2005 & Older References
-Femur Fractures in Infants and Young Children.
-Surgery: A Noble Profession in a Changing World.
Traction for Adult Femoral Shaft Fractures: a Report on 53 patients in Sierra Leone.
Spain D.A. and Miller F.B. Education and Training of the Future Trauma Surgeon in Acute Care Surgery: Trauma, Critical Care, and Emergency Surgery. American Journal of Surgery, April 2005: Vol. 190, pp. 212-217.
Abstract
Trauma surgery as a specialty in the United States is at a crossroads. Currently, less than 100 residents per year pursue additional specialty training in trauma and surgical critical care. Many forces have converged to place serious challenges and obstacles to the training of future trauma surgeons. In order for the field to flourish, the training of future trauma surgeons must be modified to compensate for these changes. Recent medical literature regarding the training of trauma surgeons and report of the Future of Trauma Surgery/Trauma Specialization Committee of the American Association for the Surgery of Trauma. The new post-graduate trauma training fellowship of the future should be built on a foundation of general surgery. The goal of this program will be to train a surgeon with broad expertise in trauma, critical care, and emergency general surgery. This new emphasis on non-trauma emergency surgery required an image change and thus a new name; Acute Care Surgery: Trauma, Critical Care, and Emergency Surgery.
Femur Fractures in Infants and Young Children.
Brown D. and Fisher E. Femur Fractures in Infants and Young Children. American Journal of Public Health, April 2004, Vol. 94, Issue 4, pp. 558-560.
Link: http://www.ajph.org/cgi/content/full/94/4/558?view=long&pmid=15054003
Abstract
Using an administrative database, we determined rates of femur fracture by year of age for children younger than 6 years and by month of age. The highest rate of femur fracture was in children younger than 1 year and in 2-year-olds; the greatest number of fractures occurred during the third month of life. While femur fractures in children are often due to accidental injury, the reasons for the peak in the first year and the subsequent decline are not clear.
Surgery: A Noble Profession in a Changing World.
Debas H.T. Surgery: A Noble Profession in a Changing World. Annals of Surgery, 2002, Vol. 236, Issue 3, pp. 263-269.
Link: http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=12192312
Abstract
Surgery is, indeed, one of the noblest of professions. Here is how Webster’s Third New International Dictionary defines the word noble: 1) possessing outstanding qualities such as eminence, dignity; 2) having power of transmitting by inheritance; 3) indicating superiority or commanding excellence of mind, character, or high ideals or morals. These three attributes befit the profession of surgery. Over centuries, the surgical profession has set the standards of ethical and humane practice. Surgeons have made magnificent contributions in education, clinical care, and science. Their landmark accomplishments in surgical science and innovations in operative technique have revolutionized surgical care, saved countless lives, and significantly improved longevity and the quality of human life. Generations of surgeons have developed their craft and passed it on to succeeding generations, as they have to me and to each one of you, to take into the future.
Fractures of the Femoral Shaft in Children: Incidence, Mechanisms, and Sociodemographic Risk Factors.
Hinton R.Y., Lincoln A., Crockett M.M., et. al. Fractures of the Femoral Shaft in Children: Incidence, Mechanisms, and Sociodemographic Risk Factors. Journal of Bone and Joint Surgery, 1999, Issue 81, pp. 500-507.
Abstract
Fractures of the femoral shaft in children are caused by major musculoskeletal trauma and result in high direct and indirect medical costs. To date, the American literature has focused on treatment options and outcomes, but the epidemiology of these injuries has been generalized from Scandinavian studies reported in the 1970s and early 1980s. The goals of the current study were (1) to determine the age, gender, and race-specific rates and mechanisms of fractures of the femoral shaft in children in a large United-States-based population and (2) to identify associations between the rates of these fractures and multiple sociodemographic indicators. Such information is vital for preventive efforts. The Hospital Discharge Database of the Maryland Health Services Cost Review Commission for the years 1990 through 1996 was used to obtain demographic data on 1485 cases of acute fracture of the femoral shaft in patients who were less than eighteen years old, and data from the United States Bureau of the Census for the state of Maryland for the year 1990 were used to obtain denominator data. Reliable external-cause data were available from the 1995 and 1996 databases for 472 patients. Small-area analysis was performed at the zip-code level to determine associations between numerous sociodemographic indicators and the rate of femoral shaft fracture. The annual rate of femoral shaft fracture in children was 19.15 per 100,000. With regard to age, there was a bimodal distribution, with peaks at two and seventeen years. Boys had higher rates of fracture than did girls at all ages, and blacks had higher rates than did whites. The primary mechanisms of fracture were age-dependent and included falls, for children less than six years old; motor vehicle-pedestrian accidents, for those six to nine years old; and motor-vehicle accidents, for teenagers. Firearm-related injuries accounted for 15 percent of the fractures among black adolescents. Adverse socioeconomic conditions were significantly associated with higher rates of fracture. The rates and mechanisms of femoral shaft fractures in children depend on age, gender, and race. For children living in the United States today, the epidemiology of these fractures is different than that described in earlier, Scandinavian reports.
