@article { author = {Babaei Jandaghi, Ali and Mardani-Kivi, Mohsen and Mirbolook, Ahmadreza and Emami-Meybodi, Mohammad Kazem and Mohammadzadeh, Solmaz and Farahmand, Maral}, title = {Comparison of Indirect MR Arthrography With Conventional MRI in the Diagnosis of Knee Pathologies in Patients With Knee Pain}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.20718}, abstract = {Background: Knee pain is a common problem in the general population. In order to determine the extent of the injury and the appropriate treatment, MRI provides the most accurate imaging method. This may be done through conventional MRI techniques or by injecting a contrast material (MR arthrography). Objectives: The purpose of this study was to compare the diagnostic value of these two methods. Patients and Methods: The study involved the diagnostic evaluation on 60 patients with knee pain who received treatment over the course of a one-year period. Referred patients were randomly divided into two groups: indirect MR arthrography was performed on one group, and conventional MRI was performed on the other group. Both groups then underwent arthroscopy. The results from both groups were compared with the arthroscopic findings. Results: In all of the pathologies studied, the sensitivity, specificity, and the positive and negative predictive values were evaluated. A high rate of accuracy was found between MR arthrography and arthroscopy (P < 0.05) for all knee injuries, however a similar rate of accuracy between conventional MRI and arthroscopy was only seen in patients with damage to the posterior cruciate ligament (PCL), the tibio-femoral articular cartilage, and patella chondromalacia (P < 0.05). The highest rate of accuracy was seen in cases where indirect MR arthrography was used for the diagnosis of anterior cruciate ligament (ACL) damage (K = 1). Conclusions: Our results have shown that indirect MR arthrography had greater diagnostic accuracy in regards to the sensitivity, specificity, and positive and negative predictive values than conventional MRI in knee pathologies.}, keywords = {Indirect MR Arthrography,Conventional MRI,Knee Pain}, url = {https://www.traumamon.com/article_99990.html}, eprint = {https://www.traumamon.com/article_99990_eef1b7c46a841536afb4192127fab356.pdf} } @article { author = {Subramanian, Arulselvi and Albert, Venencia and Mishra, Biplab and Sanoria, Shilpi and Pandey, Ravindra Mohan}, title = {Association Between the Pancreatic Enzyme Level and Organ Failure in Trauma Patients}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.20773}, abstract = {Background: The literature suggests an association of pancreatic enzymes with systemic inflammation resulting in secondary organ injury and dysfunction following trauma. Elevation in serum enzymes may not always be predictive of pancreatic disease, and can reflect extra pancreatic production. Objectives: This study was conducted to evaluate the rise in serum pancreatic enzyme levels with the incidence of organ failure following trauma. Patients and Methods: A retrospective review was performed on critically injured patients from December 2009 to March 2010. Patient’s clinical demographics, routine laboratory investigations along with amylase and lipase levels were also extracted from the patients’ records. Patients with pancreatic or duodenal injuries were excluded from the study. Results: From a total of 296 patients (mean age, 31 years), 85% were males. Blunt injury was seen in 91.6% of the cases and 8.4% had penetrating injury. One hundred and fifty-three patients had single organ failure, 96 had multiple organ failure and 47 had no organ failure. There was a significant difference in lipase levels (P = 0.04), potassium levels (P = 0.05) and hemoglobin levels (P = -0.004), among the three patient groups. There was no significant difference in amylase levels among the three patient groups. The observed independent predictors of mortality included coagulopathy (OR = 1.7), Glasgow coma scale (OR = 1.1, 4.7), pulmonary failure (OR = 0.0004), hepatic failure (OR = 0.048), renal failure (OR = 5.5), organ failure (OR =149.8), lipase levels (OR = 1.3), and infection (OR = 3.0). Conclusions: There was a significant correlation between elevated lipase levels and the incidence of multiple organ failure. Moreover, No significant association was found between the elevated amylase levels and organ failure. However, on admission, measurement of these enzymes coupled with routine laboratory investigations can be a powerful tool in the early detection of patients progressing towards organ failure.