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
CT controlled results of direct reduction and fixation of posterior malleolus in ankle fractures.
The aim of this study was to present outcomes of operative treatment of the posterior malleolus fractures of type four of the Bartoníček/Rammelt classification. ⋯ Outcomes of the study demonstrated good mid-term results in type four fractures of the posterior malleolus treated by direct reduction from posterior approaches. Postoperative CT examination allowed evaluation of the accuracy of reduction of all fractures and reduction of the distal fibula into the fibular notch. Based on postoperative CT examination, it will be possible to assess the effect of reduction of individual lesions on the functional results.
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Eur J Trauma Emerg Surg · Aug 2021
Survey on structural preparedness for treatment of thoracic and abdominal trauma in German-speaking level 1 trauma centers.
Increasing sub-specialization has reduced the number of general surgeons involved in the care of trauma patients in German-speaking countries (Germany, Austria and Switzerland) over the past decades. Thus, the aim of this study was to assess, to what extent level 1 trauma centers are still prepared to provide immediate emergency surgery in patients with thoracic or abdominal trauma. ⋯ The majority of level 1 trauma centers in Germany, Switzerland, and Austria in the TR-DGU seem to be well prepared to treat severe injuries of the abdominal and thoracic cavities. In some centers, however, a surgeon able to perform an emergency laparotomy or thoracotomy is not available within 30 min.
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Eur J Trauma Emerg Surg · Aug 2021
Ligamentous Lisfranc injuries: analysis of CT findings under weightbearing.
The aim of this study was to investigate the influence of different ligamentous Lisfranc injuries on computed tomography (CT) findings under weight-bearing and to emphasize the indications for surgical treatment of their various types. ⋯ Unequivocal instability is observed with simultaneous transection of the Lisfranc ligament with both plantar ligaments. On CT used as diagnostic tool, plantar injuries at the basis of the second and the third metatarsal are indirect signs of violation of the ligaments and represent an indication for surgical treatment. When using magnetic resonance imaging as diagnostic tool, a ruptured Lisfranc ligament alone without dislocation does not necessarily need surgical intervention.
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Eur J Trauma Emerg Surg · Aug 2021
Distal pressure monitoring and titration with percent balloon volume: feasible management of partial resuscitative endovascular balloon occlusion of the aorta (P-REBOA).
Resuscitative endovascular balloon occlusion of the aorta (REBOA) increases proximal arterial pressure, but may also induce life-threatening distal ischemia. Partial REBOA (P-REBOA) is thought to mitigate distal ischemia during aortic occlusion. However, feasible indicators of the degree of P-REBOA remain inconsistent. We hypothesised percent balloon volume could be a substitute for pressure measurements of gradients during P- REBOA. This study aimed to compare balloon volume and arterial pressure gradient, and analysed with intra-balloon pressure and balloon shape. ⋯ Monitoring distal pressure and titrating percent balloon volume is feasible to manage P-REBOA. In this experiment, 60% balloon volume was enough inflation to elevate central pressure allowing distal perfusion. The intra-balloon pressure was not reliable due to the strong influence of proximal MAP and uneven change of the balloon shape.