Common Injuries Research Articles

A stacked autoencoder-based aid system for severity degree classification of knee ligament rupture

BackgroundKnee ligament rupture is one of the most common injuries, but the diagnosis of its severity tends to require the use of complex methods and analyses that are not always available to patients. AimThe objective of this research is the investigation and development of a diagnostic aid system to analyze and determine patterns that characterize the presence of the injury and its degree of severity. MethodsImplement a novel proposal of a framework based on stacked auto-encoder (SAE) for ground reaction force (GRF) signals analysis, coming from the GaitRec database. Analysis of the raw data is used to determine the main features that allow us to diagnose the presence of a knee ligament rupture and classify its severity as high, mid or mild. ResultsThe process is divided into two stages to determine the presence of the lesion and, if necessary, evaluate variations in features to classify the degree of severity as high, mid, and mild. The framework presents an accuracy of 87 % and a F1-Score of 90 % for detecting ligament rupture and an accuracy of 86.5 % and a F1-Score of 87 % for classifying severity. ConclusionThis new methodology aims to demonstrate the potential of SAE in physiotherapy applications as an evaluation and diagnostic tool, identifying irregularities associated with ligament rupture and its degree of severity, thus providing updated information to the specialist during the rehabilitation process.

Visualization of left common carotid artery injury by glass using postmortem virtual angioscopy.

A deceased man in his 50s was found with his neck over a broken glass door frame, with blood around the body. A non-contrast postmortem computed tomography (PMCT) scan revealed subcutaneous hemorrhage, temporal bone fracture, and cerebral contusion. Also, wounds extending from the anterior to posterior neck and the presence of air in the cervical vessels suggested cervical vascular injury. A virtual angioscopy image reconstructed from PMCT angiography data revealed a ruptured left common carotid artery and allowed accurate measurement of the injury. This case demonstrates the effectiveness of postmortem virtual angioscopy for visualization and evaluation of vascular injuries, providing valuable insights for forensic investigation.

Outcomes of sliding hip screw fixation in stable versus unstable intertrochanteric hip fractures

Purpose: Unstable intertrochanteric (IT) fractures are common orthopedic injuries in the elderly people with high morbidity. The treatment of unstable IT fractures with sliding hip screw (SHS) is still controversial. The purpose of our study is to assess the outcomes of conventional SHS in unstable IT fractures in comparison to stable ones. Methods: A total of 35 stable and 23 unstable IT fracture cases were treated with SHS between January 2017 and December 2018. Patients were evaluated for infection, revision rate, screw cut-out, development of post-traumatic arthritis or heterotopic ossification, and mortality. Results: The mean age of the patients at the time of surgery was 69.8 and 73.9 years for stable and unstable IT fractures, respectively, with 38 males (25 stable vs. 13 unstable) and 20 females (10 in each group). The mean follow-up was 42.2 and 49.4 weeks in stable and unstable IT fractures, respectively. We found a significant association between the occurrence of screw cut-out in unstable fractures compared to stable ones (17.4% vs. 0%, respectively, p = 0.01). There was an obvious trend for nonunion and higher revision rates in unstable IT fractures (17.4% vs. 2.9%, p = 0.056). Logistic regression analysis did not reveal any statistically significant confounder that might affect the rates of fracture union or revision rates. Post-traumatic arthritis and heterotopic ossification occurred in one case of unstable IT fracture. There were no reported cases of infection. Conclusion: There are higher risks of screw cut-out, nonunion, and the need for revision when the SHS is used to treat unstable IT fractures.

How Vulnerable Are the Elderly in Road Traffic-Autopsy Study?

