Common Type Of Trauma Research Articles

Comparison of clinical outcomes in cases of blunt, penetrating, and combination trauma in dogs: A VetCOT registry study.

To evaluate outcome (survival to discharge) among trauma types (blunt, penetrating, both) in dogs. The secondary objective was to evaluate if other trauma registry parameters differ between trauma types and influence survival. Retrospective evaluation of veterinary trauma registry data. Veterinary Committee on Trauma (VetCOT) identified Veterinary Trauma Centers (VTCs). A total of 20,289 canine trauma patients with data entered in the VetCOT trauma registry from April 1, 2017 to December 31, 2019 INTERVENTIONS: None. Data were obtained from the VetCOT database and included patient demographics, trauma type (blunt, penetrating, both), Animal Trauma Triage (ATT) score, modified Glasgow Coma Scale (mGCS), abdominal fluid score (AFS), loss of glide sign on thoracic focused assessment with sonography for trauma (TFAST), pleural effusion on TFAST, surgical procedure performed and in what location (emergency room vs operating room), and outcome. Data from 20,289 dogs were collected over a 30-month period. The most common type of trauma was penetrating (10,816, 53.3%), followed by blunt (8360, 41.2%) and then combined blunt and penetrating trauma (1113, 5.5%). Dogs suffering only penetrating trauma had a 96.5% survival rate, blunt trauma had an 89.5% survival rate, and combined trauma had an 86.3% survival rate. Dogs suffering from both types of trauma had higher ATT scores, lower mGCS scores, and were more likely to be admitted to the ICU. Trauma type, mGCS, and ATT score were found to be associated with survival. The present study highlights that dogs suffering from a combination of blunt and penetrating trauma are more likely to suffer moderate to severe injuries, have lower survival rates, and are more likely to be admitted to the ICU compared to dogs suffering from only blunt or penetrating trauma.Trauma type, mGCS, and ATT scores were found to be associated with survival in all groups.

Reversal of Amnesia for Trauma in a Sample of Psychiatric Inpatients with Dissociative Identity Disorder and Dissociative Disorder Not Otherwise Specified

ABSTRACT The authors interviewed 118 highly dissociative inpatients in a Trauma Program with the Dissociative Disorders Interview Schedule, the Dissociative Experiences Scale and the Adverse Childhood Experiences questionnaire; of the 118 participants 42 met DSM-5 criteria for dissociative identity disorder and 52 for other specified dissociative disorder. The average score on the Dissociative Experiences Scale in the sample of 118 participants was 44.7. The authors also conducted semi-structured interviews inquiring about the circumstances and triggers for reversal of amnesia for childhood trauma in the participants. Only a small minority of the reversal of amnesia took place in therapy sessions, and 24 different triggers for remembering were described. Childhood sexual abuse was by far the most common type of trauma for which amnesia was reversed. The findings are inconsistent with the view that amnesia for childhood sexual abuse is reversed primarily during psychotherapy.

Management and Outcome of Urogenital Trauma in Tertiary Hospital: The 8-Year’s Experience in Indonesia

Introduction: The current economy, technology, and civilization's development have indirectly increased the incidence of traffic accidents, and urogenital trauma occurs in 10-20% of trauma patients. We decided to conduct this study to determine the incidence, severity, and outcome of urogenital trauma treatment at Dr Soetomo General Hospital Surabaya. 
 Material and Method: This study used an analytic observational study with a retrospective design. From 2013 to 2020, all medical record data of patients with urogenital trauma treated at Dr. Soetomo General Hospital Surabaya were collected and analyzed.
 Result: We collected 196 subjects with urogenital trauma who were treated for a period of 8 years. The most common type of trauma in urogenital trauma patients was kidney trauma, as many as 82 cases. Most of the cases were traffic accident cases, 184 patients and most of them with abdominal-pelvic trauma with 189 findings. Conservative management was most often performed, as many as 128 procedures. The outcome after receiving treatment was found to be that 27 patients died (13.8%) and 11 patients (6.5%) had a disability. Abdominal trauma was associated with external genitalia, urethra, and renal trauma (p < 0.05). External genitalia, urethra, bladder, and renal trauma were all associated with pelvic trauma (p < 0.05).
 Conclusion: Most cases were caused by accidents, and the kidney was the most commonly involved organ. Cases of urogenital trauma are often associated with multiple trauma, especially abdominal trauma, so it is important to evaluate the urogenital tract when related to accidents involving the abdominal region

Pediatric Open Globe Injury in Tertiary Hospitals of Khobar and Dhahran.

