Archives of Trauma Research Archives of Trauma Research Arch Trauma Res http://www.archtrauma.com 2251-953X 2251-9599 10.5812/atr. en jalali 2018 1 22 gregorian 2018 1 22 3 4
en 10.5812/atr.18178 Bilateral Anterior Shoulder Dislocation Bilateral Anterior Shoulder Dislocation case-report case-report Conclusions

Bilateral anterior shoulder dislocation is very rare. The excessive traction force during closed reduction may lead to nerve palsy. Clear documentation of neurovascular status and adequate imaging before and after a reduction should be performed.

Introduction

Unilateral anterior shoulder dislocation is one of the most common problems encountered in orthopedic practice. However, simultaneous bilateral anterior dislocation of the shoulders is quite rare.

Case Presentation

We report a case of a 75-year-old woman presented with simultaneous bilateral anterior shoulder dislocation following a trauma, complicated with a traction injury to the posterior cord of the brachial plexus.

Conclusions

Bilateral anterior shoulder dislocation is very rare. The excessive traction force during closed reduction may lead to nerve palsy. Clear documentation of neurovascular status and adequate imaging before and after a reduction should be performed.

Introduction

Unilateral anterior shoulder dislocation is one of the most common problems encountered in orthopedic practice. However, simultaneous bilateral anterior dislocation of the shoulders is quite rare.

Case Presentation

We report a case of a 75-year-old woman presented with simultaneous bilateral anterior shoulder dislocation following a trauma, complicated with a traction injury to the posterior cord of the brachial plexus.

Shoulder;Dislocation;Brachial Plexus Shoulder;Dislocation;Brachial Plexus http://www.archtrauma.com/index.php?page=article&article_id=18178 Yuk Chuen Siu Yuk Chuen Siu Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, China Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, China Tun Hing Lui Tun Hing Lui Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, China; Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, China. Tel: +86-85226837588, Fax: +86-85226837588 Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, China; Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, China. Tel: +86-85226837588, Fax: +86-85226837588
en 10.5812/atr.17837 The Ruled-out Scaphoid Fracture on Computed Tomography Prevalence and the Therapeutic Management of Other Carpal Fractures The Ruled-out Scaphoid Fracture on Computed Tomography Prevalence and the Therapeutic Management of Other Carpal Fractures letter letter Carpal Bones;Disease Management;Prevalence Carpal Bones;Disease Management;Prevalence http://www.archtrauma.com/index.php?page=article&article_id=17837 Johannes Gossner Johannes Gossner Department of Clinical Radiology, Evangelisches Krankenhaus Gottingen Weende, Gottingen, Germany; Department of Clinical Radiology, Evangelisches Krankenhaus Gottingen Weende, Gottingen, Germany. Tel: +49-55150341762, Fax: +49-55150341124 Department of Clinical Radiology, Evangelisches Krankenhaus Gottingen Weende, Gottingen, Germany; Department of Clinical Radiology, Evangelisches Krankenhaus Gottingen Weende, Gottingen, Germany. Tel: +49-55150341762, Fax: +49-55150341124
en 10.5812/atr.22189 Comparing the Interpretation of Traumatic Chest X-Ray by Emergency Medicine Specialists and Radiologists Comparing the Interpretation of Traumatic Chest X-Ray by Emergency Medicine Specialists and Radiologists research-article research-article Results

The evaluation of EPs was identical to that of the radiologists in 89.5% of the cases. Ninety-eight percent (98%) indicated total agreement and 1.5 percent total disagreement.

Conclusions

There is a high agreement between EPs and radiologists in CXR interpretations in Shohadaye Tajrish Hospital. Thus, EPs can substitute radiologists in the emergency department. More improvements are recommended to achieve the standard level of agreement.

Patients and Methods

This prospective study was conducted in Shohadaye Tajrish Hospital, Tehran, Iran, from March to April 2014. Based on Advanced Trauma Life Support (ATLS) guidelines, plain chest radiography (CXR) was ordered for all patients in two standard views of posterior-anterior and lateral. All CXRs were interpreted by a corresponding emergency medicine specialist and a radiologist blind to the clinical findings of the patients. Finally, the results of two interpretations were compared. Accuracy, sensitivity, specificity, and predictive values of traumatic CXR interpretation were calculated by EPs with 95% of confidence interval (CI).

