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 23 gregorian 2018 1 23 5 3
en 27800460 10.5812/atr.32933 Metacarpal Neck Fractures: A Review of Surgical Indications and Techniques Metacarpal Neck Fractures: A Review of Surgical Indications and Techniques review-article review-article Conclusions

Metacarpal neck fractures are a common injury in young and active patients that results in substantial missed time from work. While the surgical indications are well-described, there is no consensus on the optimal treatment modality because of high complication rates. Dorsal plating has higher complication rates than closed reduction and percutaneous pinning, but is necessary in comminuted fractures. The lack of an ideal fixation construct suggests that further study of the commonly utilized techniques as well as novel techniques is necessary.

Results

The indications for surgery are based on the amount of dorsal angulation of the distal fragment. The ulnar digits can tolerate greater angulation as the radial digits more easily lose grip strength. The most widely utilized fixation techniques are pinning with k-wires, dorsal plating, or intramedullary fixation. There is currently no consensus on an optimal fixation technique as surgical management has been found to have a complication rate up to 36%. Plate and screw fixation demonstrated especially high complication rates.

Context

Hand injuries are a common emergency department presentation. Metacarpal fractures account for 40% of all hand fractures and can be seen in the setting of low or high energy trauma. The most common injury pattern is a metacarpal neck fracture. In this study, the authors aim to review the surgical indications for metacarpal neck fractures, the fixation options available along with the risk and benefits of each.

Evidence Acquisition

Literature review of the different treatment modalities for metacarpal neck fractures. Review focuses on surgical indications and the risks and benefits of different operative techniques.

Conclusions

Metacarpal neck fractures are a common injury in young and active patients that results in substantial missed time from work. While the surgical indications are well-described, there is no consensus on the optimal treatment modality because of high complication rates. Dorsal plating has higher complication rates than closed reduction and percutaneous pinning, but is necessary in comminuted fractures. The lack of an ideal fixation construct suggests that further study of the commonly utilized techniques as well as novel techniques is necessary.

Results

The indications for surgery are based on the amount of dorsal angulation of the distal fragment. The ulnar digits can tolerate greater angulation as the radial digits more easily lose grip strength. The most widely utilized fixation techniques are pinning with k-wires, dorsal plating, or intramedullary fixation. There is currently no consensus on an optimal fixation technique as surgical management has been found to have a complication rate up to 36%. Plate and screw fixation demonstrated especially high complication rates.

Context

Hand injuries are a common emergency department presentation. Metacarpal fractures account for 40% of all hand fractures and can be seen in the setting of low or high energy trauma. The most common injury pattern is a metacarpal neck fracture. In this study, the authors aim to review the surgical indications for metacarpal neck fractures, the fixation options available along with the risk and benefits of each.

Evidence Acquisition

Literature review of the different treatment modalities for metacarpal neck fractures. Review focuses on surgical indications and the risks and benefits of different operative techniques.

Metacarpal Bone;Neck Fractures;Hand;Fracture Fixation, Internal;Bone Wires Metacarpal Bone;Neck Fractures;Hand;Fracture Fixation, Internal;Bone Wires http://www.archtrauma.com/index.php?page=article&article_id=32933 Eric M. Padegimas Eric M. Padegimas Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, USA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, 1025 Walnut Street, Room 516 College, Philadelphia, USA. Tel: +1-2159551500; +1-8606040902, Fax: +1-2155030530 Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, USA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, 1025 Walnut Street, Room 516 College, Philadelphia, USA. Tel: +1-2159551500; +1-8606040902, Fax: +1-2155030530 William J. Warrender William J. Warrender Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, USA Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, USA Christopher M. Jones Christopher M. Jones Department of Orthopedic Surgery, The Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, USA Department of Orthopedic Surgery, The Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, USA Asif M. Ilyas Asif M. Ilyas Department of Orthopedic Surgery, The Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, USA Department of Orthopedic Surgery, The Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, USA
en 27800461 10.5812/atr.32985 Epidemiological Patterns of Road Traffic Crashes During the Last Two Decades in Iran: A Review of the Literature from 1996 to 2014 Epidemiological Patterns of Road Traffic Crashes During the Last Two Decades in Iran: A Review of the Literature from 1996 to 2014 review-article review-article Conclusions

The findings of the current study will be beneficial in prevention of RTCs and its associated complications and hence will be vital for policy makers, health service managers and stakeholders.

Context

Despite considerable attention given to health statistics of road traffic crashes (RTCs), the epidemiological aspects of injuries resulting from RTCs are not fully understood in Iran and other developing countries. The aim of this review was to study the epidemiological pattern and issues arising due to RTCs in Iran.

Evidence Acquisition

The scope of this study involves data from a broad range of published literature on RTCs in Iran. Data collection for this study was conducted by searching for keywords such as traffic accidents, traffic crashes, motorcycle accidents, motorcycle crashes, motorcycle injury, motor vehicle injury, motor vehicle crashes and motor vehicle accidents, Iran and Iranian in various databases such as Embase, PubMed, Google Scholar, Scopus, Magiran, Iranian scientific information database (SID) and IranMedex.

Results

This study comprised of 95 articles. It is evident from this review that a large number of severe RTCs occur due to collision of two or more vehicles and most of the victims are males aged between 30 and 39 years. Male pedestrian, drivers and passengers are more likely to be severely injured in comparison to females. One of the most prevalent causes of death among adults involved in the RTCs are head injuries and the majority of deaths occur prior to hospitalization. Mortality rates for RTCs are higher in summer, especially during midnight among all age groups. The most common individual and environmental risk factors associated with RTCs include lack of attention, getting trapped in the car, listening to music, fatigue and sleepiness, duration and distance and negligence of seatbelt usage while driving.

Conclusions

The findings of the current study will be beneficial in prevention of RTCs and its associated complications and hence will be vital for policy makers, health service managers and stakeholders.

Context

Despite considerable attention given to health statistics of road traffic crashes (RTCs), the epidemiological aspects of injuries resulting from RTCs are not fully understood in Iran and other developing countries. The aim of this review was to study the epidemiological pattern and issues arising due to RTCs in Iran.

