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Objective Methods Results Conclusion To survey the current structure, capability and operational scope of pre‐hospital and retrieval aeromedical teams across Australia.The medical directors of all Australian civilian adult aeromedical retrieval organisations with pre‐hospital teams and/or doctors for inter‐hospital critical care patient transport were contacted in a survey to qualitatively assess capacity and team structure.All 17 organisations contacted completed the survey. While there is diversity in team structure with the pairing of doctors, paramedics and nurses, capacity for patient care is generally homogenous. A doctor/paramedic model is the more common team structure for rotary‐wing missions, and doctor/nurse for fixed‐wing. Differences are mostly due to state government controlled aspects of their health services. An advanced degree of intensive patient care occurs outside of the hospital. Land and sea rescue is an important aspect of Australian aeromedical work.Aeromedicine in Australia has many consistent elements, but variable contexts have resulted in a diversity of operational models. [ABSTRACT FROM AUTHOR]

Purpose: Social media has become the new information acquisition platform for all content producers. In the current literature, there are no studies examining the content quality and the strengths and weaknesses of videos on Instagram that explain anterior cruciate ligament (ACL) injuries, which is the most discussed topic of sports surgery. The aim of this study was to evaluate the quality, strengths and weaknesses of information pertaining to ACL surgery that is disseminated on Instagram. Method: An Instagram search was conducted from 30 May 2023 to 30 January 2024. The search encompassed six languages (English, Spanish, German, French, Italian and Turkish) and was performed by six different observers. The investigation focused on eight subheadings derived from current literature on the ACL. These subheadings were addressed in Instagram videos, covering ACL biology or biomechanics, injury mechanism, injury prevention, injury evaluation, surgical technique, injury or surgery complications, injury rehabilitation process and return to sport or work. Result: The content was assessed of 127 videos from 127 Instagram accounts, spanning six different languages. Across the review of eight subheadings, the average number covered for the entire group was 3 (range, 0–8). Further analysis revealed that surgical technique was the most frequently mentioned subheading for the whole group (68.5%), followed by injury evaluation (54.3%). Prevention (10.2%) and complications (19.6%) were the least mentioned subheadings. The number of followers showed a correlation with video content quality. Conclusion: Although the video quality scores were found to be moderate, the content often focused on surgery and evaluation subheadings. The prevalence of incomplete information underscores the importance of developing strategies to ensure more comprehensive and accurate dissemination of medical knowledge. Level of Evidence: Level V. [ABSTRACT FROM AUTHOR]

Background/Aim Materials & Methods Results Conclusion The knowledge of dental students about managing traumatic dental injuries (TDIs) may not be uniform, depending on global location and dental education. The aim of this study was to evaluate the level of knowledge of undergraduate and postgraduate students specializing in endodontics and pediatric dentistry at 10 dental schools in 10 countries about the 2020 International Association of Dental Traumatology (IADT) guidelines regarding the management of TDIs.A previously published questionnaire was used in the current survey. It was an online survey with 12 questions regarding the management of TDIs and some additional questions regarding sociodemographic and professional profiles of the participants were added. The survey was distributed to final‐year undergraduate students and postgraduate students in pediatric dentistry and endodontics from 10 dental schools. Simple frequency distributions and descriptive statistics were predominantly used to describe the data. Differences in the median percentage scores among the student categories were assessed using the Kruskal–Wallis test followed by Dwass–Steel–Critchlow–Fligner pairwise comparisons.A total of 347 undergraduates, 126 postgraduates in endodontics, and 72 postgraduates in pediatric dentistry from 10 dental schools participated in this survey. The postgraduates had a significantly higher percentage score for correct responses compared with the undergraduates. No significant difference was observed between the endodontic and pediatric dentistry postgraduates.The knowledge possessed by undergraduate and postgraduate students concerning the IADT‐recommended management of TDIs varied across the globe and some aspects were found to be deficient. This study emphasizes the critical importance of reassessing the teaching and learning activities pertaining to the management of TDIs. [ABSTRACT FROM AUTHOR]

Introduction: Soft tissue defects around the ankle and posterior heel need stable flap coverage for proper healing and satisfactory recovery of function. Constant and reliable vascular supply of reverse sural island flap (RSIF) have made it a popular choice for reconstruction of these defects. In this study, the outcome of RSIF with few modifications in the pedicle area were discussed. Methods: This prospective study was carried out in National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka duing April 2019 to June 2020. Total 31 patients with soft tissue defect around ankle and posterior heel were reconstructed with reverse sural artery island flap. The soft-tissue defects were located, infront of ankle in 3 cases, over lateral malleolus in 7 cases, over medial malleolus in 5 cases, over tendoachilles in 12 cases, involving two or more areas of posterior heel, tendoachilles and lateral malleolus in 4 cases. Average Flap length and width were 9.67(+1.60) cm & 6.38(+0.76) cm respectively. Pedicle area of flap was modified by including a 2 cm skin extension in the middle along with additional adipofascial tissue on both sides to improve venous return. Pedicle length to width ratio was maximum of 3:1. Average length of pedicle was 7.2 + 1.7 cm. Results: All flaps except three survived completely without any complications. One patient (3%) had partial necrosis and another one (3%) had marginal necrosis of flap due to venous congestion. Epidermolysis was observed in 3% cases. Conclusions: The distally based superficial sural artery island flap is a versatile, reliable procedure useful in reconstruction of the lower extremity. Modifying the design of pedicle area increases safety by reducing venous congestion which ultimately leads to increase flap survivability. [ABSTRACT FROM AUTHOR]

Objective: In recent advancements in artificial intelligence, ChatGPT by OpenAI has emerged as a versatile tool capable of performing various tasks; however, its application in medicine is challenged by complexities and limitations in accuracy. This article aims to compare ChatGPT's performance with orthopedic residents at Gazi University in a multiple-choice exam to assess its applicability and reliability in the field of orthopedics. Methods: In this observational study conducted at Gazi University, 31 orthopedic residents were stratified by experience level and assessed using a 50-question multiple-choice test on various orthopedic topics. The study also evaluated ChatGPT 3.5's responses to the same questions, focusing on both the correctness and reasoning behind the answers. Results: Orthopedic residents tested, ranging from 6 months to 5 years in experience, scored between 23 and 40 out of 50 in a multiplechoice exam, with a mean score of 30.81, varying by seniority. ChatGPT provided correct answers for 25 out of 50 questions, showing consistency in different languages and times, but also exhibited limitations by giving incorrect responses or stating that the correct answer was not among the choices for some questions. Conclusion: While ChatGPT can accurately answer some theoretical questions, its effectiveness is limited in interpretive scenarios and in situations with multiple variables, although its accuracy may improve with updates over time. [ABSTRACT FROM AUTHOR]

Despite the questionable validity of online-based physician review websites (PRWs), negative reviews can adversely affect a provider's practice. Several investigations have explored the effect of extremely negative "one-star" reviews across subspecialties such as adult reconstruction, sports medicine, and orthopaedic traumatology; however, to date, no study has explored one-star reviews in foot and ankle surgery. The goal of this study was to characterize factors that contribute to extremely negative, one-star reviews for foot and ankle surgeons on Vitals.com. A retrospective analysis of negative one-star reviews with corresponding patient complaints for foot and ankle surgeons (both orthopaedic surgeons as well as podiatrists) in the United States. Physicians included were selected within a 10-mile radius of the top ten largest cities in the United States. Data was stratified by patient type (e.g., those receiving surgery and those not undergoing surgical intervention) and binned according to type of patient complaint, as previously described. Of the 2645 foot and ankle surgeons identified in our initial query, 13.8% of surgeons contained one-star reviews eligible for analysis. Patient complaints related to bedside manner and patient experience are the causative factors accounting for 41.5% of the one-star reviews of foot and ankle surgeons for nonsurgical-related complaints. Surgical complications and other outcomes-related factors comprised roughly 50% of the complaints related to surgical patients. In conclusion, complaints related to bedside manner and patient experience are the causative factors accounting for 41.5% of the one-star reviews of foot and ankle surgeons for nonsurgical-related complaints. Surgical complications and other outcomes-related factors comprised roughly half of the complaints related to surgery. This data serves to inform practicing foot and ankle surgeons as to the influences behind patients leaving extremely negative reviews on PRWs. IV [ABSTRACT FROM AUTHOR]

