Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Oct 2010
Historic overview of treatment techniques for rib fractures and flail chest.
From the beginning of the twentieth century till the current time, an overview is presented of the surgical treatment for rib fractures and flail chest. ⋯ However, the recent introduction of better and fully dedicated materials provides the possibility of exploring the surgical treatment of chest injuries. The authors make a case for operative treatment of rib fractures and flail chest.
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There has been difficulty in the appropriate determination of blunt cardiac injury (BCI) related to blunt thoracic trauma (BTT). The aim of this study is to assess BCI and the effectiveness of diagnostic tests in BTT in patients admitted to the emergency department (ED). ⋯ Indicators such as cardiac enzymes and ECG have low sensitivity and specificity when used alone. The reliability of ECG in the diagnosis of BCI decreases in the later hours of trauma.
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Eur J Trauma Emerg S · Oct 2010
Emergency decompressive craniectomy for trauma patients with Glasgow Coma Scale of 3 and bilateral fixed dilated pupils.
Trauma patients with Glasgow Coma Scale (GCS) of 3 and bilateral fixed dilated pupils (BFDP) usually have dismal outcome, and neurosurgeons are less likely to treat such patients aggressively. In this work, the authors assessed whether emergency decompressive craniectomy (EDC) can change the poor outcome of these patients. ⋯ Despite control of ICP following emergency decompressive craniectomy in patients with severe TBI, GCS of 3, and BFDP, this did not change the dismal outcome of these patients; on the contrary, it may increase the suffering for patients and their families and add unnecessary medical burden. We propose that these patients have irreversible severe brain insult.
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Eur J Trauma Emerg S · Oct 2010
Surface proteins and osteoblast markers: characterization of human adipose tissue-derived osteogenic cells.
In adipose tissue-derived osteogenic cells (ADOC), osteoblast markers and surface proteins were determined and compared with osteoblasts harvested from cancellous bone (OB). ⋯ These data support the use of adipose tissue for future regenerative medicine; however, further studies are necessary to establish the role of long-term differentiation.
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Hoffa fractures are uni- or bicondylar fractures of the distal femur in a coronal tangential plane. ⋯ Traditional methods of fixation for Hoffa fractures have led either to the application of complicated constructs attempting to achieve stability, or to large articular surface defects created whilst countersinking headed lag screws. Both have negative implications for the patient. We describe a novel method, not previously described in the literature, using screws in a posterior to anterior direction. This provides compression perpendicular to the fracture site whilst protecting against shear and torsional forces, thereby providing more stable fixation. Furthermore, our method allows for a minimally invasive approach and uses headless compression screws, which reduces the chance of damage to the articular surface and is, therefore, less physiologically invasive.