The epidemiology of pelvic ring fractures in Qatar.

PURPOSE: This study aimed to determine the incidence of pelvic ring fractures and their associated epidemiological profile in Qatar. METHODS: A retrospective cross-sectional study was performed at the only level I trauma centre in Qatar for patients diagnosed with pelvic ring fractures between January 2016 and December 2018. Age, sex, mechanism of injury, fracture classification and associated characteristics, mode of treatment, associated nerve injuries, and other complications were analyzed. RESULTS: A total of 327 consecutive patients were included, with an average age of 32.6 years. Most of the included patients were males, 85% (279), with a male: female ratio of 6:1. The incidence of pelvic fractures was 3.887/100,000 across the three years. High-speed motor vehicle collisions (MVC) were the most common mechanism of injury (108, 33%), followed by falling from height (105, 32%). Young-Burgess lateral compression (LC) fracture type was the most frequent (224, 68.5%) and was associated with 25% of the entire mortalities. Nine (2.8%) cases were open fractures, and 12% (39) were deemed unstable. Around 29% of cases had associated injuries, with an overall mortality rate of 4.9% (16) observed. Most fractures were treated nonoperatively(n = 283,86.5%). CONCLUSION: This study demonstrated the epidemiology of pelvic fractures in Qatar. MVC and work-related injuries were predominant in a younger cohort compared to the literature. Also, the mortality rate was lower than those reported in the literature. Therefore, well-trained surgeons and specialized trauma centres for treating these injuries are recommended.

Outcomes of drain versus no drain in total knee arthroplasty: a retrospective cohort study.

PURPOSE: The use of suction drains in total knee arthroplasty (TKA) remains controversial. The aim of this study is to compare the outcomes of patients who received suction drains versus those who did not, focusing on blood loss, blood transfusion need, and length of hospital stay. METHODS: A retrospective observational cohort study was conducted at a tertiary hospital between January 1, 2015, and December 30, 2019, and included 262 patients who underwent unilateral non-traumatic primary TKA and were over 18 years old. The Institutional Review Board (IRB) approved the study (MRC-02-20-278). RESULTS: A total of 262 patients were included, with an age range of 47 to 91 years. Most of the included patients were females, 74.4% (195). Hypertension was the most frequent risk factor, 67.6%, followed by diabetes. Of 262 patients, 156 (59.5%) received a drain. The drain group had significantly longer hospital stay, 30% longer tourniquet time, greater haemoglobin and haematocrit drops, higher count of transfused packed RBC units, and lower use of anticoagulants. Moreover, tranexamic acid (TXA) use (n = 106) in surgery reduced hospital stays, tourniquet time, drain output, and increased pre- and postoperative haemoglobin and hematocrit levels compared to no TXA group (n = 156) (p < 0.05, z-score reported). CONCLUSIONS: This study found that patients who received a drain had longer hospital stays and greater blood loss and transfusion rates compared to those who did not. The use of TXA in surgery was associated with improved outcomes and reduced overall complications.

Vanishing solitary osteochondroma of humerus following trauma: A case report.

Osteochondromas are the most common benign tumors of the bone. Mainly these lesions affect the long-bone metaphysis and usually are asymptomatic. When complications develop from these lesions, then they become symptomatic and surgical resection may become indicated. Spontaneous resolution of osteochondroma is rare. There have been fewer case reports about this condition. We are reporting 16 years old, male, who sustained direct trauma to his shoulder and presented with fracture at the base of a solitary osteochondroma. Complete resolution of the lesion occurred without any surgical intervention 18 months following the fracture.

Comparison of Dynamic Hip Screw and Proximal Femoral Nailing Techniques in Stable Intertrochanteric Fractures.

Introduction Dynamic Hip Screw (DHS) and Proximal Femoral Nail (PFN) are two well-accepted modes of surgical treatments for intertrochanteric (IT) hip fractures. While studies have extensively explored the efficacy of one over the other in unstable fractures, the comparison is sparsely available for stable fractures. The main aim of this study is to compare DHS or PFN corrective surgeries in cases of stable IT fractures operated at the Hamad General Hospital, Doha, Qatar, between 2016 and 2018. Methods We conducted a retrospective data review of all stable IT fractures operated at the Hamad General Hospital, Doha, Qatar, between 2016 and 2018. Data were extracted from electronic medical CERNER records, including demographics, clinical notes, operative reports, radiographs, and imaging reports. Data review was followed by prospective data collection via phone about the current post-operative functional status of all cases. Data analysis was done on SPSS v.23. Study was approved by Medical Research Center (MRC) and Institutional Review Board (IRB) at Hamad Medical Corporation (HMC). Study Protocol ID: MRC-01-19-108 Results Out of 62 stable IT fractures operated at our center during the study period, 42 underwent DHS correction, while 20 had PFN. The mean age of the studied cohort was 66.56 years (± 15.95). Males were twice more than females. The mean duration of surgery was 83.73 minutes for DHS and 120.25 minutes for PFN. This difference was statistically significant (p < 0.001). Differences in intraoperative blood loss, duration between fracture and surgery, and length of hospital stay were all statistically insignificant. Patients who underwent PFN showed a higher frequency of return to ambulation (assisted and unassisted), while the number of patients with DHS was less for the functional outcome. Similarly, more post-PFN radiographs displayed union than post-DHS radiographs (55% and 38%, respectively). This difference was statistically insignificant. Conclusion Our study showed promising results for stable IT fractures treated with PFN. However, more data and prospective observational studies are required to establish more statistically significant results.

Imaging Findings of Subcutaneous Human Dirofilariasis.

Dirofilariasis is an emerging helminthic zoonosis seldom reported. Humans are accidental hosts and rarely affected. We report a case of dirofilariasis presenting as a subcutaneous nodule in the uncommon location in the thigh with concealed history of dog meat handler. Of the cases published in literature, imaging findings of this disease have been few and far between. In this article, we describe multimodality imaging findings of dirofilariasis in the thigh.