Evidence Acquisition

The scope of this study involves data from a broad range of published literature on RTCs in Iran. Data collection for this study was conducted by searching for keywords such as traffic accidents, traffic crashes, motorcycle accidents, motorcycle crashes, motorcycle injury, motor vehicle injury, motor vehicle crashes and motor vehicle accidents, Iran and Iranian in various databases such as Embase, PubMed, Google Scholar, Scopus, Magiran, Iranian scientific information database (SID) and IranMedex.

Results

This study comprised of 95 articles. It is evident from this review that a large number of severe RTCs occur due to collision of two or more vehicles and most of the victims are males aged between 30 and 39 years. Male pedestrian, drivers and passengers are more likely to be severely injured in comparison to females. One of the most prevalent causes of death among adults involved in the RTCs are head injuries and the majority of deaths occur prior to hospitalization. Mortality rates for RTCs are higher in summer, especially during midnight among all age groups. The most common individual and environmental risk factors associated with RTCs include lack of attention, getting trapped in the car, listening to music, fatigue and sleepiness, duration and distance and negligence of seatbelt usage while driving.

Epidemiological Studies;Road Traffic Crashes;Iran, Injuries;Prevention Epidemiological Studies;Road Traffic Crashes;Iran, Injuries;Prevention http://www.archtrauma.com/index.php?page=article&article_id=32985 Homayoun Sadeghi-Bazargani Homayoun Sadeghi-Bazargani Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, IR Iran; Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, IR Iran; Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden Erfan Ayubi Erfan Ayubi 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 Saber Azami-Aghdash Saber Azami-Aghdash Department of Health Services Management, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, IR Iran Department of Health Services Management, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, IR Iran Leila Abedi Leila Abedi Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, IR Iran Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, IR Iran Alireza Zemestani Alireza Zemestani Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, IR Iran Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, IR Iran Louiz Amanati Louiz Amanati Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, IR Iran Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, IR Iran Mahmood Moosazadeh Mahmood Moosazadeh Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, IR Iran Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, IR Iran Naeema Syedi Naeema Syedi School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia Saeid Safiri Saeid Safiri Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, IR Iran; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, IR Iran. Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, IR Iran; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, IR Iran.
en 27800459 10.5812/atr.30011 Effectiveness of Bicycle Safety Helmets in Preventing Facial Injuries in Road Accidents Effectiveness of Bicycle Safety Helmets in Preventing Facial Injuries in Road Accidents research-article research-article Conclusions

Higher age of cyclists and increasing speed of the accident opponent significantly increase the likelihood of sustaining facial fractures. The use of bicycle helmets does not significantly reduce the incidence of mid-facial fractures, while being correlated with an even increased incidence of mandibular fractures.

Background

The effectiveness of bicycle safety helmets in preventing head injuries is well- documented. Recent studies differ regarding the effectiveness of bicycle helmets in preventing facial injuries, especially those of the mid-face and the mandible.

Objectives

The present study was conducted to determine the protective effect of a bicycle helmet in preventing mid-face and mandibular fractures.

Patients and Methods

Data from an accident research unit were analyzed to collect technical collision details (relative collision speed, type of collision, collision partner, and use of a helmet) and clinical data (type of fracture).

Results

Between 1999 and 2011, 5,350 bicycle crashes were included in the study. Of these, 175 (3.3%) had fractures of the mid-face or mandible. In total, 228 mid-face or mandibular fractures were identified. A significant correlation was found between age and relative collision speed, and the incidence of a fracture. While no significant correlation was found between the use of a helmet and the incidence of mid-facial fractures, the use of a helmet was correlated with a significantly increased incidence of mandibular fractures.

Conclusions

Higher age of cyclists and increasing speed of the accident opponent significantly increase the likelihood of sustaining facial fractures. The use of bicycle helmets does not significantly reduce the incidence of mid-facial fractures, while being correlated with an even increased incidence of mandibular fractures.

Background

The effectiveness of bicycle safety helmets in preventing head injuries is well- documented. Recent studies differ regarding the effectiveness of bicycle helmets in preventing facial injuries, especially those of the mid-face and the mandible.

Objectives

The present study was conducted to determine the protective effect of a bicycle helmet in preventing mid-face and mandibular fractures.

Patients and Methods

Data from an accident research unit were analyzed to collect technical collision details (relative collision speed, type of collision, collision partner, and use of a helmet) and clinical data (type of fracture).

Results

Between 1999 and 2011, 5,350 bicycle crashes were included in the study. Of these, 175 (3.3%) had fractures of the mid-face or mandible. In total, 228 mid-face or mandibular fractures were identified. A significant correlation was found between age and relative collision speed, and the incidence of a fracture. While no significant correlation was found between the use of a helmet and the incidence of mid-facial fractures, the use of a helmet was correlated with a significantly increased incidence of mandibular fractures.

Bicyclist;Bicycle Helmet;Facial Injury;Mid-face Fracture;Mandibular Fracture Bicyclist;Bicycle Helmet;Facial Injury;Mid-face Fracture;Mandibular Fracture http://www.archtrauma.com/index.php?page=article&article_id=30011 Rebecca Stier Rebecca Stier Department of Cranio Maxillofacial Surgery, Hannover Medical School, Hannover, Germany; Department of Cranio Maxillofacial Surgery, Hannover Medical School (MHH), Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany. Tel: +49-5115324748, Fax: +49-5115324740 Department of Cranio Maxillofacial Surgery, Hannover Medical School, Hannover, Germany; Department of Cranio Maxillofacial Surgery, Hannover Medical School (MHH), Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany. Tel: +49-5115324748, Fax: +49-5115324740 Dietmar Otte Dietmar Otte Department for Accident Research, Hannover Medical School, Hannover, Germany Department for Accident Research, Hannover Medical School, Hannover, Germany Christian Müller Christian Müller Trauma Department, Hannover Medical School, Hannover, Germany Trauma Department, Hannover Medical School, Hannover, Germany Maximilian Petri Maximilian Petri Trauma Department, Hannover Medical School, Hannover, Germany Trauma Department, Hannover Medical School, Hannover, Germany Ralph Gaulke Ralph Gaulke Trauma Department, Hannover Medical School, Hannover, Germany Trauma Department, Hannover Medical School, Hannover, Germany Christian Krettek Christian Krettek Trauma Department, Hannover Medical School, Hannover, Germany Trauma Department, Hannover Medical School, Hannover, Germany Stephan Brand Stephan Brand Trauma Department, Hannover Medical School, Hannover, Germany Trauma Department, Hannover Medical School, Hannover, Germany
en 27800462 10.5812/atr.33051 Nightmare Frequency, Nightmare Distress and the Efficiency of Trauma-Focused Cognitive Behavioral Therapy for Post-Traumatic Stress Disorder Nightmare Frequency, Nightmare Distress and the Efficiency of Trauma-Focused Cognitive Behavioral Therapy for Post-Traumatic Stress Disorder research-article research-article Conclusions

Most participants no longer had PTSD but some still had nightmares.

