Trauma Commons^™

Lost Fractures: Prevalence And Risk Factors For Missed Costosternal And Costal Cartilage Fractures Among Patients With Radiologic Chest Wall Injury., Joseph D Forrester, Mohamad Abou Chaar, Andrew T Barnes, Zachary M Bauman, Samy Bendjemil, Nizama N Betts, Benjamin Christie, Raaga Dasari, Devoe Wb, Michelle J Earley, Bradley Faliks, Tracy J Johns, Connie Johnson, Michelle S Junker, Brian D Kim, Jonathan M King, Ariel Whitney Knight, Alexis A Schweibinz, Daniel Stephens, Mary Stuever, Simeng Wang

Trauma and Acute Care Articles

BACKGROUND: Costosternal cartilages and the costal margin, collectively termed costal cartilage, are hyaline cartilage connecting ribs to the sternum and to adjacent ribs, respectively. Presence of intact costal cartilage is essential for elasticity of the chest wall. Anecdotally, costal cartilage injuries are underdiagnosed on trauma CT scan in patients with rib fractures. Our aim was to determine a baseline frequency of acute costal cartilage injury among patients presenting with rib fractures.

METHODS: We performed a retrospective cohort study of injured adult patients admitted to Level I/II trauma centers with rib fractures from January 2020 to July 2024. CT images obtained …

Management Strategies For Traumatic Injuries In Pregnant Women: A Comprehensive Literature Review, Jaylyn D. Thompson, Jenna Zappetti, Clarence Julian Clark Ii

Rowan-Virtua Research Day

Introduction: Traumatic injuries in pregnant women are the leading cause of non-obstetric death and affect 6% to 8% of all pregnancies. Therefore, it is imperative to maintain updated guidelines to construct a framework for the optimal management strategies for traumatic injuries in pregnant women, considering the perspectives of obstetrics/gynecology, emergency medicine, and orthopedics.

Methods: To conduct this study, research was done via a database search through the Rowan-Virtua School of Osteopathic Medicine’s research library. PubMed was the sole database used to review 8 peer-reviewed sources. Articles that were published within the last 10 years were chosen.

Results: Every woman with …

An Opioid-Minimizing Multimodal Pain Regimen Reduces Opioid Exposure And Pain In Trauma-Injured Patients At High Risk For Opioid Misuse: Secondary Analysis From The Mast Trial, Constanza De Dios, Robert Suchting, Charles Green, James M Klugh, John A Harvin, Heather E Webber, Joy M Schmitz, Scott D Lane, Jin H Yoon, Angela Heads, Kandice Motley, Angela Stotts

Faculty, Staff and Student Publications

BACKGROUND: Screening to identify patients at risk for opioid misuse after trauma is recommended but not commonly used to guide perioperative opioid management interventions. The Multimodal Analgesic Strategies for Trauma trial demonstrated that an opioid-minimizing multimodal pain regimen reduced opioid exposure in a heterogeneous trauma patient population. Here, we assess the efficacy of the Multimodal Analgesic Strategies for Trauma multimodal pain regimen in a critical patient subgroup who screened at high risk for opioid misuse.

METHODS: The Multimodal Analgesic Strategies for Trauma trial compared an opioid-minimizing multimodal pain regimen (oral acetaminophen, naproxen, gabapentin, lidocaine patch, as-needed opioid) against an original …

The “Cushion Effect” Revisited:, George A. Flores, Annelyn Torres-Reveron, Raul Barreda

Research Symposium

Background: It is known the pattern and severity of injuries sustained during a motor vehicle accident depend on many variables. An interesting avenue for research is obesity as a positive or negative modifier for injury distribution patterns in MVA. We hypothesize that body mass index (BMI) will influence MVC related injury patterns.

Methods: We queried STRAC data for DHR - Edinburg for the years 2014 to 2018 using CPT codes for MVC/MVA, IS > 8, age 15 - 64. Interactions between injury location, BMI, seatbelt and gender were analyzed.

Results: We had 191 detailed crashes, we found increasing age to be …

Supporting Cardiac Perfusion By Preboa With Reduced Visceral Ischemia Despite Extended Occlusion, Paige Deville, John Hunt, Alan B. Marr, Lance Stuke, Patrick Greiffenstein, Jonathan Schoen, Alison Smith

School of Medicine Faculty Publications

No abstract provided.

