Trauma Department Research Articles

Injuries to the lower limbs and associated injuries in children and adolescents resulting from road traffic incidents

ABSTRACT Background: Fractures occurring in the lower extremities as a result of road traffic accidents (RTAs) can lead to considerable morbidity and constitute a large proportion of nonfatal injuries that necessitate hospitalization. The present study aimed to examine the epidemiology of lower extremity fractures linked with RTAs in pediatric patients. Methods: This is a descriptive retrospective research study carried out between 2015 and 2022 at St. Mary’s Children’s Hospital, Iasi, Romania, targeting the population below the age of 18 years who experienced trauma from RTAs and received treatment from the trauma department. Data pertaining to various aspects, including age distribution, the frequency of accidents, the types of injuries incurred, and surgical treatment, were gathered. Results: The findings revealed a total of 358 cases of RTAs, out of which 112 fit the required criteria, and a total of 22 patients, accounting for 19.64%, had open fractures. Conclusion: This research provides information on lower extremity fractures and associated injuries in the pediatric population living in urban and rural areas throughout the Moldova region in Romania, subsequent to RTAs. The objective is to deliver the most relevant information at the patient’s bedside and provide proper healthcare services.

Treestrand-Related Injuries Outnumber Projectile-Related Injuries in Arkansas Hunters, 1993-2022.

Epidemiologic data on hunting-related injuries is sparse. Most published studies in this arena come from case reports or case series from a trauma department or state trauma registry. Relatively few of the studies have attempted to calculate rates of injury by demographic characteristics or hunting-related activities. In this study, we summarize the epidemiologic trends in hunting-related injuries in Arkansas over the last 30 years. A descriptive analysis of hunter injury data collected by the Arkansas Game and Fish Commission from 1993 to 2022 was performed. Analyses showed that the overall number of hunting-related injuries decreased by 0.16 per 100,000 licensees per year during the study period (P=0.0009). Projectile-related injuries decreased by 0.24 per 100,000 licensees (P=0.00001), and treestand-related injuries increased by 0.06 per 100,000 licensees (P=0.02) during the same time (both trends P<0.00001). treestand-related injuries now account for two thirds of all hunting-related injuries reported to the Arkansas Game and Fish Commission. Among hunters subject to hunter education certification mandates, compliance was 48.7%. Although projectile-related hunting injuries have decreased in Arkansas in the last 30 years, treestand-related hunting injuries have increased. These injuries are largely preventable if the hunter follows treestand safety recommendations (such as using a body harness and tether at all times when off the ground), as recommended by the Treestand Manufacturers of America. In addition, implementing strategies to improve compliance with hunter education certification also may help reduce injury rates.

EXPERIENCE IN THE TREATMENT OF PROXIMAL HUMERUS FRACTURES

Summary. The article presents the experience of treatment of fractures of the proximal humerus on the basis of the trauma department of “Kryvyi Rih City Clinical Hospital №2”. In the period from 2014. by 2024, 103 patients were hospitalized. Of these, 24 patients were treated conservatively - immobilization with a bandage or plaster bandage of the Deso type or a bandage bandage was used. 79 patients underwent surgery - depending on the type of fracture, as well as on the patient’s abilities, L-shaped, T-shaped plates and plates with angular stability of the “Philos” type were used. Most patients who underwent various types of osteosynthesis had good and satisfactory results.

Ergonomics Risk Assessment of Musculoskeletal Disorder During Ultrasound-Guided Internal Jugular Venous Cannulation.

Acutely sick patients can receive emergency intravenous access through central venous cannulation to administer fluids and medicines, perform haemodynamic monitoring and extracorporeal therapies, including plasmapheresis or haemodialysis. Using the Seldinger procedure, access is gained by percutaneous puncture, frequently guided by ultrasonography into the femoral, subclavian or internal jugular veins. This study aimed to identify ergonomic risk factors for musculoskeletal disorders (MSDs) in operators performing ultrasonography-guided internal jugular vein (IJV) cannulation at various table heights and probe orientations. Sixty emergency medicine residents participated in a cross-sectional study conducted by the Emergency and Trauma Department of Hospital Universiti Sains Malaysia, Kelantan. Participants were instructed to perform the cannulation at two distinct table heights and with two distinct probe orientations. To compute the ergonomic risk score, the Rapid Entire Body Assessment (REBA) method was used. The table height of 0.5 elbow factor with varied probe resulted in a median REBA score of 5.0, whereas the table height of 0.7 elbow factor with varied probe had a median REBA score of 4.0. All four positions exhibited medium risk for MSDs. This study showed that the table height of 0.7 elbow factor is more ergonomically favourable while still imposed medium risk for MSDs.