}, keywords = {Amylase,Lipase,Organ Failure,Trauma}, url = {https://www.traumamon.com/article_99991.html}, eprint = {https://www.traumamon.com/article_99991_b31b3b49015b945266eaa4a42431b476.pdf} } @article { author = {Shams Vahdati, Samad and Rajaei Ghafouri, Rouzbeh and Razavi, Sajjad and Mazouchian, Hossein}, title = {Bicycle-Related Injuries Presenting to Tabriz Imam Reza Hospital, Iran}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.20856}, abstract = {Background: Rising fuel cost and subsequent increase in transportation prices encourage people to use cheap transportation such as a bicycle. This vehicle can also be used for sports and recreation. Bicycles are widely used in Iran, like other countries. There is not enough data about bicycle-related traumas in our country. Objectives: The aim of this study was to obtain the epidemiology of this type of injury in Tabriz Imam Reza Hospital as a referral center in northwest of Iran during 2009 to 2012. Materials and Methods: One hundred bicycle-related patients during the three years were entered in this descriptive crosssectional study. Patient’s demographics, place and time of crash, mechanism of trauma, helmet and other safety device usage, and disposition information were gathered by a researcher-made checklist. Admission rate and ward as well as the site of injuries were also collected. The data were analyzed by SPSS 16 software using descriptive statistics. Results: All the patients were males with a mean age of 31.3 ± 23.12. Seventy six bicycle-related injuries occurred during weekdays and 24 happened on holidays; 71 patients attended the emergency department in the morning and 29 at night. Only three of 100 cyclists had helmets during the accident. The rates of injuries were as follows: 65 head and face, 20 abdomen, 14 chest, 11 soft tissue, eight lower limb, eight cervical spine, six upper limb, four thoracic and lumbar spine, and three pelvis injuries. Conclusions: Head and face are the most common sites of injury and skull fracture is the most common one. Considering the preventable entity of trauma, the use of helmets seems to be beneficial to prevent most bicycle-related injuries.}, keywords = {Bicycle,Related Injury,Iran,Epidemiology,Injury Prevention}, url = {https://www.traumamon.com/article_99992.html}, eprint = {https://www.traumamon.com/article_99992_40a7482be87d3e9b4694624a8964d375.pdf} } @article { author = {Mahran, Dalia G. and Farouk, Osama and Qayed, Mohammad H. and Berraud, Amal}, title = {Pattern and Trend of Injuries Among Trauma Unit Attendants in Upper Egypt}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.20967}, abstract = {Background: Injury is a growing public health problem worldwide. Deaths due to injuries account for 10% of the world’s mortality. More than 90% of the world’s injury deaths occur in low and middle income countries. In Egypt, injury is a hidden epidemic and its related deaths are misclassified due to lack of accurate national data. Furthermore, as a research problem it has also been largely ignored in developing countries. Objectives: To determine the pattern and trend of injury from January 2002 to December 2009 among attendants at trauma unit in Assiut university hospital in Upper Egypt. Patients and Methods: A descriptive retrospective study was conducted at the trauma unit in Assiut university hospital in Upper Egypt. All registered injuries during January 2002 to December 2009 were included in the study. Results: During January 2002 to December 2009, 213835 injured cases were admitted to the trauma unit. The number of attendants increased every year from 9.3% from the total cases in all study period in 2002 up to 15.3% in 2009 with a statistically significant difference (P = 0.000). Young adults aged 20 - 29 years were the most common group affected by injuries (22.2%). Male to female ratio was 3:1. Falls represent one half of injuries (49.6%) from all attended cases, followed by exposure to inanimate mechanical forces (19.5%) and transport accidents (18.3%). Falls were ranked as the leading cause of injuries, while transport accidents were the second cause in 2007 - 2009. Conclusions: Trauma in Upper Egypt is an under-recognized problem, which requires prioritized attention. Increasing the awareness of community, making policies and establishment of a trauma system are important to decrease the burden of injuries.}, keywords = {pattern,Injuries,Trauma Unit,Egypt}, url = {https://www.traumamon.com/article_99993.html}, eprint = {https://www.traumamon.com/article_99993_5732d76eaa12684a003130c5b32e29a7.pdf} } @article { author = {Safiri, Saeid and Haghdoost, Ali Akbar and Hashemi, Fatemeh and Amiri, Shahrokh and Raza, Owais and Sadeghi-Bazargani, Homayoun}, title = {Association Between Adult Attention Deficit Hyperactivity Disorder and Helmet Use Among Motorcycle Riders}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.21066}, abstract = {Background: Use of helmets plays a major role in preventing injuries or decreasing injury severity among motorcycle riders. Use of helmets may depend on personal factors such as psychological factors. Objectives: The aim of this study was to independently assess the association between helmet use among motorcycle riders and ADHD scores, with controlling the accident history and was taken more sensitive measures if helmet use was different between motorcycle riders, according to their ADHD scores. Patients and Methods: A cross-sectional study was done on 205 motorcycle riders referred to Kerman Referral Injury Hospital after a motorcycle traffic accident. Friends and family members possessing motorcycles who visited the patient in this facility were included in our sample. The Persian version of the Conner’s Adult ADHD Rating Scale (CAARS) self-report (screening version) was used in order to screen for adult ADHD. CAARS scores were compared between those who usually used helmets and those who did not. Results: Univariable analysis showed the mean of the age variable was significantly higher in the helmeted group, 26.94 ± 7.72 vs. 23.08 ± 7.7.32, (P < 0.001). The majority of the non-helmeted group was single (P < 0.001). Subjects with secondary educational level were more often in the helmeted group (P = 0.007). Daily and weekly driving hours were higher in the non-helmeted group (P = 0.002 and P = 0.004). Most of the subjects in the helmeted group had a driving license in comparison with the other group (P < 0.001). There was not a significant association between SES and having hyperactive children and helmet use (P = 0.159). In all ADHD subscales, a significant association was found and scores were higher in the non-helmeted group (P < 0.05). Nevertheless, multivariable analysis did not confirm the association of the ADHD screening score with helmet use. Conclusions: The result of this study did not find an independent association between ADHD and helmet use.