Trauma Commons^™

Staged Reconstruction And Salvage Of 5th Finger With Corticocancellous Distal Radius Autograft: A Case Report, Emmanuel Franco, Zayd Ayas, Frank Gerold

Research Symposium

Background: Finger reconstruction in the aftermath of severe trauma poses significant challenges in restorative surgery, particularly when addressing extensive soft tissue damage, comminuted fractures, and simultaneous neurovascular complications. This study presents a case of a patient with a complicated distal phalangeal fracture that pursued digit salvage.

Case Presentation: Patient is a 31-year-old woman who sustained a severe injury to her right 5th digit during an ATV rollover. The trauma resulted in an exposed and comminuted fracture of the proximal phalanx with associated loss of soft tissues, flexor tendon, radial nerve injury, and vascular compromise. She elected to pursue digit salvage …

Intraoperative Imaging In Orthopedic Settings: An Assessment Of Changes In Adherence To Imaging Guidelines, Emmanuel Franco, Tabitha Abraham, Zayd Ayas, Frank Gerold

Research Symposium

Background: High-quality intraoperative photography is vital for treatment planning, patient counseling, and surgical education. Inconsistencies in image quality are prevalent in orthopedic literature due to the absence of formalized criteria specific to orthopedic settings. In 2014, "Medical Photography: Principles for Orthopedics" introduced guidelines intending to standardize protocols for capturing clinical images. By comparing the quality of images taken both before and after these proposed guidelines, this project aims to evaluate whether this has influenced a trend toward standardization and consistency in intraoperative orthopedic photography.

Methods: To assess quality differences in orthopedic images before and after the 2014 guidelines, 60 intraoperative …

Impact Of Diabetes On Fall Related Lower Limb Fractures, Bryce M. Bellon, Daniel Salinas, Patrick De La Torre Shutz, Hunter Butler, Sean Corcoran, Kelsey Baker

Research Symposium

Background: Diabetes is a disorder that affects many Americans, characterized primarily by hyperglycemia due to either insulin resistance or lack of insulin secretion. This condition not only impacts blood sugar levels but also has significant effects on bone health. In diabetes, bone density is often decreased due to reduced osteoblast activity, which is responsible for bone formation, and increased osteoclast activity, which leads to bone resorption. This imbalance accelerates the breakdown of bone. Additionally, diabetics frequently suffer from lower extremity arterial disease (LEAD), which results in poor vascularization of the lower limbs. These factors contribute to an increased risk of …

Oxidized Carbon Nanoparticles Enhance Cellular Energetics With Application To Injured Brain, Karthik Mouli, Anton V Liopo, Emily A Mchugh, Erica Underwood, Jing Zhao, Pramod K Dash, Anh T T Vo, Vikas H Malojirao, Muralidhar L Hegde, James M Tour, Paul J Derry, Thomas A Kent

Faculty, Staff and Student Publications

Pro-energetic effects of functionalized, oxidized carbon nanozymes (OCNs) are reported. OCNs, derived from harsh acid oxidation of single-wall carbon nanotubes or activated charcoal are previously shown to possess multiple nanozymatic activities including mimicking superoxide dismutase and catalyzing the oxidation of reduced nicotinamide adenine dinucleotide (NADH) to NAD+. These actions are predicted to generate a glycolytic shift and enhance mitochondrial energetics under impaired conditions. Impaired mitochondrial energy metabolism is increasingly recognized as an important facet of traumatic brain injury (TBI) pathophysiology and decreases the efficiency of electron transport chain (ETC)-coupled adenosine triphosphate (ATP) and NAD+ regeneration. In vitro, OCNs promote a …

A Study Of Secondary Traumatic Stress In Health Care Professionals In Long-Term Care., Bethany Proudfoot

