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Management of Major Orthopaedic Trauma

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 10539

Special Issue Editor


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Guest Editor
1. School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
2. Department of Surgery, John Hunter Hospital, Newcastle, NSW 2305, Australia
Interests: polytrauma; multiple organ failure; traumatic shock; resuscitation; orthopaedic trauma; pelvic fractures; acetabulum fractures; postinjury inflammatory response
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Special Issue Information

Dear Colleagues,

Major orthopaedic trauma is the most frequent reason for operative management of polytrauma patients. Injuries of the axial skeleton (spine, pelvis acetabulum), long bone fractures, complex metaphyseal and intraarticular fractures, limb- and life-threatening musculoskeletal injuries, open fractures, and fractures with challenging soft tissue injuries and complications are the classic examples within this challenging area. I hope you can contribute with your latest research to this special issue, which I am editing for the benefit of our multiply injured patients. 

Prof. Zsolt J. Balogh
Guest Editor

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Keywords

  • Polytrauma 
  • Spine fractures 
  • Pelvic fractures 
  • Acetabulum fractures 
  • Long bone fractures 
  • Open fractures 
  • Complex metaphyseal and articular fractures 
  • Limb salvage

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Published Papers (3 papers)

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Research

13 pages, 687 KiB  
Article
Influence of Thoracic Trauma on Fracture Healing in Long Bones—A Retrospective Analysis
by Karsten Timm, Nike Walter, Martin Heinrich, Gero Knapp, Ulrich Thormann, Thaqif El Khassawna, Volker Alt, Christian Heiss and Markus Rupp
J. Clin. Med. 2022, 11(3), 717; https://doi.org/10.3390/jcm11030717 - 28 Jan 2022
Cited by 1 | Viewed by 2123
Abstract
Purpose: Pre-clinical studies indicate that concomitant thoracic trauma impairs fracture healing of long bones and reduces callus formation. The aim of this study was to investigate whether patients with accompanying chest trauma suffer from delayed fracture healing of long bones in comparison with [...] Read more.
Purpose: Pre-clinical studies indicate that concomitant thoracic trauma impairs fracture healing of long bones and reduces callus formation. The aim of this study was to investigate whether patients with accompanying chest trauma suffer from delayed fracture healing of long bones in comparison with patients with fractures of two long bones or isolated fractures. Patients and Methods: This is a clinical retrospective study from a level I trauma center. The patients were divided into three groups: (1) thoracic trauma and fracture of a long bone, (2) fractures of two long bones, (3) isolated fracture of a long bone. The fracture consolidation was defined using the radiographic union scale in tibial fractures (RUST). A RUST value of ≥10 six-to-eight months after definitive operative intervention represented complete fracture healing. Results: In the first group 19 (43.2%) fractures did not show full consolidation, in the second group 14 (45.2%) and 13 (41.9%) and in the third group 14 (36.8%). The analysis revealed no statistically significant differences between the groups regarding consolidation of the fractures six-to-eight months after definitive operative intervention (p = 0.84). Conclusions: Unlike previously reported pre-clinical data, this study did not demonstrate a negative effect on fracture consolidation in long bones when accompanied by thoracic trauma. Furthermore, the results demonstrated that concomitant fractures of two long bones does not have a negative effect on fracture consolidation. Full article
(This article belongs to the Special Issue Management of Major Orthopaedic Trauma)
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10 pages, 388 KiB  
Article
Injury Patterns after Falling down Stairs—High Ratio of Traumatic Brain Injury under Alcohol Influence
by Jason-Alexander Hörauf, Christoph Nau, Nils Mühlenfeld, René D. Verboket, Ingo Marzi and Philipp Störmann
J. Clin. Med. 2022, 11(3), 697; https://doi.org/10.3390/jcm11030697 - 28 Jan 2022
Cited by 6 | Viewed by 2266
Abstract
Falling down a staircase is a common mechanism of injury in patients with severe trauma, but the effect of varying fall height according to the number of steps on injury patterns in these patients has been little studied. In this retrospective study, prospectively [...] Read more.
Falling down a staircase is a common mechanism of injury in patients with severe trauma, but the effect of varying fall height according to the number of steps on injury patterns in these patients has been little studied. In this retrospective study, prospectively collected data from a Level 1 Trauma Center in Germany were analyzed regarding the injury patterns of patients admitted through the trauma room with suspicion of multiple injuries following a fall down a flight of stairs between January 2016 and December 2019. In total 118 patients were examined which where consecutively included in this study. More than 80% of patients suffered a traumatic brain injury, which increased as a function of the number of stairs fallen. Therefore, the likelihood of intracranial hemorrhage increased with higher numbers of fallen stairs. Fall-associated bony injuries were predominantly to the face, skull and the spine. In addition, there was a high coincidence of staircase falls and alcohol intake. Due to a frequent coincidence of staircase falls and alcohol, the (pre-)clinical neurological assessment is complicated. As the height of the fall increases, severe traumatic brain injury should be anticipated and diagnostics to exclude intracranial hemorrhage and spinal injuries should be performed promptly to ensure the best possible patient outcome. Full article
(This article belongs to the Special Issue Management of Major Orthopaedic Trauma)
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12 pages, 3951 KiB  
Article
Comparison of Three Different Internal Brace Augmentation Techniques for Scapholunate Dissociation: A Cadaveric Biomechanical Study
by Il-Jung Park, Dohyung Lim, Mauro Maniglio, Steven S. Shin, Seungbum Chae, Victor Truong, Michelle H. McGarry and Thay Q. Lee
J. Clin. Med. 2021, 10(7), 1482; https://doi.org/10.3390/jcm10071482 - 2 Apr 2021
Cited by 10 | Viewed by 5309
Abstract
Internal bracing (IB) is an augmentation method using high-strength nonabsorbable tape. However, there is no detailed information about the direction, location, or number of IBs required for scapholunate interosseous ligament (SLIL) injury repair. Thus, this study compared the biomechanical characteristics of short-transverse IB, [...] Read more.
Internal bracing (IB) is an augmentation method using high-strength nonabsorbable tape. However, there is no detailed information about the direction, location, or number of IBs required for scapholunate interosseous ligament (SLIL) injury repair. Thus, this study compared the biomechanical characteristics of short-transverse IB, long-oblique IB, and the combination of short-transverse and long-oblique (Combo) IB for SLIL injury in a biomechanical cadaveric model. We prepared nine fresh-frozen full upper extremity cadaveric specimens for this study. The scapholunate distance, scapholunate angle, and radioscaphoid angle were measured using the MicroScribe digitizing system with the SLIL intact, after scapholunate dissociation and the three different reconstructions. Three-dimensional digital records were obtained in six wrist positions in each experimental condition. Short-transverse IB had a similar effect compared with long-oblique IB in addressing the widening of the scapholunate distance. However, both were less effective than Combo IB. For scaphoid flexion deformity, short-transverse IB had minimal effect, while long-oblique IB had a similar effect compared to Combo IB. Combo IB was the most effective for improving distraction intensity and rotational strength. This study provides important information about the biomechanical characteristics of three different IB methods for SLIL injury and may be useful to clinicians in treating scapholunate dissociation. Full article
(This article belongs to the Special Issue Management of Major Orthopaedic Trauma)
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