Limb Fractures Research Articles

Biobased polyester versus synthetic fiberglass casts for treating stable upper limb fractures in children: a randomized controlled trial

BackgroundStable upper limb fractures, such as radius, ulna, or distal humerus fractures, are common pediatric orthopedic traumas that are traditionally managed with cast immobilization. The commonly used synthetic fiberglass cast is light and water resistant but may promote skin itchiness during casting, which is a common complaint of patients. In addition, these diisocyanate-based casts have been proven to be toxic and may cause asthma. Herein, we introduce a novel biobased polyester cast to compare its clinical outcomes and patient satisfaction with conventional synthetic fiberglass casts.MethodsFrom Feb 2022 to Nov 2022, we undertook a single-center prospective randomized trial involving 100 children with cast-immobilized stable upper limb fractures. These patients were randomized into either biobased polyester or synthetic fiberglass groups. All patients were regularly followed up till the cast removal which occurred approximately 3–4 weeks after immobilizing. Objective clinical findings and subjective patient questionnaire were all collected and analyzed.ResultsAccording to the radiographs taken on the day of cast removal, there was no loss of reduction in both groups. The incidence of skin problems was 3.4 times higher in the synthetic fiberglass group than in the biobased polyester group. For the subjective questionnaire, the biobased polyester cast was preferred in every sub-item.ConclusionsOur study strongly suggested that the novel biobased polyester cast provides matching stability to conventional fiberglass casts and improves patient satisfaction in an eco-friendlier and safer way.Trial registrationClinicalTrials.gov Protocol Registration and Results System (https://www.clinicaltrials.gov/; ID: NCT06102603; Date: 26/10/2023).

Встречаемость переломов в области грудной и тазовой конечностей у собак

Currently, there is a trend towards popularization of pet dogs in the city of Moscow. Despite the rapid development of science and technology in veterinary medicine, limb fractures are still one of the most common pathologies. In this article, a retrospective analysis of the prevalence of fractures in dogs in the thoracic and pelvic limbs was performed, the age and breed groups of dogs most prone to fractures were determined, and the most traumatized limb regions were identified. The most common types of fractures were also established. Based on the results, it can be concluded that the forearm bones of small breeds of dogs with body weight up to 10kg are most susceptible to fractures in the thoracic limb. In the pelvic limb, tibia fractures were more common in medium breed dogs with body weight from 10 kg to 25 kg. Simple oblique bone fractures were more frequently registered in dogs in the studied groups.

Femur Fracture in Klippel Trenaunay Syndrome: A Case Report

Introduction: Klippel-Trenaunay Syndrome (KTS) is a medical condition that involves the abnormal enlargement of bones and soft tissues, along with the presence of arterio-venous malformations and cutaneous vascular nevus. This is an uncommon condition that is present from birth and affects the blood vessels. There are relatively few documented cases of how to treat fractures in the lower limbs of individuals with this condition. Case report: A 37-year-old Indian male patient presented to our emergency room with a history of trivial trauma resulting from slipping and falling on the floor. From a clinical perspective, there was a bone deformity observed on the right thigh, accompanied by large dilated veins on the affected limb. The radiographs revealed osteoporotic bone with a fracture in the middle third of the right femur, as well as several small calcified masses dispersed throughout the affected lower leg. A Computed Tomography angiography was performed, revealing the presence of developmental venous malformations along with dilated deep and superficial venous channels. The diagnosis of KTS was ultimately confirmed by integrating clinical and radiological observations. The patient had surgical management with closed intramedullary nailing. Subsequent examinations showed strong indications of bone union without any significant complications. Conclusion: The surgical treatment of orthopaedic injuries in patients with KTS has been demonstrated to be linked to higher amounts of blood loss during the operation. In such circumstances, it is essential to do a comprehensive clinic-radiological assessment and careful preoperative planning to effectively treat or prevent surgical problems in these patients. Keywords: Fracture, Femur, Klippel-Trenaunay Syndrome