The aim of this study was to analyze characteristic and pattern of road traffic injuries in this special aging group, as well to examine the relevance of certain injuries or risk factors to outliving the injuries. This epidemiological, analytical, retrospective, autopsy study investigated the road traffic deaths for period between 2001 and 2022. The subjects were divided into two age groups, elderly (65 years and older) and middle aged (16-64 years old). We included 213 (32%) elderly participants out of all 665 RTA subjects who died from sustained injuries or complications of the injuries. The majority of elderly subjects (61%) were pedestrians, and elderly participants in RTA were more likely to survive the injuries. The most common injuries among the elderly in all group of participants were chest injuries 81% (and among them, rib fractures were present in 76%). Cranio-cerebral injury is the most common cause of death in RTA subjects, singular (45%) or in combination with other causes. In the group of elderly RTA subjects complication of injury is represented in 36 subjects (17%), while as cause of death is represented in 22 subjects (10%). Elderly are less likely to have positive BAC, and even in cases when BAC was increased, the levels were on the lower scale. More effort should be made to enhance road safety for elderly pedestrians, especially considering the expected rapid growth in the elderly population.

Modern approaches to the management of blunt liver trauma

Relevance. Liver trauma is one of the most common abdominal injuries. The purpose is to review the evidence and present the current level of diagnosis, tactics and treatment of blunt liver trauma.Materials and methods. The results of clinical studies in liver trauma have been analyzed. Literature was searched in PubMed electronic search engines (https://pubmed.ncbi.nlm.nih.gov), eLibrary (https://elibrary.ru) by keywords: "liver trauma", "management liver trauma", "diagnosis liver trauma". 134 publications were selected for analysis.Results. Historically, most patients with liver trauma were cured promptly using techniques such as liver suturing, liver resection, ligation of the hepatic artery, atrioval shunts. Conservative management was practically not used. Consequently, mortality was high and reached almost 90% in patients with severe trauma, including damage to the main hepatic vessels. The introduction of such techniques as perigepathic packaging and direct suturing of damaged vessels significantly improved the prognosis of patients. The widespread use of conservative therapy in patients with stable hemodynamics, the management of which is based on instrumental assessment, carefully selected diagnostic imaging of the nature of liver injury, instrumental dynamic observation using operative X-ray angiology and endoscopy, in a hybrid operating room, contributed to the improvement of treatment results.Conclusion. In recent decades, conservative therapy has been performed in 80–86% of cases in patients with stable hemodynamics. The use of minimally invasive interventions such as angiography and embolization, a combination of percutaneous drainage and endoscopic methods for injury to vascular and biliary structures can be considered as the main method of treating post-traumatic complications.

Using Next-Generation Sequencing to Understand Infection Prevention in Surgical Treatment of Upper Extremity Fractures-A Prospective Cohort Study.

Postoperative fracture site infection can lead to notable patient morbidity, increase cost of care, and further contribute to healthcare disparities globally. Dogma suggests surgical blades as a vehicle for introducing bacteria into the surgical site; however, there is a paucity of literature to support this claim. This study uses advanced DNA sequencing to detect bacterial DNA on surgical blades used in upper extremity fracture surgeries. This was a prospective study, conducted at a high-volume level 1 trauma center. All acute, closed upper extremity fractures requiring surgical stabilization were consecutively enrolled in a prospective fashion. The primary end point was the presence of bacterial DNA on the surgical blade using next-generation sequencing (NGS). At the time of surgery, two blades were sterilely opened. One blade served as the control while the other was used for the initial skin incision. Two negative control blades were opened directly into a sterile container. Two positive control blades were used for skin incision through known infections. All samples were sent for NGS analysis. Forty patients were enrolled in this study. The median age was 33.5 years, and 30% were female; the median body mass index was 26.52. Humerus fractures were the most common injury (N = 17, 42.5%), followed by clavicle fractures (13, 32.5%) and radius/ulna fractures (10, 25.0%). NGS analysis revealed no contamination of test blades used for skin incision. Three control blades tested positive for bacterial DNA. Negative control blades tested negative for bacterial DNA (0/2); the positive control blades resulted positive for bacterial DNA contamination (2/2). Surgical blades used for skin incision in the upper extremity are not contaminated with bacterial DNA as analyzed by NGS. This finding challenges previous surgical dogma regarding surgical blade contamination and supports that the same surgical blade can safely be used for deeper dissection. Level II study: IRB approval-IRB#848938.

