European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Apr 2018
Lateral compression type B 2-1 pelvic ring fractures in young patients do not require surgery.
According to Young and Burgess, type B 2-1 pelvic fractures are a type of lateral compression fracture (LC-1) and are the most common pelvic injury at all ages. Although they are considered unstable in rotation and despite biomechanical recommendations for anterior stabilization, most authors recommend non-operative treatment. However, studies comparing outcomes and complications regarding operative versus non-operative treatment are still scarce. ⋯ Type B 2-1 pelvic ring fractures in young patients should be treated non-operatively.
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Eur J Trauma Emerg Surg · Apr 2018
The natural history of perforated foregut ulcers after repair by omental patching or primary closure.
The treatment of perforated foregut ulcers by omental patching (OP) or primary closure has mostly replaced vagotomy and pyloroplasty/antrectomy (VPA). We sought to determine the natural history and recurrence rate of ulceration in patients treated by omental patching or primary closure. ⋯ Omental patching does not correct the underlying disease process which causes foregut perforation, and has a 12% endoscopically proven recurrent ulceration rate and a 23% incidence of recurrent symptoms within 44 months. Patients tend to stop taking PPIs after 22 months at which time their risk increases.
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Eur J Trauma Emerg Surg · Apr 2018
Admission delays' magnitude of traumatized patients in the emergency department of a hospital in Egypt: a cross-sectional study.
Injury is an escalating public health problem, representing about 9% of global mortality, which disproportionately impacts lower- and middle-income countries. There are approximately 12,000 annual fatalities from road traffic injuries in Egypt, but a little information about delays in seeking emergent care is available. ⋯ This study demonstrated that trauma patients at our hospital experience more than 3 h of delay until they reach the ED. It also identified the possible causes accounting for that delay. However, additional nationwide research is needed to establish the clear causation or association of these causes with the delay intervals.
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Eur J Trauma Emerg Surg · Apr 2018
Impact of pelvic fractures on the early clinical outcomes of severely injured trauma patients.
Pelvic fractures contribute to morbidity and mortality following injury. We sought to study the impact of pelvic fractures on the clinical course and outcomes of trauma patients with a pelvic fracture in comparison to patients with similar injury severity without pelvic fracture to identify potential parameters to track patients' clinical course post-injury. ⋯ In this matched cohort, patients with pelvic fractures exhibited biochemical and physiological alterations upon admission. Furthermore, our results suggest that pelvic fracture affects the clinical outcomes in severely injured patients, independently of injury severity, mechanism of injury, age or gender.
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Eur J Trauma Emerg Surg · Apr 2018
Radial nerve palsy in humeral shaft fractures with internal fixation: analysis of management and outcome.
The incidence of radial nerve injury after humeral shaft fractures is on average 11.8% (Shao et al., J Bone Jt Surg Br 87(12):1647-1652, 2005) representing the most common peripheral nerve injury associated with long bone fractures (Korompilias et al., Injury, 2013). The purpose of this study was to analyze our current policy and long-term outcome, regarding surgically treated humeral shaft fractures in combination with radial nerve palsy. ⋯ Our study showed an overall rate of 19% radial nerve palsy in surgically treated humeral shaft fractures. Most of the primary palsies (13%) recovered spontaneously, and therefore, nerve exploration was only exceptionally needed. The incidence of secondary palsy after surgery (6%) was high and mainly seen after plate fixation. In these cases, we recommend early nerve exploration, to detect and treat potential curable neural lesions.