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中华创伤杂志（英文版）
中华创伤杂志（英文版）

王正国

双月刊

1008-1275

cjtrauma@163.com

023-68757483

400042

重庆市渝中区大坪长江支路10号

中华创伤杂志（英文版）/Journal Chinese Journal of TraumatologyCSCDCSTPCD北大核心
查看更多>>中华医学会主办，中华医学会创伤学分会承办。本刊是全英文高级学术刊物，是中华医学会系列杂志之一。主要对外报道我国创伤学及相关学科的成果与进展，全面反映我国创伤医学的成就与水平，促进和指导我国创伤学研究的发展，提高临床救治水平；同时将国外相应领域进展及动态介绍给中国读者。它使中国的创伤医学走向世界，使外国读者了解中国，促使国内外创伤医学的交流与合作。
正式出版
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    Management of non-compressible torso hemorrhage:An update

    Zhi-Yang ZhangHua-Yu ZhangTomer TalmyYong Guo...
    125-131页
    查看更多>>摘要：With the widespread adoption of advanced tourniquets,the mortality rate of limb wound hemorrhage has decreased significantly,and non-compressible torso hemorrhage has gradually occupied the leading position of potentially preventable death,both in military and civilian circumstances.With the emer-gence of novel hemostatic devices and materials,strategies for the management of non-compressible torso hemorrhage have changed significantly.This review summarizes the current treatment strate-gies and types of equipment for non-compressible torso hemorrhage and suggests future research di-rections,hoping to provide a comprehensive review for the medical personnel and researchers engaging in this field.
      原文链接:
    • NETL
    • NSTL
    • 维普
    • 万方数据

    Spinal cord injury in the setting of traumatic thoracolumbar fracture is not reliably associated with increased risk of associated intra-abdominal injury following blunt trauma:An analysis of a National Trauma Registry database

    Veacheslav ZilbermintsYehuda HershkovitzKobi PelegJoseph J.Dubose...
    132-135页
    查看更多>>摘要：Purpose:There is a common opinion that spinal fractures usually reflect the substantial impact of in-juries and therefore may be used as a marker of significant associated injuries,specifically for intra-abdominal injury(IAI).The impact of concomitant spinal cord injury(SCI)with the risk of associated IAI has not been well clarified.The aim of this study was to evaluate the incidence and severity of IAIs in patients suffering from spinal fractures with or without SCI.Methods:A retrospective cohort study using the Israeli National Trauma Registry was conducted.Pa-tients with thoracic,lumbar and thoracolumbar fractures resulting from blunt mechanisms of injury from January 1,1997 to December 31,2018 were examined,comparing the incidence,severity and mortality of IAIs in patients with or without SCI.The collected variables included age,gender,mechanism of injury,incidence and severity of the concomitant IAIs and pelvic fractures,abbreviated injury scale,injury severity score,and mortality.Statistical analysis was performed using GraphPad InStat ® Version 3.10,with Chi-square test for independence and two sided Fisher's exact probability test.Results:Review of the Israeli National Trauma Database revealed a total of 16,878 patients with spinal fractures.Combined thoracic and lumbar fractures were observed in 1272 patients(7.5％),isolated thoracic fractures in 4967 patients(29.4％)and isolated lumbar fractures in 10,639 patients(63.0％).The incidence of concomitant SCI was found in 4.95％(63/1272),7.65％(380/4967)and 2.50％(266/10639)of these patients,respectively.The overall mortality was 2.5％,proving higher among isolated thoracic fracture patient than among isolated lumbar fracture counterparts(11.3％vs.4.6％,p＜0.001).Isolated thoracic fractures with SCI were significantly more likely to die than non-SCI counterparts(8.2％vs.3.1％,p＜0.001).There were no differences in the incidence of IAIs between patients with or without SCI following thoracolumbar fractures overall or in isolated thoracic fractures;although isolated lumbar fractures patients with SCI were more likely to have renal(3.4％vs.1.6％,p = 0.02)or bowel injuries(2.3％vs.1.0％,p = 0.04)than the non-SCI counterparts.Conclusion:SCI in the setting of thoracolumbar fracture does not appear to be a marker for associated IAI.However,in a subset of isolated lumbar fractures,SCI patient is associated with increased risks for renal and bowel injury.
      原文链接:
    • NETL
    • NSTL
    • 维普
    • 万方数据