Doctor of Social Work Capstone Projects

Secondary traumatic stress (STS) is a significant concern for healthcare professionals in long-term care (LTC) settings. This study explores the impact of STS on clinical staff, addressing the research question: How has STS affected employees within the LTC sector, and what resources or support can be provided to mitigate its effects? The study utilized a mixed-methods approach, combining survey data from clinical staff across five LTC facilities in Ohio, incorporating the survey data measuring levels of STS and qualitative responses. Findings revealed that 64% of participants experienced high to severe levels of STS, with symptoms including anxiety, depression, sleep disturbances, …

Risk Factors Associated With Worse Outcomes In Trauma Patients Aged 55 And Older, Hector Mendez, Ilko Luque, Nicole Yordán López, Carlos Parra, Kelvin Chan, Mariel A. Javier, Marcela Ramirez, Orlando Morejón

HCA Healthcare Journal of Medicine

Background

Prior studies have shown an increase in mortality in trauma patients after 55 years of age. However, it is less certain which pre-existing comorbidities (PECs) are associated with poorer outcomes. The purpose of this study was to identify the risk factors associated with poor outcomes and death in patients 55 years old and older admitted for trauma.

Methods

Trauma patients (age ≥ 55) were studied retrospectively from the local trauma registry at HCA Florida Kendall Hospital, a level 1 trauma center (2020–22). We collected the subject’s age, gender, PECs, and outcome data. Then we performed multiple logistic regression to …

Simplicity Is The Ultimate Sophistication: Ume Lessons From Trauma-Focused Simulation, Victoria-Marie Berlandi-Short, Kelsey Yang, Jonmark Dolendo, Grace Hwang, Brianna Kuhse, Samuel Blees, Sherli Koshy-Chenthittayil, Brad Haubrich

Annual Research Symposium

Purpose: Simulation-based training has become essential in preparing medical professionals to manage high-stakes situations effectively before encountering them in real-life clinical settings. This study aimed to evaluate the impact of Cut Suit Week (CSW), a high-stress, trauma-focused simulation training for second-year military medical students hosted by Rocky Vista College of Osteopathic Medicine in San Diego, California. As members of the 2024 cohort, our team from Touro University Nevada (TUN) and Touro University California (TUC) sought to address three questions: (1) Does CSW improve confidence in managing stressful situations? (2) Does it enhance clinical and leadership skills? (3) Would similar training …

Subtalar Dislocation With Isolated Talonavicular Dislocation – A Unique Case, Yaser J. Rahim, Naveen J. Pattisapu, Maxwell C. Alley

The Lahey Journal

Subtalar joint dislocations are infrequent injuries of the foot involving interruption of the articulations in the subtalar joint complex. These injuries involve dislocation of the talocalcaneal and talonavicular joints simultaneously with or without associated fractures. Subtalar joint dislocations are classified as medial or lateral, with medial dislocations occurring more commonly. Medial subtalar dislocations are generally not associated with other injuries whereas lateral subtalar dislocations are more frequently accompanied by fractures of talus, calcaneus or navicular. Prompt recognition of this dislocation and other injuries prevent negative sequelae associated with delayed treatment, and patients typically have a good outcome and return to …

Displaced: An Ethnography Of Language And Identity Loss, Ariel Caroline Wilsey-Gopp

Dissertations and Theses

Through ethnography and personal narrative, I explore the language and identity loss of one person, my father, in order to understand the complex issues surrounding the effects of symbolic and structural violence on language and identity development. Through personal narrative, fieldwork, and interviews, I tell the story of one person, born in wartime during Nazi occupied Serbia, and follow the guiding questions: how does language get lost and what are the effects? Drawing on methodology set forth by empirical ethnographical work as well as more recent theory around epigenetics and trauma, my research synthesizes into focus three pillars of understanding …

The Role Of Adjunctive Medial Plating In Distal Femur Fractures And Distal Femur Fractures Nonunions., Jerrod Steimle, Jaron L Lohmeyer, Benjamin Taylor, Daniel T Degenova

Trauma and Acute Care Articles

PURPOSE: There exists controversy in the treatment of acute distal femur fractures as well as distal femur fracture nonunions. The objective of this study is to determine the clinical benefit of adjunctive medial plate application in the setting of acute distal femur fractures and distal femur fracture nonunions.

