Low-impact Trauma Research Articles

A Comparison of Motorcycle and Bicycle Accidents in Oral and Maxillofacial Trauma

The aim of this study was to present a large series of motorcycle- and bicycle-related traumas to the face in an attempt to identify the injury pattern in motorcyclists and bicyclists. Data were collected from patients during a 10-year period (1999 through 2009), which included demographic data, diagnosis of facial fractures, use of protective devices, dentoalveolar trauma, and facial soft tissue injuries. There were 556 patients with bicycle accidents and 367 with motorcycle accidents. Men were involved in 79% (436) of bicycles accidents and 82% (299) of motorcycle accidents. Young male patients were more frequent in bicycle and motorcycle accidents. Two hundred fifty bicyclists showed 311 maxillofacial fractures. Two hundred twenty-one motorcyclists showed 338 maxillofacial fractures. Motorcycle accidents caused multiple fractures in more patients. Seventy-six percent of motorcyclists were using helmets at the time of the accidents, whereas 6% of cyclists were using helmets. Motorcyclists showed a larger number of lacerations, whereas bicyclists showed a larger number of abrasions. Avulsion was the most common dentoalveolar injury for these accident types. Hospital stays were 3.8 days for motorcyclists and 1.3 days for bicyclists. The high-impact collisions typically observed in motorcycle accidents is directly related to larger percentages of soft tissue lacerations and facial fractures. The low-impact trauma that is observed in bicycle accidents is more commonly associated with soft tissue abrasion, hematoma, and dentoalveolar fractures. This stresses the need for compulsory legislation for helmet use with face-guards for cyclists and motorcyclists. It is important to take measures to alert the public regarding the severity of injuries likely to occur in bicycle- and motorcycle-related accidents and ways to prevent them.

Ehlers–Danlos syndrome: case report and an electron microscopy study

Ehlers-Danlos syndrome (EDS) type III is a inherited connective tissue disorders characterized by extensibility of the skin, hypermobility of the joints, chronic pain, tissue fragility, easy bruising, and delayed wound healing with result of atrophic scars. The patients report commonly a history of recurrent dislocations of the shoulders and knees after low-impact trauma, chronic joint pain, and early osteoarthritis, which lead to diagnosis. The pathogenesis of this condition is unknown, and the diagnosis is generally made in adult age, based only on clinical criteria. In this report, we describe a case of a 50-year-old woman with a 30-year history of recurrent dislocations and atrophic scars. We performed diagnosis of EDS type III after a complete clinical and instrumental evaluation, comprising of histological and electron microscopic studies, that highlighted collagen abnormalities.

Hüftgelenkluxationsfraktur nach Niedrigenergietrauma

Hip dislocations and particularly fractures of the femoral head are very rare injuries. Various therapy options are described. So far there has been consensus about the severity of the trauma which has causes this type of injury. This case study presents a type II Pipkin fracture. This specific "accident" was due to low impact trauma, which was previously considered to be insufficient to cause this type of injury. We report on the diagnostic and therapeutic measures and compare this procedure with information from the literature.

Kinematic Cervical Spine Magnetic Resonance Imaging in Low-Impact Trauma Assessment

Kinematic magnetic resonance imaging can be implemented as a noninvasive adjunct examination for injuries in the cervical spine in the clinical assessment of ligamentous, disk, and soft-tissue injuries, as a basis for determining medical vs. surgical management, and in establishing the degree of functional clinical impairment. This article discusses the clinical indications and application of kinematic cervical spine magnetic resonance imaging method in the diagnosis and management of cervical spine injuries. The spectrum and grading classification of cervical spine injuries using kinematic magnetic resonance imaging is also discussed.

Excess mortality following hip fracture: a systematic epidemiological review

This systematic literature review has shown that patients experiencing hip fracture after low-impact trauma are at considerable excess risk for death compared with nonhip fracture/community control populations. The increased mortality risk may persist for several years thereafter, highlighting the need for interventions to reduce this risk.Patients experiencing hip fracture after low-impact trauma are at considerable risk for subsequent osteoporotic fractures and premature death. We conducted a systematic review of the literature to identify all studies that reported unadjusted and excess mortality rates for hip fracture. Although a lack of consistent study design precluded any formal meta-analysis or pooled analysis of the data, we have shown that hip fracture is associated with excess mortality (over and above mortality rates in nonhip fracture/community control populations) during the first year after fracture ranging from 8.4% to 36%. In the identified studies, individuals experienced an increased relative risk for mortality following hip fracture that was at least double that for the age-matched control population, became less pronounced with advancing age, was higher among men than women regardless of age, was highest in the days and weeks following the index fracture, and remained elevated for months and perhaps even years following the index fracture. These observations show that patients are at increased risk for premature death for many years after a fragility-related hip fracture and highlight the need to identify those patients who are candidates for interventions to reduce their risk.

Multiple spontaneous dislocations in a patient with Ehlers–Danlos syndrome

Ehlers–Danlos syndrome (EDS) consists of a heterogeneous group of inherited connective tissue disorders, characterised by generalised joint hypermobility, hyperextensibility of the skin, dystrophic scars, and a tendency to excessive bleeding....