    Iliac ecchymosis,a valuable sign for hollow viscus injuries in blunt pelvic trauma patients

    Yong-Gang LiZhi-Yong WangJi-Guang TianYu-Hang Su...
    136-139页
    查看更多>>摘要：Purpose:Pelvic fractures are characterized by high energy injuries and often accompanied with abdominal and pelvic organ injury.CT has been applied for several decades to evaluate blunt pelvic trauma patients.However,it has a certain rate of inaccurate diagnosis of abdominal hollow viscus injury(HVI),especially in the early stage after injury.The delayed diagnosis of HVI could result in a high morbidity and mortality.The bowel injury prediction score(BIPS)applied 3 clinical variables to deter-mine whether an early surgical intervention for blunt HVI was necessary.We recently found another clinical variable(iliac ecchymosis,IE)which appeared at the early stage of injury,could be predicted for HVI.The main objective of this study was to explore the novel combination of IE and BIPS to enhance the early diagnosis rate of HVI,and thus reduce complications and mortalities.Methods:We conducted a retrospective analysis from January 2008 to December 2018 and recorded blunt pelvic trauma patients in our hospital.The inclusion criteria were patients who were verified with pelvic fractures using abdomen and pelvis CT scan in the emergency department before any surgical intervention.The exclusion criteria were abdominal CT insufficiency before operation,abdominal surgery before CT scan,and CT mesenteric injury grade being 5.The MBIPS was defined as BIPS plus IE,which was calculated according to 4 variables:white blood cell counts of 17.0 or greater,abdominal tenderness,CT scan grade for mesenteric injury of 4 or higher,and the location of IE.Each clinical variable counted 1 score,totally 4 scores.The location and severity of IE was also noted.Results:In total,635 cases were hospitalized and 62 patients were enrolled in this study.Of these included patients,77.4％(40 males and 8 females)were operated by exploratory laparotomy and 22.6％(8 males and 6 females)were treated conservatively.In the 48 patients underwent surgical intervention,46 were confirmed with HVI(45 with IE and 1 without IE).In 46 patients confirmed without HVI,only 3 patients had IE and the rest had no IE.The sensitivity and specificity of IE in predicting HVI was calculated as 97.8％(45/46)and 81.3％(13/16),respectively.The median MBIPS score for surgery group was 2,while 0 for the conservative treatment group.The incidence of HVI in patients with MBIPS score≥2 was significantly higher than that in patients with MBIPS score less than≤2(OR = 17.3,p＜0.001).Conclusion:IE can be recognized as an indirect sign of HVI because of the high sensitivity and specificity,which is a valuable sign for HVI in blunt pelvic trauma patients.MBIPS can be used to predict HVI in blunt pelvic trauma patients.When the MBIPS score is≥2,HVI is strongly suggested.
      原文链接:
    • NETL
    • NSTL
    • 维普
    • 万方数据

    Combined fenestrated/chimney thoracic endovascular repair for the treatment of blunt traumatic aortic injury:A case report

    Li ZhangHua-Ping WuXiang LiKai-Ping Lü...
    140-143页
    查看更多>>摘要：Blunt traumatic thoracic aortic injury(BTAI)is an extremely serious medical condition with a high rate of associated mortality.Recent advances in techniques such as thoracic endovascular repair offer new opportunities to manage the critical BTAI patients in an efficacious yet less invasive manner.A 65 year-old-male suffered from multiple injuries after a fall,including BTAI in the aortic arch,which resulted in dissection of the descending thoracic-abdominal aorta and iliac artery,development of an intimal flap in the left common carotid artery,and dissection of the left subclavian artery.Based on the imaging in-formation of this patient and our clinical experience,the combined treatment of fenestrated thoracic endovascular repair and a chimney technique was immediately planned to fully repair these dissections and moreover prevent further dissection of the branching vessels,additionally to ensure sufficient blood flow in the left subclavian artery and left common carotid artery.The intervention yielded satisfactory early outcomes.Follow-up assessment at six months reported no symptoms or complications associated with the stent-graft.Computed tomography angiography further confirmed adequate stent-graft coverage of the aortic injury.
      原文链接:
    • NETL
    • NSTL
    • 维普
    • 万方数据