Outcomes for centenarian patients admitted with orthopaedic trauma

IntroductionThe United Kingdom (UK) and world's population is aging with patients living longer, often with many co-morbidities. It is expected that patients of extreme old age would have poor outcomes following trauma; however, this assumption is not clearly evidenced. This study aims to present the outcomes of patients aged 100 or older admitted to a single hospital trust following admission for orthopaedic trauma. MethodA prospective cohort of patients aged 100 years and over admitted to the trauma and orthopaedic departments of two hospitals within the same trust between 2008 and 2022 was reviewed. Age was median 101 years (100–106 years). Outcome measures were length of stay, survival, complications and change in accommodation. Results80 patients met the inclusion criteria (71female, 9 male). Mean age at discharge was 102.5 years with survival mean 4.2 years. 2 patients with peri-prosthetic fracture survived a further 5 years. Mean length of stay was 17 days. 57 patients returned to their original place of residence. 72 patients (90 %) survived the acute hospital admission. ConclusionSurvival rates for patients aged over 100 years were high and most returned to the previous place of residence. This study supports the surgical management of trauma and helps inform patients and families expectations for mortality risk.

An evaluation of the Teachable Moments A&amp;E Service: Correlating age with presenting needs and assessing how family difficulties impact intervention effectiveness

In 2019, the Home Office established 18 Violence Reduction Partnerships to reduce violence by understanding health, social care, and economic needs and identifying risk and protective factors to support community-level interventions. The Teachable Moments A&amp;E programme was commissioned in 2021 as part of the violence reduction partnerships to support children and young people with presenting needs in hospital A&amp;E and Major Trauma departments for violence-related activities. This study expanded on previous evaluations of the programme and considered how to improve the efficiency of the programme.Monitoring data were collected over a six-month period for 601 service users. Polyseries correlations were performed between age and participants’ presenting needs, and moderation analyses were performed to assess if family-wide challenges reduce the effectiveness of the Teachable Moments programme in improve service-user outcomes.There was a strong positive correlation between age and the presenting needs peer relationships, employment, and housing, as well as a strong negative correlation between age and self-harm. Moreover, moderation analyses show that unsupported family-wide difficult significantly reduce the effectiveness of the Teachable Moments intervention on improving the outcomes self-esteem, reducing risk, health and wellbeing, relationships, and employment/education.Findings show that as participants age, the prevalence of presenting needs is likely to vary which can allow the Teachable Moments programme to offer preventative support as service-users age and become more at-risk. Additionally, moderation analyses show that support programmes for service-users should extend beyond the individual and towards family-wide support in cases where support is required to improve the effectiveness of the Teachable Moments service.Paper Content:this paper expands on previous evaluations of the Teachable Moments service and considers how to improve the effectiveness of the interventions for service-users.Practical Implications of the paper:Findings from the paper offer insight into how the Teachable moments service can be altered to reduce future risk for service users by improving preventative measures towards specific presenting needs based on age, and how the programme can be expanded to account for factors around the service user that may reduce the effectiveness of the intervention.

Elevating Trauma Care: The Impact of Dedicated Oral and Maxillofacial Surgeons in Trauma Departments

Elevating Trauma Care: The Impact of Dedicated Oral and Maxillofacial Surgeons in Trauma Departments

ХИРУРГИЧЕСКОЕ ЛЕЧЕНИЕ ВЕРТЕЛЬНЫХ ПЕРЕЛОМОВ БЕДРЕННОЙ КОСТИ С ПРИМЕНЕНИЕМ ГЕМИАРТРОПЛАСТИКИ ТАЗОБЕДРЕННОГО СУСТАВА

This article presents an analysis of the results of surgical interventions in 145 patients with trochanteric fractures of the femur, who underwent hemiarthroplasty of the hip joint in the trauma departments of the Clinical Hospital of Emergency Medicine (CHEMS), formerly the Bishkek Scientific Research Center of Traumatology and Orthopedics (BSRCTO). We are considering the stage from 2019 to the present. According to the WHO age of patient classification, the senile age had twice as many compared to the elderly. This is due to the appearance of osteoporosis among older age groups of people, with an improvement in life and a sharp increase in the number of elderly people. Surgeons concluded that hemiarthroplasty of the hip joint is rapidly regenerating and necessary in the treatment of trochanteric fractures of the femur in older people.

