The role of social media in clubfoot: information sharing and social support

PurposeClubfoot is the most common congenital foot deformity in children. Caregivers often seek medical information on the internet. The aim of the study was to characterize how social media is used by caregivers to access medical information.MethodsA search was performed on Facebook, Twitter and YouTube platforms. Information was quantitatively assessed. Comments were qualitatively assessed, and the Kruskal-Wallis test was used to study thematic comment distribution.ResultsIn total, 58 Facebook groups and pages, 109 YouTube accounts and ten Twitter accounts related to clubfoot were discovered from 2007 to 2019. Facebook groups and pages had a collective 56 123 members and 80 544 total likes, respectively. YouTube had a collective 3 280 454 views, with 54 969 total comments throughout the accounts. Comment themes most commonly included sharing information and advice (38.7%), appreciation and success stories (12.8%), emotional support (12.7%) and social media as a second opinion (11.9%). Facebook groups contained a significantly higher number of comments related to ‘social media as a second opinion’ compared with Facebook pages (p = 0.001), Twitter (p = 0.016) and YouTube (p < 0.0001) while YouTube contained a significantly lower number of comments related to ‘sharing information’ compared with Facebook groups, pages and Twitter (p < 0.0001).ConclusionSocial media continues to be a growing tool for information sharing and the findings of this study highlight the importance placed by caregivers on the advice of their peers. The online presence of caregivers may represent an opportunity for orthopaedic surgeons to communicate with patients and help them make informed decisions.Level of evidenceIV     

“Social media perceptions of hip fractures: A two-year cross-sectional analysis”

BackgroundThe outcomes of hip fracture rely heavily on subjective pain relief, and social media provides a remarkable lens to examine the patient experience.MethodsA search of public posts on Instagram and Twitter was performed over a 2 -year period, selected through use of the following hashtags: #hipfracture, #hipfracturerecovery, and #hipfracturerepair. A categorical classification system was used for media format (picture or video), perspective, timing, tone, and content. Post-popularity (number of likes) and geographic location were also recorded.ResultsOf the Instagram posts analyzed, 50.6% were made by patients. The most common content included in Instagram posts was rehabilitation and or educational posts on hip fracture. Amongst the Twitter posts analyzed, 66% of posts were made by professional organizations. Frequently referenced themes included education, and posts produced by the hospital or surgeon. Of Facebook posts analyzed, 62.8% of posts were produced by businesses.ConclusionSocial media analysis is a powerful tool for evaluating characteristics important to patients. Instagram was used more by patients and focused on rehabilitation. Twitter posts were more frequently made by professional organizations and tended to be educational. Lastly, Facebook posts were made primarily by businesses and focused on marketing.     

Factors Influencing Facebook Usage and Facebook Addictive Tendency in University Students: The Role of Online Psychological Privacy and Facebook Usage Motivation

There are few studies analysing the influence of personal traits and motivation factors on Facebook usage and Facebook addictive tendency as seen in university students. In this study, 225 Taiwanese university students completed a questionnaire to determine their online psychological privacy scale, Facebook usage motivation scale, Facebook usage scale and Facebook addictive tendency scale, in order to evaluate the items that can be conceptualized as the effect of university students' online psychological privacy personal trait and motive factors, and Facebook usage motivation with respect to Facebook usage and Facebook addictive tendency. The study found that a desire for more online psychological privacy correlates with a stronger motivation to use Facebook and more Facebook usage behaviour among university students who may become high‐risk groups for Facebook addictive tendency. The study found that a desire for or an acceptance of a lower online psychological privacy correlates with a stronger motivation to use Facebook among university students who may have more Facebook usage behaviour. This study can help understand university students' Facebook usage and Facebook addictive tendency and provide feature indicators for those who may become high‐risk groups for Facebook addictive tendency. Finally, this study conducts discussion and proposes relevant suggestions for future study. Copyright © 2014 John Wiley & Sons, Ltd.     

