European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2021
Medial injuries of the clavicle: more prevalent than expected? A big data analysis of incidence, age, and gender distribution based on nationwide routine data.
Although shoulder-girdle injuries occur frequently, injuries of the medial part remain widely unexplored. This study overviews these rare injuries with a focus on incidence, age, and sex distribution in Germany. ⋯ MCIs appear more frequently than estimated so far and are distinguished from other clavicle fractures in that they occur more at higher age and peaking around 50 years. Further work on possible prevention strategies should focus on the most frequently affected groups of men around 20 and 50 years old.
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Patients with rib fractures (RF) may require prolonged mechanical ventilation and tracheostomy. Indications for tracheostomy in trauma patients with RF remain debatable. The goal was to delineate characteristics of patients who underwent tracheostomy due to thoracic versus extra-thoracic causes, such as maxillofacial-mandibular injury (MFM), traumatic brain injury (TBI), and cervical vertebrae trauma (CVT), and to analyze clinical outcomes. The predictive values of chest trauma scoring systems for tracheostomy were also evaluated. We hypothesized that tracheostomized patients were more severely injured with more ribs fractured and had more pulmonary co-injuries. ⋯ A quarter of mechanically ventilated patients with RF required tracheostomy. Tracheostomized compared to intubated patients were more severely injured with more ribs fractured and were intubated longer. An increased amount of RF was associated with an increase in tracheostomies, especially for thoracic reasons.
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Eur J Trauma Emerg Surg · Aug 2021
Validation of radiological reduction criteria with intraoperative cone beam CT in unstable syndesmotic injuries.
Acute unstable syndesmotic lesions are regularly treated with closed or open reduction and fixation with either a positioning screw or tight rope. Conventional fluoroscopy is limited to identify a malreduction of the ankle mortise. The aim of the study was to validate the reduction criteria of intraoperative cone beam CT in unstable syndesmotic injuries by analyzing the clinical outcome. ⋯ The reduction criteria in intraoperative cone beam CT applied to unstable syndesmotic injuries could be validated. Patients with an anatomic reduced acute unstable syndesmotic injury according to the criteria have a significantly better clinical outcome.
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Eur J Trauma Emerg Surg · Aug 2021
Outcome after treatment of distal radius fractures in the elderly using the IlluminOss® System.
Distal radius fractures are very common and account for approximately 17% of all fractures treated. Multiple treatment methods are available to treat these fractures, both operative and nonoperative. This study aimed at evaluating the functional and clinical outcomes after treatment of distal radius fractures with the IlluminOss® System in adult patients. ⋯ The IlluminOss® System is a feasible option to treat distal radius fractures with seemingly good clinical and functional outcome. One out of seven complications required surgical intervention. These outcomes justify more detailed prospective research.
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Eur J Trauma Emerg Surg · Aug 2021
Impact of pathologic body composition assessed by CT-based anthropometric measurements in adult patients with multiple trauma: a retrospective analysis.
In recent years, there has been mounting evidence on the clinical importance of body composition, particularly obesity and sarcopenia, in various patient populations. However, the relevance of these pathologic conditions remains controversial, especially in the field of traumatology. Computed tomography-based measurements allow clinicians to gain a prompt and thorough assessment of fat and muscle compartments in trauma patients. Our aim was to investigate whether CT-based anthropometric parameters of fat and muscle tissues show correlations with key elements of pre-hospital and clinical care in an adult population with multiple trauma. ⋯ CT-based assessment of abdominal fat and muscle mass is a simple method in revealing pathologic body composition in trauma patients. Our study suggests that obesity influences pre-hospital and ED treatment and early immune response in multiple trauma. Nevertheless, we could not demonstrate any significant effect of abdominal fat and muscle tissue parameters on the course of treatment, in particular the duration of mechanical ventilation, ICU length of stay and neurologic outcome.