This paper attempts to relate serendipity, the natural ability to make interesting or valuable discoveries by accident (Longman Discovery of Contemporary English) with notable discoveries and inventions. It connotes...This paper attempts to relate serendipity, the natural ability to make interesting or valuable discoveries by accident (Longman Discovery of Contemporary English) with notable discoveries and inventions. It connotes the profound ability of finding out valuable things different from those who have been exploring by spending a lot of time or for years. The author will illustrate as many cases as possible within a given time constraint, so that surrounding environments and situations may be clarified, and such discoveries and inventions may be plausibly accomplished by accident or with rich reasons. These illustrations include historical as well as more recent cases. One of the cases is beyond the scope of our environment on the earth with preconceived notion, while other cases have given great impacts to our politics and also military intelligence. It should be noted that business and technological intelligence are deeply connected with discoveries, inventions and serendipity. In concluding remarks, the essence of serendipity will be summarized and how to side with the serendipity at the most important moment will be examined by viewing time series endeavors of the inventors and those who have devoted much time to discoveries.展开更多
This paper reviews the early development of design requirements for seismic events in USA early developing nuclear electric generating fleet. Notable safety studies,including WASH-1400,Sandia Siting Study and the NURE...This paper reviews the early development of design requirements for seismic events in USA early developing nuclear electric generating fleet. Notable safety studies,including WASH-1400,Sandia Siting Study and the NUREG1150 probabilistic risk study,are briefly reviewed in terms of their relevance to extreme accidents arising from seismic and other severe accident initiators. Specific characteristic about the nature of severe accidents in nuclear power plant (NPP) are reviewed along with present day state-of-art analysis methodologies (methods for estimation of leakages and consequences of releases (MELCOR) and MELCOR accident consequence code system (MACCS)) that are used to evaluate severe accidents and to optimize mitigative and protective actions against such accidents. It is the aim of this paper to make nuclear operating nations aware of the risks that accompany a much needed energy resource and to identify some of the tools,techniques and landmark safety studies that serve to make the technology safer and to maintain vigilance and adequate safety culture for the responsible management of this valuable but unforgiving technology.展开更多
Transport risk assessment for the environment has two important aspects--problem solving model and solution veracity. Problem solving model is larger understanding of tasks interconnection, which represents in itself ...Transport risk assessment for the environment has two important aspects--problem solving model and solution veracity. Problem solving model is larger understanding of tasks interconnection, which represents in itself partial solution of general risk assessment. Veracity of solution means how the results are consistent with the reality. By researching of both aspects, it rises many unanswered questions. It is concerned about verification and validation of risk assessment results. By risk assessment for the environment it is possible to meet wide variety of more or less good soluble problems. It exists simple problems based on risk assessment of common traffic accidents connected with service charge outflow. On the other site, it exists complex problems of risk assessment connected with dangerous goods transport by traffic or pipelines. By simple problems solving there are not many questions about risk assessment veracity. It is possible to determine traffic accidents frequencies and service charge outflows consequences on the basis of examined events in transportation with great veracity. By complex problems the situation is quite different. The frequencies of large accidents are very low but the consequences for the environment may be large. Both are encumbered by large level of uncertainty. That is why the question is rising. To what degree, it is in these cases correct to make decision based on risk assessment.展开更多
In recent years, the unexpected accidents of college students have occurred frequently in the playground. A student in Shanghai Sanda University suddenly fell at tile basketball class at the end of last year. In the s...In recent years, the unexpected accidents of college students have occurred frequently in the playground. A student in Shanghai Sanda University suddenly fell at tile basketball class at the end of last year. In the same month, a male student in Shanghai East China University fell on the ground when taking part in the physical test of lkm running, and then passed away after the rescue was not valid. In this paper, the physical quality of the current college students is discussed on the basis of studying college students' quality education. This study is expected to play a role in reference.展开更多