Sternal fractures are frequent among polytraumatised patients following high deceleration velocities in a severe vehicle crash

INTRODUCTION: Sternal fractures are a rare entity. We hypothesised that a sternal fracture is an indicator of injury severity following traffic accidents. METHODS: Analysis of technical indicators of the collision, preclinical and clinical data of patients with sternal fractures from 1985 to 2004 among 42,055 injured patients assessed by an Accident Research Unit. RESULTS: Only 267/42,055 patients (0.64%) suffered a sternal fracture within the 20-year period. Soft tissue bruises are most often concomitant injuries (55%), followed by cervical spine injuries (23%), multiple rib fractures (14%) and lung injuries (12%). Eighteen percent of patients were polytraumatised, with 11.2% dying at the scene, 2.3% in hospital. Deceleration velocity (DeltaV) was significantly correlated with injury severity score (ISS, r2=0.92, y=0.408x-4.1573) as with maximal abbreviated injury scale (MAIS, r2=0.81). Patients suffering a sternal fracture being polytraumatised had significantly higher deceleration velocity (60+/-17km/h versus 37+/-16km/h [37.3+/-10.6mph versus 23+/-9.9mph], p=0.0001). Patients dying with a sternal fracture had a significant higher deceleration velocity (61km/h, 37.9mph) versus those surviving (38km/h, 23.6mph, p=0.0001). Regarding the vehicle type, the majority occurred after car accidents in 0.81% (251/31,183 patients), followed by 0.19% (5/2633 patients) driving motorbikes, and 0.11% (4/3258 patients) driving a truck. Only 13% of all passengers suffering a sternal fracture had an airbag on board (33/255 car/trucks), with an airbag malfunction in 18%. 22% were not admitted to hospital, 28% were admitted to a trauma ICU with a sternal fracture. CONCLUSION: In 1/5 of cases sternal fractures encountered in polytraumatised patients following significantly higher deceleration velocities during the crash. Typically car drivers without a functioning airbag suffer a sternal fracture.     

Hoffa's fracture with ipsilateral fibular fracture in a 16-year-old girl:An approach to a rare injury

Hoffa''s fracture is an uncommon fracture of the femoral condyle with coronal orientation of the fracture line. The mechanism of injury in pediatric Hoffa''s fracture is road traffic accident, sports injury, and trivial injury. Clinical examination and proper imaging is important for diagnosis of pediatric Hoffa''s fracture because of high chances of missing these injuries which can lead to nonunion and malunion at the fracture site. Open reduction and anatomical reduction of intraarticular fragment is the gold standard treatment of these fractures. We present a rare case of Hoffa''s fracture in a 16-year-old girl with associated ipsilateral fibular fracture.     

The Clinical and Radiological Outcome of Stages 1 and 2 Enneking Benign Bone Lesions with Pathological Fracture

BackgroundPresentation of benign lesions with a pathological fracture may be confusing to general orthopedic surgeons regarding missing a fracture in a pathological bone, the need for special care for these lesions, and the potential for healing of these fractures. The objective of this work was to evaluate the clinical and radiological outcomes of the treatment of patients with stages 1 and 2 Enneking benign bone-tumors presented with pathological fractures.MethodsThis retrospective study included 66 patients who presented with a pathological fracture through stage 1 or 2 Enneking benign bone lesions and were received at the emergency unit of the orthopedic department between 2014 and 2018. Demographic data and patient's evaluation were collected. Lesion-size (length, width, and depth) was calculated from the X-ray. Surgical intervention was planned in 28 patients. The indication for surgery was either fracture fixation or curettage of the lesion with or without augmentation. There were no repeated surgeries or local recurrences. The filling of the cavity was classified according to modified Neer's classification.ResultsSixty-six patients, 45 males, and 21 females were included. Forty-two affections were right while 24 were left. The mean age was 14.9 ± 8.6 (range, 3-40) years. The most common radiological diagnoses were simple bone-cysts 43.9% (n = 29), followed by non-ossifying fibroma 27.3% (n =18). The mean length of the lesions was 4.4 ± 2.6 (range, 1 - 12) cm, width was 1.6 ± 0.8 (range, 0.3- 4.5) cm, and depth was 1.8 ± 0.9 (range, 0.3 - 5) cm. The mean follow-up was 24.15 ± 18.7 months. Minor complications occurred in 7 patients (10.6%). Fifty-four out of 65 lesions (83%) showed either almost complete or partial filling of the lesions. There was no significant difference regarding the filling of the lesions according to the modified Neer's classification between those who were treated conservatively and those who underwent surgical intervention P-value = 0.783.ConclusionCareful diagnosis of a pathological fracture through stages 1 and 2 Enneking benign bone tumors is essential before initiating treatment. These fractures have good potential for bone healing and a low incidence of complications even with conservative treatment. Special surgical care of the lesion is not mandatory in all situations and should be individualized.Level of evidence: Level III, retrospective.     