}, keywords = {Attention deficit,hyperactivity disorder,Adult ADHD,helmet,Motor Vehicles,Motorcycles}, url = {https://www.traumamon.com/article_99994.html}, eprint = {https://www.traumamon.com/article_99994_8e985d977316a243fb6dd83f6a0e8701.pdf} } @article { author = {Fazeli, Mohammad Sadegh and Kazemeini, Ali Reza and Jafarian, Ali and Bashashati, Mohammad and Keramati, Mohammad Reza}, title = {Temporary Trans-jejunal Hepatic Duct Stenting in Roux-en-y Hepaticojejunostomy for Reconstruction of Iatrogenic Bile Duct Injuries}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.21115}, abstract = {Background: Bile Duct Injuries (BDI) during cholecystectomy are now being recognized as major health problems. Objectives: Herein, we present our experience with handling major BDIs and report long-term outcome of hepaticojejunostomies followed by trans-jejunal hepatic duct stenting performed to reconstruct extra-hepatic biliary tracts. Materials and Methods: In this case series, we prospectively collected data of 22 patients, who underwent first time biliary reconstruction through Roux-en-y hepaticojejunostomy followed by hepatic duct stenting using a trans-jejunal bifurcated 6F tube drain. The long-term outcome was assessed and defined as excellent (asymptomatic, normal liver enzymes and bilirubin levels), good (asymptomatic, mild abnormality in liver enzyme and bilirubin levels), poor (symptomatic, abnormal liver enzymes and bilirubin level) and failure (requiring reoperation). Results: A total of 22 patients including four males (18.1%) and 18 females (81.8%) were evaluated. The mean age was 42.71 (range: 23 - 74) years. Twelve patients had undergone open cholecystectomy (54.5%) and the rest had a history of laparoscopic cholecystectomy. The mean interval between the primary operation and reconstruction was 92.71 days. The mean follow-up period after biliary reconstruction was 42.33 (range: 1 - 96) months. No instance of anastomotic leakage or stenosis, biliary sepsis, thromboembolic event, or respiratory infection was noted in the long-term follow-up. The outcome was excellent in all patients. No case with poor or failure of result was noticed. Conclusions: Although a devastating complication iatrogenic major bile duct injuries can be corrected surgically with a high rate of success. Temporary trans-jejunal stenting of the hepatic ducts can help in maintaining the integrity of anastomosis without stenosis or biliary sepsis.}, keywords = {biliary tract,Reconstruction,Treatment outcome,bile duct,Iatrogenic}, url = {https://www.traumamon.com/article_99995.html}, eprint = {https://www.traumamon.com/article_99995_23170767b2243f147fec78c497fa7f82.pdf} } @article { author = {Bagherifard, Abolfazl and Jafari, Davod and Keihan Shokouh, Hassan and Motavallian, Ebrahim and Najd Mazhar, Farid}, title = {Distal Radius Radiographic Indices and Perilunate Fracture Dislocation}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.21956}, abstract = {Background: Distal radius radiographic indices may play a role as risk factors in pathogenesis of Kienbock’s disease, scaphoid fracture and nonunion. Perilunate fracture dislocations are devastating wrist injuries, and their relationship and distal radius indices have not been addressed in the literature. Objectives: The aim of this study was to evaluate the possible role of distal radius radiographic indices including radial height, radial inclination, ulnar variance and volar tilt as risk factors in the perilunate fracture dislocation injury of the wrist. Patients and Methods: We studied distal radius radiographic indices including radial height, radial inclination, ulnar variance and volar tilt in 43 patients with perilunate fracture dislocations and compared them with 44 wrists in the control group. Results: The mean values of the radial height, radial inclination, ulnar variance and volar tilt were 12.74 (5 - 18), 24.20 (7 - 35), -0.73 (-5 - 4) and 12.28 (2 - 20) in the patient group. These values were 12.68 (9 - 22), 23.22 (17 - 30), -0.11 (-4 - 3) and 11.05 (-3 - 20), respectively in the control group. There was no statistically significant difference between the two groups. Conclusions: This study did not show that distal radius anatomical indices including the radial height, radial inclination, ulnar variance and volar tilt influence perilunate fracture dislocation as risk factors.