Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Jun 2009
Bone Mineral Density is Not Correlated with One-Year Functional Outcome in Distal Radial Fractures: A Preliminary Study.
The intrinsic stability of fractures related to soft tissue injury and the comminution of the metaphyseal part of the distal radius influence the chance of secondary displacement in distal radial fractures treated conservatively. A low bone mineral density may also contribute to this secondary displacement and could therefore play a role in functional outcome. This possible relation between functional outcome and bone mineral density is poorly studied. ⋯ The functional outcome of conservatively treated distal radial fractures in this study does not correlate with bone mineral density. Therefore, BMD measurement cannot be used to predict functional outcome in these patients.
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We report on a three-year-old girl who fell accidentally from the fourth floor. She suffered multiple trauma, including severe head injury, unstable T2-T3 Chance fracture, pneumothorax with lung contusion and serial rib fractures on the left side, liver laceration, splenic injury and fracture of the sacral bone on the right side. The progressive intracranial pressure was released by trepanation and bifrontal craniectomy. ⋯ After stabilization of the intracranial situation, dorsal spondylodesis from T2 to T4 was performed employing the cannulated NEON system (Ulrich(®)) with CT-controlled positioning of guide wires. One year on, the implants have been removed and the patient has good function, with only a small atactic dysfunction as residuum. To our knowledge, this is the first report of a pediatric Chance fracture located in the upper thoracic spine following a fall from great height that describes how this treatment approach led to a very favorable outcome.
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Eur J Trauma Emerg S · Jun 2009
Role of Selective Management of Penetrating Injuries in Mass Casualty Incidents.
Terrorist violence has emerged as an increasingly common cause of mass casualty incidents (MCI) due to the sequelae of explosive devices and shooting massacres. A proper emergency medical system disaster plan for dealing with an MCI is of paramount importance to salvage lives. Because the number of casualties following a MCI is likely to exceed the medical resources of the receiving health care facilities, patients must be appropriately sorted to establish treatment priorities. ⋯ An appropriate and effective application of experiences learned from the use of selective nonoperative management (SNOM) techniques may prove essential in this triage process. The present appraisal of the available literature strongly supports that the appropriate utilization of these clinical indicators to identify patients appropriate for SNOM is essential, critical, and readily applicable. We also review the initial emergent triage priorities for penetrating injuries to the head, neck, torso, and extremities in a mass casualty setting.
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Eur J Trauma Emerg S · Jun 2009
The 2001 World Trade Center Disaster: Summary and Evaluation of Experiences.
To collect and analyze data from deaths and injuries, and from evaluation of the responses by medical services and by fire, rescue, and police services 1 year after the terror attack on World Trade Center. ⋯ The difficulties encountered were very similar to those commonly seen in major accidents or disasters, although on a great scale. Response plans have to be critically reviewed based on the experiences from this and other events, in order to pre-empt difficulties such as those described here in future responses to major urban accidents and disasters.
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Eur J Trauma Emerg S · Jun 2009
Incidence, Cause and Treatment of Burn Casualties Under War Circumstances.
Five to ten percent of all combat injuries in the last decade of armed conflicts have been burns. Here, the incidence, demographics, and treatment are different compared to civilian practice. ⋯ Due to the prolonged transportation time, emergency treatment and also intermediate treatment are important for a good outcome in patients with burns suffered in a military environment. Treatment guidelines and education of the involved medical personnel according to the findings described herein are important for better results in future combat casualties.