Zuverlässigkeit notärztlicher Verdachtsdiagnosen

Background

Trauma is the leading cause of death in the patient group under 40 years of age. Within the prehospital management of seriously injured trauma victims the accuracy of the field triage by emergency physicians is of utmost importance.

Objective

The aim of this study was to determine the accuracy of prehospital emergency physician field triage in road traffic accident victims.

Material and methods

The study involved a retrospective analysis and comparison of prehospital and inhospital trauma records of road traffic accident victims treated by a Helicopter Emergency Medical Service (HEMS) team and transferred to a level I trauma centre. A comparison of prehospital and inhospital diagnostic findings was carried out according to an anatomical score (AIS).

Results

Included in the analysis were 479 patients with a mean age of 37.0?±?18.2 years, males 65.8?%, mean injury severity score (ISS) 15.5?±?13.5, ISS >?16 in 41,1?% and mortality 7.3?%. The leading causes of injury were motor vehicle accidents (56.2?%), followed by motorcycle (24.0?%) and bicycle accidents (11.6?%) as well as truck accidents (4.0?%) and pedestrian accidents (4.2?%). The most common body regions injured (AIS ≥?3) were the chest (37?%), head (25.1?%) and lower extremities (16.7?%). A correct prehospital field triage by emergency physicians was found for injuries with an AIS ≥?3 of the head 77?%, chest 69?%, abdomen 51?%, pelvis 49?%, extremities 70?%, neck/cervical spine 67?% and thoracic/lumbar spine 70?%. Overlooked injuries in the prehospital setting (AIS ≥?3) comprised predominantly injuries of the trunk (chest 12.6?%, abdomen 16.9?% and pelvis 15?%). Overlooked injuries were found significantly less for the head in patients with a Glasgow Coma Score ≤?8 on arrival at the scene (5.4?% versus 19?%, p?=?0.015), for the chest in patients with a S_pO₂?≤?96?% on arrival at the scene (18.1?% versus 35.5?%, p?=?0.004) and for the abdomen in patients with a systolic blood pressure <?90 mmHg on arrival at the scene (28.6?% versus 52.5?%, p?=?0.025).

Conclusion

Accurate field triage in seriously injured road accident victims, even by trained physicians, is difficult. This pertains especially to injuries to the abdomen and the pelvis. For the field triage a combination of anatomical and physiological criteria as well as the mechanism of injury should be used to increase accuracy.     

A preliminary investigation of road traffic accident rate after severe brain injury

PRIMARY OBJECTIVE: to investigate the road traffic accident rate in patients who have resumed driving after severe brain injury. RESEARCH DESIGN: a retrospective study conducted by means of telephone interviews. METHODS AND PROCEDURES: The caregivers of 90 patients suffering from severe brain injury were included. All of the patients had sustained severe brain injury and prolonged coma, i.e. lasting for at least 48 hours. The caregivers were interviewed by means of a Questionnaire that investigated several aspects of driving competence after coma and the incidence of road traffic accidents. MAIN OUTCOMES AND RESULTS: All patient outcomes were evaluated by means of the Glasgow Outcome Scale (GOS). The 90 caregivers reported that 29 patients (32%) had resumed driving and that 11 of the 29 (38%) were subsequently involved in road traffic accidents. During the total duration of our patient population risk exposure, we found 11 cases in our study group, against the 4.7 expected cases calculated in the normal population. The relative risk of road traffic accidents in severe brain injury patients versus uninjured individuals was 2.3. CONCLUSIONS: Our preliminary data show that a subject who has suffered from severe brain injury and coma lasting for at least 48 hours has a statistically significant higher risk of being involved in a road traffic accident.     

