European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2016
ReviewCurrent concepts for the treatment of acute scaphoid fractures.
Fractures of the scaphoid are common injuries, accounting for approximately 80 % of carpal fractures. Differentiation between stable and unstable fractures (Herbert classification) cannot be made with conventional X-rays, so evaluation by computed tomography should additionally be performed. Under most circumstances, minimally invasive surgery with cannulated screws is the treatment of choice. ⋯ Displaced fractures have a greater risk for nonunion and therefore should be treated operatively. Proximal pole fractures are definitely unstable, requiring treatment with screw fixation. The surgical approach depends on the location of the fracture and the preference of the surgeon.
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Eur J Trauma Emerg Surg · Feb 2016
Increase in urinary sodium excretion in spinal cord injury patients in the emergency department.
Spinal cord injury (SCI) is a pathological condition known to produce hyponatremia. The aim of this study was to elucidate the dynamics of urinary sodium excretion in patients with spinal cord injury. ⋯ Urinary sodium excretion calculated by FENa increased in patients with severe spinal cord injury. Sympathetic blockade due to SCI may increase urine sodium excretion and lead to hyponatremia.
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Fractures of the hand are frequently encountered with injuries to the phalanges and metacarpals comprising the vast majority. Fractures of the carpal bones excluding the scaphoid, however, are fairly uncommon. ⋯ Delayed diagnosis can result in inadequate fracture care, which places the wrist at risk of disabling sequelae. This review focuses on the current concepts of pathophysiology, diagnosis, and treatment of carpal fractures other than the scaphoid.
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Eur J Trauma Emerg Surg · Feb 2016
ReviewManagement algorithm for index through small finger carpometacarpal fracture dislocations.
Injuries to the carpometacarpal (CMC) joints are rare. The most common CMC fracture dislocations occur in the ring and small finger CMC joints. The aim of this study was to review the structured diagnostic procedure and different treatment options. ⋯ CMC fracture dislocations of the fourth and fifth CMC joints are uncommon and often overlooked. Primary goal of treatment is to restore normal function to the hand. Therefore, operative therapy might be the method of choice.