Survey of American College of Surgeons Committee on trauma members on firearm injury: Consensus and opportunities.

Background: In the United States, there is a perceived divide regarding the benefits and risks of firearm ownership. The American College of Surgeons Committee on Trauma Injury Prevention and Control Committee designed a survey to evaluate Committee on Trauma (COT) member attitudes about firearm ownership, freedom, responsibility, physician-patient freedom and policy, with the objective of using survey results to inform firearm injury prevention policy development.

Methods: A 32-question survey was sent to 254 current U.

Disaster Management Response Guidelines for Departments of Orthopaedic Surgery.

Complacency and lack of preparation are major barriers to an effective disaster response. Leadership assignments and departmental organization for a response should be outlined in advance. Response rehearsal and after-action reviews allow for thoughtful change to a response plan.

Is portable ultrasonography accurate in the evaluation of Schanz pin placement during extremity fracture fixation in austere environments?

Objective: The purpose of this study was to investigate the efficacy of ultrasonography to confirm Schanz pin placement in a cadaveric model, and the interobserver repeatability of the ultrasound methodology.

Design: This investigation is a repeated measures cadaveric study with multiple examiners.

Participants: Cadaveric preparation and observations were done by an orthopaedic traumatologist and resident, and two general surgery traumatologists.

Health-care costs associated with amputation or reconstruction of a limb-threatening injury.

Background: Recent reports have suggested that functional outcomes are similar following either amputation or reconstruction of a severely injured lower extremity. The goal of this study was to compare two-year direct health-care costs and projected lifetime health-care costs associated with these two treatment pathways.

Methods: Two-year health-care costs were estimated for 545 patients with a unilateral limb-threatening lower-extremity injury treated at one of eight level-I trauma centers.

Early predictors of long-term work disability after major limb trauma.

Background: A better understanding of the factors influencing return to work (RTW) after major limb trauma is essential in reducing the high costs associated with these injuries.

Methods: Patients (n = 423) who underwent amputation or reconstruction after limb threatening lower extremity trauma and who were working before the injury were prospectively evaluated at 3, 6, 12, 24, and 84 months. Time to first RTW was assessed.

Long-term persistence of disability following severe lower-limb trauma. Results of a seven-year follow-up.

Background: A recent study demonstrated that patients treated with amputation and those treated with reconstruction had comparable functional outcomes at two years following limb-threatening trauma. The present study was designed to determine whether those outcomes improved after two years, and whether differences according to the type of treatment emerged.

Methods: Three hundred and ninety-seven patients who had undergone amputation or reconstruction of the lower extremity were interviewed by telephone at an average of eighty-four months after the injury.

Functional outcomes following trauma-related lower-extremity amputation.

Background: The principal aims of this study were to examine functional outcomes following trauma-related lower-extremity amputation and to compare outcomes according to the amputation levels. We hypothesized that above-the-knee amputations would result in less favorable outcomes than would through-the-knee or below-the-knee amputations. A secondary aim was to examine the factors, in addition to amputation level, that influence outcome, including the type of soft-tissue coverage, selected patient characteristics, and the technological sophistication of the prosthetic device.

Functional outcomes following displaced talar neck fractures.

Objectives: To determine the outcome of displaced talar neck fractures at long-term follow-up in terms of functional outcome and secondary reconstructive surgery.

Design: Retrospective cohort study.

Setting: Academic level 1 trauma center.

An analysis of outcomes of reconstruction or amputation after leg-threatening injuries.

Background: Limb salvage for severe trauma has replaced amputation as the primary treatment in many trauma centers. However, long-term outcomes after limb reconstruction or amputation have not been fully evaluated.

Methods: We performed a multicenter, prospective, observational study to determine the functional outcomes of 569 patients with severe leg injuries resulting in reconstruction or amputation.

Factors influencing the decision to amputate or reconstruct after high-energy lower extremity trauma.

Background: Factors thought to influence the decision for limb salvage include injury severity, physiologic reserve of the patient, and characteristics of the patient and their support system.

Methods: Eligible patients were between the ages of 16 and 69 with Gustilo type IIIB and IIIC tibial fractures, dysvascular limbs resulting from trauma, type IIIB ankle fractures, or severe open midfoot or hindfoot injuries. Data collected at enrollment relevant to the decision-making process included injury characteristics and its treatment, and the nature and severity of other injuries.