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 …

Maternal Child Maltreatment And Intimate Partner Violence: Effects On Perceptions Of Infant Temperment And The Mediating Role Of Emotion Regulation And Responsiveness, Jewelian N. Fairchild, G. Anne Bogat, Amy K. Nuttall, Alytia A. Levendosky, Joseph S. Lonstein, Maria Muzik

Psychology Faculty Publications

Purpose

Maternal adverse experiences, such as maltreatment in childhood and later intimate partner violence (IPV) during pregnancy, can disrupt the mother-child relationship and influence maternal perceptions of infant temperament. The present study explored how these adversities influence mothers’ views of their infants’ temperaments and examined the role of maternal emotion regulation and responsiveness to their infants as mediators of these relationships.

Methods

Using data from a longitudinal study of highly stressed, vulnerable women, 355 mothers retrospectively reported on their own childhood maltreatment, as well as their experiences of IPV and emotion regulation during pregnancy. Maternal responsiveness was coded using mother-infant …

Migration Of Copper Bullet Fragment Through The Orbit And Conjunctiva, Maxwell A. Levi, Mehron G. Kouhestani, Giovanni Disandro, Peter A. Netland

Department of Ophthalmology Faculty Publications

This is a case report of a 31-year-old female who sustained a gunshot wound to the left orbit, resulting in a ruptured globe and retained bullet fragments extending into the frontal lobe. The patient underwent enucleation without orbital implant, and no metallic fragments were recovered intraoperatively. Three months later, she returned with bloody conjunctival discharge. Examination revealed a 1.25-cm copper-colored metallic bullet jacket fragment spontaneously protruding through the conjunctiva. Serial CT imaging confirmed anterior and inferior migration of the bullet fragment over time, with a total migration distance of 32.9 mm through the orbit. The shrapnel was removed in clinic …

A High-Stakes Landing: Traumatic Innominate Artery Injury After A Skydiving Accident, Claire G. Lewis Ms, Sarah Burki Md, Mahmound Alhusseini Md, Caroline K. Scruggs Md, Margaret L. Jackson Md, Steven Eisenberg Md, Anthony Estrera Md

Summer Research Program Abstracts

No abstract provided.

The Moderating Role Of Social And Emotional Support In The Association Between Adverse Childhood Experiences And Adult Mental Health Across Racial Groups: The Need For Investing In Social Capital, Syeda S. Jesmin, Aditya Chakraborty

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

The sustained impact of Adverse Childhood Experiences (ACE) on mental health outcomes in adulthood is well documented in the literature. ACE survivors may be especially vulnerable to poor mental health outcomes if they have limited or no social support. This study examined the moderating role of social support on the association of ACEs and mental health across different racial groups.

Methods

Data were obtained from the 2022 Behavioral Risk Factor Surveillance System (n = 14,327). The nine ACE questions about traumatic events in childhood were used to create ACE scores. Chi-square tests were used for bivariate comparisons. Both stratified …

Intimate Partner Violence And Brain Injury In Women: Understanding Prevalence, Symptomatology, And Consequences, Jacob T. Perez

Undergraduate Research Symposium

Intimate partner violence (IPV) refers to physical, sexual, or psychological harm caused by a current or former partner. While IPV can affect anyone, women are particularly vulnerable and disproportionately affected. Physical IPV often includes experiences of repeated trauma to the head, face, and neck, including strangulation. These injuries can result in a range of consequences, including comorbid conditions such as depression, PTSD, anxiety, and cognitive impairments, along with neurological effects like reduced brain connectivity and white matter integrity. Common brain injuries associated with IPV include traumatic brain injury (TBI), which results from blunt force trauma; subconcussive/repetitive blows, caused by head …

Traumatic And Incidental Diaphragmatic Hernias In Adults: A Case Series Highlighting Diagnostic Challenges, Surgical Management, And Postoperative Outcomes, Prajwal Chandrashekhara, Chanchal Raj Chhallani, Preethi Hiremath

Manipal Journal of Medical Sciences

Background:
Diaphragmatic hernia (DH) in adults, although uncommon, presents a significant clinical challenge due to its variable symptoms and potential for life-threatening complications. The condition can be either traumatic or congenital, and in some cases, it may be found incidentally during imaging for unrelated conditions. This case series aims to highlight the diverse clinical presentations, diagnostic challenges, surgical management strategies, and postoperative outcomes associated with diaphragmatic hernias in adults.

Methods:
We present four cases of diaphragmatic hernias diagnosed in adult patients, including both traumatic and incidental findings. Case 1 involves a 26-year-old male with a traumatic diaphragmatic hernia following a …

A Human Factors Analysis And Classification System (Hfacs) Approach To Compare Cardiovascular, Orthopedics, Trauma Care, And Neurosurgery, Asfandyar Khan

Doctoral Dissertations and Master's Theses

Background: Despite significant progress in patient safety, human error continues to occur at high rates in procedural settings. Traditional safety models tend to focus on retrospective incident analysis, often overlooking the systemic conditions that allow errors to occur. The Human Factors Analysis and Classification System (HFACS) offers a proactive lens to understand how and where errors emerge and is useful for identifying active and latent failures.

