total extra‐alveolar period,” with precise and clear recordings of both nonphysiologic (dry) periods and physiologic (wet) periods. [ABSTRACT FROM AUTHOR]

Orthopaedic surgery has undergone significant evolution with the development of minimally invasive techniques (MIT) for the treatment of complex lower limb fractures. These innovations have transformed orthopaedic management, offering less traumatic and more effective alternatives to traditional procedures. IMTs are designed to reduce tissue damage, speed up recovery and minimize post-operative complications, making them increasingly relevant in today’s orthopaedic scenario. The aim of this study is to discuss recent advances in minimally invasive techniques in orthopaedic surgery for complex lower limb fractures. The research explores the benefits of these techniques, the challenges faced in clinical practice and the future prospects for their widespread adoption. The research was based on a literature review, with a qualitative approach, using the PubMed, Google Scholar, and Scielo databases. For a comprehensive and relevant analysis of the advances and challenges of minimally invasive techniques in orthopaedic surgery, specific descriptors reflecting the area of study were applied, with a time frame covering publications from 2018 to 2023. The analysis is based on a review of up-to-date literature, including clinical studies and meta-analyses that demonstrate the efficacy and safety of minimally invasive techniques. Innovations such as the use of external fixators, locked intramedullary rods and surgical navigation systems are highlighted. These approaches allow for precise stabilization of fractures with smaller incisions and less impairment of soft tissue vascularization. In addition, advances in intraoperative imaging and surgical instrumentation are discussed, which have improved the precision of procedures and reduced operative time. Challenges such as the learning curve and the cost of the technologies are also addressed. Thus, advances in minimally invasive techniques have revolutionized orthopaedic surgery, offering effective solutions for the treatment of complex lower limb fractures. Despite the challenges, such as the need for specialized training and investment in new technologies, the benefits for patients, including shorter recovery times and better functional results, are undeniable. The future of orthopaedic surgery will continue to benefit from these innovations, with the potential to further increase access and the quality of treatments. [ABSTRACT FROM AUTHOR]

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Copyright of Zeitschrift für Gerontologie und Geriatrie is the property of Springer Nature 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.)

Background: The objective of this study is to organise data on complications following total hip replacement (THA) over a span of 10 years, specifically focussing on cases that necessitated revision endoprosthetic surgeries. The objective is to create a recommendation for an All-Ukrainian registry of initial and repeated hip arthroplasty (HA) and standardise the terminology used to define "revision of total hip replacement surgery". Methods: The retrospective analysis examined 236 instances of revision hip arthroplasty (rTHA) performed at the Institute of Traumatology and Orthopaedics Centre between January 2005 and December 2021. The primary factors for revision were identified through an analysis of the patient's medical records, laboratory results, visual inspection, and the state of the previously implanted prosthesis. Demographic information, primary and revision HA dates, diagnoses, and causes of complications were recorded. The statistical analysis was conducted using the Statistica package (StatSoft), version 12.6 (2015), with a significance level of p < 0.05. Results: Out of the 364 patients who were diagnosed with complications, 236 of them (55.17%) needed a procedure called 1rTHA. Among these cases, 152 (41.76%) were specifically diagnosed with aseptic component instability. Significant factors for mechanical loosening were a high body mass index (BMI ≥ 30) and older age, with respective t-values of 2.08 (p = 0.004) and 2.59 (p = 0.045). Osteoporosis significantly contributed to aseptic loosening and fractures around the implant. The occurrence of infectious complications was frequently linked to chronic infectious diseases (t = 3.37, p = 0.001). The overall percentage of need for 2rTHA was 27.22% (43 cases), with one case of infectious lesion following the revision. Conclusions: The study emphasises the urgent requirement for standardised terminology and a comprehensive registry for hip arthroplasty procedures. Primary results indicate that cement-free fixation is more effective than cement-based fixation for revision in patients with aseptic instability and that two-stage arthroplasty is effective for treating infectious inflammation. Furthermore, the most effective treatment for femoral fractures with periprosthetic involvement was determined to be open repositioning and osteosynthesis with metal retainers. The aforementioned observations emphasise the need to create a comprehensive registry across Ukraine to support patient care, enable evidence-based practices, and enhance the overall effectiveness of hip arthroplasty operations. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Introduction: Ophthalmology education is evolving with the use of new teaching approaches. Teaching based on gamification is one of the new developments in health professions education. This study was conducted to investigate the effect of gamification-based virtual reality on the learning outcome of students regarding the highly important topic of approach to eye trauma. Materials and methods: This randomized educational intervention trial with a control group was conducted at Kermanshah University of Medical Sciences (KUMS). A total of 10 ophthalmology residents and 60 medical students were recruited in this study (each group comprised 5 residents and 30 medical students). Individuals were randomly divided into two teaching groups gamification method (intervention group) and lecture-based method (Control group). Data were collected through questionnaires and tests and analyzed by SPSS-26 software using descriptive and analytical statistics. Results: Residents and medical students evaluated the usability of this method to be favorable (132.72 ± 10.17). In resident students (16.80 ± 2.58, 13.60 ± 1.14, P ≤ 0.05) and medicine students (17.27 ± 4.50, 15.20 ± 0.71, P ≤ 0.05), the mean score of learning outcome score in the intervention group was higher than the control group. Conclusion: Gamification-based teaching is an effective educational strategy that can be used as a complementary educational tool for teaching ophthalmology residents and medical students. [ABSTRACT FROM AUTHOR]

Background: Understanding gender disparities in healthcare outcomes is crucial, especially during crises like the COVID-19 pandemic. The absence of gender-specific data on hospital admissions and lengths of stay for orthopedic and traumatology patients limits the precision of current analyses, making conclusions speculative. Objective: This study aims to highlight the potential insights that could be gained from gender-disaggregated data, illustrating how a more precise gender-based analysis could reveal healthcare disparities in orthopedic and trauma care during the pandemic. Materials and Methods: A robust analysis would require gender-disaggregated data, including variables such as admission rates, lengths of stay, injury types, and access to care, along with factors like age and socioeconomic status. In the absence of such data, a hypothetical framework was developed based on known healthcare disparities, using general trends to project possible gender-specific impacts. Results: Without gender-disaggregated data, it remains challenging to identify specific gender differences in outcomes accurately. Hypothetical scenarios suggest that disparities in admission rates, hospital stay durations, and access to care could be influenced by factors such as increased caregiving responsibilities for women or differential access to healthcare based on socioeconomic status. Conclusions: To accurately assess gender disparities in orthopedic and trauma care during the pandemic, future studies must prioritize the collection and use of gender-disaggregated data. This approach is essential for drawing reliable conclusions and developing targeted interventions to address healthcare inequities effectively. [ABSTRACT FROM AUTHOR]