BackgroundEvery year, 3.3 to 5.7 million eye injuries occur worldwide in children. Open globe injury is a common type of trauma that leads to blindness in all age groups. This study aimed to review and discuss the epidemiology, causes, and clinical outcome of pediatric open globe injury.MethodsA retrospective chart review of all pediatric open globe injuries presented to King Fahad Hospital of the University and Dhahran Eye Specialist Hospital was conducted between 2010 and 2020. Data analyses were done to identify factors predicting ultimate visual acuity.ResultsThe overall number of cases was 502, of which 120 cases were children and of the documented 118 cases, around 82 (69.5%) were males with an average age of 5.1 years. The traumatic object was sharp in 90 (89.1%) cases. The most common object was glass, presented in 18 (18.4%) cases. Most injuries were accidental (68.9%) and 48 (71.6%) cases out of 67 occurred inside the house. The factors associated with better visual outcome (20/40 or better) were sharp injuries, absence of hyphema, absence of vitreous hemorrhage, trauma with intraocular foreign body, undergone one operation, and absence of cataract at presentation.ConclusionThe ultimate visual outcome post open globe injury could be predicted from the severity of the presenting signs. Also, the household environment carries the highest risk, hence it is not always a safe haven for children. Thus, childproofing the house and adult supervision is advisable.

Ophthalmic trauma: the top 100 cited articles in Ophthalmology journals.

To analyze the top 100 cited papers on ophthalmic trauma. A literature search of Ophthalmology journals within the ISI Web of Science database for the most cited papers related to ophthalmic trauma. The most cited articles were published between 1943 and 2013, the greatest number being published in 2000. Ophthalmology (45), Archives of Ophthalmology (17), and the American Journal of Ophthalmology (15) published most of the articles. The institutions with the highest number of publications were Wilmer Eye Institute (10) and Massachusetts Eye and Ear Infirmary (7). Sixty-seven percent of the articles originated from the USA. The most common type of trauma studied was non-open-globe injuries and the most frequent topic studied were pathological conditions secondary to trauma (34), particularly endophthalmitis (8), and optic neuropathy (6). Articles presenting a standardized classification system for eye injury received the highest average of citations per publication. Types of research most frequently cited were observational clinical studies (62) and epidemiological studies (30); the least frequent were clinical trials (2). This bibliographic study provides a historical perspective of the literature and identifies trends within the most highly influential papers on ophthalmic trauma. Many of these articles emerged within the past three decades and came from Ophthalmology journals that remain high impact to this day. Clinical trials have been difficult to conduct and are lacking, reflecting a critical need in ophthalmic trauma research, as most of our understanding of ophthalmic trauma comes from observational and epidemiological studies.

The risk factors and pattern of traumatic dental injuries in 10-12-year olds in Kano, Nigeria.

Traumatic dental injuries (TDIs) rank among the most common conditions in children and adolescents. Nigerian dental trauma data are largely based on studies that were conducted in the southern parts of Nigeria. This study was designed to identify the risk factors and the pattern of TDIs among school-age children in northern Nigeria. The objective of the study was to identify the risk factors for and to determine the pattern of dental injuries among 10-12-year-old males in Kano, northern Nigeria. Six hundred and ninety-six 10-12-year olds were selected through a multistage sampling of school children, street children and rehabilitated children in Kano and examined for TDIs using the WHO protocols. Data analysis was carried out using SPSS version 20. Statistical significance was considered when P < 0.05. Six hundred and ninety-four 10-12-year olds participated in the study; The prevalence of TDIs was 6.6%. Being a street-child was associated with 30% higher risk for dental injuries (adjusted odds ratio [aOR] = 1.3; 95% confidence interval [CI] = 0.60 - 3.1; P = 0.48), whereas living as a rehabilitated street child (aOR = 0.41; 95% CI = 0.19 - 0.88; P = 0.02) and older age were associated with a reduced risk (aOR = 0.63; 95% CI = 0.39 - 1.01; P = 0.06) to injuries. The most common type of trauma was enamel-dentine injuries or Ellis II, and the most common cause was falls. Street children and low-age groups had more single-tooth injuries (85.7% and 85.0%, respectively). The commonly injured teeth were the maxillary right and left central incisors. Living on the street and young age were associated with the likelihood for injuries in male adolescents in Kano. The maxillary central incisors were the commonly affected teeth.