Objective: To evaluate the utility and reliability of the Human Factors Analysis and Classification System (HFACS) in categorizing and comparing the pattern of frequencies (events) in cardiovascular, orthopedic, trauma care, and neurosurgical procedure.

Design, …

The Revised Risk Analysis Index Outperforms The 5-Factor Modified Frailty Index In Predicting Postoperative Morbidity After Pilon Fracture Fixation., Gabriel Deoliveira, Amber Park, Arsalaan Sayyed, Aruni Areti, Nithin Gupta, Taylor Manes, Morgan Turnow, Benjamin Taylor, Jack W Weick

Trauma and Acute Care Articles

BACKGROUND: Pilon fractures often result from high energy mechanisms resulting in long-term morbidity and postoperative complications. While there is extensive literature investigating frailty scales as tools for preoperative risk stratification in orthopedic surgery, there is no literature regarding their use in fixation of pilon fractures. The objective of this study was to compare the predictive ability and discriminative accuracy of the Revised Risk Analysis Index (RAI-rev) and the 5-Item Modified Frailty (mFI-5) in 30-day postoperative outcomes following surgical fixation of pilon fractures.

METHODOLOGY: The ACS-NSQIP database was used to identify patients undergoing surgical fixation of pilon fractures from 2015 to …

Intracranial Pressure Monitor Insertion In Isolated Traumatic Brain Injury: Does Timing Matter?, Michael Gaziano, Peter Aziz, Alison Muller, Anthony Martin, Christopher Lawson, Eugene Reilly, Christopher Butts, Thomas Geng, Adrian Ong

Tower Health Research Day

No abstract provided.

Use Of An Electronic Medical Record Tool To Ensure Tertiary Survey Compliance In Pediatric Trauma Patients, Ryan T. Davis, Erica Surman, Begum Akay, Nathan Novotny, Anthony Stallion, Pavan Brahmamdam

Conference Presentation Abstracts

Introduction:
The purpose of the tertiary survey is to ensure that traumatic injuries that may be missed during the primary and secondary survey are identified and treated accordingly. After a review, our trauma program identified a quality gap where tertiary surveys were not being documented. The purpose of this study is to evaluate whether the use of an electronic medical record tool, in conjunction with a reporting process, improved documentation of the tertiary survey in pediatric trauma patients.

Methods:
A review of the pediatric trauma database was performed. Patients < 16 years old who were admitted after level 1 or 2 activations or trauma evaluations were included. The study period was between January 2023 and January 2024. An Epicâ„¢ SmartPhrase was developed with input from the pediatric surgery team, pediatric trauma nurse manager, and the general surgery residents. The residents and pediatric surgery attendings were educated and the smartphrase was implanted July 2023. Reviews were made on a month-to-month basis and if a patient did not have a tertiary survey documented, emails to the trauma attending and residents of record were sent, notifying them of missed documentation of a tertiary survey.

Results:
Tertiary survey documentation compliance in the six months prior to …

Expansion Of Hand Trauma Transfers At A Level 1 Trauma Center Following Integration With The Assh Hand Trauma Center Network, William Delahoussaye, Madeline Gautreaux, Patrick A. Palines, Ramin Shekouhi, Kelly L. Babineaux

School of Medicine Faculty Publications

Purpose: This study sought to evaluate how joining the National Hand Trauma Center Network (NHTCN) affected the volume, demographics, and severity of hand trauma transfers to our institution. Methods: Data for this study were collected retrospectively over a 6-year period from 2016 to 2021 from our institutional trauma registry. Patients were selected based on the criterion of being transferred to our facility because of isolated hand trauma. Analyses of transfer rates, transfer distance, sending facilities, injury patterns, insurance type, path of care, and hospital charges prior to and after joining the NHTCN were performed. Results: There was a total of …

Erector Spinae Plane Block For Preserving Pulmonary Function In Patients With Traumatic Rib Fractures, Dakoda Farrington

Lynchburg Journal of Medical Science

Rib fractures are frequently seen in trauma patients and are associated with increased mortality, primarily due to pulmonary complications. This study investigates the efficacy of erector spinae plane block (ESPB) in preserving pulmonary function in patients with traumatic rib fractures. A search was conducted in PubMed using the terms "erector spinae plane" AND ("rib fracture" OR "rib fractures") AND trauma. The results were filtered to include studies within the past five years, available full-text articles, and relevancy to this research question. Ultimately, five studies were isolated and included in this review. The methodology for measuring pulmonary function varied between the …

Perspective: Restoring Rest-The Critical Role Of Sleep In Foster Care Well-Being, Jill Mcleigh, Anna Wani, Likhita Shaik

Health Status, Outcomes, and Literacy and Healthcare Utilization

In 2023, approximately 400,000 children were in foster care in the United States, a population disproportionately affected by trauma, instability, and systemic inequities.1 These children face chronic disruptions in sleep—an essential physiological process that underpins physical development, learning, emotional regulation, and overall health.²⁻⁴ Adverse Childhood Experiences (ACEs), including abuse, neglect, and household dysfunction, are prevalent in this group and contribute to significant sleep disturbances through pathways of hyperarousal, stress dysregulation, and recurrent nightmares. 3,4 Understanding the interplay between foster care, social determinants of health (SDOH), and sleep health disparities highlights opportunities for targeted interventions to improve outcomes.