Usability evaluation of electronic health records at the trauma and emergency directorates at the Komfo Anokye teaching hospital in the Ashanti region of Ghana

BackgroundElectronic health records (EHRs) are currently gaining popularity in emerging economies because they provide options for exchanging patient data, increasing operational efficiency, and improving patient outcomes. This study examines how service providers at Ghana's Komfo Anokye Teaching Hospital adopt and use an electronic health records (EHRs) system. The emphasis is on identifying factors impacting adoption and the problems that healthcare personnel encounter in efficiently using the EHRs system.MethodA quantitative cross-sectional technique was utilised to collect data from 234 trauma and emergency department staff members via standardised questionnaires. The participants were selected using the purposive sampling method. The Pearson Chi-square Test was used to examine the relationship between respondents' acceptability and use of EHRs.ResultsThe study discovered that a sizable number of respondents (86.8%) embraced and actively used the EHRs system. However, other issues were noted, including insufficient system training and malfunctions (35.9%), power outages (18.8%), privacy concerns (9.4%), and insufficient maintenance (4.7%). The respondents' comfortability in using the electronic health record system (X2=11.30, p=0.001), system dependability (X2=30.74, p=0.0001), and EHR's ability to reduce patient waiting time (X2=14.39, p=0.0001) were all strongly associated with their degree of satisfaction with the system. Furthermore, respondents who said elects increase patient care (X2= 75.59, p = 0.0001) and income creation (X2= 8.48, p = 0.004), which is related to the acceptability of the electronic health records system.ConclusionThe study revealed that comfort, reliability, and improved care quality all had an impact on the EHRs system's acceptability and utilization. Challenges, including equipment malfunctions and power outages, were found. Continuous professional training was emphasized as a means of increasing employee confidence, as did the construction of a power backup system to combat disruptions. Patient data privacy was highlighted. In conclusion, this study highlights the relevance of EHRs system adoption and usability in healthcare. While the benefits are obvious, addressing obstacles through training, technical support, and infrastructure improvements is critical for increasing system effectiveness.

Bacterial sepsis causes more dramatic pathogenetic changes in the Th1 pathway than does viral (COVID-19) sepsis: a prospective observational study of whole blood transcriptomes

ObjectivesThis study aimed to comprehensively compare host responses of patients with bacterial sepsis and those with viral (COVID-19) sepsis by analyzing messenger RNA (mRNA) and microRNA (miRNA) profiles to shed light on their distinct pathophysiological mechanisms.DesignProspective observational study.SettingWhole blood RNA sequencing was used to analyze mRNA and miRNA profiles of patients diagnosed as having bacterial sepsis or viral (COVID-19) sepsis at the Department of Trauma and Emergency Medicine, Osaka University Graduate School of Medicine.PatientsTwenty-two bacterial sepsis patients, 35 viral (COVID-19) sepsis patients, and 15 healthy subjects admitted to the department were included. We diagnosed bacterial sepsis patients according to the sepsis-3 criterion that the Sequential Organ Failure Assessment score must increase to 2 points or more among patients with suspected infections. Viral (COVID-19) sepsis patients were diagnosed using SARS-CoV-2 RT-PCR testing, and presence of pneumonia was assessed through chest computed tomography scans.InterventionsNone.Measurements and main resultsFor RNA sequencing, 14,500 mRNAs, 1121 miRNAs, and 2556 miRNA-targeted mRNAs were available for analysis in the bacterial sepsis patients. Numbers of genes showing upregulated: downregulated gene expression (false discovery rate < 0.05, |log2 fold change| > 1.5) were 256:2887 for mRNA, 53:5 for miRNA, and 49:2507 for miRNA-targeted mRNA. Similarly, in viral (COVID-19) sepsis patients, 14,500 mRNAs, 1121 miRNAs, and 327 miRNA-targeted mRNAs were analyzed, with numbers of genes exhibiting upregulated: downregulated gene expression of 672:1147 for mRNA, 3:4 for miRNA, and 165:162 for miRNA-targeted mRNA. This analysis revealed significant differences in the numbers of upregulated and downregulated genes expressed and pathways between the bacterial sepsis and viral (COVID-19) sepsis patients. Bacterial sepsis patients showed activation of the PD-1 and PD-L1 cancer immunotherapy signaling pathway and concurrent suppression of Th1 signaling.ConclusionOur study illuminated distinct molecular variances between bacterial sepsis and viral (COVID-19) sepsis. Bacterial sepsis patients had a greater number of upregulated and downregulated genes and pathways compared to viral (COVID-19) sepsis patients. Especially, bacterial sepsis caused more dramatic pathogenetic changes in the Th1 pathway than did viral (COVID-19) sepsis.