Identification of Potentially Preventable Traumatic Injury Among Military Working Dogs Deployed During the Global War on Terror.

Prevention of deployment-related injury is critical for readiness of US military working dogs (MWDs). This study evaluated deployment-related injuries to determine if they were potentially preventable and identify possible abatement strategies. Data were collected on 195 MWD injury events that occurred between 11 September 2001 and 31 December 2018. Injuries were reviewed by a panel of veterinarians and categorized into groups based on panel consensus. The panel also established which interventions could have been effective for mitigating injuries. Multipurpose canine (MPC) and conventional MWD injury event characteristics were compared to identify meaningful differences. Of the 195 injuries, 101 (52%) were classified as preventable or potentially preventable. Most (72%) of the potentially preventable injuries occurred in conventional MWDs, with penetrating injuries (64%) being the most common type of trauma. For the preventable/potentially preventable injuries, the most common preventative intervention identified was handler training (53%) followed by protective equipment (46%). There were differences between MPCs and conventional MWDs for injury prevention category, type of trauma, mechanism of injury, and preventative intervention (all p < .001). The application of a preventable review process to MWD populations may be beneficial in identifying potentially preventable injuries and preventative intervention strategies.

Analysis of trauma scoring system for patients with abdominal trauma.

This study investigated the correlations between several trauma scoring systems, including the injury severity score (ISS), clinical abdominal scoring system (CASS), new injury severity score (NISS), and clinical outcomes, including laparotomy, in-hospital mortality (IHM), and long hospital stay (LS) in patients with abdominal trauma. Data of 749 patients with abdominal trauma between January 2009 and December 2019 were reviewed retrospectively. Data from medical records included age, sex, initial vital signs, type and mechanism of trauma, hospital stay, laparotomy, and IHM. Injured organs and grades were collected using computed tomography. Correlations between the scoring system and clinical outcomes were analyzed using the area under Curves (AUC) of the receiver operating characteristic (ROC) curve. The mean age of the patients was 40.14±19.47 years. Blunt trauma was the most common type of trauma in 704 patients (94.0%), and traffic accident was the most common mechanism in 475 (63.4%). Injured organs included liver (45.1%) and spleen (25.1%). A total of 179 patients (23.9%) underwent laparotomy and IHM was reported in 35 (4.6%). The AUC of ROC for ISS, NISS, and CASS was significantly associated with laparotomy (0.682; p=0.001, 0.713; p=0.001; 0.845; p=0.001). The AUCs showed significant for IHM (0.606; p=0.034, 0.626; p=0.012, 0.701; p=0.001). The AUCs for LS were 0.554 (p=0.041), 0.549 (p=0.062), and 0.581 (p=0.002). The CASS is excellent for predicting laparotomy, IHM, and LS in patients with abdominal trauma. The NISS is more appropriate than the ISS for predicting laparotomy and IHM.

Traumatic dental injuries in the primary dentition and sequelae in the permanent dentition: a 7-year retrospective study

Objective: Traumatic dental injuries (TDIs) affect the aesthetics and function of primary teeth and can causesequelae in their permanent successors. This study assessed the distribution of TDIs and sequelae in the primarydentition and the respective permanent dentition in children treated at the Dental Trauma Centre in Brazil.Material and Methods: This cross-sectional study was conducted by collecting data from 256 dental recordsover 7 years. Descriptive statistical analyses and the Fisher exact test were used (p=0.05). Results: Sixty-twopatients presented with trauma in the deciduous teeth. TDIs were observed mostly in boys (64.50%) and inthe 2 to 4-year age group (44.10%); most injuries occurred from fall from the child’s own height (40.30%) andat home (71.20%). The most common type of trauma was subluxation (22.90%). The most prevalent clinicaland radiographic sequelae were mobility (45.60%) and periapical lesion (31.80%), respectively. Regarding thepermanent dentition, the most frequent sequela was hypomineralization (33.30%). Conclusion: According tothis study, TDIs in deciduous teeth made up 29.24% of all the cases in the Dental Trauma Program. The majortype of trauma in children was subluxation, with sequelae in both dentitions. Follow-up after trauma is importantto the maintenance of primary dentition and to prevent and treat possible sequelae in the permanent dentition.KEYWORDSDeciduous dentition; Dental health; Injury; Permanent dentition; Sequelae.

