The changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists

Winkler, Dennis C.; Goudie, Stuart; Court-Brown, Charles M.

doi:10.1016/j.injury.2017.11.009

Cited by 17 publications

(9 citation statements)

References 10 publications

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“…With the gradual development of society and the acceleration of industrial modernization, there are more and more cases of high-energy injuries, and limb fractures are the most common clinically [1]. Because patients are prone to wound infection, skin necrosis, and long-term wound healing after fracture, it is very easy for patients to develop traumatic osteomyelitis without effective treatment.…”

Section: Introductionmentioning

confidence: 99%

Effects of Vacuum Sealing Drainage Combined with Ilizarov Bone Transport Technique in the Treatment of Tibial Traumatic Osteomyelitis

et al. 2019

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BackgroundThe aim of this study was to analyze the efficacy of vacuum sealing drainage combined with Ilizarov bone transport technique in the treatment of tibial traumatic osteomyelitis and risk factors for postoperative pin infection.Material/MethodsWe enrolled 78 patients with tibial traumatic osteomyelitis admitted at the First People’s Hospital of Kashgar from January 2015 to September 2017 and treated with vacuum sealing drainage combined with Ilizarov bone transport technique.ResultsAfter combined treatment, SAS and SDS scores decreased significantly, while SF-36 scores increased significantly. Comparisons showed that there were significant differences in the scores of patients after treatment (P<0.05). Univariate analysis showed that there were no significant differences in gender, BMI, hypertension, diabetes mellitus, COPD, smoking index, alcohol abuse history, or residence (P>0.05). There were significant differences in age, fracture type, fixation type, pin loosening, and indwelling time between the 2 groups (P<0.05). Multivariate logistic analysis showed that age, fracture type, fixation type, pin loosening, and indwelling time were independent risk factors for pin infection. Age, fracture type, fixation type, pin loosening, and indwelling time are independent risk factors for pin infection in patients with tibial traumatic osteomyelitis.ConclusionsCombination of vacuum sealing drainage with Ilizarov bone transport technique can effectively improve the condition of tibial traumatic osteomyelitis, improve the quality of life of patients, and reduce the occurrence of adverse emotions of patients. Age, fracture type, fixation type, pin loosening, and indwelling time are independent risk factors for pin infection in patients with tibial traumatic osteomyelitis.

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Section: Introductionmentioning

confidence: 99%

Effects of Vacuum Sealing Drainage Combined with Ilizarov Bone Transport Technique in the Treatment of Tibial Traumatic Osteomyelitis

et al. 2019

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“…3,4 Epidemiological studies report a bimodal distribution, with high-energy injuries in the young and low-energy fragility injuries in the elderly. 3,5,6 Consequently, both bring a challenge with the management of the soft tissue envelope, as the young are associated with an overlying direct high-energy trauma 5 and the elderly have comorbidities such as malnutrition, obesity, diabetes and vascular disease. 7 Ankle fractures that require fixation are most often managed using AO principles of open reduction and internal fixation (ORIF) with lag screw and neutralization plate 8 or bridging plate in the case of multifragmentary fractures.…”

Section: Introductionmentioning

confidence: 99%

Fibular nails for open and closed ankle fractures: Results from a non-designer level I major trauma centre

Al-Obaidi

Wiik

Bhattacharyya

et al. 2019

J Orthop Surg (Hong Kong)