    Development status of telesurgery robotic system

    Shi-Bo XiaQing-Sheng Lu
    144-147页
    查看更多>>摘要：As an emerging field,telesurgery robotic system is changing the traditional medical mode and can de-livery remote surgical treatment anywhere in the world.Advances in telesurgery robotic technology achieve the remote control beyond the current limitation of distance and special medical environment.This review introduces the development history,the current status and the potential in future of the telesurgery robotic system.In addition,it presents the construction of control platform and the appli-cation,especially in trauma treatment,as well as the challenge in clinic.
      原文链接:
    • NETL
    • NSTL
    • 维普
    • 万方数据

    Factors influencing the length of emergency room stay and hospital stay in non-fatal bicycle accidents:A retrospective analysis

    Satoru BeppuMasahito HitosugiTadahiro UedaMirae Koh...
    148-152页
    查看更多>>摘要：Purpose:Lengthy hospitalization places a burden on patients and healthcare resources.However,the factors affecting the length of hospital stay(LHoS)and length of emergency room stay(LERS)in non-fatal bicycle accidents are currently unclear.We investigated these factors to inform efforts to minimize hospitalization.Methods:We performed a retrospective analysis of data from non-fatal injured bicyclists admitted to the Emergency and Critical Care Center at Kyoto Medical Center between January 2012 and December 2016.We measured LHoS,LERS,mechanism of injury,head injury prevalence,polytrauma,operations per-formed,injury severity score(ISS),abbreviated injury scale(AIS)score,maximum AIS score,and trauma and injury severity score probability of survival.We conducted multiple regression analysis to determine predictors of LHoS and LERS.Results:Within the study period,82 victims met the inclusion and exclusion criteria and were included.Mean age was(46.0±24.7)years.Overall mean LHoS was(16.8±25.2)days,mean LERS was(10.6±14.7)days,median ISS was 9(interquartile range(IQR):3-16),median maximum AIS was 3(IQR:1-4),and median trauma and injury severity score probability of survival was 98.0％(IQR:95.5％-99.6％).Age,maximum AIS,ISS,and prevalence of surgery were significantly greater in long LHoS and LERS group compared with short LHoS and LERS group(p＜0.05).Performance of surgery independently explained LHoS(p = 0.0003)and ISS independently explained LERS(p = 0.0009).Conclusion:Surgery was associated with long hospital stays and ISS was associated with long emergency room stays.To improve the quality life of the bicyclists,preventive measures for reducing injury severity or avoiding injuries needing operation are required.
      原文链接:
    • NETL
    • NSTL
    • 维普
    • 万方数据

    Evaluating mechanism and severity of injuries among trauma patients admitted to Sina Hospital,the National Trauma Registry of Iran

    Mina SaeednejadMohammadreza ZafarghandiNarjes KhaliliVali Baigi...
    153-158页
    查看更多>>摘要：Purpose:Injuries are one of the leading causes of death and lead to a high social and financial burden.Injury patterns can vary significantly among different age groups and body regions.This study aimed to evaluate the relationship between mechanism of injury,patient comorbidities and severity of injuries.Methods:The study included trauma patients from July 2016 to June 2018,who were admitted to Sina Hospital,Tehran,Iran.The inclusion criteria were all injured patients who had at least one of the following:hospital length of stay more than 24 h,death in hospital,and transfer from the intensive care unit of another hospital.Data collection was performed using the National Trauma Registry of Iran minimum dataset.Results:The most common injury mechanism was road traffic injuries(49.0％),followed by falls(25.5％).The mean age of those who fell was significantly higher in comparison with other mechanisms(p＜0.001).Severe extremity injuries occurred more often in the fall group than in the vehicle collision group(69.0％vs.43.5％,p＜0.001).Moreover,cases of severe multiple trauma were higher amongst vehicle collisions than injuries caused by falls(27.8％vs.12.9％,p = 0.003).Conclusion:Comparing falls with motor vehicle collisions,patients who fell were older and sustained more extremity injuries.Patients injured by motor vehicle collision were more likely to have sustained multiple trauma than those presenting with falls.Recognition of the relationship between mechanisms and consequences of injuries may lead to more effective interventions.
      原文链接:
    • NETL
    • NSTL
    • 维普
    • 万方数据

