Eur J Trauma Emerg S
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About half of all trauma-related deaths occur after hospital admission. The present study tries to characterize trauma deaths according to the time of death, and, thereby, contributes to the discussion about factors considered as the cause of death. ⋯ The time to death after severe trauma does not follow a trimodal distribution but shows a constantly decreasing incidence.
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Eur J Trauma Emerg S · Feb 2012
Optic nerve sheath measurement and raised intracranial pressure in paediatric traumatic brain injury.
The optimal management of children ventilated for more than 4 h with traumatic brain injury (TBI) necessitates invasive intracranial pressure (ICP) monitoring, though some patients never have raised ICP. If non-invasive screening can reliably rule out elevated ICP, invasive devices can be limited to those in whom neuro-intensive care measures are indicated. ⋯ All children with clinically significantly raised ICP had abnormal ONSD, whereas those with normal ICP did not. Despite the small numbers, this study suggests that the ONSD may be useful in identifying children with TBI and normal ICP and, so, help avoid the insertion of unnecessary ICP monitors.
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Eur J Trauma Emerg S · Feb 2012
Biomechanical comparison of two locking plate systems for the distal tibia.
Distal tibia fractures are known to be difficult to stabilize and nonunions often occur because of a relative instability of the fragments. Therefore, it was of interest to ascertain how different locking plates behave regarding stiffness and interfragmentary movement in comminuted distal tibia fractures. ⋯ The treatment of distal tibia fractures with angle-stable medial AxSOS plate showed less interfragmentary movement and higher stiffness than fracture fixation with a locked medial LCP. Even if there are no significant differences in torsional testing, plating of the distal tibia should be performed with a steel plate from the biomechanical view.
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Eur J Trauma Emerg S · Feb 2012
Prognostic value of various intracranial pathologies in traumatic brain injury.
Various intracranial pathologies in traumatic brain injury (TBI) can help to predict patient outcomes. These pathologies can be categorised using the Marshall Classification or the Abbreviated Injury Scale (AIS) dictionary or can be described through traditional descriptive terms such as subarachnoid haemorrhage (SAH), subdural haemorrhage (SDH), epidural haemorrhage (EDH) etc. The purpose of this study is to assess the prognostic value of AIS scores, the Marshall Classification and various intracranial pathologies in TBI. ⋯ In this relatively recent dataset, each of the brain injury classification systems enhanced equally the performance of an early mortality prediction model in traumatic brain injury patients. The significant effect of brain swelling and brain stem injury on the outcome in comparison to injuries such as SAH suggests the need to improve therapeutic approaches to patients who have sustained these injuries.
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Eur J Trauma Emerg S · Feb 2012
Open to laparoscopic conversion in hemoperitoneum of unknown origin.
Demonstrating the potential, in spite of the current trend, of closing an open emergency surgical procedure and to convert it to a minimally invasive approach. ⋯ For selected cases, the conversion of an open procedure to a laparoscopic approach offers a real benefit for the patient, avoiding a large laparotomy and its associated morbidity.