Evaluation of differences in injury patterns according to seat position in trauma victims survived traffic accidents / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Investigation of injury patterns epidemiology among car occupants may help to develop different therapeutic approach according to the seat position. The aim of the study was to evaluate and compare differences in the incidence of serious injuries, between occupants in different locations in private cars.</p><p><b>METHODS</b>A retrospective study including trauma patients who were involved in motor vehicle accidents and admitted alive to 20 hospitals (6 level Ⅰ trauma centers and 14 level Ⅱ trauma centers). We examined the incidence of injures with abbreviated injury score 3 and more, and compared their occurrence between seat locations.</p><p><b>RESULTS</b>The study included 28,653 trauma patients, drivers account for 60.8% (17,417). Front passenger mortality was 0.47% higher than in drivers. Rear seat passengers were at greater risk (10.26%) for traumatic brain injuries than front seat passengers (7.48%) and drivers (7.01%). Drivers are less likely to suffer from serious abdominal injuries (3.84%) compared to the passengers (front passengers - 5.91%, rear passengers - 5.46%).</p><p><b>CONCLUSION</b>Out of victims who arrived alive to the hospital, highest mortality was found in front seat passengers. The rate of serious chest injuries was higher as well. Rear seat passengers are at greater risk for serious traumatic brain injuries. All passengers have a greater incidence of abdominal injuries. These findings need to be addressed in order to develop "customized" therapeutic policy in trauma victims.</p>

The Little India riot: experience of an emergency department in Singapore

<p><b>INTRODUCTION</b>Singapore experienced its second riot in 40 years on 8 December 2013, in the area known as Little India. A retrospective review of 36 casualties treated at the emergency department was conducted to evaluate injury patterns.</p><p><b>METHODS</b>Characteristics including the rate of arrival, injury severity, type and location, and disposition of the casualties were analysed.</p><p><b>RESULTS</b>The injuries were predominantly mild (97.2%), with the most common injuries involving the head (50.0%) and limbs (38.9%). 97.2% of the casualties were managed as outpatient cases.</p><p><b>CONCLUSION</b>The majority of the injuries in this incident were mild and could be managed as outpatient cases. Important lessons were learnt from the incident about the utilisation of manpower and safety of staff in the emergency department.</p>

Características clinicoepidemiológicas del trauma maxilofacial por violencia física contra la mujer / Clinical and epidemiological characteristics of the maxillofacial trauma due to physical violence against the woman

Se realizó un estudio descriptivo y transversal de 576 mujeres con traumas bucofaciales por violencia física, atendidas en el Servicio de Urgencia de Cirugía Maxilofacial del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, desde enero de 2007 hasta diciembre de 2010, con vistas a caracterizarles según variables clínicas y epidemiológicas de interés para la investigación. En la serie predominó el grupo de 15-34 años, los celos y la embriaguez como móviles para el maltrato, así como el esposo y el exesposo como principales agresores; asimismo, los incidentes se desarrollaron mayoritariamente en el domicilio y en la vía pública, donde se empleó como mecanismo lesional primario el puñetazo y los golpes con objeto. Entre las lesiones bucofaciales de tejido blando sobresalieron las formas cerradas (hematomas y escoriaciones) y abiertas (laceraciones faciales no complejas); entre los patrones lesionales de tejido duro, las fracturas nasales y dentoalveolares.

A descriptive and cross sectional study of 576 women with orofacial traumas due to physical violence, assisted in the Emergencies Service of Maxillofacial Surgery from "Saturnino Lora Torres" Teaching Provincial Clinical Surgical Hospital in Santiago de Cuba was carried out from January of 2007 to December, 2010, with the aim of characterizing them according to clinical and epidemiological variables of interest for the investigation. The 15-34 years group, the jealousies and the alcohol consumption as causes for the abuse, as well as the husband and the ex-husband as main aggressors prevailed in the series; also, the incidents took place mostly at home and in the street, where the punch and the blows with objects were used as primary mechanism for the injury. Among the orofacial lesions of the soft tissue, the closed forms (hematomas and abrasions) and the open ones (non-complex facial lacerations) were relevant; among the injury patterns of hard tissue, the nasal and dentoalveolar fractures.

The Secondary Contiguous or Non-contiguous Subchondral Bone Impactions in Subaxial Cervical Spinal Injury: Incidence and Associated Primary Injury Patterns

PURPOSE: To evaluate the incidence of secondary contiguous or non-contiguous subchondral bone impactions (SBI) in subaxial cervical spinal injury and associated primary injury patterns. MATERIALS AND METHODS: A retrospective review of computed tomography, magnetic resonance imaging, and medical records was carried out for 47 patients who had sustained a subaxial cervical spinal injury. Presence, number, level, and sites of secondary contiguous or non-contiguous SBI were recorded. To evaluate primary injury patterns, the level and number of primary injury sites of subaxial cervical spine injury, injury morphology, anterior/posterior discoligamentous complex (ADC/PDC) injury, posterior ligamentous complex (PLC) injury, spinal cord injury, and mechanism of injury (MOI) were analyzed. Differences in primary injury pattern of subaxial cervical spine injury and MOI between patients with and without SBI, and between contiguous or non-contiguous SBI were analyzed using the Mann-Whitney U test, Pearson's chi square test and Fisher's exact test. RESULTS: Eighteen patients (18/47, 38.29%) had developed contiguous (n=9) or non-contiguous (n=9) SBI, most commonly involving T3 (15/47, 31.91%) and 3 levels (6/18, 33.33%). All SBIs had developed near the anterosuperior region of the body and the superior endplate and were the result of a high-impact MOI. SBIs were statistically significant in association with injury morphology and PLC injury (P=0.001, P=0.009, respectively) at the primary injury site. Non-contiguous SBI was more frequently accompanied by upper cervical spinal injuries in association with PDC injuries, as opposed to contiguous SBI, with statistical significance (P=0.009), while no other statistically significant differences were found. CONCLUSION: Secondary SBIs are common and probably associated with subaxial cervical spinal injuries with high energy compressive flexion forces.

An Analysis of the Victim's Identification Results from Commercial Aircraft Accidents in Guam

No abstract available.