Management of Distal Phalanx Intraarticular Comminuted Fracture of Small Finger with Zone I Flexor Tendon Avulsion: A Case Report

Distal phalanx fractures are a common injury in both athletes and civilians. These fractures can differ greatly in severity and treatment indications depending on the size, location, and stability of the fracture in addition to appreciation of any bony comminution. Tendon avulsion in conjugation with a fracture complicates treatment and outcomes further. The classification system for these fractures have been well classified to include Type I, II, II, and IV with IV having subtypes. More recently, Type V has been added to the classification system. Designated as a comminuted distal phalanx fracture with flexor digitorum profundus avulsion, this Leddy-Packer type has two subgroups: namely, comminution without intra-articular involvement (Va) and comminution that includes the articular surface. We report the case of a 42-year-old female presenting with injury to the distal phalanx of the right small finger sustained after her dog ran away from her as she held the collar, exerting significant force in opposition to her flexed fingers. Upon exam and following appropriate imaging, her injury was defined as a Leddy and Packer Type Vb jersey finger injury. This was effectively treated with open reduction, internal fixation of the comminuted distal phalanx base and avulsion fragment. A notably rare injury, Leddy-Packer Type Vb distal phalanx avulsion injuries must be treated in a case-by-case basis, but open reduction internal fixation with plating proves an appropriate and effective means of repair in the correct patient.

Corticosteroid-loaded chitosan-based in-situ forming gel combined with microneedle technology for improvement of burn eschar wound healing

Burn is one of the most common skin injuries and accounts for 300,000 deaths annually. Debridement and antibiotic therapy are major burn treatments, however, as debridement is not always possible and many drugs have poor penetration into necrotic tissue, permeation enhancement is acquired. Another challenge is the short duration of topically applied drugs. This study aims to address both problems by combining in-situ forming gels and microneedles.A chitosan-based in-situ forming gel of hydrocortisone was applied to human burn eschar using microneedles. The formulation was optimized using Design-Expert software. Formulation characterization was done in terms of gelling time and temperature, thermal analysis, release phenomenon, rheology, texture analysis, and stability. Finally, animal studies on mice burn wound treatment were conducted. Results showed that optimized formulation controlled the drug release, and wherever microneedle was used, drug permeation and flux increased (P-value < 0.05). In all ex-vivo and in-vivo stages, gel plus microneedle (length of 1.5 mm and application mode of 2) produced the best results concerning increased flux and faster recovery of burn eschar. In conclusion, the in-situ forming gel with appropriate texture, quality, and stability in combination with microneedle can be a good candidate for the controlled release of drugs in third-degree burn eschars.

Treatment of clavicle fracture: Interpretation of the 2023 American Academy of Orthopaedic Surgeons (AAOS) Clinical Practice Guidelines

Clavicle fracture is a common orthopedic injury, accounting for approximately 2.6%-4% of all adult skeletal fractures. In 2023, the American Academy of Orthopaedic Surgeons (AAOS) developed evidence-based treatment guidelines for clavicle fractures, which include 4 recommendations and 10 options. This article, based on a thorough review of the guidelines, discusses the clinical treatment of clavicle fractures, aiming to share advancements and the latest diagnostic and therapeutic considerations with orthopedic colleagues to enhance treatment outcomes.

Effect of low-intensity pulsed ultrasound on postoperative rehabilitation of rotator cuff tears: Protocol for a systematic review and meta-analysis.

