Official Publication of the National Center for Trauma ResearchTrauma Monthly2251-746424220190301A Survey of Accidental Fall - induced Injuries and Mortality in a Central Trauma Hospital in Iran: 2015 - 20161610197910.5812/traumamon.14285ENMahnaz YadollahiTrauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-6434-0931Maryam ZamaniTrauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, IranKazem JamaliTrauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, IranAsieh MahmoudiTrauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, IranMohammad Ali RasaeeTrauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, IranAli KashkooeStudent Research Committee, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20200123<span class="fontstyle0"><strong>Background:</strong> </span><span class="fontstyle2">The increasing rate of fall - induced trauma cases leads to an increase in mortality rates and lengthy hospital stay across the globe. The current study aimed at investigating the fall - related mortality in the age - group of 15 years and over.<br /></span><span class="fontstyle0"><strong>Methods:</strong> </span><span class="fontstyle2">The current cross sectional study was conducted in 2016 on patients visiting Shahid Rajaee Hospital of Shiraz, Iran, for fall - induced injuries by census sampling method. The researchers completed a questionnaire including demographic data, accident type, and height of fall, duration of hospital stay, injured body regions, type of activity in time of accident, injury severity score, and death. Data were categorized and analyzed.<br /></span><span class="fontstyle0"><strong>Results:</strong> </span><span class="fontstyle2">There were 544 subjects in the current study, with a mean age of 49.3 </span><span class="fontstyle3">± </span><span class="fontstyle2">22.42 years; 67% of the patients were male and 33% female, and 74.8% were married; the gender ratio was 2.02. There was no significant difference between the mean ages of injured females (59.15 </span><span class="fontstyle3">± </span><span class="fontstyle2">21.43 years) and males (44.43 </span><span class="fontstyle3">± </span><span class="fontstyle2">21.03 years) (P = 0.92). There was a significant relationship between injury site and fall - related mortality in the age group of 60 years and over (P = 0.02). Most cases of falls occurred during daily and occupational activities, mostly in the evenings. Around 54.2% of the injuries included multiple - organ injuries. Fall - induced injuries were more severe among the age group of 15 - 40 years and patients over 60 years old.<br /></span><strong><span class="fontstyle0">Conclusions: </span></strong><span class="fontstyle2">According to the high mortality and severity of injuries in the more active age - group of the society (due to occupational activity), as well as the elderly, fall prevention plans seem a necessity among at risk groups.</span>Official Publication of the National Center for Trauma ResearchTrauma Monthly2251-746424220190301Field Hospital in Disasters: A Systematic Review1910198010.5812/traumamon.65126ENShahram ManoochehryTrauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IranEdris HoseinzadehEnvironmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranParisa TahaDepartment of Nutrition, Health Center of Shahrak-e-Cheshmeh, Iran University of Medical Sciences (IUMS), Tehran, IranHamid Reza RasouliTrauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IranSaman HoseinzadehSchool of Civil Engineering, Iran University of Science and Technology, Tehran, IranJournal Article20200123<strong><span class="fontstyle0">Background: </span></strong><span class="fontstyle2">Field hospitals (FH) can be mobile or fixed. The main goal of FHs is providing health care and preventing injuries caused by disasters or providing emergency medical operations. However, preparing a safe and fast-erupting structure and facility is very important.<br /></span><strong><span class="fontstyle0">Objectives: </span></strong><span class="fontstyle2">In this systematic review study, field hospitals are reviewed.<br /></span><span class="fontstyle0"><strong>Methods:</strong> </span><span class="fontstyle2">In the present study, a systematic reviewwas performed following the PRISMA guideline. To identify the articles, MEDLINE, web of science, Google scholar, PubMed, Persian journals and databases were searched to find related papers.<br /></span><strong><span class="fontstyle0">Results: </span></strong><span class="fontstyle2">After full text screening as the final screening step, 20 papers were entered in the study. Findings showed that structures used for establishing a FH are usually tents, using vehicles (trucks and buses), pre-fabricated steel, and concrete structures. The FHs were used for war and earthquake disasters. Conex, tent, steel, and concrete structure are the most used structures for FH in wars, while tents are the most common structure used for natural disasters.<br /></span><strong><span class="fontstyle0">Conclusions: </span></strong><span class="fontstyle2">The present study reviewed available reports on FH to collect useful data that should be focused on establishment of an FH suitable for a disaster. Furthermore, this study provides a list of the most important indexes that must be considered in proposing a type of FH. Tent structure was the most common structure for the establishment of FHs.