Impact of Trauma Center Designation Level on the Survival of Trauma Patients Transported by Police in the United States

Background: Police involvement in trauma management and transport is increasing in the US. Little is known about prehospital triage criteria and transport patterns used by Police Officers. In this study, we examined the impact of trauma designation level on the survival of trauma patients transported to trauma centers by police. Methods: We used the National Trauma Data Bank (NTDB) 2017 dataset in this retrospective observational study. Adult trauma patients transported by Police to Level I, II and III trauma centers were included. We performed a univariate analysis followed by a bivariate analysis. Finally, we carried out a multivariable logistic regression analysis adjusting for confounders to assess the impact of trauma level designation on outcomes of patients transported by Police. Results: A total of 2,788 patients were included. The majority of the patients were males (84.6%) between the ages of 16 and 55 with half of them being African American. Most had a mild GCS (13–15) (89.5%) and only 17.4% were recorded to have severe traumatic injuries with ISS ≥ 16. The most common trauma type was blunt trauma (61.4%) followed by penetrating injuries (32.2%) and burns (1.5%). Around half of injuries were the result of assault (49.4%) and 43.0% were unintentional. Head and neck injuries were most common (40.8%) followed by extremities (27.4%) and torso injuries (25.0%). Approximately half of the patients were admitted to floor bed/observation unit/step-down unit (50.7%) while 18.9% and 19.8% went to the Operating Room or Intensive Care Unit respectively. Overall survival to hospital discharge was 93.2%. Survival was 91.6% in Level I, 98.2% in level II and 98.7% in Level III centers. After adjusting for significant confounders, survival to hospital discharge was similar for patients transported by police to level II and III trauma centers in comparison to those transported to level I (OR = 0.866 95%CI (0.321–2.333); p = 0.776). Conclusion: Transport of trauma patients by police to trauma centers of different designation levels was not associated with survival in this study. Survival was also similar to other trauma studies. As such, trauma patients may be safely transported by Police to closest trauma designated center without affecting outcomes.

Trauma informed interventions: A systematic review.

BackgroundHealth inequities remain a public health concern. Chronic adversity such as discrimination or racism as trauma may perpetuate health inequities in marginalized populations. There is a growing body of the literature on trauma informed and culturally competent care as essential elements of promoting health equity, yet no prior review has systematically addressed trauma informed interventions. The purpose of this study was to appraise the types, setting, scope, and delivery of trauma informed interventions and associated outcomes.MethodsWe performed database searches— PubMed, Embase, CINAHL, SCOPUS and PsycINFO—to identify quantitative studies published in English before June 2019. Thirty-two unique studies with one companion article met the eligibility criteria.ResultsMore than half of the 32 studies were randomized controlled trials (n = 19). Thirteen studies were conducted in the United States. Child abuse, domestic violence, or sexual assault were the most common types of trauma addressed (n = 16). While the interventions were largely focused on reducing symptoms of post-traumatic stress disorder (PTSD) (n = 23), depression (n = 16), or anxiety (n = 10), trauma informed interventions were mostly delivered in an outpatient setting (n = 20) by medical professionals (n = 21). Two most frequently used interventions were eye movement desensitization and reprocessing (n = 6) and cognitive behavioral therapy (n = 5). Intervention fidelity was addressed in 16 studies. Trauma informed interventions significantly reduced PTSD symptoms in 11 of 23 studies. Fifteen studies found improvements in three main psychological outcomes including PTSD symptoms (11 of 23), depression (9 of 16), and anxiety (5 of 10). Cognitive behavioral therapy consistently improved a wide range of outcomes including depression, anxiety, emotional dysregulation, interpersonal problems, and risky behaviors (n = 5).ConclusionsThere is inconsistent evidence to support trauma informed interventions as an effective approach for psychological outcomes. Future trauma informed intervention should be expanded in scope to address a wide range of trauma types such as racism and discrimination. Additionally, a wider range of trauma outcomes should be studied.

Pain after a motor vehicle crash: The role of socio-demographics, crash characteristics and peri-traumatic stress symptoms.

