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
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
ReviewBiomechanical analysis of fixation methods in acetabular fractures: a systematic review of test setups.
Optimal anatomical reduction and stable fixation of acetabular fractures are important in avoiding secondary dislocation and osteoarthritis. Biomechanical studies of treatment options of acetabular fractures aim to evaluate the biomechanical properties of different fixation methods. As the setup of the biomechanical test can influence the experimental results, this review aimed to analyze the characteristics, comparability and clinical implications of studies on biomechanical test setups and finite element analyses in the fixation of acetabular fractures. ⋯ The limited comparability and restricted clinical implications should be kept in mind when interpreting the results of biomechanical studies and when designing test setups to evaluate fixation methods for acetabular fractures.
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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.
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Eur J Trauma Emerg Surg · Oct 2022
Multicenter StudyDoes surgical treatment for unstable fragility fracture of the pelvis promote early mobilization and improve survival rate and postoperative clinical function?
This retrospective multicenter study aimed to compare rates of early mobilization and survival and functional outcome of surgical treatment (S) with that of conservative treatment (C) according to each unstable fragility fracture of the pelvis (FFP) classification type with displacement of the posterior component ≥ 5 mm. ⋯ In this study, the superiority of surgical treatment for unstable FFP was not proven. However, the results suggest that type IVb may be a relatively stable type compared to type III and that type IVb should be considered separately from bilaterally complete unstable sacral fractures due to high-energy trauma.