Injury
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The common source for reconstruction of soft tissue defects of the fingers is either the same finger or the adjacent finger. However, when the donor areas are damaged by concomitant injuries, these options are not available. The purpose of this study was to report on reconstruction of these complex digital injuries using the dorsal digito-metacarpal flaps (DDMFs) and to evaluate the efficacy of this technique. ⋯ Therapeutic/IV.
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We evaluated the relationship between survival and time from arrival to angiography for hemodynamically unstable patients with pelvic trauma. ⋯ Earlier pelvic embolization within 60 min may affect the survival of hemodynamically unstable patients with pelvic fracture.
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Randomized Controlled Trial Comparative Study
Comparative study of comminuted posterior acetabular wall fracture treated with the Acetabular Tridimensional Memory Fixation System.
Posterior wall fractures are one of the most common acetabular fractures. However, only 30% of these fractures involve a single large fragment, and comminuted acetabular posterior wall fractures pose a particular surgical challenge. The purpose of this study was to compare outcomes between patients who received fixation for comminuted posterior wall fracture using the Acetabular Tridimensional Memory Fixation System (ATMFS) and patients who underwent fixation with conventional screws and buttress plates (Plates group). ⋯ Patients with comminuted posterior wall fractures of the acetabulum treated with the ATMFS or conventional screws and buttress plate techniques achieve a good surgical result. Both techniques are safe, reliable, and practical. Use of the ATMFS technique may reduce blood loss and improve rigid support to marginal bone impaction. The use ATMFS may need additional support when fractures involve the superior roof.
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The human body strives at maintaining homeostasis within fairly tight regulated mechanisms that control vital regulators such as core body temperature, mechanisms of metabolism and endocrine function. While a wide range of medical conditions can influence thermoregulation the most common source of temperature loss in trauma patients includes: exposure (environmental, as well as cavitary), the administration of i.v. fluids, and anaesthesia/loss of shivering mechanisms, and blood loss per se. Loss of temperature can be classified either according to the aetiology (i.e. accidental/spontaneous versus trauma/haemorrhage-induced temperature loss), or according to an unintended, accidental induction in contrast to a medically intended therapeutic hypothermia. ⋯ Prevention of hypothermia is imperative through all phases of trauma care and must be an interest among all team members. Hypothermia in the trauma setting has attracted focus in the past from a pathophysiological, preventive and prognostic perspective; yet recent focus has shifted towards the potential for using hypothermia for pre-emptive and cellular protective purposes. This paper gives a brief update on some of the clinically relevant aspects of hypothermia in the injured patient.