Background: Trauma remains the leading cause of pediatric mortality in the United States. Although use of massive transfusion protocols (MTPs) in this population is widespread, optimal pediatric resuscitation is not well established. We sought to assess contemporary pediatric MTP practice in the United States. Study Design and Methods: A web‐based survey was designed by the Association for the Advancement of Blood & Biotherapies (AABB) Pediatric Transfusion Medicine Subsection and distributed to select American College of Surgeons (ACS) Level I Verified pediatric trauma centers. The survey assessed current MTP policy, implementation, and recent changes in practice. Results: Response rate was 55% (22/40). Almost half of the respondents were from the South. The median RBC:plasma ratio was 1 (interquartile range 1–1.5). Protocolized fibrinogen supplementation was common while integration of antifibrinolytic therapy into MTPs was infrequent. Viscoelastic testing (VET) was available at most sites, 71% (15/21, one site did not respond), and was generally utilized on an ad‐hoc basis. Roughly, a third of sites had changed their MTP in the past 3 years due to blood supply issues, and about a third reported having group O Whole Blood on‐site. Conclusion: MTP practice is similar throughout the United States. Though fibrinogen supplementation is common—other emerging interventions such as antifibrinolytic therapy or utilization of routine viscoelastic testing—are not widespread. Pediatric transfusion medicine experts must continue to follow practice change, as contemporary large trials begin to characterize new supportive modalities to optimize resuscitation in pediatric trauma patients. [ABSTRACT FROM AUTHOR]

Patients before and after lung transplantation often have osteoporosis with existing and recent symptomatic insufficiency fractures, which reduce the quality of life and increase general morbidity and mortality. Due to the reduced bone quality with a significantly increased fracture risk, even low-energy trauma results in the risk of acquiring multiple and complex fractures. The rarefied bone substance can be very challenging for subsequent osteosynthetic treatment. Antiosteoporotic medication is always necessary, and osteoanabolic therapy should be discussed in such cases. In the following, we report about the successful osteosynthetic treatment of an immunosuppressed patient with multiple fractures after a fall from low height. To support fracture healing with antiosteoporotic drug therapy, the patient was switched from antiresorptive to osteoanabolic medication, which resulted in complete fracture consolidation over the course of 6 months. There were also no new insufficiency fractures during this period; however, no improvement in bone density was achieved. [ABSTRACT FROM AUTHOR]

Despite significant progress in the medical field, there is still a pressing need for minimal‐invasive tools to assist with decision‐making, especially in cases of polytrauma. Our team explored the potential of serum‐derived large extracellular vesicles, so called microparticles/microvesicles/ectosomes, to serve as a supportive tool in decision‐making in polytrauma situations. We focused on whether monocyte derived large EVs may differentiate between polytrauma patients with internal organ injury (ISS > 15) and those without. Thus, we compared our EV data to soluble biomarkers such as tumour necrosis factor alpha (TNF alpha) and Interleukin‐8 (IL‐8). From the blood of 25 healthy and 26 patients with polytrauma large EVs were isolated, purified, and characterized. TNF alpha and IL‐8 levels were quantified. We found that levels of these monocyte derived large EVs were significantly higher in polytrauma patients with internal organ damage and correlated with the ISS. Interestingly, we also observed a decline in AnnV+CD14+ large EVs during normal recovery after trauma. Thus, inflammatory serological markers as TNF alpha and as IL‐8 demonstrated an inability to discriminate between polytrauma patients with or without internal organ damage, such as spleen, kidney, or liver lacerations/ruptures. However, TNF and IL‐8 levels were elevated in polytrauma cases overall when contrasted with healthy non‐traumatic controls. These findings suggest that delving deeper into the potential of AnnV+ large EVs derived from monocytes could highly beneficial in the managment of polytrauma, potentially surpassing the efficacy of commonly used serum markers. [ABSTRACT FROM AUTHOR]

Dr. Ney Bienvenido Arias Lora emerged not only as a pioneer in neurosurgery but a community leader in the Dominican Republic (DR), contributing significantly to a region where both fundamental and neurosurgical resources were scarce. This account aims to shed light on the remarkable life and career of Dr. Arias Lora, emphasizing the critical role he played in establishing and advancing neurosurgery in the DR. This paper relies on original bibliographic materials, providing an in-depth analysis of Dr. Arias Lora's life. Through a thorough examination of his career, we aim to highlight his pioneering efforts in the Caribbeans where neurosurgical expertise was nearly nonexistent during his time. Dr. Arias Lora, born in 1926, and became the first neurosurgeon in the DR in 1959. He played a pivotal role in establishing the Neurosurgery Residency Program at the Hospital Salvador B. Gautier and was instrumental in the development of neurosurgery training in his home country and the Caribbeans. Beyond his medical contributions, Dr. Arias Lora served as an educator, authoring significant works, and holding prestigious academic positions. His legacy is reflected in the " Dr. Ney Arias Lora Traumatology Hospital " in Santo Domingo, a testament to his dedication to neurosurgery and public service. Dr. Ney Bienvenido Arias Lora's life and achievements stand as a testament to the transformative impact dedicated individuals can have on the advancement of neurosurgery. Despite the intricacies inherent in the field of neurosurgery and broader societal challenges, his story serves as an inspiration. [ABSTRACT FROM AUTHOR]

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Introduction. Pediatric traumatology is a complex field that requires a comprehensive understanding of physeal development, remodeling potential, and the ossification process in order to ensure appropriate patient treatment. The objective of this study was to assess the willingness of practicing physicians to participate in a telemedicine collaboration aimed at enhancing the exchange between the outpatient and inpatient sectors and promoting the digitalization of the pediatric sector. This is in response to the growing significance of digitalization in the medical field. Methods. A survey consisting of 15 items was sent to 800 practicing trauma surgeons, pediatric surgeons, and pediatricians within a 100 km radius of Hamburg, Germany. The survey included questions about the respondents' professional experience and telemedicine experience, as well as inquiries about possible telemedicine collaborations. Results. The response rate was 19.3%. Less than half of the participants already used telemedicine in daily practice. In general, 75% of respondents expressed an interest in collaborating with the inpatient sector. The most common reasons for hospital referral were the need for surgery, inadequate treatment of children in practice and co-assessment. The majority were in favor of flexible communication, either via video telephony, imaging applications like or messaging applications. Conclusions. The study revealed a high level of interest in telemedicine collaboration. Information exchange should be tailored to individual needs, with practitioners requiring a versatile and personalized approach that includes imaging. Strict enforcement of data protection regulations is essential. Further research is needed to evaluate the effectiveness of telemedicine collaboration in the treatment of pediatric trauma in both hospital and outpatient settings. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic has affected the personal and social lives of millions of people and also impacted the etiological factors of midfacial trauma such as falls, interpersonal violence or traffic accidents. The aim of this study was to analyze the influence of the COVID-19 pandemic on maxillofacial trauma surgery in the German healthcare system. Methods: Nationwide data regarding the national diagnosis-related-group (DRG) inpatient billing system used in all German hospitals was received from the German Federal Statistical Office. Various trauma-associated procedures of the Operation and Procedure Classification System (OPS), a German modification of the International Classification of Medical Procedures (ICPM), were statistically associated with different epidemiological factors between 2012 and 2021. Results: A statistically significant decrease (p < 0.05) in surgeries regarding maxillofacial fractures was registered during the years 2020 and 2021. Young male patients had the largest decline in maxillofacial trauma surgeries during this period (p < 0.05). In contrast. elderly patients 80 years and older showed a dramatic increase in the frequency of fractures in both the midface and the mandible (p < 0.05). Conclusions: During the COVID 19 pandemic there has been a shift in the number, composition and etiology of maxillofacial fracture surgeries. Measures of social distancing and personal risk avoidance had a societal positive effect on the frequency of facial injuries. This stands in contrast to the drastic increase in fractures of elderly people who should be protected primarily by the measures taken. These results can help to understand these influences better in future pandemics. Trial registration: German Clinical Trials Register No: DRKS00032778. [ABSTRACT FROM AUTHOR]

