Scand J Trauma Resus
-
Scand J Trauma Resus · Mar 2015
Review Meta AnalysisMeta-analysis of plate fixation versus intramedullary fixation for the treatment of mid-shaft clavicle fractures.
This systematic review and meta-analysis aims to critically compare the outcomes of plate fixation (PF) versus intramedullary fixation (IF) for the treatment of mid-shaft clavicle fractures. ⋯ The present evidence from this meta-analysis suggested that IF was a more advantaged method for the treatment of midshaft clavicle fractures. This present study might aid surgeons in making evidence-based decision about optimal surgical treatment of mid-shaft clavicular fracture.
-
Scand J Trauma Resus · Mar 2015
Randomized Controlled Trial Comparative StudyPrehospital response model and time to CT scan in blunt trauma patients; an exploratory analysis of data from the head injury retrieval trial.
It has been suggested that prehospital care teams that can provide advanced prehospital interventions may decrease the transit time through the ED to CT scan and subsequent surgery. This study is an exploratory analysis of data from the Head Injury Retrieval Trial (HIRT) examining the relationship between prehospital team type and time intervals during the prehospital and ED phases of management. ⋯ This study suggests that well-rehearsed and efficient interventions carried out on-scene, by a highly trained physician and paramedic team can allow earlier critical care treatment of severely injured patients without increasing the time elapsed between injury and hospital-based intervention. There is also indication that role specialisation improves time intervals in physician staffed HEMS which should be confirmed with purpose designed trials.
-
Scand J Trauma Resus · Feb 2015
The off-hour effect on trauma patients requiring subspecialty intervention at a community hospital in Japan: a retrospective cohort study.
Because most community hospitals in Japan do not maintain 24-h availability of in-house anesthesiologists, surgeons, and interventional radiologists, staffing dramatically declines during off hours. It is unclear whether, in such under-resourced hospitals, trauma patients presenting during off hours and requiring subspecialty intervention have worse outcomes than those who present during business hours. ⋯ At a community hospital in Japan, presentation during off hours was associated with a longer ER stay for severely injured patients and increased risk of adverse events in the ER. However, these disadvantages did not impact mortality or unexpected outcome.
-
Scand J Trauma Resus · Feb 2015
Review Meta AnalysisRisk factors for wound complications of closed calcaneal fractures after surgery: a systematic review and meta-analysis.
To better clinical outcomes, open reduction and internal fixations (ORIFs) have been commonly performed in the case of closed displaced intra-articular calcaneal fractures (CDICFs). Nonetheless, postoperative wound complications remain a significant problem. Therefore, the aim of our study is to summarise relevant evidence investigating the risk factors for postoperative wound complications of CDICFs following ORIFs. ⋯ Based on available relevant evidence, bone graft, diabetes, no drainage and fracture severity were all associated with an increased risk of wound complications after ORIF for CDICFs.
-
Scand J Trauma Resus · Feb 2015
ReviewTreatments for blunt chest trauma and their impact on patient outcomes and health service delivery.
Blunt chest trauma is associated with a high risk of morbidity and mortality. Complications in blunt chest trauma develop secondary to rib fractures as a consequence of pain and inadequate ventilation. This literature review aimed to examine clinical interventions in rib fractures and their impact on patient and hospital outcomes. ⋯ However there was a paucity of evidence describing methods to implement and evaluate such multidisciplinary interventions. Isolated interventions can be effective in improving patient and health service outcomes for patients with blunt chest injuries, however the literature recommends implementing strategies such as clinical pathways to improve the care and outcomes of thesetre patients. The implementation of evidence-practice interventions in this area is scarce, and evaluation of interventions scarcer still.