Injury
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Observational Study
Female sex protects from organ failure and sepsis after major trauma haemorrhage.
Biological sex is considered a risk factor for adverse outcome after major trauma. We hypothesized that female sex is protective against organ failure, sepsis and mortality in patients with traumatic haemorrhage. ⋯ Our study supports the hypothesis that female sex is associated with improved organ function following traumatic injury and haemorrhagic shock, in particular in age groups that are at reproductive age. However, further studies are warranted before sex steroids can be deployed as therapeutic intervention in critically ill trauma patients.
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Hand trauma may lead to multiple fingertip defects, causing functional restrictions. We evaluated the use of reverse-flow homodigital flap reconstruction of the distal phalanx and pulp defects associated with multiple finger injuries. ⋯ The reconstruction of multiple fingertip injuries with reverse-flow homodigital flaps is a safe, effective method that can be combined with other local finger flaps. These flaps can be applied to two consecutive fingers without reducing finger length or function.
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To evaluate the clinical results of surgical resection of severe heterotopic ossification (HO) after the open reduction and internal fixation (ORIF) of acetabular fractures. ⋯ The early surgical resection of severe HO after an acetabular fracture ORIF can provide satisfactory results, however the complication rate is relatively high.
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Asymmetrical callus formation and incomplete bone formation underneath stiff locking plates have been reported recently in clinical and experimental fracture healing studies. After similar effects were observed in the outcome of high tibial osteotomy (HTO) patients, a retrospective study was performed to quantify the frequency and level of such incomplete healing cases. ⋯ These results support the hypothesis that low bone formation underneath locking plates is induced by increased stiffness. This high stiffness situation could be altered by replacing the standard screws with dynamic screws which allow for a movement of 0.35mm perpendicular to the screw axis. This resulted in an approximately threefold increase in the IFM and may be a potential concept to avoid incomplete bone healing under stiff plate fixations.
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The present paper is a description and summary of methods used in non-randomised cohort data where the comparability of the study groups usually is not granted. Such study groups are formed by a diagnostic or therapeutic intervention, or by other characteristics of the patient or the treatment environment. This is a typical situation in the analysis of registry data. ⋯ However, any method used for the reduction of bias depends on the quality and completeness of recorded confounders. Factors which are difficult or even impossible to be measured could thus not be adjusted for. This is a general limitation of retrospective analyses of cohort data.