Injury Extra 40 (2009) 183–235 Contents lists available at ScienceDirect Injury Extra journal homepage: www.elsevier.com/locate/inext Abstracts from the 2009 Meeting of the British Trauma Society 14–15 May 2009 The following three abstracts, presented during the 2009 Annual Meeting of the British Trauma Society, were the winners of the Injury Journal Awards. [2A.5] 1st Prize The presence and pattern of vascular insufficiency in the older patient suffering an unstable ankle fracture: The relationship to skin and wound complications K.M. Willett a,* , B. Gray a , S. Lamb a , A. Handa a , S. Lamb a , R. Handley b a University of Oxford, UK b Oxford Radcliffe Hospital, UK Hypothesis: Impaired vascularity of the skin in elderly ankle fracture patients causes the skin and wound complications. Materials and methods: This is part of a RCT comparing ORIF and close contact casting (CCC) for isolated unstable ankle fractures in patients >60 years. Assessments over 6 months: (i) transcutaneous O 2 saturation (TcPO 2 ) of medial and lateral ankle skin; (ii) Ankle- Brachial Pressure Index (ABPI); (iii) three-vessel arterial duplex scan; (iv) distal calf perforator artery patency. The uninjured limb was the control. Results: 89 patients eligible; 59 participated (76% female). 30 randomised to ORIF; 29 to CCC. Each had one death and one with- drawal. Vascular data available on 55. Two patients had delays in wound healing (>25% for >6 weeks). Two further developed wound infections. No skin breakdowns in CCC group. There was a reduced TcPO 2 on day 3 in the injured limb. The TcPO 2 rose at 6 weeks com- pared to day 3 (medial 58 mmHg; lateral 53 mmHg, p = 0.002) in the injured leg. At 6 months the TcPO 2 measurements were not different to uninjured leg. A critical TcPO 2 (<20 mmHg) found in 4, correlated with skin problems (p = 0.003). Two of these had the only major delays in wound healing and one of the two wound infections. 94% of participants had normal ABPIs (>1.0). There was no difference between patients with or without an impaired ABPI (<0.7 mmHg) and wound problems (p = 0.20). There was no difference in patient perforators between the injured and uninjured (p = 0.39). Conclusions: Occult vascular insufficiency is present but at low inci- dence. ABPI and Duplex-US are insensitive for predicting infection or delayed healing. The ankle fracture injury does not disrupt the local perforators. TcPO 2 is sensitive and specific for predicting skin problems. Impairment of skin oxygenation is transient. Current TcPO 2 technology however is impractical as a clinical tool. Keywords: Vascularity; Ankle fracture; Older people; Wound com- plications doi:10.1016/j.injury.2009.06.170 [7A.3] 2nd Prize Lateral compression type I injuries of the pelvic ring: Are they mechanically stable? N.K. Kanakaris * , C. Tzioupis, V.S. Nikolaou, P.V. Giannoudis Leeds General Infirmary, UK Aim: To investigate whether lateral compression type I injuries of the pelvic ring are inheritably mechanically stable. Patients and methods: Between January 2005 to January 2007 all consecutive admissions of a tertiary referral centre for pelvic ring reconstruction with a LC I injury pattern were eligible for inclusion. Exclusion criteria were other patterns of pelvic ring injuries. All patients underwent radiological assessment including AP pelvis, inlet/outlet views and CT. Patient demographics, mechanism of injury, other associated injuries, ISS, length of hospitalisation, type of operation, mode of mobilization, preoperative and postoperative visual analogue score pain VAS and follow up until fracture union were prospectively documented. Mechanical stability of the pelvic ring was assessed in the operating theatre under general anaesthe- sia. Instability was defined as displacement >2 cm of the anterior or posterior elements. The minimum follow up was 12 months. Results: Out of 210 patients admitted with pelvic fractures, 40 ful- filled the inclusion criteria (LC1 type). There were 23 female, 17 male and with a mean age of 33.5 (range 18–68). The mean ISS was 10 (range 9–19). 23 patients (group 1) were found to have more than 2 cm rotational displacement during EUA and were stabilised with SI screws posteriorly and a combination of retropubic screws, 1572-3461