European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2022
Review Meta AnalysisSciatic nerve injury after acetabular fractures: a meta-analysis of incidence and outcomes.
To investigate the incidence and the outcome of post-traumatic and iatrogenic sciatic nerve palsy (SNP) associated with fractures of the acetabulum. The results of sciatic nerve grafting for treatment were also investigated. ⋯ A favorable outcome of both post-traumatic and iatrogenic SNP related to acetabular fractures has been found. Due to the poor results of sciatic nerve grafting, a "wait and see" approach may be the best option, in cases of a contused but anatomically intact sciatic nerve.
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Eur J Trauma Emerg Surg · Aug 2022
Comparison of long-term outcomes from rib fractures for patients undergoing both operative and non-operative management: a survey analysis.
Surgical stabilization of rib fractures (SSRF) has been gaining popularity for the treatment of rib fractures. Limited literature exists regarding the long-term effects of SSRF versus non-operative (NO) intervention. The goal of this study is to better understand these long-term effects, hypothesizing SSRF patients have better outcomes. ⋯ Patients who undergo SSRF show significant long-term improvements in pain scores and better return to baseline function with less overall issues from their rib fractures compared to those managed non-operatively.
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Eur J Trauma Emerg Surg · Aug 2022
Review Meta AnalysisOpen plate fixation versus nailing for humeral shaft fractures: a meta-analysis and systematic review of randomised clinical trials and observational studies.
This meta-analysis compares open reduction and internal fixation with a plate (ORIF) versus nailing for humeral shaft fractures with regard to union, complications, general quality of life and shoulder/elbow function. ⋯ Nailing carries a lower risk of infection, postoperative radial nerve palsy, has a shorter operation duration and possibly a shorter time to union. Shoulder impingement requiring re-intervention, however, is an inherent disadvantage of nail fixation. Notably, absolute differences are small and almost all patients with radial nerve palsy recovered spontaneously. Satisfactory results can be achieved with both treatment modalities.
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Eur J Trauma Emerg Surg · Aug 2022
The effects of pelvic ring injuries on quality of life, physical, and mental health: results of a 2-year prospective cohort study.
Pelvic ring injuries are known to affect the patients' daily life in terms of physical functioning and quality of life (QoL). Still, prospective studies on the patient's perception over the first 2 years of rehabilitation are lacking. Therefore, patients cannot be properly informed about whether or when they will return to their pre-existing level of physical functioning and QoL. ⋯ Pelvic ring injuries have a large impact on the patients' daily life in the first 2 years of rehabilitation. Directly after the injury, physical functioning and QoL decrease strongly but then gradually improve over a 2-year period with about 75% of patients fully recovering. Female gender and high-energy trauma are shown to be independent predictors for not fully recovering. After 3 months, patients experience difficulties with both the physical and mental effects of the injury which continue to be present after 1 year.
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Eur J Trauma Emerg Surg · Aug 2022
Randomized Controlled TrialEfficacy and safety of the second in-hospital dose of tranexamic acid after receiving the prehospital dose: double-blind randomized controlled clinical trial in a level 1 trauma center.
Prehospital administration of tranexamic acid (TXA) to injured patients is increasing worldwide. However, optimal TXA dose and need of a second infusion on hospital arrival remain undetermined. We investigated the efficacy and safety of the second in-hospital dose of TXA in injured patients receiving 1 g of TXA in the prehospital setting. We hypothesized that a second in-hospital dose of TXA improves survival of trauma patients. ⋯ The second TXA dose did not change the mortality rate, need for blood transfusion, thromboembolic complications, organ failure and HLOS compared to a single prehospital dose and thus its routine administration should be revisited in larger and multicenter studies.