}, keywords = {Anatomical indices,Distal Radius,Perilunate Fracture Dislocation}, url = {https://www.traumamon.com/article_99996.html}, eprint = {https://www.traumamon.com/article_99996_ee3c506a2dbab99ef690228fba4f7f2b.pdf} } @article { author = {Shafaiee, Yousef and Shahbazzadegan, Bita}, title = {Facial Nerve Laceration and its Repair}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.22066}, abstract = {Introduction: Facial paralysis is a devastating condition with profound functional, aesthetic and psychosocial consequences. Tumors within or outside the skull, Bell’s palsy and trauma are the most common causes of facial paralysis in adults. Case Presentation: Our patient was a 35-year-old man with deep laceration wounds. The patient was taken to the operating room and the nerves were repaired. We observed gradual improvement of muscle performance except branches of the frontal nerve. Conclusions: Complete rupture of the facial nerve is challenging and the treatment is surgery, which requires careful planning}, keywords = {Nerve and Vascular Injuries,Penetrating Wounds,facial nerve palsy}, url = {https://www.traumamon.com/article_99997.html}, eprint = {https://www.traumamon.com/article_99997_b31fa4e16ce836d9817382b160617985.pdf} } @article { author = {Maghsoudi, Mohammadreza and Shahbazzadegan, Bita and Pezeshki, Arastoo}, title = {Asymptomatic Intracranial Foreign Body: An Incidental Finding on Radiography}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.22206}, abstract = {Introduction: Intracranial needles are rare entities. Intracranial foreign bodies due to non-missile intracranial penetrations are one of the most rarely encountered situations in neurosurgery. Sewing needles are among the more unusual foreign bodies that may be found in the brain. Although uncommon, foreign body cases are important and interesting. Foreign bodies enter the body through trauma or iatrogenic injuries. Needles are mostly inserted through fontanelles, cranial sutures, and more rarely through the orbits in infancy for the purpose of killing unwanted babies. Case Presentation: This article presents a case of intracranial foreign body found upon radiography. A 24-year-old female, who two days prior to presentation suffered only once from dizziness, and was otherwise healthy. Conclusions: Because this incident may have occurred during the patient’s neonatal period, it may be a case of child abuse. In spite of the very limited number of cases in the literature, having a stepmother, a stepfather, or a babysitter, being the youngest child, or having family members who suffer from psychiatric disorders, (especially if these relatives are responsible for child care), living in a society that allows homicide of children born from extramarital relationships, and being female have been suggested as possible risk factors.}, keywords = {Asymptomatic Diseases,Foreign Bodies,CT scan,X,Ray,Radiology,Radiography}, url = {https://www.traumamon.com/article_99998.html}, eprint = {https://www.traumamon.com/article_99998_2f8c142e2c88235e90bbfcd57183c112.pdf} } @article { author = {Saberi, Sadegh and Arabzadeh, Aidin and Farhoud, Amir Reza}, title = {Lunate Osteochondral Fracture Treated by Excision: A Case Report and Literature Review}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.22378}, abstract = {Introduction: Lunate fracture is a rare injury. Most reports are associated with other wrist injuries such as perilunate dislocation and distal radius fracture. Isolated lunate fracture has been reported even more rarely. The choice of treatment and outcomes are consequently undetermined. Case Presentation: In this case report we will describe a lunate avulsion fracture as an isolated injury after a fall from nine meters treated operatively by excision of the comminuted avulsed fragment. After 33 months of follow-up radiographs showed no sign of degenerative joint disorder on simple X-ray, but slight Volar Intercalated Segment Instability (VISI) by a capitolunate angle of 26 degrees was noted. Clinically, the patient was pain free near full wrist and forearm range of motion and could perform his previous vocational and recreational tasks without any limitations. Conclusions: Despite apparently good short and mid-term clinical outcome, slight volar intercalated segment instability after 33 months of follow-up revealed that lunotriquetral ligament function was probably lost, which led to static instability. This ligament injury may be missed primarily. Excision of the avulsed osteochondral fragment should be the last option of treatment and most attempts should be tried to fix and/or restore the normal anatomy of ligamentous structure.}, keywords = {Lunate,Osteochondral Fracture,Kienbock’s Disease,excision}, url = {https://www.traumamon.com/article_99999.html}, eprint = {https://www.traumamon.com/article_99999_abe03e94fb5c31abb185053eed2bbd88.pdf} } @article { author = {Golbakhsh, Mohammadreza and Sadaat, Mirmostafa and Noughani, Fatemeh and Mirbolook, Ahmadreza and Gholizadeh, Amirmohammad and Abedi, Sadegh}, title = {The Impact of Psychological Factors on Device Removal Surgery}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.25871}, abstract = {Background: Implant removal is a common procedure in orthopedic surgery which can be associated with many complications such as scar formation, hematoma, nerve injury, infection, and refracture. Indications for orthopedic implant removal have declined in recent years. Most studies have considered orthopedic hardware removal as an unnecessary procedure in the absence of severe complications