This paper presents the STAMP (system-theoretic accident modeling and processes) accident model, based on systems theory, and describes its application in the context of risk prevention related to the remediation of...This paper presents the STAMP (system-theoretic accident modeling and processes) accident model, based on systems theory, and describes its application in the context of risk prevention related to the remediation of contaminated sediments. The implementation of the model is described, and results are presented both in methodological and technical terms. The goal of this article is to emphasize the need of new approaches to take into account hazards and accidents within socio-technical systems.展开更多
It is a sunny,early-spring morning,and three foreign students from different countries have just arrived at the new Tibet University campus.Linda I Am Pema Metok from Northern TibetFrom the very end of the foreign stu...It is a sunny,early-spring morning,and three foreign students from different countries have just arrived at the new Tibet University campus.Linda I Am Pema Metok from Northern TibetFrom the very end of the foreign student dormitory building comes one student in front of the others,and that is Linda from Indonesia.On the classroom’s blackboard,展开更多
The influence that traditional Ghanaian norms, taboos, and folktales had in ensuring environmental protection and sustainability has been greatly minimized by the inroads of foreign cultures and religions such as Chri...The influence that traditional Ghanaian norms, taboos, and folktales had in ensuring environmental protection and sustainability has been greatly minimized by the inroads of foreign cultures and religions such as Christianity and Islam. Currently, modem methods of environmental protection and sustainability have not achieved the desired goals. As a result, Ghana is at the mercy of countless forms of environmental abuses to the extent that Ghana is ranked the seventh dirtiest nation and also second in open defecation worldwide. This paper examines how the incorporation of Humanist ethical principles to integrate with the traditional Ghanaian environmental taboos and modem technological methods to salvage the continuous and relentless environmental abuses in Ghana.展开更多
Traffic accidents caused the most accidental deaths at work in Malaysia. The SOCSO (Social Security Organization) reported that the number of deaths due to commuting accidents was 760, nearly two times more than dea...Traffic accidents caused the most accidental deaths at work in Malaysia. The SOCSO (Social Security Organization) reported that the number of deaths due to commuting accidents was 760, nearly two times more than deaths caused by accidents that happened at the workplace (471 deaths). The aim of this study is to investigate the relationship of socio-demographic background and the risk exposure of the drivers during their work commuting trips. The study was based on compensation claims to SOCSO where data were extracted from "Form 21" provided by SOCSO. A total of 377 respondents were selected through systematic random sampling method from a list of SOCSO claimants. It was found that majority of the traffic accidents (83%) involved males and most of them (92.2%) were on motorcycles. Male drivers have an average driving experience of 10.7 years and 8.6 years for females. The estimation of the travelled distance for the sample from home to the workplace is 0.65-131 km. Mean accident occurrence time was 23 rain whilst mean distance was 11.6 km. The multiple regression analysis showed that the accident distance was affected by the age of driver, actual travel distance, travel objective and speed.展开更多
Objective: To describe mortality pattern and to determine undiagnosed fatal injuries according to autopsy findings among road traffic accident victims in Yazd, Iran. Methods: In this retrospective study, 251 victims...Objective: To describe mortality pattern and to determine undiagnosed fatal injuries according to autopsy findings among road traffic accident victims in Yazd, Iran. Methods: In this retrospective study, 251 victims of road traffic accidents who were admitted to a tertiary trauma hospital over a two-year period (2006 and 2007) and received medical cares were included. Hospital records were reviewed to gather demographic characteristics, road user type, and medical data. Autopsy records were also reviewed to determine actual causes of death and possible undiagnosed injuries occurred in the initial assessment of the emergency unit or during hospitalization. Results: There were 202 males (80.5%) and 49 