Chinese expert consensus on emergency surgery for severe trauma and infection prevention during corona virus disease 2019 epidemic (version 2023) / 中华创伤杂志

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Application of lumbo-iliac fixation in pelvic ring reconstruction following communited Denis Ⅲ sacral fractures / 中华创伤杂志

Objective To study the anatomic morphology of posterior column of ilium(PCI)and valne of lumbo-iliac fixation(LIF)in pelvic ring reconstruction following communited Denis Ⅲ sacral fractures.Methods A total of 17 hemi-sectional pelvis and dry ilia were selected to observe the length,width and height(safety and standard)of PCI,when a detailed description was done on the methods determining entry point and operation techniqus for iliac screws anchoring.Nine patients with eommunited sacral fractures involving Denis Ⅲ areas combined with neurologic deficits were decompressed for recovery of neurological function and reconstruction of pelvic ring by using LIF.Postoperative follow-up was done on role of LIF and result of neural rehabilitation.Results PCI was mean 110.57 mm in length,24.24 mm in width,14.54 mm in standard height and 31.46 mm in safe height.Nine patients could turn over in bed immediately following operation and walk one month later.A follow-up for 13-37 months in eight patients showed stable reconstructed pelvic ring,sound function of movement and bone graft fusion,which met the target of keeping stability of fractured extremity and pelvis.Conclusions pCI can provide anatomic support for LIF.When decompression and fixation is needed for sacral fractures combined with anterior pelvic ring disruptions,LIP can provide stable fixation and play an important role in reconstruction,nursing and rehabilitation of pelvic ring.

Relevant research of spinal cord blood flow and the evoked potential by the extramarrow impacting / 中国矫形外科杂志

[Objective]To research the influence of spinal cord blood flow(SCBF) and the evoked potential(EP) by the extramarrow impacting and to explore the correlation and regularity between the spinal cord blood flow and evoked potential after spinal cord injury.[Method]Normal 120 SD rats were randomized into 4 groups,with 30 in each.Group A was the control group.In groups B,C,D,impacts of 10,15,20N were given to lamina respectively.The blood flow of impacting position and evoked potential were observed at different time points including 0 min,1 h,6 h,1 d,6 d,12 d,24 d.[Result]The blood flow of spinal cord represents a dimning trend with the impacting load raising.The blood flow of group A,had no marked change,the SEP and MEP also.The blood flow of group B represented a temporaly lowing,then recovered normal,the SEP and MEP also.The blood flow of group C and D represented a continuous lowing,then slowly raising.The group C recovered normal at 24d,the group D still lower than normal.[Conclusion]The impact load to lamina can influence the spinal cord function through altering the spinal cord blood flow.There is evident correlation between the SCBF and EP.