https://www.traumamon.com/ Trauma Monthly en daily 1 Sun, 01 Nov 2026 00:00:00 +0330 Sun, 01 Nov 2026 00:00:00 +0330 https://www.traumamon.com/article_234047.html Introduction: Physical anthropometry, which includes the measurement of human anatomical structures such as lumbar vertebrae, is generally used to evaluate and measure human body dimensions. Its morphometry branch is used to define these structures. Today, the best standard for fusion inside the spine uses pedicular screw fixation. Objectives: This study aimed to analyze the three-dimensional tomography of the lumbar vertebrae based on gender and ethnicity in Gorgan, North of Iran. Methods: This descriptive-analytical study was performed on three different ethnical populations: Native Fars, Turkmen, and Sistani, which included 120 participants divided into three groups of 40 cases (20 females and 20 male), in the age group of 18-45 years, with the average heights of 165-180 cm for men and 165-170 cm for women.  The dimensions of the intervertebral discs, bodies, and foramina of lumbar vertebrae were determined from the main axial view by coronal and sagittal reconstruction in 1.5 mm slices by a Computed Tomography (CT) scan. Results: Based on the findings, differences were observed in the dimensions of intervertebral discs, bodies, and foramina of lumbar vertebrae based on gender and ethnicity using CT between the two genders (P<0.05). The above dimensions were higher in men than in women. The evaluation of the height and width of the vertebral body based on ethnicity showed a difference only in the width of the L1 lumbar vertebrae between Native Fars and Turkmen (P<0.05). Also, there were differences in the width of the foramina in the L3, L4, and L5 vertebrae among the Native Fars, Turkmen, and Sistani groups.   Conclusion: The present study found that dimensions of the intervertebral discs, bodies, and foramina of lumbar vertebrae were different based on gender and ethnicity, though, in terms of the lumbar disc, the difference was only observed in the two genders. https://www.traumamon.com/article_238162.html Introduction: Clinical education in trauma wards presents unique challenges for nursing internship students, which can adversely affect their learning outcomes and professional development. Understanding these challenges is critical to enhancing the quality of nursing education and student preparedness. This study aimed to explain the challenges faced by nursing internship students in trauma departments of hospitals not affiliated with Baqiyatallah University of Medical Sciences.Method: Seventeen participants, including 12 nursing trainees (mean age 22.3 years) and five clinical instructors (mean age 42.4 years), were purposively sampled to achieve maximum diversity. Data were collected through semi-structured interviews conducted in Tehran from September 2024 to December 2024. Conventional content analysis was conducted using the Graneheim and Lundman approach and MAXQDA version 10 software to identify categories and subcategories reflecting the participants' experiences.Result: In this study, 12 nursing students with a mean age of 22.3 and 5 nursing instructors with a mean age of 42.4 were identified. Their experiences of trauma ward challenges were categorized into three main categories and seven subcategories. The main categories included psychological factors with two subcategories: fear and stress of violence and high workload; organizational factors with three subcategories: irregular shuttle service, lack of staff familiarity with event recording objectives, inadequate facilities and equipment; and educational factors with two subcategories: poor collaboration between nursing staff and students, and limited time available.Conclusion:  Nursing trainees in trauma units face multifaceted psychological, organizational, and educational challenges that hinder optimal clinical learning. Addressing these challenges requires targeted interventions such as improving clinical staff awareness of students' educational goals, ensuring adequate resources, strengthening supportive relationships between staff and students, and optimizing logistical arrangements. Such measures can improve the clinical learning environment and better prepare students for professional roles in trauma care. Given that the study was conducted in selected trauma units affiliated with non-university hospitals in Tehran, the study's findings cannot be generalized to other healthcare settings. https://www.traumamon.com/article_238163.html Introduction: Drowning is a leading cause of unintentional injury-related deaths worldwide, with significant geographical variations in mortality rates. This study aims to identify high-risk drowning areas and assess epidemiological trends using Geographic Information Systems (GIS) from 2016 to 2022.Method: A cross-sectional analytical study was conducted using data recorded by the Emergency and Medical Incident Management Center of Gilan Province. A total of 588 drowning incidents were analyzed, considering variables such as age, gender, seasonality, and geographical location. GIS software was used to map high-risk areas using Spot and Heatmap techniques, while statistical analyses were conducted in Stata. The Odds Ratio (OR) index was used to assess risk levels.Result: Of the 588 reported drowning incidents, 497 were non-fatal, while 91 resulted in fatalities. The majority of incidents (474 cases) occurred in high-risk locations. Male individuals accounted for 