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Acute Care for Traumatic Injuries and Surgical Outcomes: 2nd Edition
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Acute Care for Traumatic Injuries and Surgical Outcomes: 2nd Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Emergency Medicine".

Deadline for manuscript submissions: 25 March 2026 | Viewed by 2012

Special Issue Editors

Dr. Matthias Fröhlich

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Guest Editor
Department of Traumatology, Orthopedic Surgery and Sports Traumatology, Cologne-Merheim Medical Center (CMMC), Witten/Herdecke University, 51109 Cologne, Germany
Interests: orthopedics; trauma surgery; sports traumatology; polytrauma care; hip and knee, preclinical trauma care
Special Issues, Collections and Topics in MDPI journals
Dr. Michael Caspers

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Guest Editor
1. Department of Traumatology, Orthopedic Surgery and Sports Traumatology, Cologne-Merheim Medical Center (CMMC), Witten/Herdecke University, 51109 Cologne, Germany
2. Institute for Research in Operative Medicine (IFOM), Cologne Merheim Medical Center (CMMC), University of Witten/Herdecke, Ostmerheimerstr. 200, 51109 Cologne, Germany
Interests: trauma surgery; polytrauma care; coagulation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is my pleasure to invite you to contribute to the Special Issue entitled “Acute Care for Traumatic Injuries and Surgical Outcomes: 2nd Edition”. This is one new volume; we published 11 papers in the first volume. For more details, please visit:

https://www.mdpi.com/journal/jcm/special_issues/R41L31JMEX

This Special Issue focuses on the immediate management and treatment of traumatic injuries, as well as the subsequent surgical outcomes, resulting from accidents, falls, violence, or other forms of physical trauma. The field of acute care for traumatic injuries involves providing timely and specialized medical interventions to stabilize patients, prevent further damage, and optimize outcomes, which may include emergency resuscitation, diagnostic imaging, surgical interventions, pain management, and rehabilitation. Since the average life expectancy of global populations has been increasing in recent decades, doctors now often have to provide care for patients who suffer from several comorbidities, which may require specialized treatment algorithms for older patients.

By continually improving acute care protocols and surgical techniques, healthcare professionals aim to enhance patient outcomes, minimize complications, and improve the overall quality of life of individuals who have experienced traumatic injuries. With this purpose in mind, we cordially invite all authors to submit original or review articles to the Special Issue.

Dr. Matthias Fröhlich
Dr. Michael Caspers
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • trauma injuries
  • orthopedics
  • polytrauma
  • emergency care
  • coagulation disorders
  • fractures
  • surgical outcomes
  • acute care
  • diagnostic imaging

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Related Special Issue

Published Papers (3 papers)