Results

The presence of nightmares did not impact overall CBT efficiency. Specific CBT components were efficient in reducing the frequency and distress of nightmares.

Patients and Methods

Participants received a validated CBT of 20 weekly individual sessions. They were evaluated at five measurement times: at pre-treatment, after the third and ninth session, at post-treatment, and at 6 months follow-up.

Objectives

The present study examined whether nightmares before the beginning of cognitive behavior therapy (CBT) for post-traumatic stress disorder (PTSD) could influence overall PTSD symptom reduction for 71 individuals with PTSD and different types of traumatic events.

Background

Up to 71% of trauma victims diagnosed with PTSD have frequent nightmares (NM), compared to only 2% to 5% of the general population.

Conclusions

Most participants no longer had PTSD but some still had nightmares.

Results

The presence of nightmares did not impact overall CBT efficiency. Specific CBT components were efficient in reducing the frequency and distress of nightmares.

Patients and Methods

Participants received a validated CBT of 20 weekly individual sessions. They were evaluated at five measurement times: at pre-treatment, after the third and ninth session, at post-treatment, and at 6 months follow-up.

Objectives

The present study examined whether nightmares before the beginning of cognitive behavior therapy (CBT) for post-traumatic stress disorder (PTSD) could influence overall PTSD symptom reduction for 71 individuals with PTSD and different types of traumatic events.

Background

Up to 71% of trauma victims diagnosed with PTSD have frequent nightmares (NM), compared to only 2% to 5% of the general population.

PTSD;Dream;Cognitive-Behavior Therapy;Trauma;Sleep;Nightmare PTSD;Dream;Cognitive-Behavior Therapy;Trauma;Sleep;Nightmare http://www.archtrauma.com/index.php?page=article&article_id=33051 Katia Levrier Katia Levrier Department of Psychology, University of Quebec a Montreal, Quebec, Canada Department of Psychology, University of Quebec a Montreal, Quebec, Canada Andre Marchand Andre Marchand Department of Psychology, University of Quebec a Montreal, Quebec, Canada Department of Psychology, University of Quebec a Montreal, Quebec, Canada Genevieve Belleville Genevieve Belleville Department of Psychology, School of Psychology, University of Laval, Quebec, Canada; Department of Psychology, School of Psychology, University of Laval, Bibliotheques st., Quebec, Canada. Tel: +1-4186562131 Department of Psychology, School of Psychology, University of Laval, Quebec, Canada; Department of Psychology, School of Psychology, University of Laval, Bibliotheques st., Quebec, Canada. Tel: +1-4186562131 Beaulieu-Prevost Dominic Beaulieu-Prevost Dominic Department of Sexology, University of Quebec a Montreal, Quebec, Canada Department of Sexology, University of Quebec a Montreal, Quebec, Canada Stephane Guay Stephane Guay School of Criminology, University of Montreal, Quebec, Canada School of Criminology, University of Montreal, Quebec, Canada
en 27800463 10.5812/atr.33335 Hemiprosthesis for Femoral Neck Fractures in the Elderly: A Retrospective Study of 319 Patients Hemiprosthesis for Femoral Neck Fractures in the Elderly: A Retrospective Study of 319 Patients research-article research-article Results

From a total of 319 patients, 78% (n = 249) were female and 22% (n = 70) were male, with the mean age of 83.6 years. Seventeen percent of the patients suffered from heart failure, 23% from diabetes, and 19% from renal insufficiency. Time to surgery averaged one day postinjury. Average operative time skin-to-skin was 50 minutes. Seventy-three percent of the patients could mobilize independently on discharge. Of the remaining patients, 2/3 had already lost independent mobilization prior to the fracture. Hospital mortality averaged 5% (national average in Germany: 8%), and 30-day and 90-day mortality rates were 5% and 15%, respectively. Within one year, 22% of the patients died (national average: 27%). Also, 14 patients were re-admitted, for contralateral prosthetic implantation (n = 7) or revision after the periprosthetic fracture (n = 5). Fifty-three percent of the patients were admitted to hospital during the year for other diseases (national average: 54%).

Background

In geriatric patients with Pauwels types II and III femoral neck fractures, hemiprosthesis is the therapy of choice.

Objectives

This study was conducted to analyze the results after cemented hemiprosthesis placement, the first year after surgery.

Patients and Methods

This retrospective study was conducted on 319 patients over 70 years with displaced femoral neck fractures treated surgically at our hospital from 2007 to 2012. All medical information was available including retrospective posthospital discharge records as well as inpatient course and one-year mortality.

Conclusions

Hemiprosthesis placement for displaced femoral neck fractures is a common and safe procedure. Despite recent decreases in hospital mortality, the risk of death remains more than twice as high within one year than that for uninjured patients of the same age.

Results

From a total of 319 patients, 78% (n = 249) were female and 22% (n = 70) were male, with the mean age of 83.6 years. Seventeen percent of the patients suffered from heart failure, 23% from diabetes, and 19% from renal insufficiency. Time to surgery averaged one day postinjury. Average operative time skin-to-skin was 50 minutes. Seventy-three percent of the patients could mobilize independently on discharge. Of the remaining patients, 2/3 had already lost independent mobilization prior to the fracture. Hospital mortality averaged 5% (national average in Germany: 8%), and 30-day and 90-day mortality rates were 5% and 15%, respectively. Within one year, 22% of the patients died (national average: 27%). Also, 14 patients were re-admitted, for contralateral prosthetic implantation (n = 7) or revision after the periprosthetic fracture (n = 5). Fifty-three percent of the patients were admitted to hospital during the year for other diseases (national average: 54%).

