Eur J Trauma Emerg S
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Arthrodesis of the ankle joint in proper position (neutral position in respect to flexion/extension, 5° external rotation, 0-5° of valgus). Pain-free weight bearing of the affected limb. ⋯ one tibial shaft fracture, one hematoma needing evacuation, three superficial infections, and eight deep infections. Three patients developed an osteoarthritis of the subtalar joint. 70 patients (63.6%) reported an improvement, 37 (33.6%) no notable change of symptoms, and three (2.7%) a deterioration.
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For nearly 40 years, extramedullary stabilization using the sliding hip screw and plate has been the standard fixation method for proximal femoral fractures. In patients with stable fractures, this device produces excellent results. However, in patients with unstable fractures, the sliding hip screw and plate is associated with an increased prevalence of complications, particularly cut-out, medialization of the shaft, shortening, and subsequent loss of reduction. ⋯ However, intramedullary methods of therapy for trochanteric fractures require extensive operative experience. The incidence of complications, e.g. cut-out, femoral shaft fractures, and the learning curve has resulted in a loss off popularity of these devices in the past. The aim of this overview is to analyze and record the current standards by means of recent papers and to present the experience after intramedullary stabilization of more than 3,000 patients with proximal femoral fractures at our level I trauma center.
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To establish the impact of the transportation on the condition and outcome of the victims of the Volendam fire incident. ⋯ The transported patients had a lower pH the first day after transportation, but condition during the second day as well as ventilation day and mortality did not differ between the transported and the non-transported group. Therefore, transportation during the unstable phase, the first day post-burn, seemed not to have had a negative impact on patient outcome.