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Martimianaki A, Papadakaki M, Tosounidis T, Tsiligianni I. Factors of traffic incidents at University General Hospital of Heraklion, March-August 2018. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Injury caused by a traffic accident is the leading cause of death in all age groups with a significant impact on public health expenditure. One of the highest accident rates in Greece is recorded in Crete
Methods
A retrospective archival study. It was carried out at the University General Hospital of Heraklion recording all the incidents in areas of the region of Heraklion and the transits of patients carried out from the rest of Crete.
Results
From March 2018 to August 2018, 493 cases were recorded in the Orthopedic Clinic by the Emergency Department. 89 incidents related to road accident injuries. Men were more involved in traffic accidents, with an average age of 42.5 years. The monthly allocation was roughly the same for all months. Insurance types were about 73.6% of the public provider, 5.7% of the private body, and 20.7% of the uninsured patients. The two-wheelers had the highest participation with 66.3%, cars with 38.8%, and 3.8% with pedestrians and cyclists. The highest incidence of injuries occurred by 22.7% was about fractures in legs and knees, pelvis, and spine fractures by 19.3%. Hip and thigh fractures followed by 14.8%. As caused factors were referred to the non-use of belts and helmets and alcohol in driving. The average hospitalization duration ranged from 7.6 days to 51 days. The average cost per patient ranged from €1,907 to €18,025. The largest total cost involved the fractures of the legs and knee with €52,315 and the spine and spine fractures with €41,459. The total cost in all three categories of insurance was approximately €25-26,000.
Conclusions
The percentage of road accidents in Crete remains at a high level. The highest incidence of injuries refers to legs and knee, pelvic and spinal fractures. Their hospitalization cost includes larger amounts in other European countries. Accompanied illnesses seem to have an impact on road behavior increasing the risk of a road accident.
Key messages
It is highlighted the implementation of more effective prevention programs aimed at youth. The proper management of the problem can bring huge financial relief to health expenditures.
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Affiliation(s)
- A Martimianaki
- Nursing, University General Hospital Heraklion, Heraklion, Greece
| | - M Papadakaki
- Hellenic Mediteranean University, Department of Social Work, Heraklion, Greece
| | - T Tosounidis
- University of Crete, Faculty of Medicine, Heraklion, Greece
| | - I Tsiligianni
- University of Crete, Faculty of Medicine, Heraklion, Greece
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Claessen FMAP, Stoop N, Doornberg JN, Guitton TG, van den Bekerom MPJ, Ring D, Chauhan A, Wahegaonkar A, Shafritz A, Garcia G A, Miller A, Barquet A, Kristan A, Apard T, Armstrong A, Berner A, Jubel A, Kreis B, Babis C, Sutker B, Sears B, Nolan B, Crist B, Cross B, Wills B, Barreto C, Ekholm C, Swigart C, Oliveira Miranda C, Manke C, Zalavras C, Goldfarb C, Cassidy C, Walsh C, Jones C, Garnavos C, Young C, Moreno-Serrano C, Lomita C, Klostermann C, van Deurzen D, Rikli D, Polatsch D, Beingessner D, Drosdowech D, Eygendaal D, Patel M, Brilej D, Walbeehm E, Ballas E, Ibrahim E, Melamed E, Stojkovska Pemovska E, Hofmeister E, Hammerberg E, Kaplan F, Suarez F, Fernandes C, Lopez-Gonzalez F, Walter F, Frihagen F, Kraan G, Kontakis G, Dyer G, Kohut G, Panagopoulos G, Hernandez G, Porcellini G, Bayne G, Merrell G, DeSilva G, Della Rocca G, Bamberger