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Research

9 pages, 207 KB  
Article
Utility of the Shock Index as a Prognostic Predictor in Patients Undergoing Emergency Surgery for Trauma: A Single Center, Retrospective Study
by Byungchul Yu, Chun Gon Park, Kunhee Lee and Youn Yi Jo
J. Clin. Med. 2025, 14(19), 6783; https://doi.org/10.3390/jcm14196783 - 25 Sep 2025
Viewed by 572
Abstract
Background: Shock index (SI) is calculated by dividing heart rate (HR) by systolic blood pressure (sBP) and is a useful tool for predicting the prognosis of trauma patients. This study aimed to determine whether SI is useful in predicting mortality in patients undergoing [...] Read more.
Background: Shock index (SI) is calculated by dividing heart rate (HR) by systolic blood pressure (sBP) and is a useful tool for predicting the prognosis of trauma patients. This study aimed to determine whether SI is useful in predicting mortality in patients undergoing emergency surgery for trauma. Methods: We analyzed 1657 patients who underwent emergency surgery for trauma. Patients were divided into SI < 1 and SI ≥ 1 groups and the Glasgow Coma Scale (GCS), Injury Severity Score (ISS), revised trauma score (RTS), Korean Triage and Acuity Scale (KTAS), transfusion amount, and mortality were compared. Binary logistic regression analysis was performed to identify factors associated with mortality. Results: There were significant differences in GCS, ISS, RTS, and KTAS in the SI ≥ 1 group compared to the SI < 1 group (all p-values < 0.001). In the SI < 1 cohort, the mortality rate was 11% (144/1283), and in the SI ≥ 1 group the mortality rate was 33% (125/374) (p < 0.001). Age, GCS, ISS, SI ≥ 1, and KTAS were determined to be predictors of mortality by logistic regression analysis. In particular, SI ≥ 1 group members exhibited a high association with elevated mortality (OR, 2.498; 95% CI, 1.708–3.652; p < 0.01). Conclusions: Although SI alone has limitations in predicting the patient’s prognosis, patients with SI ≥ 1 upon arrival at the emergency room are associated with mortality of patients undergoing emergency surgery for trauma, along with already known trauma assessment systems such as GCS, ISS, and KTAS. Full article
(This article belongs to the Special Issue Acute Care for Traumatic Injuries and Surgical Outcomes: 2nd Edition)
14 pages, 486 KB  
Article
Clinical Indicators and Imaging Characteristics of Blunt Traumatic Diaphragmatic Injury: A Retrospective Single-Center Study
by Hoon Ryu, Chun Sung Byun, Sungyup Kim, Keum Seok Bae, Il Hwan Park, Jin Rok Oh, Chan Young Kang, Jun Gi Kim and Young Un Choi
J. Clin. Med. 2025, 14(18), 6562; https://doi.org/10.3390/jcm14186562 - 18 Sep 2025
Viewed by 399
Abstract
Background/Objectives: Blunt trauma injury of the diaphragm is uncommon. Even after imaging examination, accurate diagnosis remains difficult. We sought to identify clinical factors that raise suspicion of such injuries, which can be applied during the initial evaluation of trauma patients. Methods: We retrospectively [...] Read more.
Background/Objectives: Blunt trauma injury of the diaphragm is uncommon. Even after imaging examination, accurate diagnosis remains difficult. We sought to identify clinical factors that raise suspicion of such injuries, which can be applied during the initial evaluation of trauma patients. Methods: We retrospectively analyzed patients with blunt trauma who were diagnosed with diaphragmatic injury between January 2015 and July 2025. Demographic variables, clinical findings, operative records, and imaging findings were reviewed. Results: The most common mechanism of injury in patients with diaphragmatic injury was traffic accidents (64.2%), and 77.4% were identified as severe injuries with an Injury Severity Score (ISS) ≥ 16. Computed tomography (CT) scans of these patients frequently showed hemothorax, hemoperitoneum, and pneumothorax, but 49.1% of cases did not show diaphragmatic injury on preoperative imaging. In these patients, pneumothorax, lower rib fractures, and liver injury were more common. Notably, pneumothorax strongly suggested the possibility of diaphragmatic injury in patients where intrathoracic herniation was not clear. Conclusions: In patients with polytrauma and unstable vital signs, CT evaluation of torso injuries and careful interpretation are essential. Even when CT does not reveal diaphragmatic injury, suspicion should be elevated in cases with high ISS accompanied by pneumothorax, hemoperitoneum, hemothorax, lower rib fractures, or extremity injuries. If the injury mechanism further raises clinical suspicion, repeated physical examinations and imaging studies should be performed. When suspicion remains high, surgical intervention should be considered to confirm the diagnosis. Full article
(This article belongs to the Special Issue Acute Care for Traumatic Injuries and Surgical Outcomes: 2nd Edition)
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13 pages, 491 KB  
Article
Transsacral Bar Fixation for Osteoporotic H-Type Sacral Fractures: A Viable Alternative to Spinopelvic Fixation
by Martin Naisan, Felix Schmitz, Yazan Noufal, Yama Afghanyar, Matthias Fröhlich, Marcus Richter, Philipp Drees and Philipp Hartung
J. Clin. Med. 2025, 14(18), 6503; https://doi.org/10.3390/jcm14186503 - 16 Sep 2025
Viewed by 932
Abstract
Background: Fragility fractures of the pelvis (FFP) are an increasing challenge in aging societies. Among these, FFP type 4B (“H-shaped” sacral fractures) represent the most unstable subtype, characterized by bilateral sacral ala fractures with transverse dissociation. Optimal fixation strategies remain debated, as [...] Read more.
Background: Fragility fractures of the pelvis (FFP) are an increasing challenge in aging societies. Among these, FFP type 4B (“H-shaped” sacral fractures) represent the most unstable subtype, characterized by bilateral sacral ala fractures with transverse dissociation. Optimal fixation strategies remain debated, as spinopelvic fixation provides maximal stability but is invasive, while iliosacral screws often fail in osteoporotic bone. Trans-sacral bar (TSB) fixation has been proposed as a less invasive alternative, though evidence for its use in FFP 4B remains limited. Methods: We conducted a retrospective single-center study of 31 elderly patients (mean age 77.9 years; 87.1% female) with CT-confirmed FFP type 4B fractures treated between 2015 and 2022 using navigation-guided TSB constructs. Surgical configurations included hybrid fixation (TSB + bilateral iliosacral screws, n = 25) and dual-bar fixation (n = 6). Outcomes included perioperative complications, implant survival, radiographic healing, pain, and mobility at 3 and 12 months. Opportunistic CT-derived Hounsfield units (HU) were used to assess bone quality. Results: All patients had severe osteoporosis (mean HU 75.8 ± 30.1). Mean operative time was 71 min, and mean hospitalization was 9.1 days. No intraoperative or postoperative complications occurred, and no implant loosening, migration, or revision surgeries were required. At 3 months, mean pain score was 1.9, further decreasing to 1.1 at 12 months; 60.9% of patients reported complete pain resolution. Mobility improved in most cases, with 80.6% discharged with a walker or crutches. Radiographic follow-up confirmed stable healing in all patients. Conclusions: Navigation-guided TSB-based fixation provided stable osteosynthesis with excellent implant survival, significant pain relief, and early mobilization in elderly patients with FFP type 4B fractures. Hybrid and dual-bar constructs both achieved reliable outcomes. TSB fixation thus represents a safe and effective alternative to spinopelvic fixation in this fragile population. Larger multicenter prospective studies are warranted to confirm these findings and refine fixation strategies. Full article
(This article belongs to the Special Issue Acute Care for Traumatic Injuries and Surgical Outcomes: 2nd Edition)
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