Objectives

This prospective study was conducted to assess the discrepancies between emergency and radiology departments with respect to interpretation of the traumatic chest X-ray.

Background

Discrepancy between X-ray readings of emergency physicians (EPs) versus radiologists was reported between 0.95% and 16.8% in different studies. The discordance was even higher when specific studies such as chest X-rays (CXR) were probed.

Results

The evaluation of EPs was identical to that of the radiologists in 89.5% of the cases. Ninety-eight percent (98%) indicated total agreement and 1.5 percent total disagreement.

Conclusions

There is a high agreement between EPs and radiologists in CXR interpretations in Shohadaye Tajrish Hospital. Thus, EPs can substitute radiologists in the emergency department. More improvements are recommended to achieve the standard level of agreement.

Patients and Methods

This prospective study was conducted in Shohadaye Tajrish Hospital, Tehran, Iran, from March to April 2014. Based on Advanced Trauma Life Support (ATLS) guidelines, plain chest radiography (CXR) was ordered for all patients in two standard views of posterior-anterior and lateral. All CXRs were interpreted by a corresponding emergency medicine specialist and a radiologist blind to the clinical findings of the patients. Finally, the results of two interpretations were compared. Accuracy, sensitivity, specificity, and predictive values of traumatic CXR interpretation were calculated by EPs with 95% of confidence interval (CI).

Objectives

This prospective study was conducted to assess the discrepancies between emergency and radiology departments with respect to interpretation of the traumatic chest X-ray.

Background

Discrepancy between X-ray readings of emergency physicians (EPs) versus radiologists was reported between 0.95% and 16.8% in different studies. The discordance was even higher when specific studies such as chest X-rays (CXR) were probed.

Emergency Medicine;Advanced Trauma Life Support Care;Radiography, Thoracic;Radiographic Image Interpretation Emergency Medicine;Advanced Trauma Life Support Care;Radiography, Thoracic;Radiographic Image Interpretation http://www.archtrauma.com/index.php?page=article&article_id=22189 Saeed Safari Saeed Safari Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Alireza Baratloo Alireza Baratloo Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-9122884364, Fax: +98-2122721155 Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-9122884364, Fax: +98-2122721155 Ahmed Said Negida Ahmed Said Negida Faculty of Medicine, Zagazig University of Medical Sciences, Zagazig, Egypt Faculty of Medicine, Zagazig University of Medical Sciences, Zagazig, Egypt Morteza Sanei Taheri Morteza Sanei Taheri Department of Radiology, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Radiology, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Behrooz Hashemi Behrooz Hashemi Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Samaneh Hosseini Selkisari Samaneh Hosseini Selkisari Department of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
en 10.5812/atr.16720 Correlation Between Health-Related Quality of Life in Veterans With Chronic Spinal Cord Injury and Their Caregiving Spouses Correlation Between Health-Related Quality of Life in Veterans With Chronic Spinal Cord Injury and Their Caregiving Spouses research-article research-article Conclusions

The results indicate that a decrease in health status level of veterans, physically and mentally, can affect the health-related QOL of their caregiving spouses.

Results

The mean age and standard deviation of veterans and their spouses were 48.5 ± 5.9 and 44.8 ± 7.2, respectively and their number of children ranged between 0-6. Our data analysis showed that there was a significant difference between the two groups in some domains of the SF-36, including PF, MH, PCS, MCS, BP and GH (P < 0.05), but there was no significant difference in RP, VT, SF and RE between the two groups.

Objectives

The purpose of this study was to examine the relationship between health-related QOL of veterans with chronic spinal cord injury and their caregiving spouses.

Patients and Methods

We designed a cross-sectional study including two groups; veterans with chronic spinal cord injury and their caregiving wives who were living in the city of Mashhad, Iran. The patients with spinal cord injury were veterans from the Iran-Iraq war (1980-1988). All the participants filled out the short form 36 (SF-36) health survey questionnaire. A Pearson correlation coefficient was calculated for the scales of the two groups.

