Browsing by Author "Roussot, Mark"

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    Amputation rate following tibia fractures with associated popliteal artery injuries
    (2017) Roussot, Mark; Maqungo, Sithombo; Roche, Stephen
    Objectives: 1. Determine the amputation rate; and 2. identify risk factors in patients with tibia fractures and associated popliteal artery injuries. Intervention: Amputation or limb salvage. Design: Retrospective case-control study. Setting: Level 1 trauma center. Patients: Thirty popliteal artery injuries with ipsilateral tibial fractures. Outcome measures: Primary and delayed amputation rates were determined. Risk factors tested for significance (Fischer's Exact) included: mechanism of injury, signs of threatened viability, compartment syndrome, fracture pattern, surgical sequence, and time delay from injury or presentation to revascularization. Results: The study group consisted of 22 males and 8 females, with a mean age of 31 years. Motor vehicle accidents and gunshot wounds constituted the mechanism in 17 and 11 patients respectively. Twenty-one were polytrauma victims. Intra/extra16 articular metaphyseal fractures (OTA 41 A-C) were recorded in 19 and diaphyseal (OTA 42 A-C) in 7 patients. Primary amputation was performed in 7 and delayed in 10 patients (overall rate 57%). No individual risk factors were predictive of amputation; however, the "miserable triad" of a proximal tibia fracture (OTA 41) with signs of threatened viability, and delay to revascularization ≥ 6 hours from injury or ≥ 2 hours from presentation was predictive of amputation (p = 0,036 and p = 0,018 respectively). Conclusions: We should aim to intervene within 6 hours following injury or 2 hours following presentation to reduce the risk of amputation. This provides a target for trauma teams even with uncertain time of injury. Level of Evidence: III.
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    Upper limb injuries in athletes participating at the London 2012 Paralympic Games
    (2014) Roussot, Mark; Schwellnus, Martin; Derman, Wayne
    The International Paralympic Committee (IPC) has witnessed growing participation in the Games since its inception and has made strong efforts to collect comprehensive injury and illness data during the London 2012 Paralympics. Until now, no studies have comprehensively evaluated upper limb injuries at the Paralympic Games. To describe the epidemiology and clinical characteristics of upper limb injuries in athletes participating in the London 2012 Paralympic Games and identify the groups of athletes at risk. This study forms a component of the large prospective cohort study conducted over the 14-day period of the London 2012 Paralympic Games, coordinated through the IPC Medical Committee. Data were collected in two phases. Phase 1 involved the determination of the incidence and severity for 3,565 athletes (85% of the Paralympic athletes) from a collation of three data sources, providing 46,606 athlete days of data for analysis. Phase 2 involved the collection of more detailed medical data using a novel web-based surveillance system for 3,329 athletes participating in the study (80% of Paralympic athletes). Incidence proportion (IP) has been defined as the number of injuries per 100 athletes (%) during the study period. Incidence rate (IR) has been defined as the number of injuries per 1000 athlete days for the study period and 95% confidence intervals (CI) are reported in parentheses.