Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Apr 2010
Spinal Fusion of an Unstable Atlantoaxial Fracture in a Completely Tetraplegic Patient Using Silicate-Substituted Calcium Phosphate.
Bone graft harvesting from the iliac crest constitutes the gold standard in spinal surgery due to its osteogenic, osteoconductive and osteoinductive properties. Large amounts of autograft can provoke complications like donor site morbidity, pain and the need for a second operation. Therefore, research into bone graft substitutes is of great interest. ⋯ Computed tomography showed bone bridging between the segment C1/C2, the surface of the implant and the remodeled bone at follow-up at 8 months. The use of silicate-substituted calcium phosphate as a bone graft extender in spinal surgery could be an alternative to autografting from the iliac crest. Vegetative symptoms are often underestimated but can be triggered by donor site morbidity or pain in patients after spinal cord injury.
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Severe open injuries of the pelvis go with a high complication, morbidity and mortality rate. A stepwise approach is the way to achieve reasonable results; however, final clinical outcome is in a large number of cases suboptimal.
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Pelvic disruption is a combination of fractures or dislocations of the pelvic ring with trauma of the soft tissues on the inside and outside of this ring. Hemodynamic instability is the result of blood loss out of the fracture fragments, the posterior venous plexus, ruptured pelvic organs, or arterial lesions. In the resuscitation phase, different measures are possible to reduce the volume of the disrupted pelvis and to restore mechanical stability. ⋯ It is effective in severe venous bleeding in the small pelvis. Pelvic angiography and selective embolization is performed in patients with active arterial bleeding. These patients can be identified by a convincing clinical picture, by early multislice computed tomography (CT) with contrast- enhanced angiographic technique, or by the persistent need for volume replacement after C-clamping, external fixation, or pelvic packing.
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A young female victim of multiple trauma had a Recovery inferior vena cava filter placed for pulmonary embolism prophylaxis. She was lost to follow-up for planned retrieval of the filter. After a period of more than four years she re-presented and had successful and uneventful retrieval of the filter. Certain inferior vena cava filters may potentially be retrieved even after very long implantation periods.
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To assess the current management and outcome of perforated duodenal peptic ulcer managed with open repair, a focused analysis was conducted, excluding gastric, traumatic and iatrogenic perforations. ⋯ The majority of patients with perforated duodenal ulcer can be diagnosed with conventional clinical and radiological methods, and treated according to established surgical principles. The mortality and duodenal morbidity rates have remained unchanged for the last decade. Shortening preoperative delay could improve the prognosis.