Rotator cuff tears are a common shoulder injury that significantly impacts patients' daily lives and work abilities. Although surgical treatment methods for rotator cuff tears have been continuously improved with advances in medical technology, postoperative rehabilitation remains challenging. Therefore, finding effective rehabilitation treatments is crucial for improving patient prognosis and enhancing quality of life. This study will aim to systematically evaluate the impact of low-intensity pulsed ultrasound (LIPUS) on postoperative rehabilitation of rotator cuff tears, comprehensively assessing the efficacy and safety of LIPUS in postoperative recovery. This protocol will search multiple databases including PubMed/MEDLINE, Embase, Cochrane Library, CNKI, Scopus, and Web of Science to identify randomized controlled trials related to LIPUS for postoperative rehabilitation of rotator cuff tears. The search will encompass literature published from the inception of the databases up to April 2024. Methodological quality assessment and data extraction will be conducted using the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. Meta-analysis will be performed on appropriate studies using either random-effects or fixed-effects models, and subgroup analyses will be conducted to explore potential heterogeneity. Studies meeting the inclusion criteria will be included in the analysis. All analyses will be performed using Stata version 16.0. The incidence of rotator cuff tear rates will be assessed by imaging techniques such as MRI or ultrasound. Pain intensity will be scored using standardized pain assessment scales, such as the Visual Analog Scale (VAS). Improved range of motion (ROM) in shoulder flexion, abduction, and rotation. Functional outcomes will be evaluated using effective measures such as Constant-Murley scores (CMS) and shoulder joint scores by American Shoulder and Elbow Surgeons (ASES). Adverse events associated with LIPUS therapy, including skin irritation, increased pain, or any other complications. Subgroup analysis will also be carried out if possible. Following the meta-analysis, we will assess the overall effect of LIPUS on postoperative rehabilitation of rotator cuff tears, and further explore its impact on aspects such as pain relief, functional improvement, and postoperative complications. It is anticipated that this study will provide comprehensive evidence regarding the role of LIPUS in postoperative rehabilitation of rotator cuff tears, guiding clinical practice and future research. The resultant manuscript will be submitted for publication in a peer-reviewed journal. CRD42024530798.

Bone stress injuries in athletics (track and field) championships: findings from a prospective injury surveillance conducted across 24 international championships with 29,147 registered athletes

BackgroundAthletics (track and field) athletes are prone to develop bone stress injuries (BSIs) but epidemiological data on BSIs from top-level sports events are scarce.ObjectiveTo describe the incidence and characteristics of BSIs during 24 international athletics championships held from 2007 to 2023.MethodsBSI-related data were prospectively collected during 24 international athletics championships, including the Olympic Games (n = 3), World Outdoor Championships (n = 4), European Outdoor Championships (n = 6), World Indoor Championships (n = 3) and European Indoor Championships (n = 8). Descriptive and comparative statistics were used to assess the epidemiological characteristics of BSIs.ResultsBSIs accounted for 1.5% of all reported injuries (n = 36; 1.2 per 1000 registered athletes (95%CI 0.8 to 1.6)). No significant difference of BSI incidence was detected between female (2.0 per 1000 athletes (95%CI: 0.9 to 2.3)) and male athletes (0.9 per 1000 athletes (95%CI: 0.4 to 1.4)) (relative risk (RR) = 1.73, 95%CI: 0.88 to 3.40). BSI incidence was significantly higher during outdoor championships (1.6 per 1000 registered athletes (95%CI: 1.0 to 2.1)) as compared to indoor championships (0.2 per 1000 registered athletes (95%CI: 0.0 to 0.5)) (RR = 10.4, 95%CI: 1.43 to 76.0). Most BSIs were sustained in the foot (n = 50%) or leg (n = 33%). BSIs were reported in athletes participating in endurance disciplines (52.8%) or in explosive disciplines (47.2%).ConclusionsBSIs represent a small portion of injuries sustained during international athletics championships. Collective results suggest that injury rates are higher in outdoor competitions as compared to indoor competitions. The most common injury locations comprise the foot and leg.Clinical Trial NumberNot applicable.