Abdominal Vascular Injuries- What General/ Trauma Surgeons Should Know?, Zia Ur Rehman

Department of Surgery Docs

Abdominal vascular injuries are the common cause of death post-trauma. These are challenging injuries to manage due to severe haemodynamic instability, other associated injuries and difficulty in accessing and controlling these deep-seated vessels. Early control of bleeding can decrease mortality in these patients. Abdominal vasculature is divided into three zones, each requiring different operative strategy for exposure. Standard vascular surgery principles of achieving proximal and distal control before exploring any haematoma are followed when managing these injuries. Resuscitative endovascular balloon occlusion of aorta is a minimally invasive method of achieving proximal aortic occlusion. This also acts as bridge for definitive …

Long-Term Patient-Reported Outcomes And Patient-Reported Outcome Measures After Injury: The National Trauma Research Action Plan (Ntrap) Scoping Review, Juan P. Herrera-Escobar, Samia Y. Osman, Sophiya Das, Alexander Toppo, Claudia P. Orlas, Manuel Castillo-Angele, Angel Rosario, Mahin B. Janjua, Muhammad Abdullah Arain, Adil H. Haider

Section of General Surgery

Background: The aim of this scoping review is to identify and summarize patient-reported outcome measures (PROMs) that are being used to track long-term patient-reported outcomes (PROs) after injury and can potentially be included in trauma registries.
Methods: Online databases were used to identify studies published between 2013 and 2019, from which we selected 747 articles that involved survivors of acute physical traumatic injury aged 18 years or older at time of injury and used PROMs to evaluate recovery between 6 months and 10 years postinjury. Data were extracted and summarized using descriptive statistics and a narrative synthesis of the results. …

The National Burden Of Orthopedic Injury: Cross-Sectional Estimates For Trauma System Planning And Optimization, Molly P. Jarman, Michael J. Weaver, Adil H. Haider, Ali Saleem, Mitchel B. Harris

Department of Surgery Docs

Background: Management of orthopedic injuries is a critical component of comprehensive trauma care. As patterns of injury incidence and recovery change in the face of emerging injury prevention efforts and technologies and an aging US population, assessment of the burden of orthopedic injury is essential to optimize trauma system planning. We sought to estimate the incidence of orthopedic injury requiring emergency orthopedic surgery in the United States.
Methods: Using nationally representative samples from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project, we estimated the incidence of orthopedic injury, polytrauma with orthopedic injury, and emergency operative orthopedic …

Spinal Cord Trauma: An Overview Of Normal Structure And Function, Primary And Secondary Mechanisms Of Injury, And Emerging Treatment Modalities, Daniel Morin

Senior Honors Theses

The structures of the spinal cord and vertebral column are designed to provide flexibility, while still providing ample protection for the spinal cord deep within. While it does offer remarkable protection against most routine trauma, the spinal cord is still vulnerable to high-force etiologies of trauma and may become damaged as a result. These events are referred to as primary injury. Following the initial injury, the body’s own physiological responses cause a cascade of deleterious effects, known as secondary injury. Secondary injury is a major therapeutic target in mitigating the effects of spinal cord injury (SCI), and much research is …

Angioembolization Is Necessary With Any Volume Of Contrast Extravasation In Blunt Trauma., Ankur Bhakta, David S Magee, Matthew S Peterson, Michael Shay O'Mara

Trauma and Acute Care Articles

INTRODUCTION: Reduction of nonessential angiogram and embolization for patients sustaining blunt abdominal and pelvic trauma would allow improved utilization and decreased morbidity related to nontherapeutic embolization. We hypothesized that the nature of intravenous contrast extravasation (IVCE) on computed tomography (CT) would be directly related to the finding of extravasation on angiogram and need for embolization.

METHODS: A 5-year retrospective evaluation of trauma patients with IVCE on CT. Demographics, hemodynamics, and IVCE location and maximal dimension/volume were examined for relationship to IVCE on angiography and need for embolization. Primary complications were defined as nephropathy and acute respiratory distress syndrome.

RESULTS: A …

Intentional And Unintentional Poisoning In Pakistan: A Pilot Study Using The Emergency Departments Surveillance Project., Nadeem Ullah Khan, Ricardo Pérez-Núñez, Nudrat Shamim, Uzma Rahim Khan, Naureen Naseer, Asher Feroze, Junaid Abdul Razzak, Adnan A. Hyder

Department of Emergency Medicine

Background: Acute poisoning is one of the most common reasons for emergency department visits around the world. In Pakistan, the epidemiological data on poisoning is limited due to an under developed poison information surveillance system. We aim to describe the characteristics associated with intentional and unintentional poisoning in Pakistan presenting to emergency departments.
Methods: The data was extracted from the Pakistan National Emergency Department Surveillance (Pak-NEDS) which was an active surveillance conducted between November 2010 and March 2011. All patients, regardless of age, who presented with poisoning to any of Pakistan's seven major tertiary care centers' emergency departments, were included. …

Non Fatal Injuries Among Infants: A Pilot Study, Seema Zainulabdin Lasi, Ghazala Rafique, Habib Peermohammad

Human Development Programme

Objective: To determine the incidence, nature and the extent of infant injuries in two suburban and rural communities of Pakistan.
Methods: The cross-sectional study was conducted on a cohort of 310 infants in suburban and rural communities of Pakistan in September 2007. The information was collected from primary care-givers based on any injury that had occurred to their infants during the preceding 3 months that required treatment at home or in a hospital.
Result: The incidence of non-fatal injury for infants up to 1-year-old was found to be 19 injuries per 100 person (child) years of exposure (95% CI 9.90 …