Archives of Trauma Research
Volume:3 Issue: 3, Jul-Sep 2014

Plate on plate technique can lessen operative time and patient morbidity.. This study aimed to evaluate the outcomes of minimally invasive percutaneous plate osteosynthesis (MIPPO) using plate on plate technique of locking plate fixation for closed fractures of distal tibia in a prospective study..Patients and Twenty-five patients with distal tibial fractures were treated by MIPPO using locking plate by plate on plate technique. Preoperative variables including age of patient, mode of trauma, type of fracture and soft tissue status were recorded for each patient. Perioperative variables included surgical time and radiation exposure. Postoperative variables included wound status, time to union, return to activity and the American orthopaedic foot and ankle score (AOFAS).. All the fractures had united at one year. The average time to union was 16.8 weeks. There were two cases of superficial infection and two cases of deep infection, which required removal of hardware after the fracture was united. The average AO foot and ankle score was 83.6 in our study population.. MIPPO using locking plate by plate on plate technique was a safe, effective, inexpensive and easily reproducible method for the treatment of distal tibial fractures in properly selected patients, which minimized operative time and soft tissue morbidity..

In contemporary practice, acute mesenteric ischemia (AMI) remains a serious cause of morbidity and mortality in abdominal emergencies.. We report the measurement of peritoneal fluid potassium and pH on a small series of rats that developed extensive AMI following the surgical ligation of superior mesenteric vessels and compare the results with control groups.. A total of 32 rats were used in our study. They were divided into four groups with eight rats in each one and received following treatments: group I (G-I), 60-minute controls; group II (G-II), 120-minute controls; group III (G-III), 60-minute cases; and group IV (G-IV), 120-minute cases. In case groups, the small bowel mesenteric root was double-ligated and an arrow single-lumen central venous catheter was passed through the skin to the peritoneum. In control groups, the catheter was placed without any intervention. Postoperatively, peritoneal lavage was performed at 60 (G-I, G-III) and 120 minutes (G-II, G-IV).. The mean peritoneal potassium values were 1.3 ± 0.3, 1.97 ± 1.06, 2.14 ± 0.89, and 3.28 ± 0.66 mmol/L in G-I, G-II, G-III, and G-IV, respectively. There were significant differences between G-III and G-IV (P = 0.002), between G-I and G-III (P = 0.024), and between G-II and G-IV (P = 0.001). The mean value of peritoneal fluid pH were 7.1 ± 0.26, 6.82 ± 0.22, 6.66 ± 0.16, and 6.78 ± 0.04 in G-I, G-II, G-III, and G-IV, respectively, which indicated significant differences between G-I and G-III (P = 0.001) and between G-II and G-IV (P = 0.018). There was a significant correlation between peritoneal fluid potassium and intestine ischemic grade (F = 4.77, P = 0.048). Our findings show that for early detection of bowel ischemia, an evaluation of intraperitoneal potassium and pH was useful and with prolongation of ischemia, potassium changes were more significant..

Activities of daily living (ADL) are an important indicator of health and independence in elderly. It provides useful information for proper planning in the field of elderly care. Trauma in elderly population is frequent and can negatively affect the independence in ADL.. The purpose of the present study was to evaluate elderly independence in activities of daily living (ADL) following limb trauma and its related factors in patients referred to trauma emergency ward of Shahid Beheshti Hospital, Kashan, Iran, in 2013..Patients and This descriptive study was conducted on 200 traumatic patients admitted to trauma emergency ward of Shahid Beheshti Hospital in 2013. The questionnaire used in this study had three parts as demographic data, information related to trauma and ISADL (independency scale of activities of daily living). ISADL was completed in emergency ward to declare pretraumatic status; it was also completed 1 and 3 months after trauma. Statistical analysis was conducted by Chi-square test, One-way and two-factor ANOVA, and Multiple regression analysis. Data analysis was conducted using SPSS software, version 16.. The average age of participants was 70.57 ± 9.05 years. In total, 80.5% of the elderly were completely independent in ISADL before trauma; this decreased to 13.5% one month after trauma. Besides, 32% of the elderly were completely or relatively dependent three months after trauma. Two-factor ANOVA showed a significant association between the scores of ISADL, the time interval and the type and location of an injured organ, and having the surgery as a treatment.. More than three-quarters of the elderly were independent in ISADL before the trauma, but trauma in elderly patients had a substantial negative effect on patients'' ability and ADL function..

