European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2021
Multicenter StudyNailing the fibula: alternative or standard treatment for lateral malleolar fracture fixation? A broken paradigm.
Despite the fact that open reduction and internal fixation with a plate, either non-locked or locked, is the standard of care for managing lateral malleolus fractures, intramedullary (IM) fixation of the fibula has been recently introduced as an alternative, mainly for some potential complicated situations. We hypothesized that almost all patterns of distal fibula fracture can be safely fixed with an IM device, with the potential benefit of providing biomechanical efficiency, but using a soft-tissue friendly implant. Here, we present a multicenter case series based on a proposed algorithm. ⋯ In this multicenter case series, intramedullary fixation for the lateral malleolus fracture presented itself as a viable and safe option for the treatment of almost all patterns of fibula fracture in adults. Overall, we were able to demonstrate the potential indications of the proposed algorithm for the choice of IM implant for the lateral malleolus fracture in terms of the Lauge-Hansen staged classification.
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There is no evidence supporting intubation for a Glasgow Coma Scale (GCS) of 8. We investigated the effect of intubation in trauma patients with a GCS 6-8, with the hypothesis that intubation would increase mortality and length of stay. ⋯ Among patients with GCS of 6 to 8, intubation on arrival was associated with an increase in mortality and with longer ICU and overall length of stay. The use of a strict threshold GCS to mandate intubation should be revisited.
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Eur J Trauma Emerg Surg · Dec 2021
Prevelance of the costal cartilage fracture on the computerised tomography in chest trauma.
Radiography remains limited in costal cartilage injuries, and sonography, CT and MR imaging turns out to be more sensitive in the detection of cartilage injuries. This study aims to determine the frequency of costal cartilage fractures detected in the CT images of the patients with high energy chest trauma and to evaluate the association of costal cartilage fracture with the complications of trauma. ⋯ Costal cartilage fractures frequently occur in blunt thoracic trauma with multiple rib fractures and are of clinical importance as they lead to the instability of chest wall. The incidence of cartilage fractures increases in elderly patients with costal cartilage calcification.
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Eur J Trauma Emerg Surg · Dec 2021
Characteristics and outcome of severe traumatic brain injuries based on occupational status.
The association of TBI with socioeconomic characteristics of patients has not been studied extensively. The objective of this study was to analyse the differences in injury characteristics and outcome in TBI patients based on their occupational status. ⋯ Our paper provides clues pertaining specifically to variations in patterns and outcomes of TBI according to occupational status which can inform prevention and planning of services and can serve to plan priorities for further research.
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Eur J Trauma Emerg Surg · Dec 2021
Radiographic predictors of therapeutic operative intervention after blunt abdominal trauma: the RAPTOR score.
Bowel and mesenteric injuries are rare in patients following blunt abdominal trauma. Computed tomography (CT) imaging has become a mainstay in the work-up of the stable trauma patient. The purpose of this study was to identify radiographic predictors of therapeutic operative intervention for mesenteric and/or bowel injuries in patients after blunt abdominal trauma. ⋯ CT imaging remains vital in assessing for potential bowel and/or mesenteric injuries following blunt abdominal trauma. The RAPTOR score provides a simplified approach to predict the need for early therapeutic operative intervention.