Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Apr 2012
Results of the femur fractures treated with the new selfdynamisable internal fixator (SIF).
As axial dynamisation is a recognised method, many authors using interlocking femoral nail perform an additional small operation two months after the primary operation in order to remove one screw so as to provide axial dynamisation. According to the literature, dynamisation happens in about 15-25% of cases, but it cannot be predicted which patient or fracture will need dynamisation. The aim of this study is to present a new selfdynamisable implant and a minimally invasive method for the internal fixation of different femoral fractures. ⋯ The online version of this article (doi:10.1007/s00068-011-0157-7) contains supplementary material, which is available to authorized users.
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Eur J Trauma Emerg S · Apr 2012
Indications for bullet removal: overview of the literature, and clinical practice guidelines for European trauma surgeons.
The incidence of gunshot wounds from civilian firearms is increasing. Despite this fact, guidelines on indications for bullet removal are scarce. In this analysis, we combine an overview of the available literature in these rare entities with our experiences in our own clinical practices. ⋯ In summary, there are only a few clear indications for bullet removal. These include bullets found in joints, CSF, or the globe of the eye. Fragments leading to impingement on a nerve or a nerve root, and bullets lying within the lumen of a vessel, resulting in a risk of ischemia or embolization, should be removed. Rare indications are lead poisoning caused by a fragment, and removal that is required for a medico-legal examination. In all other cases the indication should be critically reviewed.
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Eur J Trauma Emerg S · Apr 2012
Causes of inpatient death for patients with warfare-related limb trauma and logistic regression analysis of the risk factors.
To explore the causes and risk factors of inpatient death for patients with warfare-related limb trauma. ⋯ The primary cause of death from warfare-related limb trauma is ARF. The appropriate and prompt management of shock patients, the correct timing of amputation, and the prevention and correct handling of infection are important in reducing mortality.
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Eur J Trauma Emerg S · Apr 2012
Severe pelvic fracture-related bleeding in pediatric patients: does it occur?
Pediatric pelvic fractures are rare and less likely to cause hemodynamic instability than similar injuries in adult patients. The associated injuries are common, and they have a major impact on mortality. The aim of the present study was to evaluate the risk of life-threatening hemorrhage associated with unstable pelvic fractures in children. ⋯ We conclude that life-threatening bleeding from pelvic or acetabular fractures in pediatric patients is rare (2.8%), and does not contribute to the overall mortality.
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Eur J Trauma Emerg S · Apr 2012
Prehospital HMG Co-A reductase inhibitor use and reduced mortality in hemorrhagic shock due to trauma.
3-Hydroxy-3-methyl-glutaryl Co-A reductase inhibitors (HMG Co-A reductase inhibitors, statins) are commonly used medications for the control of serum cholesterol. Recent data suggests that these medications also modify the inflammatory pathways in sepsis, septic shock, and hemorrhagic shock due to ruptured abdominal aortic aneurysms. Statin use in hemorrhagic shock due to trauma, however, has conflicting data, with one study showing improvement, but only in certain subsets of patients. ⋯ Prehospital HMG Co-A reductase use was associated with improved survival in a population with severe trauma and evidence of ongoing hemorrhagic shock.