Database : MEDLINE
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[PMID]: 29524587
[Au] Autor:Levy J; Lansaman T; Frémondière F; Ferrapie AL; Sher A; Dinomais M; Bensmail D
[Ad] Address:Department of Physical and Rehabilitation Medicine, spinal cord injuries unit - APHP, Raymond Poincaré Hospital, Garches, France; UMR1179, INSERM - University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France. Electronic address: levyjonathan2@gmail.com.
[Ti] Title:Spasticity or periodic limb movements? Lessons from a not-uncommon case report.
[So] Source:Ann Phys Rehabil Med;, 2018 Mar 07.
[Is] ISSN:1877-0665
[Cp] Country of publication:Netherlands
[La] Language:eng
[Pt] Publication type:LETTER
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

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[PMID]: 29523475
[Au] Autor:Sexton SJ; Granieri MA; Lentz AC
[Ad] Address:Department of Surgery, Division of Urology, Duke University Medical Center, Durham, NC, USA.
[Ti] Title:Survey on the Contemporary Management of Intraoperative Urethral Injuries During Penile Prosthesis Implantation.
[So] Source:J Sex Med;, 2018 Mar 06.
[Is] ISSN:1743-6109
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: Intraoperative urethral injury is an uncommon event during the placement of a penile prosthesis, and alternative management strategies have been proposed with continuation of implantation after urethral injury. AIM: To evaluate surgeon practices in the management of intraoperative urethral injury. METHODS: An online survey was sent to the society listservs of the Genitourinary Reconstructive Surgeons (GURS) and the Sexual Medicine Society of North America (SMSNA). Physicians were queried on their fellowship training, experience with penile prosthesis implantation, and management of urethral injuries during prosthesis placement. The response data were analyzed using SAS 9.4 (SAS Institute, Cary, NC, USA). The χ test and Fisher exact test were used to determine associations between variables. OUTCOMES: Survey responses. RESULTS: 131 survey responses were analyzed. Of the responders, 41.2% were GURS fellowship trained, 19.1% were SMSNA trained, 30.5% were non-fellowship trained, and 9.2% were trained in other fellowships. 25.4% of participants performed more than 50 implantations per year, 37.7% performed 20 to 50 per year, and 36.9% performed fewer than 20 per year. Urethral injury during prosthesis implantation was uncommon, with 26.2% reporting 0 injury, 58.5% reporting 1 to 3 injuries, and 15.4% reporting more than 3 career injuries. Injuries were most commonly encountered during corporal dilation (71.1%) compared with corporal exposure (12.5%) or penile straightening maneuvers (7.0%). There was no statistically significant difference with aborting or continuing implantation among GURS-trained, SMSNA-trained, other fellowship-trained, and non-fellowship-trained surgeons. Of all responders, 55% would abort the procedure after distal urethral injury, whereas 45% would continue the procedure with unilateral or bilateral insertion of cylinders. Patient factors that increased likelihood of terminating the procedure in the case of urethral injury included immunosuppression, spinal cord injury, and clean intermittent catheterization dependence. CLINICAL IMPLICATIONS: A urethral injury during penile prosthesis implantation might not mandate termination of the procedure despite classic teaching. STRENGTHS AND LIMITATIONS: The strength of this study is that it provides difficult to obtain epidemiologic data on the frequency and management of this clinically significant injury. Limitations include the inherent biases from a survey-based study including response bias and recall bias. The survey response rate could not be obtained. CONCLUSION: Urethral injury during penile prosthesis implantation is a rare but clinically significant risk of the procedure, with many variations in management of the injury. Termination and delayed implantation might not be necessary after injury, although long-term outcome data are difficult to obtain. Sexton SJ, Granieri MA, Lentz AC. Survey on the Contemporary Management of Intraoperative Urethral Injuries During Penile Prosthesis Implantation. J Sex Med 2018;XX:XXX-XXX.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

