European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Oct 2022
Randomized Controlled TrialAre small-diameter intramedullary nails enough for treating simple diaphyseal tibial fractures? A comparative study between small versus large nails.
The aim of our study was to compare the results of using small-diameter versus large-diameter interlocking reamed intramedullary nails in treatment of simple tibial shaft fractures. ⋯ Small IMN showed comparable clinical and radiological results to large IMN with lesser operative and radioscopic time. We can recommend that small IMN should be used more often in treating simple stable tibial fractures.
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Eur J Trauma Emerg Surg · Oct 2022
Percutaneous operative treatment of fragility fractures of the pelvis may not increase the general rate of complications compared to non-operative treatment.
Despite an increasing number of fragility fractures of the pelvis (FFP) over the last 2 decades, controversy persists on their therapy with special regard to potential complications. Therefore, the present study compared the complication rates and in-hospital mortality of non-operative therapy, percutaneous treatment and open reduction and internal fixation (ORIF) of pelvic fractures in elderly patients. ⋯ Complication rates and hospital mortality in elderly patients with FFPs are high and associated with long LOS. For surgical treatment of FFPs, the complication rate and mortality can be significantly reduced using percutaneous procedures compared to ORIF. Therefore, percutaneous surgery should be preferred where possible.
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Eur J Trauma Emerg Surg · Oct 2022
Plate fixation of the anterior pelvic ring in patients with fragility fractures of the pelvis.
In fragility fractures of the pelvis (FFP), fractures of the posterior pelvic ring are nearly always combined with fractures of the anterior pelvic ring. When a surgical stabilization of the posterior pelvis is performed, a stabilization of the anterior pelvis is recommended as well. In this study, we aim at finding out whether conventional plate osteosynthesis is a valid option in patients with osteoporotic bone. ⋯ There is a high rate of SL in plate fixation of the anterior pelvic ring in FFP. In the vast majority, SL is located near to the pubic symphysis. DPO is associated with a lower rate of SL, less severe SL and a later onset of SL. Revision surgery is less likely in DPO. In FFP, we recommend DPO instead of SPO for fixation of fractures of the anterior pelvic ring, which are located in or near to the pubic symphysis.
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Eur J Trauma Emerg Surg · Oct 2022
Observational StudyDiagnostic accuracy of ultrasonography for diagnosis of elbow fractures in children.
Elbow injuries and fractures are a common pathology in the pediatric emergency unit. X-ray and CT scan of the elbow are the standard diagnostic procedures, which increase exposure to radiation in children. Previous studies have shown that fractures can also be visualized by ultrasound (US); thus, this study aimed to evaluate the diagnostic accuracy of elbow US compared with radiography for the diagnosis of elbow fracture in children. ⋯ Our results showed high diagnostic accuracy for the ultrasonography diagnosis of an elbow fracture, which allows us to confirm ultrasonography imaging of the elbow as a safe alternative in the primary evaluation of pediatric elbow injuries.
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Eur J Trauma Emerg Surg · Oct 2022
Randomized Controlled TrialA new universal 3D-printable device to prevent excessive drilling in orthopedic surgery.
The occurrence of vascular injury during drilling is a rare but severe complication. Unfortunately, drilling protection systems are not available in all hospitals. Thanks to the development of 3D printing in recent years, sharing devices and materials to solve surgical problems has become easy and inexpensive. The objective of our work is to evaluate a universal, freely accessible, 3D-printable drilling protection device. ⋯ The device improves drilling in both expert surgeons and resident surgeons, showing greater benefits in the latter. The device is printable with any 3D printer, making it universally accessible, inexpensive, and effective, allowing expert surgeons to improve precision in high-risk situations and resident surgeons to improve their technique without increasing risk to the patient.