Retrospective analysis of nonfatal skeletal injuries sustained in road incidents involving electric scooters

BACKGROUND: Although scooters were officially recognized as vehicles in the Russian Federation not so long ago, the incidence of scooter injuries has been growing for several years. AIM: To analyze epidemiological data and the nature of injuries in victims of nonfatal electric scooter incidents. MATERIALS AND METHODS: The study included 78 medical records of persons injured in road incidents involving electric scooters who were treated in the trauma department of the Regional Hospital No. 4 of Adler between 2020 and 2021. The nature of the injury by sex, age, seasonality, time of day, and characteristics of damage depending on the category of road users (driver and pedestrian) were analyzed retrospectively. RESULTS: Of the 78 road incidents involving electric scooters, 28 occurred in 2020 and 50 in 2021. The sex distribution was nearly the same, with ≥40 men and 38 women, and their median age was 36 (30–45.8) years. Most of the accidents (n=52) occurred in summer and autumn months. The exact time of injury was known in 35 cases (17‰ in the daytime, 18‰ in the evening. Depending on the circumstances, all accidents were divided into falls from electric scooters (n=73), collisions of moving scooters with pedestrians (n=3), and collisions of moving scooters with a moving car (n=2). Of the 73 patients who sustained fractures, 67 had a closed type. Intra-articular fractures were detected in 41 victims. Lowe-limb fractures (n=43) prevailed over fractures of other localizations. In addition, 18 cases of knee injuries and 14 cases of trauma to the proximal tibial epiphysis were recorded. CONCLUSION: The incidence of scooter injury is increasing. In the warm regions of the Russian Federation, such accidents have a year-round prevalence with predominance in the summer months owing to the large influx of vacationers. More often than other incidents, falls from electric scooters are noted, resulting in lower limb injuries, including with intra-articular fractures of the condyles of the tibia.

A Survey of the Estimated Cost of Surgical Consumable Items Within Trauma and Orthopaedic Departments.

Introduction The impact of the current economic and environmental climate, both nationally and globally, is further straining the NHS. This has led to scrutiny of high-expenditure areas, including consumables. Clinician's knowledge surrounding health economics is sparse, and we conducted this survey to assess cost-awareness within the Trauma and Orthopaedic (T&O) departmental staff. Methods A questionnaire was digitally distributed to T&O staff in the East Kent Hospitals Trust. This included demographic data and to make estimations of the cost of 10 specialty-specific items. The data were analysed to determine the average, median, and interquartile range (IQR) of the estimated prices and compared to the actual costs. Results Approximately 7.1% of all item estimates were deemed 'correct'. No correlation was seen between years of staff experience and the accuracy of estimates. 'Kenalog 1 mL ampoule' (Kenalog, Bristol-Myers Squibb, NJ) had the highest accuracy of estimation across all responses (13%), whilst both 'kirschner wires' and '3.2 drill bit' had the lowest accuracy (4% each). The median estimated cost was closest to the actual cost for 'cement pack' (median estimate/actual cost = 0.9). The median estimated cost was furthest from the actual cost for 'tourniquet cuffs' (median estimate/actual cost = 0.16). 'Velcro wrist splint' was the item that was the most overestimated (median estimate/actual cost = 1.57), with only two of the 10 items being overestimated ('velcro wrist splint' and 'dynamic hip screw and plate'). The most underestimated item was 'tourniquet cuffs' (median estimate/actual cost = 0.16). Conclusions There is a paucity of knowledge surrounding the cost of specialist T&O consumables. The limitations included the sample size (98 respondents) and geographical area (East Kent Hospitals Trust). This study shows that there is a need for further research into this topic, with long-term outcomes, which may be beneficial both economically and environmentally.