METHODS: This is a retrospective comparative study at a Level 1 academic trauma center, including 104 patients treated for acute distal femur fractures and 23 patients treated for distal femur nonunions between 2015 and 2019. The study compared dual plate fixation to other methods of fixation.

RESULTS: In the acute fracture setting, …

Viscoelastic Hemostatic Assays Are Associated With Mortality And Blood Transfusion In A Multicenter Cohort, Shyam Murali, Eric Winter, Nicolas M. Chanes, Allyson M. Hynes, Madhu Subramanian, Alison A. Smith, Mark J. Seamon, Jeremy W. Cannon

School of Medicine Faculty Publications

Objectives: Trauma-induced coagulopathy (TIC) carries significant risks, including increased mortality. Traditional TIC definitions rely on laboratories that result slowly and do not highlight therapeutic targets. We hypothesized that a TIC score, based on thromboelastography (TEG) and rotational thromboelastometry (ROTEM), collectively termed viscoelastic hemostatic assays, is associated with in-hospital mortality and packed red blood cell (pRBC) transfusion. Methods: This retrospective cohort study used a database of adult patients undergoing institutional massive transfusion at seven level 1 trauma centers (2013-2018). A “TIC score” was developed, with 1 point assigned for abnormal TEG R-time ( ≥ 9 min) or ROTEM clot time ( …

Adverse Prehospital Events And Outcomes After Traumatic Brain Injury, Amelia W Maiga, Hsing-Hua Sylvia Lin, Stephen R Wisniewski, Joshua B Brown, Ernest E Moore, Martin A Schreiber, Bellal Joseph, Chad T Wilson, Bryan A Cotton, Daniel G Ostermayer, Brian G Harbrecht, Mayur B Patel, Jason L Sperry, Francis X Guyette, Henry E Wang

Faculty, Staff and Student Publications

Importance: While national guidelines recommend avoidance of hypoxia, hypotension, and hypocarbia in the prehospital care of traumatic brain injury (TBI), limited data validate the association of these adverse physiologic events with TBI outcomes.

Objective: To validate the associations of prehospital hypoxia, hypotension, and hypocarbia with TBI outcomes in a US national trauma network.

Design, setting, and participants: This cohort study examined data from 8 level I trauma centers and their affiliated ground and air emergency medical services (EMS) agencies in the Linking Investigations in Trauma and Emergency Services (LITES) Network from January 1, 2017, to June 30, 2021. Adult patients …

Effects Of Rideshare Services On Alcohol Related Motor Vehicle Collision (Mvc) Outcomes, David Bassa, Morgan Johnson, Devika Pavuluri, Michael Truitt

North Texas Research Forum 2025

BACKGROUND: In 2022, The National Highway Traffic Safety Administration (NHTSA) reported over 42,000 motor vehicle collisions (MVCs) deaths with 31% of MVC deaths secondary to alcohol (AR-MVCs). In 2010, rideshare services (RSS) were introduced to the market providing a new method of transportation with the potential to reduce the incidence of driving under the influence (DUI). We analyzed the NHTSA database to evaluate trends in alcohol related MVC deaths (AR-MVC Deaths) since the initiation of ride share services. METHODS: Fatality Analysis Reporting System (FARS) source from the NHTSA was used to obtain data from years 2009 and 2022 from 50 …

Lessons Learned: A Multicenter Approach To A Mass-Casualty Incident, Kristen Payne, Elizabeth Kim, Luis Taveras, Morgan Collom, Danielle Pigneri

