Ulus Travma Acil Cer
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We aimed to compare different fluids indicated in volume replacement in multiple trauma patients, enlightening the indications, mechanisms of action and side effects. An extensive review of references (indexed journals) between 1997 and 2008 was performed. There is not yet a consensus about which fluids should be used in trauma patients. ⋯ Gelatins are no longer used in developed countries due to their insignificant ability regarding volume expansion when compared to crystalloids and the potential risks of anaphylactic reactions. The crystalloids are used more in trauma, even if some authors prefer the use of colloids, which can produce a quicker restoration of the intravascular volume. No convincing evidence shows a clear superiority of colloids over crystalloids for restoration of the volume depletion.
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Penetrating cardiac trauma represents an increasingly important form of trauma due to the frequent use of firearms and bombs in civilian violence. We report our experience over the past 16 years with missile-induced cardiac injuries. ⋯ In missile cardiac injuries, results are best if operated early, and outcome depends upon multiple factors including clinical status at arrival, time interval till management, nature of injury, and associated injuries.
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Blunt colonic injuries are rare but can complicate the management of the blunt trauma patient and worsen the outcome. We analyzed in this study the colonic injuries caused by blunt abdominal trauma. ⋯ We conclude that in patients with shock at presentation, severe fecal contamination and higher CIS grade, two-staged operation is appropriate.
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Ulus Travma Acil Cer · Jul 2009
[Analysis of motorcycle accident victims presenting to the emergency department].
Motorcycle accidents are one of the major causes of traumatic injuries and deaths. The purpose of this study was to analyze the features of the victims presenting with motorcycle-related injuries. ⋯ Motorcycle accidents result in more serious injuries than motor vehicle accidents due to the limited safety precautions and the difference in injury mechanism. The frequency of accidents, higher admission rates, longer periods of admissions, and higher total hospital costs highlight motorcycle accidents as a major public health issue and an economical burden. To prevent accidents, compliance with the legal requirements should be regularly audited. Studies should be done to increase motorcycle safety precautions, and education programs should be organized for motorcyclists. The effects of these interventions should be analyzed.
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Ulus Travma Acil Cer · Jul 2009
[Treatment of femoral shaft fractures with expandable intramedullary nail].
Femoral shaft fractures are usually seen in the young population as a result of high energy traumas and are often accompanied by major organ injuries. In this paper, we aimed to assess the clinical results of expandable femoral intramedullary nails in the treatment of 20 femoral shaft fractures. ⋯ Use of expandable nails provides union without major complications and offers advantages such as less exposure to radiation as seen in distal locking of classical intramedullary nails. In conclusion, the good results of this study show that the expandable femoral intramedullary nail provides a successful option to classical intramedullary nails.