such as nonunion. Some studies have reported the complications of orthopedic hardware removal to be 24% to 50% dependent on their types and locations as well as on other factors such as patient’s condition and the orthopedist’s experience. Objectives: The present study surveyed possible mental and psychological causes among patients who asked for removal procedures in spite of orthopedic surgeons’ advice and being aware of complications. Patients and Methods: Patients who had undergone plating for the treatment of radius and ulna fractures from 2011 to 2013, were told that it is not necessary to remove the plate and they were warned of all the risks of removal surgery, such as anesthesia, possible nerve or vascular damage, and the cost of surgery. Then, their tendency to remove the plate was examined based on evaluation criteria scores. Patients were divided into two groups: patients who insisted on surgery despite all the risks and patients who had little tendency or gave up after explanations. Both groups were given visual analog pain scale (VAS), symptom checklist-90 (SCL-90), and pain catastrophizing scale (PCS) questionnaires. The questions were explained for patients by an expert trained in the clinic and in case of ambiguity further explanations were given to the patients. The data were then entered into statistical package for the social science (SPSS) version 20 for analysis. Results: A total of 29 patients with plates were enrolled. The first group consisted of 16 male and 13 female patients. In the control group (group II), there were 30 patients with no tendency for plate removal. In this group, 15 patients were male and 15 were female. The mean age of the first group was 38.25 ± 11.12 years and for the second group it was 36.82 ± 12.01 years. There was no significant difference between the two groups in terms of age and gender. Mean discomfort of patients was 7.75 ± 1.74 in the first and 3.96 ± 1.90 in the second group, indicating a statistically significant difference (P = 0.000). Mean VAS score was 3.96±1.20 in the first group and 3.80 ± 1.15 in the second group, which was not statistically significant (P = 0.593). Mean daily pain and discomfort was 10.62 ± 3.09 hours in the first and 4.86 ± 2.23 hours in the control group, indicating a statistically significant difference (P = 0.000). Linear regression analysis results demonstrated a significant correlation between increased VAS scores in the first group (P = 0.000), but it was not significant in the second group (P = 0.083). The results also showed that increase in time of daily pain and discomfort had a linear relationship with increased discomfort score in both groups (P = 0.00). Mean pain catastrophizing scale (PCS) score was 10.13 ± 3.62 in the first and 9.56 ± 3.07 in the second group, which was not statistically significant. Mean somatization score was 52% ± 6.53% and 47.96% ± 7.17% in the first and second groups, respectively, which showed no significant differences (P = 0.013). Obsessive compulsive score was 54.63 ± 5.34 in the first and 46.63 ± 4.49 in the second group, which was statistically significant (P = 0.000). Conclusions: Mental and psychological backgrounds can affect the severity of discomfort of the implant. Given that so far the present study is the only study investigating the relationship between mental criteria and tendency of patients for implant removal, further studies with larger sample sizes seem warranted.}, keywords = {Psychological factors,Device Removal,Surgery}, url = {https://www.traumamon.com/article_100000.html}, eprint = {https://www.traumamon.com/article_100000_c725eab412540123e25035eb66b58f8a.pdf} } @article { author = {Bahador, Reza and Mirbolook, Ahmadreza and Arbab, Sara and Derakhshan, Pooya and Gholizadeh, Amirmohammad and Abedi, Sadegh}, title = {The Relation Between Reflex Sympathetic Dystrophy Syndrome and Trauma Severity in Patients With Distal Tibia Fracture}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.25926}, abstract = {Background: Reflex sympathetic dystrophy (RSD) syndrome is a multifactorial disorder with clinical features of neurogenic inflammation that causes hypersensitivity to pain or severe allodynia as well as blood flow problems, swelling, skin discoloration and maladaptive neuroplasticity due to vasomotor disorders. Patients with major trauma are prone to homeostasis leading to inflammatory response syndrome and multiple organ distress syndrome. Several studies have investigated the etiology of this condition, but the cause remains unknown. The role of associated factors such as the limb immobilization technique and genetics has been reported in the development of this complication, but, so far, there is no information regarding the effect of trauma severity on the risk of RSD occurrence. Objectives: Given the importance of diagnosing and treating this condition, we aimed to study the effect of trauma severity on the prevalence of RSD. Patients and Methods: In this cross-sectional study, we examined patients with distal tibial fracture who visited Rasht Poursina hospital from 2010 to 2013. Exclusion criteria included associated fractures, underlying musculoskeletal diseases and mental and cognitive problems. To assess the severity of the initial injury in patients, the Hannover Fracture Scale 98 (HFS98) scoring checklist was used. The diagnosis of RSD