Eur J Trauma Emerg S
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Vertical deceleration injury is a known but not well understood form of blunt injury in both the urban and rural environment. The purpose of this study was to investigate the financial cost of treatment for this specific mechanism of injury in the acute care setting, and to continue to expand a fall prevention program from our unit. ⋯ The cost of treatment of vertical deceleration injuries is very high. Hospital stays are prolonged and rehabilitation needs frequent. Overall, ISS is the best predictor of cost of treatment and length of hospital stay.
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Eur J Trauma Emerg S · Jun 2007
Proximal Radio-Ulnar Synostosis at the Pin-Track Site after External Fixation of the Forearm.
Posttraumatic synostosis of the forearm bones is a rare but serious complication following fixation or even conservative treatment of adult forearm fractures. This is the second report in the English literature of such a complication at the pin-track site following external fixation of proximal forearm fractures. ⋯ It was managed by external fixation of the ulna and plate fixation of the radius. At follow-up, a type 3 radio-ulnar synostosis at the pin-track site became evident, which was treated after 20 months with surgical resection of the bony bridge to regain the rotatory motion of his forearm.
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Eur J Trauma Emerg S · Jun 2007
Changing the Management from Olecranon Screw Traction to Percutaneous Wiring for Displaced Supracondylar Fractures of the Humerus in Children. A Justified Decision?
In this institution, the management of displaced (Gartland III) supracondylar fractures in children was changed from overhead olecranon screw traction to manipulation and percutaneous wiring in 1996. The purpose of this study was to compare the two methods of treatment and observe whether the decision to change management was justified. ⋯ Outcomes achieved from percutaneous wiring of displaced supracondylar fractures are similar to those from olecranon screw traction. The advantage of percutaneous wiring to both patient and provider is the reduced hospital stay. The decision to change management therefore appears to be justified. However, percutaneous wiring is generally a technically more demanding procedure and olecranon screw traction should remain a possible treatment option for the management of this injury.
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Eur J Trauma Emerg S · Jun 2007
Traumatic Hemipelvectomy: A Case Report and a Review of the Literature.
Traumatic hemipelvectomy is a life threatening, devastating pelvic injury with very low survival rates. Excessive loss of blood, related systemic problems and additional injuries about the gastrointestinal and genitourinary systems increase mortality of this severe sort of injury. A young, male farmer injured violently by an agricultural heavy machine; a survivor of traumatic hemipelvectomy is described in this case report.
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Following injuries to the pancreas and duodenum (PDI) patients often present in extremis and undergo immediate laparotomy for hemodynamic instability and peritoneal signs. Nonoperative management (NOM) may be offered in selected patients with lowgrade injuries. Precise mapping of the injury, most commonly by computed tomography, is a prerequisite for NOM because clinical symptomatology can be variable and misleading. ⋯ In these cases, the reported success rates vary from 74 to 95%. There are also a few severe pancreatic injuries that can be managed by stents with adequate reconstitution of the major pancreatic duct integrity and resolution of symptoms and without the need for operative management. Intensive monitoring and follow-up by clinical examination and repeat CT imaging is essential in these patients, as the risk of complications, and particularly a pseudocyst is high.