    Three-dimensional printing combined with open reduction and internal fixation versus open reduction and internal fixation in the treatment of acetabular fractures:A systematic review and meta-analysis

    Dong-Peng TuYi-Kang YuZhen LiuWen-Kai Zhang...
    159-168页
    查看更多>>摘要：Purpose:This meta-analysis compared the clinical outcome of three-dimensional(3D)printing com-bined with open reduction and internal fixation(ORIF)to traditional ORIF in the treatment of acetabular fractures.Methods:We searched the Cochrane Library,PubMed,Embase,VIP database,CNKI,and Wanfang data-base with keywords"acetabular fracture","3D printing","three-dimensional printing","open reduction and internal fixation","Acetabulum","Acetabula"from January 2000 to March 2020.Two reviewers independently selected articles,extracted data,assessed the quality evidence and risk bias of included trials using the Cochrane Collaboration's tools and/or Newcastle-Ottawa scale.When the two analysts had different opinions,they would ask the third analyst for opinion.Randomized controlled trials or retrospective comparative studies of 3D printing combined with ORIF(3D printing group)versus tradi-tional ORIF(conventional group)in the treatment of acetabular fractures were selected.The data of operation time,intraoperative blood loss,intraoperative fluoroscopy times,incidence of complications,excellent and good rate of Matta score for reduction,and excellent and good rate of hip function score were extracted.Stata14.0 statistical software was used for data analysis.Results:Altogether 9 articles were selected,including 5 randomized controlled trials and 4 retrospective studies.A total of 467 patients were analyzed,250 in the conventional group,and 217 in the 3D printing group.The operation time in the 3D printing group was less than that in the conventional group and the difference was statistically significant(standardized mean difference(SMD)=-1.19,95％CI:-1.55 to-0.82,p＜0.05).The intraoperative bleeding volume of the 3D printing group was significantly lower than that of the conventional group(SMD =-1.08,95％CI:-1.65 to-0.51,p＜0.05).The fluoroscopy times were less in the 3D printing group than in the conventional group and the difference was sta-tistically significant(SMD =-1.64,95％CI:-2.35 to-0.93,p＜0.05).The total incidence of complications in the 3D printing group was significantly lower than that in the conventional group(OR = 0.43,95％CI:0.24-0.79,p＜0.05).There was no significant difference in the excellent and good rate of Matta score for reduction between the two groups(OR = 0.60,95％CI:0.34-1.06,p＞0.05).There was no significant difference in the excellent and good rate of hip function score at the end of postoperative follow-up between the two groups(OR = 0.84,95％CI:0.46-1.56,p＞0.05),but the follow-up time varies from 6 months to 40 months.Conclusion:Compared with traditional ORIF,3D printing combined with ORIF has certain advantages in terms that 3D printing not only helps surgeons to understand acetabular fractures more intuitively,but also effectively reduces operation time,intraoperative blood loss,intraoperative fluoroscopy times,and postoperative complications.However,there were no significant differences in the excellent and good rate of Matta score for reduction and the excellent and good rate of hip function score at the end of follow-up.
      原文链接:
    • NETL
    • NSTL
    • 维普
    • 万方数据

    Comparison of the clinical efficacy of different fixation systems for the treatment of transverse patellar fractures