The structure of traumatic brain injury in the city of Rostov-on-Don during the new coronavirus infection COVID 19

Objective: to study the frequency and structure of traumatic brain injury in the pre-ovoid, covid and post-ovoid periods in Rostov-on-Don.Materials and methods: to study the frequency and structure of traumatic brain injury in three years from 2019 to 2021 (in the pre-ovoid, covid and post-ovoid periods) according to the neurosurgical department and the department of combined trauma of the Emergency Medical Hospital No. 2 in Rostov-on-Don. Data processing using the IBM SPSS Statictic program version 26.0 using the χ2-Pearson criterion, in pairwise a posteriori comparative analysis, the χ2-Pearson criterion with Yates correction and likelihood correction were used. If the significance level is p&lt;0.05, the differences are statistically significant.Results: in the pre-crisis period (2019), household trauma prevailed, the total number of hospitalized with TBI was 1,322. Of these, concussions accounted for 71%, brain contusions accounted for 28%, diffuse brain injury — 1%, street injury — 6.9%, transport injury — 6.81% and intentional injury — 24.1%. In the covid period (2020), the total number of patients admitted to the department decreased by 24%. The structure of the injury remained unchanged (concussions in 70% of cases, brain contusions in 28%, diffuse brain injury in 2%). In 2021 (completion of covid restrictions), the number of inpatient patients with TBI remained reduced (by 23%), the ratio of concussions, bruises, diffuse brain injuries remained the same.Conclusions: during the period of social isolation, there was a decrease in the number of hospitalized with TBI, which coincides with global indicators. The end of the restrictions associated with the pandemic is also characterized by a decrease in the number of patients admitted to the hospital with TBI. At the same time, a decrease in the ratio of the number of hospitalizations to the total number of deaths from head injury in 2019 and 2020 should be taken into account. from 19.83 to 14.98 in the Rostov region (according to the Federal State Statistics Service on the number of deaths from head injuries in 2019-2020), which reflects the level of accessibility of medical care. There was also a significant decrease in household, street, transport, school, sports and intentional types of TBI (p&lt;0.05), while occupational injuries and trauma, the circumstances of which are unknown, did not significantly differ from the pre-pandemic indicators. Taking into account these results will improve the organization of emergency and emergency medical care for patients with TBI.

Incidence of intra-abdominal injuries in hemodynamically stable blunt trauma patients with a normal computed tomography scan admitted to the emergency department

ObjectivesBlunt abdominal trauma is a common cause of emergency department admission. Computed tomography (CT) scanning is the gold standard method for identifying intra-abdominal injuries in patients experiencing blunt trauma, especially those with high-energy trauma. Although the diagnostic accuracy of this imaging technique is very high, patient admission and prolonged observation protocols are still common practices worldwide. We aimed to evaluate the incidence of intra-abdominal injury in hemodynamically stable patients with high-energy blunt trauma and a normal abdominal CT scan at a Level-1 Trauma Center in Colombia, South America, to assess the relevance of a prolonged observation period.MethodsWe performed a retrospective study of patients admitted to the emergency department for blunt trauma between 2021 and 2022. All consecutive patients with high-energy mechanisms of trauma and a normal CT scan at admission were included. Our primary outcomes were the incidence of intra-abdominal injury identified during a 24-hour observation period or hospital stay, ICU admission, and death.ResultsWe included 480 patients who met the inclusion criteria. The median age was 33 (IQR 25.5, 47), and 74.2% were male. The most common mechanisms of injury were motor vehicle accidents (64.2%), falls from height (26%), and falls from bikes (3.1%). A total of 99.2% of patients had a Revised Trauma Score of 8. Only 1 patient (0.2%) (95% CI: 0.01–1.16) presented with an abdominal injury during the observation period. No ICU admissions or deaths were reported.ConclusionThe incidence of intra-abdominal injury in patients with hemodynamically stable blunt trauma and a negative abdominal CT scan is extremely low, and prolonged observation may not be justified in these patients.