Background

Recently, investigations have indicated that caring of a chronically ill family member strongly influences the health status and the quality of life (QOL) of the caregiving family members.

Conclusions

The results indicate that a decrease in health status level of veterans, physically and mentally, can affect the health-related QOL of their caregiving spouses.

Results

The mean age and standard deviation of veterans and their spouses were 48.5 ± 5.9 and 44.8 ± 7.2, respectively and their number of children ranged between 0-6. Our data analysis showed that there was a significant difference between the two groups in some domains of the SF-36, including PF, MH, PCS, MCS, BP and GH (P < 0.05), but there was no significant difference in RP, VT, SF and RE between the two groups.

Objectives

The purpose of this study was to examine the relationship between health-related QOL of veterans with chronic spinal cord injury and their caregiving spouses.

Patients and Methods

We designed a cross-sectional study including two groups; veterans with chronic spinal cord injury and their caregiving wives who were living in the city of Mashhad, Iran. The patients with spinal cord injury were veterans from the Iran-Iraq war (1980-1988). All the participants filled out the short form 36 (SF-36) health survey questionnaire. A Pearson correlation coefficient was calculated for the scales of the two groups.

Background

Recently, investigations have indicated that caring of a chronically ill family member strongly influences the health status and the quality of life (QOL) of the caregiving family members.

Spinal Cord Injury;Veterans;Caregiving;Quality of Life;Iran Spinal Cord Injury;Veterans;Caregiving;Quality of Life;Iran http://www.archtrauma.com/index.php?page=article&article_id=16720 Mohammad Hosein Ebrahimzadeh Mohammad Hosein Ebrahimzadeh Orthopedic Research Center, Qhaem Hospital Medical School, Mashhad University of Medical Sciences, Mashhad, IR Iran Orthopedic Research Center, Qhaem Hospital Medical School, Mashhad University of Medical Sciences, Mashhad, IR Iran Farideh Golhasani-Keshtan Farideh Golhasani-Keshtan Orthopedic Research Center, Qhaem Hospital Medical School, Mashhad University of Medical Sciences, Mashhad, IR Iran; Orthopedic Research Center, Qhaem Hospital Medical School, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-9153024084 Orthopedic Research Center, Qhaem Hospital Medical School, Mashhad University of Medical Sciences, Mashhad, IR Iran; Orthopedic Research Center, Qhaem Hospital Medical School, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-9153024084 Bibi Soheila Shojaee Bibi Soheila Shojaee Orthopedic Research Center, Qhaem Hospital Medical School, Mashhad University of Medical Sciences, Mashhad, IR Iran Orthopedic Research Center, Qhaem Hospital Medical School, Mashhad University of Medical Sciences, Mashhad, IR Iran
en 10.5812/atr.23083 Injuries Due to Wedging of Bicycle Wheels in On-road Tram Tracks Injuries Due to Wedging of Bicycle Wheels in On-road Tram Tracks research-article research-article Conclusions

Tram tracks on public roads are potentially dangerous and can lead to serious injuries and even mortality amongst cyclist. Operative intervention is frequently needed.

Background

In cities with trams as public transportation, tram tracks are often on public roads, creating a shared road situation with other road participants like cyclists. Beside the risk of direct collisions, this situation can also lead to bicycle wheels getting wedged in tram tracks, causing cyclists to fall.

Objectives

The aim of this study was to gain more insight in the injury pattern of this trauma mechanism and to draw attention to the risks of the infrastructural situation with on-road tram tracks.

Patients and Methods

A one-year, prospective, observational cohort study was conducted. All patients admitted after presentation to the emergency department of a level 1 trauma center, who got injured because their bicycle wheels got wedged in tram tracks, were included. Data were collected on patient demographics, type of injury and treatment.

Results

Ten patients were included. Six were male. The mean age was 38 years. Six patients required surgery, mostly because of extremity injuries. Mean duration of admission was 4 days. Mean injury severity score was 13. One patient died as a result of the injuries sustained in the accident.

