European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Oct 2021
Observational StudyReappraising the need for a control CT in mild head injury patients on anticoagulation.
Head injury is a frequent reason for admission to the emergency department. In parallel, there is a growing use of anticoagulants in an increasingly aging population, which renders this particular group of trauma patients more frequent. In several countries, including Portugal, a 24-h surveillance period followed by repetition of head computed tomography (CT) is the standard procedure for these patients. However, these recommendations have not been based on studies of prevalence of intracranial hemorrhages in control head CTs, namely in this group of anticoagulated patients. This study intends to evaluate the prevalence of de novo intracranial hemorrhages in control head CTs in anticoagulated patients. ⋯ In conclusion, de novo intracranial hemorrhage in control head CT of anticoagulated patients is rare. We propose that these patients may be discharged if the admission CT does not reveal intracranial hemorrhage, providing that they are accompanied by a caregiver and informed about red flags.
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Fractures of the clavicle are common injuries, accounting 2.6-4% of all fractures in adults. Of these fractures, 21-28% are lateral clavicle fractures and 2-3% are medial clavicle fractures. Bipolar clavicle fractures are defined as a lateral and medial fracture and are uncommon. There is no consensus on the treatment of these fractures. The aim of this study is to provide a treatment on bipolar clavicle fractures based on the current literature. ⋯ A missed bipolar fracture can complicate the clinical progress. Surgical management of these fractures may be necessary; however, the treatment of choice depends on the age of the patient, daily activities and comorbidity.
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Eur J Trauma Emerg Surg · Oct 2021
Observational StudySoluble terminal complement activation fragment sC5b-9: a new serum biomarker for traumatic brain injury?
Terminal complement pathway activation after traumatic brain injury (TBI) leads to formation of the membrane attack complex (MAC/C5b-9) which induces neuronal cell death and host-mediated secondary brain injury. Serum levels of soluble MAC (sC5b-9) have not been previously determined in patients with isolated TBI. ⋯ The soluble terminal complement complex sC5b-9 represents a potential novel serum biomarker specific for isolated head injuries, since peripheral trauma did not appear to affect the serum sC5b-9 levels.
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Eur J Trauma Emerg Surg · Oct 2021
Long-term results of reconstructing the joints' articular surface in the knee and ankle with the surgical diamond instrumentation (SDI).
The surgical diamond instrumentation (SDI), a precise wet-grinding technology, promised contact healing of press-fit inserted bone and even hyaline cartilage, lacks medium- and long-term results. This retrospective study was conducted to identify risk factors associated with the failure of the technique and the subjective patient outcome. ⋯ The SDI technique provides promising results with excellent joint survival rates and satisfying patient-reported outcomes. Failure of the technique might be associated with higher age.
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Eur J Trauma Emerg Surg · Oct 2021
Does increased acetabular depth affect safe infra-acetabular screw placement in acetabular fracture fixation?
Infra-acetabular screws enhance the fixation strength in acetabular fractures with separation of both columns. Placement without iatrogenic femoral head violation is challenging. ⋯ The virtual possibility to place an infra-acetabular screw was given in all patients. An increasing depth of the acetabulum correlated with a decrease in residual distances. As hip joint cartilage thickness was not considered in measurements, intraoperative rule-out of screw mispositioning especially in deep acetabular sockets and females is still of utmost importance.