Management of Ipsilateral Fractures After Rotationplasty

Case: Rotationplasty is a surgical procedure used for restoring functionality after skeletal tumor resection. Multiple complications have been described, including the potential occurrence of fractures. Literature on fracture management after rotationplasty is limited. In this article, we present 2 cases of late ipsilateral fractures in rotated limbs successfully treated with intramedullary nailing. Conclusion: Effective management of fractures after rotationplasty requires thorough understanding of the rotated limb anatomy and careful planning. The clinical considerations presented in this article aim to provide guidance for surgeons to achieve successful outcomes in the management of fractures after rotationplasty.

Multimodal ultrasound evaluation of asymptomatic ulnar nerve dislocation at the cubital tunnel.

Ultrasonography has received broad acceptance as an effective peripheral nervous imaging examination. Shear wave elastography (SWE) can quantitatively assess the stiffness of nerves; however, little research has been conducted on elastography for ulnar nerve dislocation. The purpose of this study was thus to investigate the characteristics of multimodal ultrasound, including high-resolution ultrasonography and SWE, for asymptomatic ulnar nerve dislocation at cubital tunnel. In this prospective cross-sectional study, 41 participants were recruited in Shandong Provincial Hospital Affiliated to Shandong First Medical University in July 2022. The inclusion criteria for participants were being in good health and being 18-60 years of age. Meanwhile, the exclusion criterion was a history of upper limb pain or fractures, peripheral neuropathy, or systemic or immunological diseases. Finally, 38 participants were enrolled. Two ultrasound doctors measured the maximum diameter, the maximum cross-sectional area (CSA), and the shear modulus of the ulnar nerve at the cubital tunnel independently. Another two ultrasound doctors determined whether dislocation was present during dynamic elbow flexion and extension and divided the elbows into a dislocation group and a control group. The descriptive statistics and independent sample t-test were used for data analysis, and intragroup correlation coefficient (ICC) was used to determine the consistency of evaluation between observers. Ulnar nerve dislocation was observed in 15.8% (12/76) of the ulnar nerves. There was no significant difference in the maximum diameter between the dislocation group (0.194±0.022 cm) and the control group (0.181±0.023 cm) (t=1.888; P=0.063). The CSA and SWE of the ulnar nerve were 0.064±0.009 cm2 and 43.629±6.737 kPa in the dislocation group, respectively, and were 0.050±0.008 cm2 and 31.293±7.858 kPa in the control group, respectively. There were significant differences between the two groups in terms of CSA (P<0.001) and SWE (P<0.001). The ICCs of the maximum diameter, CSA, and SWE values between observers were 0.970, 0.900, and 0.915, respectively. Multimodal ultrasound consisting of high-resolution ultrasonography combined with elastography can comprehensively and quantitatively evaluate the morphological changes and mechanical properties of the dislocated ulnar nerve and monitor disease progress.

Evaluation and Quantifying the Difference between Male and Female Agility in Football Players: A Cross-sectional Pilot Study

Introduction: Football is an intermittent sport which requires agility as essential trait for player conditioning, selection and prevention of injury. Agility is a conditional motoric attribute classified as a locomotor skill combining both a muscular and cognitive component. Previous study, revealed that Illinois and T-test were most significant tests to evaluate agility. Aim: To evaluate and quantify the difference in agility between male and female footballers. Materials and Methods: Purposive sampling was used in this crosssectional study. 30 professional football players, aged between 18- 25 years with normal BMI and had atleast 3 years of systematic football training with 3-4 training sessions weekly and 8 hours of football training per week were included. Those players who had visual/hearing impairments, history of lower limb fractures, Anterior Cruciate Ligament (ACL) reconstruction and meniscectomy were excluded from the study. Illinois and T-test was used to access agility of football players. Normality of data was checked using ShapiroWilk test. Descriptive statistics in form of Mean±SD were used to find normative value and Independent T-test was utilised to quantify the difference. Results: Reference value of male and female player’s agility in T-test was 10.35±0.58 and 14.52±0.50 whereas for Illinois test it is 16.34±0.79 and 18.12±1.02 respectively. Independent T-test showed significant difference in male and female agility for both Illinois and T-test (p&lt;0.001). Conclusion: Normative values are established for both genders. It is concluded that female players are clinically and statistically less agile when compared to male players (p-value &lt;0.001).