Education in trauma: An educational alternative that promotes injury prevention

Purpose: As trauma is a public health problem, different programs have been designed to prevent injuries. The aim of this study was to evaluate the effectiveness of an educational model that measures the adolescents'' attitudes towards the rules of road safety, alcohol and road accidents in Colombia. Methods: A pedagogical model evaluating the effect of road safety education and adolescents'' attitudes towards and experiences of alcohol and road accidents in Colombia was created. After the education concluded, this educational process is analyzed by its impact on adolescents'' behavior. The educational program included 160 adolescents with the mean age being 17.5 years. Results: The test results indicated that before the educational program 80% of adolescents did not use a safety element when driving, while after the educational program the percentage of no helmet use among adolescents decreased from 72.5% to 24.3% (p=0.0001) and driving a vehicle under the state of drunkenness from 49.3% to 8.1% (p=0.0001). Conclusion: An educational model aimed at preventing injuries caused by traffic accidents is shown to be effective in generating changes in adolescents'' customs of and attitudes towards alcohol and road safety standards in Colombia.     

Psychological distress and quality of life after orthopedic trauma: an observational study

Objective

Little is known about the clinical consequences of psychological morbidity associated with orthopedic trauma. The objective of our study was to investigate the extent of psychological symptoms that patients experience following orthopedic trauma and whether these are associated with quality of life.

Methods

All patients attending 10 orthopedic fracture clinics at 3 university-affiliated hospitals between January and October 2003 were screened for study eligibility. Eligible patients were aged 16 years or older, were English-speaking, were being followed actively for a fracture(s), were cognitively able to complete the questionnaires and provided informed consent. All consenting patients completed a baseline assessment form, the Symptom Checklist-90-Revised and a health-related quality of life questionnaire (the Medical Outcomes Study 36-item Short Form [SF-36]). We conducted regression analyses to determine predictors of quality of life among study patients.

Results

Of the patients, 250 were eligible, and 215 agreed to participate; 59% were men; the patients'' mean age was 44.5 (standard deviation [SD] 18.8) years. Over one-half (54%) of the patients had lower extremity fractures. Patient Physical Component summary scores were associated with older age (β = –0.28, p < 0.001), ongoing litigation (β = –0.18, p = 0.02), fracture location (β = –0.18, p = 0.01) and Positive Symptom Distress Index (i.e., the intensity of psychological symptoms; β = –0.08, p = 0.003). This model predicted 21% of the variance in patients'' Physical Component summary scores. Somatization was an important psychological symptom negatively associated with Physical Component summary scores. Reduced Mental Component summary scores were associated with ongoing litigation (β = –0.18, p = 0.03) and Global Severity Index of psychological symptoms (β = –0.50, p < 0.001). This model explained 31% of the variability in patients'' Mental Component summary scores.

Conclusion

In a prospective study of 215 patients, 1 in 5 met the threshold for psychological distress. Only ongoing litigation and psychological symptoms were significantly associated with both SF-36 Physical Component and Mental Component summary scores. Future research is necessary to determine whether orthopedic trauma patients would benefit from early screening and intervention to address comorbid psychopathology.     