females (19.5%). The mean (+SD) age of fatalities was 34.1 (+21.5) years. Pedestrian-vehicle accidents were the most common cause of trauma (100 cases, 39.8%). The most common cause of death was central nervous system injury (146 cases, 58.1%). The other causes were skull base fractures (10%), internalbleeding (8%), lower limb hemorrhage (8%), skull vault fractures (4%), cervical spinal cord injury (3.6%), airway compromise (3.2%), and multifactor cases (5.1%), respectively. Thirty-six fatal injuries in 30 victims (12%) mainly contributed to death according to autopsy, but were not diagnosed in initial assessments. The head (72.2%) and cervical spine (13.8%) regions were the two most common sites for undi- agnosed injuries. Conclusion: Training courses for emergency unit medical staff with regard to interpreting radiological findings of head and neck and high clinical suspicion for cervical spine injuries are essential to improve the quality of early hospital care and reduce the mortality and morbidity of traffic accident patients.展开更多
Objective: To study the patterns and morphologic characteristics of blunt head injury and analyse its formative mechanism in attempt to provide references for medicolegal expertise. Methods: The statistical analysi...Objective: To study the patterns and morphologic characteristics of blunt head injury and analyse its formative mechanism in attempt to provide references for medicolegal expertise. Methods: The statistical analysis was done in terms of gender, age, as well as the nature, pattern, location, and feature of the injuries. Results: Among the 202 cases of head injury-induced death, 124 were male and 78 female with the age ranging from 1-81 years. Death caused by homicide was dominant (106, 52.5%), followed by suicide (49, 24.3%) and accident (44, 21.8%). The majority of suicide-induced death were byfalling from height, and traffic crash was responsible for majority of unexpected death cases. The morphology and pathogenesis of the injuries varied according to differences on the mode, magnitude, and orientation of the outside force giving rise to blunt injury as well as the character of vulnerants. Conclusion: Studies on the morphology and its forma- tive rationale of blunt head injury will offer easy access to medicolegal expertise on the mode and character of the injury.展开更多
Objective: To analyze the time factor in road traffic accidents (RTAs) in Fats Province of Iran. Methods: This study was conducted in Fars Province, Iran from November 22, 2009 to November 21,2011. Victims' info...Objective: To analyze the time factor in road traffic accidents (RTAs) in Fats Province of Iran. Methods: This study was conducted in Fars Province, Iran from November 22, 2009 to November 21,2011. Victims' information consisted of age, sex, death toll involving dri- vers or passengers of cars, motorcycles and pedestrians, and site of injury etc. Accidents were analyzed in relation to hour of the day, season of the year, lighting condition in- cluding sunrise, sunset, daytime and nighttime. Results: Atotal of 3 642 deaths (78.3% were males, and the ratio of males to females was about 3.6:1) were studied regarding their autopsy records. There was a steady in- crease in fatal accidents occurring at midnight to 15:59. The risk of being involved in a fatal traffic accident was higherfor those injured between 4:00 to 7:59 than at other times (OR=2.13, 95% C11.85-2.44). The greatest number of fatal RTAs took place in summer. Mortalities due to RTA during spring and summer were more pronounced at 20:00 to 23:59 and midnight to 3:59, whereas mortalities in fall and winter were more pronounced from 12:00 to 15:59. Conclusion: The high mortality rate ofRTAis a major public health problem in Fars Province. Our results indicate that the time is an important factor which contributes to road traffic deaths.展开更多
Purpose: The epidemiology of pediatric trauma is different in different parts of the world. Some researchers suggest falls as the most common mechanism, whereas others report road traffic accidents (RTAs) as the mo...Purpose: The epidemiology of pediatric trauma is different in different parts of the world. Some researchers suggest falls as the most common mechanism, whereas others report road traffic accidents (RTAs) as the most common cause. The aim of this study is to find out the leading cause of pediatric admissions in Trauma Surgery in New Delhi, India. Methods: Inpatient data from January 2012 to September 2014 was searched retrospectively in Jai Prakash Narayan Apex Trauma Centre Trauma Registry. All patients aged 18 years or less on index presentation admitted to surgical ward/ICU or later taken transfer by the Department of Trauma Surgery were included. Data were retrieved in predesigned proformas. Information thus compiled was coded in unique alphanumeric codes for each variable and subjected to statistical analysis using SPSS version 21. Results: We had 300 patients over a 33 month period. Among them, 236 (78.6%) were males and 64 (21.3%) females. Overall the predominant cause was RTAs in 132 (43%) patients. On subgroup analysis of up to 12 years age group (n - 147), the most common cause was found to be RTAs again. However, falls showed an incremental upward trend (36.05% in up to 12 age group versus 27% overall), catching up with RTAs (44.89%). Pediatric Trauma Score (PTS) ranged from 0 to 12 with a mean of 8.12 _+ 2.022. 