Clearance of senescent cells enhances skin wound healing in type 2 diabetic mice.

Background: Diabetic foot ulcers (DFUs) pose a substantial healthcare challenge due to their high rates of morbidity, recurrence, disability, and mortality. Current DFU therapeutics continue to grapple with multiple limitations. Senescent cells (SnCs) have been found to have a beneficial effect on acute wound healing, however, their roles in chronic wounds, such as DFU, remain unclear. Methods and results: We collected skin, fat, and muscle samples from clinical patients with DFU and lower limb fractures. RNA-sequencing combined with qPCR analyses on these samples demonstrate a significant accumulation of SnCs at DFU, as indicated by higher senescence markers (e.g., p16 and p21) and a senescence-associated secretory phenotype (SASP). We constructed a type 2 diabetic model of db/db mice, fed with a high-fat diet (Db-HFD), which were wounded using a 6 mm punch to the dorsal skin. HFD slightly affected wound healing in wild-type (WT) mice, but high glucose significantly delayed wound healing in the Db-HFD mice. We injected the mice with a previously developed fluorescent probe (XZ1208), which allows the detection of SnCs in vivo, and observed a strong senescence signal at the wound site of the Db-HFD mice. Contrary to the beneficial effects of SnCs in acute wound healing, our results demonstrated that clearance of SnCs using the senolytic compound ABT263 significantly accelerated wound healing in Db-HFD mice. Conclusion: Collectively, these findings suggest that SnCs critically accumulate at wound sites, delaying the healing process in DFUs. Thus, targeting SnCs with senolytic therapy represents a promising approach for DFU treatment, potentially improving the quality of life for patients with DFUs.

Analysis of the trajectory and influencing factors of kinesiophobia in elderly patients during the rehabilitation phase of limb fractures.

To explore the trajectory and influencing factors of kinetophobia in elderly patients with limb fracture during the rehabilitation period. In this retrospective study, we retrieved the follow-up records of 150 elderly patients with limb fractures from our hospital's electronic medical record system. We collected the demographic data and Tampa Scale for Kinesiophobia (TSK) scores of patients at postoperative day 1 (T0), 1 week (T1), 3 weeks (T2), 6 weeks (T3), and 12 weeks (T4) to track changes in kinesiophobia over time. We used Mplus 8.3 software to fit the development trajectory types of kinesiophobia based on TSK scores at time points T0 to T4 using a Latent Class Growth Model (LCGM). After selecting the best fitting model, logistic regression analysis was performed to identify the risk factors for kinesiophobia in different types. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to compare the predictive value of relevant influencing factors for kinetophobia in elderly patients recovering from limb fracture. The TSK scores decreased steadily from T0 to T4 [(46.03±7.88) at T0, (41.14±8.89) at T1, (34.61±5.64) at T2, (29.95±6.79) at T3, and (26.71±5.03) at T4], [F (4, 745) = 193.1, P < 0.001]. We identified the trajectory of changes in kinesiophobia symptoms through LCGM, gradually establishing models with 1 to 5 categories. By integrating the results of relevant fit indices, we ultimately selected the best fitting model with 2 categories. Among them, 119 patients in Class 1 (79.3%) showed a slow and continuous decline in kinesiophobia symptoms from T0 to T4, while 31 patients in Class 2 (20.7%) exhibited rapid decline followed by rebound in kinesiophobia symptoms. Logistic regression showed that older the age (OR = 1.219), per capita monthly income < 3000 yuan (OR = 12.657), numeric rating scale (NRS), patients with higher NRS (OR = 2.401) and higher self-efficacy (OR = 1.212) were more likely to be in Class 1. The ROC curve results show that the combined above indicators have a higher predictive value for the changes in fear of movement in elderly patients with lower limb fractures during the rehabilitation period (AUC = 0.934), compared to age (AUC = 0.694), per capita monthly income (AUC = 0.654), NRS score (AUC = 0.812), and self-efficacy (AUC = 0.811) as individual indicators. As the recovery time progresses for elderly patients with limb fractures, the overall trend of kinesiophobia scores decreases. Kinesiophobia presents with two different trajectories, with age, average monthly income, NRS score, and self-efficacy being important factors influencing the trajectory categories of kinesiophobia changes.

