European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jan 2025
The effects of timing on fasciotomy outcomes in compartment syndrome - experience from crush-induced trauma following 2023 Turkey earthquakes.
This study was planned to evaluate limb survival and clinical outcomes of fasciotomies done before and after 24-48 h due to compartment syndrome in the extremities caused by crush injuries after the earthquakes in Turkey on February 6-7, 2023. ⋯ Fasciotomies earlier than 24 h prevented amputation and rate of muscle compartment excision was higher in fasciotomies done after 24 h especially for lower extremities. Upper extremity fasciotomy timing early or late did not change the outcomes.
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Eur J Trauma Emerg Surg · Jan 2025
European surgical societies rarely have recommendations for the treatment of appendicitis - a survey.
Guidelines for management and treatment of appendicitis recommends the removal of a normal-looking appendix, but the recommendations are deemed as weak because they are based on low quality evidence. We aimed to provide an overview of the recommendations from the European societies or associations of surgeons regarding the treatment of acute appendicitis and especially recommendations for the macroscopically normal-looking appendix. ⋯ Only two surgical societies had a published national recommendation or guideline on the treatment of suspected appendicitis, only one had a guideline for the management of the normal-looking appendix, and most societies answered that the operating surgeon decided.
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Eur J Trauma Emerg Surg · Jan 2025
Curative and preemptive treatment of amputee pain by targeted muscle reinnervation: experience from a French military trauma center.
Targeted muscle reinnervation (TMR) is a technique that has proven effective for the treatment and prevention of chronic pain following amputation, though its adoption remains limited. The authors report on their initial experience using TMR. ⋯ These results confirm the benefits of TMR for the curative treatment of RLP and PLP. However, within the limits of this small sample size, preemptive TMR did not show added value. TMR appears to be a complex technique that requires a learning curve.
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Eur J Trauma Emerg Surg · Jan 2025
LetterLetter to the editor regarding "a retrospective chart analysis with 5-year follow-up of early care for geriatric hip fracture patients: why we should continue talking about hip fractures".
Timing of surgery remains a topic of debate for hip fracture treatment in the geriatric patient population. The quality indicator "early surgery" was implemented in 2014 at the Department of Trauma Surgery of the University Hospitals Leuven to enhance timely operative treatment. In this follow-up study, we aim to evaluate the performance of this quality indicator, the clinical outcomes, and room for improvement. ⋯ We have been able to maintain the early surgery hip fracture protocol in approximately 90% of the patients. Comorbidities and anticoagulant use were responsible for delayed surgery in the majority of the patients. Correct implementation of the existing protocol on anticoagulant use could lead to a one-third decrease in the number of delayed surgeries. Subsequently, since the LOS and ICU stay in the delayed surgery group were significantly longer, a further increase of early surgery will lower the current economic burden.
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Eur J Trauma Emerg Surg · Jan 2025
Dual-energy CT in diagnosing sacral fractures: assessment of diagnostic accuracy and intra- and inter-rater reliabilities.
Evaluating sacral fractures is crucial in fragility fractures of the pelvis. Dual-energy CT (DECT) is considered useful for diagnosing unclear fractures on single-energy CT (SECT). This study aims to investigate the effectiveness of DECT in diagnosing sacral fractures. ⋯ Combined use of DECT with SECT improved the detection rate of sacral fractures and enhanced intra-rater and inter-rater reliability. High diagnostic accuracy was achieved regardless of the observer's experience. These results indicate that DECT is a useful imaging modality for diagnosing sacral fractures.