223 (74.33%) patients experienced trauma limited to one anatomic region only, whereas 77 (25.66%) patients suffered polytrauma. 288 patients were discharged to home care. Overall, 12 patients expired in the cohort. Median hospital stay was 6 days (range 1-182). Conclusion: Pediatric trauma is becoming a cause of increasing concern, especially in the developing countries. The leading cause of admissions in Trauma Surgery is RTAs (43%) as compared to falls from height (27%); however, falls from height are showing an increasing trend as we move to younger age groups. Enhancing road safety alone may not be a lasting solution for prevention of pediatric trauma and local injury patterns must be taken into account when formulating policies to address this unique challenge.展开更多
Purpose: To investigate the early and mid-term results of open reduction and internal fixation (ORIF) with transarticular external fixation (TEF) but no deltoid ligament repair (DLR) in the treatment of supinat...Purpose: To investigate the early and mid-term results of open reduction and internal fixation (ORIF) with transarticular external fixation (TEF) but no deltoid ligament repair (DLR) in the treatment of supination-external rotation type Ⅳ equivalent (SER Ⅳ E) ankle fractures (AO/OTA classification 44-B 3.1 ) and provide evidence for clinical practice. Methods: This study cohort consisted of 22 patients with SER IV E ankle fractures that underwent ORIF with TEF but no DLR between December 2011 and December 2014, There were 13 males and 9 females, mean age 38.9 years (range, 17-73 years). Eight cases involved the left side and 14 the right side. The causes of fractures included road traffic accidents (11 cases), falling from height (6 cases) and sports injuries (5 cases). The mean period of hospitalization was 9.8 days (range, 6 14 days). For all the patients, MRI and three-dimensional CT were done before surgery and X-rays done preoperatively and during follow-ups. The external frame was kept for 8-10 weeks. The preoperative American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 56.86 m 4.400, the Medical Outcomes Short Form 36-item (SF-36) questionnaire score was 57.41 ± 4.102 and the visual analog score (VAS) was 5.50 m 1.058. Patients' main complaints about inconvenience of daily life were also recorded. Results: All the 22 patients were followed up for 24 63 months (mean, 33.6 months). None of them developed nonunion during the follow-up; pin site infection was observed in one patient and posttraumatic osteoarthritis in another. At the final follow-up, the average AOFAS score, SF-36 score and VAS score were respectively 90.59 e 5.096, 79.59± 5.394 and 1.82 ± 1.181, which were significantly improved compared with the preoperative data (t - 26.221, p 〈 0.001; t - 11.910, p 〈 0.001; t - 11.571, p 〈 0.001). The therapeutic effect was excellent in 13 cases, good in 7 cases and fair in 2 cases, with a good-excellent rate of 90.9%. Patients' main complaints were inconvenience of clothing (17 cases) and extremity cleaning (5 cases). Conclusion: In the treatment of SER IV E ankle fractures, ORIF with TEF but no DLR can achieve satis- factory outcome, but long-term effect should be confirmed by large sample randomized controlled trials.展开更多
文摘This paper attempts to relate serendipity, the natural ability to make interesting or valuable discoveries by accident (Longman Discovery of Contemporary English) with notable discoveries and inventions. It connotes the profound ability of finding out valuable things different from those who have been exploring by spending a lot of time or for years. The author will illustrate as many cases as possible within a given time constraint, so that surrounding environments and situations may be clarified, and such discoveries and inventions may be plausibly accomplished by accident or with rich reasons. These illustrations include historical as well as more recent cases. One of the cases is beyond the scope of our environment on the earth with preconceived notion, while other cases have given great impacts to our politics and also military intelligence. It should be noted that business and technological intelligence are deeply connected with discoveries, inventions and serendipity. In concluding remarks, the essence of serendipity will be summarized and how to side with the serendipity at the most important moment will be examined by viewing time series endeavors of the inventors and those who have devoted much time to discoveries.