</span>Official Publication of the National Center for Trauma ResearchTrauma Monthly2251-746424220190301Evaluation of Oral and Maxillofacial Trauma in Tehran from 2008 to 20161510198110.5812/traumamon.67802.ENFarzin SarkaratDepartment of Oral and Maxillofacial Surgery and Craniomaxillofacial Research Center, Dental Branch, Islamic Azad University, Tehran, IranMohammad Hosein Kalantar MotamediDepartment of Oral and Maxillofacial Surgery and Craniomaxillofacial Research Center, Dental Branch, Islamic Azad University, Tehran, IranHamidreza Mahaseni Aghdam Hamidreza Mahaseni AghdamHossein RastegarmoghadamshalduziCraniomaxillofacial Research Center, Dental Branch, Islamic Azad University, Tehran, IranJournal Article20200123<span class="fontstyle0"><strong>Background:</strong> </span><span class="fontstyle2">The management of maxillofacial injuries is one of the most common challenges in the healthcare field as surgeons, who treat these patients have additional responsibilities in terms of esthetic reconstruction as well as restoration of the patient’s appearance and function.<br /></span><span class="fontstyle0"><strong>Objectives:</strong> </span><span class="fontstyle2">The aim of the present studywas to evaluate the epidemiology and etiology of trauma at BualiHospital of Tehran during 2008 to 2016.<br /></span><strong><span class="fontstyle0">Methods: </span></strong><span class="fontstyle2">In this retrospective study, the files of all the trauma patients (n = 293) that had referred to Buali Hospital were investigated, and demographic data and etiologic factors were extracted. Radiographs were analyzed with regards to fracture patterns. The results were statistically analyzed using the SPSS 22 software.<br /></span><strong><span class="fontstyle0">Results: </span></strong><span class="fontstyle2">The mean age was 29.18 </span><span class="fontstyle3">± </span><span class="fontstyle2">14.74 years in males and 34.48 </span><span class="fontstyle3">± </span><span class="fontstyle2">19.81 years in females. Fractures were more frequent at ages between 21 and 30 years (39.9%) and less common among 71- to 84-year-olds (2.4%). Most patients were males (78.8%). Of all 474 fractures in 293 patients, zygomatic fractures were the most common fractures (18.6%), while Lefort III in the maxilla was the least common type (1.3%). The main cause of fracture was motor vehicle accidents (51.5%), whereas workplace injuries were uncommon (11.4%).<br /></span><strong><span class="fontstyle0">Conclusions: </span></strong><span class="fontstyle2">According to the results, fractures often occur in males in the third decade of life due to their roles in the community. In the current study, similar to other studies carried out in developing countries, the main cause of fractures was motor vehicle accidents. Most of the patients were treated by open reduction. The most frequent side effect was sensory disorders.</span>Official Publication of the National Center for Trauma ResearchTrauma Monthly2251-746424220190301Community Safety Walk-Rounds; An Extended Strategy for Community Safety Promotion1110198210.5812/traumamon.68278ENMohammad SaadatiRoad Traffic Injury Research Center, Tabriz University of Medical Sciences0000-0003-3047-5624Homayoun Sadeghi BazarganiRoad Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, IranJournal Article20200123No Abstract.Official Publication of the National Center for Trauma ResearchTrauma Monthly2251-746424220190301Successful percutaneous coronary intervention in a case of right coronary artery dissection after blunt chest trauma1510198310.5812/traumamon.69434ENSu Young YoonDepartment of Thoracic surgery, Chungbuk National University Hospital, Cheongju, South KoreaYoung Hoon SulDepartment of Trauma surgery, Chungbuk National University Hospital, Cheongju, South KoreaJin Bong YeDepartment of Trauma surgery, Chungbuk National University Hospital, Cheongju, South KoreaSeung Je KoDepartment of Trauma surgery, Chungbuk National University Hospital, Cheongju, South KoreaHong Rye KimDepartment of Neurosurgery, Chungbuk National University Hospital, Cheongju, South KoreaJung Hee ChoiDepartment of Anesthesiology and Pain Medicine, Chungbuk National University Hospital, Cheongju, South KoreaJang Whan BaeDepartment of Internal Medicine, Chungbuk National University, Cheongju, South KoreaSi Wook KimDepartment of Thoracic surgery, Chungbuk National University, Cheongju, South KoreaJin Young Lee Jin Young LeeJournal Article20200123<span><strong>Introduction:</strong> Coronary artery dissection after blunt chest trauma is rare, can lead to myocardial infarction, and be rapidly fatal if not appropriately diagnosed and managed. </span>
<span><strong>Case Presentation:</strong> We had experienced a case of right coronary artery dissection after blunt chest trauma. A 57-year-old female who complained of anterior chest wall pain after a traffic accident exhibited ventricular tachycardia and complete atrioventricular block with myocardial infarction. Right coronary artery dissection was detected by coronary angiography and was successfully treated by percutaneous coronary intervention.</span>
