European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Apr 2021
Prospective validation of a new protocol with preperitoneal pelvic packing as the mainstay for the treatment of hemodynamically unstable pelvic trauma: a 5-year experience.
Hemodynamically unstable pelvic trauma has been a significant challenge even in most experienced Trauma Centres. In 2011 preperitoneal pelvic packing (PPP) was introduced in our Hospital as the first manoeuvre. This study aims to review overall mortality at 24 h from arrival in the emergency department. ⋯ In our experience, PPP resulted to be quick to perform and effective. No death occurred from direct pelvic bleeding.
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Eur J Trauma Emerg Surg · Apr 2021
Prolonged pain in patients with fragility fractures of the pelvis may be due to fracture progression.
Most fragility fractures of the pelvis (FFPs) are conservatively treated in the early phase. However, the definition of conservative treatment failure and the subsequent treatment protocol is controversial. Fracture progression (FP) sometimes occurs during conservative treatment of FFPs. This study aimed to assess the association between FP and prolonged pain in patients with FFPs receiving conservative treatment. ⋯ In patients with FFPs, prolonged pain was associated with FP (p = 0.022, OR 8.12). The presence of prolonged pain might help identify FP. If FP is identified, surgical treatment may be required with cautious follow-up particularly in cases, where FFP progresses to type III or IV fracture.
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Eur J Trauma Emerg Surg · Apr 2021
Nonunion of the radial neck in children: a rare but severe complication after fractures of the radial neck.
Nonunion of the radial neck poses an enormous challenge for treating surgeons. It is a very rare complication of the radial neck with limited experiences. In this current major study, the authors report of their own experiences concerning this problem. ⋯ Treatment of radial neck nonunion in children should not be delayed until pain, deformity and limited function occurs because this goes along with severe transition of the radial head right up to bone atrophy.
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Eur J Trauma Emerg Surg · Apr 2021
Evolution of high-energy pelvic trauma in southern Finland: a 12-year experience from a tertiary trauma centre.
We compared incidence, demographics, and injury mechanisms in severely injured patients with and without a pelvic ring fracture treated at a tertiary trauma centre. We also analyzed the changes in injury mechanisms that lead to high-energy pelvic trauma. ⋯ High-energy pelvic trauma can no longer be characterized as traffic accident injuries among young men. MVAs leading to pelvic trauma are decreasing and the most common injury mechanism is high fall. The patients are older and often female. Every fourth high-energy pelvic trauma was due to attempted suicide.
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Eur J Trauma Emerg Surg · Apr 2021
Third day laboratory follow-up: mandatory for surgical site infections of tibial plateau fractures.
Tibial plateau fractures are common fractures in adults and can be extremely challenging for surgeons. State-of-the-art therapy is open reduction and internal fixation (ORIF), although major complications of ORIF are surgical site infections (SSIs). This is especially critical on the proximal tibia, which is only sparsely covered by soft tissue and has a close relation to the knee joint. We analyzed SSIs after ORIF to correlate established laboratory parameters to the occurrence of SSIs. ⋯ We highly recommend a laboratory analysis with WBC count and CRP on the third day after ORIF. Patients with a CRP level above 100 mg/l should be closely watched, even if laboratory parameters few days later are adequate-since a one-time increase above this landmark might be a hint regarding the development of a SSI.