Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Dec 2007
Planning Analysis of Knee-Adjacent Deformities : I. Frontal Plane Deformities.
The planning analysis of leg deformities around the knee joint is based on a standardized clinical examination and on long leg standing anteroposterior (AP) radiographs, which may be complemented by spot-film radiographs and stress radiographs. The principles of true-nominal analysis in six steps are used to characterize the deformity and plan the corrective osteotomy:1. Drawing in the anatomic points of reference.2. ⋯ Deciding on the osteosynthesis technique and the osteotomy level.6. Measuring the angle of correction. All the steps are exemplified on a valgus deformity and a varus deformity.
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Eur J Trauma Emerg S · Dec 2007
Ischemia-Reperfusion Injury : Pathophysiology and Clinical Implications.
The term ischemia-reperfusion injury describes the experimentally and clinically prevalent finding that tissue ischemia with inadequate oxygen supply followed by successful reperfusion initiates a wide and complex array of inflammatory responses that may both aggravate local injury as well as induce impairment of remote organ function. Conditions under which ischemia-reperfusion injury is encountered include the different forms of acute vascular occlusions (stroke, myocardial infarction, limb ischemia) with the respective reperfusion strategies (thrombolytic therapy, angioplasty, operative revascularization) but also routine surgical procedures (organ transplantation, free-tissue-transfer, cardiopulmonary bypass, vascular surgery) and major trauma/shock. Since the first recognition of ischemia-reperfusion injury during the 1970s, significant knowledge has accumulated and the purpose of this review is to present an overview over the current literature on the molecular and cellular basis of ischemia-reperfusion injury, to outline the clinical manifestations and to compile contemporary treatment and prevention strategies. Although the concept of reperfusion injury is still a matter of debate, it is corroborated by recent and ongoing clinical trials that demonstrated ischemic preconditioning, inhibition of sodium-hydrogen-exchange and administration of adenosine to be effective in attenuating ischemia-reperfusion injury.
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Eur J Trauma Emerg S · Dec 2007
Plating of Femoral Shaft Fractures: the Experience in an African Teaching Hospital.
Femoral shaft fractures are common presentation in our trauma units. It is obvious that all these fractures cannot be treated conservatively due to the pressure on trauma beds and thus a suitable method of internal fixation that is feasible in the environment has had to be adopted. ⋯ Femoral shaft plating gives good result if the principles of fixation is carefully followed and in developing countries where initial cost of procurement of equipments for closed nailing may not be forth coming, it thus provide a safe efficient and low cost method of fixation of femoral shaft fracture.
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Suicide bombing attacks have emerged as a lethal weapon in the hands of terrorist groups. Our aim was to review the medical experience acquired in Israel, Spain, the United Kingdom and the United States in managing terrorist attacks, and prepare medical systems for the difficult task of managing these events. EMS protocols are amended to deal with a large number of victims in an urban setting who must be rapidly evacuated to a medical center where resuscitative as well as definitive care is delivered. ⋯ Professional personnel and resources are recruited and re-directed away from routine tasks towards treating the victims. This is achieved by deferring non-urgent operations, procedures and imaging studies. Victims are frequently re-assessed and re-evaluated to control chaos, minimize missed injuries and ensure delivery of an adequate level of care.
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Eur J Trauma Emerg S · Dec 2007
Epidemiology, Etiology, Pathophysiology and Diagnosis of the Acute Compartment Syndrome of the Extremity.
Due to an insult that causes a pressure elevation in the compartment, which is the limited space surrounded by the unyielding bone and fascia, the circulation is compromised resulting in muscular and neural ischemia and eventually tissue necrosis. The diagnosis of the compartment syndrome has always been based on the clinical symptoms, however, multiple studies suggested that clinical examination alone is insufficient and may result in delayed diagnosis, delayed treatment and serious sequelae. ⋯ There is, however, no consensus about the indications for the compartment pressure monitoring, or about the threshold pressure that should be used for dermatofasciotomy. A diagnostic guideline is proposed.