Pediatric Blunt Carotid Injury from Low-Impact Trauma: A Case Report and Review of the Literature

Pediatric Blunt Carotid Injury from Low-Impact Trauma: A Case Report and Review of the Literature

The Dose of Exposure and Prevalence Rates of Post Traumatic Stress Disorder in a Sample of Turkish Children Eleven Months After the 1999 Marmara Earthquakes

Since Turkey is a centrally prime earthquake zone, Turkey’s children are at risk for developing Post Traumatic Stress Disorder (PTSD) caused by earthquake exposures and threats of anticipated earthquakes. Given the gaps in the literature and the risk to children living in Turkey, the present study was undertaken to investigate the severity and prevalence of PTSD in 4th and 5th grade Turkish children after the notorious 1999 earthquakes in the city of Sakarya. Data were collected in May 2000. The research focus was to compare results between high-impact trauma and low-impact trauma groups according to percentage, severity and the frequency of PTSD diagnosis. Group means were compared for mild, moderate, severe and very severe categories of PTSD diagnosis. High and low impact groups were not significantly different in any category; the number of children who met the PTSD requirement was almost the same in both groups in number and severity.

Soccer causes degenerative changes in the cervical spine.

Radiological changes and degeneration of the cervical spine have been previously described in soccer players. The onset of such changes was 10-20 years earlier than that of the normal population. The aim of this study was to assess these early degenerative changes in amateur active and veteran soccer players in a cross-sectional descriptive study using biomechanical, radiological, and magnetic resonance measures. The subjects were active (<30 years; n=15) and veteran (>30 years; n=15) male amateur soccer players, and their age-matched controls ( n=13 and n=15). Biomechanical measurements were made on a cervical dynamometer. Dynamic radiological and magnetic resonance findings were also obtained and evaluated. The normalized mean extension moment was higher in the active soccer players, but the mean range of motion was lower. Degenerative changes were prominent in veteran players, and the sagittal diameter of their spinal canal at C2 to C6 was lower when compared to active players and controls. Magnetic resonance findings of degeneration were more prominent in soccer players when compared to their age-matched controls. A tendency towards early degenerative changes exists in soccer players most probably due to high- and/or low-impact recurrent trauma to the cervical spine caused by heading the ball.

Can the Initial History Predict Whether a Child With a Head Injury Has Been Abused?

Previous studies of child abuse have used the presenting history as part of the case definition of abuse. Thus, data from these studies cannot be used to determine the diagnostic utility of historical features for identifying cases of abuse. The objective of this study was to determine the diagnostic utility of certain historical features for identifying cases of abusive head trauma. We retrospectively studied all children, aged 0 to 3 years, who had acute traumatic intracranial injury and were admitted to a tertiary care pediatric hospital from 1993 to 2000. Cases were categorized as either "definite abuse" or "not definite abuse" on the basis of radiologic, ophthalmologic, and physical examination findings, without regard to the presenting history. Forty-nine (30%) of 163 children met the criteria for definite abuse. Having no history of trauma had a high specificity (0.97) and positive predictive value (PPV; 0.92) for abuse. Among the subgroup of patients with persistent neurologic abnormality at hospital discharge (n = 34), having a history of no or low-impact trauma had a specificity of 1.0 and a PPV of 1.0 for definite abuse. Injuries were blamed on home resuscitative efforts in 12% of definite abuse cases and 0% of not definite abuse cases. The initial history of trauma was changed in 9% of definite abuse cases, as compared with 0% of not definite abuse cases. Among young children with a head injury, certain historical features have high specificity and PPV for diagnosing child abuse.

Commotio cordis: An underappreciated cause of sudden cardiac death in young patients: Assessment and management in the ED

Commotio cordis is the condition of sudden cardiac death or near sudden cardiac death after blunt, low-impact chest wall trauma in the absence of structural cardiac abnormality. Ventricular fibrillation is the most commonly reported induced arrhythmia in commotio cordis. Blunt impact injury to the chest with a baseball is the most common mechanism. Survival rates for commotio cordis are low, even with prompt CPR and defibrillation.

Cervical spine injury in low-impact blunt trauma

Few data are available regarding the incidence of cervical spine injuries following relatively low-impact blunt trauma. This prospective level II trauma center study of low-impact blunt trauma found a 1.30% incidence of cervical spine injury. Impressive differences were found in such parameters as population characteristics, modes of injury, elapsed times to emergency department evaluation, and Revised Trauma Scores between this study group and those reported in prospective level I highimpact blunt trauma series. Cervical spine injury in low-impact blunt trauma is significant and often presents less than dramatically, thus emphasizing a need for maintaining a high index of suspicion at all times.

Changes in free fatty acids, phospholipids, and cholesterol following impact injury to the rat spinal cord

Free fatty acids (FFA), phospholipid, and cholesterol levels were measured in spinal cord samples from rats subjected to low (25 g-cm), moderate (50 g-cm), or severe (100 g-cm) impact trauma to the T10 spinal segment. All degrees of injury caused early (15 min) declines in total phospholipids after trauma; phospholipid levels remained significantly below controls in rats subjected to moderate and severe injuries for up to 3 days, whereas phospholipids had returned to baseline values by 4 hr in the low injury group. Rapid and persistent decreases in cholesterol levels were observed for all injury groups. Severe trauma was associated with biphasic increases in FFA levels: levels were elevated at 5 and 15 min post-trauma and had declined by 30 min; a second elevation was observed at 1 hr, progressively increasing to reach a maximum at 24 hr, before declining over the next 6 days. Low and moderate injuries caused similar early total FFA increases; later increases were significantly smaller than in the severely injured group. Among the free fatty acids, significant increases were observed in palmitate, stearate, oleate, linoleate, linolenate, arachidonate, and docosahexaenoate. These findings indicate that traumatic spinal cord injury results in early, transient, postinjury membrane phospholipid hydrolysis, the magnitude of which is relatively independent of the severity of injury. More delayed and sustained lipid hydrolysis also occurs after trauma, the magnitude of which is related to the severity of injury.