The vast majority of individuals who come to the emergency department (ED) for care after a motor vehicle collision (MVC) are diagnosed with musculoskeletal strain only and are discharged to home. A significant subset of this population will still develop persistent pain and posttraumatic psychological sequelae may play an important role in pain persistence. We conducted a multisite longitudinal cohort study of adverse post-traumatic neuropsychiatric sequelae among patients seeking ED treatment in the aftermath of a traumatic life experience. We report on a sub-group of patients (n=666) presenting after an MVC, the most common type of trauma and we examine associations of socio-demographic and MVC characteristics, and persistent pain 8weeks after MVC. We also examine the degree to which these associations are related to peritraumatic psychological symptoms and 2-week acute stress reactions using an applied approach. Eight-week prevalence of persistent moderate or severe pain was high (67.4%) and positively associated with patient sex (female), older age, low socioeconomic status (education and income) and pain severity in the ED. Peritraumatic stress symptoms (distress and dissociation) appear to exert some influence on both acute pain and the transition from acute to persistent pain. The early aftermath of an MVC may be an important time period for intervening to prevent and reduce persistent pain. Substantial variation in mediating pathways across predictors also suggests potential diverse and complex underlying biological and psychological pathogenic processes are at work in the early weeks following trauma. The first several days after trauma may dictate recovery trajectories. Persistent pain, pain lasting beyond the expected time of recovery, is associated with pain early in the recovery period, but also mediated through other pathways. Future work is needed to understand the complex neurobiological processes in involved in the development of persistent and acute post-traumatic pain.

Interference of Lactobacillus casei with Pseudomonas aeruginosa in the treatment of infected burns in Wistar rats.

Objective(s):Burns are the most common type of trauma with a high mortality rate worldwide. The use of modern and natural medicines, especially probiotic products, has been recently considered for cutaneous wound healing. The present study was designed to investigate the effect of Lactobacillus casei on wound healing caused by Pseudomonas aeruginosa. Materials and Methods: In this study, the anti-adhesion activity of L. casei was examined by the glass slide method, and inhibitory substances in the cell-free supernatant (CFS) were quantified by high-performance liquid chromatography (HPLC). Following the induction of second-degree wounds, multidrug-resistant (MDR) P. aeruginosa was injected subcutaneously and directly on the burn. The animals were divided into four groups. The supernatant of L. casei was sprayed for treatment every day and wound healing was examined. Results:Based on our findings, the supernatant of L. casei showed considerable anti-adhesion effects on P. aeruginosa. HPLC analysis indicated that the inhibitory effect of this supernatant can be due to four main organic acids including lactic acid, acetic acid, citric acid, and succinic acid. The effect of treatment on fibroblastic cells showed that the treated group by supernatant of L. casei had more fibroblastic cells compared with the non-treated group. Moreover, this supernatant increased the rate of fibroblastic cells, re-epithelialization in the wound area, and the largest thickness of the epidermis and dermis layers.Conclusion:The present findings showed that L. casei supernatant significantly reduced inflammation and could be used to treat P. aeruginosa infection in second-degree burns.

Assessing the risk factors for injuries to maxillary permanent incisors and soft tissues among school children - A cross-sectional study.

The present study aimed to determine the risk factors related to permanent maxillary incisors and soft tissue injuries along with providing information about the age distribution of trauma, overjet, lip competence and physical activity. The sample consisted of 2100 school children aged 8-14 years from 15 schools in the Nellore district. The sample was selected adopting a stratified random sampling method and screened applying WHO criteria for the oral examination. The screening was done in classrooms to obtain demographic data, including name, age, gender and children's experience to the maxillary incisor and soft tissue injuries. The injuries were categorized according to Andreasen classification. Overjet and lip competences were recorded, and physical activity was assessed using a questionnaire (PAQ-C). Of the 2100 children, 228 (10.8%) had suffered traumatic injuries. Boys were 1.6 fold more prone to trauma than girls. Enamel fractures were a common type of trauma, and the commonly involved were maxillary central incisors. The relative risk for trauma is 1.215 times higher in increased overjet when compared to normal overjet. Incompetent lips showed 1.189 times greater risk of trauma. The high physical activity showed 1.692 times higher risk for trauma when compared to low physical activity. The prevalence of traumatic dental injuries among 8-14 year children was 10.8%. Boys were more commonly injured than girls. Increased overjet incompetent lips and high physical activities are risk factors for trauma. Enamel fracture was the most common type, and maxillary central incisors were the most common teeth having traumatic injuries.

A 10-year retrospective analysis of intimate partner violence patients in the emergency department.