Analysis Of Efficacy Of Cork Screw Tipped Telescopic Nailing In Lower Limb Fractures In Cases Of Osteogenesis Imperfecta In Children–Case Series

Analysis Of Efficacy Of Cork Screw Tipped Telescopic Nailing In Lower Limb Fractures In Cases Of Osteogenesis Imperfecta In Children–Case Series

Effects of Intrathecal Anesthesia with Hyperbaric Bupivacaine for Hind Limb Orthopedic Surgery in Calves

Anesthesia obtained by the injection of local anesthetic into the cerebrospinal fluid is defined as intrathecal or spinal anesthesia. This study aimed to compare intrathecal anesthesia with gas anesthesia in calves operated for hind limb fractures. Twelve calves with hind leg femur and tibia fractures were included in the study. Six of these calves were subjected to intrathecal anesthesia (IT) and the other 6 to gas anesthesia (GA). Sedation with xylazine was performed after general operative preparations. In the IT group, hyperbaric bupivacaine was injected lumbosacrally, while in the GA group, general anesthesia was achieved with isoflurane after mask induction. Anesthesia onset, operation and anesthesia durations, and intraoperative parameters were recorded. Systolic and diastolic blood pressure, pulse, respiratory rate, body temperature, and electrocardiography were monitored and recorded. In addition, postoperative pain was evaluated with the postoperative pain visual analog scale (VAS), simple descriptive pain scale (SDS), and bovine pain assessment scale (BPAS). Although there were statistical differences between the hemodynamic values measured in the study, they remained within reference ranges. In conclusion, it can be said that intrathecal anesthesia is practical for hind leg surgery in calves and has advantages, especially in terms of postoperative pain management.

VIABILITY OF CARDBOARD SPLINTS IN THE EMERGENCY MANAGEMENT OF LOWER LIMB FRACTURES

At Mbarara Regional Referral Hospital Uganda, 60% of all admissions are due to severe trauma, 30-35% of which are from tibia/fibular fractures. Emergency splinting of these fractures can be lifesaving and ideally, Plaster of Paris (P.O.P) is the gold standard. Improvised cardboard splints have replaced P.O.P, since they were more readily available and thought to be less expensive to apply especially during the covid 19 pandemic supply chain crisis. While anecdotal evidence exists dating since the First World War, scarce published works exist in measuring the clinical effectiveness of cardboard splints in comparison to P.O.P. The aim of this study was to find out if cardboard can be an effective and cheaper emergency alternative splint to P.O.P especially during the supply chain crises frequent in low resource environments. A prospective, experimental, cadaveric study was done where 44 open tibia-fibular fractures were splinted with both cardboard and P.O.P. The clinical effectiveness of cardboard and P.O.P splints was found through the measurement of immobilization at a fracture site via the use of 5 angular and 9 linear measurements. Cost comparisons of the splint were also done. Cardboard proved to be the non-inferior splint in 9 of the 14 measures of effectiveness. In the other 4 measures, no statistically significant differences were seen, while P.O.P was superior in 1 measurement. Cardboard proved to be the least expensive splint. During extreme shortages, cardboard could be considered as an emergency material for adequate splinting of lower limb fractures.

