Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Jun 2007
Changing the Management from Olecranon Screw Traction to Percutaneous Wiring for Displaced Supracondylar Fractures of the Humerus in Children. A Justified Decision?
In this institution, the management of displaced (Gartland III) supracondylar fractures in children was changed from overhead olecranon screw traction to manipulation and percutaneous wiring in 1996. The purpose of this study was to compare the two methods of treatment and observe whether the decision to change management was justified. ⋯ Outcomes achieved from percutaneous wiring of displaced supracondylar fractures are similar to those from olecranon screw traction. The advantage of percutaneous wiring to both patient and provider is the reduced hospital stay. The decision to change management therefore appears to be justified. However, percutaneous wiring is generally a technically more demanding procedure and olecranon screw traction should remain a possible treatment option for the management of this injury.
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Eur J Trauma Emerg S · Jun 2007
Proximal Radio-Ulnar Synostosis at the Pin-Track Site after External Fixation of the Forearm.
Posttraumatic synostosis of the forearm bones is a rare but serious complication following fixation or even conservative treatment of adult forearm fractures. This is the second report in the English literature of such a complication at the pin-track site following external fixation of proximal forearm fractures. ⋯ It was managed by external fixation of the ulna and plate fixation of the radius. At follow-up, a type 3 radio-ulnar synostosis at the pin-track site became evident, which was treated after 20 months with surgical resection of the bony bridge to regain the rotatory motion of his forearm.
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Eur J Trauma Emerg S · Jun 2007
The Finnish Forward Surgical Team Experience During EUFOR Operation RD Congo in 2006.
The army Forward Surgical Team (FST) is a mobile surgical asset designed to provide life- and limbsaving combat surgery in remote and austere terrains. Operation EUFOR RDC in Democratic Republic of the Congo (DRC) in 2006 was the first one planned and conducted solely by the European Union Forces (EUFOR). The first two European FSTs reported in the present article were established by the Finnish Defence Forces. ⋯ All trauma cases were of noncombat origin, and only one of them was severe. The European FST concept should be developed for future missions regarding the experiences gained during the reported deployment, the main goals being the mobility and the lightness of the unit. This kind of special trauma surgical asset, designed for remote theatres, will possibly be useful also in other emergency operations taking place in non-conventional circumstances; a concept of FST could easily be deployed in short notice to various accidental and natural disasters.
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Eur J Trauma Emerg S · Jun 2007
Complications after Intramedullary Stabilization of Proximal Femur Fractures: a Retrospective Analysis of 178 Patients.
Secondary dislocation, non-union, re-fracture and implant failure are generally known complications after intramedullary fixation of proximal femur fractures with the PFN(®) (Synthes GmbH, Solothurn, Switzerland). The goal of our study was to assess the impact of patient- and treatment-specific risk factors on these complications. Complex fracture type and poor bone quality were defined as patient-specific risk factors. ⋯ Complication rate in these patients highly depended on treatment-specific risk factors. We conclude that the PFN is a secure implant for the stabilization of simple cases. Stabilization of complex proximal femoral fractures with the PFN, however, has a relevant complication rate and should therefore be considered a challenge.
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Duodenal injuries are uncommon injuries but are associated with significant morbidity and mortality from a delayed diagnosis in the case of blunt trauma and associated major vascular injuries in penetrating trauma. A simplistic approach with primary repair or resection and anastomosis is ideal for the vast majority. Complex procedures such as pyloric exclusion with or without gastrojejunostomy may be indicated for delayed treatment or severe, high-grade combined pancreato-duodenal injuries. A high index of suspicion and a judicious treatment plan based on a careful consideration of all the available options are crucial for optimal outcome.