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[PMID]: 29523358
[Au] Autor:Yu YR; DeMello AS; Greeley CS; Cox CS; Naik-Mathuria BJ; Wesson DE
[Ad] Address:Baylor College of Medicine, Michael E. DeBakey Department of Surgery, Division of Pediatric Surgery, Texas Children's Hospital, Houston, TX, United States.
[Ti] Title:Injury patterns of child abuse: Experience of two Level 1 pediatric trauma centers.
[So] Source:J Pediatr Surg;, 2018 Feb 10.
[Is] ISSN:1531-5037
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: This study examines non-accidental trauma (NAT) fatalities as a percentage of all injury fatalities and identifies injury patterns in NAT admissions to two level 1 pediatric trauma centers. METHODS: We reviewed all children (<5years old) treated for NAT from 2011 to 2015. Patient demographics, injury sites, and survival were obtained from both institutional trauma registries. RESULTS: Of 4623 trauma admissions, 557 (12%) were due to NAT. However, 43 (46%) of 93 overall trauma fatalities were due to NAT. Head injuries were the most common injuries sustained (60%) and led to the greatest increased risk of death (RR 5.1, 95% CI 2.0-12.7). Less common injuries that increased the risk of death were facial injuries (14%, RR 2.9, 95% CI 1.6-5.3), abdominal injuries (8%, RR 2.8, 95% CI 1.4-5.6), and spinal injuries (3%, RR 3.9, 95% CI 1.8-8.8). Although 76% of head injuries occurred in infants <1year, children ages 1-4years old with head injuries had a significantly higher case fatality rate (27% vs. 6%, p<0.001). CONCLUSION: Child abuse accounts for a large proportion of trauma fatalities in children under 5years of age. Intracranial injuries are common in child abuse and increase the risk of death substantially. Preventing NAT in infants and young children should be a public health priority. TYPE OF STUDY: Retrospective Review. LEVEL OF EVIDENCE: II.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

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[PMID]: 29357466
[Au] Autor:Cappellini G; Sylos-Labini F; MacLellan MJ; Sacco A; Morelli D; Lacquaniti F; Ivanenko Y
[Ad] Address:Centre of Space Bio-medicine, University of Rome Tor Vergata , Rome , Italy.
[Ti] Title:Backward walking highlights gait asymmetries in children with cerebral palsy.
[So] Source:J Neurophysiol;119(3):1153-1165, 2018 Mar 01.
[Is] ISSN:1522-1598
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:To investigate how early injuries to developing motor regions of the brain affect different forms of gait, we compared the spatiotemporal locomotor patterns during forward (FW) and backward (BW) walking in children with cerebral palsy (CP). Bilateral gait kinematics and EMG activity of 11 pairs of leg muscles were recorded in 14 children with CP (9 diplegic, 5 hemiplegic; 3.0-11.1 yr) and 14 typically developing (TD) children (3.3-11.8 yr). During BW, children with CP showed a significant increase of gait asymmetry in foot trajectory characteristics and limb intersegmental coordination. Furthermore, gait asymmetries, which were not evident during FW in diplegic children, became evident during BW. Factorization of the EMG signals revealed a comparable structure of the motor output during FW and BW in all groups of children, but we found differences in the basic temporal activation patterns. Overall, the results are consistent with the idea that both forms of gait share pattern generation control circuits providing similar (though reversed) kinematic patterns. However, BW requires different muscle activation timings associated with muscle modules, highlighting subtle gait asymmetries in diplegic children, and thus provides a more comprehensive assessment of gait pathology in children with CP. The findings suggest that spatiotemporal asymmetry assessments during BW might reflect an impaired state and/or descending control of the spinal locomotor circuitry and can be used for diagnostic purposes and as complementary markers of gait recovery. NEW & NOTEWORTHY Early injuries to developing motor regions of the brain affect both forward progression and other forms of gait. In particular, backward walking highlights prominent gait asymmetries in children with hemiplegia and diplegia from cerebral palsy and can give a more comprehensive assessment of gait pathology. The observed spatiotemporal asymmetry assessments may reflect both impaired supraspinal control and impaired state of the spinal circuitry.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1152/jn.00679.2017