康复护理对下肢骨折患者的临床效果及膝关节功能改善情况分析

康复护理对下肢骨折患者的临床效果及膝关节功能改善情况分析

Early diagnosis of occult pulmonary embolism secondary to lower limb fractures: summary of 18 cases.

Pulmonary thromboembolism is a severe but probably underdiagnosed disorder. Patients with lower limb fractures are at high risk for pulmonary thromboembolism. This study aimed to demonstrate the early identification strategies for occult pulmonary thromboembolism. From January to December 2022, 18 patients diagnosed with pulmonary thromboembolism were reviewed for this study. Data on patients' demographics, laboratory test results, and radiographic findings were collected. Finally, the data was analyzed. Eighteen patients with lower limb fractures were included in this study. All of them present different symptoms, including 12 cases (12/18, 66%) of unexplained decrease in oxygen saturation; 16 patients had deep vein thrombosis in the lower limbs, with nine cases involving proximal veins and seven involving distal veins. One patient had an antithrombin III level of 35%. Thirteen cases were diagnosed with pulmonary embolism using CT pulmonary angiography. Four patients had pulmonary embolisms incidentally detected during coronary CT angiography, and one patient during aortic CT angiography. Patients with lower limb fractures showing chest tightness and unexplained decrease in finger pulse oxygen levels should be assessed for pulmonary thromboembolism. Simultaneously, selecting appropriate diagnostic tools is essential to guaranteeing quick and accurate diagnosis.

Focused Shock Waves in Delayed Union and No-union After Intramedullary Nailing in Lower Limbs

Shock waves have changed medical therapy substantially. Accounting for the epidemiology of the treated diseases, this therapeutic tool may equal or even surpass the impact of extracorporeal shock wave lithotripsy. Lower limb fractures after intramedullary nailing generally heal without problems when there are good local conditions and no associated pathologies, but sometimes if the biomechanical or biological variables are not ideal, they can lead to a delay in healing or develop a non-union. Extracorporeal shock waves therapy is a treatment option in delayed union and no-union after intramedullary nailing in lower limbs cases in which there is mechanical stability of the fracture focus, as they can allow healing without the need for new surgeries. Keywords: Extracorporeal shockwave therapy, Shock waves, Non-union, Delayed union

Patterns and Management of Upper and Lower Limb Fractures in Pediatric Patients Presenting to the Pediatric Emergency Department at a Tertiary Care Hospital: A Retrospective Study in Riyadh, Saudi Arabia

Background: Pediatric fractures constitute a significant public health concern globally, with varying implications on healthcare systems and affected individuals. While global trends have been well-documented, research in Saudi Arabia, particularly within a tertiary care setting, continues to contribute significantly to the understanding of this issue. Methods: This retrospective chart review, conducted over a four-year period from 2019 to 2023, analyzed pediatric fracture cases at a major hospital in Riyadh, Saudi Arabia. The study included 286 children aged 14 years or younger presenting with new fractures. Data on demographics, fracture types, anatomical locations, and treatment modalities were extracted from electronic health records and analyzed using IBM SPSS Statistics Version 25. Results: The study found a higher incidence of fractures in males, particularly increasing after age 8, with radial, metatarsal, and humeral fractures being the most common. Radial fractures, especially distal radial fractures, were predominant, and the majority were treated with casts and backslabs. Metatarsal fractures were more prevalent in males, predominantly treated with backslabs, while humeral fractures were more common in females, mainly treated with backslabs and slings. Conclusion: This study provides essential insights into pediatric fracture patterns in a Saudi Arabian tertiary care setting, echoing global trends and underscoring the need for conservative treatment approaches. Future research should expand on long-term outcomes, broader demographic factors, and the impact of comorbidities to enhance pediatric fracture management and healthcare strategies.

Role of Pregabalin in Pre-Operative and Post-Operative Pain Management of Lower Limb Orthopedic Surgeries.