77.21% of the total cases and 81.98% of fatalities, highlighting gender disparities in drowning rates. Rasht County recorded the highest number of fatalities (20 deaths), while Shaft and Sowme'eh Sara had zero reported drowning deaths. Geographic analysis using GIS mapping revealed that most drowning incidents occurred along the shorelines and river confluences, particularly in Bandar Anzali, Rasht, Astarabad, and Rudsar. Odds Ratio (OR) indicated that men had significantly higher drowning risks than women (OR = 2.57, 95% CI: 2.21–2.96), and drowning risk was notably elevated in coastal zones (OR = 3.19, 95% CI: 2.65–3.85)Conclusion:  Drowning mortality in Gilan Province is disproportionately higher among older men, primarily due to occupational exposure, risky behaviors, and environmental factors. Preventive measures such as enhanced safety regulations, swimming education programs, improved tourist signage, and stricter enforcement of occupational safety standards are recommended to reduce drowning incidents. Identifying high-risk zones through GIS analysis provides valuable insights for targeted interventions and policy development. https://www.traumamon.com/article_238166.html Introduction: This study aimed to determine the types of trauma inflicted on different areas of the body as a result of shotgun injuries, while also evaluating the diagnostic and therapeutic interventions performed.Method: This was a descriptive-analytical cross-sectional study conducted on individuals injured by a shotgun during the 2022 unrest in Tehran. A total of 180 individuals were included. Injured individuals were categorized into police or security and protester groups and compared in terms of type of injury and severity. Data were collected from hospital records, including demographic information, injured body areas, trauma-related complications, and diagnostic and therapeutic measures. The Injury Severity Score (ISS) and Abbreviated Injury Scale (AIS) were calculated based on available data. Statistical analysis was performed using SPSS software.Result: Out of 180 injured patients included in the study, 172 were male and eight were female. The mean age was 31.82 ± 11.47 years, ranging from 10 to 63 years. Among them, 106 were police or security personnel and 74 were protesters. The mean ISS for all patients was 1.48 ± 0.96. Comparison between the two groups showed that police or security personnel sustained more severe injuries (1.69 ± 1.24 vs. 1.18 ± 0.55; P = 0.01). Injuries to the head, face, neck, and chest were significantly more common among police or security personnel (P = 0.024), while abdominal, pelvic, and lower limb injuries were more prevalent among protesters (P = 0.015).  Imaging tools such as plain radiography and CT scans were used for diagnostic evaluation. All 21 cases of chest trauma were diagnosed by chest X-rays. Two cases required chest CT scans, which showed no lung or cardiac injury. In abdominal injuries, 51% of radiological assessments had positive findings. Among 40 cases of head and neck trauma, only one showed pellet penetration of the skull bone, and no brain tissue injury was observed. Regarding treatment, 42 patients (23.3%) required hospitalization, while 138 (76.7%) were treated on an outpatient basis. None required CPR or airway management.Conclusion:  Shotgun pellets has not high energy and usually cause minor injury but sometime may cause serious injuries. Removal during early hospitalization is not recommended. Deep pellets in limbs generally do not require removal unless surgery is indicated due to vascular or neurological damage. Chest injuries with deep or multiple wounds require more radiographic study. Deep or multiple wounds in the abdomen need additional evaluation to rule out serious intra-abdominal injuries. Greater caution is needed in managing facial and neck injuries, necessitating more intensive care. https://www.traumamon.com/article_236055.html Introduction: Traumatic experiences are commonplace worldwide and have been proven to have detrimental effects on health. Unlike traditional survival analysis, which focuses on a single endpoint, multistate models are beneficial for evaluating the progression of multiple health conditions over time. The primary goal of this paper is to employ a multistate model to ascertain the patterns in hospitalizations among traumatic patients.Method: In this longitudinal study, 502 eligible trauma patients who were referred to Shahid Rajaee Hospital in Shiraz, Iran, were chosen and followed from July 2018 to March 2019. A Semi-Markov Multistate model was utilized in the current study. Patients were assumed to transition between five states. Transition times (triage → general ward, triage → death, general ward → Intensive Care Unit [ICU], general ward → death, and surgical ward → death) were assumed to follow an exponential distribution. The hazard ratio (HR) for each covariate was estimated for each transition. Result: Based on in-hospital triage evaluations, some patients needed surgery. Injury Severity Score (ISS) more than 15 (HR= 1.41), blunt trauma with brain injury (HR=2.15), hypotension (HR=1.41), and low pulse rate (HR=1.40) increased the probable requirements of the surgery. Following surgical treatments, patients with moderate Glasgow Coma Scale (GCS) were more likely to die (HR=1.42). Further, those who had experienced blunt trauma and brain damage had a lower chance of death following surgery (HR=0.62). The need for intensive care directly after triage