Factors influencing nurses’ pain assessment and management of road traffic casualties: a qualitative study at a military hospital in Ghana

BackgroundEvidence shows that patients who visit the surgical and trauma emergency units may be discharged with untreated or increased pain levels. This study explored nurses’ pain assessment and management approaches at a trauma-surgical emergency unit in Ghana.MethodsSeventeen nurses who work in the trauma department participated in this qualitative exploratory descriptive study. In-depth individual interviews were conducted, and the thematic analysis was utilized to identify emerging themes and subthemes.ResultsThree main themes were identified: patient pain indicators, pain management, and institutional factors influencing pain management. The study revealed that nurses rely on verbal expressions, non-verbal cues, physiological changes, and the severity of pain communicated. The findings highlighted staff shortage, inadequate resources, and lack of standardized guidelines as factors affecting pain and management.ConclusionsAlthough the study offers critical new perspectives on nurses’ experiences regarding pain related issues at the trauma-surgical emergency units, its small sample size limited its generalizability.

Management of Suspected Peripheral Vascular Injuries in Orthopedic Trauma.

In orthopedic trauma, identification of extremity trauma combined with vascular injury is challenging. Missed diagnosis may result in amputation or even death. The purpose of this study was to investigate whether physical examination combined with handheld vascular ultrasound Doppler examination could be an effective method of screening for peripheral vascular injury and to explore the characteristics of vascular injuries in orthopedic trauma patients. Retrospective analysis of patients in the emergency department of orthopedic trauma in our hospital from January 2022 to October 2023. Physical examination combined with handheld vascular ultrasound Doppler examination was used as a screening method for suspected vascular injuries. Patients with suspected vascular injury would undergo further angiography and receive multidisciplinary treatment. Angiography was used as the gold standard for diagnosing vascular injuries. Patient demographics, mechanism of injury, location and type of injury, angiographic results, surgical notes, and early treatment outcome data were recorded. A total of 55 cases (58 limb injuries) with suspected vascular injury were ultimately included. Angiography revealed that 53 cases (55 limbs, positive rate 94.8%) were considered to have confirmed vascular injuries. Forty-three were male (81.1%) and 10 were female (18.9%), with mean age 44.1 ± 16.6 years. The main mechanism of injury was traffic accident (30, 56.7%). Most common site of vascular injuries was knee joint (30/55, 54.5%), and popliteal artery (23, 47.9%) was the most commonly injured blood vessel. After multidisciplinary collaborative treatment, overall patient mortality was 3.8% (2/53), and limb survival rate among surviving patients was 81.1% (43/53) in our study. In orthopedic trauma, "Hard signs" and "soft signs" combined with handheld vascular ultrasound Doppler examination were effective ways to screen for suspected vascular injuries. Most limbs had associated fractures or dislocations at the site of vascular injury. Collaboration of vascular surgery, microsurgery and orthopedic trauma may help improve patients' prognosis.

Intraoperative slide rail CT assistance in percutaneous sacroiliac joint screws for the treatment of pelvic posterior ring injury

