Background: Identification of risk factors involved in road traffic deaths (RTDs) could help policymakers and road traffic managers to adopt effective strategies and approaches for the prevention and control of these incidents, while the lack of accurate data on the risk factors of RTDs causes the problem to persist. This systematic review aimed at assessing the national studies regarding the risk factors of RTDs in the regions covered by the World Health Organization (WHO). Methods: This review study was conducted during 2008–2018 via searching in databases of PubMed, Science Direct, Scopus, Cochrane, Thomson Reuters, Web of Science, EMBASE, ProQuest, and Trip databases. Initially, a literature review was performed to find similar systematic reviews, followed by another literature review to retrieve the published or registered protocols. At the next stage, PECOTS was developed for the search strategy, followed by the quality assessment. The eligibility criteria in this study were the national-level studies about the risk factors related to RTDs, English-language studies, and studies published during 2008–2018. Results: In total, 169 articles were included in this study, with the highest and lowest number of the published articles in the United States and African countries, respectively. According to the reviewed studies, human factors accounted for the most common risk factors involved in RTDs. In the southeastern regions of Asia, the main road-related risk factor for RTDs was reported to be the type of roads. Furthermore, roadside departure to the right side and long roads were denoted in the national data of the Western Pacific region on the incidence of RTDs. Differences were observed between the six regions covered by the WHO in terms of the time-related risk factors for RTDs. Conclusions: Several risk factors have been reported for RTDs in the countries covered by the WHO, and each risk factor is considered to have various subcategories. Therefore, it could be concluded that there are different epidemiological patterns for road traffic accidents and RTDs.

Background: There is an ongoing debate if bone graft substitutes (BGSs) are beneficial in the treatment of displaced intra-articular calcaneal fractures (DIACFs). The purpose of this study was to evaluate the effect of an injectable calcium sulfate/hydroxyapatite BGS (CERAMENTTM iBONE VOID FILLER, BONESUPPORT AB, Lund, Sweden) in internal fixation of calcaneal fractures. Methods: The records of patients presenting with calcaneal fractures type Sanders III and IV and treated with internal fixation plus BGS were reviewed. Radiographs were analyzed using different measurements (including Böhler's angle and calcaneal facet height). The clinical outcome was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale. Results: A total of 20 fractures were available for radiographic and clinical examination at a minimum follow-up of 12 months. No decrease in Böhler's angle was recorded in six fractures, a reduction of <5° in 6 and of more than 5° in 8 fractures. In all fractures, the BGS was completely resorbed at 12 months on radiographs. The AOFAS score was on an average 89.8 (range, 68–99) at 1-year follow-up and indicated an excellent outcome in 11, a good outcome in 8, and a fair outcome in 1 fracture. Conclusions: The study results support the use of an injectable, in situ hardening calcium sulfate/hydroxyapatite BGS in DIACFs. The BGS is easy and safe to use as an augment to open reduction and internal fixation.

Scalp arteriovenous malformation (SAVM) as a rare lesion may be a complication of head injury. A case and its management are presented in this article and literature is reviewed. A 27-year-old man came to us with a slowly growing pulsatile mass in his right retroauricular and parietal region of the scalp. On examination, there was a compressible mass with loud bruit. Paraclinical studies revealed a large, tortuous tuft of vessels with two different feeders. Intracranial vessels were 3 normal. The lesion excised totally by direct surgical intervention after ligation of its feeders. The patient recovered and discharged without any abnormal findings. Increased number of reports of SAVM in the past decade may be due to improved diagnostic facilities; however, the high incidence of trauma and even its increasing pattern in developing countries may be another important factor.

Background: The increased use of computed tomography (CT) results in higher occult hemothorax detection in blunt chest trauma. The indication for pleural decompression is not well defined. This research aims to study the overall factors determining pleural decompression. Methods: All blunt chest injury patients were retrospectively reviewed from the institutional trauma registry. Patients who underwent chest or whole-abdomen CT within 24 h were reviewed by a radiologist to identify initial occult hemothorax defined as a negative chest X-ray with the presence of hemothorax in the CT. The data included demographic data, mechanism of injury, complications, treatments, and characteristics of the hemothorax from the CT. Results: Six hundred and eighty-six blunt chest injury patients were reviewed over a period of 30 months. Eighty-one (24.9%) patients had occult hemothorax. The mean time from injury to CT was 5.7 h. Most patients (87.6%) were male. Most patients (70.2%) suffered from traffic collisions and 84.4% had rib fractures. Pleural decompression was performed in 25 patients who had significantly thicker hemothorax (1.1 cm vs. 0.8 cm,P 1.1 cm was associated with increased risk of pleural decompression (odds ratio [OR]: 5.51, 95% confidence interval [CI]: 1.42–21.42) and occult pneumothorax (OR: 6.93, 95% CI: 1.56–30.77). Conclusions: Drainage of occult hemothorax after blunt chest trauma was significantly associated with concomitant occult pneumothorax, lung contusion, and hemothorax thicker than 1.1 cm.