was made on the basis of the IASP criterion. Demographic data, HFS98 scores, and information regarding RSD prevalence were analyzed using SPSS version 20. The Mann Whitney U nonparametric test was used for variables that were not normally distributed; the chi-square test was used to compare the qualitative variables. Results: Among the 488 patients, 292 (59.83%) were male. The mean age of the study population was 44 ± 9.82 years. During the 6- month follow-up, RSD occurred in 45 patients, of whom 28 (62.22%) were female and 17 (37.77%) weremale; there was thus a significant difference in the prevalence of RSD in terms of gender (P = 0.00; chi square test). The mean HFS98 score in patients without and with RSD was 3.081±4.083 and 4.080±4.622, respectively, and the difference was not statistically significant (P = 0.363; Mann Whitney U test). Analyses of the eight items of HFS98 shows that local circulation in patients with RSD is significantly better than that in patients without RDS (0.683 ± 0.822 vs. 0.528 ± 0.629, respectively). Statistical analysis showed that the odds ratio for RSD for patients with HFS95 score > 0 was 1.079 (confidence interval [CI]: 0.898 - 1.333). Moreover, the odds ratio for RSD was 1.100 (CI: 795 - 1.531) in patients with an injury severity score higher than the calculated mean score in patients without RSD (> 4.083). Conclusions: The results suggest no significant relationship between the severity of injury and risk of RSD occurrence, although themean injury severity score was higher in patients with RSD than in those without RSD in this study population. The lower score of local circulation in patients with RSD than in those without RSD is a statistically significant finding and can be attributed to changes in the antioxidant levels at the injury site, which is one of themainmechanisms for the onset of RSD. Wound contamination was also justifiably higher in patients with RSD, although the difference was not statistically significant. In summary, the severity of injury alone cannot be a determining factor for predicting the probability of RSD.}, keywords = {Reflex Sympathetic Dystrophy,RSD,CRPS1,Trauma,Tibia}, url = {https://www.traumamon.com/article_100001.html}, eprint = {https://www.traumamon.com/article_100001_2bddefbf79e93f4684cc163444f5e29a.pdf} } @article { author = {Bagherifard, Abolfazl and Jabalameli, Mahmoud and Hadi, Hosseinali and Rahbar, Mohammad and Minator Sajjadi, Mohammadreza and Jahansouz, Ali and Karimi Heris, Hossein}, title = {Surgical Management of Tibial Plateau Fractures With 3.5 mm Simple Plates}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.26733}, abstract = {Background: Tibial plateau fractures can be successfully fixed utilizing 3.5 mm locking plates. However, there are some disadvantages to using these plates. Objectives: In the current prospective study, we investigated the outcome of treating different types of tibial plateau fractures with 3.5 mm simple plates which, to our knowledge, has not been evaluated in previous studies. Materials and Methods: Between 2011 and 2013, 32 patients aged 40 ± 0.2 years underwent open reduction and internal fixation for tibial plateau fractures with 3.5 mm simple plates. The patients were followed for 16.14 ± 2.1 months. At each patient’s final visit, the articular surface depression, medial proximal tibial angle, and slope angle were measured and compared with measurements taken early after the operation. The functional outcomes were measured with the WOMAC and Lysholm knee scores. Results: The mean union time was 13±1.2 weeks. The mean knee range of motion was 116.8°±3.3°. The mean WOMAC and Lysholm scores were 83.5±1.8 and 76.8±1.6, respectively. On the early postoperative and final X-rays, 87.5% and 84% of patients, respectively, had acceptable reduction. Medial proximal tibial and slope angles did not change significantly by the last visit. No patient was found to have complications related to the type of plate. Conclusions: In this case series study, the fixation of different types of tibial plateau fractures with 3.5 mm simple non-locking and non-precontoured plates was associated with acceptable clinical, functional, and radiographic outcomes. Based on the advantages and costs of these plates, the authors recommend using 3.5 mm simple plates for different types of tibial plateau fractures.}, keywords = {fracture,Osteosynthesis,Tibial Plateau,Internal Fixation}, url = {https://www.traumamon.com/article_100002.html}, eprint = {https://www.traumamon.com/article_100002_f976ccaef8e6fae77904daf0e2f4395b.pdf} } @article { author = {Elkhayat, Hussein and Nousseir, Hager}, title = {Fixing a Traumatic Sternal Fracture Using Stainless Steel Wires}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.27231}, abstract = {}, keywords = {Thoracic Injuries,Sternum,Fracture fixation,Internal}, url = {https://www.traumamon.com/article_100003.html}, eprint = {https://www.traumamon.com/article_100003_741151c15e609117d2e13ac7663edb14.pdf} } @article { author = {Abdollah Zadegan, Shayan and Ghodsi, Seyed Mohammad and Arabkheradmand, Jalil and Amirjamshidi, Abbas and Sheikhrezaei, Abdolreza and Khadivi, Masoud and Faghih Jouibari, Morteza and Tabatabaeifar, Seyed Mahmood and Sharifi, Guive and Abbaszadeh Ahranjani, Jalal and Motlagh Pirooz, Farhad and Tavakoli, Seyed Fakhredin and Mohit, Parviz and