H, Broekhuyse H, Durchholz H, Kodde I, McGraw I, Harris I, Pountos I, Wiater J, Choueka J, Kazanjian J, Gillespie J, Biert J, Fanuele J, Johnson J, Greenberg J, Abrams J, Hall J, Fischer J, Scheer J, Itamura J, Capo J, Braman J, Rubio J, Ortiz J, Filho J, Nolla J, Abboud J, Conflitti J, Abzug J, Patiño J, Rodríguez Roiz J, Adams J, Bishop J, Kabir K, Chivers K, Prommersberger K, Egol K, Rumball K, Dickson K, Jeray K, Poelhekke L, Campinhos L, Mica L, Borris L, Adolfsson L, Schulte L, Elmans L, Lane L, Paz L, Taitsman L, Guenter L, Austin L, Waseem M, Palmer M, Abdel-Ghany M, Richard M, Rizzo M, Pirpiris M, Di Micoli M, Bonczar M, Loebenberg M, Richardson M, Mormino M, Menon M, Soong M, Wood M, Meylaerts S, Darowish M, Nancollas M, Prayson M, Grafe M, Kessler M, Kaminaris M, Pirela-Cruz M, Mckee M, Merchant M, Tyllianakis M, Shafi M, Powell A, Shortt N, Felipe N, Parnes N, Bijlani N, Elias N, Akabudike N, Rossiter N, Lasanianos N, Kanakaris N, Brink O, van Eerten P, Paladini P, Martineau P, Appleton P, Levin P, Althausen P, Evans P, Jebson P, Krause P, Schandelmaier P, Peters A, Dantuluri P, Blazar P, Andreas P, Inna P, Quell M, Ramli R, de Bedout R, Ranade A, Ashish S, Smith R, Babst R, Omid R, Buckley R, Jenkinson R, Gilbert R, Page R, Papandrea R, Zura R, Gray R, Wagenmakers R, Pesantez R, van Riet R, Calfee R, van Helden S, Bouaicha S, Kakar S, Kaplan S, Scott F, Kaar S, Mitchell S, Rowinski S, Dodds S, Kennedy S, Beldner S, Schepers T, Guitton T, Gosens T, Baxamusa T, Taleb C, Tosounidis T, Wyrick T, Begue T, DeCoster T, Dienstknecht T, Varecka T, Mittlmeier T, Fischer T, Chesser T, Omara T, Bafus T, Siff T, Havlicek T, Sabesan V, Nikolaou V, Philippe V, Giordano V, Vochteloo A, Batson W, Hammert W, Satora W, Weil Y, Ruch D, Marsh L, Swiontkowski M, Hurwit S. Interpretation of Post-operative Distal Humerus Radiographs After Internal Fixation: Prediction of Later Loss of Fixation. J Hand Surg Am 2016; 41:e337-e341. [PMID: 27522299 DOI: 10.1016/j.jhsa.2016.07.094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 04/17/2016] [Accepted: 07/13/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE Stable fixation of distal humerus fracture fragments is necessary for adequate healing and maintenance of reduction. The purpose of this study was to measure the reliability and accuracy of interpretation of postoperative radiographs to predict which implants will loosen or break after operative treatment of bicolumnar distal humerus fractures. We also addressed agreement among surgeons regarding which fracture fixation will loosen or break and the influence of years in independent practice, location of practice, and so forth. METHODS A total of 232 orthopedic residents and surgeons from around the world evaluated 24 anteroposterior and lateral radiographs of distal humerus fractures on a Web-based platform to predict which implants would loosen or break. Agreement among observers was measured using the multi-rater kappa measure. RESULTS The sensitivity of prediction of failure of fixation of distal humerus fracture on radiographs was 63%, specificity was 53%, positive predictive value was 36%, the negative predictive value was 78%, and accuracy was 56%. There was fair interobserver agreement (κ = 0.27) regarding predictions of failure of fixation of distal humerus fracture on radiographs. Interobserver variability did not change when assessed for the various subgroups. CONCLUSIONS When experienced and skilled surgeons perform fixation of type C distal humerus fracture, the immediate postoperative radiograph is not predictive of fixation failure. Reoperation based on the probability of failure might not be advisable. TYPE OF STUDY/LEVEL OF EVIDENCE Diagnostic III.
