European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2016
Comparative StudyComparison of MRI, CT and bone scintigraphy for suspected scaphoid fractures.
The best diagnostic modality for confirmation of the diagnosis of a scaphoid fracture that is not visible on the initial radiograph (occult scaphoid fracture) is still subject of debate. The aim of this study was to compare the accuracy of magnetic resonance imaging (MRI), computed tomography (CT) and bone scintigraphy (BS) for the diagnosis of these occult scaphoid fractures. ⋯ This study shows that neither MRI, nor CT and BS are 100 % accurate in diagnosing occult scaphoid fractures. MRI and CT miss fractures, and BS tends to over-diagnose. The specific advantages and limitations of each diagnostic modality should be familiar to the treating physicians and taken into consideration during the diagnostic process.
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Eur J Trauma Emerg Surg · Dec 2016
ReviewIndications and anatomic landmarks for the application of lower extremity traction: a review.
Fractures of the lower extremity, particularly of the femur and acetabulum, may be difficult to immobilize with splinting alone. These injuries may be best stabilized with the application of various types of skeletal traction. Often, traction is applied percutaneously in an emergent setting, making the knowledge of both superficial and deep anatomy crucial to successful placement. ⋯ By palpating and marking superficial landmarks and observing specific anatomic relationships, safe application of traction pins can be performed while minimizing iatrogenic injury to vital anatomic structures, and avoiding intra-articular placement which could potentially lead to joint infection.
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Eur J Trauma Emerg Surg · Dec 2016
ReviewEmergency resuscitative thoracotomy performed in European civilian trauma patients with blunt or penetrating injuries: a systematic review.
Emergency resuscitative thoracotomy (ERT) is a lifesaving procedure in selected patients. Indications are still being debated, but outcome in blunt trauma is believed to be poor. Recent reports from European populations, where blunt trauma predominates, have suggested favorable outcome also in blunt trauma. Our aim was to identify all European studies reported over the last decade and compare reported outcomes to existing knowledge. ⋯ The reported outcome after ERT in European civilian trauma populations is favorable, with one in every four ERTs in the ED surviving. Notably, outcome is at variance with previously reported collective data, in particular for blunt trauma. Multicenter, prospective, observational data are needed to validate the modern role of ERT in blunt trauma.
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Eur J Trauma Emerg Surg · Dec 2016
ReviewEndovascular solutions for the management of penetrating trauma: an update on REBOA and axillo-subclavian injuries.
Endovascular procedures continue to gain acceptance as management options for penetrating traumatic injuries. Currently, several areas of potential endovascular application are being investigated. However, the bulk of the literature on this topic is still limited to case series or small retrospective studies. Therefore, we performed a review of the published experience involving the application of endovascular therapy to trauma patients who have sustained penetrating injuries with focus on outcomes of resuscitative endovascular balloon occlusion of the aorta (REBOA) and endovascular repair of axillo-subclavian injuries. ⋯ REBOA is a safe and effective alternative to open thoracotomy in critically ill trauma patients at risk of death due to torso hemorrhage. Endovascular repair outcomes are comparable to open repair after axillo-subclavian injuries. Long-term results of endovascular repair remain to be defined in this patient population.
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Eur J Trauma Emerg Surg · Dec 2016
ReviewPredicting serious complications and high cost of treatment of tooth-knuckle injuries: a systematic literature review.
The tooth-knuckle injury (TKI) is a serious and potentially costly injury seen in orthopaedic practice. The aim was to conduct a systematic literature review on the factors associated with serious complications and high treatment costs in tooth-knuckle injuries. ⋯ PROSPERO CRD42016029949 ( http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016029949 ).