European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2019
Medial humeral condyle fracture in childhood: a rare but often overlooked injury.
The medial condyle fracture of the humerus is-in comparison to the lateral condyle fracture-a very rare Salter-Harrison IV-fracture of the elbow. In this prospective study 14 children were included and reviewed. One child had minimal displacement fracture type I, one child had type II, and 12 children had type III-fractures. ⋯ If in this injury the diagnosis is made without delay, an appropriate therapy is implemented and radiographical controls are performed until consolidation, good results can be expected. The main risk in medial condyle fractures of the humerus is to overlook them. This can lead to the development of a nonunion with joint malformations.
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Eur J Trauma Emerg Surg · Aug 2019
Observational Study"Second-look" laparotomy: warranted, or contributor to excessive open abdomens?
The overuse of temporary abdominal closure and second look (SL) laparotomy in emergency general surgery (EGS) cases has been questioned in the recent literature. In an effort to hopefully decrease the number of open abdomen (OA) patients, we hypothesize that reviewing our cases, many of these SL patients could be managed with single-stage operative therapy and thus decrease the number of OA patients. ⋯ Almost one-fifth of the patients undergoing SL laparotomy for open abdomen required bowel resections, with 6.8% of those having normal appearing bowel at index operation, therefore in select EGS patients, SL laparotomy is a reasonable strategy.
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Eur J Trauma Emerg Surg · Aug 2019
Early identification of trauma patients in need for emergent transfusion: results of a single-center retrospective study evaluating three scoring systems.
The Trauma-Induced Coagulopathy Clinical Score (TICCS) was developed to be calculable on the site of injury to discriminate between trauma patients with or without the need for damage control resuscitation and thus transfusion. This early alert could then be translated to in-hospital parameters at patient arrival. Base excess (BE) and ultrasound (FAST) are known to be predictive parameters for emergent transfusion. We emphasize that adding these two parameters to the TICCS could improve the scoring system predictability. ⋯ Diagnostic test, level III.
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Eur J Trauma Emerg Surg · Aug 2019
Review Meta AnalysisFixation of flail chest or multiple rib fractures: current evidence and how to proceed. A systematic review and meta-analysis.
The aim of this systematic review and meta-analysis was to present current evidence on rib fixation and to compare effect estimates obtained from randomized controlled trials (RCTs) and observational studies. ⋯ Rib fixation for flail chest improves short-term outcome, although the indication and patient subgroup who would benefit most remain unclear. There is insufficient data regarding treatment for multiple rib fractures. Observational studies show similar results compared with RCTs.
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Eur J Trauma Emerg Surg · Aug 2019
Review Meta AnalysisThe use of polymeric clips in securing the appendiceal stump during laparoscopic appendicectomy: a systematic review.
A key step during laparoscopic appendicectomy is securing the appendiceal stump. This has traditionally been achieved using vicryl endoloops, but increasing evidence suggests that the use of polymeric clips (Hem-o-lok) may be a safe and viable method. Current evidence for its clinical use in laparoscopic appendicectomy is unknown. We performed a systematic review of the literature examining the clinical outcomes of laparoscopic appendicectomy using polymeric clips compared to other methods of stump closure. ⋯ Current evidence suggests that polymeric clips are an effective and cost-efficient method for stump closure in laparoscopic appendicectomy for acute appendicitis. Further high-quality evidence is required before polymeric clips can be recommended as the gold standard for appendiceal stump closure.