Utility of Diffusion Tensor Imaging in Preterm Infants with Germinal Matrix Hemorrhage and Intraventricular Hemorrhage: A Systematic Review

IntroductionIntraventricular hemorrhage (IVH) and germinal matrix hemorrhage (GMH) are the most common brain injuries in preterm infants. Neonates with these injuries are at greater risk of impaired neurodevelopmental outcome. Current guidelines recommend screening infants with cranial ultrasound (CUS), although this is prone to missing subtle injury patterns, particularly within the posterior fossa. The present report sought to discuss the utility of diffusion tensor imaging (DTI) in preterm infants. MethodsA systematic review of PubMed, Ovid MEDLINE, and Ovid EMBASE was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included manuscripts were methodically scrutinized for quality; DTI use; neurologic outcome. ResultsTwenty studies with 1574 infants who underwent DTI were included. There were 574 preterm infants with GMH-IVH on DTI. Twelve studies documented decreased fractional anisotropy (FA) while six demonstrated structural segregation and asymmetrical white matter myelination in these infants. Seven studies documented concurrent CUS use with two studies comparing DTI findings to CUS findings. In both studies, DTI more accurately detected presence of GMH, especially within the cerebellum. Among GMH-IVH preterm infants, 58.5% demonstrated cognitive, intellectual, and language delays at follow-up (mean: 32.4 months). Additionally, lower FA values on initial DTI were associated with cognitive, language, and motor delays. ConclusionAlthough DTI is more sensitive for picking up subtle injury patterns, CUS remains the standard of care when screening for injuries that would necessitate surgical intervention. DTI offers a refined understanding of the sequelae of GMH-IVH with microstructural changes found on DTI being associated with childhood motor and cognitive outcomes.

Occupational Injuries of Spanish Wildland Firefighters: A Descriptive Analysis.

The work of wildland firefighters, especially of the so-called 'Brigadas de Refuerzo contra Incendios Forestales', is characterised by high physical demands and extreme operating conditions. These professionals face long workdays (12 h), walking with heavy loads (~25 kg), being exposed to high temperatures (>30 °C), and handling specialised tools in high-risk environments. This study aimed to describe the prevalence of occupational injuries among members of the 'Brigadas de Refuerzo contra Incendios Forestales' and its relationship to variables such as age and work experience. A total of 217 wildland firefighters (18 female and 199 male) correctly answered a questionnaire developed on an ad hoc basis to meet the study's objectives. A high prevalence of occupational injuries was observed among them (~76%). Age and work experience were shown to be significantly associated with injuries. Individuals over 35 years of age with more than 10 years' experience had a higher probability of injury (OR = 2.14, CI = 1.12-4.06 and OR = 2.46, CI = 1.30-4.67, respectively). Injuries occurred mainly during physical training (~46%), followed by preventive work (~33%) and forest fires (~20%). The most common injuries were tendonitis and muscle pain (~44% and ~21% respectively), followed by sprains (~21%). The results underline the need for physical activity programmes adapted to help wildland firefighters, especially older and more experienced individuals. The identification of risk factors such as age and work experience can contribute to the prevention and management of occupational injuries among this group of highly specialised forestry workers. Specific preventative measures during training are required to mitigate the risk of injury among these crews, who play a crucial role in protecting the environment and public safety.

Evaluation and Management of Pediatric Proximal Humerus Greater and Lesser Tuberosity Avulsion Fractures.

Proximal humerus fractures account for 2% of fractures in skeletally immature patients. Avulsion fractures of the lesser and greater tuberosity are a rare subset of these injuries. Lack of awareness of these fracture types and subtle radiographic findings can result in delayed diagnosis and treatment. Case reports provide most of the current literature, and thus common injury mechanisms, clinical presentation, and ideal treatment time frame and modality are still undetermined. There are limited data directly comparing outcomes with nonsurgical or surgical management leading to unclear treatment guidelines. Presently, techniques for management of these injuries continue to evolve. Although these injuries represent a subset of pediatric proximal humerus injuries, they must be considered when evaluating a child with atraumatic and traumatic shoulder pain.

