Optimal entry point for antegrade and retrograde femoral intramedullary nails / 中华创伤杂志(英文版)

Surgical management of femoral shaft fractures with intramedullary nails has become the standard of care, with multiple options for entry point described, including piriformis entry, trochanter entry and retrograde femoral nails. Our present review describes the surgical anatomy of the proximal and distal femur and its relation to different entry points for intramedullary femoral nails. In addition, we reviewed relative indications for each technique, difficulties associated and possible complications.

Trauma profile at a tertiary intensive care unit in Saudi Arabia

Trauma is a leading cause of death worldwide and in Saudi Arabia. This study describes the injury profiles and ICU outcomes of patients in a tertiary trauma care referral center in Riyadh, Saudi Arabia. A retrospective analysis of ICU data collected prospectively over 5 years in a 21-bed medical and surgical intensive care unit [ICU] in a tertiary care teaching hospital. We collected ICU data on all patients admitted secondary to motor vehicle accidents [MVAs], excluding patients younger than 18 years, brain dead patients and readmissions. We collected data on age, gender, and Glasgow coma scale score at admission, injury severity scores at admission, injury severity scores, Acute Physiology and Chronic Health Evaluation II [APACHE II] score, and other data. Multivariate logistic regression was used to identify predictors of mortality. During the study period, of 1659 patients, MVA was the most common cause of injury [78.4%], followed by pedestrian accident [12.7%]. ICU mortality included 221 patients [13.3%] during the study period. Severe head injury, age >60 years, Glascow coma scale score, injury severity scores, APACHE II and international normalized ratio were independent predictors of mortality. MVA is very common in our country and leads to significant mortality and morbidity. Public education and strict law enforcement are needed to reduce these adverse events