<span><strong>Conclusions:</strong> Blunt cardiac injury (BCI) is often difficult to diagnosis and a high index of suspicion is needed. Coronary angiography with revascularization should be performed immediately when coronary artery occlusion or dissection is suspected.</span>Official Publication of the National Center for Trauma ResearchTrauma Monthly2251-746424220190301Comparing Z-Plasty versus Z-Plasty and Skin Grafting for Surgical Tension-Free Treatment of Post-Burn Elbow Contractures: A Randomized Clinical Trial1510198510.5812/traumamon.82921ENSeyed Nejat Hosseini Seyed Nejat HosseiniMehran KhorramDepartment of Burns Surgery, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, IranMasoud VakiliDepartment of Health Education and Promotion, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, IranFarnaz SamaniDepartment of Anesthesiology, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, IranJournal Article20200123<span class="fontstyle0"><strong>Background:</strong> </span><span class="fontstyle2">Elbow contracture is a common incidence. It has surgical treatments such as scar release and skin graft, Z or V-Y plasty, and lateral or medial arm flap. In this study, we compared Z-plasty versus Z-plasty and skin grafting in the surgical tensionfree treatment of post-burn elbow contractures.<br /></span><span class="fontstyle0"><strong>Methods:</strong> </span><span class="fontstyle2">30 patients with elbow joint extension restriction participated in this randomized clinical trial in two groups: experimental (Z-plasty with skin graft) and control (Z-plasty alone) groups. In both groups, Z-plasty was designed with a 60 angle. In the experimental group, the flaps were rotated without tension, and then the upper and lower parts of the flaps were grafted by a midsplit-thickness skin graft. The surgery area was examined regarding infections, wound healing time, necrosis, and scar. Significant differences were evaluated using unpaired student </span><span class="fontstyle3">t</span><span class="fontstyle2">-test.<br /></span><span class="fontstyle0"><strong>Results:</strong> </span><span class="fontstyle2">Only seven participants in the control group had complications. The statistical analysis of all variables in both groups showed that Z-plasty with skin graft treatment had a significantly better result than the Z-plasty alone (P = 0.006). However, the two groups showed no significant differences in terms of infection, flap tip necrosis, surgery site infection, and feeling of pressure in joint extension or scar recurrence (P = 0.273).<br /></span><strong><span class="fontstyle0">Conclusions: </span></strong><span class="fontstyle2">Tension-free flap must be used in patients with mild or moderate wide elbow scar contracture. Combining Z-plasty with skin graft is easy and has better results than Z-plasty alone. It is recommended using this technique in patients with intraoperative flap tension.</span>Official Publication of the National Center for Trauma ResearchTrauma Monthly2251-746424220190301Impression of Delayed Pelvic and Acetabular Fracture Fixation on the Prevalence of Preoperative Venous Thromboembolic Events1510198610.5812/traumamon.84945ENMohamad Qoreishi Mohamad QoreishiDepartment of Orthopedics, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranSeyed Mahdi Hosseini KhamenehDepartment of Orthopedics, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranOmid JafariDepartment of Orthopedics, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranFarshad SafdariBone Joint and Related Tissues Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20200123<strong><span class="fontstyle0">Background: </span></strong><span class="fontstyle2">Pelvic ring fractures (PRF) and acetabular fractures (AF) are among the most challenging orthopedic injuries. These injuries usually involve operative fixation, with considerable delay after the accident. There are limited studies regarding the effects of delayed surgery on the risk of venous thromboembolism (VTE) in these patients.<br /></span><span class="fontstyle0"><strong>Objectives:</strong> </span><span class="fontstyle2">In this study, the effect of delayed fixation of PRF and AF on the risk of preoperative VTE was investigated.<br /></span><span class="fontstyle0"><strong>Methods:</strong> </span><span class="fontstyle2">There were 86 patients with PRF and/or AF enrolled in the current study. Preoperatively, the presence of deep venous thrombosis (DVT) was examined utilizing Color Doppler ultrasound (CDU). The time interval between accident and CDU was recorded (time delay). Finally, the time delay was compared between patients with and without DVT formation.<br /></span><strong><span class="fontstyle0">Results: </span></strong><span class="fontstyle2">The CDU revealed the presence of DVT in lower limb veins of 11 patients (12.8%). The time delay between the accident and CDU was significantly longer in patients with DVT formation (12.4 </span><span class="fontstyle3">± </span><span class="fontstyle2">4.1 days versus 7.6 </span><span class="fontstyle3">± </span><span class="fontstyle2">2.4 days; P < 0.001).<br /></span><strong><span class="fontstyle0">Conclusions: </span></strong><span class="fontstyle2">Delayed fixation of PRF and AFmay increase the risk of preoperative VTE. The authors suggest surgical fixation in these patients as soon as possible in cases without definite contraindication for early fixation.</span>