Self-alienation is an expression of deeply internalized shame. The self-alienated individual feels trapped, imprisoned by shame. Psychotherapy patients with significant relational trauma typically reveal a persistent internal battle against self-doubt, self-condemnation, and often self-loathing. They are referencing shameful fears and beliefs about themselves that are born from problematic attachment and developmental experiences. The author provides illustrations of work with self-alienated individuals integrating psychoanalytic principles with concepts from contemporary traumatology, with a focus on helping patients develop self-compassion as the chief agent of therapeutic healing and growth. [ABSTRACT FROM AUTHOR]

Purpose: Short-segment minimally invasive percutaneous spinal osteosynthesis has now become one of the treatments of choice to treat thoracolumbar fractures. The question of implant removal once the fracture has healed is still a matter of debate since this procedure can be associated with loss of sagittal correction. Therefore, we analyzed risk factors for kyphosis recurrence after spinal implants removal in patients treated with short-segment minimally invasive percutaneous spinal instrumentation for a thoracolumbar fracture. Methods: A total of 32 patients who underwent implant removal in percutaneous osteosynthesis for post-traumatic thoracolumbar fracture were enrolled in our study. Patient's medical record, operative report and imaging examinations carried out at the trauma and during the follow-up were analyzed. Results: Every patient experienced fracture union. Vertebral kyphotic angle (VKA) and Cobb angle (CA) improved significantly after stabilization surgery. VKA, CA, upper disk kyphotic angle (UDKA) and lower disk kyphotic angle (LDKA) significantly gradually decreased during follow-up. Traumatic disk injury (p: 0.001), younger age (p: 0.01), canal compromise (p: 0.04) and importance of surgical correction (p < 0.001) were significantly associated with kyphosis recurrence after implant removal. Anterior body augmentation did not affect loss of correction (CA and VKA) during the follow-up period (p: 0.57). Conclusion: Despite correction of the fracture after stabilization, we observed a progressive loss of correction over time appearing even before implant removal. Particular attention should be paid to post-traumatic disk damage or canal invasion, to young patients and to surgical overcorrection of the traumatic kyphosis. [ABSTRACT FROM AUTHOR]

Jacopo Berengario da Carpi was Renaissance-era physician, surgeon, and anatomy lecturer who transformed medieval anatomy and surgery—which were, at the time, dominated mostly by religious dogma—into a modern science based on direct observation, experience, and cadaveric dissection. He was an accomplished and innovative neuroanatomist and educator, a prolific researcher and publisher, and a successful practicing surgeon who treated the head injuries of many renowned patients of that period. He published a landmark commentary on skull fractures that was the first printed book in history devoted to head injuries, which became a model of new medical understanding. Nonetheless, Berengario's achievements in anatomy, medicine, neuroanatomy, and what would later become neurotraumatology and neurosurgery, would have been more widely known had his work and research not been surpassed by Andreas Vesalius and Ambroise Paré, both of whom advanced anatomic and medical knowledge even further. In this historical vignette, we discuss the political conditions of sixteenth Century Italy and pay a homage to Berengario da Carpi, emphasizing his work in establishing neuroanatomy as a field of medicine that became a precursor to modern neuroscience. We also describe the improvements he made in neurotraumatology technique and instrumentation, and his explanations of skull fractures and other brain injuries outlined in ground-breaking clinical books he published. Finally, we try to elucidate possible reasons why his scientific and professional achievements—despite of their enormous impact—were overshadowed by the achievements of his more famous immediate successors. [ABSTRACT FROM AUTHOR]

Background/Aim: Several publications highlight the insufficient knowledge possessed by dentists and dental students regarding the management of traumatic dental injuries (TDIs). A lack of clinical experience during Undergraduate (UG) education could explain the reported deficits in managing dental trauma post‐graduation. Despite its importance in dentistry, there are very few reports on how, where and who teaches Dental Traumatology (DT) in the UG curriculum. The aim of this study was to investigate teaching practices in DT around the world in UG education. Materials and Methods: UG educators involved in DT teaching activities were invited to complete an online questionnaire hosted on Qualtrics®. The survey consisted of close‐ended and open‐ended questions on their teaching practices in DT. Only one answer per institution was included in the final descriptive analysis. Results: A total of 203 responses from 164 institutions were obtained from 69 countries. All institutions reported that DT is included in their UG curriculum, and is mainly taught within Paediatric Dentistry and Endodontics. Most teaching and evaluation was delivered in traditional format. The number of contact hours dedicated to DT teaching activities ranged from 2 to 185 h (median = 10). Only 35% of institutions had a unified approach across disciplines. DT was taught as a separate course/module in 23% of the universities. Insufficient exposure to emergency care and the lack of formal clinical exposure to TDI was highlighted by many institutions. The need for a core curriculum was supported by 84% of the institutions with agreement on essential topics required at UG level. Conclusions: Teaching practices in DT varied internationally. Very few teaching hours were devoted to DT and many institutions identified a need for increased clinical exposure. There was a desire for a standardised coherent approach to DT in the UG education with suggestions to improve educational resources. [ABSTRACT FROM AUTHOR]

Background/Aim: The updated version of the International Association of Dental Traumatology (IADT) guidelines was published online in May 2020 in the form of four papers. They are extensively used in dental trauma education in textbooks, undergraduate and postgraduate programs, and clinical workshops. Hence, this study aimed to assess the impact, global scientific reach, and utilization of these guidelines through altmetric and citation analysis. Material and Methods: The protocol was prepared after an expert group discussion. Dimensions database was used to derive the altmetric and citation data on April 10th, 2023. The data was extracted by using a self‐designed pre‐piloted form by two authors independently. The citing articles were further categorized into the type of study and the domains and subdomains of dental traumatology. The VOSviewer program was utilized to explore the correlation between the subdomains and the overlap of citations was assessed by creating a citation matrix. Results: A total of 552 citations had been collectively received by the four papers. The highest was seen for the guidelines for fracture and luxation in permanent teeth (FL), avulsion in permanent teeth (AV), general introduction (GI), and primary teeth (PT). Dental Traumatology had the maximum number of citing papers for each guideline. They were from 52 countries with English being the commonest language. Overall, the maximum number of citations had been received in narrative reviews (n = 104) and the majority of cited papers were categorized in the therapeutic domains. The most common subdomain for the papers that cited GI, FL, and AV was "treatment protocols in permanent teeth", while it was "awareness of prevention and emergency management of traumatic dental injuries" for the papers that had cited PT. Conclusions: This analysis highlighted that the IADT 2020 guidelines are globally popular resources, which are widely used by the researchers across specialities and are intended towards clinical application. [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: Scaphocapitate syndrome is a rare clinical entity consisting of a combined scaphoid and capitate fracture along with a 90- or 180-degrees rotation of the proximal capitate fragment. The syndrome is scarcely described in the literature, with proximal migration of the capitate fragment being reported only by Mudgal et al in 1995. Concurrent compression of the median nerve is a highly unfortunate event, suggesting a unique case presented here. Case Report: We present a unique case of scaphocapitate fracture-dislocation in a 25-year-old man with volar dislocation of the capitate's fragment deep to the median nerve. X-rays and CT scan were performed and the patient was treated few hours after the injury by a hand specialist, in order to prevent median neuropathy and avascular necrosis of the fragment. Open reduction and internal fixation utilizing a Herbert screw for the scaphoid fracture and 3 additional K-wires was performed. Immediately post-operatively, the acute neurological symptoms had subsided and good reduction was acquired radiologically. One year post-operatively the patient had regained good hand and wrist functionality, with no extension or flexion ROM deficits. Conclusions: Immediate intervention in a specialized center with reduction and fixation utilizing a Herbert screw and K-wires showed favorable 1-year results in our case of scaphocapitate syndrome. The impending complications of median neuropathy and capitate avascular necrosis were avoided despite the high-risk injury pattern. [ABSTRACT FROM AUTHOR]

