scholarly journals The effect of COVID-19 on a Major Trauma Network. An analysis of mechanism of injury pattern, referral load and operative case-mix

Injury ◽  
2021 ◽  
Author(s):  
B.M. Sephton ◽  
P. Mahapatra ◽  
M. Shenouda ◽  
N. Ferran ◽  
K. Deierl ◽  
...  
Keyword(s):  
Major Trauma ◽  
Injury Pattern ◽  
Case Mix ◽  
Trauma Network ◽  
Mechanism Of Injury ◽  
Operative Case

Pelvic and acetabular fracture care in England: current workload and future directions

2021 ◽  
Author(s):  
A Martin ◽  
J McMaster ◽  
C Bretherton ◽  
D Noyes
Keyword(s):  
Online Survey ◽  
Major Trauma ◽  
Research Network ◽  
Service Development ◽  
Trauma Network ◽  
Specialist Care ◽  
Case Volume ◽  
Training Opportunity ◽  
Recent Trends ◽  
Staffing And Training

Introduction Fractures of the pelvis and acetabulum (PAFs) are challenging injuries, requiring specialist surgical input. Since implementation of the major trauma network in England in 2012, little has been published regarding the available services, workforce organisation and burden of PAF workload. The aim of this study was to assess the recent trends in volume of PAF workload, evaluate the provision of specialist care, and identify variation in available resources, staffing and training opportunity. Methods Data on PAF volume, operative caseload, route of admission and time to surgery were requested from the Trauma Audit and Research Network. In order to evaluate current workforce provision and services, an online survey was distributed to individuals known to provide PAF care at each of the 22 major trauma centres (MTCs). Results From 2013 to 2019, 23,823 patients with PAF were admitted to MTCs in England, of whom 12,480 (52%) underwent operative intervention. On average, there are 3,971 MTC PAF admissions and 2,080 operative fixations each year. There has been an increase in admissions and cases treated operatively since 2013. Three-quarters (78%) of patients present directly to the MTC while 22% are referred from regional trauma units. Annually, there are on average 37 operatively managed PAF injuries per million population. Notwithstanding regional differences in case volume, the average number of annual PAF operative cases per surgeon in England is 30. There is significant variation in frequency of surgeon availability. There is also variation in rota organisation regarding consistent specialist surgeon availability. Conclusions This article describes the provision of PAF services since the reorganisation of trauma services in England. Future service development should take into account the current distribution of activity, future trends for increased volume and casemix, and the need for a PAF registry.

The impact of the Major Trauma Network: will trauma units continue to treat complex foot and ankle injuries?

Injury ◽  
2014 ◽  
Vol 45 (12) ◽  
pp. 2005-2008 ◽  
Author(s):  
A.G.C. Hay-David ◽  
S.A. Clint ◽  
R.R. Brown
Keyword(s):  
Major Trauma ◽  
Ankle Injuries ◽  
Trauma Network ◽  
Foot And Ankle ◽  
The Impact

scholarly journals 1213 Cycling-related Trauma Admissions to the Major Trauma Centre in the Cycling Capital of the United Kingdom

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
Z Arshad ◽  
M majeed ◽  
A Thahir ◽  
F Anwar ◽  
J Rawal ◽  
...  
Keyword(s):  
United Kingdom ◽  
Major Trauma ◽  
Injury Severity ◽  
Trauma Centre ◽  
Vehicle Group ◽  
Mechanism Of Injury ◽  
Helmet Use ◽  
The United Kingdom ◽  
Body Regions ◽  
Major Trauma Centre

Abstract Aim The number of cyclists travelling on roads in the United Kingdom (UK) is increasing. The government has recently introduced initiatives to promote cycling uptake and so these numbers are likely to increase. This study aims to characterise cycling related injuries presenting to a major trauma centre located within a region with the highest rates of cycling in the UK. Method A retrospective review of cycling related trauma admissions occurring between January 2012 and June 2020 was performed. All patients were split into three groups based on the mechanism of injury. Our institution’s electronic patient record system was used to collect data including age, gender, mechanism of injury, Glasgow coma scale score on arrival, incident date and time, injured body regions, 30-day mortality, helmet use, and length of stay. Results A total of 606 cycling related trauma cases were identified, with 52 being excluded due to incomplete data. The ‘cyclist v vehicle’ group was associated with a significantly higher Injury Severity score (ISS), lower GCS and longer hospital stay than the other two groups. Helmet wearers were significantly older than non-wearers and helmet use was associated with a significantly reduced risk of head injury, lower ISS and higher GCS. Conclusions With a likely increase in future cycling uptake, it is crucial that effective interventions are put in place to improve the safety of cyclists. A multi-faceted strategy involving driver and cyclist education, road infrastructure changes and helmet promotion campaigns targeting the younger generation could be employed.

scholarly journals The Epidemiology of Adult Distal Femoral Shaft Fractures in a Central London Major Trauma Centre Over Five Years

2017 ◽  
Vol 11 (1) ◽  
pp. 1277-1291 ◽  
Author(s):  
Akib Majed Khan ◽  
Quen Oat Tang ◽  
Dominic Spicer
Keyword(s):  
Major Trauma ◽  
Femoral Fractures ◽  
Femoral Shaft ◽  
High Energy ◽  
Locking Plates ◽  
Mechanism Of Injury ◽  
Femoral Shaft Fractures ◽  
Technical Requirements ◽  
Shaft Fractures ◽  
Major Trauma Centre

Background:Distal femoral fractures account for 3-6% of adult femoral fractures and 0.4% of all fractures and are associated with significant morbidity and mortality rates. As countries develop inter-hospital trauma networks and adapt healthcare policy for an aging population there is growing importance for research within this field.Methods:Hospital coding and registry records at the central London Major Trauma Center identified 219 patients with distal femoral shaft fractures that occurred between December 2010 and January 2016. CT-Scans were reviewed resulting in exclusion of 73 inappropriately coded, 10 pediatric and 12 periprosthetic cases. Demographics, mechanism of injury, AO/OTA fracture classification and management were analyzed for the remaining 124 patients with 125 fractures. Mann Whitney U and Chi Squared tests were used during analyses.Results:The cases show bimodal distribution with younger patients being male (median age 65.6) compared to female (median age 71). Injury caused through high-energy mechanisms were more common in men (70.5%) whilst women sustained injuries mainly from low-energy mechanisms (82.7%) (p<0.0001). Majority of fractures were 33-A (52.0%) followed by 33-B (30.4%) and 33-C (17.6%). Ninety-two (73.6%) underwent operative management. The most common operation was locking plates (64.1%) followed by intramedullary nailing (19.6%).Interpretation:The epidemiology of a rare fracture pattern with variable degrees of complexity is described. A significant correlation between biological sex and mechanism of injury was identified. The fixation technique favored was multidirectional locking plates. Technical requirements for fixation and low prevalence of 33-C fractures warrant consideration of locating treatment at centers with high caseloads and experience.

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