Background

In geriatric patients with Pauwels types II and III femoral neck fractures, hemiprosthesis is the therapy of choice.

Objectives

This study was conducted to analyze the results after cemented hemiprosthesis placement, the first year after surgery.

Patients and Methods

This retrospective study was conducted on 319 patients over 70 years with displaced femoral neck fractures treated surgically at our hospital from 2007 to 2012. All medical information was available including retrospective posthospital discharge records as well as inpatient course and one-year mortality.

Conclusions

Hemiprosthesis placement for displaced femoral neck fractures is a common and safe procedure. Despite recent decreases in hospital mortality, the risk of death remains more than twice as high within one year than that for uninjured patients of the same age.

Geriatric;Femur Fracture;Hemiprosthesis;Trauma in Elderly Geriatric;Femur Fracture;Hemiprosthesis;Trauma in Elderly http://www.archtrauma.com/index.php?page=article&article_id=33335 Axel Prokop Axel Prokop Clinic for Trauma Surgery, Hospital Sindelfingen, Sindelfingen, Germany; Clinic for Trauma Surgery, Hospital Sindelfingen, Sindelfingen, Germany. Tel: +49-70319812422, Fax: +49-70319812842 Clinic for Trauma Surgery, Hospital Sindelfingen, Sindelfingen, Germany; Clinic for Trauma Surgery, Hospital Sindelfingen, Sindelfingen, Germany. Tel: +49-70319812422, Fax: +49-70319812842 Marc Chmielnicki Marc Chmielnicki Clinic for Trauma Surgery, Hospital Sindelfingen, Sindelfingen, Germany Clinic for Trauma Surgery, Hospital Sindelfingen, Sindelfingen, Germany
en 27800465 10.5812/atr.33595 Modeling of Individual and Organizational Factors Affecting Traumatic Occupational Injuries Based on the Structural Equation Modeling: A Case Study in Large Construction Industries Modeling of Individual and Organizational Factors Affecting Traumatic Occupational Injuries Based on the Structural Equation Modeling: A Case Study in Large Construction Industries research-article research-article Conclusions

Path analysis of occupational injuries based on the SEM reveals that individual and organizational factors and their indicator variables are very influential on the severity of traumatic occupational injuries. So, these should be considered to reduce occupational accidents’ severity in large construction industries.

Materials and Methods

The present cross-sectional analytical study was implemented on traumatic occupational injuries within a ten-year timeframe in 13 large Iranian construction industries. Modeling and data analysis were done using the structural equation modeling (SEM) approach and the IBM SPSS AMOS statistical software version 22.0, respectively.

Results

The mean age and working experience of the injured workers were 28.03 ± 5.33 and 4.53 ± 3.82 years, respectively. The portions of construction and installation activities of traumatic occupational injuries were 64.4% and 18.1%, respectively. The SEM findings showed that the individual, organizational and accident type factors significantly were considered as effective factors on occupational injuries’ severity (P < 0.05).

Background

Individual and organizational factors are the factors influencing traumatic occupational injuries.

Objectives

The aim of the present study was the short path analysis of the severity of occupational injuries based on individual and organizational factors.

Conclusions

Path analysis of occupational injuries based on the SEM reveals that individual and organizational factors and their indicator variables are very influential on the severity of traumatic occupational injuries. So, these should be considered to reduce occupational accidents’ severity in large construction industries.

Materials and Methods

The present cross-sectional analytical study was implemented on traumatic occupational injuries within a ten-year timeframe in 13 large Iranian construction industries. Modeling and data analysis were done using the structural equation modeling (SEM) approach and the IBM SPSS AMOS statistical software version 22.0, respectively.

Results

The mean age and working experience of the injured workers were 28.03 ± 5.33 and 4.53 ± 3.82 years, respectively. The portions of construction and installation activities of traumatic occupational injuries were 64.4% and 18.1%, respectively. The SEM findings showed that the individual, organizational and accident type factors significantly were considered as effective factors on occupational injuries’ severity (P < 0.05).

Background

Individual and organizational factors are the factors influencing traumatic occupational injuries.

Objectives

The aim of the present study was the short path analysis of the severity of occupational injuries based on individual and organizational factors.

Traumatic Occupational Injuries;Structural Equation Modeling;Accident Severity Rate;Individual and Organizational Factors;Construction Industry Traumatic Occupational Injuries;Structural Equation Modeling;Accident Severity Rate;Individual and Organizational Factors;Construction Industry http://www.archtrauma.com/index.php?page=article&article_id=33595 Iraj Mohammadfam Iraj Mohammadfam Department of Occupational Hygiene Engineering, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, IR Iran Department of Occupational Hygiene Engineering, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, IR Iran Ahmad Soltanzadeh Ahmad Soltanzadeh Department of Occupational Hygiene Engineering, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, IR Iran; PhD Candidate, Department of Occupational Hygiene Engineering, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-9120187486 Department of Occupational Hygiene Engineering, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, IR Iran; PhD Candidate, Department of Occupational Hygiene Engineering, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-9120187486 Abbas Moghimbeigi Abbas Moghimbeigi Modeling of Non-communicable Disease Research Center, Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran Modeling of Non-communicable Disease Research Center, Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran Mehdi Akbarzadeh Mehdi Akbarzadeh Epidemiology and Biostatistics Department, Public Health Faculty, Hamadan University of Medical Sciences, Hamadan, IR Iran Epidemiology and Biostatistics Department, Public Health Faculty, Hamadan University of Medical Sciences, Hamadan, IR Iran
en 27800466 10.5812/atr.33664 Emerging Carbapenem-Resistant Pseudomonas aeruginosa Isolates Carrying blaIMP Among Burn Patients in Isfahan, Iran Emerging Carbapenem-Resistant <italic>Pseudomonas aeruginosa</italic> Isolates Carrying <italic>bla</italic><sub>IMP</sub> Among Burn Patients in Isfahan, Iran research-article research-article Conclusions

The results of this study show that the rate of P. aeruginosa-caused burn wound infections was very high, and many of the isolates were resistant to three or more classes of antimicrobials. Such extensive resistance to antimicrobial classes is important because few treatment options remain for patients with burn wound infections. blaIMP-producing P. aeruginosa isolates are a rising threat in burn-care units, and should be controlled by conducting infection-control assessments.