Introduction Aim Method Results Discussion Conclusions Using a duoethnological approach, supported by relational trauma theories, this paper synthesises idiosyncratic formulations and perspectives of working with relational trauma.Initially, focus is centred on reflecting on the authors' research with different and diverse groups. These include in‐reach rehabilitation and recovery services for people with profound and enduring mental health needs, as well as experiences of trauma, loss, grief and post‐traumatic growth of sanctuary seekers.Duoethnography, which is a collaborative research methodology that promotes introspection and critical reflexivity in researchers, was followed for over a year, and this provided rich data, which were analysed.Duoethnological dialogue offered rich data, which was conceptualised into four themes, which are presented and elaborated on: (i) the importance of the therapists acknowledging and witnessing meaning‐making with those who present with relational trauma and engaging with the evolving process of remembering, repeating and working through their trauma; (ii) the importance of therapists clarifying the aim or function of therapy from their modality; (iii) the importance of the idiosyncratic experiencing and processing of relational trauma; and (iv) the importance of the dynamic process and diversity of possible stages in working through relational trauma.These themes support an argument for a praxis of relational trauma and exploration of different approaches that may be helpful in therapeutic practice, training and psychotraumatology research.The paper concludes with reflections on how a human rights trauma‐informed approach entails facilitating hope in trauma work and offers recommendations for psychotraumatology therapeutic practice and trauma‐informed training. [ABSTRACT FROM AUTHOR]

In this study, forensic traumatology reports prepared in the emergency department were compared with reports of the same cases prepared by the forensic medicine polyclinic. The aim was to determine the extent of differences, discuss their causes and consequences, and provide solutions and recommendations. Retrospective analysis was conducted by comparing the demographic data, types of incidents, injury sites, and the forensicmedical evaluation results in the forensic reports prepared by emergency departments with those prepared by the forensic medicine policlinic for the same incidents. Of the 383 reports issued by the emergency department stating that the injuries were not of a nature that could be resolved with a simple medical intervention, reports of the same cases by the forensic medicine outpatient clinic revealed that 216 (56.4%) of these cases were, in fact, of a nature that could be resolved with a simple medical intervention. In 108 reports issued by the emergency department stating that injuries were life-threatening, 74 (68.5%) were assessed as non-life-threatening by the forensic medicine policlinic. It was observed that more errors were made in evaluations of intoxication and polytrauma cases conducted in the emergency department. It has been acknowledged that the majority of forensic reports prepared in emergency departments pose problems for the proper implementation of the legal process. To reduce or even eliminate errors and deficiencies in forensic reports, we believe that it is important to increase both the duration and quality of pre-graduate forensic medical education, as well as provide postgraduate training focused on responsibilities in forensic cases and medico-legal evaluation in trauma cases, particularly for emergency department physicians who bear a heavy burden of forensic report preparation. [ABSTRACT FROM AUTHOR]

Background: Bromelain and coumarins are recognized as safe and effective therapeutic agents, used by individuals to treat ailments such as postoperative edema, inflammation and other diseases. Bromelain has been proven to be well absorbed by the body after oral administration, and it has no major side effects even after prolonged use. The purpose of this study is to evaluate the effectiveness of bromelain and other nutraceuticals in reducing post-surgical swelling, pain and the need of anti-inflammatory drugs in maxillofacial post-traumatic surgery. Methods: This prospective open-label study was conducted on patients undergoing surgery for trauma of the maxillofacial area. One hundred patients were selected and divided into two groups: one group who underwent therapy with bromelain, Aesculus hippocastanum and Melilotus officinalis and a control group that was not given the drug in postoperative therapy. Results: Patients in the experimental group showed a reduction of edema in the first and second postoperative weeks, a faster complete reduction of facial edema and a lower reduction in maximum mouth opening and needed less anti-inflammatory therapy to control pain. Conclusions: These findings seem to provide evidence that Brovas® may be effective in improving postoperative edema outcomes in patients undergoing surgical treatment of facial fractures. [ABSTRACT FROM AUTHOR]

This study aimed to share our experience of a self-developed plate for acetabular fracture fixation through the presentation of clinical cases. Eight patients with complex acetabular fractures (Letournel classification) underwent surgery using a modified Stoppa approach and the novel plate design between 2021 and 2023 at the National Scientific Center for Traumatology and Orthopedics. Criteria such as the mechanism of injury, type of fracture, surgical approach, intraoperative and postoperative complications, quality of reduction, and functional and radiological results were evaluated. All patients included in the study presented complex types of acetabular fractures according to the Letournel classification. In all cases, surgical interventions were performed using a modified Stoppa approach. The assessment of reduction quality was conducted based on the radiological standards established by Matta. The reduction in quality was excellent in two patients, good in four, and satisfactory in two. One patient developed a post-traumatic false joint requiring additional surgery. The remaining patients achieved fracture healing with satisfactory Harris Hip Score (HHS) scores, indicating good overall function. The results of the self-developed plate for acetabular fracture fixation in our series were satisfactory. [ABSTRACT FROM AUTHOR]

Purpose: As tourniquets have been present in medicine since almost its conception, understanding and following their development through time is not only an exercise in history but also an insight into the evolution of medical devices over more than two millennia. From simple leather bands wrapped around patients' limbs to the modernised digital devices used widely in surgical theatres globally, tourniquets have undergone tectonic change both in their design and application, moving from battlefields to hospitals. Hence, the aim of this article is to outline the historical development of these devices alongside their present and modern use. Methods: The historical development of emergency and surgical tourniquets is chronologically outlined, with particular emphasis on the impact of warfare on their widespread adoption in trauma and emergency medicine and elective surgery. Novel surgical trends and their impact on the future of tourniquet use are evaluated. Results: The development of tourniquets across two millennia has closely reflected both the scientific understanding of human physiology and anatomy as well as technological discoveries and advancements that have reshaped their design and application. Prominent figures in the field of surgery, such as Sushruta, Fabricius Hildanus, John Louis Petit, Joseph Lister, Harvey Cushing and James McEwen, all fundamentally influenced their evolution and helped popularise and modernise them. The views on their use have been controversial and drastically changed across different eras, with data collected from modern warfare serving to embed their use in clinical practice. Conclusion: The historical development of tourniquets since pre-historic times represents an excellent outline of the adaptive nature of medicine, led, firstly, by scientific rigour and discipline and, secondly, by pioneers who serve as catalysts for change and improvement. The modern inflatable cuff tourniquets that are omnipresent in theatres globally will undoubtedly remain the standard of care for the foreseeable future. Tourniquets that can dynamically monitor blood pressure and consequently adjust inflation pressures, as well as ones with inbuilt axonal excitability monitoring, will further improve their safety profile, reduce associated complication rates and represent the next step in the evolution of these devices. Notably, there might be a shift away from tourniquet use altogether, reflected by the wide use of the wide-awake local anaesthesia no-tourniquet technique that has become the new norm in hand surgery. [ABSTRACT FROM AUTHOR]

The Japanese Urological Association's guidelines for the treatment of renal trauma were published in 2016. In conjunction with its revision, herein, we present the new guidelines for overall urotrauma. Its purpose is to provide standard diagnostic and treatment recommendations for urotrauma, including iatrogenic trauma, to preserve organ function and minimize complications and fatality. The guidelines committee comprised urologists with experience in urotrauma care, selected by the Trauma and Emergency Medicine Subcommittee of the Specialty Area Committee of the Japanese Urological Association, and specialists recommended by the Japanese Association for the Surgery of Trauma and the Japanese Society of Interventional Radiology. The guidelines committee established the domains of renal and ureteral, bladder, urethral, and genital trauma, and determined the lead person for each domain. A total of 30 clinical questions (CQs) were established for all domains; 15 for renal and ureteral trauma and five each for the other domains. An extensive literature search was conducted for studies published between January 1, 1983 and July 16, 2020, based on the preset keywords for each CQ. Since only few randomized controlled trials or meta‐analyses were found on urotrauma clinical practice, conducting a systematic review and summarizing the evidence proved challenging; hence, the grade of recommendation was determined according to the 2007 "Minds Handbook for Clinical Practice Guidelines" based on a consensus reached by the guidelines committee. We hope that these guidelines will be useful for clinicians in their daily practice, especially those involved in urotrauma care. [ABSTRACT FROM AUTHOR]