文摘This paper reviews the early development of design requirements for seismic events in USA early developing nuclear electric generating fleet. Notable safety studies,including WASH-1400,Sandia Siting Study and the NUREG1150 probabilistic risk study,are briefly reviewed in terms of their relevance to extreme accidents arising from seismic and other severe accident initiators. Specific characteristic about the nature of severe accidents in nuclear power plant (NPP) are reviewed along with present day state-of-art analysis methodologies (methods for estimation of leakages and consequences of releases (MELCOR) and MELCOR accident consequence code system (MACCS)) that are used to evaluate severe accidents and to optimize mitigative and protective actions against such accidents. It is the aim of this paper to make nuclear operating nations aware of the risks that accompany a much needed energy resource and to identify some of the tools,techniques and landmark safety studies that serve to make the technology safer and to maintain vigilance and adequate safety culture for the responsible management of this valuable but unforgiving technology.
文摘Transport risk assessment for the environment has two important aspects--problem solving model and solution veracity. Problem solving model is larger understanding of tasks interconnection, which represents in itself partial solution of general risk assessment. Veracity of solution means how the results are consistent with the reality. By researching of both aspects, it rises many unanswered questions. It is concerned about verification and validation of risk assessment results. By risk assessment for the environment it is possible to meet wide variety of more or less good soluble problems. It exists simple problems based on risk assessment of common traffic accidents connected with service charge outflow. On the other site, it exists complex problems of risk assessment connected with dangerous goods transport by traffic or pipelines. By simple problems solving there are not many questions about risk assessment veracity. It is possible to determine traffic accidents frequencies and service charge outflows consequences on the basis of examined events in transportation with great veracity. By complex problems the situation is quite different. The frequencies of large accidents are very low but the consequences for the environment may be large. Both are encumbered by large level of uncertainty. That is why the question is rising. To what degree, it is in these cases correct to make decision based on risk assessment.
文摘In recent years, the unexpected accidents of college students have occurred frequently in the playground. A student in Shanghai Sanda University suddenly fell at tile basketball class at the end of last year. In the same month, a male student in Shanghai East China University fell on the ground when taking part in the physical test of lkm running, and then passed away after the rescue was not valid. In this paper, the physical quality of the current college students is discussed on the basis of studying college students' quality education. This study is expected to play a role in reference.
文摘This paper presents the STAMP (system-theoretic accident modeling and processes) accident model, based on systems theory, and describes its application in the context of risk prevention related to the remediation of contaminated sediments. The implementation of the model is described, and results are presented both in methodological and technical terms. The goal of this article is to emphasize the need of new approaches to take into account hazards and accidents within socio-technical systems.
文摘It is a sunny,early-spring morning,and three foreign students from different countries have just arrived at the new Tibet University campus.Linda I Am Pema Metok from Northern TibetFrom the very end of the foreign student dormitory building comes one student in front of the others,and that is Linda from Indonesia.On the classroom’s blackboard,
文摘The influence that traditional Ghanaian norms, taboos, and folktales had in ensuring environmental protection and sustainability has been greatly minimized by the inroads of foreign cultures and religions such as Christianity and Islam. Currently, modem methods of environmental protection and sustainability have not achieved the desired goals. As a result, Ghana is at the mercy of countless forms of environmental abuses to the extent that Ghana is ranked the seventh dirtiest nation and also second in open defecation worldwide. This paper examines how the incorporation of Humanist ethical principles to integrate with the traditional Ghanaian environmental taboos and modem technological methods to salvage the continuous and relentless environmental abuses in Ghana.
文摘Traffic accidents caused the most accidental deaths at work in Malaysia. The SOCSO (Social Security Organization) reported that the number of deaths due to commuting accidents was 760, nearly two times more than deaths caused by accidents that happened at the workplace (471 deaths). The aim of this study is to investigate the relationship of socio-demographic background and the risk exposure of the drivers during their work commuting trips. The study was based on compensation claims to SOCSO where data were extracted from "Form 21" provided by SOCSO. A total of 377 respondents were selected through systematic random sampling method from a list of SOCSO claimants. It was found that majority of the traffic accidents (83%) involved males and most of them (92.2%) were on motorcycles. Male drivers have an average driving experience of 10.7 years and 8.6 years for females. The estimation of the travelled distance for the sample from home to the workplace is 0.65-131 km. Mean accident occurrence time was 23 rain whilst mean distance was 11.6 km. The multiple regression analysis showed that the accident distance was affected by the age of driver, actual travel distance, travel objective and speed.