Social media,advertising, and internet use among general and bariatric surgeons

The use of the internet and technology has increased, and its implication with medicine is inevitable. Along with these technologies, social media platforms have changed the interaction between peers, forcing an evolution on medical activities and patient relationship. There is no clear information on how surgeons interact with these platforms within their daily practice. A transverse study with a survey obtained from general and bariatric surgeons from Mexico was performed, aimed to gather information about social media platforms use (Facebook, Instagram, Twitter, and LinkedIn). Personal, professional, academic, and marketing activities were analyzed and compared between general and bariatric surgeons. Secondly, the same analysis was performed in younger participants. Other variables were also analyzed, such as type of marketing and monthly budget. We obtained 523 surveys (84.1% general and 15.8% bariatric surgeons), where male gender comprised 86.4%. Almost a third considered social media as an important tool. In 53% of the cases, Facebook was preferred for professional activities; Twitter was the second most used. Bariatric surgeons were younger, used all platforms more frequently, and preferred Facebook for every activity. They also invested more in publicity, and showed wider marketing methods than general surgeons. There is an important awareness of internet and social media use among general and bariatric surgeons. Facebook leads the activities for both specialties (personal, professional, academic, and marketing), but bariatric surgeons are significantly more involved; additionally, there are more marketing strategies and investment among them.     

Facial Fractures in Kajang Hospital,Malaysia: A 5-Year Review

Abstract Objective: The objective of this study was to determine the demographic data as well as other relevant data pertaining to the management of patients with maxillofacial injury in a Malaysian government regional hospital. Study Design: Medical records of 313 patients who sustained maxillofacial injury treated in Kajang Hospital, Selangor, Malaysia over a 5-year period (1998–2002) were collected. Data regarding age, gender and race, etiology of injury, site of injury, other associated injuries and treatment undertaken were analyzed. Results: Two hundred and forty-nine male (79.6%) and 64 female patients (20.4%) were treated for maxillofacial trauma. The patients' age range from 1 to 67 years old, with a median age of 23 years old. A high number of Malays (60.1%) sustained maxillofacial injury, followed by Indians (16%), Chinese (13.4%) and other races (10.5%). Road traffic accident was the main etiology for maxillofacial injury with 230 cases (73.5%), followed by fall (16.6%), assault (5.4%), industrial accident (2.6%), sports injuries (0.6%) and others (1.3%). Mandibular fractures were the most common, occurring in 83.1% of the cases while the midfacial fractures accounted for 16.9%. Majority of patients were treated with closed reduction and intermaxillary fixation (88.1%) and 11.9% underwent open reduction and internal fixation. Conclusion: Road traffic accident involving motorcyclists was the main cause of maxillofacial trauma in Malaysia. The most common facial fracture was the mandibular fracture. Non-surgical manipulation of fracture was the most common treatment carried out in this hospital.     

Polymorphisms of Muscle Genes Are Associated with Bone Mass and Incident Osteoporotic Fractures in Caucasians

The interaction between muscle and bone is complex. The aim of this study was to investigate if variations in the muscle genes myostatin (MSTN), its receptor (ACVR2B), myogenin (MYOG), and myoD1 (MYOD1) were associated with fracture risk, bone mineral density (BMD), bone mineral content (BMC), and lean body mass. We analyzed two independent cohorts: the Danish Osteoporosis Prevention Study (DOPS), comprising 2,016 perimenopausal women treated with hormone therapy or not and followed for 10 years, and the Odense Androgen Study (OAS), a cross-sectional, population-based study on 783 men aged 20–29 years. Nine tag SNPs in the four genes were investigated. In the DOPS, individuals homozygous for the variant allele of the MSTN SNP rs7570532 had an increased risk of any osteoporotic fracture, with an HR of 1.82 (95 % CI 1.15–2.90, p = 0.01), and of nonvertebral osteoporotic fracture, with an HR of 2.02 (95 % CI 1.20–3.41, p = 0.01). The same allele was associated with increased bone loss (BMC) at the total hip of 4.1 versus 0.5 % in individuals either heterozygous or homozygous for the common allele (p = 0.006), a reduced 10-year growth in bone area at the total hip of 0.4 versus 2.2 and 2.3 % in individuals heterozygous or homozygous for the common allele, respectively (p = 0.01), and a nonsignificantly increased 10-year loss of total-hip BMD of 4.4 versus 2.7 and 2.9 % in individuals heterozygous or homozygous for the common allele, respectively (p = 0.08). This study is the first to demonstrate an association between a variant in MSTN and fracture risk and bone loss. Further studies are needed to confirm the findings.     