Purpose: Orbital fractures are common injuries and represent an interesting chapter in maxillofacial surgery. This retrospective study analyses data collected from 528 patients surgically treated at the University Hospital "Magna Graecia", Catanzaro, Italy, from 1st January 2007 to 31st January 2021. Methods: The inclusion criteria were a diagnosis of orbital bone fracture, complete clinical and radiological records, and a minimum follow-up of 12 months. We analyzed gender, age, etiology, fracture type, treatment, timing of repair, and associated complications. Results: The most frequent cause of trauma was road accidents (37.88%), followed by domestic accidents (25.95%). The manifestation of diplopia (72.35%), infraorbital nerve hypoesthesia (53.41%), extrinsic eye movement limitation (51.70%), and enophthalmos (41.29%), determined the indication for surgery. Our trauma team preferred the sub-eyelid approach (79.36%). The study shows a statistical significance in the correlation between the severity of the herniation of the lower rectus muscle and the presence of preoperative diplopia (p-value = 0.00416); We found the same statistical significance for the post-postoperative diplopia (p-value = 0.00385). Patients treated two weeks after the trauma show a higher rate of diplopia and a greater limitation of long-term post-operative eye movements than those treated within two weeks (diplopia 23.08% vs. 15.56%; eye movements limitation 13.33% vs. 7.69%). Early surgical treatment (> 14 days) reduces the likelihood of functional and structural damage to the lower rectus muscle. Conclusion: Our data will support future maxillofacial traumatology studies, and the education and prevention measures taken will reduce the incidence of orbital trauma. [ABSTRACT FROM AUTHOR]

Background and Objectives: There are numerous techniques for the surgical treatment of Achilles tendon lesions described in the literature, and it is possible to distinguish repair techniques as either open surgery or percutaneous repair techniques. Both approaches have advantages and disadvantages. With this retrospective study, we aim to analyze the incidence of re-ruptures and other complications, return to sport and overall quality of life at a long-term follow-up in the treatment of acute ATRs, comparing the results of percutaneous repair with those of open repair. Materials and Methods: This is a retrospective study on a consecutive series of patients with complete tear of the AT who were managed through a surgical approach by the Operative Unit of Orthopaedics and Traumatology of Sant'Anna University Hospital (Ferrara, Emilia-Romagna, Italy) between April 2014 and December 2021. Patients were treated with a percutaneous or an open technique according to the surgeon's preference without randomization. Results: We considered 155 patients who met the established inclusion criteria. Of these, 103 (66.45%) patients underwent percutaneous treatment with the Tenolig® system, and 52 (33.55%) underwent open surgery, with an average ATRS in the first group of 92.5 compared to an average ATRS value of 82 in patients treated with the open technique. Conclusions: In our experience, following overlapping rehabilitation protocols in all patients included, we observed that the Tenolig® repair system led to a better ATRS at long-term follow-up, with comparable complication rates to open surgery. [ABSTRACT FROM AUTHOR]

Study Design: The purpose of this study was to do a retrospective analysis about patients with mandibular fracture who were treated at the department of Maxillofacial Surgery, Regional University Hospital of Ancona, Italy, between 2011 and 2021. Objective: In this study we evaluated clinical and epidemiological findings of mandible fractures focusing on the association between surgical timing, type of surgical approach and mid- and long-term outcomes. Methods: Patients were evaluated based on various parameters including age, sex, etiology, symptoms, comorbidity, clinical findings, mandible fracture type, other facial fractures, treatment, waiting time before the operation, complications and sequelae. In the period described, we recorded 1023 mandibular fractures. 93% of patients underwent surgery under general anesthesia, almost exclusively patients undergoing an open approach to internal fixation. Results: Of the patients, 684 were male (66.86%) and 339 were female (33.13%). The average age of the patients was 42, 38 years (range, 7-94 years). The leading cause of these fractures was traffic accidents (27.3%) and mandibular parasymphysis fractures were the most frequent (34.1%). The most common clinical signs and symptoms were malocclusion, difficulty in chewing, limitation of the buccal opening, hypoesthesia extending through the territory of the inferior alveolar nerve, difficulty in protrusion movements and mandibular lateralization. Conclusions: The continuous research in epidemiology, etiology, materials, and techniques will further refine the treatments of mandible fractures, which are nowadays more and more customized according to the type of trauma. [ABSTRACT FROM AUTHOR]

Mucormycosis is an uncommon infection but is increasing in prevalence. Cutaneous disease is associated with burns and traumatic injuries. Cutaneous mucormycosis is the least deadly form but mortality is still approximately 36%. Burn superinfection with mucormycosis is increasingly common and can be an insidious process that may not present until the disease disseminates. We present the case of a 30-year-old male who presented to the emergency department for a rash. A rash with yellow crusting was noted to involve his scalp, face, ear, right shoulder, and parts of both feet. He had been placed on antibiotics by an urgent care a few days prior to presenting. He denied systemic symptoms, chemical exposure, change in detergent, autoimmune diseases, or travel. The patient has a history of intravenous opioid and dissociative abuse and had multiple episodes of syncope—including at his work in a factory where there were hot metals, refrigerants, and numerous corrosive chemicals. Surgical debridement revealed mucormycosis on pathology. The patient was treated with isavuconazole, surgical debridement, and skin grafting. He experienced complete recovery. [ABSTRACT FROM AUTHOR]

Abstract Background Only a few cases of bilateral traumatic sternoclavicular dislocations have been reported in the literature. This injury is considered one of the rarest injuries of the human musculoskeletal system. Therefore, we present the first documented case of a cyclist with a third-degree open thoracic trauma (Gustilo–Anderson 3a) associated with a dislocated manubrium sterni fracture in the upper thoracic aperture, bilateral anterior dislocations of the sternoclavicular joints, rib fractures, and pleural ruptures. Case presentation The patient, a 27-year-old Caucasian male, incurred this injury while participating in a professional cycling race at Nürburgring, Germany and received immediate interdisciplinary surgical treatment and has encountered no complications. We conducted a 1-year follow-up and present the clinical findings of this follow up. Additionally, we conducted a comprehensive review of the existing literature on this injury. Conclusions Immediate interdisciplinary intervention, including surgical repair and meticulous postoperative care, facilitated successful patient recovery. This underscores the critical role of comprehensive trauma management in complex polytrauma cases. In conclusion, this case report highlights the rarity and complexity of a traumatic injury involving bilateral sternoclavicular dislocation, with this case being the first case reported with concomitant open thorax trauma. Our patient benefited greatly from immediate air-bound transportation to an interdisciplinary care provider, which houses both thoracic and trauma surgery departments.