Alimohammadi, Yadollah and Rahimi-Movaghar, Vafa}, title = {Adaptation of Traumatic Brain Injury Guidelines in Iran}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.28012}, abstract = {Context: The National institute for health and care excellence (NICE) and scottish intercollegiate guidelines network (SIGN) are two well-known sources of clinical guideline development. In the past years, they have developed clinical guidelines for the management of head injury. In this report, we will highlight our modifications to these guidelines according to the domestic situation in a developing country. Evidence Acquisition: The guidelines were appraised using the appraisal of guidelines for research and evaluation (AGREE) instrument. All key recommendations were reviewed by 14 prominent Iranian neurosurgeons; levels of evidence were evaluated and items with limited evidence were determined. Available evidence for selected items were reviewed and discussed. Results: The following items were the most challenging when accounting for the domestic situation in Iran: age as a risk factor for referral, computed tomography scan, the impact of medical comorbidities, pregnancy, consultation, referral to a neurosurgical unit, and teleconsulting and observation before discharge. Conclusions: The evidence in the discussed topics was limited and controversial. This report is important because it exposes the current knowledge gap in head trauma studies in Iran.}, keywords = {Brain Injuries,Trauma,Practice Guideline,Referral and Consultation,comorbidity,Age Factors}, url = {https://www.traumamon.com/article_100004.html}, eprint = {https://www.traumamon.com/article_100004_6469ea84af7d651fe8cd1354ba7a67de.pdf} } @article { author = {Movahedinejad, Tayebeh and Adib-Hajbaghery, Mohsen and Zahedi, Mohammad Reza}, title = {A Study on Hospital Admissions For Eye Trauma in Kashan, Iran}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.28073}, abstract = {Background: Eye trauma is among the most common reasons for referral to hospital emergency departments and ophthalmologists’ offices. It also is a common cause of vision loss worldwide. However, few studies are available on the changes in the epidemiology of eye trauma in Iran in recent years. Objectives: This study aimed to investigate the characteristics of hospital admissions for eye trauma in Kashan from August 2011 to February 2014. Patients and Methods: A cross-sectional study was carried out on the hospital records of all patients with eye trauma who were admitted to Kashan’s Matini hospital between August 2011 and February 2014. Having an eye trauma and being hospitalized for at least one day was selected as the criteria for inclusion in the study. The data were then recorded on a checklist devised by the researcher. After entering the data into the SPSS software, descriptive statistics (i.e., percentage, frequency, mean, and standard deviation) were calculated for all variables. Chi-square, Fisher’s exact test, and Mann-Whitney U test were used to analyze the data. Results: In total, 200 patients with eye trauma had been hospitalized in Matini Hospital between August 2011 and February 2014. Of these patients, 86% were males, 40% were in the age range of 20-39 years, 68% lived in urban areas, and 21% of those in employment were manual and industrial workers. Approximately 38.5% of eye traumas had occurred in the work place; 72.5% of patients had penetrating injuries and 98% of cases were injured in one eye. More injuries occurred in the cornea (25.5%) than elsewhere in the eye, and 75.5% of patients were treated surgically. Among all variables, only the type of trauma (P = 0.009) and cause of trauma (P = 0.004) were significantly related to the patients’ gender. Conclusions: Eye trauma was prevalent among males, young people, urban residents, and manual and industrial workers. As the eyes play a vital role in daily life, communication, and work activities, and eye health is so important for individuals to attain high educational status and productivity, the public should be thoroughly educated about eye protection and the use of safety measures, especially in occupational activities.}, keywords = {Eye Injuries,Iran,Epidemiology}, url = {https://www.traumamon.com/article_100005.html}, eprint = {https://www.traumamon.com/article_100005_fc07b10e87e0a32e9a8d83123194150e.pdf} } @article { author = {Shabanikiya, Hamidreza and Abolghasem Gorgi, Hasan and Seyedin, Hesam and Jafari, Mehdi}, title = {Assessment of Hospital Management and Surge Capacity in Disasters}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.30277}, abstract = {Background: Hospital administrators play a key role in the effective management of surge capacity in disasters, but there is little information available about the characteristics required to manage this. Objectives: In this study, we aimed to identify characteristics of hospital administrators that are important in the effective management of surge capacity in disasters. Materials and Methods: This was a qualitative study. Semi-structured purposive interviews were conducted with 28 hospital administrators who had experience working in surge situations in hospitals during disasters. Framework analysis was used to analyze the data. Results: Three themes and 12 subthemes were identified. The themes were as follows: 1) crisismanagerial characteristics, 2) personal characteristics, and 3) specific requirements. Conclusions: In this study, some characteristics that had a positive impact on the success of a manager in a hospital surge situation were identified. These characteristics ought to be taken into account when appointing hospital administrators and designing training programs for hospital administrators with the aim of being better prepared to face disasters.