Background: Trauma surgery has an interdisciplinary nature among the surgical specialties, and trauma surgeons are required to identify its related scientific fields to acquire the needed skills in controlling the injuries. This study was conducted to investigate the science mapping of trauma surgery based on the bibliographic data of MEDLINE. Methodology: Based on the bibliographic data from the MEDLINE database, the visualizing techniques of bibliometric networks and all the scientific products of the trauma surgery realm indexed at MEDLINE from 2008 to 2017 were investigated. Data analysis was performed using co-word analysis and cluster analysis using the VOSviewer. Results: The growth trend of scientific productions in the field of trauma surgery has been on the rise in the past 10 years. The keyword “trauma,” followed by “osteoporosis,” “fracture outcome,” “trauma surgery,” and “mortality” had respectively the highest frequency. The results of cluster analysis identified the most important basic research subjects of trauma surgery published in MEDLINE in the past 10 years and categorized them into five clusters. Trauma surgery field had a close relationship with the field of orthopedics, basic studies, and laboratory research in comparison with its clinical domains. Conclusion: We attempted to identify the vastness of the knowledge subjects of trauma surgery and to conduct educational research, and technological planning so that the managers and stakeholders can trace the path of future scientific activities in the field of trauma surgery. The identification of this important realm and provision of the required information on the core issues for the users can be facilitated by drawing up a science map and visualizing the main traumatic sciences.

Introduction: Numerous geometrically simplified models may be found in the literature on simulation of the traumatic brain injuries due to the increased intracranial pressure induced by severe translational accelerations of the brain inside the cranium following the impact waves. While numerous researchers have utilized viscoelastic models, some have employed specific hyperelastic models for behavior analysis of the brain tissue. No research has been presented so far based on the more realistic visco-hyperelastic model. Materials and Methods: In the present research, a realistic finite element model and four visco-hyperelastic constitutive models (viscoelastic models on the basis of the polynomial, Yeoh, Arruda-Boyce, and Ogden hyperelastic models) are employed to accomplish the outlined task. Therefore, the main motivation of the present research is checking the accuracy of the modeling procedure rather than presenting clinical results. In this regard, a realistic skull-brain model is constructed in CATIA computer code based on the magnetic resonance imaging scans and optimized in the HYPERMESH finite element software. Results: Influence of the contact and nonlinear characteristics of the brain tissue are considered in the simulation of the relative motions in LS-DYNA software to predict time histories of the acceleration and the coup and countercoup pressures by means of ANSYS finite element analysis software. Discussion: Comparing results of the four proposed visco-hyperelastic constitutive models with the available experimental reveals that employing Arruda–Boyce or Ogden-type viscoelastic models may lead to inaccurate or even erroneous results.