To compare the clinical efficacy of intraoperative slide rail CT combined with C-arm X-ray assistance and just C-arm for percutaneous screw in the treatment of pelvic posterior ring injury. A retrospective analysis was performed on the patient data of 76 patients with posterior pelvic ring injury admitted to the Department of Orthopedic Trauma from December 2018 to February 2022. Among them, 39 patients in the CT group were treated with C-arm combined with slide rail CT-assisted inline fixation including 23 males and 16 females with an average age of (44.98±7.33) years old;and the other 37 patients in the C-arm group were treated with intraline fixation treatment under only C-arm fluoroscopy including 24 males and 13 females with an average age of (44.37±10.82) years old. Among them, 42 patients with anterior ring fractures were treated with percutaneous inferior iliac spines with internal fixation (INFIX) or suprapubic support screws to fix the anterior pelvic ring. Postoperative follow-up time, operation time, complications of the two groups were compared. Results of Matta reduction criteria, Majed efficacy evaluation, the CT grading and the rate of secondary surgical revision were compared. The nailing time of (32.63±7.33) min in CT group was shorter than that of (52.95±10.64) min in C-arm group (t=-9.739, P<0.05). The follow-up time between CT group (11.97±1.86) months and C-arm group (12.03±1.71) months were not statistically significant(P>0.05). The postoperative complication rates between two groups were not statistically significant (χ2=0.159, P>0.05). Results of Matta reduction criteria (Z=2.79, P<0.05), Majeed efficacy evaluation(Z=2.79, P<0.05), CT grading (Z=2.83, P<0.05) in CT group were better than those in C-arm group(P<0.05); the secondary surgical revision rate in the CT group was significantly lower than that in the C-arm group (χ2=5.641, P<0.05). Compared with traditional C-arm fluoroscopy, intraoperative slide rail CT combined with C-arm assisted percutaneous sacroiliac joint screw placement surgery has the characteristics of short operation time, high accuracy and safety, and significant decrease in postoperative secondary revision rate, and is one of the effective methods for re-establishing the stability of the posterior ring of pelvic fracture.

The Impact of Early Rehabilitation and the Acceptance of the Disease on the Quality of Life of Patients after Hip Arthroplasty: An Observational Study.

Background: The early introduction of physiotherapy significantly shortens the time required for a patient to regain full mobility after hip arthroplasty. Obtaining the expected result is determined by cooperation with a physiotherapist and the patient's involvement in the rehabilitation process. The aim of this study was to assess the quality of life, life satisfaction, and motor ability of patients after hip arthroplasty. Methods: This study included 147 patients who underwent hip arthroplasty at the Orthopedic and Trauma Department. The research material was collected using questionnaires, and the study used the Barthel Index (BI), Harris Hip Score (HHS), Visual Analogue Scale (VAS), Acceptance of Illness Scale (AIS), and Quality of Life Assessment Questionnaire (WHOQOL-BREF). In the studied group of patients, the Excia cementless endoprosthesis was primarily used (69.39%), as well as the Metha Short Hip prosthesis (15.65%), AM hip prosthesis (10.20%), and bipolar hip prosthesis (4.76%). Results: The analyzed group of patients included 95 women (64.63%) and 52 men (35.37%); the average age was 67 years. Six weeks after hip arthroplasty, mild disability occurred in 53.74% of the patients, while the remaining 46.26% had no disability, and 95.24% of the patients achieved a high level of acceptance of the disease and quality of life. Conclusions: Early improvement after hip replacement surgery contributes to eliminating the disability of the hip joint in the following areas: pain sensation, functionality, lack of deformation, and range of motion. Each subsequent stage of treatment increased the level of acceptance of the disease in the study group. The applied surgical treatment increased satisfaction with overall health and quality of life.

"Survey of Knowledge about Fracture Prevention Among Patients and their Relatives at Department of Orthopaedic Trauma An Binh Hospital"

"Survey of Knowledge about Fracture Prevention Among Patients and their Relatives at Department of Orthopaedic Trauma An Binh Hospital"

Clinical-radiological results of the tibial osteotomy of valgization by internal addition in Gonarthrosis.

In knee osteoarthritis, medial-opening tibial osteotomy remains a good surgical technique, and have been effective in stabilizing and even improving osteoarthritis, Our study is about 20 cases of gonarthrosis on genu varum, treated by opening wedge valgus high tibial osteotomyconducted within the orthopedic trauma department '' B'' of the University Hospital Mohamed VI of Marrakech, over a period of 4 years. The mean age of our patients was 49 years (39-60), with a sex ratio of 1M/4F. In 55% of cases (11 cases) thegonarthrosis was related to primitive genu varum, while 45% cases (9 cases) was secondary to trauma ormeniscectomy. Clinically the knee pain was the main symptom in all cases, with an intensity level 3 on the simple verbal scale. The imagery was designed to measure angular deviations and surgical correction and monitoring the evolution. Angular deviation adjusted mean was 10.3 ° (6 ° -16 °), stages II and III of Ahlback classification, represent the mostcases of tibiofemoral osteoarthritis (90%).The filling was done by autologous bone graft, and the average degree of varus correction was 9.6 °.The results evaluated by the IKS score were excellent or good in 60% of cases for the knee score and 73% for the function score.