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A-0408 Characteristics of Radiocarpal Dislocations at a Level 1 Trauma Center: a 9 Year Review
James Paul Hovis, Alexandria L. Case, Raymond A. Pensy, W. A. Eglseder, Ebrahim Paryavi, Joshua M. Abzug, University of Maryland School of Medicine, Baltimore, Maryland, USA
Thursday, June 14, 2018 · 3:31 p.m. · 05m 00s
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00:00:01
and i thank you um actually i trash absent the senior author oh arm from university maryland in shock trauma
00:00:09
and uh we're here to talk about the research regarding real couple dislocations at shock trauma
00:00:15
wait a couple dislocations are on comment only reportable
00:00:18
sure in small retrospective studies in case reports
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they're typically caused by high energy trauma however they chew instance of these
00:00:27
injuries is unknown as well as the various patterns of dislocation
00:00:32
the purpose of this study was to investigate the overall incense and various patterns
00:00:36
of real couple dislocations and a high volume level one trauma centre
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reform a retrospective study at shock trauma over nine year period
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we identified our patients you know i think our trauma registry to
00:00:50
isolate i. c. d. nine code specific for radio couple dislocation
00:00:54
basis the various factors of each patient including the injury mechanism
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dissociate injuries mortality injury severity score like the hospital
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stay treatments complications many for subsequent procedures were excluded all
00:01:09
perry eliminate or i sort of delayed dislocations
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over nine years we would identify twenty patients seventeen of which were male
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the average age of patients the time of injury was just under forty years eighty
00:01:22
percent of the injuries were closed in eighty five percent of them were
00:01:25
high energy mechanisms the vast majority being the motor vehicle a motorcycle collisions as
00:01:31
we look at the table all the patients we can see the all
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highlights one look at gender again the vast majority patients were male well look at age
00:01:39
the vast majority of patients were younger in age look at the injury mechanism
00:01:44
the vast majority of injuries were closed you can see that the
00:01:47
vast majority injuries were motorcycle collisions remote of ego collisions you
00:01:51
can also know for the last column that the vast majority of patients with destruction of possible within approximately ten days
00:01:59
many patients did have concurrent injuries as well including it's a lateral approximately fractures dislocations
00:02:05
high energy lower tummy long bone fractures nerve asker trauma
00:02:09
in tendon injuries about the hand the rest
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in our series there were no assisted mortality is the injury severity score
00:02:17
this is definitely lower for clues dislocations compared open dislocations
00:02:23
however with now identified difference between injuries already score for dislocations
00:02:27
with fracture versus those that were soft tissue nature only
00:02:31
the mind to stay was also suffering lower for clothes dislocations compared to open dislocations but we
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didn't know that patients that i can comment wrist fractures an increased chance arlington possible solution
00:02:44
we're a fair number of complications we included the inability initially close the surgical would as
00:02:49
a complication is is is not technically an unplanned return to the operating room
00:02:53
from our initial onset conversation with the patient which was present anyway half of our patients
00:02:58
other reasons for trying to the operating room included removal of hardware
00:03:03
or patients that one on to partial or complete wrist fusion
00:03:07
from the study we can note the radio couple dislocations are sincere with high energy my cousins of
00:03:11
injury to the clean young males in common dresser or long gone trauma is also common
00:03:17
the injury severity score mine to stay or variable it's not pure has an easy
00:03:22
different relationships to injury characteristics as a except for potentially a close dislocation
00:03:28
a high rate of complications and need for additional procedures was found in a series including infection
00:03:34
t. i. e. j. instability and build a primary closer surgical wounds and says what the for removal of hardware and
00:03:40
he should be explains the patient at the onset to up allow for proper expectations with these injuries thank you
00:03:52
thank you very much no questions from the audience
00:04:01
over a questioning the use the the the uh the uh would you go about
00:04:06
this like you should move up to you from the of your uh
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the ring of hospitals engine so that uh because you you completely should be
00:04:16
to open the a promo austen the allusion what is the reason
00:04:21
yeah unfortunately card if you look at only the twenty patience is fairly small because
00:04:25
danger is so rare we think that uh at fracture association lead to higher
00:04:31
rates of additional injuries that ultimately led to the increase length of stay they also
00:04:36
required multiple procedures so other patients initially got x. channel fixation to stable lies
00:04:43
the rest and fixed the fracture and then went back really gonna be construction
00:04:46
so both of those things one uh cause length and possible solutions
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other question in the flow
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nope
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