a b s t r a c tApproximately 50% of infant and toddler long bone fractures are attributed to nonaccidental trauma; however, differentiating from benign mechanisms is subjective, due to an absence of evidence-based diagnostic tools. Previous studies investigated small ranges of rotational velocities in animal long bone models, although did not report the variation in the spiral fracture angle. This study considered the fracture angle as a potential clinical measure, correlating this data with a wider range of rotational velocities. The spiral fracture angle was measured relative to the long axis, whilst noting the narrowest diaphysial diameter, location of the fracture, and the extent of comminution and periosteal disruption. Twenty-six bones failed in spiral fracture, with the potting material failing in the remaining tests. All spiral fractures centred on the narrowest diaphysial diameter.Slower rotational velocities caused fracture angles approaching 45 , whereas fractures at greater velocities caused fracture angles nearer 30 . A relatively strong trend (R 2 ¼ 0.78) is reported when the normalised fracture angle (against the narrowest diaphysial dimension) was plotted against the rotational rate. A relationship has been identified between the angle of spiral fracture and the rotational velocity using the immature bovine metatarsal model. This trend forms a scientific foundation from which to explore developing a diagnostic, evidence-based tool that may ultimately serve to assist differentiating between accidental and non-accidental injury.

Anterior crown fractures are a common form of injury that mainly affects children and adolescents due to their position in the oral cavity especially in the maxillary arch. Reattachment of original tooth fragment to the fractured tooth forms a relatively quick, biologic and esthetic restoration. A 28 years old male reported to the Department of conservative dentistry & endodontics with a complex crown fracture of 21 and 22 one day after the trauma had occurred. Following endodontic treatment, a glass fibre post was used to increase retention and distribute stresses along the tooth. The dental restoration was completed using the original fragment and a dual cure resin composite. Clinical and radiographic examination at 3, 6 & 11 months recall showed the glass fiber post and restoration was in place, indicating the success of the treatment in maintaining the fractured tooth.

Background:In situ simulation shows promise as an effective training tool for trauma; however, its disruptive nature is a major downside. Although the benefits of in situ simulation in trauma have been described, the potential perceived harms of running an unscheduled simulation using working staff are unknown. The aim of this study is to assess trauma team members' perceptions regarding the value of in situ simulation relative to its perceived impact on patient care. Methods: We conducted a longitudinal survey study including all members of the multidisciplinary trauma team at the Halifax Infirmary, a level 1 trauma centre in Nova Scotia. Following an in situ simulation, participants were given a 10-question survey with answers on a 5-point Likert scale. Results: A total of 61 surveys were collected. Survey respondents were grouped into allied health (nurses, paramedics, respiratory therapists; 44%), learners (residents and medical students; 44%) and other (staff physicians, those who did not specify their role; 12%). Respondents felt that participating in the in situ simulation delayed (28%) or compromised patient care (5%) infrequently. No respondents felt that patients were harmed. In situ simulation was felt to identify important safety issues (70%), improve trauma team communication (89%) and improve trauma patient care (89%). The in situ simulation was considered enjoyable (92%) and was identified as a good educational experience (95%). It was felt by participants that simulations should continue to be done in situ in the trauma bay rather than in a sim laboratory (54%). Conclusion:The trauma in situ simulation program at the Halifax Infirmary is not felt to cause delays or compromise patient care. The program is considered to be a good learning opportunity that identifies safety issues and improves patient care. Epidemiology of submersion injuries inCanadian children and adolescents: 1990-2018.

Hydatid cyst is a common parasitic disease found mostly in developing countries, causing diagnostic and therapeutic challenges to the radiologists and physicians. Orbital hydatid is quite rarely reported in literature (<1%). Surgical excision is the treatment of choice. Care should be taken pre-operatively to avoid the risk of rupture with the help of imaging modalities depending on the location of hydatid cyst. Our objective is to report an unusual case of hydatid cyst in orbit with help of superior imaging modality like magnetic resonance imaging. This was successfully managed by complete surgical resection. Further, histopathological diagnosis led us to prompt diagnosis.