Background: Field hockey is one of the most popular sports in the world, yet little is known about patient outcome following fracture injuries sustained during this sport. Objectives: The aim of this study is to describe the epidemiology, management, and outcome of field hockey-related fractures in a known UK population at all skill levels. Materials and Methods: All fractures sustained during field hockey from 2007 to 2008 within the adult Lothian population were prospectively recorded and confirmed by an orthopedic surgeon during treatment at the sole adult orthopedic center in the region. Nonresident individuals were not included in the study. Follow-up data were obtained in September 2010 to determine return rates and times to field hockey. Results: Nineteen fractures were recorded over the study period in 19 patients. Seventeen (89%) of the fractures were recorded in the upper limb, with 15 (79%) recorded in hand. Eighteen fractures (85%) in 18 patients (95%) were followed up at a mean interval of 31 months (range: 25-37 months; standard deviation [SD] 2.1 months). The mean time for return to field hockey from injury was 10.8 weeks (range: 3-26 weeks; SD 7.1 weeks). For patients with upper limb injuries, the mean time was 9.2 weeks (range: 3-20 weeks; SD 5.7 weeks), compared to 22 weeks (range: 18-26 weeks; SD 5.7 weeks) for patients with lower limb injuries. Eleven percent of the cohort did not return to field hockey. Seventy-eight percent of the cohort returned to field hockey at the same level or higher. Fifty percent had ongoing related problems, yet only 17% had impaired field hockey ability because of these problems. Fractures with the highest morbidity in not returning to field hockey were as follows: Metacarpal 14% and finger phalanx 13%. Conclusions: The significant majority of field hockey-related fractures are sustained in the upper limb, notably the hand. Around ninety percent of patients sustaining a fracture during field hockey will return to this sport at a similar level. While half of these will have persisting symptoms 2 years postinjury, only one-third of symptomatic patients will have impaired field hockey ability because of this.

Background: Problems of emotional regulation and lack of social skills in veterans' families are very common and like psychological complications have unpleasant consequences for them. Therefore, effective and helpful interventions and therapies are highly important. Objectives: The current study aimed at evaluating the effect of mindfulness-based stress reduction (MBSR) on the improvement of emotional regulation and psychological well-being in veterans' homemakers with secondary posttraumatic stress disorder. Patients and Methods: In the current study, the permuted blocked randomization method was used. Participants were selected from veterans' homemakers referred to the counseling center of veterans in Kashan city (Iran) in 2015. They were randomly assigned into two groups (30 controls and 31 cases). The case group underwent the MBSR treatment. Results: Results showed no significant difference between the two groups at the baseline (P < 0.05). No significant difference was observed in the total score of MBSR on emotional regulation between the groups. However, the difference between pre- and post-test of rejection of emotional response subscale was significant. In addition, the total score in the psychological well-being at pre- and post-test was significant. Conclusions: It seems that MBSR significantly affects the psychological well-being, but it has no effect on the emotional regulation except the subscale of emotional response rejection.

Context Acute acromioclavicular joint (ACJ) dislocations are very common in young and active adults. Despite the high incidence of this injury, there is still some controversy on its diagnosis and treatment. Evidence Acquisition This review was based on the knowledge of the current literature listed in PubMed. It summarizes the current strategies for acute AC joint injuries. Results Acute injuries of the AC joint are very common among active individuals. Most authors recommend panorama- (stress-) view radiographs and additional radiographs for the horizontal instability. Low-grade injuries (Rockwood I-II) should be treated conservatively whereas high-grade injuries (Rockwood IV-VI) are best treated surgically. The most appropriate treatment for Rockwood III injuries is still a matter of debate and should be recommended based on the individual needs of the patient. Conclusions Based on the current literature, there still is no gold standard for the diagnosis of acute AC joint injuries. As surgical techniques, the hook plate as well as the arthroscopic button techniques are commonly used leading to good and reproducible results. However, evidence of the superiority of these techniques over alternative methods is lacking.

ContextMusculoskeletal injuries may be painful, troublesome, life limiting and also one of the global health problems. There has been considerable amount of interest during the past two decades to stem cells and tissue engineering techniques in orthopedic surgery, especially to manage special and compulsive injuries within the musculoskeletal system.Evidence AcquisitionThe aim of this study was to present a literature review regarding the most recent progress in stem cell procedures and current indications in orthopedics clinical care practice. The Medline and PubMed library databases were searched for the articles related with stem cell procedures in the field of orthopedic surgery and additionally the reference list of each article was also included to provide a comprehensive evaluation.ResultsVarious sources of stem cells have been studied for orthopedics clinical care practice. Stem cell therapy has successfully used for major orthopedic procedures in terms of bone-joint injuries (fractures-bone defects, nonunion, and spinal injuries), osteoarthritis-cartilage defects, ligament-tendon injuries, femoral head osteonecrosis and osteogenesis imperfecta. Stem cells have also used in bone tissue engineering in combining with the scaffolds and provided faster and better healing of tissues.ConclusionsLarge amounts of preclinical studies have been made of stem cells and there is an increasing interest to perform these studies within the human population but preclinical studies are insufficient; therefore, much more and efficient studies should be conducted to evaluate the efficacy and safety of stem cells.