Intimate partner violence (IPV) is an important human rights problem faced by one in three women worldwide. The aim of this study is to evaluate the demographic, trauma, and radiological characteristics of patients admitted to a tertiary emer-gency department due to IPV. Sociodemographic characteristics (age, gender, education level, and marital status), trauma characteristics (severity, type, and location), radiological imaging findings (radiography, computed tomography, and magnetic resonance imaging) of patients diagnosed with IPV were evaluated. In the study, 1225 patients were evaluated, and 98.7% of them were women (mean age 35 [IQR: 17] years). Of the pa-tients, 63.1% were high school and university graduates. The rate of married women was 74.6%. No relationship was found between gender, age, educational status, and marital status (p>0.05). Most of the traumas were minor (85.4%) and blunt (81.9%) trauma, and the most common types of trauma were kicking (49.9%) and punching (47.3%). It was found that the most frequently affected areas of the patients were the head and neck (76.7%), and the frequency of pelvic trauma was high in male patients (p<0.05). The most com-mon bone fracture was nasal (40.5%) followed by ulna fractures (14.5%). The left-sided diaphyseal fractures were the most common in patients exposed to IPV. In our study, the frequency of mortality was 12.9%, and it was found to be significantly higher in males (p<0.05). Female patients are more frequently exposed to IPV. Specific injury characteristics can be detected in patients diagnosed with IPV and old fractures detected in these patients should alert the clinician about IPV.

Clinical outcomes of globe injury at dr. H. Abdul Moeloek Hospital, Lampung

Globe injury is one of the most common traumas in the workplace. The aim of the study was to evaluate clinical outcomes of globe injury in dr. H. Abdul Moeloek Hospital Lampung. This study was a cross-sectional study. Data collection from medical record included demographic characteristic, the type of globe injury, visual acuity before and after treatment from January 2016 to December 2017. The data was analysed by using used chi-square test and Fisher exact test. There were 39 subjects with globe injury. There were 26 (66.7%) subjects of male and 13 (33,3 %) subjects of female. There were 15 subjects (38.5%) who worked as farmers and laborers. A total of 16 subjects (41.0%) presented with visual acuity less than three meters finger counting. The most common types of trauma were open globe injury in 26 subjects (66.66%) and closed globe injury in 13 subjects (33.33%). There was a significant difference between the type of trauma and the early visual acuity at initial presentation (p-value = 0.008). Visual acuity improvement was found in 11 subjects (28.2%). There was no difference between the type of trauma and visual acuity improvement after trauma management (p-value = 0.136). This study showed that workers in the informal sector have a higher incidence of eye trauma. Open globe injury results in worse visual acuity and irreversible blindness. Preventing eye trauma in the work environment will reduce the prevalence of permanent blindness. Keywords: Globe injury, visual acuity, workers

Incidence of Cerebral Hemorrhage in Traumatic Patients using Computed Tomography in Tabuk City, Saudi Arabia

Computed Tomography (CT) is the most commonly used imaging modality in the evaluation of cerebral hemorrhage in the head trauma patients. Objective: To study the incidence of a cerebral hemorrhage in traumatic patients using computed tomography. Method: This retrospective study was conducted at King Khalid hospital in Tabuk city, Saudi Arabia, in the radiology department, in the period from September 2018 to April 2020. The study was done by collecting 471 CT reports of patients all of them were exposed to head trauma with deferent reasons. The data were analyzed by Statistical Package for the Social Sciences (SPSS) program (ver. 20) and presented in tables and graphs according to the checklist which includes: patient age, gender, type of trauma, CT finding, and type of hemorrhage. Results: The most age group suffered from head trauma was less than 20 years percentage (55%), The male patients more exposed to head trauma than female patients with percentage (84.5%), the road traffic accident (RTA) is the most common type of trauma by percentage (63.5%), according to the CT finding; the cerebral hemorrhage represented (15.5%) with the highest percentage in a subdural hematoma (31.2%), the fracture represented (2.8%) while the normal appearance represented (81.7%) as the highest percentage. Conclusion: Most of the traumatic brain injury in patients caused cerebral hemorrhage and the CT scan reports show that: the common type of cerebral hemorrhage is subdural hematoma and it is common in males which exposed to (RTA) in the age group (21 - 40) years old.

