Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Aug 2007
Biology and Biomechanics in Osteosynthesis of Proximal Humerus Fractures.
Surgical treatment of proximal humeral fractures still remains a challenge. This is primarily due to the fact that sufficient implant fixation in humeral head fractures is often not achieved due to substantial bone tissue loss with increasing age. ⋯ The biomechanical studies have focused on locking plate osteosynthesis as well. The following paper focuses on bone quality, biomechanical studies and biology of proper osteosynthesis and reviews the most recent literature.
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Eur J Trauma Emerg S · Aug 2007
Stent Grafts for Acute Traumatic Injury of the Thoracic Aorta: A Single-Centre Experience.
The presented study reveals the single centre experiences with the minimally invasive endovascular repair for acute traumatic thoracic aortic lesions in the care of multitrauma patients. ⋯ The endovascular approach to acute traumatic thoracic aortic lesions is feasible, safe, and effective in multitrauma patients. The low endovascular therapy-related morbidity and mortality in the postoperative period is encouraging. The results seem to be favorable to those published of open emergency repair.
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Pancreatic fistula is usually a complication of acute and chronic pancreatitis but can also occur postoperatively or after abdominal trauma. Conservative treatment of pancreatic fistula is time-consuming and often fails. Endoscopic treatment has become the preferred first-line treatment in many centres. Surgery is necessary in few cases when endoscopy fails or is not technically possible.
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Replacement of the fractured humeral head with a modular prosthesis. The procedure aims at an adequate reconstruction of shape and function of the shoulder. ⋯ 13 out of 22 patients treated by primary hemiarthroplasty (within 10 days after the fracture) and 34 out of 50 patients treated by secondary arthroplasty could be assessed after a mean follow-up of 40 (15-70) and 44 (8-98) months, respectively. The absolute Constant score amounted to 45 and 50 points, respectively, and the relative score to 56% in both groups. The majority of patients was free of pain or suffered less pain than before the operation (secondary arthroplasty; p < 0.001). In contrast to these, only satisfactory, objective results, self-assessment was good or better than before (secondary prostheses; p < 0.001). In both groups, prognostic factors were the size and position of the tuberosities (p < 0.001).