In the 1950s, the concept of artificial intelligence emerged, suggesting that machines could possess the ability to think and learn. In the 21st century, with advancements in GPUs and CPUs, deep learning has become an integral part of human life. Proximal femoral fractures are known to be one of the leading causes of mortality and injuries among the elderly population. This study aims to detect proximal femoral fractures in X-ray images and compare the success of using the YOLOv4 algorithm and provide decision support system within the diagnosis. To retrain the algorithm, more than 500 patients' X-ray images were examined. Through data augmentation techniques, the initial set of 410 patients' femur proximal fracture X-ray images was expanded to 820 images. After retraining the YOLO algorithm, two different groups were included for comparing the algorithm's performance: orthopedic specialists and general practitioners. The results from these three groups were evaluated using specific criteria. The YOLOv4 model demonstrated an accuracy of 90.33%. In comparison, orthopedic and traumatology resident doctors achieved an accuracy of 91.42%, while the general practitioner group achieved an accuracy of 81.30%. [ABSTRACT FROM AUTHOR]

Ankle fracture is the third most prevalent fracture in older adults. Wound dehiscence is the most frequent complication. Our objective is to determine the operative wound complication rate in patients with unstable ankle fracture in whom a prophylactic simple fasciocutaneous advancement was used. Prospective registry of patients with unstable ankle fracture, in whom a prophylactic fasciocutaneous advancement was performed between August 2020 and July 2021. Demographic variables, time spent in performing the flap, cost of osteosynthesis, minor and major complications of the surgical wound, readmission or reoperation were registered. 42 older adults with ankle fracture were included. Median age 69 (60−94). 31% diabetics and 21.5% active smokers. A 40% trimalleolar fracture pattern. There were 7% of superficial complications of the surgical wound. No major complications, no reoperations. Prophylactic fasciocutaneous advancement at the beginning of traumatological surgery is technically simple, reproducible, cheap and with low complications. Level IV, cross-sectional study. [ABSTRACT FROM AUTHOR]

Patient satisfaction is a complex concept influenced by various factors and is one of the most important indicators of the quality of patient care. Patient satisfaction is generally focused on whether the healthcare service rendered meets the patient’s expectations or how the patient perceives the service delivered because theories are insufficient to explain patient satisfaction. This study aims to test and investigate patient satisfaction in the orthopedic and traumatology departments of a public hospital. The study was conducted with 140 patients who were hospitalized in the orthopedics and traumatology ward in Istanbul, Turkey, between April and June 2022. Data were collected using a five-point Likert scale. Patients’ data were selected randomly, and patients who had the time and consented to participate in the study were selected. The patients were frequently satisfied with the nurses’ respect for their privacy (76.2%), their helpfulness (58.7%), and individual behavior (54.3%). It was determined that the orthopedic and traumatology patients participating in the study were very satisfied with the care they received. [ABSTRACT FROM AUTHOR]

Intracranial hemorrhages require an immediate diagnosis to optimize patient management and outcomes, and CT is the modality of choice in the emergency setting. We aimed to evaluate the performance of the first scanner-integrated artificial intelligence algorithm to detect brain hemorrhages in a routine clinical setting. This retrospective study includes 435 consecutive non-contrast head CT scans. Automatic brain hemorrhage detection was calculated as a separate reconstruction job in all cases. The radiological report (RR) was always conducted by a radiology resident and finalized by a senior radiologist. Additionally, a team of two radiologists reviewed the datasets retrospectively, taking additional information like the clinical record, course, and final diagnosis into account. This consensus reading served as a reference. Statistics were carried out for diagnostic accuracy. Brain hemorrhage detection was executed successfully in 432/435 (99%) of patient cases. The AI algorithm and reference standard were consistent in 392 (90.7%) cases. One false-negative case was identified within the 52 positive cases. However, 39 positive detections turned out to be false positives. The diagnostic performance was calculated as a sensitivity of 98.1%, specificity of 89.7%, positive predictive value of 56.7%, and negative predictive value (NPV) of 99.7%. The execution of scanner-integrated AI detection of brain hemorrhages is feasible and robust. The diagnostic accuracy has a high specificity and a very high negative predictive value and sensitivity. However, many false-positive findings resulted in a relatively moderate positive predictive value. [ABSTRACT FROM AUTHOR]

The number of general surgeons has decreased owing to specialization in the surgical field. Moreover, interest in the development of acute care surgeons is increasing. It is estimated that not many trauma surgical procedures are sufficient to train acute care surgeons in Japan. However, the actual status of trauma surgery in Japan remains unclear. This study aimed to clarify the actual condition of trauma surgery in Japan and to examine measures for training acute care surgeons and improving surgical outcomes. We analyzed trauma surgical procedures registered in the National Clinical Database between 2011 and 2016. The annual number of surgical procedures performed for trauma in the National Clinical Database increased. The surgical procedures for trauma accounted for only 3% of all National Clinical Database registrations. Moreover, the number of trauma surgical procedures for acute care surgery-certified surgeons in Japan was only 0.3%. Average mortality and morbidity rates were 8.3% and 22.5%, respectively. To train acute care surgeons and improve surgical outcomes, it is necessary to aggregate patients with severe trauma to designated facilities with trauma centers. We propose that National Clinical Database should be reformed to enable data collection and analysis of trauma surgery, including anatomical and physiological severity. [ABSTRACT FROM AUTHOR]

An instructional review of the anatomy, investigation, and management of scapholunate ligament injuries. Aimed at the knowledge level required for the trauma and orthopaedic FRCS examination. [ABSTRACT FROM AUTHOR]

Background: This study was designed to examine the effect of guided imagery applied to geriatric orthopaedic patients on preoperative anxiety and comfort. Methods: This study was conducted as a randomized controlled trial. The population of the study consisted of geriatric patients treated in the orthopaedics and traumatology clinic of a university hospital. The sample consisted of 80 patients, including the experimental group (n = 40) and the control group (n = 40). Personal Descriptive Form, The State–Trait Anxiety Inventory (STAI) and General Comfort Scale were used as data collection tools. Results: After the guided imagery application, it was determined that the anxiety of the experimental group decreased statistically significantly, and their comfort improved (P < 0.05). Conclusion: After the imagery, it was determined that the patients in the experimental group had a decrease in their anxiety level and an improvement in their comfort. Since it is a low‐cost and easily accessible method, applying imagery in the preoperative period is recommended. [ABSTRACT FROM AUTHOR]

