European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2024
Complex elbow fracture-dislocations- what factors are associated with a poor post-operative outcome?
Despite standardized treatment algorithms, patients with complex elbow fracture-dislocation frequently suffer from poor post-operative elbow function leading to reduced quality of life. Up to now, there is no valuable data regarding risk factors that lead to poor post-operative outcome after surgical reconstruction of complex elbow fracture-dislocations. ⋯ In most cases, good post-operative functional results can be achieved using standardized treatment protocols. However, complication and revision rates remain high. Patients older than 70 years of age or with a BMI over 35 kg/m2 are at risk for an inferior outcome and require close follow-up monitoring.
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Eur J Trauma Emerg Surg · Aug 2024
Posterior perforator tibial artery flaps for soft tissue defects of limbs: a retrospective cohort study.
To investigate the clinical effect of posterior perforator tibial artery flaps on repairing soft tissue defects of limbs. ⋯ Posterior perforator tibial artery flaps have the advantages of relatively simple technique, few damage, few complications and satisfying appearance. It is a good choice for soft tissue defects of limbs.
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Eur J Trauma Emerg Surg · Aug 2024
Therapy aspects of peri-implant femoral fractures-a retrospective analysis of 64 patients.
The incidence of peri-implant femoral fractures (PIFF) is increasing. Information regarding outcomes, timing of surgery, risk factors, and a clinically applicable treatment algorithm are lacking. The aim of this study was to identify outcome-related risk factors and to derive a treatment algorithm. ⋯ Risk factors for 1-year mortality in patients with PIFFs were identified. A treatment algorithm and general principles for surgery of PIFFs were developed.
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Eur J Trauma Emerg Surg · Aug 2024
Costs of fracture-related infection: the impact on direct hospital costs and healthcare utilisation.
Fracture-Related Infection (FRI) is associated with high medical costs and prolonged healthcare utilization. However, limited data is available on the financial impact. The purpose of this study was to investigate the impact of FRI on direct hospital costs and healthcare utilization. ⋯ Direct healthcare costs of patients with single occurrence of FRI after long bone fracture treatment are three times higher compared to non-FRI patients. In case of FRI-recurrence, the differences in costs might even increase to sevenfold. To put this in perspective, cost of severely injured trauma patients were recently established at approximately 25.000 euros. Compared to non-FRI patients, increased costs in patients with FRI or recurrent FRI are due to respectively a fivefold or even tenfold prolonged length-of-stay, two or seven additional infection-related surgeries and 21 or 55 days of intravenous antibiotic treatment. Not only from patient perspective but also from a financial aspect, it is important to focus on prevention of (recurrent) FRI.
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Eur J Trauma Emerg Surg · Aug 2024
Interobserver variability in preclinical assessment of collision variables following traffic accidents.
Traffic accidents persist as a leading cause of death. European law mandates the integration of automatic emergency call systems (eCall). Our project focuses on an automated injury prediction device for car accidents, correlating technical and epidemiological input data, such as age, gender, seating position, impact on the passenger compartment, seatbelt usage, impact direction, EES, vehicle class, and airbag deployment. This study aims to explore interobserver variability in data collection quality in real accident scenarios. The assessment will evaluate the impact of user training and measure the time needed for data collection to inform user recommendations for the prehospital assessment. Insights from this study can aid in evaluating the ability of different professional groups to identify potential accident-independent parameters at accident scenes. This includes, among other things, relaying information to dispatchers at rescue control centers, also within the context of telemedicine approaches. ⋯ Significant differences in the assessment quality of technical accident parameters were observed based on technical and medical expertise. After user training, interdisciplinary differences were reconciled, and all professional groups yielded comparable results, indicating that training can enhance the assessment abilities of all participants in the rescue chain, while the time required for assessing accident parameters was significantly reduced with training.