Background

Metallo-β-lactamase (MBL)-producing Pseudomonas aeruginosa is a significant pathogen in burn patients.

Objectives

The aim of this study was to determine the prevalence of carbapenem-resistant P. aeruginosa isolates, including those resistant to imipenemase (IMP), in a burn unit in Isfahan, Iran.

Patients and Methods

One hundred and fifty P. aeruginosa isolates from burn patients were tested for antibiotic susceptibility by the disc diffusion method in accordance with CLSI guidelines. Production of MBL was identified with the EDTA disk method. DNA was purified from the MBL-positive isolates, and detection of the blaIMP gene was performed with PCR.

Results

Fifty-seven out of 150 (38%) isolates were multi-drug resistant (MDR), and 93 (62%) were extensively-drug resistant (XDR). Among all isolates, the resistance rate to ciprofloxacin, tobramycin, imipenem, meropenem, amikacin, ceftazidime, and cefepime was higher than 90%, while the resistance rates to piperacillin/tazobactam and aztreonam were 70.7% and 86%, respectively. Colistin and polymyxin B remained the most effective studied antibiotics. All of the imipenem-resistant P. aeruginosa isolates were MBL-positive, and 107 out of 144 (74.3%) of the MBL isolates were positive for the blaIMP gene.

Conclusions

The results of this study show that the rate of P. aeruginosa-caused burn wound infections was very high, and many of the isolates were resistant to three or more classes of antimicrobials. Such extensive resistance to antimicrobial classes is important because few treatment options remain for patients with burn wound infections. blaIMP-producing P. aeruginosa isolates are a rising threat in burn-care units, and should be controlled by conducting infection-control assessments.

Background

Metallo-β-lactamase (MBL)-producing Pseudomonas aeruginosa is a significant pathogen in burn patients.

Objectives

The aim of this study was to determine the prevalence of carbapenem-resistant P. aeruginosa isolates, including those resistant to imipenemase (IMP), in a burn unit in Isfahan, Iran.

Patients and Methods

One hundred and fifty P. aeruginosa isolates from burn patients were tested for antibiotic susceptibility by the disc diffusion method in accordance with CLSI guidelines. Production of MBL was identified with the EDTA disk method. DNA was purified from the MBL-positive isolates, and detection of the blaIMP gene was performed with PCR.

Results

Fifty-seven out of 150 (38%) isolates were multi-drug resistant (MDR), and 93 (62%) were extensively-drug resistant (XDR). Among all isolates, the resistance rate to ciprofloxacin, tobramycin, imipenem, meropenem, amikacin, ceftazidime, and cefepime was higher than 90%, while the resistance rates to piperacillin/tazobactam and aztreonam were 70.7% and 86%, respectively. Colistin and polymyxin B remained the most effective studied antibiotics. All of the imipenem-resistant P. aeruginosa isolates were MBL-positive, and 107 out of 144 (74.3%) of the MBL isolates were positive for the blaIMP gene.

Antibiotic Resistance;Carbapenem-Resistant;Metallo-Beta-Lactamase;Burn;P. aeruginosa Antibiotic Resistance;Carbapenem-Resistant;Metallo-Beta-Lactamase;Burn;P. aeruginosa http://www.archtrauma.com/index.php?page=article&article_id=33664 Mohsen Radan Mohsen Radan Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Rezvan Moniri Rezvan Moniri Faculty of Medicine, Department of Microbiology and Immunology, Kashan University of Medical Sciences, Kashan, IR Iran; Faculty of Medicine, Department of Microbiology and Immunology, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3155540021-5, +98-9133612636, Fax: +98-3155541112 Faculty of Medicine, Department of Microbiology and Immunology, Kashan University of Medical Sciences, Kashan, IR Iran; Faculty of Medicine, Department of Microbiology and Immunology, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3155540021-5, +98-9133612636, Fax: +98-3155541112 Ahmad Khorshidi Ahmad Khorshidi Faculty of Medicine, Department of Microbiology and Immunology, Kashan University of Medical Sciences, Kashan, IR Iran Faculty of Medicine, Department of Microbiology and Immunology, Kashan University of Medical Sciences, Kashan, IR Iran Hamidreza Gilasi Hamidreza Gilasi Faculty of Health, Department of Epidemiology, Kashan University of Medical Sciences, Kashan, IR Iran Faculty of Health, Department of Epidemiology, Kashan University of Medical Sciences, Kashan, IR Iran Zohreh Norouzi Zohreh Norouzi Department of Microbiology, Falavarjan Branch, Islamic Azad University, Isfahan, IR Iran Department of Microbiology, Falavarjan Branch, Islamic Azad University, Isfahan, IR Iran Fahimeh Beigi Fahimeh Beigi Department of Genetic, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Department of Genetic, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Yasaman Dasteh Goli Yasaman Dasteh Goli University of Maryland College Park, Maryland, United States of America University of Maryland College Park, Maryland, United States of America
en 27800467 10.5812/atr.36570 A Time Series Model for Assessing the Trend and Forecasting the Road Traffic Accident Mortality A Time Series Model for Assessing the Trend and Forecasting the Road Traffic Accident Mortality research-article research-article Conclusions

There was a decreasing trend in the study and the future years. It seems that implementation of some interventions in the recent decade has had a positive effect on the decline of RTA fatalities. Nevertheless, there is still a need to pay more attention in order to prevent the occurrence and the mortalities related to traffic accidents.

Results

The mean age of the victims was 37.22 years (SD = 20.01). From a total of 2571 deaths, 77.5% (n = 1992) were males and 22.5% (n = 579) were females. The study models showed a descending trend of fatalities in the study years. The SARIMA (1, 1, 3) (0, 1, 0) 12 model was recognized as a best fit model in forecasting the trend of fatalities. Forecasting model also showed a descending trend of traffic accident mortalities in the next 4 years.

Objectives

This study aimed to assess the trend of RTAs and forecast it in the next years by using time series modeling.

Materials and Methods

In this historical analytical study, the RTA mortalities in Zanjan Province, Iran, were evaluated during 2007 - 2013. The time series analyses including Box-Jenkins models were used to assess the trend of accident fatalities in previous years and forecast it for the next 4 years.