Background/Aims: High methodological quality is required to interpret results of systematic reviews (SRs) in a reliable and accurate manner. The primary aim of this study was to appraise the methodologic quality of SRs with meta‐analysis within the field of traumatic dental injuries using the A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 tool and assess overall confidence in their results. A secondary aim was to identify potential predictive factors associated with methodological quality. Materials and Methods: SRs with meta‐analyses published in English in the field of traumatic dental injuries from inception to March 2023 were identified. The methodological quality of the included reviews was assessed using the AMSTAR 2 checklist. Two independent evaluators scored each AMSTAR 2 item as "yes" if it was adequately addressed, "partial yes" if it was partially addressed, and "no" if it was not addressed. The overall confidence in the results of each review was classified as "High," "Moderate," "Low," or "Critically low." Using multiple regression, the relationship between five predictor variables (journal impact factor, year of publication, number of authors, journal adherence to Preferred Reporting Items for Systematic reviews and Meta‐analyses [PRISMA] guidelines and a priori protocol registration) and the total AMSTAR 2 scores was analyzed. The p‐value was 5%. Results: Forty‐one SRs were included. The overall confidence in the results of 13 reviews was categorized as "Critically low," 18 as "Low," 3 as "Moderate" and 7 as "High." Among the five predictor variables analyzed statistically, impact factor of the journal and year of publication significantly influenced the total AMSTAR 2 scores. The number of authors, adherence to PRISMA guidelines, and a priori protocol registration had no significant impact on AMSTAR 2 scores. Conclusion: The overall confidence in the results of SRs with meta‐analysis within the field of traumatic dental injuries was "Low" or "Critically Low" in the vast majority of studies (31 of 41). SRs with meta‐analyses published in journals with higher impact factors and more recent publications had significantly higher methodological quality. [ABSTRACT FROM AUTHOR]

Introduction Mixed reality has been used in trauma and emergency medicine simulation for more than a decade. As mixed reality potential in trauma simulation continues to expand, so too does the need to validate it as a surrogate for real-life emergency scenarios. Validation of these simulations can occur by measuring fidelity, or the degree to which a computing system can reproduce real-world experiences. After performing a literature review, we determined that most fidelity assessments of trauma and emergency simulations focus on how the user subjectively experiences the simulation. Although subjective user assessment is an important component of determining fidelity, we pose an introductory three-part framework that may assess mixed reality trauma simulation more adequately. Materials and Methods A literature review was conducted using Google Scholar, PubMed, and the Uniformed Services University PowerER search database. Relevant articles were assessed to identify how studies measured fidelity in trauma simulation. We then designed the three-part framework to aid researchers in assessing the fidelity of mixed reality trauma simulations. Results The domains we determined to best assess mixed reality emergency simulation are as follows: 1. Continue assessing fidelity via subjective user assessments. This allows the researcher to know how real the simulation looked and felt to the user based on their individual report. 2. Determine whether the trauma simulation changes the medical decision-making capacity of the user. If the user's decision-making capacity changes with a stress-inducing trauma simulation versus a non–stress-inducing simulation, then the stress-inducing trauma environment would be approaching greater fidelity. 3. Study the domain of our newly proposed concept: physiologic fidelity. We define physiologic fidelity as the degree to which the simulation elicits a measurable, autonomic response independent of observed emotion or perceived affect. Recreating objective autonomic arousal may be the best way to ensure a trauma simulation reaches fidelity. Conclusion We propose a methodology to assess mixed reality trauma simulation fidelity. Once fidelity is more fully known to the researcher and the simulation user, adjustments can be made to approach reality more closely. Improved simulators may enrich the preparedness of both junior and senior learners for real-life emergencies. We believe assessing the three domains using the Wide Area Virtual Experience at the Val G. Hemming simulation center in Bethesda, MD, will validate mixed reality-trauma simulators as invaluable surrogates for real-life emergency scenarios and ultimately contribute to improved clinical outcomes for clinicians and their patients. [ABSTRACT FROM AUTHOR]

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD). [ABSTRACT FROM AUTHOR]

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD). [ABSTRACT FROM AUTHOR]

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD). [ABSTRACT FROM AUTHOR]

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD). [ABSTRACT FROM AUTHOR]

Purpose: Skin closure disorders in ankle surgery are a recurrent problem not only in traumatology but also in elective surgery. The aim of the study was to describe the anatomical basis of the fasciocutaneous vascularization of the lateral malleolus region to develop a posterior cover flap for the region. Methods: We dissected ten fresh frozen specimens after arterial injection of an Indian ink preparation and individualized the perforating arteries. Their positions and diameters were collated. Then, the surgical technique was clinically applied for two different cases by transferring the fasciocutaneous flap posterior to the lateral malleolus to cover a loss of skin substance. Results: There were in average 5 fibular perforators over the last 100 mm of the fibula. The average diameter of the first two perforating arteries was 0.6 ± 0.12 mm and 0.9 ± 0.25 mm, respectively, and the consistency of the latter makes it possible to produce a skin flap with anterior translation. This is an axial flap. Two patients were operated on using this technique. There was no necrosis of the posterior fibular flap and healing was achieved by the third post-operative week. Conclusion: This study showed the presence of fibular perforating arteries with a high reproducibility of their dissection. This anatomical description served as the basis for the description of a new distal fibular perforating flap. [ABSTRACT FROM AUTHOR]

Background/Aims: The Preferred Reporting Items for Case Reports in Endodontics (PRICE) 2020 guidelines were published to help authors produce high‐quality case reports. The aim of this study was to use the PRICE 2020 guidelines to appraise a sample of 50 case reports related to dental traumatology that were published before the guidelines were available in order to assess various parameters influencing the reporting quality. Methods: Fifty case reports published between 2015 and 2019 and related to dental traumatology were randomly selected from the PubMed database. Reports were assessed by two independent evaluators using the PRICE checklist. Each item received a score of "1" if the manuscript met all pertinent criteria, "0" if it was not reported, and "0.5" if it was reported insufficiently. "Not Applicable" (NA) was assigned to items that were irrelevant to a specific report. The estimated total PRICE score for each case report was computed by adding all the scores, with a maximum score of 47 minus any "NA" scores. Descriptive and Inferential statistics (Student's t‐test and ANOVA) were used for analysis. Results: The percentage of case reports that fully met each applicable criteria ranged from 0% to 100%. The percentage of case reports partially satisfying each applicable criterion varied from 0% to 88%. There was a significant difference in scores for case reports published in journals with an impact factor compared with those without (p =.042). No significant difference was observed between the mean scores that compared the period of publication. There was no significant difference between journals that followed the CARE guidelines and those that did not. Conclusion: Several items within the PRICE 2020 guidelines were either not reported or only partially reported in case reports related to dental traumatology prior to the checklist publication. It is recommended that authors follow the PRICE 2020 guidelines to improve the overall quality of their case reports. [ABSTRACT FROM AUTHOR]

(1) Background: Ankle fractures are common injuries that typically require surgical treatment. Complications may arise, leading to reinterventions with poor recovery and reduced quality of life for patients. The aim of this study was to determine the number of patients who underwent surgical reintervention for ankle fractures, characteristics, and associated factors. (2) Methods: A cross-sectional study was conducted to analyze the number of patients requiring surgical intervention for ankle fractures at General Hospital Zone No1 IMSS in Colima over a period of two years. The age, gender, comorbidities, laterality, cause of surgical reintervention, Weber classification, and elapsed time to reintervention were analyzed. (3) Results: A total of 33 patients were included in this study, of whom 63.3% were male, ranging in age from 18 to 51 years old. The predominant Danis–Weber classification for both sexes was suprasyndesmotic fracture (Type C). No established relationship was found between comorbidities and surgical reintervention; however, a significant relationship was observed between home accidents and the need for reintervention. (4) Conclusions: Reintervention in patients previously operated on for ankle fractures is more frequent in male patients and those who sustained the injury at home. [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: A retained ferrous intraocular foreign body (IOFB), introduced via penetrating ocular trauma, may result in ocular siderosis and visual loss that may occur after days or years. If diagnosis is delayed, therapy may also be delayed, resulting in a poor outcome. The present report presents the case of a 58-year-old man with a retained iron IOFB and late-onset siderotic glaucoma 1 month after the initial trauma. Case Report: A 58-year-old man presented with redness and eye pain in the right eye for 1 month after ocular trauma. His visual acuity was very good, with no sign of eye strain. High intraocular pressure had been detected for several weeks, but the B-scan ultrasound and fundus examination were normal and the reason for the high intraocular pressure was unknown. He was later transferred to our senior hospital. The diagnosis of IOFB was confirmed by computed tomography (CT) scan and ultrasound biomicroscopy (UBM). The patient was successfully managed by vitrectomy. Conclusions: This report highlights that a retained IOFB can be challenging to diagnose and that cases associated with siderotic glaucoma require multiple investigations. Early detection of the IOFB using the right tools is vital to reduce the risk of siderotic glaucoma. Although the fundus examination was normal after ocular trauma, the use of CT scan and UBM assisted in finding the IFOB and the patient was successfully treated by vitrectomy. [ABSTRACT FROM AUTHOR]

