Journal of Trauma & Treatment

Background: There has been varying and divergent methods in the treatment of paediatric and adult wrist fractures. Current opinion and evidence suggest that in paediatric torus distal radius fractures, management with splinting is as comparable a method of treatment to the traditional plaster or Paris (POP) casting. This is a retrospective look at the safety of using the EXOS® thermoplastic (TP) splint to treat wrist fractures.

A 50-year-old patient, with no significant morbid history, suffers an assault and is attacked with a knife, receiving an injury in his left orbit (Figure 1). Patient is transferred to the emergency service. In the initial evaluation, normal neurological examination and the patient was hemodynamically stable. In the ophthalmological examination: the sharp object is seen in the medial region of the left orbit. The surrounding tissue had edema, which hindered the evaluation of that eye. The right eye is was normal.

Background: The literature suggests that the use of the Ilizarov frame is the last line of treatment of tibia fracture non-unions. However, there is a lack of clear guidelines for management of the 3-18% of persistent tibial fracture nonunion after management with Ilizarov method. An amputation rate of 4-10% is reported in this population. This paper describes the ‘Brankov pathway’ to manage this difficult scenario in order to achieve union.
Methods: Retrospective analysis of all tibia fractures managed with an Ilizarov frame by a single surgeon between 1st January 2009 and 1st January 2017 in Perth, Western Australia. Clinical and radiological fracture union was the final outcome of interest.
Results: 100% union of the 59 cases identified using our pathway. This includes 8 cases of non-union after Ilizarov frame use. These 8 cases initially had a ‘frame holiday’, 7 then progressed to an intramedullary nail and one had an open reduction and internal fixation. This series of 8 patients with non-union management post Ilizarov frame appears to be the largest series in the literature.
Conclusion: The ‘Brankov pathway’ enables earlier identification of non-union cases thus shortening the time spent in a frame for patients. In cases of non-union there are also benefits in earlier conversion of the frame to nail/ plate after a ‘frame holiday’. Recurrent infection is possible but less likely with this pathway.

There has been varying and divergent methods in the treatment of paediatric and adult wrist fractures. Current opinion and evidence suggest that in paediatric torus distal radius fractures, management with splinting is as comparable a method of treatment to the traditional plaster or Paris (POP) casting. This is a retrospective look at the safety of using the EXOS® thermoplastic (TP) splint to treat wrist fractures.

Veterans are identified as a vulnerable population with an increased risk for suicidal ideations and attempts. They face multiple challenges after separation from military service, including finding employment and housing, reintegration into family and civilian life. Veterans have a high rate of homelessness, which may predispose them to greater risk for depression and suicide. Lesbian, gay, bisexual, transgender, and queer (LGBTQ) veterans have a potentially higher risk for the suicide compared to the heterosexual/cis-gendered veterans. The lack of research on the LGBTQ community within the U.S. military is sparse due to the military’s historical policies with respect to homosexuals serving in the military. This article focuses on identifying future research aimed toward understanding the suicidal risk of veterans. A vignette is presented as an illustration of the severity of this problem