Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Oct 2007
Isolated Gallbladder Injury after Blunt Abdominal Trauma: a Case Report and Review.
We describe a case of isolated gallbladder contusion after deceleration trauma. On admission, no evident signs of intra-abdominal injury were present. However, after 24 h observation an explorative laparotomy was performed because of persistent abdominal complaints. ⋯ Contusion of the gallbladder allows conservative treatment, but in case of a rupture, surgery will be necessary. Accompanying bile duct injuries can be treated by endoscopic stenting. If active arterial bleeding is present, selective embolization can be performed.
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Eur J Trauma Emerg S · Oct 2007
Operative Timing and Management of Spinal Injuries in Multiply Injured Patients.
Spinal injuries occurring in polytrauma patients are caused by high impact trauma. Due to high velocity mechanism, trauma of the vertebral column may be accompanied by injuries of adjacent body cavities such as thorax, abdomen, and pelvis. Neurologic examination is mandatory and has to be documented preferably using the ASIA/IMSOP-classification. ⋯ On the day of injury ventral spondylodesis of unstable cervical spine fractures of C3-C7 and dorsal spondylodesis of unstable thoraco-lumbar fractures using internal fixator are the standard procedures. Polytrauma patients benefit from early stabilization of spinal fractures including reduction of ventilation and ICU treatment, pneumonia rate, general complications, as well as hospital stay. However, it is controversial if mortality rate and neurologic outcome are affected by the time point of operative stabilization.
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The acute compartment syndrome of the forearm is rare and may therefore be easily missed. Although many clinicians will not see such a patient during their entire career, profound knowledge of the symptoms is required to recognize the syndrome in time. Besides immediate identification of the compartment syndrome early surgical treatment is mandatory to avoid its devastating consequences. ⋯ This paper aims to attend the reader to this diagnostic pitfall. Two patients with a compartment syndrome of the forearm are described to illustrate both ends of this diagnostic challenge. Pathophysiological, anatomical and clinical aspects, classification and therapeutic modalities are reviewed.
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Eur J Trauma Emerg S · Oct 2007
Primary Hemiarthroplasty for Proximal Humeral Fractures in the Elderly: Long-Term Functional Outcome and Social Implications.
Primary shoulder hemiarthroplasty is an established treatment modality for complex fractures of the proximal humerus. Long-term functional outcome is often disappointing. However, little is known about social implications particularly in the elderly. ⋯ Most patients managed their daily life independently despite poor shoulder function.