North Texas Research Forum 2025

Background: On May 6, 2023, an armed gunman opened fire at a shopping mall in Allen, Texas. Eight people including the perpetrator were killed with more injured. Medical City McKinney, a level 2 trauma center received seven patients. Medical City Plano, a level one trauma center received one patient. Medical City Dallas Children’s Hospital, a level three pediatric trauma center received one pediatric patient. Methods: Medical City North Texas Division command center engaged Emergency Department leadership at North Texas facilities to prepare for transfer of patients. Ground transport and an air medic team on standby was staged early on. Nearby …

Traumatic Rupture Of Gall Bladder After Blunt Trauma, Chris Robert, Alicia Lay

North Texas Research Forum 2025

Introduction: Gallbladder injury accounts for less than 1% of the patient presenting with blunt abdominal trauma, due to its protected location in the undersurface of the liver. Case report: A 41-year-old male presented to the emergency department after a motor vehicle collision. Patient was hemodynamically stable; on exam, patient had focal tenderness in the lower abdomen. Initial lab results revealed elevated blood alcohol of 302 mg/dl, elevated lactate of 3.9 mmol/l, a white blood cell count of 6.76 K/mm3, and a hemoglobin of 15.2 g/dl. Patient was pan-scanned as per trauma protocol. A computed tomography scan revealed a mesenteric hematoma …

Complete Gastric Transection After Blunt Force Trauma, Sydney Parker, Sophia Jimenez, Riley Blanton, Samprit Karra, Alejandro Garcia

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Working With Foster Families: What Providers Should Know, The Rees-Jones Center For Foster Care Excellence

White Papers and Policy Briefs

Foster parents play a vital, yet often challenging role in the lives of children who have experienced trauma and instability. Navigating the healthcare system for children in foster care can be particularly complex and overwhelming, requiring understanding, collaboration, and a unique approach from healthcare professionals. This page offers insights and practical ideas for healthcare professionals to effectively support foster parents, ultimately contributing to the well-being of the children in their care.

For questions about this publication or others, please email [email protected]

childrens.com/fostercare

Ensuring The Health And Well-Being Of Children After Adoption, The Rees-Jones Center For Foster Care Excellence

White Papers and Policy Briefs

Children in foster care have higher rates of health concerns and healthcare utilization than their peers who have not experienced foster care. For example, one study found that children in foster care had 2.5- and 2.3-times higher odds of having a mental health diagnosis and developmental disability diagnosis, respectively. Data on our patient population supports these findings, revealing that 70.4% of our patients had chronic or complex chronic health conditions.

For questions about this publication or others, please email [email protected]

childrens.com/fostercare

Optimizing Fluid Resuscitation: Balancing Access Efficiency And Infusion Speed In Trauma Care, Chris Robert, Enoch Wong, David Bassa, Danielle Pigneri, Paul Granet

North Texas Research Forum 2025

Study Objective: Time is a critical resource during the initial treatment of an injured patient. Fluid resuscitation is also a critical component of trauma care. Clinicians are faced with the need to actively resuscitate an injured patient while simultaneously working to provide them operative or procedural hemorrhage control as quickly as possible. In these circumstances, physicians must balance perceived flow efficiency with time required to place certain types of access devices, though little data exists to guide this decision process. This study aims to evaluate the infusion times of different sizes of peripheral and central venous catheters to optimize fluid …

There’S A Qr Code For That: Trauma Performance Improvement, Patient Safety, And Peer Review, April Miller, Luis Taveras, Elizabeth Kim, Kathy Galt

North Texas Research Forum 2025

In preparation for our facility’s initial ACS verification visit, a Trauma Consultative Site visit in 2021 identified the need for a streamlined process to communicate issues to the Trauma Program that were recognized during patient care. This was especially true on weekends and nights when issues were most likely to occur. A recent literature review revealed implementation of electronic communication tools increased reporting of performance improvement and patient safety (PIPS) events and improved tracking and resolution of events. The authors of that study used a virtual chatroom accessible from cell phone to post PIPS events. One perceived drawback to this …