Uncommon Mechanism of Mangled Extremity; Three Cases of Rope Entanglement Injury of the Lower Leg

Rope entanglement injury is a rare entity. Previous reported studies mainly consisted of finger-related injuries. We describe three cases of rope entanglement injury of the lower leg. In the first patient, a belowthe- knee amputation was performed as the primary treatment for unilateral amputated lower limb. In the second patient, a below-the-knee amputation and perineal wound management were simultaneously performed. The third patient had vascular injury combined with internal soft tissue injury without related bone fracture. He suffered serious sequelae from a delay in transfer from a local hospital. Rope entanglement injuries of the lower leg do not present in a consistent manner, and the treatment of accompanying injuries should be considered from an early stage. Care should be taken to ensure that there are no internal injuries missed because the exterior appears to be stable.

The Efficiency of Ground Transport and Efficacy of Mobile Trauma Unit on the Inter-Hospital Transfer of Severe Trauma Patients

PURPOSE: The author's trauma center implemented Mobile Trauma Units (MTU), which are ground transportation automobiles constructed with advanced medical equipment, in an attempt to improve the survival rate of severe trauma patients. The purpose of this study was to examine the efficacy of MTU as a means of inter-hospital transfer of patients in urban environments. METHODS: Patients with an injury severity score (ISS) of 16 or more were enrolled in this study. The participants must also be patients who were transferred with the MTU in the 18 months between January 2017 and June 2018. To assess the survival probability, the revised trauma score (RTS), trauma and injury severity score (TRISS), and w-score were used as the outcome indices. RESULTS: Forty-four (86.3%) of the severe trauma patients with an ISS of 16 or more were male and 7 (13.7%) were female. The number of patients from the territory were 32 (62.7%), and patients from the others were 19 (37.3%). All the patients received their injury from blunt force trauma. The average time of from the scene of the accident to the trauma center was 176 minutes. In 13 deaths, 10 (76.9%) of the RTS values were below 4 points. Among the 51 patients, TRISS was more than 0.5 in 32 patients (62.7%). The w-score was 13.25 and the actual survival rate of a patient was 74.50%. CONCLUSION: Ground transportation automobiles that use MTU for severe trauma patients in urban areas are more economically beneficial and more efficient. The survival rate while using MTU was also shown to be higher than that of medical helicopter transfers.