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Affiliation(s)
- Femke M A P Claessen
- Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Nicky Stoop
- Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Job N Doornberg
- Orthotrauma Research Center Amsterdam, University of Amsterdam Orthopaedic Residency Program, Amsterdam, The Netherlands
| | - Thierry G Guitton
- Orthotrauma Research Center Amsterdam, University of Amsterdam Orthopaedic Residency Program, Amsterdam, The Netherlands
| | | | - David Ring
- Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Boston, MA.
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Kanakaris N, Gudipati S, Tosounidis T, Harwood P, Britten S, Giannoudis PV. The treatment of intramedullary osteomyelitis of the femur and tibia using the Reamer–Irrigator–Aspirator system and antibiotic cement rods. Bone Joint J 2014; 96-B:783-8. [DOI: 10.1302/0301-620x.96b6.32244] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Intramedullary infection in long bones represents a complex clinical challenge, with an increasing incidence due to the increasing use of intramedullary fixation. We report a prospective case series using an intramedullary reaming device, the Reamer–Irrigator–Aspirator (RIA) system, in association with antibiotic cement rods for the treatment of lower limb long bone infections. A total of 24 such patients, 16 men and eight women, with a mean age of 44.5 years (17 to 75), 14 with femoral and 10 with tibial infection, were treated in a staged manner over a period of 2.5 years in a single referral centre. Of these, 21 patients had had previous surgery, usually for fixation of a fracture (seven had sustained an open fracture originally and one had undergone fasciotomies). According to the Cierny–Mader classification system, 18 patients were classified as type 1A, four as 3A (discharging sinus tract), one as type 4A and one as type 1B. Staphylococcus species were isolated in 20 patients (83.3%). Local antibiotic delivery was used in the form of impregnated cement rods in 23 patients. These were removed at a mean of 2.6 months (1 to 5). Pathogen-specific antibiotics were administered systemically for a mean of six weeks (3 to 18). At a mean follow-up of 21 months (8 to 36), 23 patients (96%) had no evidence of recurrent infection. One underwent a planned trans-tibial amputation two weeks post-operatively due to peripheral vascular disease and chronic recalcitrant osteomyelitis of the tibia and foot. The combination of RIA reaming, the administration of systemic pathogen-specific antibiotics and local delivery using impregnated cement rods proved to be a safe and efficient form of treatment in these patients. Cite this article: Bone Joint J 2014; 96-B:783–8.
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Affiliation(s)
- N. Kanakaris
- Leeds Teaching Hospitals NHS Trust, Academic
Department of Trauma and Orthopaedics, Leeds
General Infirmary, Clarendon wing Level A, LS13EX, Leeds, UK
| | - S. Gudipati
- Leeds Teaching Hospitals NHS Trust, Academic
Department of Trauma and Orthopaedics, Leeds
General Infirmary, Clarendon wing Level A, LS13EX, Leeds, UK
| | - T. Tosounidis
- Leeds Teaching Hospitals NHS Trust, Academic
Department of Trauma and Orthopaedics, Leeds
General Infirmary, Clarendon wing Level A, LS13EX, Leeds, UK
| | - P. Harwood
- Leeds Teaching Hospitals NHS Trust, Academic
Department of Trauma and Orthopaedics, Leeds
General Infirmary, Clarendon wing Level A, LS13EX, Leeds, UK
| | - S. Britten
- Leeds Teaching Hospitals NHS Trust, Academic
Department of Trauma and Orthopaedics, Leeds
General Infirmary, Clarendon wing Level A, LS13EX, Leeds, UK
| | - P. V. Giannoudis
- University of Leeds, School
of Medicine, Academic Department of Trauma
and Orthopaedics, 21 Cricketers Fold, Shadwell, Leeds, LS17
8WE, UK
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