European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jun 2018
Intramedullary tibial nailing of distal tibiofibular fractures: additional fibular fixation or not?
The anatomy of the distal tibia accounts for reduced biomechanical stability and higher complication rates when treating distal tibiofibular fractures with an intramedullary tibia nail (IMTN). The goal of this study was to identify variables that affect the stability of IMTN. We assessed the value of additional fibular fixation, angular stable interlocking screws (ASLS) and multiplanar screw configuration in IMTN. ⋯ The level of the tibial fracture (AO/OTA type) and (suprasyndesmotic) fibular fractures were the main determinants of LOR after IMTN. ASLS was found to increase the stability of IMTN. Due to heterogeneity, however, we could not demonstrate the value of fibular fixation in IMTN. Therefore, a future prospective study with uniform treatment strategy for IMTN of distal tibiofibular fractures, with or without fixation of the fibula, is mandatory.
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Eur J Trauma Emerg Surg · Jun 2018
Long-term follow-up of 1217 consecutive short-stem total hip arthroplasty (THA): a retrospective single-center experience.
An arthroplasty registry in Germany has been recently established but long-term results for most short-stem innovations are missing. Short-stem hip arthroplasty is usually indicated in young active patients. Our indication was extended to older age groups, femoral neck fractures (FNF), and dysplasia. We evaluated all total hip arthroplasties (THAs) in this population with a collum femoris preserving stem (CFP) performed from 2003 to 2013. ⋯ The survival rate of the CFP stem was as high as 96% after 9 years of followup which compares well-to-previously published long-term survival rates. There is no higher risk for revision in patients 80 years old or older and in cases with femoral neck fractures. The CFP preserves also allowed using standard stems in the rare cases of revision.
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Eur J Trauma Emerg Surg · Jun 2018
ReviewPediatric head trauma: an extensive review on imaging requisites and unique imaging findings.
The effects of trauma in children are different due to association with some anatomical and physiological differences compared with adults. The role of neuroimaging gains importance in early detection of traumatic brain injuries and prevention of secondary post-traumatic complications. Many algorithms are described for children with head trauma to decide the necessity of a computed tomography scan. The aims of this article are to describe differences of these algorithms, the mechanism of traumatic brain injury with radiological imaging findings in the pediatric population, and explain complications of undiagnosed traumatic brain lesions.
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Eur J Trauma Emerg Surg · Jun 2018
ReviewA systematic review of propensity score methods in the acute care surgery literature: avoiding the pitfalls and proposing a set of reporting guidelines.
Propensity score methods are techniques commonly employed in observational research to account for confounding when estimating the effects of treatments and exposures. These methods have been increasingly employed in the acute care surgery literature in an attempt to infer causality; however, the adequacy of reporting and the appropriateness of statistical analyses when using propensity score matching remain unclear. ⋯ We have proposed reporting guidelines for the use of propensity score methods in the acute care surgery literature. This is to help investigators improve the adequacy of reporting and statistical analyses when using observational data to estimate effects of treatments and exposures.
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Eur J Trauma Emerg Surg · Jun 2018
Failure to rescue the elderly: a superior quality metric for trauma centers.
Trauma centers require reliable metrics to better compare the quality of care delivered. We compared mortality after a reported complication, termed failure to rescue (FTR), and FTR in the elderly (age >65 years) (FTRE) to determine which is a superior metric to assess quality of care delivered by trauma centers. ⋯ Higher FTRE predicts increased adjusted mortality better than FTR after trauma and should, therefore, be considered an important metric when comparing quality care delivered by trauma centers.