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[PMID]: 28452700
[Au] Autor:Ghadersohi S; Ference EH; Detwiller K; Kern RC
[Ad] Address:Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
[Ti] Title:Presentation, workup, and management of penetrating transorbital and transnasal injuries: A case report and systematic review.
[So] Source:Am J Rhinol Allergy;31(2):29-34, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: A foreign body (FB) penetrating intracranially after passing transorbitally or transnasally is a rare occurrence. However, otolaryngologists are increasingly being asked to participate in the care of these patients for both endoscopic removal of the object and repair of any skull base defects. OBJECTIVE: To assess the presentation, workup, and management of transnasal or transorbital penetrating FB injury. METHODS: Systematic review of the presentation, workup, and management of transnasal or transorbital penetrating FB injury; plus, a case report of a 53-year-old woman with a transorbital penetrating rose bush branch. We searched medical literature data bases, which resulted in 215 total titles, which were then narrowed based on inclusion and exclusion criteria. RESULTS: Thirty-five cases of transorbital or transnasal low-velocity trauma that involved the paranasal sinuses were reviewed from 33 articles. The average age was 30 years, 40% of the objects were made of wood. Fifty-seven percent of the cases were transorbital, whereas 43% were transnasal. Forty-six percent of the surgical interventions were completed endoscopically or with endoscopic assistance. Complications of injury were common, with 66% of patients experiencing cerebrospinal fluid leaks; 23%, permanent blindness; 17%, meningitis; 14%, ophthalmoplegia; 9%, decreased visual acuity; and 3%, brain abscess. Our patient presented with a traumatic cerebrospinal fluid leak, and recovered well after transorbital and endoscopic removal of the branch, skull base repair, and a prolonged course of antibiotics and antifungal medications. CONCLUSIONS: Transnasal and transorbital penetrating FB injuries are a relatively uncommon occurrence but when they do occur require rapid workup and interdisciplinary management to prevent acute and delayed complications.
[Mh] MeSH terms primary: Cerebrospinal Fluid Leak/epidemiology
Craniocerebral Trauma/epidemiology
Endoscopy
Eye Injuries/epidemiology
Head Injuries, Penetrating/epidemiology
Orbit/surgery
Paranasal Sinuses/surgery
Postoperative Complications/epidemiology
[Mh] MeSH terms secundary: Cerebrospinal Fluid Leak/etiology
Craniocerebral Trauma/surgery
Eye Injuries/surgery
Female
Foreign Bodies
Head Injuries, Penetrating/surgery
Humans
Middle Aged
Skull Base/surgery
United States/epidemiology
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4421

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[PMID]: 29521796
[Au] Autor:Marcotte J; Hazelton J; Arya C; Dalton M; Batool A; Gaughan J; Nguyen L; Porter J; Fox N
[Ad] Address:General Surgery Resident, Department of Surgery, Cooper University Hospital, Camden, NJ.
[Ti] Title:A Selective Placement Strategy for Surgical Feeding Tubes Benefits Trauma Patients.
[So] Source:J Trauma Acute Care Surg;, 2018 Mar 08.
[Is] ISSN:2163-0763
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The indications for surgical feeding tube (SFT) placement in trauma patients are poorly defined. Patient selection is critical as complications from SFTs have been reported in up to 70% of patients. A previous analysis by our group determined that 25% of the SFTs we placed were unnecessary and that older patients, patients with head and spinal cord injuries, and patients who needed a tracheostomy were more likely to require long term SFTs. Following this study, we modified our institutional guidelines for SFT placement. We hypothesized that a more selective placement strategy would result in fewer unnecessary SFTs. METHODS: A retrospective review of all adult patients from 2012-2016 with an ICU LOS>4 days and a SFT placed during admission was conducted. This group was compared to data collected prior to our change in practice (2007-2010). Data from 2011 was excluded as a washout period. "Necessary" SFT use was defined per established guidelines as either daily use of the SFT through discharge or for ≥28 days and "unnecessary" SFT use as all others. RESULTS: 257 SFTs were placed from 2007-2010 and 244 from 2012-2016. Following implementation of our selective SFT placement strategy, unnecessary SFT placement decreased from 25% in 2007-2010 to 8% in 2012-2016 (p<0.0001). Significant predictors of necessary SFT placement by univariate regression were: increasing age (OR 1.03/yr CI 1.01-1.04), head injury (OR 2.80 CI 1.71-4.60), cervical spinal cord injury (OR 4.42 CI 1.34-14.50), and need for tracheostomy (OR 1.41 CI 2.21-7.67). The overall complication rate was 11% (9% in the selective group vs. 13% in the pre-selective group, p=0.2574), and was highest following open SFT placement (22%). CONCLUSIONS: A selective placement strategy for SFTs in our trauma population resulted in fewer unnecessary SFTs and a trend toward fewer complications. SFTs should be placed through a percutaneous approach whenever possible. LEVEL OF EVIDENCE: III STUDY TYPE: Therapeutic.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1097/TA.0000000000001867

