Injury

Individuals with psychiatric disorders and substance use are at greater risk of sustaining severe injuries due to behavioral impulsivity, impaired judgment, and medication effects. The influence of psychiatric comorbidities on the hospitalization of patients with pelvic fractures remains underexplored. This study investigates the impact of psychiatric disorders and substance abuse on hospitalization outcomes for these patients.

Trauma team activation protocols are critical for mobilizing resources in the care of severely injured patients. In the US, the American College of Surgeons (ACS) specifies minimum criteria for the highest-level (full) trauma activation (fTA), but hospitals retain discretion to add criteria, potentially leading to variability in activation practices and resource utilization. The extent of this variation and its impact on patient outcomes is unknown. The aim of this study was to quantify inter-hospital variability in fTA use and its relationship to mortality.

Periprosthetic distal femur fractures are deleterious injuries, found commonly in the elderly osteoporotic population, typically addressed with open reduction internal fixation (ORIF). Fractures that are very distal (Su type III) require special considerations due to limited distal bone stock for fixation. The utilization of the nail-plate combination (NPC) technique for these patients aims for an early return to ambulation by maximizing distal fixation and stability while allowing for immediate postoperative weight-bearing.

To evaluate the prevalence of barriers to care and IPV risk and assessed associations between economic hardship and violence.

The objective of this study is to closely examine the preferred anastomoses of the superior thyroid artery, facial artery, lingual artery, maxillary artery, and superficial temporal artery anastomoses for the reconstruction of maxillomandibular defects caused by firearm injuries. The study will also examine the reasons for choosing these arteries, their advantages and disadvantages, surgical techniques, complications, and their postoperatively clinically and scintigraphically assessable viability.

Concomitant ipsilateral fractures of the clavicle, scapula, and ribs, termed forequarter lateral implosion injury, represent a severe but underrecognized injury pattern resulting from high-energy lateral shoulder trauma. While the surgical indications for isolated chest wall and shoulder girdle injuries are well described, guidance on the integrated management of this combined injury complex remains limited. We describe a reproducible multidisciplinary approach for the concurrent surgical fixation of clavicle, scapula, and rib fractures, illustrated through two cases of forequarter lateral implosion injury resulting from high-energy road traffic accidents.

Each week I go into the operating room and “perform” an operation on a patient. If one ever wonders why the operating room is called a “theatre”, it was based upon the early period of observational learning that young physicians would be expected to be a part of. Their famous elder surgical mentors would “perform” in front of them with crude tools and methods such as amputating a mangled leg or teaching proper anatomic dissection. Can you imagine the racing/raging emotions of those first patients as they went to the OR “theatre” (especially before introduction of successful anaesthetic)? Would this surgical performance in the “theatre” lead to a “drama”, a “tragedy”, or “improvisational art”? And what of the emotions of the surgeon who is meant to perform successfully before the audience of young learners and aspiring future surgical disciples? I know how I feel as a surgeon before most operations – superficially calm but deep down I know that this surgery may end up as a theatrical stalemate between the orthopaedic trauma pathology presented by the patient and the balance of my experienced team’s best planning, skills and ingenuity.

This study investigates the pathophysiological mechanisms, risk factors, and conditions contributing to the occurrence of paralyzing disc herniation (PDH) following L4-L5 disc herniation surgery. Despite the significance of PDH, comprehensive understanding remains limited due to the inherent challenges in recruiting patients with neurologic deficits and the variability in research methodologies.

Venous thromboembolism (VTE) is a major complication in pelvic ring and acetabular fractures (PAF). Evidence on incidence and optimal prophylaxis strategies remains limited. This study aimed to investigate the incidence of VTE in PAF patients under a standardized prophylaxis regimen.

To evaluate fixation failure following femoral neck system fixation (FNS) for intracapsular femoral neck fractures (FNF) and to determine whether fracture characteristics, particularly fracture orientation, were associated with fixation failure.