Aims: The aim of this study was to create artificial intelligence (AI) software with the purpose of providing a second opinion to physicians to support distal radius fracture (DRF) detection, and to compare the accuracy of fracture detection of physicians with and without software support. Methods: The dataset consisted of 26,121 anonymized anterior-posterior (AP) and lateral standard view radiographs of the wrist, with and without DRF. The convolutional neural network (CNN) model was trained to detect the presence of a DRF by comparing the radiographs containing a fracture to the inconspicuous ones. A total of 11 physicians (six surgeons in training and five hand surgeons) assessed 200 pairs of randomly selected digital radiographs of the wrist (AP and lateral) for the presence of a DRF. The same images were first evaluated without, and then with, the support of the CNN model, and the diagnostic accuracy of the two methods was compared. Results: At the time of the study, the CNN model showed an area under the receiver operating curve of 0.97. AI assistance improved the physician’s sensitivity (correct fracture detection) from 80% to 87%, and the specificity (correct fracture exclusion) from 91% to 95%. The overall error rate (combined false positive and false negative) was reduced from 14% without AI to 9% with AI. Conclusion: The use of a CNN model as a second opinion can improve the diagnostic accuracy of DRF detection in the study setting. Cite this article: Bone Joint Res 2024;13(10):588–595.

Relevance. According to statistical data, fractures of the scapula are quite rare, accounting for approximately 3-5% of all shoulder girdle fractures and less than 1% of the total number of fractures. Because of the high-energy nature of scapula fractures, 80% to 95% of cases are associated with additional traumatic injuries. The aim: to analyze the technique of performing surgical intervention in a fragment fracture of the right scapula with displacement of the fragments on the example of a clinical case. Object and methods. Patient G., 21 years old, on 12.10.2023 applied to the trauma center № 114 after a wind-driven tree fell on his right forearm area. A fracture of the right scapula with displacement of the fragments was detected, the patient was referred to the emergency room of the R.R. Vreden Research and Development Center for further examination and treatment. On admission to the department, the patient's right supraclavicular region was longer than the left one, the right supraclavicular region at the acromial end was swollen and painful, without visible deformity. Results. The study presents traumatologic pathology, namely, fractures of the articular and clavicular processes of the scapula with displacement of the fragments, as well as fracture of the acromial process of the scapula with minimal displacement of the fragments and cranial subluxation of the acromial end of the clavicle. The causes, diagnostic methods and surgical treatment of this pathology are described. Conclusions. Due to the growing amount of data on satisfactory postoperative results in patients with scapula fractures, there is still interest in surgical trends in the treatment of these patients. However, it is worth remembering that postoperative complications after repositioning and fixation of bone fragments continue to be an urgent problem.

The purpose of this study was to do a retrospective analysis about patients with zygomatic arch who were treated at the department of Maxillofacial Surgery, Regional University Hospital of Ancona, Italy, between 2007 and 2021. Patients were evaluated based on various parameters including age, sex, aetiology, symptoms, comorbidity, clinical findings, zygomatic arch fracture type, other facial fractures, treatment, waiting time before the operation, complications and sequelae. In the period described we recorded 103 zygomatic arch fractures. Of the patients, 64 were male (65,92%) and 39 were female (34,08%). The average age of the patients was 47,02 years (ranging from 8 to 93 years). The leading cause of these fractures was sports-related injury (n = 24; 23,30%), and isolated zygomatic arch fractures were the most frequent (63,1%). The most common clinical signs and symptoms were, pain, depression of the facial profile, difficulty in chewing, limitation of the buccal opening, difficulty in protrusion movements and mandibular lateralization. 93% of patients underwent surgery under local anesthesia, almost exclusively patients undergoing an open approach to internal fixation. The successful and effective management of zygomatic arch fractures requires a solid understanding of its anatomy, pathophysiology and related biomechanical structures and forces. The continuous research in epidemiology, aetiology, materials and techniques will further refine our treatments which are nowadays more and more customized according to the type of trauma. [ABSTRACT FROM AUTHOR]

To assess the actual presence of underlying depressed skull fractures and traumatic brain injuries (TBI) on computed tomography (CT) in children with and without palpable skull fractures on physical examination following minor head trauma. This was a secondary analysis of a prospective, observational multicenter study enrolling 42,412 children < 18 years old with Glasgow Coma Scale scores ≥ 14 following blunt head trauma. A palpable skull fracture was defined per the treating clinician documentation on the case report form. Skull fractures and TBIs were determined on CT scan by site radiologists. Palpable skull fractures were reported in 368/10,698 (3.4%) children < 2 years old, and in 676/31,613 (2.1%) of older children. Depressed skull fractures on CT were observed in 56/273 (20.5%) of younger children with palpable skull fractures and in 34/3047 (1.1%) of those without (rate difference 19.4%; 95%CI 14.6–24.2%), and in 30/486 (6.2%) vs 63/11,130 (0.6%) of older children (rate difference 5.6%; 95%CI 3.5–7.8%). TBIs on CT were found in 73/273 (26.7%) and 189/3047 (6.2%) of younger children with and without palpable skull fractures (rate difference 20.5%; 95%CI 15.2–25.9), and in 61/486 (12.6%) vs 424/11,130 (3.8%) of older children (rate difference 8.7%; 95%CI 6.1–12.0). Conclusions: Although depressed skull fractures and TBIs on CT are more common in children with palpable fractures than those without, most of these children do not have underlying depressed fractures. The discriminatory ability of the scalp examination could be enhanced by direct bedside visualization of the skull, such as through ultrasound. What is Known: • "Palpable skull fractures" are a high-risk predictor in the PECARN traumatic brain injury (TBI) rule for children younger than 2 years. • The reliability of physical exam findings suggestive of underlying skull fractures is unclear. What is New: • In children younger than 2 years of age, approximately one in five of those with "palpable skull fractures" will actually have a depressed skull fracture on CT, while 60% will have any skull fracture. • The discriminatory ability of the scalp examination could be enhanced by direct bedside visualization of the skull, such as through ultrasound. [ABSTRACT FROM AUTHOR]

Abstract Musculoskeletal disorders encompass a wide range of conditions that impact the bones, joints, muscles, and connective tissues within the body. Despite the ongoing debate on toxicity and administration, ozone demonstrated promise in managing several musculoskeletal disorders, modulating pain and inflammation. A literature search was conducted. The research design, methods, findings, and conclusions of the studies were then examined to evaluate the physiological effects, clinical application, controversies, and safety of the application of ozone in musculoskeletal medicine. Ozone application demonstrates considerable therapeutic applications in the management of musculoskeletal disorders, including fractures, osteoarthritis, and chronic pain syndromes. Despite these advantages, studies have raised concerns regarding its potential toxicity and emphasized the importance of adhering to stringent administration protocols to ensure safety. Additionally, heterogeneities in patient reactions and hazards from oxidizing agents were observed. Given its anti-inflammatory and analgesic qualities, ozone therapy holds potential in the management of several musculoskeletal disorders. Additional high-quality research with long follow-up is required to refine indications, efficacy and safety profile. Finally, for wider clinical acceptability and utilization, the development of international recommendations is essential.

