Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Dec 2009
Operative Treatment and Soft Tissue Management of Open Distal Tibial Fractures - Pitfalls and Results.
Open tibial fractures usually result from high-energy trauma. Severe soft-tissue injuries are often combined with open fractures of the distal tibia. A consecutive series of 42 patients with open extraarticular distal tibial fractures (Gustilo I-IIIc) operated on between July 2006 and February 2009 were included in the study reported here. ⋯ Gustilo II patients with primary wound closure remained hospitalized for 11 days, while patients with secondary wound closure stayed in hospital for an average of 20 days. Our early results concerning infection rate, number of reoperations, and time to bony consolidation can be compared with other studies. Functional results will have to be evaluated at clinical follow-up.
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Eur J Trauma Emerg S · Oct 2009
Development and validation of the revised injury severity classification score for severely injured patients.
Trauma scores are often used for prognostication and the adjustment of mortality data. The appropriate consideration of identified prognostic factors is mandatory for a valid score with good outcome prediction properties. The Trauma Registry of the German Society for Trauma Surgery (TR-DGU) initially used the Trauma and Injury Severity Score (TRISS) but various reasons led to the development of a new scoring system, the Revised Injury Severity Classification (RISC). ⋯ Outcome prediction including initial laboratory values was able to significantly improve the ability to discriminate between survivors and nonsurvivors. The adjustment of mortality rates should be based on the best available prediction model.
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Eur J Trauma Emerg S · Oct 2009
Role of lung contusions on posttraumatic inflammatory response and organ dysfunction in traumatized patients.
Multiple trauma is often accompanied by lung contusion leading to secondary pulmonary inflammation and organ dysfunction. The particular role of lung contusions on the systemic inflammatory response remains unclear. Therefore, the aim of the present study was to compare the degree of lung contusion with markers of inflammation and multiple organ failure (MOF) in trauma patients. ⋯ Our data show that severe lung contusions contributes to an immediate onset of posttraumatic inflammation in severely traumatized patients, resulting in MOF, while in severely injured patients without lung contusion, this development requires up to 5 days.