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External hinge fixation system for leg lengthening and correction of axial deviations, / Salamehfix 1/. configuration and clinical advantages

International Orthopaedics -

Int Orthop. 2025 Sep 16. doi: 10.1007/s00264-025-06652-8. Online ahead of print.

ABSTRACT

PURPOSE: To present the design, clinical application, and outcomes of a novel three-dimensional external hinge distraction fixation system (Salamehfix 1), allowing simultaneous limb lengthening and correction of axial deviations with stable fixation, early mobility, and full weight bearing.

METHODS: Between 2000 and 2024, a total of 1103 patients (aged 4-57.5 years) underwent lower limb reconstruction using Salamehfix 1. Indications included congenital limb length discrepancy (LLD), post-traumatic and developmental deformities, stature lengthening, achondroplasia and cosmetic lengthening. Using (Salamaehfix 1), 640 patients out of the total 1103 underwent simultaneous lengthening and deformity correction and 193 patients were stature lengthening cases. The device employs three small anterior arcs with hinged distraction rods, customizable to patient anatomy and deformity pattern. Additionally, the device is an arc hinged system with pins in different angles and levels to provide a stable bone fixation and weight bearing. Outcomes were assessed in terms of gained bone's length, functional mobility, healing time, and complication rate.

RESULTS: Mean bone lengthening was 5.6 cm (range: 2-18 cm), and bone healing time of 260 days. Complications were minimal and manageable; superficial pin site infection occurred in 25 patients, contractures in 9, and deep infection in one. Stature cases (n = 193) had a mean lengthening of 6.5 cm, with excellent functional outcomes.

CONCLUSION: Salamehfix 1 is an effective, patient-friendly external fixation system enabling simultaneous correction and lengthening in a wide variety of deformities and cosmetic cases. It offers significant mechanical and clinical advantages over traditional devices.

PMID:40956411 | DOI:10.1007/s00264-025-06652-8

Augmented reality for medical education in the primary survey of burns: an exploratory study

Injury -

Injury. 2025 Sep 6:112747. doi: 10.1016/j.injury.2025.112747. Online ahead of print.

ABSTRACT

INTRODUCTION: Augmented reality (AR) technology is rapidly evolving and is finding an increasing application in education, including medical training. This feasibility study aimed to explore the usability and didactic potential of AR with the HoloLens2™ for medical students, teaching the primary survey of burn wounds.

METHODS: This feasibility study was conducted using a prospective observational cohort design. Test groups consisted of participants with limited (n = 18), moderate (n = 10), or high (n = 5) experience in burn care, and filled in a questionnaire after training with the HoloLens2™.

RESULTS: Outcomes of the questionnaires show AR to be a promising technology for educating medical students in the primary survey of burn wounds.

DISCUSSION: However promising, there is further need for development in usability and image quality. The ability to simulate realistic scenarios in a safe and scalable environment could pave the way for a new era for medical education, where AR becomes a valuable supplement or even replacement for traditional learning methods.

PMID:40947373 | DOI:10.1016/j.injury.2025.112747

Unabated violence: Evaluating the impact of the "state of exception" in Ecuador on surgical trauma admissions

Injury -

Injury. 2025 Sep 8:112758. doi: 10.1016/j.injury.2025.112758. Online ahead of print.

ABSTRACT

PURPOSE: Ecuador has seen a dramatic increase in violence, with homicides rising from 6.4 per 100,000 inhabitants in 2015 to 47.25 in 2023. In response, the government declared a state of internal armed conflict and a "state of emergency" This study aims to analyze the impact of this political measure on the admission of patients who are victims of violence to a hospital in the coastal region of the country.

METHODS: This is an analytical cross-sectional study conducted over nine months, from October 2023 to July 2024, divided into three-month periods. The independent variable was the period of surgical trauma: pre-exception, during the state of exception, and post-exception. The dependent variable was surgical trauma due to violence. A bivariate analysis was performed and a p-value of <0.05 was considered statistically significant.

RESULTS: The study included 160 cases of surgical trauma. Of the traumas reported during the nine months, 80 % (N=128) were due to violence. 78 % (N=125) of patients underwent surgery for penetrating trauma, with 77 % (96/125) of these due to firearms. The proportion of penetrating injuries due to firearms varied significantly according to period (p = 0.020). During the state of exception it fell to 60 % (21/35) from 79 % (31/39) pre-exception, but rose again in the post-exception period to 86 % (44/51).

CONCLUSION: The strategies implemented did not significantly reduce trauma admissions due to violence at this hospital, underscoring the imperative for additional interventions and a comprehensive understanding of the social determinants underlying this public health issue.

PMID:40946074 | DOI:10.1016/j.injury.2025.112758

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