Motorcycle crashes are the cause of severe morbidity and mortality especially because of head injuries. It seems that wearing a helmet has an effective role in protection against head injuries. Nevertheless, motorcyclists usually have no tendency to wear a helmet when driving in cities and have several reasons for this behavior.. This study aimed to evaluate the use and reasons for not using a helmet by motorcyclists admitted to an emergency ward of a trauma hospital due to accident in Kerman, Iran..Patients and This study was carried out by recoding the opinions of motorcyclists who had been transferred to the emergency ward of Shahid Bahonar Hospital (Kerman/Iran). Since no data was available on the frequency of the use of helmets, a pilot study was carried out and a sample size of 377 was determined for the main study. Then a researcher-made questionnaire was used to investigate the motorcyclists’ reasons for not using a helmet.. Only 21.5% of motorcyclists had been wearing helmets at the time of the accident. The most frequent reasons for not using a helmet were the heavy weight of the helmet (77%), feeling of heat (71.4%), pain in the neck (69.4%), feeling of suffocation (67.7%), limitation of movement of the head and neck (59.6%) and all together, physical discomfort was the main cause of not wearing a helmet during motorcycle rides.. In general, it appears that it is possible to increase the use of helmets by eliminating its physical problems, and increasing the knowledge of community members in relation to the advantages of helmet use, which will result in a significant decrease in traumas resulting from motorcycle accidents..

The Iran-Iraq war during the 1980-1988 has left many consequences on veterans and their families that persist long after the war ended.. The aim of this study was to evaluate the impact of psychological problems and marital adjustment of Iranian veterans on their children''s quality of life and happiness 24 years after the war ended..Patients and The sample was all children of veterans in Isfahan city that registered by Veterans and Martyrs Affair Foundation (VMAF). One hundred sixty-three veterans were selected by systematic randomized sampling and the symptom checklist-90-revised (SCL-90-R) and dyadic adjustment scale (DAS) were administered for them. Their wives filled out the DAS and their children answered to World Health Organization Quality of Life-Brief version (WHOQOL-BREF) and Oxford Happiness Inventory (OHI). The data from questionnaires completed by 149 families were analyzed using the multiple regressions analysis.. Global Severity Index (GSI) scores of veterans and veteran''s age were inversely correlated with the scores of children''s quality of life, while marital adjustment of parents and number of rooms in house were positively correlated. Mother''s age was inversely correlated with the scores of children''s happiness, while marital adjustment of the parents, the number of rooms in their house and the number of children were positively correlated.. In veterans'' family, psychological health of the veterans and marital adjustment of the parents have a significant relationship with their children''s quality of life and happiness..

Loss of motion is a well-known complication after elbow trauma and in severe cases, arthrolysis of elbow is the procedure of choice. The posterior approach might have some advantages especially in post-traumatic patients who have undergone the same surgical approach in the past.. The aim of this study was to evaluate the short-term outcomes of elbow arthrolysis through posterior approach. Moreover, we assessed the effect of operation on the patients’ quality of life.. Patients and During a retrospective-cohort study, the medical records of 14 patients (12 men, two women) whose range of movement had been limited post-traumatically and had undergone elbow arthrolysis with posterior approach were reviewed. Before intervention, the patients had a flexion less than 100 degrees or an extension lag of 30 degrees or more. For evaluation of the final outcomes, they were invited to participate in our study and the final range of motion, visual analogue score (VAS), disability of arm, shoulder and hand (DASH), Mayo elbow score (MES) and short form health survey (SF-36) scores were measured in the patients.. Mean age of the participants was 28.7 years. The interval from initial injury and arthrolysis was 16 months and the patients were followed for 14 months. The mean range of motion in patients before surgery was 35.8 degrees, which was increased to a mean of 108.9 after the surgery, indicating a 73.1 degrees improvement. The means of VAS, DASH, Mayo elbow and SF-36 scores in the patients were 1.6, 34, 68 and 43, respectively. A significant inverse correlation was found between the preoperative range of motion and final range of motion.. According to our results, elbow arthrolysis through posterior approach could be an effective technique with low complications. Since the final range of motion improved significantly, it might be a valuable method in promoting the patients’ quality of life..

Iatrogenic patellar fracture is reported as a complication of patella procedures, such as medial patellofemoral ligament reconstruction, reconstruction of the anterior cruciate ligament of the knee using bone-patellar tendon-bone technique, and resurfacing the patella in total knee arthroplasty.. A 65-year-old lady with right patella fracture was treated with open reduction and cerclage wiring. An iatrogenic split fracture was noted during tension of the cerclage wire and was successfully managed by screw fixation of the split fracture.. Split fracture is a rare complication of circumferential cerclage wiring of patellar fracture. The surgeon should be aware of the contributing factors in order to avoid this complication..