Orthopedics and traumatology are clinical specialties that require continuous learning and skill enhancement. Traditional teaching methods may not always be sufficient to meet the needs of contemporary learners. This study aims to compare the effectiveness of microlearning as an additional tool in orthopedics and traumatology university courses alongside traditional teaching methods. The study concluded that microlearning significantly improved students' knowledge retention, practical skills, and overall performance compared to traditional teaching methods alone. The findings suggest that integrating microlearning into orthopedics and traumatology curricula can improve student learning outcomes and better prepare them for real-world practice. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to comprehensively compare host responses of patients with bacterial sepsis and those with viral (COVID-19) sepsis by analyzing messenger RNA (mRNA) and microRNA (miRNA) profiles to shed light on their distinct pathophysiological mechanisms. Design: Prospective observational study. Setting: Whole blood RNA sequencing was used to analyze mRNA and miRNA profiles of patients diagnosed as having bacterial sepsis or viral (COVID-19) sepsis at the Department of Trauma and Emergency Medicine, Osaka University Graduate School of Medicine. Patients: Twenty-two bacterial sepsis patients, 35 viral (COVID-19) sepsis patients, and 15 healthy subjects admitted to the department were included. We diagnosed bacterial sepsis patients according to the sepsis-3 criterion that the Sequential Organ Failure Assessment score must increase to 2 points or more among patients with suspected infections. Viral (COVID-19) sepsis patients were diagnosed using SARS-CoV-2 RT-PCR testing, and presence of pneumonia was assessed through chest computed tomography scans. Interventions: None. Measurements and main results: For RNA sequencing, 14,500 mRNAs, 1121 miRNAs, and 2556 miRNA-targeted mRNAs were available for analysis in the bacterial sepsis patients. Numbers of genes showing upregulated: downregulated gene expression (false discovery rate < 0.05, |log2 fold change| > 1.5) were 256:2887 for mRNA, 53:5 for miRNA, and 49:2507 for miRNA-targeted mRNA. Similarly, in viral (COVID-19) sepsis patients, 14,500 mRNAs, 1121 miRNAs, and 327 miRNA-targeted mRNAs were analyzed, with numbers of genes exhibiting upregulated: downregulated gene expression of 672:1147 for mRNA, 3:4 for miRNA, and 165:162 for miRNA-targeted mRNA. This analysis revealed significant differences in the numbers of upregulated and downregulated genes expressed and pathways between the bacterial sepsis and viral (COVID-19) sepsis patients. Bacterial sepsis patients showed activation of the PD-1 and PD-L1 cancer immunotherapy signaling pathway and concurrent suppression of Th1 signaling. Conclusion: Our study illuminated distinct molecular variances between bacterial sepsis and viral (COVID-19) sepsis. Bacterial sepsis patients had a greater number of upregulated and downregulated genes and pathways compared to viral (COVID-19) sepsis patients. Especially, bacterial sepsis caused more dramatic pathogenetic changes in the Th1 pathway than did viral (COVID-19) sepsis. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion The rise in popularity of ride share e‐scooters has led to an increase in the number of e‐scooter injuries, with existing literature reporting increases in rates of admission by more than 350%. In April 2023, the Broome Shire signed a contract to provide 300 e‐scooters as part of a shared micro mobility platform. This study aimed to describe the demographics, clinical presentation and health system utilization of patients presenting with e‐scooter‐related injuries at Broome Regional Hospital (BRH).A retrospective cohort study examined all e‐scooter‐related injuries presenting to BRH between April 1st 2023 and April 30th 2024. Patients with e‐scooter injuries described in their Emergency Department (ED) electronic triage records were included. Data was collected from chart review.A total of 190 patients were identified as having sustained an e‐scooter injuries over the 12‐month trial period. The median age was 26 years with equal numbers of males and females. Most injuries occurred between 6 pm and 12 am (28%) with 53% of patients reporting being intoxicated, while 75% were not wearing a helmet. Almost all patients (80%) were managed in the emergency department because of the low severity of their injuries. Of the remaining patients, 22 were admitted, with 16 transferred for tertiary‐level operative management.The introduction of e‐scooters for shared micromobility represents a new cause of trauma related presentations to BRH. Our study's results have raised awareness regarding the incidence and severity of electric scooter injuries in Broome. [ABSTRACT FROM AUTHOR]

Background: Maxillofacial trauma (MFT) caused by falls, interpersonal violence or traffic accidents leading to fractures of different facial regions, including the midface and the mandible, are common clinical conditions requiring open reduction and internal fixation. The aim of this study was to analyze the incidence and time trends in MFT-associated surgeries regarding different facial regions in the German healthcare system over time. Materials and methods: Nationwide data regarding the national diagnosis-related group (DRG) inpatient billing system was received from the German Federal Statistical Office for the years 2005–2022. We estimated the age–gender standardized incidence of MFT-associated procedures classified by the Operation and Procedure Classification System (OPS) and evaluated age- and gender-adjusted time trends using Poisson regression analysis. Results: The total standardized incidence rate of MFT-associated procedures in the observational period 2005–2022 was 25.1 (♀13.3; ♂37.5) per 100,000 person-years within a slight significant annual decrease of 0.5%. A significant increase in the incidence of MFT-related procedures within the observational period was found in older adults from 60 to 79 years (+55.1%; ♀+54.8%; ♂+56.3%) and elderly patients over 80 years (+66.7%; ♀+59.1%; ♂+85.1%). Other significant trends are decreases in MFT-related procedures performed in children from 0–14 years (−28.1%; ♀−30.3%; ♂−27.3%) and young adults between 15 and 35 years (−20.4%; ♀−7.3%; ♂−22.5%). Conclusions: MFT-associated surgery is a persisting challenge in the German healthcare system. There is an ongoing transition in MFT-associated surgeries from younger to older patients beyond the scope of demographic change, highlighting the increasing importance of interdisciplinary treatment of patients with pre-existing conditions in maxillofacial surgery. Implementation of injury prevention measures might be beneficial in this population. [ABSTRACT FROM AUTHOR]

