European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Oct 2016
Anterior fixation of unstable pelvic ring fractures using the modified Stoppa approach: mid-term results are independent on patients' age.
Open surgical management of unstable pelvic ring injuries has been discussed controversially compared to percutaneous techniques in terms of surgical site morbidity especially in older patients. Thus, we assessed the impact of age on the outcome following fixation of unstable pelvic ring injuries through the modified Stoppa approach. ⋯ Increasing age did not impact the analysed parameters. Open reduction and internal fixation of the anterior pelvic ring through a modified Stoppa approach in unstable pelvic ring injuries did not result in an unfavourable outcome with increasing age of patients.
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Eur J Trauma Emerg Surg · Oct 2016
ReviewA small case series of aortic balloon occlusion in trauma: lessons learned from its use in ruptured abdominal aortic aneurysms and a brief review.
EndoVascular and Hybrid Trauma Management (EVTM) is an emerging concept for the early treatment of trauma patients using aortic balloon occlusion (ABO), embolization agents and stent grafts to stop ongoing traumatic bleeding. These techniques have previously been implemented successfully in the treatment of ruptured aortic aneurysm. ⋯ EVTM, including the usage of ABO, can be initiated on patient arrival and is feasible. Further data need to be collected to investigate proper indications for ABO, best clinical usage, results and potential complications. Accordingly, the ABOTrauma Registry has recently been set up. Existing experiences of EVTM and lessons from the endovascular treatment of rAAA may be useful in trauma management.
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Eur J Trauma Emerg Surg · Oct 2016
Review Meta Analysis Comparative StudyInternal versus external fixation of the anterior component in unstable fractures of the pelvic ring: pooled results from a systematic review.
Improving reduction of the pelvic ring improves long-term functional outcomes for patients. It has been demonstrated that posterior internal fixation is necessary to adequately control fractures to the posterior ring and there is evidence that supplementing this with fixation of the anterior ring improves stability. It is accepted that internal fixation provides greater stability than external fixation of the anterior ring but long-term differences in radiographic and functional outcomes have not yet been quantified. ⋯ Internal fixation of the anterior pelvic ring as supplementary fixation for unstable injuries to the pelvic ring appears to result in better radiographic and functional outcomes as well as fewer complications. However, data that separated outcomes and complications in relation to interventions of the anterior pelvic ring were limited. More studies looking specifically at outcomes in relation to the type of anterior ring intervention are needed.
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Eur J Trauma Emerg Surg · Oct 2016
Review Multicenter StudyManagement of malnutrition in geriatric trauma patients: results of a nationwide survey.
Prevalence of malnutrition in geriatric trauma patients ranges between 30 and 50 % in Germany. Malnutrition is associated with impaired wound healing, a prolonged in-hospital stay, reduced post-traumatic mobility, as well as a higher mortality. Thus, detection and improvement of nutritional status could be a fundamental contribution in optimizing the treatment of these patients. ⋯ Although we know malnutrition is a frequent condition in geriatric patients, a minority of clinics considered it. The BMI and the NRS showed acceptance in practice; other parameters were used inhomogeneously. Although these findings may be limited in their significance, they indicate that the detection of malnutrition needs further investigation.
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Eur J Trauma Emerg Surg · Oct 2016
Review Comparative StudyThe Aachen Mobility and Balance Index to measure physiological falls risk: a comparison with the Tinetti POMA Scale.
The most commonly used mobility assessments for screening risk of falls among older adults are rating scales such as the Tinetti performance oriented mobility assessment (POMA). However, its correlation with falls is not always predictable and disadvantages of the scale include difficulty to assess many of the items on a 3-point scale and poor specificity. The purpose of this study was to describe the ability of the new Aachen Mobility and Balance Index (AMBI) to discriminate between subjects with a fall history and subjects without such events in comparison to the Tinetti POMA Scale. ⋯ The AMBI comprises mobility and balance tasks with increasing difficulty as well as a measurement of the dominant hand-grip strength. Its ability to identify fallers was comparable to the Tinetti POMA Scale. However, both measurement sets showed shortcomings in discrimination between fallers and non-fallers based on a self-reported retrospective falls-status.