is more likely in cases with a severely low GCS score.Conclusion:  This study confirmed that elderly patients are at lower risk of surgical interventions after ICU. Cases with more injuries were more likely to require surgery after triage. Identifying specific prognostic factors that significantly impact the progression and outcomes of traumatic care can help healthcare providers prioritize interventions and allocate resources more effectively, ultimately enhancing patient outcomes. https://www.traumamon.com/article_234046.html Introduction: Although the importance of anatomical repair and fixation for syndesmotic injury has been emphasized, the best surgical approach remains a topic of discussion. This study sought to evaluate and compare the post-operative pain and surgical outcomes between screw fixation and the suture endobutton method in patients with Weber type C ankle fractures. Methods: A total of 56 consecutive patients with Weber type C ankle fractures participated in this prospective cohort study and underwent either screw fixation or suture endobutton surgery in 2022. Pain, infection, and the Foot and Ankle Outcome Score (FAOS) were monitored 3, 6, and 12 months’ post-operation. Results: The study included 14 women and 42 men, aged 18 to 47 years. There were no differences in age and sex between the two surgical groups. The pain score was significantly lower in the suture endobutton group compared to the screw fixation group three months after the operation (P=0.042). However, the two groups had no significant differences in pain scores at six and twelve months. Within each treatment method, the pain scores were statistically significantly different over time (Ptotal<0.001 in two groups). The suture endobutton method resulted in higher FAOS scores compared to the screw fixation method at three, six, and twelve months after surgery. The difference in this score within each group during the follow-up period was statistically significant (Ptotal<0.001 in two groups). Conclusion: The suture endobutton method has demonstrated advantages over screw fixation surgery. Patients have improved performance at three, six, and twelve months’ post-surgery, indicating that it may be a potentially superior approach to treating syndesmosis injuries. https://www.traumamon.com/article_238178.html Introduction: Trauma is one of the leading causes of death and disability worldwide. This study aimed to investigate the severity and patterns of trauma, as well as to analyze the treatment outcomes for victims of urban riots who were referred to a general hospital in Tehran from October to December 2022.Methods: This cohort study involved 1,032 individuals injured during urban riots, all of whom were referred to a Hospital in Tehran between October and December 2022. The severity of their injuries was assessed based on operational descriptions, CT scans of the brain and other organs, and ultrasound examinations, all of which were obtained from patient records. The likelihood of survival for each patient was calculated using the TRISS method.Results: One thousand thirty-two individuals were injured, consisting of 1,030 males and two females. The patients ranged in age from 14 to 65, with an average age of 30.9 ± 9.9 years (median age of 30 years). Among the injured, two people (0.19%) were aged between 0 and 15, 1,008 people (97.7%) were between 15 and 55, and 22 people (2.1%) were over 55 years old. The average Injury Severity Score (ISS) was 1.8 ± 3, with a median score of 1. The average survival probability of patients using the TRISS model was 99.487 ± 2.7%. The overall average TRISS score was 0.513 ± 2.7%.Conclusion: TRISS can be utilized to evaluate the quality of various programs, such as educational initiatives, the establishment of cardiopulmonary resuscitation teams, and trauma surgical teams. Given the potential for urban accidents, it is essential to develop trauma care protocols based on the severity of patients' injuries. Additionally, it is recommended to establish a trauma registration center that utilizes standard questionnaires and checklists. https://www.traumamon.com/article_238179.html The Zionist state of Israel struck the Islamic Republic of Iran on 13th June 2025 with sudden and unprovoked air attacks in a blatant act of aggression assassinating many military commanders, nuclear scientists, and killing civilians, mostly women and children. This 12 days of US-Israeli aggression also destroyed houses, apartments, schools, clinics, hospitals, industrial areas and defense and military facilities. It was condemned by the world community including UN. International Organizations should be reminded and are hereby emphasized to observe ethical and humanitarian principles in wars, especially not to harm relief and medical personnel. https://www.traumamon.com/article_240694.html Introduction: This study aimed to determine the effects of Scrophularia striata and adipose tissue–derived stem cells on the expression of Kruppel-like factor 4 (KLF4), monocyte chemoattractant protein-1, and brain-derived neurotrophic factor genes during pulp tissue regeneration.Methods: The methanolic extract of Scrophularia striata was prepared by maceration (Scro). Adipose tissue was harvested from the bilateral inguinal region of rats that did not undergo surgery, and adipose-derived stem cells (SC) were isolated and characterized. Pulp inflammation was induced in the rats, and pulpectomy was performed at the end of the second week. After placement of a