This article discusses various topics related to dental traumatology research. It emphasizes the importance of qualitative research methods in gaining insights into patients' perspectives of traumatic dental injuries. The use of finite element analysis (FEA) in dentistry research is also explored, highlighting its value in understanding the biomechanics of the oral cavity. Other topics covered include the treatment of immature teeth with necrotic pulps, the need for comprehensive dental trauma education, the importance of dental trauma first aid, the impact of the COVID-19 pandemic on traumatic injuries, the correlation between facial fractures and traumatic brain injuries, the demographics and causes of mandibular condylar fractures in pediatric patients, the effectiveness of sports mouthguards in preventing orofacial injuries, and the appropriate use of splinting materials in stabilizing traumatized teeth. [Extracted from the article]

This review highlights the recent contributions of qualitative research in advancing understanding of dental trauma injury and the barriers and enablers to guide policy for improved patient‐centred care including transitional care. It summarises the common approaches and methods used and outlines the key factors that guide the appraisal of qualitative studies. It highlights the importance of the application of qualitative research methods in dental research to generate rich and detailed data to provide explanations and insights into people's experiences, beliefs and attitudes and the complexity of human decision‐making and behaviour. In the past decade while there have been a growing number of publications of qualitative studies in dental journals, qualitative studies remain a small percentage of the published dental traumatology research. This may be because of limited understanding about the background, methods and rigour of qualitative research. [ABSTRACT FROM AUTHOR]

The primary objective of this study was to compare the clinical outcomes of total elbow arthroplasty as the index procedure in the treatment of traumatic distal humerus fractures with those of secondary total elbow arthroplasty after failed internal fixation. The secondary objective was to compare the complication rates and the radiographic results in the 2 groups. Our hypothesis was that the clinical results of total elbow arthroplasty performed after failed internal fixation were comparable to those of primary total elbow arthroplasty in the treatment of distal humerus fractures in the elderly population. We conducted a retrospective cohort comparison study, including 60 patients with a median age of 80 years (71-85 years), who either underwent a primary total elbow arthroplasty (group 1; 45 patients) or secondary total elbow arthroplasty after failed internal fixation (group 2; 15 patients) in the treatment of a post-traumatic supra and intercondylar fracture of the distal humerus, between January 2004 and January 2021. The clinical examination, including the Mayo Elbow Performance Score and triceps proficiency test, complication rates, and the need for reoperation were noted. The average clinical and radiographic follow-up was 40.8 months (24-120 months). The clinical results of the 2 groups were comparable when looking at the Mayo Elbow Performance Score (90.00 [85.00, 100.00], P =.486). With regard to complications, there were 2 surgical site infections in group 1 and 3 in group 2 (P =.099), 1 case of mechanical loosening of the humeral component in group 1 and 1 in group 2 (P =.448), and 1 patient with triceps insufficiency in group 1. Secondary total elbow arthroplasty after failed internal fixation has shown good functional results and a complication rate comparable to that of index total elbow arthroplasty in the treatment of articular fractures of the distal humerus in the elderly. [ABSTRACT FROM AUTHOR]

Copyright of Nursing Journal / Sestrinski Glasnik is the property of Croatian Nurses Association 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.)

An urgent issue is the preservation or reconstruction of the volume of bone tissue in planning and surgical treatment in the fields of medicine, such as traumatology, orthopedics, maxillofacial surgery and dentistry. After tooth extraction, resorption of the bone tissue of the alveolar crest of the jaws occurs, which must either be further eliminated by performing additional operations or using osteoplastic material for socket preservation at the extraction stage. Background and Objectives: The aim of the study was a comparative analysis of various osteoplastic materials used to preserve the volume of bone tissue in the preimplantation period. Materials and Methods: As part of the study, 80 patients were treated, who underwent socket preservation using xenografts, plasma enriched with growth factors, an autologous dentin matrix (ADM) and hydroxyapatite. Results: The results of the treatment 16 weeks after removal were comprehensively analyzed using a morphometric analysis of the bone's volume, cone beam tomography and morphological examination of burr biopsy specimens, as well as by determining the stability of the installed implant at different stages of treatment. Conclusions: The lowest level of bone tissue resorption according to the CBCT data was noted in the ADM and xenograft groups. It should be noted that the use of osteoplastic material in jaw surgery when reconstructing alveolar defects is an essential procedure for preventing the atrophy of bone tissue. [ABSTRACT FROM AUTHOR]

Globally, traumatic injury is a leading cause of suffering and death. The ability to curtail damage and ensure survival after major injury requires a time‐sensitive response balancing organ perfusion, blood loss, and portability, underscoring the need for novel therapies for the prehospital environment. Currently, there are few options available for damage control resuscitation (DCR) of trauma victims. We hypothesize that synthetic polymers, which are tunable, portable, and stable under austere conditions, can be developed as effective injectable therapies for trauma medicine. In this work, we design injectable polymers for use as low volume resuscitants (LVRs). Using RAFT polymerization, we evaluate the effect of polymer size, architecture, and chemical composition upon both blood coagulation and resuscitation in a rat hemorrhagic shock model. Our therapy is evaluated against a clinically used colloid resuscitant, Hextend. We demonstrate that a radiant star poly(glycerol monomethacrylate) polymer did not interfere with coagulation while successfully correcting metabolic deficit and resuscitating animals from hemorrhagic shock to the desired mean arterial pressure range for DCR – correcting a 60 % total blood volume (TBV) loss when given at only 10 % TBV. This highly portable and non‐coagulopathic resuscitant has profound potential for application in trauma medicine. [ABSTRACT FROM AUTHOR]

Musculoskeletal disorders encompass a wide range of conditions that impact the bones, joints, muscles, and connective tissues within the body. Despite the ongoing debate on toxicity and administration, ozone demonstrated promise in managing several musculoskeletal disorders, modulating pain and inflammation. A literature search was conducted. The research design, methods, findings, and conclusions of the studies were then examined to evaluate the physiological effects, clinical application, controversies, and safety of the application of ozone in musculoskeletal medicine. Ozone application demonstrates considerable therapeutic applications in the management of musculoskeletal disorders, including fractures, osteoarthritis, and chronic pain syndromes. Despite these advantages, studies have raised concerns regarding its potential toxicity and emphasized the importance of adhering to stringent administration protocols to ensure safety. Additionally, heterogeneities in patient reactions and hazards from oxidizing agents were observed. Given its anti-inflammatory and analgesic qualities, ozone therapy holds potential in the management of several musculoskeletal disorders. Additional high-quality research with long follow-up is required to refine indications, efficacy and safety profile. Finally, for wider clinical acceptability and utilization, the development of international recommendations is essential. [ABSTRACT FROM AUTHOR]