Objectives: Treatment of acromioclavicular joint dislocations vary. In this study, we aim to examine the functional results of patients who underwent hook plate fixation due to dislocation of acromioclavicular joint. Methods: We retrospectively observed 21 patients who had been treated with hook plate due to dislocation of acromioclavicular joint. At follow up, Constant-Murley scoring system was performed for shoulder function evaluation, while radiological results were performed by X-ray. Results: Seventeen of these patients were male and four were female. Eleven of these patients had Rockwood type 5 joint dislocation and ten had Rockwood type 3 joint dislocation. The mean age was 36.7 ± 13.37 years (range: 19-61 years). The mean follow-up period was 27.3 ± 19.3 months (range: 10-59). Constant-Murley shoulder scoring was excellent in 18 patients (93.6) and good (82.5) in 3 patients. While one patient had wound site infection and one patient had plate broken, no one had any neurological damage. Except for the failed implant, plate removal was not performed because the patients did not have plate-related complaints. At followup, it was observed that the acromioclavicular joint was in the reduced position on direct radiographs. Conclusions: We observed good clinical and functional results for the treatment of acromioclavicular joint dislocation with hook plate treatment. The hook plate method is a safe and effective method in the acute treatment of type 3-5 injuries according to the Rockwood classification [ABSTRACT FROM AUTHOR]

Étudier l'impact psychopathologique de l'exposition à la violence conjugale des parents chez les enfants et les adolescents en consultation de pédopsychiatrie et les facteurs associés à la capacité de résilience face à cette violence. L'étude était transversale sur un échantillon de 30 enfants et adolescents, âgés entre 6 et 18 ans, exposés à des situations de violence conjugale et suivis au service de pédopsychiatrie de Sfax. L'étude des répercussions psychopathologiques a été réalisée à partir des entretiens pédopsychiatriques. L'évaluation de la résilience a été effectuée par la Child and Youth Resilience Measure. Les enfants et les adolescents exposés à la violence conjugale étaient atteints de troubles liés à des traumatismes et à des facteurs de stress dans 40 % des cas, de troubles de l'humeur dans 33,3 % des cas et de troubles externalisés dans 6,6 % des cas. Il a été noté que les enfants étaient plus résilients, par rapport aux adolescents, dans le domaine des soins affectifs prodigués par leurs parents (12,66 ± 2,02 vs. 9,46 ± 2,69 chez les adolescents ; p = 0,001). Par contre, les adolescents étaient significativement plus résilients que les enfants dans le domaine des facteurs contextuels englobant la spiritualité (6,46 ± 1,4 vs. 4,53 ± 1,06 ; p = 0,000), l'éducation (11,13 ± 2,13 vs. 8,4 ± 1,54 ; p = 0,000) et la culture (11,13 ± 2,13 vs. 8,4 ± 1,54 ; p = 0,000). La scolarisation de l'enfant et l'absence de trouble psychiatrique chez la mère étaient associées à une meilleure résilience chez les enfants. L'exposition de l'enfant à la violence conjugale en étant à la fois témoin et victime était associée à une moindre capacité de résilience. L'exposition à la violence conjugale a un retentissement important sur la santé mentale des enfants qui y sont exposés. L'étude de la résilience et des facteurs qui y sont associés pourrait être ainsi utile afin de limiter les répercussions délétères chez les enfants et favoriser un développement harmonieux. Conjugal violence is a social problem whose impact extends beyond the couple, to the children who are exposed. To study the psychological impact of exposure to conjugal violence in children and adolescents in child psychiatry consultation and the factors associated with their capacity for resilience. We conducted a cross-sectional study on a sample of 30 children and adolescents, aged between 6 and 18 years and exposed to conjugal violence. Patients were recruited from the child psychiatry unit of the Hospital University of HediChaker of Sfax. We conducted clinical interviews to identify the psychological impact of conjugal violence on children. The resilience evaluation was done by self or hetero passation of the Child and Youth Resilience Measure (CYRM). Children and adolescents exposed to conjugal violence suffered from trauma-related disorders and stressors in 40% of cases, mood disorders in 33.3% of cases and externalized disorders in 6.6% of cases. We found that children were more resilient than adolescents in the area of emotional care provided by their parents (12.66 ± 2.02 vs. 9.46 ± 2.69 among adolescents; P = 0.001). In contrast, adolescents were significantly more resilient than children in the area of contextual factors including spirituality (6.46 ± 1.4 vs. 4.53 ± 1.06; P = 0.000), education (11.13 ± 2.13 vs. 8.4 ± 1.54; P = 0.000) and culture (11.13 ± 2.13 vs. 8.4 ± 1.54; P = 0.000). The child's education and good mental health for the mother were associated with better resilience in the children. The child's exposure to conjugal violence by being both a witness and a victim was associated with a reduced capacity for resilience. Exposure to conjugal violence has a significant impact on the mental health of children exposed. The study of resilience and associated factors could thus be useful in order to limit the deleterious repercussions on children and provide them with harmonious development both on the somatic and psychological levels. [ABSTRACT FROM AUTHOR]

Background: This systematic review summarizes recent literature on the use of extended reality, including augmented reality (AR), mixed reality (MR), and virtual reality (VR), in preoperative planning for orbital fractures. Methods: A systematic search was conducted in PubMed, Embase, Web of Science and Cochrane on 6 April 2023. The included studies compared extended reality with conventional planning techniques, focusing on computer-aided surgical simulation based on Computed Tomography data, patient-specific implants (PSIs), fracture reconstruction of the orbital complex, and the use of extended reality. Outcomes analyzed were technical accuracy, planning time, operative time, complications, total cost, and educational benefits. Results: A total of 6381 articles were identified. Four articles discussed the educational use of VR, while one clinical prospective study examined AR for assisting orbital fracture management. Conclusion: AR was demonstrated to ameliorate the accuracy and precision of the incision and enable the better identification of deep anatomical tissues in real time. Consequently, intraoperative imaging enhancement helps to guide the orientation of the orbital reconstruction plate and better visualize the precise positioning and fixation of the PSI of the fractured orbital walls. However, the technical accuracy of 2–3 mm should be considered. VR-based educational tools provided better visualization and understanding of craniofacial trauma compared to conventional 2- or 3-dimensional images. [ABSTRACT FROM AUTHOR]

Epidemiological data on the use of eye-related emergency services by children are limited. The objective of this study was to determine how COVID-19 affected the epidemiological trends of pediatric ocular emergencies. We performed a retrospective chart review of children under the age of 18 years who visited our eye-related emergency department between March 17 and June 7, 2020 and between March 18 and June 9, 2019. This was a descriptive and comparative analysis of the two study periods based on the demographic characteristics of patients and the diagnosis reported by the ophthalmologist in the digital medical charts. One of the investigators performed a second reading of the files to homogenize the diagnosis classification based on the most frequently found items. In total, 754 children were seen in our eye-related emergency department during the 2020 study period versus 1399 in 2019, representing a 46% decrease. In 2019, the four main diagnoses were traumatic injury (30%), allergic conjunctivitis (15%), infectious conjunctivitis (12%), and chalazion/blepharitis (12%). In the 2020 study period there was a significant decrease in the proportion of patients presenting with traumatic injuries (p < 0.001), infectious conjunctivitis (p = 0.03), and chalazion/blepharitis (p < 0.001). Consultations for chalazion/blepharitis were the most affected by the pandemic, followed by traumatic injuries (−72% and −64%, respectively). The proportion of patients who required surgery after trauma was higher in 2020 than in 2019 (p < 0.01), but the absolute number of severe trauma cases remained stable. The COVID-19 pandemic was accompanied by a decrease in the overall use of a pediatric eye-related emergency services in Paris. Visits due to benign causes and ocular trauma also decreased, but visits for more severe pathologies were not affected. Longer-term epidemiological studies may confirm or refute a change in eye emergency department use habits. [ABSTRACT FROM AUTHOR]

