Eur J Trauma Emerg S
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To evaluate the clinical outcomes of multiple rib fracture due to blunt trauma in young patients, a 3-year retrospective study was conducted. Patients with ≥3 rib fractures were divided into two groups (group I: <45 years old and group II: ≥45 years old). Mortality, hospital stay, ventilatory support, chest tubes insertion and associated injuries were studied. ⋯ Old age presenting with rib fractures is associated with higher mortality in comparison to young age; however, this difference becomes statistically insignificant in the presence of multiple rib fracture.
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Trauma surgeons frequently encounter injured limbs at risk for compartment syndrome. This article reviews data regarding the pathophysiology of compartment syndrome, factors in measuring compartment pressures, thresholds for performing fasciotomies, and outcomes from the development of compartment syndromes and performing fasciotomies.
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Eur J Trauma Emerg S · Dec 2013
Computerized dynamic posturography analysis of balance in individuals with a shoulder stabilization sling.
Sling immobilization of the upper limb may affect balance. Computerized dynamic posturography (CDP) provides a validated, objective assessment of balance control and postural stability under dynamic test conditions. We tested the balance of individuals with a shoulder stabilization sling (SSS) using an EquiTest machine to objectively assess imbalance while wearing a sling. ⋯ Wearing a sling causes balance decompensation in almost one-third of healthy volunteers, and this is greater when worn in the non dominant hand, with double the number of falls. This has significant implications for patients having prolonged use of a sling. Consideration should be given to operative procedures or conservative management of shoulder pathology where sling use is required and promotion of the early discontinuation of sling use can be considered.
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Eur J Trauma Emerg S · Dec 2013
Evaluation of the use of the hook plate in Neer type 2 lateral clavicle fractures and Rockwood types 3-5 acromioclavicular joint dislocations.
For most types of acromioclavicular (AC) injuries, treatment is well established. For Neer type 2 lateral clavicle fractures and Rockwood types 3-5 AC dislocations, the ideal treatment is still a point of debate. The purpose of this study was to evaluate the functional and radiological outcome in patients treated for one of these two lesions in our hospital. ⋯ This study suggests that hook plate fixation is a reliable treatment for Neer type 2 lateral clavicle fractures and Rockwood types 3-5 AC injuries. It results in a good and comparable function of the shoulder when compared to the contralateral side, high union rate, good to excellent objective and subjective results, and allows early active motion with limited abduction. A disadvantage is the necessity to remove the plate.
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Eur J Trauma Emerg S · Dec 2013
Diagnosis of cervical spine injuries in children: a systematic review.
The objective of this systematic review was to discuss current knowledge of the diagnostic management of cervical spine (c-spine) injuries in children. ⋯ The incidence of cervical spine injury (CSI) in children is rare (1.39 %). It seems that the upper c-spine is more often injured in children younger than 8 years of age. When a CSI is expected, immobilization should be performed. The best immobilization is achieved with a combination of a half-spine board, rigid collar, and tape. The literature for thoracic elevation or an occipital recess in children younger than 8 years of age is inhomogeneous. The c-spine in children can be cleared by a combination of the National Emergency X-Radiography Utilization Study (NEXUS) low-risk criteria and the Canadian C-Spine Rule. Caution is advised for nonverbal and/or unconscious children. In these children, plain radiographs should be performed. If these images are inadequate or show hints for bony injuries, a computed tomography (CT) of the c-spine should be considered. Additional views of the c-spine offer only little information for clearing the c-spine.