Background: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that affects both the upper and lower motor neurons, it has a heterogeneous clinical presentation, there are atypical variants that differ from the classic form of the disease. The criteria for diagnosis have evolved over time, with the support of electromyography (EMG), we present a patient series with these variants in which EMG was crucial to make the diagnosis. Clinical cases: Six cases are described with atypical presentation of motor neuron disease, for the isolated bulbar ALS phenotype, three cases are reported: two male patients (68 and 62 years old) and one woman (33 years old), with initial symptoms in the bulbar segment and late progression. to a second segment, corroborating characteristic findings by EMG. For the variant of Vulpian-Bernhardt syndrome (VBS), two male patients aged 82 and 72 years are reported, with initial symptoms in the thoracic segment with electromyographic support for the diagnosis; Finally, a case of amyotrophic diplegia of the legs (APD) is described in a 50-year-old female patient with symptoms isolated to the pelvic limbs, with a slow clinical evolution, corroborated by EMG with involvement of other spinal segments. Conclusions: ALS is part of the spectrum of motor neuron diseases, a neurodegenerative disease of the central nervous system, without curative treatment and with a fatal outcome. The diagnosis of ALS is complex and becomes more complicated for atypical phenotypes, as observed in the cases presented, EMG is an essential part of the approach and is part of the most recent diagnostic criteria. [ABSTRACT FROM AUTHOR]

Introduction: Aging adversely impacts the functioning of the organs of the human body and the musculoskeletal system. Orthopedics and traumatology clinics are a speciality area where services are provided for health issues requiring long-term care and multi-disciplinary teamwork. Consequently, patient–nurse interaction occurs for an extended period. Materials and Method: This descriptive study aimed to determine the perception of nursing care and satisfaction levels of orthopedics and traumatology patients. The data were collected after face-to-face interviewswith patients who had applied to an orthopedics and traumatology clinic between May 2022 and April 2023 and had undergone surgical procedures. The patient information form, Newcastle Nursing Care Satisfaction Scale, and Patient’s Perception of Nursing Care Scale were used for data collection. Results: The mean age of the study participants was 65.83±15.90 and 47.6% (n=137) of the participants were catagorized as elderly. The mean score on the Newcastle Nursing Care Satisfaction Scale was 85.01±16.85 and on the Patient’s Perception of Nursing Care Scale was 64.47±13.26. There was a moderate positive significant relationship between the scores on the Newcastle Nursing Care Satisfaction Scale and Patient’s Perception of Nursing Care Scale (r_s=.391; p<.01). Conclusion: Patients’ satisfaction with nursing care and perception of care were positive. Additionally, as the patients’ satisfaction with nursing care increased, their perception of nursing care also increased. [ABSTRACT FROM AUTHOR]

Aim: In previous studies it has been shown that scapular morphology is associated with supraspinatus tears. However, the relationship between subscapularis tears and scapular morphology is controversial. The aim of this study is to investigate whether or not subscapularis tear accompying supraspinatus tear is related to scapular morphology. Materials and Method: Records and imaging of 679 shoulder arthroscopy surgeries performed for rotator cuff tear in our orthopedics and traumatology clinic between 2016 and 2020 were retrospectively analyzed. 162 patients with isolated full-thickness supraspinatus tear and 83 patients with subscapularis tear accompanying supraspinatus tear were included in the study. The critical shoulder angle (CSA), glenoid version (GV), glenoid inclination (GI) and critical coracoid process angle (CCPA) of the patients were measured. Results: In the patient group with isolated supraspinatus tear and in the group with subscapularis tear accompanying supraspinatus tear; The mean age was 53.8±8.9 and 61.1±8.4 respectively, and there was a significant difference (P<0.001); the mean CSA values were 36.9°±4.25° and 35.6°±5.1°respectively, (P=0.32); GI mean values were 7.72°±5.4° and 8.4°±5.3°respectively, (P=0.51); GV mean values were 2.1°±4,5° and 2.5°±4.7° respectively, (P = 0.85); mean CCPA values were 21.4°±4.5° and 22.3°±4.9°respectively, (P=0.73). There was no significant difference between the groups in terms of gender (P=0.59). In the logistic regression analysis performed by using criteria of the measured angles, age and gender, it was observed that advanced age had an effect on the subscapularis tear accompanying the supraspinatus tear, independent of the other parameters (P < 0.001 OR:1.09). Conclusion: There appears not to be a significant difference between isolated supraspinatus tears and subscapularis tear accompanying supraspinatus tear, in terms of radiological parameters regarding scapular morphology. Age seems to be the most important factor in subscapularis tear accompanying supraspinatus tears. In patients with supraspinatus tear, an increase in age by one unit (in years) increases the odds of subscapularistear by1.09 times. [ABSTRACT FROM AUTHOR]

Introduction: This study analysed the trend of publications on anterior cruciate ligament (ACL) in Italy. It was hypothesised that publications on this topic have quickly increased in recent years due to increased knowledge of both clinical and radiological pathology. Methods: PubMed and Scopus were accessed on 29/11/2023. This retrieved 838 articles from PubMed and 1050 from Scopus. We analysed the top 10 authors, and journals in publication numbers, citation numbers, and citations per year. We have also looked at the top 10 institutions publishing on anterior cruciate ligament from Scopus as PubMed does not give this information in the output. Data mining was performed using the Orange software, Mac version 3.32.0 (https://orangedatamining.com/) from the titles of all articles. A word cloud analysis of titles, authors, journals and universities was performed. Results: The peak of citations was in 2017 with 1529, whilst the peak of publications was in 2019 with 59 articles published. Analysing the number of publications and citations for the journal, the most impacted journal is Knee Surgery, Sports Traumatology, Arthroscopy with 5472 citations and 183 articles, followed by The American Journal of Sports Medicine, with 2722 citations and 56 articles and Arthroscopy with 1990 citations and 62 articles. Considering also international collaborations, the most cited author is Della Villa F. in 2020 with 43.67 citations per year. The Italian author with the major number of publications is Zaffagnini S. with 39 articles, whilst the author with the higher number of citations is Aglietti P. with 1612 citations. Conclusions: ACL reconstruction has gained growing interest amongst the scientific community. Publications and citations presented a rising trend, the majority of the highly cited papers were contributed by few centres, and clinical trials were the most cited study designs. The long-term outcomes of ACL lesions have attracted interest. The authors hypothesised that shortly there will be an increase in articles analysing the results of ACL revisions, the use of lateral extra-articular tenodesis, and meniscus transplants. Level of evidence IV: Cross-Sectional Study [ABSTRACT FROM AUTHOR]