Blood phosphatidyl ethanol levels as a tool to detect alcohol misuse in trauma patients

Introduction There is a strong need for a reliable marker of harmful alcohol consumption to identify injured patients that can benefit from alcohol interventions, and blood phosphatidyl ethanol (PEth) has not previously been tested on this population. This study aims to compare the performance of blood PEth concentration, blood alcohol concentration (BAC) and the Alcohol Use Disorders Identification Test Consumption (AUDIT-C) for the screening of alcohol misuse in trauma patients. Methods Prospective cross-sectional study of 238 adult patients presenting in the emergency department with any type of trauma. PEth concentration was determined in whole blood by high-performance liquid chromatography with tandem mass spectrometry. Consent, AUDIT-C score and demographic data were obtained. Results The sample consisted of majority male (67.6%), single (46.2%) and employed (66%) patients. The most common type of trauma was traffic collision (63.9%). The mean age was 41.7 years. We found a significant correlation between PEth levels with AUDIT-C score (Spearman’s r = 0.654; p < .0001). PEth had an area under the ROC curve of 0.885 to detect hazardous alcohol consumption (AUDIT-C score ≥ 6) and PEth ≥23.9 ng/mL cutoff point provided 91.2% of sensitivity and 78.4% of specificity. Twelve patients reported alcohol abstinence, but had quantifiable levels of PEth. Conclusions PEth levels and AUDIT-C score had a moderate correlation in our population. PEth was useful to identify 12 cases of underreporting of alcohol consumption habits. PEth shows promising results, but more research is needed to identify the best screening tool for alcohol misuse in trauma patients.

MANAGEMENT OF INTRAARTICULAR FRACTURE OF THE BASE OF THE FIRST METACARPAL BONE BY DYNAMIC EXTERNAL FIXATOR

Background: Fractures of the hand are common injuries and in particular, fractures involving the articular surfaces can present difficulties to the orthopedic surgeon in practice. Objective: To assess how to surgically manage intra-articular fracture of the base of the first metacarpal bone by Dynamic K-wire External Fixator. Subjects and methods: This was a non-randomized clinical trial carried out at Al-Azhar University Hospitals on 10 patients, during the period from March 2018 till May 2020. Results: The mean time before operation was 9.5±5, Blunt trauma was most common type of trauma with a percent of 60%.The mean operative time (minutes) was 40.1 ±2 with range of (30-45) minutes and mean time for k wire removal was 28.1 ±5 with range of (15-41).There was significant improvement of Quick DASH functional scoring. There was high significant improvement of range of motion. There is significant difference between the normal and operated side as regard range of motion. Regarding complications, 10% of cases had post-operative pain which continued whole period of follow up, 0% had secondary arthrosis, 10% had superficial pin tract infection and 0% had valgus deformity. Conclusion: Closed reduction and external fixation can be effective and safe treatments for unstable fractures at the base of the first metacarpal. Such external fixation structures were simple and versatile and able to simultaneously achieve effects such as meeting the retractor, adjusting the angulation, and shortening the displacement, especially for local wounds.

MANAGEMENT OF INTRAARTICULAR FRACTURE OF THE BASE OF THE FIRST METACARPAL BONE BY DYNAMIC EXTERNAL FIXATOR

Background: Fractures of the hand are common injuries and in particular, fractures involving the articular surfaces can present difficulties to the orthopedic surgeon in practice. Objective: To assess how to surgically manage intra-articular fracture of the base of the first metacarpal bone by Dynamic K-wire External Fixator. Subjects and methods: This was a non-randomized clinical trial carried out at Al-Azhar University Hospitals on 10 patients, during the period from March 2018 till May 2020. Results: The mean time before operation was 9.5±5, Blunt trauma was most common type of trauma with a percent of 60%.The mean operative time (minutes) was 40.1 ±2 with range of (30-45) minutes and mean time for k wire removal was 28.1 ±5 with range of (15-41).There was significant improvement of Quick DASH functional scoring. There was high significant improvement of range of motion. There is significant difference between the normal and operated side as regard range of motion. Regarding complications, 10% of cases had post-operative pain which continued whole period of follow up, 0% had secondary arthrosis, 10% had superficial pin tract infection and 0% had valgus deformity. Conclusion: Closed reduction and external fixation can be effective and safe treatments for unstable fractures at the base of the first metacarpal. Such external fixation structures were simple and versatile and able to simultaneously achieve effects such as meeting the retractor, adjusting the angulation, and shortening the displacement, especially for local wounds.