Journal of Trauma & Treatment

Introduction: A large number of patients are admitted to government hospitals without any information or identification; these patients are known as "unknown" patients. In any healthcare setting, unknown and unaccompanied patients pose a substantial challenge to the treating doctor and Hospital Administration.

Aims and Objective: The study aimed to determine the demographic characteristics of such patients, their care management, the primary cause of injury and the outcome.

Material and methods: It was a hospital-based, prospective and retrospective study, using total enumeration, done in the Advanced Trauma Centre of tertiary care institute (PGIMER, Chandigarh); the study period was from 1st January 2018 to 31st March 2022.

Results: A total of 53583 patients reported to the trauma centre, out of which 438 were unknown patients, out of which 413 (94.3%) were males, and 25 (5.7%) were females. The significant age group seen as unknown patients was of 30-60 years accounting for 71.5% (313). The primary cause of trauma was a road traffic accident (RTA), accounting for 83.6%(366), majority of unknown got admitted to neurosurgery department accounting 51.4% (225), followed by orthopedics 21.7% (95), majority of these unknown patients were brought by health care worker 74% (324). On analyzing the outcome, the majority were discharged 62.1% (272), followed by brought dead or died here 31.3% (137), there were 5.7% (25) patients absconded, and 0.9% (4) were referred back.

Traumatic optic neuropathy (TON) is defined as damage to the optic nerve resulting in loss of visual function that cannot be explained by other ocular pathology. Mechanisms of TON can be classified into “direct” or “indirect”. Investigation of TON via various imaging modalities has been reported. The management and appropriate timing of intervention of indirect TON has been much debated. To date, there is insufficient evidence and guidance in determining the most appropriate treatment. In this review, we summarize the clinical features and investigations, and propose a guideline for the management of TON.

Intra articular calcaneum fractures remain a challenging task for management owing to the various complications of both non operative and operative procedure. Non operative management can lead to heel widening and shortening, varus mal alignment leading to difficulty in walking. On the other hand operative technique using lateral extensile approach can lead to skin necrosis and infection. As a result it is important to try and manage these fractures in a minimally invasive manner. In this study we have selected patients with intra articular depressed calcaneum fractures and we have treated them using a minimally invasive approach using k wires and cc screws. In this way we were able to avoid any wound complications and we were able to restore the normal anatomy of calcaneum.

Proximal phalanx fractures can be epiphyseal or shaft fractures and can be intra-articular or extra-articular. They are most often the result of forced rotation, hyperextension or direct trauma. The fracture is generally well seen on plain radiographs, angulation of these fractures is best seen on the lateral projection. The clinical consolidation is in 4 or 6 weeks; radiological consolidation takes longer. However, it should be noted that the fingers don't tolerate immobilization very well so it shouldn't exceed 3 weeks.

Treatment can be conservative in the case of a non-displaced fracture. Surgery is required in the case of an open fracture, when there is significant displacement or instability after reduction. In our study we have included 10 patients, 4 of whom were treated with Suzuki frame application and the other 6 were treated with josh external stabilization system (JESS).