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
Optimal plate position in minimally invasive plate osteosynthesis for mid-shaft clavicle fractures: simulation using 3D-printed models of actual clinical cases.
This study evaluated the optimal anatomical locking plate position using three-dimensional printed models of the clavicle. ⋯ Fitting the anatomical plate in MIPO for clavicle fractures depends on the fracture location. This can help surgeons determine the optimal plate for clavicle MIPO.
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Eur J Trauma Emerg Surg · Oct 2021
Observational StudyImpact of frailty in surgical emergencies. A comparison of four frailty scales.
Frailty is a geriatric syndrome, leading to declines in homeostatic reserve and physical resistance. It has been considered as a risk factor for falls, fractures, need of institutionalization, length of stay and mortality. Our aim was to evaluate the relationship between frailty, 30-day postoperative mortality and morbidity, for elderly patients undergoing surgical emergencies. ⋯ Frailty represents a predictive marker of mortality and major complications, in surgical emergencies. FRAIL score, shows the strongest relationship with mortality and complications, compared to other frailty scales.
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Eur J Trauma Emerg Surg · Oct 2021
Current practice in the management of acromioclavicular joint dislocations; a national survey in the Netherlands.
The aim of this study was to investigate current practice in the management of acromioclavicular joint dislocations in the Netherlands. ⋯ This survey showed a significant individual variation on diagnosis and treatment strategies among surgeons in the Netherlands. The majority of the Dutch surgeons concern a flexible implant the best available technique for patients who require operative treatment.
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Eur J Trauma Emerg Surg · Oct 2021
Intracranial pressure monitors associated with increased venous thromboembolism in severe traumatic brain injury.
Utilization of intracranial pressure monitors (ICPMs) has not been consistently shown to improve mortality in patients with severe traumatic brain injury (TBI). A single-center analysis concluded that venous thromboembolism (VTE) chemoprophylaxis (CP) posed no significant bleeding risk in patients following ICPM implementation; however, there is still debate about the optimal use and timing of CP in patients with ICPMs for fear of worsening intracranial hemorrhage. We hypothesized that ICPM use is associated with increased time to VTE CP and thus increased VTE in patients with severe TBI. ⋯ Compared to patients without ICPMs, those with ICPMs had a longer delay to initiation of CP leading to an increase in VTE. In addition, there was a nearly two-fold higher associated risk for VTE in patients with ICPMs even when controlling for known VTE risk factors. Improved adherence to initiation of CP in the setting of ICPMs may help decrease the associated risk of VTE with ICPMs.
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The mortality rate from road traffic accidents (RTAs) in Nigeria is almost double that of the USA. In Nigeria, the first emergency medical services (EMS) system was established in March 2001, The Lagos State Ambulance Service (LASAMBUS). The objectives of this study are to (1) determine the burden of RTAs in Lagos, (2) assess RTA call outcomes, and (3) analyze LASAMBUS's response time and causes for delay. ⋯ LASAMBUS response rates are significantly lower than response rates in high-income countries such as the USA and lead to increased RTA mortality rates. Eliminating causes for delay will improve both LASAMBUS effectiveness and RTA victims' health outcomes. Changing the public perception of LASAMBUS and standardizing LASAMBUS' contact information will aid this as well.