Trauma Monthly
Volume:24 Issue: 2, Mar-Apr 2019

The increasing rate of fall - induced trauma cases leads to an increase in mortality rates and lengthy hospital stay across the globe. The current study aimed at investigating the fall - related mortality in the age - group of 15 years and over.

The current cross sectional study was conducted in 2016 on patients visiting Shahid Rajaee Hospital of Shiraz, Iran, for fall - induced injuries by census sampling method. The researchers completed a questionnaire including demographic data, accident type, and height of fall, duration of hospital stay, injured body regions, type of activity in time of accident, injury severity score, and death. Data were categorized and analyzed.

There were 544 subjects in the current study, with a mean age of 49.3 ± 22.42 years; 67% of the patients were male and 33% female, and 74.8% were married; the gender ratio was 2.02. There was no significant difference between the mean ages of injured females (59.15 ± 21.43 years) and males (44.43 ± 21.03 years) (P = 0.92). There was a significant relationship between injury site and fall - related mortality in the age group of 60 years and over (P = 0.02). Most cases of falls occurred during daily and occupational activities, mostly in the evenings. Around 54.2% of the injuries included multiple - organ injuries. Fall - induced injuries were more severe among the age group of 15 - 40 years and patients over 60 years old.

According to the high mortality and severity of injuries in the more active age - group of the society (due to occupational activity), as well as the elderly, fall prevention plans seem a necessity among at risk groups.

Field hospitals (FH) can be mobile or fixed. The main goal of FHs is providing health care and preventing injuries caused by disasters or providing emergency medical operations. However, preparing a safe and fast-erupting structure and facility is very important.

In this systematic review study, field hospitals are reviewed.

In the present study, a systematic reviewwas performed following the PRISMA guideline. To identify the articles, MEDLINE, web of science, Google scholar, PubMed, Persian journals and databases were searched to find related papers.

After full text screening as the final screening step, 20 papers were entered in the study. Findings showed that structures used for establishing a FH are usually tents, using vehicles (trucks and buses), pre-fabricated steel, and concrete structures. The FHs were used for war and earthquake disasters. Conex, tent, steel, and concrete structure are the most used structures for FH in wars, while tents are the most common structure used for natural disasters.

The present study reviewed available reports on FH to collect useful data that should be focused on establishment of an FH suitable for a disaster. Furthermore, this study provides a list of the most important indexes that must be considered in proposing a type of FH. Tent structure was the most common structure for the establishment of FHs.

The management of maxillofacial injuries is one of the most common challenges in the healthcare field as surgeons, who treat these patients have additional responsibilities in terms of esthetic reconstruction as well as restoration of the patient’s appearance and function.

The aim of the present studywas to evaluate the epidemiology and etiology of trauma at BualiHospital of Tehran during 2008 to 2016.

In this retrospective study, the files of all the trauma patients (n = 293) that had referred to Buali Hospital were investigated, and demographic data and etiologic factors were extracted. Radiographs were analyzed with regards to fracture patterns. The results were statistically analyzed using the SPSS 22 software.

The mean age was 29.18 ± 14.74 years in males and 34.48 ± 19.81 years in females. Fractures were more frequent at ages between 21 and 30 years (39.9%) and less common among 71- to 84-year-olds (2.4%). Most patients were males (78.8%). Of all 474 fractures in 293 patients, zygomatic fractures were the most common fractures (18.6%), while Lefort III in the maxilla was the least common type (1.3%). The main cause of fracture was motor vehicle accidents (51.5%), whereas workplace injuries were uncommon (11.4%).

According to the results, fractures often occur in males in the third decade of life due to their roles in the community. In the current study, similar to other studies carried out in developing countries, the main cause of fractures was motor vehicle accidents. Most of the patients were treated by open reduction. The most frequent side effect was sensory disorders.

Coronary artery dissection after blunt chest trauma is rare, can lead to myocardial infarction, and be rapidly fatal if not appropriately diagnosed and managed.

We had experienced a case of right coronary artery dissection after blunt chest trauma. A 57-year-old female who complained of anterior chest wall pain after a traffic accident exhibited ventricular tachycardia and complete atrioventricular block with myocardial infarction. Right coronary artery dissection was detected by coronary angiography and was successfully treated by percutaneous coronary intervention.

Blunt cardiac injury (BCI) is often difficult to diagnosis and a high index of suspicion is needed. Coronary angiography with revascularization should be performed immediately when coronary artery occlusion or dissection is suspected.

Elbow contracture is a common incidence. It has surgical treatments such as scar release and skin graft, Z or V-Y plasty, and lateral or medial arm flap. In this study, we compared Z-plasty versus Z-plasty and skin grafting in the surgical tensionfree treatment of post-burn elbow contractures.

30 patients with elbow joint extension restriction participated in this randomized clinical trial in two groups: experimental (Z-plasty with skin graft) and control (Z-plasty alone) groups. In both groups, Z-plasty was designed with a 60 angle. In the experimental group, the flaps were rotated without tension, and then the upper and lower parts of the flaps were grafted by a midsplit-thickness skin graft. The surgery area was examined regarding infections, wound healing time, necrosis, and scar. Significant differences were evaluated using unpaired student t-test.

Only seven participants in the control group had complications. The statistical analysis of all variables in both groups showed that Z-plasty with skin graft treatment had a significantly better result than the Z-plasty alone (P = 0.006). However, the two groups showed no significant differences in terms of infection, flap tip necrosis, surgery site infection, and feeling of pressure in joint extension or scar recurrence (P = 0.273).

Tension-free flap must be used in patients with mild or moderate wide elbow scar contracture. Combining Z-plasty with skin graft is easy and has better results than Z-plasty alone. It is recommended using this technique in patients with intraoperative flap tension.

Pelvic ring fractures (PRF) and acetabular fractures (AF) are among the most challenging orthopedic injuries. These injuries usually involve operative fixation, with considerable delay after the accident. There are limited studies regarding the effects of delayed surgery on the risk of venous thromboembolism (VTE) in these patients.

In this study, the effect of delayed fixation of PRF and AF on the risk of preoperative VTE was investigated.

There were 86 patients with PRF and/or AF enrolled in the current study. Preoperatively, the presence of deep venous thrombosis (DVT) was examined utilizing Color Doppler ultrasound (CDU). The time interval between accident and CDU was recorded (time delay). Finally, the time delay was compared between patients with and without DVT formation.

The CDU revealed the presence of DVT in lower limb veins of 11 patients (12.8%). The time delay between the accident and CDU was significantly longer in patients with DVT formation (12.4 ± 4.1 days versus 7.6 ± 2.4 days; P < 0.001).

Delayed fixation of PRF and AFmay increase the risk of preoperative VTE. The authors suggest surgical fixation in these patients as soon as possible in cases without definite contraindication for early fixation.