}, keywords = {Characteristics,Hospital Administrators,Surge Capacity}, url = {https://www.traumamon.com/article_100006.html}, eprint = {https://www.traumamon.com/article_100006_0b11dbf225133af6c75428ae5a850090.pdf} } @article { author = {Bahadori, Mohammadkarim and Ghardashi, Fatemeh and Izadi, Ahmad Reza and Ravangard, Ramin and Mirhashemi, Sedigheh and Hosseini, Seyed Mojtaba}, title = {Pre-Hospital Emergency in Iran: A Systematic Review}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.31382}, abstract = {Context: Pre-hospital care plays a vital role in saving trauma patients. Objectives: This study aims to review studies conducted on the pre-hospital emergency status in Iran. Data Sources: Data were sourced from Iranian electronic databases, including SID, IranMedex, IranDoc, Magiran, and non-Iranian electronic databases, such as Medline, Embase, Cochrane Library, Scopus, and Google Scholar. In addition, available data and statistics for the country were used. Data Selection: All Persian-language articles published in Iranian scientific journals and related English-language articles published in Iranian and non-Iranian journals indexed on valid sites for September 2005 - 2014 were systematically reviewed. Data Extraction: To review the selected articles, a data extraction form developed by the researchers as per the study’s objective was adopted. The articles were examined under two categories: structure and function of pre-hospital emergency. Results: A total of 19 articles were selected, including six descriptive studies (42%), four descriptive-analytical studies (21%), five review articles (16%), two qualitative studies (10.5%), and two interventional (experimental) studies (10.5%). In addition, of these, 14 articles (73.5%) had been published in the English language. The focus of these selected articles were experts (31.5%), bases of emergency medical services (26%), injured (16%), data reviews (16%), and employees (10.5%). A majority of the studies (68%) investigated pre-hospital emergency functions and 32% reviewed the pre-hospital emergency structure. Conclusions: The number of studies conducted on pre-hospital emergency services in Iran is limited. To promote public health, consideration of prevention areas, processes to provide pre-hospital emergency services, policymaking, foresight, systemic view, comprehensive research programs and roadmaps, and assessments of research needs in pre-hospital emergency seem necessary.}, keywords = {Pre,Hospital Emergency,Iran,Systematic review}, url = {https://www.traumamon.com/article_100007.html}, eprint = {https://www.traumamon.com/article_100007_b05d98e1cebd3f0b99219944b832ac91.pdf} } @article { author = {Mahmoudi, Sadrollah and Taghipour, Hamid Reza and Javadzadeh, Hamid Reza and Ghane, Mohammad Reza and Goodarzi, Hassan and Kalantar Motamedi, Mohammad Hosein}, title = {Hospital Readmission Through the Emergency Department}, journal = {Trauma Monthly}, volume = {21}, number = {2}, pages = {-}, year = {2016}, publisher = {Official Publication of the National Center for Trauma Research}, issn = {2251-7464}, eissn = {2251-7472}, doi = {10.5812/traumamon.35139}, abstract = {Background: Hospital readmission places a high burden on both health care systems and patients. Most readmissions are thought to be related to the quality of the health care system. Objectives: The aim of this study was to examine the causes and rates of early readmission in emergency department in a Tehran hospital. Patients and Methods: A cross-sectional investigation was performed to study readmission of inpatients at a large academic hospital in Tehran, Iran. Patients admitted to hospital from July 1, 2014 to December 30, 2014 via the emergency department were enrolled. Descriptive statistics were used to summarize the distribution demographics in the sample. Data was analyzed by chi2 test using SPSS 20 software. Results: The main cause of readmission was complications related to surgical procedures (31.0%). Discharge from hospital based on patient request at the patient’s own risk was a risk factor for emergency readmission in 8.5%, a very small number were readmitted after complete treatment (0.6%). The only direct complication of treatment was infection (17%). Conclusions: Postoperative complications increase the probability of patients returning to hospital. Physicians, nurses, etc., should focus on these specific patient populations to minimize the risk of postoperative complications. Future studies should assess the relative connections of various types of patient information (e.g., social and psychosocial factors) to readmission risk prediction by comparing the performance of models with and without this information in a specific population.}, keywords = {HOSPITAL READMISSION,Emergency Patients}, url = {https://www.traumamon.com/article_100008.html}, eprint = {https://www.traumamon.com/article_100008_675350b50256b2f92b45bf78a13935bd.pdf} }