Injury
-
Multicenter Study Comparative Study
Management of polytraumatized patients with associated blunt chest trauma: a comparison of two European countries.
Blunt chest trauma represents one of the most common injuries in polytrauma patients. Blunt chest injury complicating polytrauma is associated with significant prolongation of intensive care stay. Further, it has a great impact on the timing of fixation of skeletal injuries, possibly contributing to adverse outcome. The purpose of this study is to assess whether there are any differences in the management and outcome of polytrauma patients with blunt chest trauma between trauma units in two different countries. Detailed information about advantages and disadvantages of these two systems might allow optimising the management of blunt chest trauma. ⋯ The reasons for the differences regarding survival times and survival rates seem to be multiple. German patients received more red blood cells, had a longer hospital stay in intensive care and a better survival rate. The use of kinetic therapy in Germany, not standard in the UK, may contribute to a more favourable outcome.
-
During 13 months of data gathering, all injury-related information concerning trauma patients was gathered according to International Classification of Diseases, 10th revision (ICD-10). The severity of the injury was calculated according to Abbreviated Injury Scale (AIS-90) in six major university hospitals in Tehran. Twelve percent of 8000 hospitalised trauma patients were elderly (65 years or older) and 70% of them (675 patients) had suffered from fall-related injuries. ⋯ After adjustment for the gender, kind of fall and Injury Severity Score, it was shown that the elderly were more prone to death than their younger counterparts (odds ratio=5.8, 95% CI for odds ratio: 2.3-7.2), but there was no significant difference in mortality rate between elderly men and women. Further studies are needed to evaluate personal and environmental risk factors for falls in our population. Furthermore, significantly higher mortality rate in our elderly trauma victims necessitates prudent attention to elderly trauma care in our teaching hospitals.
-
Multicenter Study Clinical Trial
First clinical results of the Locking Compression Plate (LCP).
The Locking Compression Plate (LCP) is a new screw-plate system that offers the possibility of inserting conventional and locking head screws into the specially designed combination holes. It represents a further development of the PC-Fix and the LISS and was released for clinical application in March 2000. In a prospective multicentre study, the new system was used to treat 144 patients (f: 67, m: 77; average age: 51.4 years) with 169 fractures: of these, 57 were tibial fractures, 45 humerus, 19 radius and 18 femoral. ⋯ The new system can be regarded as technically mature. It offers numerous fixation possibilities and has proven its worth in complex fractures situations and in revision operations after the failure of other implants. A good knowledge of biomechanics is essential as well as precise preoperative planning.
-
Multicenter Study
The Mennen femoral plate for fixation of periprosthetic femoral fractures following hip arthroplasty.
Periprosthetic fractures can be treated by various methods. The Mennen femoral plate used to be a common implant in our region to stabilise periprosthetic femoral fractures following hip arthroplasty. This device has been used in 16 patients in our region from three different centres. ⋯ In all of these patients the main complication was varus mal-union of the fracture. As per our study the Mennen femoral plate seems to be a weak fixation device. The plate is unable to counter the medial compressive forces on the femur leading to a varus collapse of the fracture.
-
Multicenter Study Clinical Trial
Minimally invasive fracture stabilization of distal femoral fractures with the LISS: a prospective multicenter study. Results of a clinical study with special emphasis on difficult cases.
The LISS-DF (Less invasive stabilization system-distal femur) is a new type of implant system for the treatment of distal femoral fractures according to the principles of "Minimally Invasive Surgery". A plate, pre-contoured to the anatomy, is inserted through a minimally invasive incision into the epiperiosteal space by means of an aiming device after indirect, closed fracture reduction. The implant is stabilized by insertion of screws which lock into the plate holes and prevent tilting. ⋯ The complications can be attributed in nearly all cases to the severity of the trauma and/or a lack of experience when applying the new style implant to a wider range of indications. The results of the study show that with a sound knowledge of the operative technique and careful preoperative planning this system represents an excellent, safe procedure for the treatment of almost all distal femoral fracture types including periprosthetic fractures of the distal femur. There is generally no need for primary cancellous bone grafting.