For questions about …

Differences In Emergency Department Imaging Modalities For Femur Fractures Based On Insurance And Demographics, Patrick De La Torre Schutz, Bryce M. Bellon, Daniel Salinas, Kelsey Baker, Hamaad Gohar

Research Colloquium

Insurance status and race have been significant predictors of delayed care and reduced imaging utilization in emergency settings, particularly among minority and Medicaid-insured populations (Moser, Shan). The reasoning for the disparities in treatment for these underserved populations is still not well understood. To further analyze these claims, this study examined whether demographic factors such as ethnicity, sex, age, insurance type, and fracture classification were associated with differences in imaging modality among patients with femur fractures. Data from the Texas Department of State Health Services Trauma Registry (2018–2022) was analyzed using logistic regression to determine the odds ratios of receiving CT, …

Interleukin-22 And Interleukin-22 Binding Protein Signaling Axis Influences Intubation Status In Trauma, Augustus E. Anderson, Jacob Broome, Aaron L. Albuck, Megan Shenk, Valeria Noguera, Wid Covey, Alison Smith, Juan Duchesne, Danielle Tatum, Christine M. Bojanowski, Derek Pociask, Jay K. Kolls, Olan Jackson-Weaver, Sharven Taghavi

School of Medicine Faculty Publications

Background: Interleukin-22 is a cytokine involved in mucosal immunity, whereas interleukin-22 binding protein is a soluble receptor that can potently block interleukin-22. The role of interleukin-22 and interleukin-22 binding protein in trauma remains unclear. This study investigates whether IL-22 levels are associated with intubation in patients with trauma. We hypothesized interleukin-22 levels would be lower in intubated patients. Methods: Plasma samples were prospectively obtained in the trauma bay at consecutive Level 1 activations from November 2021 to November 2022. Patients were categorized as having respiratory failure (intubated) or as controls (nonintubated). Two-to-one case-control matching was conducted based on age, sex, …

A Religious Etiology Of Genito-Pelvic Pain And Pain With Penetration, Emily L. Carlson

Theses and Graduate Projects

Pelvic pain during penetration (PPDP) has been described using various diagnostic terms, including vaginismus, dyspareunia, and vulvodynia. The most recent and comprehensive classification is Genito-pelvic pain/penetration disorder (GPPPD) which is characterized by psychological distress associated with pain during or in anticipation of vaginal penetration (DSM-5-TR; American Psychiatric Association [APA], 2022). The etiology of PPDP is multifactorial, involving a complex interplay of biological, psychological, and relational factors. Religious and cultural influences may play a significant role in shaping individuals’ experiences of sexual pain. This study investigated the etiology of PPDP in relation to the religious influences among women raised in Judeo-Christian …

Hormonal Modulation Of Sexual Approach And Avoidance Among Women With A History Of Sexual Trauma, Anneliis Susan Sartin-Tarm

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

A history of sexual trauma places women at a high risk for sexual dysfunction and other health sequelae, yet the influence of ovarian hormones in this population is poorly understood. This dissertation tested the theory that the effects of ovarian hormones are mediated by cognitive approach-avoidance systems to shape sexual well-being, and that this process is moderated by sexual trauma history. This was investigated across three studies examining the menstrual cycle, hormonal contraceptive use, and menopause. Across each chapter, I present complementary evidence demonstrating that hormones interact with the interpretation of ambiguous internal and external cues with respect to sexual …

Chronic Pain After Traumatic Brain Injury: Treatment Experiences And Effects On Cognition And Functioning, Rachael L. Snyder

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Traumatic brain injury (TBI) can contribute to changes in cognitive and emotional functioning, quality of life, and psychosocial reintegration. Chronic pain is a common consequence of TBI which can uniquely impact such outcomes. Still, the exact nature of the contribution of pain on post-TBI outcomes remains unclear, and there are few existing studies exploring the treatment journey for chronic pain and injury rehabilitation through qualitative methods, specifically individual interviews with TBI survivors. This study aimed to document these narratives and to identify precisely how the experiences of TBI survivors seeking treatments, rather than the treatments themselves, impact outcomes. It also …

Experiences Of Disclosure Among Transgender And Gender Diverse Sexual Assault Survivors, Merle E. Huff Ii

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Around half of TGD people have experienced sexual assault victimization (Abern et al., 2023; Clements-Nolle et al., 2006; James et al., 2016; Martin et al., 2022; Risser et al., 2005; Stotzer, 2009), which leads to higher rates of depression and PTSD (Grant et al., 2011; Grocott et al., 2023; Fernández-Rouco et al., 2017; Hawkey et al., 2021; Matsuzaka & Koch, 2019; Parr, 2020; Ussher et al., 2020). Disclosure of victimization may be important among TGD survivors. The current study was guided by minority stress theory (Meyer, 2003) and the gender minority stress and resiliency model (Testa et al., 2015) to …