Conclusions

Tram tracks on public roads are potentially dangerous and can lead to serious injuries and even mortality amongst cyclist. Operative intervention is frequently needed.

Background

In cities with trams as public transportation, tram tracks are often on public roads, creating a shared road situation with other road participants like cyclists. Beside the risk of direct collisions, this situation can also lead to bicycle wheels getting wedged in tram tracks, causing cyclists to fall.

Objectives

The aim of this study was to gain more insight in the injury pattern of this trauma mechanism and to draw attention to the risks of the infrastructural situation with on-road tram tracks.

Patients and Methods

A one-year, prospective, observational cohort study was conducted. All patients admitted after presentation to the emergency department of a level 1 trauma center, who got injured because their bicycle wheels got wedged in tram tracks, were included. Data were collected on patient demographics, type of injury and treatment.

Results

Ten patients were included. Six were male. The mean age was 38 years. Six patients required surgery, mostly because of extremity injuries. Mean duration of admission was 4 days. Mean injury severity score was 13. One patient died as a result of the injuries sustained in the accident.

Traffic Accidents;Blunt Injury;Accident Prevention;Accidental Fall Traffic Accidents;Blunt Injury;Accident Prevention;Accidental Fall http://www.archtrauma.com/index.php?page=article&article_id=23083 Jaap Deunk Jaap Deunk Department of Trauma Surgery, VU University Medical Center, Amsterdam, The Netherlands; Department of Trauma Surgery, VU University Medical Center, Amsterdam, The Netherlands. Tel: +31-204444554, Fax: +31-204444512 Department of Trauma Surgery, VU University Medical Center, Amsterdam, The Netherlands; Department of Trauma Surgery, VU University Medical Center, Amsterdam, The Netherlands. Tel: +31-204444554, Fax: +31-204444512 Annelieke M. K. Harmsen Annelieke M. K. Harmsen Department of Trauma Surgery, VU University Medical Center, Amsterdam, The Netherlands Department of Trauma Surgery, VU University Medical Center, Amsterdam, The Netherlands Casper P. Schonhuth Casper P. Schonhuth Department of Orthopedic Surgery, VU University Medical Center, Amsterdam, The Netherlands Department of Orthopedic Surgery, VU University Medical Center, Amsterdam, The Netherlands Frank W. Bloemers Frank W. Bloemers Department of Trauma Surgery, VU University Medical Center, Amsterdam, The Netherlands Department of Trauma Surgery, VU University Medical Center, Amsterdam, The Netherlands
en 10.5812/atr.19507 Waiting Times in Emergency Department After Using the Emergency Severity Index Triage Tool Waiting Times in Emergency Department After Using the Emergency Severity Index Triage Tool research-article research-article Background

Hospital emergency departments (EDs) are as barometers of the health care system. Crowded EDs threaten delivery of timely care. Prolonged ED wait times reduce the quality of care and increase adverse and sometimes irreversible events.

Objectives

The purpose of this study was to determine the patients' waiting time at Namazi and Shahid Faghihi hospitals in Shiraz, Iran.

Patients and Methods

This analytical cross-sectional study was conducted in two phases from December 2012 to May 2013. First, the researcher attended the EDs of the two hospitals and recorded the information of 900 patients who entered the ED, including arrival time, level of triage, and time of first visit by physician. Then, among patients admitted to the ED units, 273 were followed and waiting times for the first physician order in the referral unit and the commencement of clinical interventions (defined as check time by the nurse) were recorded.

Results

The median waiting time from arrival to first visit by physician for the 900 patients included in the study was 8 (5-14) minutes [median (interquartile range)]. For the patients admitted to referral units, waiting time was 84 (43-145) minutes for the physician order and 85 (45-147) minutes for the commencement of first clinical intervention; 75% of the patients in triage level I, 84.6% in triage level II, and 95.6% in triage level III were visited within the target time limit.