Identifying potential kidney donors using social networking web sites

Social networking sites like Facebook may be a powerful tool for increasing rates of live kidney donation. They allow for wide dissemination of information and discussion and could lessen anxiety associated with a face‐to‐face request for donation. However, sparse data exist on the use of social media for this purpose. We searched Facebook, the most popular social networking site, for publicly available English‐language pages seeking kidney donors for a specific individual, abstracting information on the potential recipient, characteristics of the page itself, and whether potential donors were tested. In the 91 pages meeting inclusion criteria, the mean age of potential recipients was 37 (range: 2–69); 88% were US residents. Other posted information included the individual's photograph (76%), blood type (64%), cause of kidney disease (43%), and location (71%). Thirty‐two percent of pages reported having potential donors tested, and 10% reported receiving a live‐donor kidney transplant. Those reporting donor testing shared more potential recipient characteristics, provided more information about transplantation, and had higher page traffic. Facebook is already being used to identify potential kidney donors. Future studies should focus on how to safely, ethically, and effectively use social networking sites to inform potential donors and potentially expand live kidney donation.     

Craniofacial trauma in adolescents: incidence, etiology, and prevention

BACKGROUND: The lack of a common agreement on the precise meaning of the term "adolescence" makes it difficult to interpret the literature regarding fractures in this age group. METHODS: The records of all patients with craniofacial trauma admitted to the Division of Maxillo-Facial Surgery of the Rome "La Sapienza" University Hospital between February 2001 and August 2004 were reviewed retrospectively. Besides the anatomical site of the fracture, the authors also reviewed in the group of adolescent fractures the cause, complications, and the safety devices employed and their effectiveness. RESULTS: Of 601 patients admitted after facial or craniofacial fractures, 96 were between 11 and 19 (15.97%). The most frequent cause of fracture in this age group was motorcycle crash (39/96), followed by car crash (26/96), sporting accident (15/96), attacks (11/96), microcar crash (2/96), accidental fall (2/96), and firearm trauma (1/96). Only three patients wearing a full-face helmet suffered facial fractures; the most severe fractures with neurosurgical complications occurred in patients without a helmet; the majority of facial fractures occurred in patients wearing an open-face helmet. CONCLUSIONS: It is universally agreed that the primary cause of fracture is road collisions and, although car crashes prevail in all other age groups, motorcycle crashes are more frequent in adolescents. It is necessary to emphasize the need for protective devices capable of avoiding not only neurosurgical complications but also maxillofacial fractures (full-face helmet).     

Long‐Term Randomized Trial of Intensive Versus Symptomatic Management in Paget's Disease of Bone: The PRISM‐EZ Study

It has been suggested that normalization of bone turnover may improve clinical outcome in Paget's disease of bone (PDB) by preventing complications such as fractures and the development of osteoarthritis. Here we investigated the long‐term effects of a treatment strategy that aimed to normalize bone turnover in PDB with that of symptomatic treatment. The study group comprised 502 subjects who were enrolled into a 3‐year extension of the Paget's Disease: Randomized Trial of Intensive versus Symptomatic Management (PRISM) study. Intensive bisphosphonate therapy was continued in 270 of these subjects with the aim of normalizing bone turnover using zoledronic acid as the treatment of first choice. Symptomatic treatment continued in 232 subjects in whom bisphosphonates were only given for the treatment of bone pain. The primary outcome was fracture and secondary outcomes were orthopedic procedures, quality of life, and bone pain, adjusted for baseline characteristics. Serum total alkaline phosphatase (ALP) concentrations were significantly lower in the intensive group on entry to the study and the differences between groups increased as the study progressed. There were no clinically important differences in quality of life measures or bone pain between the treatment groups. Intensive treatment was associated with a nonsignificant increase in fracture risk (hazard ratio = 1.90; 95% CI, 0.91 to 3.98; p = 0.087), orthopedic procedures (1.81; 95% CI, 0.71 to 4.61; p = 0.214), and serious adverse events (relative risk 1.28; 95% CI, 0.96 to 1.42). We conclude that long‐term intensive bisphosphonate therapy confers no clinical benefit over symptomatic therapy and is associated with a nonsignificant increase in the risk of fractures, orthopedic events, and serious adverse events. The results of this study suggest that in patients with established PDB, bisphosphonate therapy should focus on control of symptoms rather than suppression of bone turnover. © 2016 American Society for Bone and Mineral Research.     