Post-operative pain after orthopedic surgery has remained a challenging problem, which prolongs hospital stay and early rehabilitation. Pregabalin comes under the class of gabapentinoids that have been used in postoperative pain in arthroplasty and spine surgeries but studies regarding its role as pre-emptive analgesia in orthopedic limb surgeries are very few. To compare the efficacy of pre-operative pregabalin with a placebo drug in early post-operative pain management for lower limb orthopedics surgeries. A randomized double blinded prospective study was undertaken. Sixty patients were enrolled with age between 18 and 70 years and were divided into 2 groups. Group A - received 150 mg of oral pregabalin capsule, and Group B - received matched color empty capsules. Standard spinal anesthesia was given. Breakthrough analgesia was given with an injection of tramadol 50 mg intravenous. Assessment of pain was done with a Visual Analog Scale (VAS) at 6, 12, 24, and 48 h. In comparison to Group B, Group A had a significantly lower postoperative VAS score and required much less breakthrough analgesia within the 1st 24 h after surgery. In orthopedic lower limb fracture surgeries, pre-emptive pregabalin of 150 mg provides adequate postoperative analgesia with relatively few unfavorable side effects.

Treatment Strategy for a Closed Tibial Pilon Fracture Concomitant with a Closed Lateral Malleolus Fracture That Occurred in a Context of Low Energy Trauma: A Case Report of a 43-Year-Old Man

Tibial pilon fractures are rare and challenging fractures of the lower limb that account for about 1% of all lower limbs fractures and up to 10% of tibial fractures. They are challenging in terms of treatment outcomes. The injury is generally caused by high energy axial trauma from motor vehicle accidents or a fall from height. The type of definitive fixation is still a great challenge for surgeons and is dictated by the soft tissue injury and energy imparted to the fracture. In this case report, we describe the combination of a closed tibial pilon fracture and a closed lateral malleolus fracture occurring in an unusual context for this type of injury in a 43-year-old-man. It actually occurred in a context of low energy trauma of the ankle during a friendly soccer match. A one step internal fixation method was chosen for definitive treatment. For this, two screws were used for the fixation of the tibial pilon fracture and the external malleolus was fixed with two Kirschner wires. Post-operative follow-up was uncomplicated.

Augmenting locking plate with autologous bone graft for the treatment of nonunion of long bone fracture in the lower extremity with retaining of the original intramedullary nail

To explore clinical effect of attaching locking plate with bone grafting based on retaining the original intramedullary nail in treating non-union after intramedullary nail fixation of long shaft fractures of lower limbs. A retrospective study was conducted on 20 patients treated with non-union fractures after intramedullary nailing of long shaft fractures of lower limbs from June 2015 to June 2020. All patients were treated with the original intramedullary nailing and bone grafting from the iliac bone, and were underwent open reduction plate internal fixation and bone grafting for old fractures. Among them, 14 were males and 6 were females, aged from 35 to 56 years old with an average of (42.2±9.6) years old. Nine patients were femoral shaft fracture and 11 patients were tibial shaft fracture. According to characteristics of fracture end nonunion, 6 patients were stable/atrophic, 9 patients were unstable/large, and 5 patients were unstable/atrophic. The nonunion time ranged from 8 to 12 months with an average of(9.8±2.0) months after the initial surgery. Visual analogue scale (VAS), knee range of motion, bone healing time, complications and fracture-end healing were recorded before and at the latest follow-up. All patients were followed up for 18 to 48 months with an average of (36.3±10.5) months. The incision of all patients were healed at stageⅠwithout complications such as infection or internal fixation ruptur. Healing time of femur and tibia was (8.5±2.6) months and (9.5±2.2) months. Knee joint motion increased from preoperative (101.05±8.98) ° to postoperative (139.35±8.78) ° at the latest follow-up (t=-12.845, P<0.001). VAS decreased from preoperative (5.15±1.72) to postoperative (0.75±0.96) at the latest follow-up (t=11.186, P<0.001). On the basis of retaining the original intramedullary nail, the addition of locking plate internal fixation and autogenous iliac bone grafting have advantages of simple operation, less trauma, fewer complications and high fracture healing rate. It is one of the effective surgical schemes for the treatment of nonunion after intramedullary nail fixation of long bone fracture of lower extremity.

