Journal Article > CommentaryAbstract
Nature. 27 October 2011; Volume 478 (Issue 7370); DOI:10.1038/478458a
Guerrier G, Baron E, Fakri R, Mouniaman I
Nature. 27 October 2011; Volume 478 (Issue 7370); DOI:10.1038/478458a
The burden of war-related mental disorders is well documented among US veterans (Nature 477, 390–393; 2011), but not among civilians in Iraq. This oversight must be rectified so that adequate medical support can be provided to the Iraqi people. US combat troops will soon depart Iraq, leaving Iraqis to cope with the consequences of the 2003 invasion. Although the number of violent deaths is falling, civilians have been killed almost every day this year, most of them in coordinated bomb attacks. Roadside blasts cause long-term disabilities and societal effects among injured civilians. However, these have been largely neglected by the media and no systematic surveillance has been undertaken.
Journal Article > ResearchAbstract Only
J Orthop Trauma. 7 July 2012; Volume 26 (Issue 7); e76-82.; DOI:10.4269/ajtmh.2012.10-0631
Fakri R, Al Ani AM, Rose AMC, Alras MS, Daumas L, et al.
J Orthop Trauma. 7 July 2012; Volume 26 (Issue 7); e76-82.; DOI:10.4269/ajtmh.2012.10-0631
OBJECTIVE
To describe medical care and surgical outcome after functional reconstructive surgery in late-presenting patients who already had at least one prior operation.
DESIGN
Retrospective review of medical care and surgical outcome from August 2006 to December 2008 using patient records for initial data with active follow-up for the latest outcome information.
SETTING
Médecins sans Frontières surgical programme in Jordan Red Crescent Hospital, Amman, Jordan.
PATIENTS
Sixty-two civilians with nonunion tibial fractures caused by war-related trauma in Iraq; 53 completed follow-up.
INTERVENTION
Amputation and/or reconstruction.
MAIN OUTCOME MEASUREMENTS
Late surgical complications (after the patient's return to Iraq) were analyzed for infection recurrence, bone union, and functional condition (defined using the Short Musculoskeletal Functional Assessment score).
RESULTS
Almost three fourths of patients arrived with infected injuries, 9 of whom had amputation as the initial surgery; the rest, and all uninfected patients, had reconstruction. Excluding loss to follow-up, only 4 of 53 (8%) patients who arrived with an infected injury had infection recurrence. Excluding loss to follow-up and amputation, 2 of 14 (14%) patients in the uninfected and 5 of 30 (17%) in the infected injury group did not achieve successful tibial union. Mean Dysfunctional and Bothersome Indices overall were 27.1 and 29.8, respectively, with similar results for all 3 groups (amputations, uninfected, and infected injuries).
CONCLUSIONS
Our study shows that patients with infected and uninfected injuries surgically treated in Amman achieved similar outcomes. Despite late presentation, our patients had a comparable outcome to other studies dealing with early reconstruction. Reconstruction for the infected group required longer treatment time.
To describe medical care and surgical outcome after functional reconstructive surgery in late-presenting patients who already had at least one prior operation.
DESIGN
Retrospective review of medical care and surgical outcome from August 2006 to December 2008 using patient records for initial data with active follow-up for the latest outcome information.
SETTING
Médecins sans Frontières surgical programme in Jordan Red Crescent Hospital, Amman, Jordan.
PATIENTS
Sixty-two civilians with nonunion tibial fractures caused by war-related trauma in Iraq; 53 completed follow-up.
INTERVENTION
Amputation and/or reconstruction.
MAIN OUTCOME MEASUREMENTS
Late surgical complications (after the patient's return to Iraq) were analyzed for infection recurrence, bone union, and functional condition (defined using the Short Musculoskeletal Functional Assessment score).
RESULTS
Almost three fourths of patients arrived with infected injuries, 9 of whom had amputation as the initial surgery; the rest, and all uninfected patients, had reconstruction. Excluding loss to follow-up, only 4 of 53 (8%) patients who arrived with an infected injury had infection recurrence. Excluding loss to follow-up and amputation, 2 of 14 (14%) patients in the uninfected and 5 of 30 (17%) in the infected injury group did not achieve successful tibial union. Mean Dysfunctional and Bothersome Indices overall were 27.1 and 29.8, respectively, with similar results for all 3 groups (amputations, uninfected, and infected injuries).
CONCLUSIONS
Our study shows that patients with infected and uninfected injuries surgically treated in Amman achieved similar outcomes. Despite late presentation, our patients had a comparable outcome to other studies dealing with early reconstruction. Reconstruction for the infected group required longer treatment time.
Journal Article > ResearchAbstract
J Trauma. 1 July 2011; Volume 71 (Issue 1); DOI:10.1097/TA.0b013e31821b8622
Murphy RA, Ronat JB, Fakri R, Herard P, Blackwell N, et al.
J Trauma. 1 July 2011; Volume 71 (Issue 1); DOI:10.1097/TA.0b013e31821b8622
War-related orthopedic injury is frequently complicated by environmental contamination and delays in management, placing victims at increased risk for long-term infectious complications. We describe, among Iraqi civilians with war-related chronic osteomyelitis, the bacteriology of infection at the time of admission.