Thoracolumbar spine injuries are commonly seen in trauma settings and have a high risk of causing serious morbidity. There can be controversy when it comes to classifying thoracolumbar injuries within the spinal community, but there remains a need to classify, evaluate and manage thoracolumbar fractures. This article aims to provide a guide on classification of thoracolumbar spine injuries using the AO Spine Thoracolumbar Injury Classification System (AO TLICS). [ABSTRACT FROM AUTHOR]

Purpose: We propose to survey — even if arbitrarily — the publications in paediatric orthopaedics and traumatology that have had the greatest impact on the specialty during the period extending from the beginning of the COVID-19 pandemic in December 2020 and the end of all health restrictions in March 2023. Methods: Only studies with a high level of evidence or clinical relevance were selected. We briefly discussed the results and conclusions of these quality articles to situate them in relation to the existing literature and current practice. Results: Publications are presented by dividing traumatology and orthopaedics whose publications are further subdivided according to anatomical districts; articles concerning neuro-orthopaedics, tumours, and infections were presented separately while sports medicine is jointly presented with knee-related articles. Conclusions: Despite the difficulties encountered during the global COVID-19 pandemic (2020–2023), orthopaedic and trauma specialists, including paediatric orthopaedic surgeons, have maintained a high level of scientific output, in terms of quantity and quality of production. [ABSTRACT FROM AUTHOR]

Introduction: The treatment of facial bone fractures dates back to ancient civilizations, with various methods of prosthetic immobilization developed and in the second half of the 19th and the beginning of the 20th century. In our literature, there are almost no studies that examined the quality of life of patients with facial bone fractures, although worldwide this is an extremely current topic indicating the importance of this problem. Methods: This paper will present results from proffessional/scientific relevant data sources on the historical development of maxillofacial surgery with reference to etiology, epidemiology and instruments for assessing the quality of life of patients with jaw bone fractures. Topic: Medical treatment of these surgical injuries involves a highly specialized team led by a maxillofacial surgeon. This paper deals with the etiology, epidemiology and quality of life of patients with facial bone fractures. Conclusion: Surgical interventions for fractures of the facial bones are becoming more and more demanding, resulting in development of maxillofacial surgery as an independent branch. In the etiology of facial bone fractures, traffic accidents are mentioned more and more often as the main way of injury. The incidence of facial bone fractures in human pathology is about 30 per 100,000 hospitalized patients. Research has shown that the quality of life in operated patients with fractures of the facial bones is significantly lower than those operated on some other region. [ABSTRACT FROM AUTHOR]

Dental patient‐reported outcomes (dPROs) are self‐reported descriptions of a patient's oral health status that are not modified or interpreted by a healthcare professional. Dental patient‐reported outcome measures (dPROMs) are objective or subjective measurements used to assess dPROs. In oral healthcare settings, the emphasis on assessing treatment outcomes from the patient's perspective has increased and this is particularly important after traumatic dental injuries (TDIs), as this group of injuries represent the fifth most prevalent disease or condition worldwide. The purpose of this review is to summarize the current use of dPROs and dPROMs in the field of dental traumatology. Oral Health‐Related Quality of Life, pain, swelling, aesthetics, function, adverse effects, patient satisfaction, number of clinical visits and trauma‐related dental anxiety are the key dPROs following TDIs. Clinicians and researchers should consider the well‐being of patients as their top priority and conduct routine evaluations of dPROs using measures that are appropriate, accurate and reflect what is important to the patient. After a TDI, dPROs can assist clinicians and patients to choose the best management option(s) for each individual patient and potentially improve the methodology, design and relevance of clinical studies. [ABSTRACT FROM AUTHOR]

On 17 April 2019, a coach with tourists from Germany crashed in Madeira, requiring repatriation by the German Air Force. The Advanced Trauma Life Support (ATLS) concept was the central component of patient care. Data in Madeira were collected through a structured interview. The analysis of the Aeromedical Evacuation was based on intensive care transport records. In Germany, all available medical data sheets were reviewed for data collection. Quality of life (HRQoL) was evaluated by the 12-item Short Form Health Survey (SF-12). Twenty-eight prehospital patients were transported to the Level III Trauma Center in Funchal (Madeira). Five operative procedures were performed. Fifteen patients were eligible for Aeromedical Evacuation (AE). In the second hospital phase in Germany, in total 82 radiological images and 9 operations were performed. Hospital stay lasted 11 days (median, IQR 10–18). Median follow-up (14 of 15 patients) was 16 months (IQR 16–21). Eighty percent (8 out of 10) showed an increased risk for post-traumatic stress disorder (PTSD). Six key findings were identified in this study: divergent injury classification, impact of AE mission on health status, lack of communication, need of PTSD prophylaxis, patient identification, and media coverage. Those findings may improve AE missions in the future, e.g., when required after armed conflicts. [ABSTRACT FROM AUTHOR]

This joint report from the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP) aims for a consensus around the scientific rationale and clinical strategy for the management of osteoporotic patients affected by periodontitis who are undergoing anti-resorptive (AR) therapy to manage the risk of the occurrence of a medication-related osteonecrosis of the jaws (MRONJ). Osteoporosis and periodontitis are chronic diseases with a high prevalence in aging patients, and they share some of the same pathogenetic mechanisms based upon inflammation. Available evidence shows the relationship among osteoporosis, AR agents, periodontitis and implant therapy in relation to the incidence of MRONJ. Uncontrolled periodontitis may lead to tooth loss and to the need to replace teeth with dental implants. Tooth extraction and surgical dental procedures are recognized as the main risk factors for developing MRONJ in individuals taking AR therapy for osteometabolic conditions. Although the incidence of MRONJ in osteometabolic patients taking AR therapy may be as low as 0.9%, the increasing prevalence of osteoporosis and the high prevalence of periodontitis suggest that this potential complication should not be overlooked. Good clinical practice (GCP) guidelines are proposed that aim at a more integrated approach (prescriber, dentist, periodontist and dental hygienist) in the management of periodontitis patients undergoing AR therapy for osteometabolic disorders to reduce the risk of MRONJ. Dental professional and prescribers should educate patients regarding the potential risk associated with the long-term use of AR therapy and oral health behavior. Highlights: AR drugs such as bisphosphonates (BPs), denosumab (DNB) and romosozumab (RMB) are very effective in the treatment of osteoporosis and in the prevention of fragility bone fractures. Periodontitis is a widespread infective inflammatory disease that is the major cause of tooth loss, and it is strongly connected with other systemic diseases, including osteoporosis. MRONJ is a serious and rare complication associated with the use of AR drugs in osteoporotic patients. The reported incidence is rather low and ranges between 0.01 and 0.9%, but may be higher in the presence of comorbidities. Periodontitis and MRONJ share some risk factors, such as diabetes, smoking, steroids, cardiovascular diseases and rheumatoid arthritis. The risk of developing MRONJ in a case of successfully treated periodontitis is much lower than the risk of fragility fracture in a high-risk person such as one with a previous fracture. Oral and periodontal conditions should be assessed before starting an AR therapy, and local intra-oral inflammation should be brought under control. Periodontal therapy is effective at reducing the risk of teeth extraction and therefore the need for major bone reconstructive intervention and implant placement. Control of periodontal inflammation should be achieved and maintained over time in osteoporosis-affected patients treated with AR. Peri-implant diseases rather than dental implant placement may be considered a trigger for MRONJ; for this reason, periodontitis and peri-implant inflammatory disease control and the inclusion of patients in a supportive periodontal program are critical. AR therapy should not be discontinued or deferred by the dentist unless done in accordance with the prescriber. The suspension of BP therapy is not recommended on a routine basis, as BP binds to the skeletal sites and continue to be released for months or years after treatment, with a long tail effect on bone metabolism. DNB administration should not be withdrawn because the rebound effect may increase the risk of bone fractures. A therapeutic window in which to perform dento-alveolar surgical procedures is suggested. It is advisable to calibrate the timing of dental extraction and surgical procedures between the dentist and prescribers according to the oral condition, the general health condition, and the time and type of AR drugs used. A more integrated approach between prescriber, dentist, periodontist and dental hygienist should be encouraged, particularly in the management of periodontitis-affected patients who are taking AR drugs for osteometabolic disorders. Prescribers and dentists must educate patients regarding the potential risk associated with long-term use of AR therapy. [ABSTRACT FROM AUTHOR]

