Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Oct 2009
Traumatic deaths in the emergency room: A retrospective analysis of 115 consecutive cases.
The aim of the present study was to characterise traumatic deaths occurring in the emergency room (ER) and to assess retrospectively the quality of given emergency care by evaluating whether any of the deaths could be identified as potentially preventable. ⋯ Missed injuries did not play a major role in the preventable deaths. Seven potentially preventable deaths were considered to be failures in the surgical decision-making process, resulting in futile non-operative treatment or a delay in surgical bleeding control.
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Eur J Trauma Emerg S · Oct 2009
Management of blunt bowel and mesenteric injuries: Experience at the Alfred hospital.
The incidence of blunt bowel and mesenteric injury (BBMI) has increased recently in blunt abdominal trauma, possibly due to an increasing number of high-speed motor accidents and the use of seat belts. ⋯ The timing of surgical intervention in cases of BBMI is mostly determined by the clinical examination and the results of the helical CT scan findings. The FAST lacks sensitivity and specificity for identifying bowel and mesenteric trauma. A delayed diagnosis of > 48 h has a significantly higher bowelrelated morbidity but not mortality.
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Eur J Trauma Emerg S · Oct 2009
Base excess determined within one hour of admission predicts mortality in patients with severe pelvic fractures and severe hemorrhagic shock.
Unstable pelvic ring fractures with exsanguinating hemorrhages are rare but potentially lifethreatening injuries. The aim of this retrospective study was to evaluate whether early changes in acid- base parameters predict mortality of patients with severe pelvic trauma and hemorrhagic shock. ⋯ Base excess, lactate, and pH discriminate early survivors from nonsurvivors suffering from severe pelvic trauma and hemorrhagic shock. Base excess measured 1 h after admission best predicted early mortality following pelvic trauma with concomitant hemorrhage.
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Eur J Trauma Emerg S · Oct 2009
Proximal humeral fractures and intramedullary nailing: Experience with a new nail system.
The goal of this study was to evaluate fracture healing and alignment as well as functional outcome and complication risks after internal fixation with the intramedullary proximal humeral nail (PHN). This device shows promise for applications involving the reconstruction of the humeral shaft and head with minimal soft tissue stripping and for providing a locked, fixed-angle construct for secure fixation to permit controlled, early, and active rehabilitation. ⋯ Nailing of proximal humeral fractures with the PHN is possible, but indication is limited to mainly A- and B-type fractures. The results of this multicenter study with many participating surgeons show that the operative technique is demanding and that the majority of documented complications are related to a violation of published basic technical steps during the operative procedure.
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Eur J Trauma Emerg S · Oct 2009
Iatrogenic femoral neck fracture during closed nailing of the femoral shaft fracture.
Intramedullary nails have become a popular implant in the management of femoral shaft fractures. The occurrence of a femoral neck fracture after closed intramedullary nailing is an exceptional complication of this technique that has been rarely reported in the literature. ⋯ The event of a femoral neck fracture during closed intramedullary nailing is an unusual complication that may be caused due to a technical mistake related to the location of the nail entry portal in the proximal femur.