Prevention of firecracker injuries via the digital platform: A Malaysian experience

IntroductionHealth campaigns include physical campaigns in schools, community halls, or community malls. They can also be broadcast via television, newspaper, and radio. We launched a health campaign on social media platforms that have a powerful impact in this digital era.MethodsA three-dimensional short animation was developed for the Burn and Blast Injury Awareness campaign. It was launched during the fasting month and Eid 2020 when firecracker-related injuries are highly incident in Malaysia. The video was launched primarily on Universiti Sains Malaysia (USM) and Wau Animation Sdn Bhd social media platforms. Each party shared the video on the top 3 social media platforms, which are Facebook, Instagram, and YouTube. The numbers of viewers, reaches, and shares, and demographic data were captured at 1 month after the release.ResultsWe recorded 29,585 views, 60,920 reach, and 874 shares from the USM and Wau Animation platforms alone. The USM Facebook platform showed predominant female viewership (60%), whereas the Wau Facebook platform showed predominant male viewership (66%). In both platforms, the viewers were aged 18–34 years.ConclusionHealth awareness campaigns on digital platforms are powerful because the message spreads faster, and it is also safe during the pandemic.     

Epidemiology of traumatic spine fractures

Objectives

To illustrate the correlations and effects of age, gender and cause of accident on the type of vertebral fracture and fracture distribution, as well as on the likelihood to sustain an associated injury or neurological deficit.

Design

Retrospective analysis of 562 patients with a traumatic fracture of the spine. Each patient was analysed by reviewing the medical records, the initial radiographs and CT-scans.

Setting

Level 1 trauma centre from 01/1996 to 12/2000.

Results

The most common cause of accident was a high-energy fall (39%), followed by traffic accidents (26.5%). While fall related fractures were evenly distributed over the whole spine, traffic accidents induced significantly more fractures of the cervical and thoracic spine. Sixty-five percent of all cervical spine fractures and 80% of the multisegmental injuries were accompanied by an associated injury. The highest incidence of associated injuries was observed in patients with multilevel fractures (96.5%). Patients with a concomitant injury were more likely to sustain a spinal cord lesion. Sixty-three (11.2%) patients exhibited a complete motor and sensory deficit, 76 (13.5%) an incomplete and 423 (75.3%) no neurological deficit. The highest number of complete motor and sensory neurological deficits was found in cervical spine fractures (19.7%). The majority of patients, 308 (54.8%), sustained a compression fracture, 95 (16.9%) a distraction fracture, and 104 (18.5%) patients experienced a rotational fracture.

Conclusions

This study demonstrates correlations between the cause of accident, the type of spinal fracture and the fracture distribution. Using the AO classification, the likelihood to sustain either associated and/or spinal cord injuries, is predictable.     

Double lésion traumatique du rachis cervical (fracture de l’odontoïde et contusion médullaire C5–C6) et syndrome de Klippel-Feil

Klippel-Feil syndrome (KFS) is defined as a congenital fusion of at least two cervical vertebrae. Patients with KFS are known to be at high risk for spinal cord injury in case of cervical trauma even with weak kinetic. We report the case of a patient with C4–C5 and C6–C7 congenital fusion, harbouring C5–C6 post-traumatic spinal cord injury, associated with an odontoid fracture type 2 of Anderson and D’Alonzo classification following a motorbike accident.