The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Feb 2012
Impact of isolated acetabular and lower extremity fractures on long-term outcome.
The long-term clinical status of surviving patients with multiple injuries has not been well described. The aim of this study was to evaluate the long-term outcome of acetabular and lower limb injuries. ⋯ Our results demonstrate a better long-term outcome in patients with femur shaft fractures, whereas patients with articular fractures and proximal femur fractures were associated with poorer outcomes. Fracture location is determining factor for long-term outcome
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J Trauma Acute Care Surg · Feb 2012
Operating room or angiography suite for hemodynamically unstable pelvic fractures?
Few patients require angiography and therapeutic embolization for bleeding pelvic fractures, but they are risk for significant morbidity and mortality. In hemodynamically unstable trauma patients with pelvic fractures, the decision to proceed to the operating room (OR) to address intraabdominal bleeding, or angiography to address pelvic bleeding (ANGIO), is rarely straightforward. This study tested the hypothesis that outcomes are similar regardless if the sequence was OR-ANGIO or ANGIO-OR. ⋯ III, retrospective review.
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J Trauma Acute Care Surg · Feb 2012
The floating shoulder—-clinical and radiological results after intramedullary stabilization of the clavicle in cases with minor displacement of the scapular neck fracture.
The aim of this study was to compare the clinical and radiologic results of titanium elastic nail (TEN) and plate osteosynthesis for treatment of clavicle fractures in patients with a floating shoulder injury. ⋯ The treatment of floating shoulder injuries with TEN and plate osteosynthesis of the clavicle and nonoperative treatment of a minimally displaced glenoid neck fracture provide equal functional results. However, in type B and C (but not in type A) fractures of the clavicle, a shortening of 5 mm can be expected after titanium elastic nailing.
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J Trauma Acute Care Surg · Feb 2012
Comparative StudyClinical outcome of arthroscopic fixation of anterior tibial eminence avulsion fractures in skeletally mature patients: a comparison of suture and screw fixation technique.
Extreme tensile force to the anterior cruciate ligament results in an avulsion of the tibial eminence and it was believed to be more common in skeletally immature adolescent than adult. The purpose of this study is to compare the clinical results of both screw and suture fixation for surgical treatment of anterior tibial eminence fractures in skeletally mature patients. ⋯ Significant better IKDC objective evaluation, lower glide pivot shift phenomenon, and shorter operating time requirement in screw fixation group with respect to suture fixation group were shown in our study although the other functional knee scores (Lysholm score, Tegner activity level, and the IKDC subjective score) and KT-1000 manual side-to-side difference only revealed a trend with better clinical results in screw fixation group than in suture fixation group rather than significant difference.
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J Trauma Acute Care Surg · Feb 2012
High circulating adrenaline levels at admission predict increased mortality after trauma.
Trauma-induced acute coagulopathy predicts a poor outcome. Although its pathophysiology is unclear, severe injury and shock(hypoperfusion) are proposed drivers. This study investigated the association between sympathoadrenal activation (circulating catecholamines) and biomarkers of coagulopathy. ⋯ The trauma-induced catecholamine surge is closely associated with biomarkers of tissue and endothelial damage, glycocalyx degradation,coagulopathy including hyperfibrinolysis and independently predicts mortality.