Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Aug 2007
A Retrospective Study of Five Clinical Criteria and One Age Criterion for Selective Prehospital Spinal Immobilization.
Full spinal immobilization of blunt trauma victims is a widely accepted prehospital measure, applied in order to prevent (further) damage to the spinal cord. However, looking at the marginal evidence that exists for the effectiveness of spinal immobilization, and the growing evidence for the negative effects following immobilization, a more selective protocol might be able to reduce possible morbidity and mortality as good as the present prehospital immobilization protocol. In a retrospective study, the sensitivity of a selective prehospital immobilization protocol that adds an age criterion to five clinical spine clearance criteria is examined. ⋯ In this retrospective study, a selective protocol based on clinical criteria instead of trauma mechanism showed 99.2% sensitivity for spinal fractures with or without spinal cord damage. Based on this study and the current controversy surrounding spinal immobilization, a prospective study should be considered to evaluate the five clinical criteria and one age criterion in the prehospital setting.
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Eur J Trauma Emerg S · Aug 2007
Arthroscopical Findings after Antegrade Nailing of a Proximal Humeral Fracture : Case Report and Review of the Literature.
Proximal humeral fractures represent up to five percent of all fractures in adults, commonly found in elderly patients. The final functional results after different operative procedures are among other factors dependent on whether or not a rotator cuff lesion is pre-existent, prior to the fracture, and how its surgical therapy is carried out. However, to what extent prior rotator cuff tears in this special patient group contribute to the functional outcome remains widely unclear. ⋯ Diagnostic glenohumeral arthroscopy revealed neither a residual lesion of the former rotator cuff incision nor a chondral lesion at the former insertion site of the nail. In the same session subacromial decompression and a nettoyage of adhesions were performed. We assume that splitting the rotator cuff for the insertion of an antegrade nail in a proximal humeral fracture is less relevant than previously assumed and described.
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Eur J Trauma Emerg S · Aug 2007
Perioperative Application of a Serum Protein Solution (Biseko(®)) After Proximal Femur Fracture of Elder Patients.
Fractures of the proximal femur are frequently seen in elderly people and will increase due to the demographic development of most industrialized countries. Early operation of dislocated fractures with either osteosynthesis or hemiprothesis has become a standard treatment for this type of injury. The high co-morbidity often leads to secondary complications like infections still resulting in a perioperative mortality rate of 11%. ⋯ Concerning IL-6, IL-8, IL-10 and serum leukocytes no significant differences were observed. The result shows a beneficial influence of the serum protein solution Biseko(®) concerning the number of perioperative complications. The design of this study and the small number of patients does not yet allow any conclusion concerning the effectiveness of this treatment.
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Traumatic facial diplegia is an uncommon pathology, and is usually associated with bitemporal bone fractures. Traumatic Horner syndrome is mostly associated with carotid artery dissection. ⋯ The patient had developed his neurological deficits 9 days following trauma. We discuss the mechanisms of the facial palsy and Horner syndrome and the importance of their diagnosis.
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Eur J Trauma Emerg S · Aug 2007
The Evaluation of Protective Effects of FK-506 on Neural Ischemic-Reperfusion Injury: an Experimental Study.
In this study, we aimed to delineate the mode of neuroprotective action of FK-506, and demonstrated that FK-506 could decrease oxidative stress and apoptotic cell death in an in vivo rat model of neural ischemia-reperfusion after hemorrhagic shock. ⋯ The results suggest that the prophylactic use of FK-506 in an in situ ischemic neural tissue may prevent reperfusion injury.