文摘Objective: To describe mortality pattern and to determine undiagnosed fatal injuries according to autopsy findings among road traffic accident victims in Yazd, Iran. Methods: In this retrospective study, 251 victims of road traffic accidents who were admitted to a tertiary trauma hospital over a two-year period (2006 and 2007) and received medical cares were included. Hospital records were reviewed to gather demographic characteristics, road user type, and medical data. Autopsy records were also reviewed to determine actual causes of death and possible undiagnosed injuries occurred in the initial assessment of the emergency unit or during hospitalization. Results: There were 202 males (80.5%) and 49 females (19.5%). The mean (+SD) age of fatalities was 34.1 (+21.5) years. Pedestrian-vehicle accidents were the most common cause of trauma (100 cases, 39.8%). The most common cause of death was central nervous system injury (146 cases, 58.1%). The other causes were skull base fractures (10%), internalbleeding (8%), lower limb hemorrhage (8%), skull vault fractures (4%), cervical spinal cord injury (3.6%), airway compromise (3.2%), and multifactor cases (5.1%), respectively. Thirty-six fatal injuries in 30 victims (12%) mainly contributed to death according to autopsy, but were not diagnosed in initial assessments. The head (72.2%) and cervical spine (13.8%) regions were the two most common sites for undi- agnosed injuries. Conclusion: Training courses for emergency unit medical staff with regard to interpreting radiological findings of head and neck and high clinical suspicion for cervical spine injuries are essential to improve the quality of early hospital care and reduce the mortality and morbidity of traffic accident patients.
文摘Objective: To study the patterns and morphologic characteristics of blunt head injury and analyse its formative mechanism in attempt to provide references for medicolegal expertise. Methods: The statistical analysis was done in terms of gender, age, as well as the nature, pattern, location, and feature of the injuries. Results: Among the 202 cases of head injury-induced death, 124 were male and 78 female with the age ranging from 1-81 years. Death caused by homicide was dominant (106, 52.5%), followed by suicide (49, 24.3%) and accident (44, 21.8%). The majority of suicide-induced death were byfalling from height, and traffic crash was responsible for majority of unexpected death cases. The morphology and pathogenesis of the injuries varied according to differences on the mode, magnitude, and orientation of the outside force giving rise to blunt injury as well as the character of vulnerants. Conclusion: Studies on the morphology and its forma- tive rationale of blunt head injury will offer easy access to medicolegal expertise on the mode and character of the injury.
文摘Objective: To analyze the time factor in road traffic accidents (RTAs) in Fats Province of Iran. Methods: This study was conducted in Fars Province, Iran from November 22, 2009 to November 21,2011. Victims' information consisted of age, sex, death toll involving dri- vers or passengers of cars, motorcycles and pedestrians, and site of injury etc. Accidents were analyzed in relation to hour of the day, season of the year, lighting condition in- cluding sunrise, sunset, daytime and nighttime. Results: Atotal of 3 642 deaths (78.3% were males, and the ratio of males to females was about 3.6:1) were studied regarding their autopsy records. There was a steady in- crease in fatal accidents occurring at midnight to 15:59. The risk of being involved in a fatal traffic accident was higherfor those injured between 4:00 to 7:59 than at other times (OR=2.13, 95% C11.85-2.44). The greatest number of fatal RTAs took place in summer. Mortalities due to RTA during spring and summer were more pronounced at 20:00 to 23:59 and midnight to 3:59, whereas mortalities in fall and winter were more pronounced from 12:00 to 15:59. Conclusion: The high mortality rate ofRTAis a major public health problem in Fars Province. Our results indicate that the time is an important factor which contributes to road traffic deaths.