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[PMID]: 29520416
[Au] Autor:Yoong S; Kothari R; Brooks A
[Ad] Address:Queen's Medical Centre, Derby Rd, Nottingham, NG7 2UH, UK. susanyoong@hotmail.com.
[Ti] Title:Assessment of sensitivity of whole body CT for major trauma.
[So] Source:Eur J Trauma Emerg Surg;, 2018 Mar 08.
[Is] ISSN:1863-9941
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Whole body computed tomography has become standard practice in many centres in the management of severely injured trauma patients, however, the evidence for it's diagnostic accuracy is limited. AIM: To assess the sensitivity of whole body CT in major trauma. METHOD: Retrospective review of all patients with injury severity score (ISS) > 15 presenting with blunt trauma to a UK Major Trauma Centre between May 2012 and April 2014. Injuries were classified as per ISS score-1 = head and neck 2 = face 3 = chest 4 = abdomen. The authors reviewed patient's electronic charts, radiological results; interventional procedure records, discharge letters and outpatient follow up documentation and referenced this with Trauma Audit and Research Network data. RESULTS: 407 patients with ISS > 15 presented to the Trauma centre during May 2012 and April 2014. Of these, 337 (82.8%) had a whole body CT scan. 246 pts were male, 91 were female. 74 (21.9%) were due to a fall from > 2 m, 41 (12.2%) due to a fall from < 2 m, 208 (61.7%) were due to motor vehicle crashes, 1 (0.3%) due to a blast injury, 5 (1.5%) due to blows, and 8 (2.4%) due to crush injuries. Sensitivity for Region 1 was 0.98, Region 2 = 0.98, Region 3 = 0.98 and Region 4 was 0.95. Overall sensitivity was 0.98. 15 injuries (2.4%) were not identified on initial CT (false -ve). These injuries were: colonic perforation = 1, splenic contusion = 1, pneumothorax = 1, liver laceration = 1, intracranial haemorrhage = 1, cerebral contusions = 1, spinal injuries = 7, canal haemorrhage = 1, maxilla fracture = 1. CONCLUSION: These results show that whole body CT in trauma has a high sensitivity and a low rate of missed injuries (2.4%). However, our study only evaluated a subgroup of patients with ISS > 15 and further work is required to assess the use of this investigation for all major trauma patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1007/s00068-018-0926-7

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[PMID]: 29504495
[Au] Autor:Dickerson CR; Alenabi T; Martin BJ; Chaffin DB
[Ad] Address:a Digital Industrial Ergonomics and Shoulder Evaluation Laboratory (DIESEL), Faculty of Applied Health Sciences, Department of Kinesiology , University of Waterloo , Waterloo , Canada.
[Ti] Title:Shoulder muscular activity in individuals with low back pain and spinal cord injury during seated manual load transfer tasks.
[So] Source:Ergonomics;:1-8, 2018 Mar 08.
[Is] ISSN:1366-5847
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:This study aimed to compare the activity of four shoulder muscles in individuals with low back pain (LBP), spinal cord injuries (SCI) and a control group, during one-handed load transfer trials. Nine individuals with minimum one-year of LBP, eleven with thoracic/lumbar SCI and nine healthy controls participated in this study. The activations of anterior deltoid, upper trapezius, infraspinatus and pectoralis major were recorded by surface EMG during one-handed transferring of a cylinder from a home shelve to six spatially distributed target shelves. The integrated EMG values were compared using repeated measure ANOVA. Both LBPs and SCIs had higher anterior deltoid activation and LBPs required more upper trapezius activation than controls (p < 0.05). The spatial position of the targets also significantly influenced demands for these two muscles. The anterior deltoid and upper trapezius in LBP and SCI individuals are under higher demand during occupational load transfer tasks. Practitioner Summary: This study aimed to compare the activation of four shoulder muscles in individuals with low back pain, spinal cord injuries and healthy condition. EMG analysis showed that the injured groups required more upper trapezius and anterior deltoid activation during load transfer tasks, which may predispose them to muscle overexertion.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1080/00140139.2018.1447690