Background

Road traffic accident (RTA) is one of the main causes of trauma and known as a growing public health concern worldwide, especially in developing countries. Assessing the trend of fatalities in the past years and forecasting it enables us to make the appropriate planning for prevention and control.

Conclusions

There was a decreasing trend in the study and the future years. It seems that implementation of some interventions in the recent decade has had a positive effect on the decline of RTA fatalities. Nevertheless, there is still a need to pay more attention in order to prevent the occurrence and the mortalities related to traffic accidents.

Results

The mean age of the victims was 37.22 years (SD = 20.01). From a total of 2571 deaths, 77.5% (n = 1992) were males and 22.5% (n = 579) were females. The study models showed a descending trend of fatalities in the study years. The SARIMA (1, 1, 3) (0, 1, 0) 12 model was recognized as a best fit model in forecasting the trend of fatalities. Forecasting model also showed a descending trend of traffic accident mortalities in the next 4 years.

Objectives

This study aimed to assess the trend of RTAs and forecast it in the next years by using time series modeling.

Materials and Methods

In this historical analytical study, the RTA mortalities in Zanjan Province, Iran, were evaluated during 2007 - 2013. The time series analyses including Box-Jenkins models were used to assess the trend of accident fatalities in previous years and forecast it for the next 4 years.

Background

Road traffic accident (RTA) is one of the main causes of trauma and known as a growing public health concern worldwide, especially in developing countries. Assessing the trend of fatalities in the past years and forecasting it enables us to make the appropriate planning for prevention and control.

Traffic Accidents;Mortality;Forecasting;Trends Traffic Accidents;Mortality;Forecasting;Trends http://www.archtrauma.com/index.php?page=article&article_id=36570 Shahrokh Yousefzadeh-Chabok Shahrokh Yousefzadeh-Chabok Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, IR Iran Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, IR Iran Fatemeh Ranjbar-Taklimie Fatemeh Ranjbar-Taklimie Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, IR Iran Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, IR Iran Reza Malekpouri Reza Malekpouri Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, IR Iran Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, IR Iran Alireza Razzaghi Alireza Razzaghi Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, IR Iran; Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, IR Iran. Tel: +98-1333338373, Fax: +98-1333338373 Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, IR Iran; Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, IR Iran. Tel: +98-1333338373, Fax: +98-1333338373
en 27800468 10.5812/atr.36952 Effectiveness of Chitosan Films Impregnated With Ciprofloxacin for the Prophylaxis of Osteomyelitis in Open Fractures: An Experimental Study in Rats Effectiveness of Chitosan Films Impregnated With Ciprofloxacin for the Prophylaxis of Osteomyelitis in Open Fractures: An Experimental Study in Rats research-article research-article Conclusions

In this experimental model of open fracture, the chitosan film pure or impregnated with ciprofloxacin was not effective in the prophylaxis of osteomyelitis.

Results

In cultures of the CT group, there was less bacterial growth compared to the results of the cultures of the IC (P = 0.005), C (P = 0.005) and CA (P = 0.009) groups. The inflammation was lower in the CT group compared to the IC (P = 0.014), C (P = 0.001) and CA (P = 0.007) groups.

Materials and Methods

In this experimental study, 24 Holtzman rats were distributed into 4 groups of 6 rats each. The CT (control of treatment) group: an open fracture model treated with systemic antimicrobial; the IC (infection control) group: an open fracture untreated model; the C (chitosan) group: an open fracture model treated using a chitosan film; and the CA (chitosan with antimicrobial) group: an open fracture model treated using a chitosan film impregnated with antimicrobial. After 3 weeks the animals were killed by an overdose of anesthetic, and a fragment osseous was removed for histological and microbiological analysis. The comparisons between the groups considered significant values of P ≤ 0.05.

Objectives

This study aimed to evaluate the effectiveness of prophylaxis of osteomyelitis through experimental model of open fractures with the use of chitosan films, whether or not impregnated with ciprofloxacin.

Background

The systemic antimicrobial prophylaxis is the standard treatment in the prevention of osteomyelitis after open fractures, with topical application of antimicrobials as an alternative due to their high concentrations at the site of the fracture, low systemic concentrations and fewer side effects.

Conclusions

In this experimental model of open fracture, the chitosan film pure or impregnated with ciprofloxacin was not effective in the prophylaxis of osteomyelitis.

Results

In cultures of the CT group, there was less bacterial growth compared to the results of the cultures of the IC (P = 0.005), C (P = 0.005) and CA (P = 0.009) groups. The inflammation was lower in the CT group compared to the IC (P = 0.014), C (P = 0.001) and CA (P = 0.007) groups.

Materials and Methods

In this experimental study, 24 Holtzman rats were distributed into 4 groups of 6 rats each. The CT (control of treatment) group: an open fracture model treated with systemic antimicrobial; the IC (infection control) group: an open fracture untreated model; the C (chitosan) group: an open fracture model treated using a chitosan film; and the CA (chitosan with antimicrobial) group: an open fracture model treated using a chitosan film impregnated with antimicrobial. After 3 weeks the animals were killed by an overdose of anesthetic, and a fragment osseous was removed for histological and microbiological analysis. The comparisons between the groups considered significant values of P ≤ 0.05.

Objectives

This study aimed to evaluate the effectiveness of prophylaxis of osteomyelitis through experimental model of open fractures with the use of chitosan films, whether or not impregnated with ciprofloxacin.

Background

The systemic antimicrobial prophylaxis is the standard treatment in the prevention of osteomyelitis after open fractures, with topical application of antimicrobials as an alternative due to their high concentrations at the site of the fracture, low systemic concentrations and fewer side effects.

