Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Apr 2007
Extending the Indication of Intramedullary Nailing of Tibial Fractures.
Intramedullary nailing is an effective and well-established method for the treatment of a wide spectrum of tibial fractures. Nevertheless, the handling of metaphyseal and open fracture remains challenging. Surgical and technical advancements have opened up new possibilities to broaden the indication of intramedullary nailing in these areas.
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Eur J Trauma Emerg S · Apr 2007
Antegrade Versus Retrograde Locked Intramedullary Nailing for Femoral Fractures: Which Is Better?
Locked intramedullary nailing or interlocking nailing (ILN) is a proven mode of treatment for femoral shaft fractures. It can be inserted via the antegrade or retrograde approach. Retrograde approach is technically less demanding especially if the patient is overweight. But there are concerns with regard to the violation of the knee and its effect on subsequent knee function. ⋯ Both methods of nailing achieved excellent union rates with good alignment of the limb. Contrary to popular belief, we found that retrograde nailing does not give rise to a higher rate of knee complications. Therefore, we strongly recommend this approach of nailing as it is technically less demanding.
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Eur J Trauma Emerg S · Apr 2007
Seat Belt Syndrome and Aortoiliac Lesion: Case Report and Review of the Literature.
Blunt vascular trauma represents 7-9% of the vascular lesions in civilians. There are few reports associating blunt trauma with aortoiliac lesion to the trauma associated with the use of seat belts. ⋯ However, the patient died 5 days after due to respiratory distress syndrome. A high index of suspicion and early diagnosis are essential for patient survival and limb salvage.
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There is an increasing interest in intramedullary nailing for humeral fractures. Starting with diaphyseal fractures, now also proximal metaphyseal fractures of the humerus can be nailed with satisfying results. Basic ideas for humeral nailing are less invasive approaches to the humerus, less soft tissue damage, e.g. lower rates of radial nerve palsy, closed reduction and the biomechanical aspects of a central implant with elastic fixation properties. ⋯ Static interlocking is advisable. High torsional stability of the fracture fixation has to be achieved, since significant torsional load occurs during the usual movement of the upper limbs. As there is an important learning curve, possible complications of intramedullary nailing have to be kept in mind and avoided by a careful operation technique.
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Eur J Trauma Emerg S · Apr 2007
Acute Gluteal and Thigh Compartment Syndrome following Pelvic Fracture and Superior Gluteal Artery Bleed : A Case Report and Review of the Literature.
Injury to the superior gluteal artery as a result of pelvic fracture is well recognized. Superior gluteal artery bleed leading to gluteal compartment syndrome without fracture of the pelvis has been reported but is extremely rare. ⋯ As far as is known, no previous case has been reported where a combination of pelvic fracture and superior gluteal artery bleed has led to acute gluteal and thigh compartment syndrome. We report on such a patient who developed these complications and highlight the importance of early detection, which may be difficult in an unconscious or comatose patient.