Effectiveness of Non-Elastic Rigid Tape Application on Static and Dynamic Balance in Players with Chronic Inversion Ankle Sprain- A Pilot Study

Background – Chronic Repetitive Inversion Ankle Sprain is one of the common injuries that occurs in contact as well as non-contact sports especially combat and jumping sports. As this injury is directly related to the ligament, proprioceptive deficit is observed in such players. The effect of taping on functional performance is still a topic of discussion. The purpose of this pilot study is to evaluate whether players with chronic repetitive inversion ankle sprain have any functional deficit and whether taping with non-stretchable athletic tape improves speed and agility. Methods - Players playing contact sports between the age of 18-24 years were included in the study after the initial screening for chronic repetitive inversion ankle sprain using IdFAI index and history of their injury. Speed was assessed using 10-m Sprint test while Agility was assessed using T-test for Agility. Post-application of the tape, data was collected on three time-intervals, i.e. immediate post-application of tape, post-3 days and post-14 days of application of tape. Results - Collected data was analyzed using One-way ANOVA test and the result showed statistically non-significant results in speed and agility, i.e. p=0.954 &amp; p=0.999 respectively. These results suggest that there is statistically non-significant improvement in speed and agility post-application of the tape but comparing with the means of pre-test measures, there is an improvement in speed and agility after the application of the tape.

A Systematic Review of the Optimal Management of Pediatric Distal Radius Displacement Fractures: Open Reduction and Internal Fixation Versus Cast Placement.

Distal radius fracturesare among the most common pediatric injuries, affecting thousands of children each year. These fractures often require clinical intervention to reduce displacement and ensure the proper healing of the growth plate and wrist bone. The primary objective of this comprehensive analysis is to compare the effectiveness of open reduction and internal fixation (ORIF) versus cast placement in the treatment of pediatric distal radius fractures, with the aim of identifying the optimal treatment approach. Therefore, a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted on pediatric distal radius displacement fractures using extensive database searches from 2000 to 2024 for specific keywords, ensuring transparency and reproducibility. Our findings indicate that higher displacement necessitates ORIF to minimize long-term complications and ensure better functional outcomes for pediatric patients. Rare studies comparing ORIF and cast placement are analyzed, emphasizing the advantages and limitations of each approach. The document concludes that the choice between ORIF and casting depends on factors such as fracture severity, patient's age, and specific characteristics of the injury to ensure optimal outcomes in pediatric distal radius fracture management. In conclusion, our data suggests that ORIF and cast placement each have pros and cons for pediatric distal radius fractures, with the best treatment depending on fracture specifics and patient factors, but neither method is clearly superior for long-term outcomes.

Epidemiological Characteristics of Fracture Among Children Aged 6-17 Years - China, 2019-2021.

Fractures are a common and serious injury among children. While many studies have utilized clinical data, there is a lack of large-scale community-based research in China. This cross-sectional study provides national and regionally representative data on the prevalence of fractures among Chinese children aged 6-17 years (6.93%), with higher rates observed in males than in females (8.13% vs. 5.71%) and in rural areas compared to urban areas (7.22% vs. 6.62%). The most common site of fracture was the upper limbs (4.24%, accounting for 63.0% of fractures). The need to enhance awareness of fracture prevention is critical, particularly for children in rural areas and males in middle childhood. We recommend that local authorities increase investments in educational programs and child safety oversight. Additionally, promoting balanced diets for children, training in proper exercise techniques, and reinforcing participation in outdoor sports are essential.

Taking a Closer Look: "Evaluating Online Video Content for Rehabilitation after Distal Radius Fracture".