Introduction: A venous port system consists of a port chamber attached to a central catheter, which is implanted into the central venous system. The removal of the vascular port includes all items of this system. This procedure is usually simple and quick. Complications with port removal are rare but possible. Aim: The study aimed to summarize venous port removal procedures performed by pediatric surgeons. Material and methods: The single-center, retrospective study was conducted on 360 pediatric patients treated during the years 2010–2022 in the Department of Pediatric Surgery, Traumatology, and Urology in Poznan. Results: The port usage time before the removal ranged from 3 days to 8 years and 3 months, with an average of 22 months. The leading cause of vascular port removal was the end of treatment (78.06%). Other less frequent reasons were the infection (13.89%) and mechanical damage of the port (3.33%). There were almost no complications connected with the procedure of vascular port removal (92.2%). If the complications occurred, they included bleeding during surgery (3%), covering the vascular catheter with bone tissue of the clavicle, causing difficulties with the catheter removal from the vein (1.4%), and connected with the previous complications- prolonged clavicle pain after surgery (1.4%) and hematoma after surgery (2%). Conclusions: Removing the venous port is a safe procedure with a low risk of complications. This procedure can be considered as an appropriate training procedure for young trainees. A more extended period of use of the vascular port before its removal may be associated with more difficulties during surgery. [ABSTRACT FROM AUTHOR]

Background: Patient‐Specific Surgical Guides (PSSGs) are advocated for reducing radiation exposure, operation time and enhancing precision in surgery. However, existing accuracy assessments are limited to specific surgeries, leaving uncertainties about variations in accuracy across different anatomical sites, three‐dimensional (3D) printing technologies and manufacturers (traditional vs. printed at the point of care). This study aimed to evaluate PSSGs accuracy in traumatology and orthopaedic surgery, considering anatomical regions, printing methods and manufacturers. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines. Studies were eligible if they (1) assessed the accuracy of PSSGs by comparing preoperative planning and postoperative results in at least two different planes (2) used either computer tomography or magnetic resonance imaging (3) covered the field of orthopaedic surgery or traumatology and (4) were available in English or German language. The 'Quality Assessment Tool for Quantitative Studies' was used for methodological quality assessment. Descriptive statistics, including mean, standard deviation, and ranges, are presented. A random effects meta‐analysis was performed to determine the pooled mean absolute deviation between preoperative plan and postoperative result for each anatomic region (shoulder, hip, spine, and knee). Results: Of 4212 initially eligible studies, 33 were included in the final analysis (8 for shoulder, 5 for hip, 5 for spine, 14 for knee and 1 for trauma). Pooled mean deviation (95% confidence interval) for total knee arthroplasty (TKA), total shoulder arthroplasty (TSA), total hip arthroplasty (THA) and spine surgery (pedicle screw placement during spondylodesis) were 1.82° (1.48, 2.15), 2.52° (1.9, 3.13), 3.49° (3.04, 3.93) and 2.67° (1.64, 3.69), respectively. Accuracy varied between TKA and THA and between TKA and TSA. Conclusion: Accuracy of PSSGs depends on the type of surgery but averages around 2–3° deviation from the plan. The use of PSSGs might be considered for selected complex cases. Level of Evidence: Level 3 (meta‐analysis including Level 3 studies). [ABSTRACT FROM AUTHOR]

Background: Increased incidence of firearm injuries in developing countries has been attributed to poverty, unemployment, political instability, lack of education and unequal distribution of wealth. It is one of the important causes of morbidity and mortality in our country. Material and methods: This prospective study was conducted at Jawaharlal Nehru Medical College Hospital, AMU, Aligarh in the department of Forensic Medicine and in the Trauma and Emergency department between October 2018 to September 2020.130 patients of Gunshot injuries were included after obtaining informed consent. Results: Males (n=115; 88.46 %) were the predominant victims of gunshot injuries while female patients comprise of 11.54 % (n=15) only. Male to female ratio was 7.67:1. Majority (n=115; 88.46 %) of the gunshot injury cases were the result of homicidal motive. Lower (n=50; 35.46 %) and upper extremities (n=41; 31.53 %) were the most common sites of injury. Conclusion: There is a need to decrease the number of firearms used and sold in India. We need to eradicate illicit local community gun manufacturing units. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion To survey the current structure, capability and operational scope of pre‐hospital and retrieval aeromedical teams across Australia.The medical directors of all Australian civilian adult aeromedical retrieval organisations with pre‐hospital teams and/or doctors for inter‐hospital critical care patient transport were contacted in a survey to qualitatively assess capacity and team structure.All 17 organisations contacted completed the survey. While there is diversity in team structure with the pairing of doctors, paramedics and nurses, capacity for patient care is generally homogenous. A doctor/paramedic model is the more common team structure for rotary‐wing missions, and doctor/nurse for fixed‐wing. Differences are mostly due to state government controlled aspects of their health services. An advanced degree of intensive patient care occurs outside of the hospital. Land and sea rescue is an important aspect of Australian aeromedical work.Aeromedicine in Australia has many consistent elements, but variable contexts have resulted in a diversity of operational models. [ABSTRACT FROM AUTHOR]

Copyright of Sport-Orthopadie - Sport-Traumatologie is the property of Elsevier B.V. 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.)

This contribution gives basic information about the mechanical behavior of the facial part of the human skull cranium, i.e., the splanchnocranium, associated with external loads and injuries caused mainly by brachial violence. The main areas suffering from such violence include the orbit, frontal, and zygomatic bones. In this paper, as a first approach, brachial violence was simulated via quasi-static compression laboratory tests, in which cadaveric skulls were subjected to a load in a testing machine, increasing till fractures occurred. The test skulls were also used for research into the dynamic behavior, in which experimental and numerical analyses were performed. A relatively high variability in forces inducing the fractures has been observed (143–1403 N). The results lay the basis for applications mainly in forensic science, surgery, and ophthalmology. [ABSTRACT FROM AUTHOR]

Copyright of Arthroskopie is the property of Springer Nature 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.)

Purpose: The objective of this multicenter study was to examine the differences in maxillo-facial fractures epidemiology across the various phases of the SARS-CoV-2 pandemic. Methods: This is a retrospective study on patients who underwent surgery for facial bone fractures in 18 maxillo-facial surgery departments in Italy, spanning from June 23, 2019, to February 23, 2022. Based on the admission date, the data were classified into four chronological periods reflecting distinct periods of restrictions in Italy: pre-pandemic, first wave, partial restrictions, and post-pandemic. Epidemiological differences across the groups were analysed. Results: The study included 2938 patients. A statistically significant difference in hospitalization causes was detected between the pre-pandemic and first wave groups (p = 0.005) and between the pre-pandemic and partial restriction groups (p = 0.002). The differences between the pre- and post-pandemic groups were instead not significant (p = 0.106). Compared to the pre-pandemic period, the number of patients of African origin was significantly higher during the first wave and the post-pandemic period. No statistically significant differences were found across the periods concerning gender, age, fracture type, treatment approach, and hospital stay duration Conclusions: The COVID-19 pandemic brought about significant changes in fracture epidemiology, influenced by the restrictive measures enforced by the government in Italy. Upon the pandemic's conclusion, the fracture epidemiology returned to the patterns observed in the pre-pandemic period. [ABSTRACT FROM AUTHOR]