triple-antibiotic paste for 2 weeks, regenerative treatment with drugs and materials was performed. The teeth were randomly divided into four groups (n = 4/group): (1) control (blood clot only), (2) Scrophularia alone (Scro), (3) stem cells alone (SC), and (4) Scrophularia + stem cells (SC+Scro). One to four weeks after tooth filling, the dental pulp was harvested from the animals. Real-time PCR was used to measure the expression levels of KLF4, MCP-1, and BDNF genes.Results: The highest level of KLF4 expression was observed in the SC group (P = 0.001), which was significantly reduced in the SC+Scro group compared with the SC group (P = 0.001). Injection of Scro significantly decreased MCP-1 gene expression compared with the control group (P = 0.001). Injection of Scro, SC, and SC+Scro significantly increased BDNF gene expression compared with the control group (P = 0.001). The highest BDNF expression was observed in the Scro group (P = 0.001), which was significantly reduced in the SC+Scro group compared with the Scro and SC groups (P = 0.001).Conclusion: Application of the Scro extract increased the expression of KLF4 and BDNF genes and decreased MCP-1 expression. Application of the Scro+SC combination increased the expression of KLF4, BDNF, and MCP-1 genes. https://www.traumamon.com/article_243073.html Introduction: Total hip arthroplasty (THA) is an effective treatment for advanced hip conditions, yet postoperative dislocation remains a major complication, especially in patients with spinal disorders. Altered spinopelvic alignment and reduced spinal mobility can lead to prosthetic instability. Given the growing prevalence of these coexisting conditions, this study aimed to develop a predictive model to identify individuals at increased risk of hip dislocation after THA in the presence of spinal abnormalities.Material and methods: This descriptive cross-sectional study was conducted over ten years until 2023 at shohada Hospital, including 225 patients (75 with spinal disorders and 150 controls) who experienced hip dislocation after total hip arthroplasty. Key variables such as demographic data, surgical factors, comorbidities, and medication history were analyzed. Two predictive models—logistic regression and elastic net regularization—were developed to identify dislocation risk factors, using SPSS and advanced statistical modeling techniques.Results: In this study, two predictive models were developed to assess postoperative hip dislocation risk in patients with spinal disorders. Model I, based on logistic regression, included 14 variables and showed moderate discrimination (C-index=0.67) but limited calibration and low R² (0.04). Model II, using elastic net regression, selected 9 key predictors—including hip rotation, anemia, BMI 30–35, and certain medications—and achieved better discrimination (AUC=0.73), though with similarly low explanatory power (R²=0.02).Conclusion:This study identified demographic variables (age, BMI), clinical factors (history of psychosis, preoperative anemia), surgical parameters (type of femoral fixation, preoperative hip internal rotation, surgical indication), and medication use (antiepileptic drugs, muscle relaxants, antidiabetic medications) as significant predictors of postoperative hip dislocation risk following total hip arthroplasty in patients with spinal disorders.Keywords: Total Hip Replacement, Hip Dislocation, Spinal Disorders, Predictive Model, prosthetic instability, https://www.traumamon.com/article_243074.html Background: Hallux valgus is a prevalent deformity of the forefoot, shown by deviation of the great toe (hallux) toward 2nd toe and prominence of metatarsal.The purpose of this retrospective study was to compare the efficacy, VAS pain scale, patient satisfaction of the cases of Chevron and Simple, Effective, Rapid, Inexpensive (SERI) surgical techniques in the correction and treatment of moderate hallux valgus.Methods: This is a retrospective comparative cohort study of 70 patients undergone surgery for correction of hallux valgus using one of 2 techniques (Chevron technique n=35, SERI technique n=35) at Baqiyatallah Hospital in the second half of 2022. The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured preoperatively and 1 year after the operation, using radiographic and medical records . The pain level of patients was evaluated using the Visual Analog Score (VAS) pain scale, as well as subjective satisfaction. Both were evaluated and documented in patients medical records. Results: In preoperative evaluation, the mean preoperative intermetatarsal angle (IMA) was 12.97 ±1.70 (11.27-14.67) in the SERI group and 12.08±1.24 (10.84 -13.32) in the Chevron group. The mean preoperative hallux valgus angle (HVA) was 32.80 ±3.26 (29.54-36.06) in the SERI group and 32.17±1.94 (30.23-34.11) in the Chevron group. In postoperative 1-year follow-up the mean preoperative intermetatarsal angle (IMA) was 8.14±1.50 (7.64-10.64) in the SERI group and 9.37±1.03 (8.34-10.40) in the Chevron group. The mean preoperative hallux valgus angle (HVA) was 10.28 ±1.60 (8.68-11.88) in the SERI group and 14.4±1.41 (12.99-15.81) in the Chevron group. Postoperative HVA and IMA measurements showed a statistically meaningful difference between the two groups (P < 0.05). Conclusion: SERI technique provides higher patient satisfaction and lower pain levels compared to the Chevron technique in 1-year follow-up. This study demonstrated better surgery outcome in the SERI technique for moderate hallux valgus.