Chest Trauma Experience: Incidence, associated factors, and outcomes among patients in Saudi Arabia.

BACKGROUND AND OBJECTIVE: Worldwide chest trauma is considered one of the leading causes of morbidity and mortality. There is a lack of sufficient information on the etiology, pattern, and management of these injuries in Saudi Arabia. Therefore, the current study was conducted to determine the spectrum of chest trauma and its associated factors among patients admitted to King Khalid University Hospital, Riyadh, Saudi Arabia. METHODS: A quantitative observational cross-sectional analysis was performed, data obtained from the medical records of the chest trauma patients which were admitted in the thoracic surgery unit, King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia from January 2013 to Jan 2019. The records of all these patients were reviewed and data were collected and analyzed prospectively. RESULTS: A total of 236 patients (male: 87.3%; mean age: 32.4 years) were included in the analyses. The majority of these chest trauma cases (n=205; 86.9%) were caused by road traffic accidents (RTA). Blunt trauma predominated the cases n=225 (95.3%). Ribs fracture had the highest prevalence among the chest injuries with a number of 150 (63.5%) followed by lung contusion 140 (59.3%). Pneumothorax occurred in 131 (55.5%) and hemothorax occurred in 80 (33.8%) with most common indication for emergency thoracotomy. Extra-thoracic injuries involving the head/brain, limbs, and abdominal organs occurred in 189 (80%). 130 (55%) were intubated and ventilated, and almost half of the patients 115 (48.7%) were required a chest tube insertion. CONCLUSIONS: Chest trauma is a major health issue particularly in young male adults and road traffic accidents are the leading cause of chest trauma in Saudi Arabia. Early recognition of the patterns, etiology and appropriate management of trauma reduce the incidence of chest trauma related injuries.

Prevalence of knee injuries among male college students in Riyadh, Kingdom of Saudi Arabia.

BACKGROUND: The knee is considered the most common injured joint between young sport participants. However, there is lack of proper prevalence estimation in our population. The purpose of this study was to identify the prevalence of knee injuries among male college students and to observe the demographic data associated with it. Our secondary objective was to evaluate the awareness and knowledge about these injuries. METHODS: This is a cross-sectional study. A survey was distributed to collect the data among male college students, King Saud University, Riyadh, Saudi Arabia. Out of 688 students who participated and completed the questionnaire, a total of 482 were considered valid and met the inclusion criteria. Data were analyzed using Statistical Package for Social Sciences (SPSS). RESULTS: The overall prevalence of knee injury was 23.2% (n = 112). Most of them injured during sport activities especially soccer and 68.7% involved in a non-contact mechanism of injury. Among those who went to a hospital mostly were diagnosed as contusion (31.4%) then as meniscus tear, ACL, and collateral ligament injury, respectively. Majority was treated conservatively and only 10.7% needed surgery surprisingly. There was no statistically significant difference between those who are injured and whether they were warmed up and stretched or not (P = 0.619). Low level of knowledge about knee injuries was noticed among the participants 57.7%. CONCLUSION: Our study has highlighted the high prevalence of knee injuries and the need to raise the level of awareness and knowledge about these injuries in our population. Soccer was the most common sport associated with knee injuries; most of these injuries were treated conservatively.

Revision surgery for refractory cubital tunnel syndrome: A systematic review.

BACKGROUND: Indications for revision surgery are unclear in refractory cubital tunnel syndrome patients, and the optimal surgical method has not been determined. The systematic review evaluates the evidence of functional outcome for revision surgery in refractory cubital tunnel syndrome patients. HYPOTHESIS: We hypothesize that functional outcome of revision surgery in refractory cubital tunnel syndrome will be favorable. METHODS: We searched PubMed, Ovid/MEDLINE, Cochrane, Google Scholar, and EMBASE databases using the keywords "cubital tunnel syndrome" or "recurrent cubital tunnel syndrome" and "revision surgery" according to the MeSH index for English-language studies. We performed a systematic review using PRISMA guidelines. The review was registered in PROSPERO (CRD42018096622). RESULTS: Based on the Oxford Centre for Evidence-Based Medicine criteria, one level 3b study and nine level 4 studies were identified, including 195 elbows of 192 patients aged 15-75 years. The remission period for recurrent cubital tunnel syndrome was 6-21 months, and the follow-up period was 6-113 months. Transposition surgery was the primary surgery in 99 (51%) of 178 elbows. The most common intraoperative finding at revision surgery was perineural scarring (79%), with the most frequent entrapment site being the medial intermuscular septum (33%). The most common revision surgery was submuscular transposition of the ulnar nerve (75%). Most studies reported favorable outcomes, although outcomes varied widely among studies. CONCLUSION: This is the first study to summarize the functional outcomes of revision surgery for refractory cubital tunnel syndrome which showed to be favorable. Functional outcomes were averagely reported and varied widely. A consensus regarding the functional outcomes parameter after surgery for cubital tunnel syndrome is urgently needed. LEVEL OF EVIDENCE: III, systematic review.