Conclusions

Waiting time for commencement of clinical action in patients admitted to the EDs was considerably high for patients with higher priorities; so, rapid care of critically ill patients, identified during the triage process, should be emphasized.

Background

Hospital emergency departments (EDs) are as barometers of the health care system. Crowded EDs threaten delivery of timely care. Prolonged ED wait times reduce the quality of care and increase adverse and sometimes irreversible events.

Objectives

The purpose of this study was to determine the patients' waiting time at Namazi and Shahid Faghihi hospitals in Shiraz, Iran.

Patients and Methods

This analytical cross-sectional study was conducted in two phases from December 2012 to May 2013. First, the researcher attended the EDs of the two hospitals and recorded the information of 900 patients who entered the ED, including arrival time, level of triage, and time of first visit by physician. Then, among patients admitted to the ED units, 273 were followed and waiting times for the first physician order in the referral unit and the commencement of clinical interventions (defined as check time by the nurse) were recorded.

Results

The median waiting time from arrival to first visit by physician for the 900 patients included in the study was 8 (5-14) minutes [median (interquartile range)]. For the patients admitted to referral units, waiting time was 84 (43-145) minutes for the physician order and 85 (45-147) minutes for the commencement of first clinical intervention; 75% of the patients in triage level I, 84.6% in triage level II, and 95.6% in triage level III were visited within the target time limit.

Conclusions

Waiting time for commencement of clinical action in patients admitted to the EDs was considerably high for patients with higher priorities; so, rapid care of critically ill patients, identified during the triage process, should be emphasized.

Emergency Department;Efficiency;Triage Emergency Department;Efficiency;Triage http://www.archtrauma.com/index.php?page=article&article_id=19507 Farzad Mahmoodian Farzad Mahmoodian Department of Medical Ethics, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Medical Ethics, Shiraz University of Medical Sciences, Shiraz, IR Iran Razie Eqtesadi Razie Eqtesadi Trauma Research Center, kashan University of Medical Sciences, Kashan, IR Iran; Department of Emergency Medicine, Shiraz University of Medical Sciences Shiraz, IR Iran; Trauma Research Center, kashan University of Medical Sciences, Kashan, IR Iran. Tel/Fax: +98-3155620634 Trauma Research Center, kashan University of Medical Sciences, Kashan, IR Iran; Department of Emergency Medicine, Shiraz University of Medical Sciences Shiraz, IR Iran; Trauma Research Center, kashan University of Medical Sciences, Kashan, IR Iran. Tel/Fax: +98-3155620634 Atefe Ghareghani Atefe Ghareghani Shiraz University of Medical Sciences, Shiraz, IR Iran Shiraz University of Medical Sciences, Shiraz, IR Iran
en 10.5812/atr.25446 Mechanical Ventilation in Chest Trauma Mechanical Ventilation in Chest Trauma editorial editorial Trauma;Chest;Ventilation Trauma;Chest;Ventilation http://www.archtrauma.com/index.php?page=article&article_id=25446 Ebrahim Razi Ebrahim Razi Trauma Research Center, Shahid-Beheshti Hospital, Kashan University of Medical Sciences, Kashan, IR Iran; Trauma Research Center, Shahid-Beheshti Hospital, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3155620634 Trauma Research Center, Shahid-Beheshti Hospital, Kashan University of Medical Sciences, Kashan, IR Iran; Trauma Research Center, Shahid-Beheshti Hospital, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3155620634
en 10.5812/atr.22551 Epidemiological Pattern of Bullying Among School Children in Mazandaran Province, Iran Epidemiological Pattern of Bullying Among School Children in Mazandaran Province, Iran research-article research-article Crime Victim;bullying;Epidemiology;Adolescent Crime Victim;bullying;Epidemiology;Adolescent http://www.archtrauma.com/index.php?page=article&article_id=22551 Meysam Rezapour Meysam Rezapour School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Hamid Soori Hamid Soori Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Corresponding author: Hamid Soori, Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-22439980, E-mail: Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Corresponding author: Hamid Soori, Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-22439980, E-mail: Soheyla Khodakarim Soheyla Khodakarim Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran