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Abstracts / Injury

hest AIS severity was added up, to test the hypothesis that severityf chest trauma may be different between Group 1 and Group 2.

Results: From January 2004 to January 2009, 387 (79 females)et the inclusion criteria. Group 1 consisted of 39 patients and

roup 2 of 348. The mean ISS were 41 (group 1) and 34 (group). There were 10 and 54 non-survivors in group 1 and group 2espectively. The mean ISS between survivors and non survivorsn group 1 was 34.6 and 47.5, respectively, (p = 0.01). In group 2t was 29.7 and 38.4, (p = 0.02). The AIS score (number of injuries)or survivors and non-survivors in group 1 was 6 and 8.4, (p = 0.06)hereas for group 2 was 6.6 and 7.7, respectively.

Conclusion: In patients that have sustained blunt chest trauma,he number of chest injuries may be an important contributingactor on outcome.

oi:10.1016/j.injury.2011.06.335

B.13

aving limbs, saving time, saving money—The Ganga Hospitalractice

.A. Ayub, A.D. Patel

Norfolk and Norwich University Hospital, United Kingdom

Objective: To assess the application of the Ganga Hospital Opennjury Score in a western setting. With a far higher rate of open longone fractures, the specialist team at the Ganga Hospital in Indiaave become the foremost experts in the management of thesemergencies and have devised the Ganga Hospital Open Injurycore (GHS) as a culmination of their knowledge.

Traditionally, open fractures receive immediate stabilisationollowed by definitive fixation and closure often in several stages.he endurance of these methods mean repeated anaesthetics asell as increased infection risk, hospital stay and cost. The GHS pro-

ides clear criteria for the application of their various protocols: ‘fixnd close’, ‘fix, bone graft and close’ and ‘fix and flap’, designed tollow one index procedure and obviate the need for a protractedreatment course.

We prospectively scored 21 open long bone fractures using theHS. Of the 21 cases analysed, 15 met the criteria set out in the GHS

or one of their protocols. 2 patients had delayed wound closures,patients had further operations for bone grafting and 3 patientsad further operations for plastic surgical procedures.

According to the GHS these 7 operations may have been avoided.Another feature of the GHS is that it can predict outcome in

erms of hospital stay and expected discharge. The GHS accu-ately predicted the recovery course for 71% of our cases. It is alsonteresting to note that had the protocols been adhered to, twoostoperative infections may have been avoided.

Conclusion: The GHS is a proven tool for managing open longone fractures in an Indian setting, however the analysis of these

ases suggests that it may be applicable in the UK.

oi:10.1016/j.injury.2011.06.336

2 (2011) 95–169 143

2B.15

Impact of opening a skate park on the incidence and severity ofinjuries presenting to a district hospital

P.R. Loughenbury, R.A. Gledhill, D. Watkin, F.A. Barnett, A.P.Volans, N. Evans

Scarborough General Hospital, Scarborough, UK

Introduction: The opening of dedicated Skate Parks has beenlinked to an increase in the incidence of paediatric injuries in someunits. This study provides a retrospective review of the effect of aSkate Park opening close to a district hospital.

Methods and materials: The number and pattern of admissionsto the emergency department were investigated in the first monthfollowing opening of the Skate Park. The operative workload of theorthopaedic department was also examined. These were comparedwith the same time period in the previous year.

Results: In the first month after opening of the Skate Park393 patients attended the ED following minor trauma (234 limbinjuries, 126 head injuries, 33 contusions/lacerations). 55 (14%)required inpatient treatment. In the previous year 392 patientsattended the ED following minor trauma (218 limb injuries, 145head injuries, 29 contusions/lacerations). 54 (14%) required inpa-tient treatment. There was no difference between the number andpattern of ED attendances during these two time periods. In themonth after the Skate Park opened 28 paediatric patients requiredoperative fixation of limb injuries (19 manipulations under anaes-thetic ± k-wire fixation; 9 open procedures). In the previous year,23 paediatric patients required operative fixation of limb injuries(21 manipulations under anaesthetic ± k-wire fixation, 2 open pro-cedures). 32% of cases required open reduction following openingof the Skate Park compared with 9% in the previous year (p = 0.0168,Chi squared test).

Conclusion: In our unit the opening of a Skate Park did not alterthe number or pattern of ED attendances. However, a larger num-ber of paediatric injuries required operative fixation and a greaterproportion of these were open procedures. Although the number ofinjuries did not change, the severity of paediatric injuries increasedfollowing opening of the Skate Park.

doi:10.1016/j.injury.2011.06.337

2B.16

Effect of weight bearing regime on fractures site strain of distalthird tibial fractures treated with a locking compression plate

P. Upadhyay ∗, J. Beazley, M. Dunbar, M. Costa

Warwick Orthopaedics, United Kingdom

Introduction: Fracture site strain is important in determining thetype of bony healing that will occur. Strain across a fixed fracture ismodulated both by force applied across fracture and the stiffness ofplate/bone construct, both influenced by the surgeon. Whilst sev-eral papers have examined the stiffness of bone/plate constructs,no paper has examined the influence of differing weight baringregimes on fracture strain. This study investigates the effect of dif-fering weight baring regimes on fracture site strain for distal 1/3rdtibial fractures treated with a locking compression plate (LCP).Additionally the effect of modulating the stiffness of plate/boneconstruct with locking vs. non-locking fixation and its resultanteffect on fracture strain was investigated.

Methods and results: A standardized oblique fracture pattern wascreated in the tibial metaphysis of 3rd generation composite tibias,40 mm from the distal end of the tibia (AO 43-A2.3). A 10 mm frac-