Open Fracture;Prophylaxis;Osteomyelitis;Chitosan;Ciprofloxacin Open Fracture;Prophylaxis;Osteomyelitis;Chitosan;Ciprofloxacin http://www.archtrauma.com/index.php?page=article&article_id=36952 Lincoln Paiva Costa Lincoln Paiva Costa Hospital Madre Teresa, Belo Horizonte, Brazil; Hospital Madre Teresa, Belo Horizonte, Brazil. Tel: +55-31987750451 Hospital Madre Teresa, Belo Horizonte, Brazil; Hospital Madre Teresa, Belo Horizonte, Brazil. Tel: +55-31987750451 Luiz Eduardo Moreira Teixeira Luiz Eduardo Moreira Teixeira Hospital Madre Teresa and Universidade Federal de Minas Gerais Minas Gerais, Belo Horizonte, Brazil Hospital Madre Teresa and Universidade Federal de Minas Gerais Minas Gerais, Belo Horizonte, Brazil Gustavo Silame Maranhão Lima Gustavo Silame Maranhão Lima Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil Marcelo Mendes Ferreira Marcelo Mendes Ferreira Hospital Madre Teresa, Belo Horizonte, Brazil Hospital Madre Teresa, Belo Horizonte, Brazil Mateus Antunes de Andrade Mateus Antunes de Andrade Hospital Madre Teresa, Belo Horizonte, Brazil Hospital Madre Teresa, Belo Horizonte, Brazil Paula Vieira Teixeira Vidigal Paula Vieira Teixeira Vidigal Universidade Federal de Minas Gerais Minas Gerais, Belo Horizonte, Brazil Universidade Federal de Minas Gerais Minas Gerais, Belo Horizonte, Brazil André Augusto Gomes Faraco André Augusto Gomes Faraco Universidade Federal de Minas Gerais Minas Gerais, Belo Horizonte, Brazil Universidade Federal de Minas Gerais Minas Gerais, Belo Horizonte, Brazil Eduardo Frois Temponi Eduardo Frois Temponi Hospital Madre Teresa, Belo Horizonte, Brazil Hospital Madre Teresa, Belo Horizonte, Brazil Ivana Duval de Araújo Ivana Duval de Araújo Universidade Federal de Minas Gerais Minas Gerais, Belo Horizonte, Brazil Universidade Federal de Minas Gerais Minas Gerais, Belo Horizonte, Brazil
en 27800469 10.5812/atr.37005 The Serum Changes of Neuron-Specific Enolase and Intercellular Adhesion Molecule-1 in Patients With Diffuse Axonal Injury Following Progesterone Administration: A Randomized Clinical Trial The Serum Changes of Neuron-Specific Enolase and Intercellular Adhesion Molecule-1 in Patients With Diffuse Axonal Injury Following Progesterone Administration: A Randomized Clinical Trial research-article research-article Conclusions

In summary, progesterone administration reduced serum ICAM-1, and whereby may attenuate blood brain barrier disruption, the latter needs further investigation for confirmation.

Results

A reduction in the serum level of ICAM-1 was noticed in the progesterone group 24 hours after the injury (P < 0.05). There was no significant difference in the serum level of NSE between the study groups during evaluation. At 24 hours after the injury, the level of ICAM-1 in the control group was higher than that at admission time (P < 0.05). The lowest level of NSE in the two groups was seen six days after DAI (P < 0.01).

Objectives

The aim of this study was to examine the effect of progesterone administration on serum levels of neuron-specific enolase (NSE), and intercellular adhesion molecule-1 (ICAM-1) in clinical DAI.

Patients and Methods

In this study, the serum levels of ICAM-1 and NSE of 32 male DAI patients (18 - 60 years of age, a Glasgow coma scale of 12 or less, and admitted within 4 hours after injury) who were randomized for a controlled phase II trial of progesterone were analyzed. The analysis was performed between the control and progesterone groups at admission time, and 24 hours and six days after DAI, respectively.

Background

Improvement of neurologic outcome in progesterone-administered patients with diffuse axonal injury (DAI) has been found in a recent study. Also, there has been interest in the importance of serum parameters as predictors of outcome in traumatic brain injury.

Conclusions

In summary, progesterone administration reduced serum ICAM-1, and whereby may attenuate blood brain barrier disruption, the latter needs further investigation for confirmation.

Results

A reduction in the serum level of ICAM-1 was noticed in the progesterone group 24 hours after the injury (P < 0.05). There was no significant difference in the serum level of NSE between the study groups during evaluation. At 24 hours after the injury, the level of ICAM-1 in the control group was higher than that at admission time (P < 0.05). The lowest level of NSE in the two groups was seen six days after DAI (P < 0.01).

Objectives

The aim of this study was to examine the effect of progesterone administration on serum levels of neuron-specific enolase (NSE), and intercellular adhesion molecule-1 (ICAM-1) in clinical DAI.

Patients and Methods

In this study, the serum levels of ICAM-1 and NSE of 32 male DAI patients (18 - 60 years of age, a Glasgow coma scale of 12 or less, and admitted within 4 hours after injury) who were randomized for a controlled phase II trial of progesterone were analyzed. The analysis was performed between the control and progesterone groups at admission time, and 24 hours and six days after DAI, respectively.

Background

Improvement of neurologic outcome in progesterone-administered patients with diffuse axonal injury (DAI) has been found in a recent study. Also, there has been interest in the importance of serum parameters as predictors of outcome in traumatic brain injury.

Intercellular Adhesion Molecule-1;Neuron-Specific Enolase;Progesterone;Serum;Diffuse Axonal Injury Intercellular Adhesion Molecule-1;Neuron-Specific Enolase;Progesterone;Serum;Diffuse Axonal Injury http://www.archtrauma.com/index.php?page=article&article_id=37005 Nader Shahrokhi Nader Shahrokhi Physiology Research Center, Institute of Neuropharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, IR Iran Physiology Research Center, Institute of Neuropharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, IR Iran Zahra Soltani Zahra Soltani Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, IR Iran; Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, IR Iran. Tel: +98-3433257581, Fax: +98-3433257581 Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, IR Iran; Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, IR Iran. Tel: +98-3433257581, Fax: +98-3433257581 Mohammad Khaksari Mohammad Khaksari Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, IR Iran Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, IR Iran Saeid Karamouzian Saeid Karamouzian Department of Neurosurgery, Kerman University of Medical Sciences, Kerman, IR Iran Department of Neurosurgery, Kerman University of Medical Sciences, Kerman, IR Iran Behshad Mofid Behshad Mofid Department of Neurosurgery, Kerman University of Medical Sciences, Kerman, IR Iran Department of Neurosurgery, Kerman University of Medical Sciences, Kerman, IR Iran Gholamreza Asadikaram Gholamreza Asadikaram Department of Biochemistry, Kerman University of Medical Sciences, Kerman, IR Iran Department of Biochemistry, Kerman University of Medical Sciences, Kerman, IR Iran
en 28138434 10.5812/atr.24760 Concurrent Lateral Condyle Mass Fracture With Olecranon Fracture: A Case Report and Brief Review of Literature Concurrent Lateral Condyle Mass Fracture With Olecranon Fracture: A Case Report and Brief Review of Literature case-report case-report Introduction

There is very limited literature describing the association of lateral condyle mass (LCM) fracture of the distal humerus associated concurrently with olecranon fracture. Herein, a case is reported of a displaced LCM fracture with displaced olecranon fracture, due to complex trauma while getting out of a vehicle, which was managed by open reduction and internal fixation.