    Zhi-Biao BaiShi-Chang GaoHai-Bo ZhouChao Zhang...
    169-173页
    查看更多>>摘要：Purpose:This study was designed to compare the clinical efficacy of"8"and"0"wire fixation systems combined with double-head cannulated compression screws or Kirschner wires for the treatment of transverse patellar fractures.Methods:From September 2011 to September 2018,patients with closed transverse patellar fractures treated with a double-head compression screw or Kirschner wire were included and analyzed retro-spectively.Patients with patellar fractures combined with distal femoral fractures,tibial plateau fracture or preoperative lower limb dysfunction were excluded.The patients treated with the"8"tension band wire fixation system and Kirschner wire were taken as Group A;those treated with the"0"fixation system and Kirschner wire were taken as Group B;those treated with the"8"fixation system and double-head cannulated compression screw were taken as group C;and those treated with the"0"fixation system and double-head cannulated compression screw were taken as group D.Six weeks and one year after the operation and every month from the third month after the operation until the fractures healed,an X-ray examination was performed to identify fracture healing.The time of fracture healing and postoperative complications of the four groups were compared.One year after the operation,knee function was evaluated by Bostman's score.Results:During the study period,168 patients with patellar fractures were treated by operations,and 88 patients were excluded because the fracture type did not meet the requirements or because there were combined fractures of the distal femur or tibial plateau.As a result,80 patients were included in this study,20 in each group.All the patients were followed up for an average period of 12.2 months.Compared with Group A,patients in Group D presented less postoperative discomfort in the prepatellar region,quicker fracture healing,less fixation failure and better postoperative knee function scores(all p＜0.05).The incidence of internal fixation failure in Group(B+D)was lower than that in Group(A+C)(p＞0.05).Conclusion:The"0"wire fixation system combined with a double-head cannulated compression screw seems to be more beneficial than the other three fixation systems for the treatment of transverse patellar fractures.
      原文链接:
    • NETL
    • NSTL
    • 维普
    • 万方数据

    Ankle and foot mechanics in individuals with chronic ankle instability during shod walking and barefoot walking:A cross-sectional study

    Osama Ragaa AbdelraoufAmr Almaz Abdel-aziem
    174-179页
    查看更多>>摘要：Purpose:This study evaluated the angular kinematic and moment of the ankle and foot during shod walking and barefoot walking in individuals with unilateral chronic ankle instability(CAI).Methods:Recreational soccer players with unilateral CAI were recruited for this cross sectional study conducted between January and August 2019.A total of 40 participants were screened for eligibility but only 31 met the inclusion criteria based on the methods of Delahunt et al and Gribble et al.Except for 3 participants not attending the evaluation session,28 participants were finally included.A three dimensional motion analysis system made up of ProReflex motion capture unit and an AMTIb Kistler force plate,embedded in the middle of nine meter walkway,were used to assess the ankle and foot angles and moment during shod walking and barefoot walking conditions.A Statistical Package for Social Sciences(version 20.0)was used to analyze data.Results:During shod walking,the ankle joint plantar-flexion range of motion(ROM)at 10％of the gait cycle(GC)and dorsiflexion ROM at 30％of the GC were significantly higher than those during barefoot walking for both feet(p = 0.001,0.001,0.027,and 0.036 respectively).The inversion ROM during shod walking was significantly higher than that during barefoot walking for both feet at 10％and 30％of the GC(p = 0.001.0.001,0.001,and 0.042 respectively).At 10％of the GC,the eversion moment was significantly higher between barefoot and shod walking for both feet(both p = 0.001).At 30％of the GC,there was no significant difference between shod and barefoot walking plantar-flexion moment of both feet(p = 0.975 and 0.763 respectively),and the eversion moment of both feet(p = 0.116 and 0.101 respectively).Conclusion:At the early stance,shod walking increases the ankle plantar-flexion and foot inversion ROM,and decreases the eversion moment for both feet in subjects with unilateral CAI.Therefore,the foot wearing condition should be considered during evaluation of ankle and foot kinematics and kinetics.
      原文链接:
    • NETL
    • NSTL
    • 维普
    • 万方数据