Infection with multi‑drug resistant organisms in patients with limb fractures: Analysis of risk factors and pathogens.

Infection with multi-drug resistant organisms (MDROs) has emerged as a global problem in medical institutions. Overuse of antibiotics is the main cause of drug resistance. Notably, the incidence of infection with MDROs increases in patients with limb fractures who have undergone invasive surgery. The present study aimed to analyze the risk factors for postoperative MDROs infection in a cohort of patients with limb fractures. A retrospective study was performed on the data of patients with fractures between January 2020 and August 2022. Postoperative surgical site infection occurred in 114 patients in total, of which 47 were infected with MDROs. Univariate logistic regression analysis and multivariate binary logistic regression were used to confirm the associations between independent risk factors and MDRO infection. A total of 155 bacteria were collected from patients with MDROs infection and patients with non-MDROs infection, of which 66.5% were gram-positive bacteria and 33.5% were gram-negative. Staphylococcus aureus accounted for 26.5% of the 155 pathogens. MDROs, such as methicillin-resistant S. aureus and extended-spectrum β-lactamases-positive gram-negative bacillus, were detected after antibiotic treatment. Univariate analysis indicated that the number of antibiotics administered, being bedridden, repeat infection, operative time and repeated operation were different in the two groups. In addition, univariate logistic analysis indicated that being bedridden (OR, 3.98; P=0.001), administration of >2 antibiotics (OR, 2.42; P=0.026), an operative time of >3 h (OR, 3.37; P=0.003), repeated infection (OR, 3.08; P=0.009) and repetition of procedures (OR, 2.25; P=0.039) were individual risk factors for MDRO infection. Multivariate analysis showed that being bedridden (OR, 2.66; P=0.037), repeated infection (OR, 4.00; P=0.005) and an operative time of >3 h (OR, 2.28; P=0.023) were risk factors of MDRO infection. In conclusion, constrained antibiotic use, shortened operative time and increased activity duration can effectively prevent surgical-site infection with MDROs in patients with fractures.

Incidence and distribution of injuries associated with e-scooter use: a radiological perspective.

To investigate electric scooter (e-scooter)-associated radiological injury incidence and distribution of injuries. Retrospective cross-sectional study of radiological examinations related to e-scooter injuries at a major trauma centre in a small university city. The hospital radiology information system was searched for terms related to e-scooters between January 1, 2015, and October 31, 2022. E-scooter use was confirmed by review of the patients' electronic medical records. Specific injuries were divided based on site of injury using the Injury Severity Scale categorized groups. A total of 568 radiological studies related to e-scooter injuries were identified on 340 distinct patients (56% male, with an average age of 28 years). Peak incidence of e-scooter-related injuries was seen in the summer months, after a local scooter sharing system was introduced in October 2020. A total of 149 patients had radiologically diagnosed injuries, with extremity injuries being most frequent (80%). Facial (8%), head/neck (8%), and thorax/abdomen (4%) were less common. Radial head fractures were the most common injury (n = 27). Thirteen patients had multiple sites of injury, four of which had both upper limb and facial bone fractures described. We report a significant increase in radiological investigations and injuries in the context of e-scooter injuries, particularly since the introduction of an e-scooter sharing scheme. This study informs radiologists on common locations of injuries when reporting studies of patients that have had e-scooter-related injuries. This is the first UK-based study providing a comprehensive radiological perspective of the impact of e-scooter use and associated distribution of injuries, adding important data for many cities that are currently undertaking review of their e-scooter sharing schemes.