Conclusions

In view of the paucity of literature and rare incidence of this injury, this case report highlights the need to be aware of other injuries which can occur in association with LCM fractures in children.

Case Presentation

A 4.5- year- old boy suffered severe pain and swelling around his right elbow due to trauma which he suffered while trying to get out of a vehicle which was in motion. Plain radiographs of the anteroposterior, lateral, and oblique views showed a displaced lateral mass fracture associated with a displaced olecranon fracture. Open reduction and internal fixation was carried out and near normal function was achieved.

Introduction

There is very limited literature describing the association of lateral condyle mass (LCM) fracture of the distal humerus associated concurrently with olecranon fracture. Herein, a case is reported of a displaced LCM fracture with displaced olecranon fracture, due to complex trauma while getting out of a vehicle, which was managed by open reduction and internal fixation.

Conclusions

In view of the paucity of literature and rare incidence of this injury, this case report highlights the need to be aware of other injuries which can occur in association with LCM fractures in children.

Case Presentation

A 4.5- year- old boy suffered severe pain and swelling around his right elbow due to trauma which he suffered while trying to get out of a vehicle which was in motion. Plain radiographs of the anteroposterior, lateral, and oblique views showed a displaced lateral mass fracture associated with a displaced olecranon fracture. Open reduction and internal fixation was carried out and near normal function was achieved.

Lateral Mass Fracture;Olecranon Fracture;Complex Elbow Injuries Lateral Mass Fracture;Olecranon Fracture;Complex Elbow Injuries http://www.archtrauma.com/index.php?page=article&article_id=24760 Munir Farooq Munir Farooq Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India Younis Kamal Younis Kamal Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India; Postgraduate Department of Orthopaedics, Government Medical College, Srinagar, Jammu and Kashmir, India. Tel: +91-06966960, Fax +91-1942423389 Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India; Postgraduate Department of Orthopaedics, Government Medical College, Srinagar, Jammu and Kashmir, India. Tel: +91-06966960, Fax +91-1942423389 Hayat Ahmad Khan Hayat Ahmad Khan Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India Naseemul Gani Naseemul Gani Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India Adil Bashir Shah Adil Bashir Shah Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India Mohammed Ashraf Khan Mohammed Ashraf Khan Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India Shahid Bhat Shahid Bhat Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India Postgraduate Department of Orthopaedics, Government Medical College, Jammu and Kashmir, India
en 27800464 10.5812/atr.33405 Traumatic Globe Subluxation and Intracranial Injury Caused by Bicycle Brake Handle Traumatic Globe Subluxation and Intracranial Injury Caused by Bicycle Brake Handle case-report case-report Introduction

Penetration of a bicycle brake handle into the orbit is a rare and serious type of trauma. Globe subluxation due to such trauma has not been previously reported.

Case Presentation

A 10-year-old girl presented after falling from a bicycle, which resulted in the handbrake penetrating her right upper eyelid. On examination, the globe was subluxated anteriorly, there was no light perception, and the pupilla was fixed and dilated. Radiologic studies revealed orbitonasal fractures, hemorrhage, emphysema in the orbit and cranium, and rupture of the extraocular muscles. The globe was replaced into the orbit with the help of lateral cantholysis and orbital septotomy. During 22 months of follow-up, the globe remained intact, but total loss of vision, blepharoptosis, and extraocular motility restriction persisted.

Conclusions

This case and previous reports show that bicycle brake handles can cause severe, penetrating orbital and cerebral traumas that can result in vision loss or fatality. Brake handles should be designed to protect bicyclists from such injuries.

Introduction

Penetration of a bicycle brake handle into the orbit is a rare and serious type of trauma. Globe subluxation due to such trauma has not been previously reported.

Case Presentation

A 10-year-old girl presented after falling from a bicycle, which resulted in the handbrake penetrating her right upper eyelid. On examination, the globe was subluxated anteriorly, there was no light perception, and the pupilla was fixed and dilated. Radiologic studies revealed orbitonasal fractures, hemorrhage, emphysema in the orbit and cranium, and rupture of the extraocular muscles. The globe was replaced into the orbit with the help of lateral cantholysis and orbital septotomy. During 22 months of follow-up, the globe remained intact, but total loss of vision, blepharoptosis, and extraocular motility restriction persisted.

Conclusions

This case and previous reports show that bicycle brake handles can cause severe, penetrating orbital and cerebral traumas that can result in vision loss or fatality. Brake handles should be designed to protect bicyclists from such injuries.

Brain Injuries;Child;Orbital Fracture;Optic Nerve Injuries;Extraocular Muscle Brain Injuries;Child;Orbital Fracture;Optic Nerve Injuries;Extraocular Muscle http://www.archtrauma.com/index.php?page=article&article_id=33405 Ceren Poroy Ceren Poroy Department of Ophthalmology, Uludag University, Bursa, Turkey Department of Ophthalmology, Uludag University, Bursa, Turkey Cansu Cibik Cansu Cibik Department of Ophthalmology, Uludag University, Bursa, Turkey Department of Ophthalmology, Uludag University, Bursa, Turkey Bulent Yazici Bulent Yazici Department of Ophthalmology, Uludag University, Bursa, Turkey; Department of Ophthalmology, Uludag University, Bursa, Turkey. Tel: +90-2242952415, Fax: +90-2444428070 Department of Ophthalmology, Uludag University, Bursa, Turkey; Department of Ophthalmology, Uludag University, Bursa, Turkey. Tel: +90-2242952415, Fax: +90-2444428070