Background: Fractures of the distal radius are among the most common bone injuries, and their frequency is constantly increasing, leading to an elevated need for subsequent rehabilitation. This growing need has led to the emergence of online content aimed at providing guidance on rehabilitation. Nonetheless, unreviewed online content raises concerns about its reliability; therefore, the objective of this study was to evaluate the quality, reliability, and comprehensiveness of online videos concerning rehabilitation following a distal radius fracture. Methods: A total of 240 YouTube videos were screened, identifying 33 videos that met the inclusion criteria. These selected videos were evaluated by five independent experts from various professional groups, using the Global Quality Scale, the DISCERN reliability tool, and the JAMA Benchmark Score, as well as a structured set of questions to assess their comprehensiveness and coverage of pertinent aspects. Results: The observers' assessment of the Global Quality Scale exhibited a broad spectrum of viewpoints, indicating considerable variability in evaluations. In most cases, therapy aligned well with the diagnosed condition, and most raters deemed the indication and instruction in the videos acceptable. A proportion of 87% of the videos was deemed suitable for home training by at least three raters. However, a concerning trend emerged, as potential risks and pitfalls were scarcely addressed. Conclusions: The moderate overall quality of the videos and the divergence in expert opinions highlight the need for a regulatory authority to ensure adherence to guidelines and maintain high-quality content. Additionally, our results raise concerns about the applicability of established assessment tools in this context.

Management of metacarpal shaft fractures.

The aims of this study were to describe the epidemiology of metacarpal shaft fractures (MSFs), assess variation in treatment and complications following standard care, document hospital resource use, and explore factors associated with treatment modality. A multicentre, cross-sectional retrospective study of MSFs at six centres in the UK. We collected and analyzed healthcare records, operative notes, and radiographs of adults presenting within ten days of a MSF affecting the second to fifth metacarpal between 1 August 2016 and 31 July 2017. Total emergency department (ED) attendances were used to estimate prevalence. A total of 793 patients (75% male, 25% female) with 897 MSFs were included, comprising 0.1% of 837,212 ED attendances. The annual incidence of MSF was 40 per 100,000. The median age was 27 years (IQR 21 to 41); the highest incidence was in men aged 16 to 24 years. Transverse fractures were the most common. Over 80% of all fractures were treated non-surgically, with variation across centres. Overall, 12 types of non-surgical and six types of surgical treatment were used. Fracture pattern, complexity, displacement, and age determined choice of treatment. Patients who were treated surgically required more radiographs and longer radiological and outpatient follow-up, and were more likely to be referred for therapy. Complications occurred in 5% of patients (39/793). Most patients attended planned follow-up, with 20% (160/783) failing to attend at least one or more clinic appointments. MSFs are common hand injuries among young, working (economically active) men, but there is considerable heterogeneity in treatment, rehabilitation, and resource use. They are a burden on healthcare resources and society, thus further research is needed to optimize treatment.

Traumatic peripheral nerve injuries in young Korean soldiers: a recent 10-year retrospective study.

Traumatic peripheral nerve injury (PNI), which occurs in up to 3% of trauma patients, is a devastating condition that often leads to permanent disability. However, knowledge of traumatic PNI is limited. We describe epidemiology and clinical characteristics of traumatic PNI in Korea and identify the predictors of traumatic complete PNI. A list of enlisted soldier patients who were discharged from military service due to PNI over a 10-year period (2012-2021) was obtained, and their medical records were reviewed. Patients were classified according to the causative events (traumatic vs. nontraumatic) and injury severity (complete vs. incomplete). Of traumatic PNIs, we compared the clinical variables between the incomplete and complete PNI groups and identified predictors of complete PNI. Of the 119 young male patients who were discharged from military service due to PNI, 85 (71.4%) were injured by a traumatic event; among them, 22 (25.9%) were assessed as having a complete injury. The most common PNI mechanism (n=49, 57.6%), was adjacent fractures or dislocations. Several injury-related characteristics were significantly associated with complete PNI: laceration or gunshot wound, PNI involving the median nerve, PNI involving multiple individual nerves (multiple PNI), and concomitant muscular or vascular injuries. After adjusting for other possible predictors, multiple PNI was identified as a significant predictor of a complete PNI (odds ratio, 3.583; P=0.017). In this study, we analyzed the characteristics of enlisted Korean soldiers discharged due to traumatic PNI and found that the most common injury mechanism was adjacent fracture or dislocation (57.6%). Patients with multiple PNI had a significantly increased risk of complete injury. The results of this study contribute to a better understanding of traumatic PNI, which directly leads to a decline in functioning in patients with trauma.