European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2014
The pediatric vs. the adolescent elbow. Some insight into age-specific treatment.
Almost 20 % of all long bone fractures in childhood and adolescents involve the elbow region. Physicians dealing with pediatric trauma cases on a regular basis must be familiar with the specific radiologic features of the elbow at every developmental stage. This includes the shape and the appearance of elbow ossification centers, and knowledge of age-specific injury patterns. ⋯ Treatment options depend on fracture type, age and demands and vary from immobilization to closed reduction and open reduction including internal fixation with different types of materials. Special circumstances to influence the treatment regimen in every single injury entity are discussed. Additionally, the most common malformations and nontraumatic diseases of the elbow region are mentioned.
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Eur J Trauma Emerg Surg · Feb 2014
Elastic stable intramedullary nailing (ESIN) in the adolescent patient-perils, pearls, and pitfalls.
Elastic stable intramedullary nailing (ESIN) has become the treatment of choice for diaphyseal long-bone fractures in children. This paper reviews the complications and limitations of this method which can occur when applying this osteosynthesis to patients within the adolescent age group. ⋯ The best prophylaxis for failure of ESIN is a stable and symmetric construct with correctly sized implants. This holds even more true for the adolescent patient. Using ESIN in difficult situations such as longitudinally unstable fractures, patients with a body weight >50 kg, or away from the diaphysis should be considered and followed up carefully. If possible, these patients should be treated in specialized pediatric trauma centers.
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Eur J Trauma Emerg Surg · Feb 2014
Refining the trauma triage algorithm at an Australian major trauma centre: derivation and internal validation of a triage risk score.
To derive and internally validate a clinical prediction rule for trauma triage. ⋯ We have derived and internally validated a trauma risk prediction rule using trauma registry data. This may assist with the formulation of revised local and regional trauma triage protocols. External validation is required before implementation.
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Eur J Trauma Emerg Surg · Feb 2014
Psoas:lumbar vertebra index: central sarcopenia independently predicts morbidity in elderly trauma patients.
Central sarcopenia as a surrogate for frailty has recently been studied as a predictor of outcome in elderly medical patients, but less is known about how this metric relates to outcomes after trauma. We hypothesized that psoas:lumbar vertebral index (PLVI), a measure of central sarcopenia, is associated with increased morbidity and mortality in elderly trauma patients. ⋯ Psoas:lumbar vertebral index is independently and negatively associated with posttraumatic morbidity but not mortality in elderly, severely injured trauma patients. PLVI can be calculated quickly and easily and may help identify patients at increased risk of complications.