文摘Purpose: The epidemiology of pediatric trauma is different in different parts of the world. Some researchers suggest falls as the most common mechanism, whereas others report road traffic accidents (RTAs) as the most common cause. The aim of this study is to find out the leading cause of pediatric admissions in Trauma Surgery in New Delhi, India. Methods: Inpatient data from January 2012 to September 2014 was searched retrospectively in Jai Prakash Narayan Apex Trauma Centre Trauma Registry. All patients aged 18 years or less on index presentation admitted to surgical ward/ICU or later taken transfer by the Department of Trauma Surgery were included. Data were retrieved in predesigned proformas. Information thus compiled was coded in unique alphanumeric codes for each variable and subjected to statistical analysis using SPSS version 21. Results: We had 300 patients over a 33 month period. Among them, 236 (78.6%) were males and 64 (21.3%) females. Overall the predominant cause was RTAs in 132 (43%) patients. On subgroup analysis of up to 12 years age group (n - 147), the most common cause was found to be RTAs again. However, falls showed an incremental upward trend (36.05% in up to 12 age group versus 27% overall), catching up with RTAs (44.89%). Pediatric Trauma Score (PTS) ranged from 0 to 12 with a mean of 8.12 _+ 2.022. 223 (74.33%) patients experienced trauma limited to one anatomic region only, whereas 77 (25.66%) patients suffered polytrauma. 288 patients were discharged to home care. Overall, 12 patients expired in the cohort. Median hospital stay was 6 days (range 1-182). Conclusion: Pediatric trauma is becoming a cause of increasing concern, especially in the developing countries. The leading cause of admissions in Trauma Surgery is RTAs (43%) as compared to falls from height (27%); however, falls from height are showing an increasing trend as we move to younger age groups. Enhancing road safety alone may not be a lasting solution for prevention of pediatric trauma and local injury patterns must be taken into account when formulating policies to address this unique challenge.
文摘Purpose: To investigate the early and mid-term results of open reduction and internal fixation (ORIF) with transarticular external fixation (TEF) but no deltoid ligament repair (DLR) in the treatment of supination-external rotation type Ⅳ equivalent (SER Ⅳ E) ankle fractures (AO/OTA classification 44-B 3.1 ) and provide evidence for clinical practice. Methods: This study cohort consisted of 22 patients with SER IV E ankle fractures that underwent ORIF with TEF but no DLR between December 2011 and December 2014, There were 13 males and 9 females, mean age 38.9 years (range, 17-73 years). Eight cases involved the left side and 14 the right side. The causes of fractures included road traffic accidents (11 cases), falling from height (6 cases) and sports injuries (5 cases). The mean period of hospitalization was 9.8 days (range, 6 14 days). For all the patients, MRI and three-dimensional CT were done before surgery and X-rays done preoperatively and during follow-ups. The external frame was kept for 8-10 weeks. The preoperative American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 56.86 m 4.400, the Medical Outcomes Short Form 36-item (SF-36) questionnaire score was 57.41 ± 4.102 and the visual analog score (VAS) was 5.50 m 1.058. Patients' main complaints about inconvenience of daily life were also recorded. Results: All the 22 patients were followed up for 24 63 months (mean, 33.6 months). None of them developed nonunion during the follow-up; pin site infection was observed in one patient and posttraumatic osteoarthritis in another. At the final follow-up, the average AOFAS score, SF-36 score and VAS score were respectively 90.59 e 5.096, 79.59± 5.394 and 1.82 ± 1.181, which were significantly improved compared with the preoperative data (t - 26.221, p 〈 0.001; t - 11.910, p 〈 0.001; t - 11.571, p 〈 0.001). The therapeutic effect was excellent in 13 cases, good in 7 cases and fair in 2 cases, with a good-excellent rate of 90.9%. Patients' main complaints were inconvenience of clothing (17 cases) and extremity cleaning (5 cases). Conclusion: In the treatment of SER IV E ankle fractures, ORIF with TEF but no DLR can achieve satis- factory outcome, but long-term effect should be confirmed by large sample randomized controlled trials.