Background: The increase in orthopedic injuries after earthquakes imposes a significant burden on the health system. However, the impact of earthquakes on outpatient admissions remains unclear. This study compared patient admissions to the orthopedics and traumatology outpatient clinics before and after earthquakes. Methods: The study was conducted at a tertiary university hospital near the earthquake zone. In total, 8549 outpatient admissions were retrospectively analyzed. The study population was divided into pre-earthquake (pre-EQ) and post-earthquake (post-EQ) groups. Factors such as gender, age, city of origin, and diagnosis were compared between the groups. In addition, unnecessary outpatient utilization (UOU) was defined and analyzed. Results: The pre-EQ and post-EQ groups included 4318 and 4231 patients, respectively. The two groups had no significant differences in age and sex distribution. However, the proportion of non-local patients increased after the earthquake (9.6% vs. 24.4%, p < 0.001). UOU was the most common reason for admission in both groups. The distribution of diagnoses differed significantly between the pre-EQ and post-EQ groups, with an increase in the number of trauma-related diagnoses (15.2% vs. 27.3%, p < 0.001) and a decrease in UOU (42.2% vs. 31.1%, p < 0.001) after the earthquake. Conclusions: Patient admission patterns at orthopedics and traumatology outpatient clinics changed significantly after the earthquake. The number of non-local patients and trauma-related diagnoses increased, whereas the number of unnecessary outpatients decreased. Level of evidence Observational study. [ABSTRACT FROM AUTHOR]

Objective: Artistic swimming is a highly challenging discipline, requiring physical skills and creativity. There are almost no published data on trauma. We aimed to assess the incidence and the nature of injuries in artistic swimmers. Design: An 11-year retrospective single-center cohort study. Setting: Department of Sport Medicine of a University Hospital. Patients: One hundred and twenty-four elite female artistic swimmers aged 12.9 ± 1.6 years. Interventions: The cohort was divided into 3 groups according to the competition categories (from 9 to 12 years old called "future", 12-15 years old called "youth", 15-19 years old called "junior"). Main Outcome Measures: Injury rate per season and per athlete was assessed. Results: The injury rate was 0.95 injuries/season/athlete and 1.05 injuries/1000 hours of practice. The most frequent injuries were rotator cuff tendinopathy (13.6%), acute low back pain (13.6%), and patellofemoral syndrome (11.9%). Swimmers in the youth and junior categories had significantly more injuries than those in the future category (P = 0.009), possibly because of more training hours (P < 0.001). Twelve major injuries occurred, all in the same group of youth swimmers. Conclusion: This is the first study investigating trauma during artistic swimming practice. A better knowledge of the main injuries is necessary for the physician to provide optimal care for athletes and to develop prevention. Attention should be particularly paid to the swimmers' shoulders and knees. [ABSTRACT FROM AUTHOR]

• Sixty-eight point six percent of corneal transplant donors exhibited a time from the donor's death to the end of processing interval of up to 6 hours. • Over 94% demonstrated a cell density >2000 cells/mm². • With each hour-long increase in the time from the donor's death to the end of processing, cellularity decreased by 11.4 cells/mm². • Seventy point eight percent of brain death cases exhibited cellularity >2000 cells/mm². Corneal transplantation success depends on good practices in tissue selection and preservation. This study aimed to assess the relationship between the time from the donor's death to the end of processing and corneal cellularity provided by the Eye Bank. This was a retrospective study of 839 donor records (2013-2021) from the Eye Bank of the National Institute of Traumatology and Orthopedics, totaling 1445 corneas. Donors were classified based on cellularity (≤2000 and >2000 cells/mm2) and laterality. The dependent variable was cellularity in the right eye (RE) and left eye (LE), categorized into ≤2000 and >2000 cells/mm2 groups. Independent variables included sex, age, cause of death, and Δ-death. The statistical software SPSS 26.0 (IBM SPSS, Inc, Armonk, NY, United States) was used, and P < 0.05 was considered significant. Among 839 donors, most were male (58.2%) and ≥60 years old (36.5%). Brain death (BD) was the primary cause of death (66.2%). A time from the donor's death to the end of processing interval of ≥10 hours occurred in 35.6% of cases. Cellularity >2000 cells/mm2 was similar for the RE (94.5%) and LE (93.9%). Age showed statistical significance (P < 0.001) in both eyes, with cellularity decreasing for donors ≥60 years. In BD cases, higher cellularity was observed in the LE (P < 0.001; 70.8%). A time from the donor's death to the end of processing interval and cellularity comparison showed relevance for the LE (P = 0.03) but no association for the RE. Corneal cellularity decreased with increasing donor age. Significant differences in Δ-death were associated with cellularity, BD, and right and left cornea. [ABSTRACT FROM AUTHOR]

The scientific study aimed to explore the practical implementation of artificial intelligence (AI) technologies in radiology and traumatology for fracture detection, as well as evaluate their overall effectiveness in modern medicine. In recent years, AI has gained significant traction in the healthcare industry, enabling the analysis of patients' clinical data and facilitating disease diagnosis, monitoring, risk assessment, and surgical intervention possibilities. The relevance of the scientific work is in the gradual expansion of practical applications of artificial intelligence technologies in medicine, particularly in radiology for diagnosing fractures. The study aimed to investigate the practical effectiveness of AI technology in fracture detection on example of Hospital of Traumatology and Orthopaedics in Riga, Latvia. The methodological approach combined system analysis of AI system implementation in modern medical institutions for creating X-ray images with a clinical study of fracture diagnosis experience at the Hospital of Orthopedics and Traumatology in Riga, Latvia. Fractures were detected by radiologists, attending physicians, and the AI program, with comparisons made between them. Results were analyzed to assess the program's efficacy. The results of the study demonstrated the high effectiveness of AI technologies in fracture detection. The application of these systems in clinical practice led to a significant reduction in diagnostic errors (by 2-3 times) and an increase in diagnostic accuracy (from 78.1% to 85.2%). Moreover, AI systems proved to be capable of detecting fractures that were not initially identified during routine examinations by paramedics and medical practitioners. This emphasized the practicality of expanding the use of these systems in clinical practice. The practical significance of the obtained results is in their potential use in the development of software systems based on AI, aimed at enhancing fracture diagnosis in medical institutions. These findings provided valuable insights for further advancements in AI-based technologies for fracture detection. [ABSTRACT FROM AUTHOR]

Starting from freudian theory of trauma in two times (seduction theory and the concept of Nachtäglichkeit), the Author’s proposal is to extend temporal scansion into four times: 1) the impact of trauma; 2) the attribution of meaning to events and experiential context; 3) the “creation” of subjective and personal responses and finally 4) the stiffening of responses, i.e. structures and fixed procedures driving ideas and behaviors. Text goes on to explore the philosophy of the internal time (St. Augustine and Heidegger), that differs from the external time. Within this temporal framework, Author’s opinion is that trauma is not a “product” but a “process” that happens in the subject’s internal time. The patient’s stay on the temporal perspective of the past is named “selftrauma.” “Dwelling” in the house of mental past means “trauma” and stasis, on the contrary the mental future pertains to the time of change. That time where the subject reads his/her “trauma” in another way and consequently dissolves both the traumatical cores and his/her adopted static responses. [ABSTRACT FROM AUTHOR]