European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2020
Review Meta AnalysisRisk factors for fracture redisplacement after reduction and cast immobilization of displaced distal radius fractures in children: a meta-analysis.
Displaced distal radius fractures in children are common and often reduced if necessary and immobilized in cast. Still, fracture redisplacement frequently occurs. This can be prevented by fixation of fracture fragments with K-wires, but until now, there are no clear guidelines for treatment with primary K-wire fixation. This meta-analysis aimed to identify risk factors for redisplacement after reduction and cast immobilization of displaced distal radius fractures in children, and thereby determine which children will benefit most of primary additional K-wire fixation. ⋯ For children with a displaced distal radius fracture, the presence of a both-bone fracture, complete displacement of the distal radius and non-anatomical reduction are risk factors for redisplacement after reduction of their initially displaced distal radius fracture. Children with one or more of these risk factors probably benefit most of reduction combined with primary K-wire fixation.
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Eur J Trauma Emerg Surg · Aug 2020
Early cranioplasty associated with a lower rate of post-traumatic hydrocephalus after decompressive craniectomy for traumatic brain injury.
Post-traumatic hydrocephalus (PTH) is one of the primary complications during the course of traumatic brain injury (TBI). The aim of this study was to define factors associated with the development of PTH in patients who underwent unilateral decompressive craniectomy (DC) for TBI. ⋯ Our results show that early cranioplasty within 2 months after DC was associated with a lower rate of PTH development after TBI.
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Eur J Trauma Emerg Surg · Aug 2020
ReviewInjury-related variation in patient-reported outcome after musculoskeletal trauma: a systematic review.
The purpose of this study was to explore injury-related characteristics that differentiate between patient-reported outcomes (PROs) following traumatic musculoskeletal injury. ⋯ Based on the included studies, we propose a framework where musculoskeletal injuries occur in one of 4 scenarios that is associated with a different context-dependent outcome: (1) polytrauma with neurotrauma, (2) polytrauma without neurotrauma, (3) high-energy monotrauma, and (4) low-energy monotrauma. Our results suggest that standardization of outcome instruments is needed to facilitate future meta-analyses that assess PROs in this population.
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Mass-casualty terrorist incidents are a medical and organisational challenge for every hospital. The Terror and Disaster Surgical Care (TDSC®) course was developed because such incidents are associated with special injury patterns, escalating situations, and surges of casualties and haemodynamically unstable patients requiring treatment and can overwhelm the resources of hospitals. ⋯ The TDSC course complements already established courses and provides training in tactical surgical care after hospital admission. The TDSC course integrates and builds on elements of individualised trauma care such as the primary survey and the extended focused assessment with sonography in trauma (eFAST). This underlines again that it complements and does not replace other course formats. We can conclude that the presentations and the tabletop simulation game were well suited to the target group and that the participants were able to increase their knowledge of this complex subject.
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Eur J Trauma Emerg Surg · Aug 2020
Return to work after early repair of acute traumatic rotator cuff tears.
Lost workdays following rotator cuff repair is not well-studied in the literature. We aimed to define the time away from work following early arthroscopic repair of acute traumatic rotator cuff tears and compare it with the recommendations of the American Medical Disability Advisor (MD Guidelines) and The Swedish Social Insurance Agency. ⋯ According to the present study, acute traumatic rotator cuff tears cause a considerable loss of work days. However, almost all patients are expected to return to work after a median time of 5 months following arthroscopic repair. Current guidelines and recommendations regarding sick leave following repair of rotator cuff tears might have to be reviewed.