European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Apr 2016
Multicenter Study Observational StudyA multicentre cross-sectional study to examine physicians' ability to rule out a distal radius fracture based on clinical findings.
To study current use of radiography in patients with wrist trauma and examine physicians' ability to rule out a distal radius fracture based on their physical findings. ⋯ Although physicians in the ED are able to accurately discriminate between patients with and without a distal radius fracture based on their physical findings, they were only completely certain of their diagnosis in 19 % of the patients. A validated clinical decision rule could reinforce physician's clinical judgment and support them in their decision not to routinely request radiography.
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Eur J Trauma Emerg Surg · Apr 2016
ReviewOut of hospital point of care ultrasound: current use models and future directions.
Ultrasound has evolved from a modality that was once exclusively reserved to certain specialities of its current state, in which its portability and durability lend to its broadly increasing applications. ⋯ Prehospital ultrasound has the ability to increase diagnostic ability and allow for therapeutic intervention in the field. In austere environments, ultrasound may be the only available imaging modality and thus can guide diagnosis, therapeutics and determine which patients may need emergent transfer to a healthcare facility. The most cutting edge applications of portable ultrasound employ telemedicine to obtain and transmit ultrasound images. This technology and ability to transmit images via satellite and cellular transmission can allow for even novice users to obtain interpretable images in austere environments. Portable ultrasound uses have steadily grown and will continue to do so with the introduction of more portable and durable technologies. As applications continue to grow, certain technologic considerations and future directions are explored.
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Ultrasound technology has become ubiquitous in modern medicine. Its applications span the assessment of life-threatening trauma or hemodynamic conditions, to elective procedures such as image-guided peripheral nerve blocks. ⋯ Currently available ultrasound devices are more affordable, portable, and feature user-friendly interfaces, making them well suited for use in the demanding situation of a mass casualty incident (MCI) or disaster triage. We have reviewed the existing literature regarding the application of sonology in MCI and disaster scenarios, focusing on the most promising and practical ultrasound-based paradigms applicable in these settings.
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Eur J Trauma Emerg Surg · Apr 2016
Secondary abdominal compartment syndrome after complicated traumatic lower extremity vascular injuries.
Secondary abdominal compartment syndrome (ACS) can occur in trauma patients without abdominal injuries. Surgical management of patients presenting with secondary ACS after isolated traumatic lower extremity vascular injury (LEVI) continues to evolve, and associated outcomes remain unknown. ⋯ The association between secondary ACS and lower extremity vascular injuries carries high morbidity and mortality rates. Further research efforts should focus at identifying parameters to accurately determine resuscitation goals, and therefore, prevent such a devastating condition.
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Eur J Trauma Emerg Surg · Apr 2016
Comparative StudyClinical results of treatment of garden type 1 and 2 femoral neck fractures in patients over 70-year old.
We retrospectively analyzed the clinical results of treatment of impacted or undisplaced femoral neck fractures (Garden types 1 and 2) by osteosynthesis in elderly patients >70-year old. ⋯ A relatively high rate of complications or reoperations developed after treatment of Garden 2 femoral neck fractures in senile patients >70 years of age with osteoporosis. Although internal fixation has been recommended in the literature for undisplaced femoral neck fractures, primary arthroplasty may be a better option for treatment of Garden type 2 fractures in elderly patients.