Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Dec 2008
Mortality Distribution in a Trauma System: From Data to Health Policy Recommendations.
Trimodal distribution of deaths and the golden hour concepts are in part responsible for the genesis of all modern trauma systems but these concepts have been challenged recently. Our aim was to describe distribution of death in trauma using data from a trauma system and discuss what could be done from the organizational point of view to improve outcome. ⋯ A tetramodal pattern of death distribution could be described. Our data support the need to focus on the treatment of severe head injuries namely in the intensive care environment.
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Eur J Trauma Emerg S · Dec 2008
The Second Most Common Bone Disease: A Review on Paget's Disease of Bone.
Paget disease of bone (PDB) is the second most common metabolic bone disease. It is a chronic disease with a mono- or polyostotic appearance that is characterized by an increased bone turnover. The orthopedic surgeon is often confronted with such symptoms and complications as bone pain, skeletal deformities, and pathologic fractures caused by the "out-of-balance bone remodeling process". ⋯ Patients with PDB are at increased risk for surgical complications, such as blood loss and heterotopic bone formation, if operative treatment is necessary. However, advances in surgical techniques and accompanying medical treatment could potentially improve the overall outcome of these patients. To achieve that goal, careful perioperative interdisciplinary management and monitoring are essential.
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Eur J Trauma Emerg S · Dec 2008
Management of Morel-Lavallee Lesion Associated with Pelvic and/or Acetabular Fractures.
Management of Morel-Lavallee soft tissue lesion (MLL) in patients with associated pelvic and/or acetabular fractures is still under discussion. Especially, the sequence of treatment of MLL soft tissue management and osteosynthesis of pelvic and acetabular injury remains controversial. ⋯ We recommend debridement for early and delayed treatment of MLL. Osteosynthesis during first debridement may be performed without adverse outcome. Identical surgical access for both procedures can be used. In case of repeated surgical debridement VAC(®) therapy may be a helpful tool for dead space reduction and wound conditioning.
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Eur J Trauma Emerg S · Dec 2008
Transanal Small Bowel Evisceration: An Unusual Presentation of Rectal Impalement.
Traumatic transanal small bowel evisceration is a rare condition usually associated with suction injuries or blunt abdominal trauma. We report the first case of intestinal evisceration through the anus caused by penetrating trauma (rectal impalement). Additionally, we performed a literature review of all English language articles since 1970 concerned with traumatic transanal small bowel evisceration. Mechanisms of injury and the surgical management are discussed.