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[PMID]: 29489692
[Au] Autor:Hong HN; Shim JH; Won YJ; Yoo JY; Hwang CH
[Ad] Address:Department of Anatomy.
[Ti] Title:Therapeutic time window for the effects of erythropoietin on astrogliosis and neurite outgrowth in an in vitro model of spinal cord injury.
[So] Source:Medicine (Baltimore);97(9):e9913, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The objective of this study was to investigate the underlying molecular mechanisms and the therapeutic time window for preventing astrogliosis with erythropoietin (EPO) treatment after in vitro modeled spinal cord injury (SCI). METHODS: Cultured rat spinal cord astrocytes were treated with kainate and scratching to generate an in vitro model of SCI. EPO (100U/mL or 300U/mL) was added immediately or 2, 4, or 8 hours after injury. Some cultures were also treated with AG490, an inhibitor of the EPO-EPO receptor (EpoR) pathway mediator Janus kinase 2 (JAK2). To evaluate neurite extension, rat embryonic spinal cord neurons were seeded onto astrocyte cultures and treated with EPO immediately after injury in the presence or absence of anti-EpoR antibody. RESULTS: EPO treatment at up to 8 hours after injury reduced the expression of axonal growth inhibiting molecules (glial fibrillary acidic protein, vimentin, and chondroitin sulfate proteoglycan), cytoskeletal regulatory proteins (Rho-associated protein kinase and ephephrin A4), and proinflammatory cytokines (tumor necrosis factor-alpha, transforming growth factor-beta, and phosphorylated-Smad3) in a dosedependent manner (P < .001). Most effects peaked with EPO treatment 2-4hours after injury. Additionally, EPO treatment up to 4 hours after injury promoted expression of the EpoR (>2-fold) and JAK2 (>3-fold) in a dose-dependent manner (P < .001), whereas co-treatment with AG490 precluded these effects (P < .001). EPO treatment up to 4hours after injury also enhanced axonal b-III tubulin-immunoreactivity (>12-fold), and this effect was precluded by co-treatment with an anti-EpoR antibody (P < .001). CONCLUSIONS: EPO treatment within 8 hours after injury reduced astrogliosis, and EPO treatment within 4 hours promoted neurite outgrowth. EPO therapy immediately after spinal cord injury may regulate glia to generate an environment permissive of axonal regeneration.
[Mh] MeSH terms primary: Erythropoietin/administration & dosage
Gliosis/drug therapy
Neuronal Outgrowth/drug effects
Spinal Cord Injuries/drug therapy
Time-to-Treatment
[Mh] MeSH terms secundary: Animals
Astrocytes
Axons/drug effects
Cells, Cultured
Drug Administration Schedule
Rats
Rats, Sprague-Dawley
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:11096-26-7 (Erythropoietin)
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009913

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[PMID]: 29372269
[Au] Autor:Wang H; Zhou Y; Liu J; Ou L; Zhao Y; Han J; Xiang L
[Ad] Address:Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Shenyang, Liaoning, 110016, China. cplawhw@163.com.
[Ti] Title:Traumatic fractures as a result of motor vehicle collisions in children and adolescents.
[So] Source:Int Orthop;42(3):625-630, 2018 Mar.
[Is] ISSN:1432-5195
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:PURPOSE: We investigated the incidence and pattern of traumatic fractures resulting from motor vehicle collisions in a population of children and adolescents (≤18 years old) and to determine the risk factors for nerve injury. METHODS: We retrospectively reviewed 734 patients admitted to our university-affiliated hospitals from 2001 to 2010. RESULTS: This study enrolled 498 male (67.8%) and 236 female (32.2%) patients aged 10.9 ± 5.3 years old. The most common injuries were to pedestrians, and the most common fracture sites (438, 59.7%) were to lower extremities (n = 441, 60.0%). A total of 201 (27.4%) patients experienced a nerve injury. Univariate logistic regression analysis showed that age (P = 0.014), lower-extremity (P = 0.000), craniofacial (P = 0.000) and spinal (P = 0.000) fractures were risk factors for nerve injury. Multivariate logistic regression analysis indicated that craniofacial [odds ratio (OR) = 9.003, 95% confidence interval (CI) 5.159-15.711, P = 0.000)] and spinal (experiencedOR = 10.141, 95% CI: 4.649-22.121, P = 0.011) fractures were independent risk factors for nerve injury. CONCLUSIONS: Patients in the 15- to 18-years old group and drivers had the largest sex ratio and highest frequencies of both nerve injury and early complications. Craniofacial and spinal fractures were independent risk factors for nerve injury. It is therefore important to focus on these risk factors to determine the presence of a nerve injury so that early, timely diagnosis and targeted treatment can be provided.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.1007/s00264-018-3777-2


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