Trauma Care

External fixation is widely used in trauma care for managing bone and soft tissue injuries. These devices are often associated with psychological challenges and are often not followed up with sufficient psychological support for the patient. The specific psychological impact of external fixation following traumatic injuries remains underexplored. This scoping review aimed to synthesize the current literature on the psychological impact of external fixation in trauma patients. A systematic search of CINAHL, Cochrane Library, PsycInfo, PubMed, Scopus, Google Scholar, and EBSCO identified ten studies (2006–2024), from the USA, Europe, Asia, and Oceania to be included based on inclusion criteria of using the device for traumatic injuries (excluding limb lengthening procedures) and assessing psychological outcomes using validated tools. Data extracted included injury type, fixator application, survey type, and mental health outcomes. Common measures included HADS, SF-36/SF-12, PedsQL, CRIES-13, EQ-5D-5L, and patient-reported questionnaires. The findings showed that elevated psychological distress was greatest during early recovery (~1 month). Body image concerns were frequently reported with the fixator in place; however, partial recovery of mental health scores was seen by 12–24 months. These findings emphasize the need for additional research and a greater integration of mental health resources in trauma care protocols involving external fixation.

Background: Quality of life is a foundational component of overall health and is negatively impacted by post-traumatic stress disorder (PTSD). In the last decade, acupuncture treatment has become a popularized treatment option for PTSD, especially for Veterans. Research evidence is needed to provide support for acupuncture as a treatment for PTSD which leads to an enhanced quality of life. Objectives: This paper investigated the changes in health-related quality of life in Veterans with combat PTSD who enrolled in a 5-year randomized (two-arm, parallel-group, prospective, single-blinded) clinical trial, completing either a control (Sham) or acupuncture (Verum) treatment (N = 93). Methods: Health-related quality of life was measured by the Veterans RAND 12-item Health Survey (VR-12). Paired t tests between and among participants’ differences were calculated for the Verum acupuncture group, Sham acupuncture group, and Total group. Results: Veterans who completed acupuncture treatment in either randomized arm (Verum and Sham) had a self-perceived improvement in quality of life when assessing physical and mental health symptoms. Specifically, those who were randomized and completed Verum acupuncture treatment reported the greatest improvement in mental health quality of life. Conclusions: Study results support prior foundational findings that acupuncture has a positive effect on self-reported quality of life by reducing PTSD symptoms in Veterans with combat PTSD, with Verum acupuncture eliciting the greatest improvement on mental health symptoms.

Aim: This study aims to assess the relationship between the time-to-CT and outcomes in trauma patients presenting to a regional Australian hospital. Method: This study is a retrospective analysis of prospectively collected data to review the relationship between time-to-CT and the outcomes of mortality, length of stay, and intrahospital transfer for trauma patients presenting to a single regional Australian hospital between January 2000 and July 2022. Results: There were 127 trauma patients who met the inclusion criteria during the study period. Comparing patients who had a CT performed within 1 h of arrival to patients those who had a CT performed more than 1 h after arrival, there was no statistically significant difference in mortality rate (8.0% vs. 7.7%, p = 1.000), and no statistically significant difference in length of stay (4.5 days vs. 3 days, p = 0.496). Increased age was associated with an increased risk of mortality while First Nations people were found to have a shorter length of stay within hospital. Conclusions: In this cohort study, the time-to-CT was not predictive of increased mortality risk in trauma patients presenting to a regional hospital. The time-to-CT in this regional hospital was comparable to published data from level I trauma centres in Australia. What does this paper add to the literature? This paper is the first to look at the impact of time-to-CT in the regional Australian setting.