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To evaluate the outcome of a fibular nail in the treatment of open and closed unstable ankle fractures in a nondesigner centre. Methods: In a retrospective cohort study, a total of 39 ankle fractures (14 open and 25 closed) treated with a locking fibular nail were evaluated between 2012 and 2015 in a non-designer level I major trauma centre. Postoperative radiographs were analysed to assess the quality of reduction (McLennan and Ungersma marking system), fracture union and complications. Three patient reported outcome scores (Olerud and Molander score (OMAS), American Association of Orthopaedic Surgeons (AAOS) foot and ankle score and 12-Item Short Form Survey (SF-12)) were collected to obtain an overall measure of the patient's physical and mental outcome. Results: The adequacy of reduction data was available for 38 of 39 cases; 33 (87%) achieved good, 3 (8%) fair and 2 (5%) poor ratings, based on the McLennan and Ungersma marking system. Thirty-five (12 open and 23 closed) patients were available for initial follow-up. Five (14.3%) of 35 had documented complications (2 of 12 in the open cohort and 3 of 23 in the closed cohort). All fibular fractures treated with the fibular nail went on to unite. Twenty-three (66%) of 35 patients were available at 1-year followup for measurement of objective outcome. The combined mean OMAS for both groups was 53.7 (0-85) with statistically better results (59.5 (25-85) vs. 37.3 (0-75)) in favour of the closed versus open injuries, respectively. The mean AAOS score was also statistically better for the closed group than the open, 70.3 (30-95) versus 46.6 (20-77), respectively. The mean SF-12 score (physical component) was 40 (21.6-52.4) in the closed group versus 36.1 (19.4-51.5) in the open group; the mean mental component was 42.5 (26.6-54.3) in the closed group versus 38.8 (28.4-60.5) in the open group, these however were not statistically different. Conclusion: Fibular nails are an effective alternative for the treatment for both closed and open unstable ankle fractures with soft tissue compromise.

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“…According to Winkler et al, the number of road traffic accidents (RTAs) as a cause of accident has decreased during 1988-2010. 13 In our study from more recent years, the number of falls was higher than RTAs among patients with moderate injuries, who represent 88% of the study population. This is consistent with the trend of improved road safety, and at the same time increasing group of the elderly.…”

Section: Discussionmentioning

confidence: 56%

<p>Diagnosis of Open Tibial Fracture Showed High Positive Predictive Value in the Swedish National Patient Register</p>

Tampe¹,

Frank²,

Weiss³

et al. 2020

CLEP

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Introduction: The Swedish National Patient Register was validated only for a few diagnoses in the field of trauma. In this study, we calculated the positive predictive values (PPV) of the diagnosis of open tibial fracture and corresponding E-codes (cause of injury). Patients and Methods: Out of 2845 cases from a 10-year period (2007-2016), a random sample of 300 cases was selected for review of medical records. The accuracy of the diagnosis and cause of injury was calculated and presented as PPV. We divided the study population into two subgroups (moderate and severe injury) that were analyzed separately. Severe injury was defined as when a patient had an amputation and/or reconstructive surgical procedures, indicated by corresponding ICD-codes. Results: The PPV of the diagnosis of open tibial fracture was 87% (95% CI: 86-88%) overall, 86% (95% CI: 79-91%) for moderate injuries and 96% (95% CI: 91-98%) for severe injuries. The PPV for E-codes was 74% (95% CI: 65-81%). The majority of injuries were caused by falls (47%) or transport accidents (38%). Most of these injuries were caused by high-energy trauma (60%). Conclusion: The PPV of the diagnosis of open tibial fracture in the Swedish National Patient Register is high (87%). The PPV of E-codes was lower (79%). The results imply that the register is well suited for healthcare evaluation and research purposes regarding trauma diagnoses. Most open tibial fractures are high-energy injuries.

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The changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists

Cited by 17 publications

References 10 publications

Effects of Vacuum Sealing Drainage Combined with Ilizarov Bone Transport Technique in the Treatment of Tibial Traumatic Osteomyelitis

Effects of Vacuum Sealing Drainage Combined with Ilizarov Bone Transport Technique in the Treatment of Tibial Traumatic Osteomyelitis

Fibular nails for open and closed ankle fractures: Results from a non-designer level I major trauma centre

<p>Diagnosis of Open Tibial Fracture Showed High Positive Predictive Value in the Swedish National Patient Register</p>

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