Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Feb 2009
Reconstruction of Large Diaphyseal Defects of the Femur and the Tibia with Autologous Bone.
Post-traumatic segmental bone defects of the femur and the tibia above the critical size require special attention because conventional bone grafts result in high rates of nonunion. The biological and biomechanical aspects of this challenging surgery, as well as ongoing refinements to achieve mechanically stable bone healing with correct bone alignment are reviewed. ⋯ Three patients with successful bone reconstruction using two-stage reconstruction with cancellous bone graft, double-barrel free vascularized fibula transfer and distraction osteogenesis are described. Advantages and disadvantages of these methods are discussed in accordance with recent literature.
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Eur J Trauma Emerg S · Feb 2009
Clinical Risk Factors for Hip Fracture in Young Adults Under 50 Years Old.
Established risk factors for hip fracture exist for older individuals. Young adults (less than 50 years old) presenting with hip fractures have received little attention. ⋯ Our data suggest that intravenous drug abusers under 50 are a particular group that we should be targeting for intervention strategies.
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Eur J Trauma Emerg S · Feb 2009
The Value of the Trauma Mechanism in the Triage of Severely Injured Elderly.
The triage of trauma patients is currently based on the trauma mechanism. However, it is known that elderly patients can sustain severe injuries due to insignificant trauma mechanisms. As such, triage methods might be questionable. ⋯ In elderly people a low energy trauma may lead to severe consequences. Not only the trauma mechanism, but also age, co-morbidity, and the likelihood of a brain injury should be leading in the triage and subsequent management of severely injured elderly.
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Eur J Trauma Emerg S · Feb 2009
Historical Treatment Results of Pelvic Ring Fractures: A 12-year Cohort Study.
Since the Academic Medical Center Amsterdam was appointed as a level-1 trauma center in July 1997, the number of polytrauma patients who were presented has increased. This stimulated us to perform a retrospective analysis on the treatment results of patients with a pelvic ring fracture and to evaluate our treatment strategies. ⋯ Evaluating two consecutive patient groups shows an increase in the number of fractures. A more aggressive surgical treatment has lead to lower mortality, improved anatomical reduction, and lower rate of complications.
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A compartment syndrome is an increased tissue pressure within a closed osteofascial compartment. This compromises blood flow to the muscles and nerves within that compartment, which -if not treated adequately in an early stage-results in permanent tissue and nerve damage. It most frequently occurs in the lower leg, but can also occur elsewhere when muscles are enclosed in tight fascial compartments, such as the forearm and hand. ⋯ Possibly a wet-suit or dry-suit offers some protection. However, the duration of strangulation determines much of the damage. Although diagnosis of a compartment syndrome can be difficult, a high index of suspicion combined with fast and adequate treatment with a fasciotomy improve outcome and prognosis.