European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Apr 2023
Intercalary fragments in posterior malleolar fractures: incidence, treatment implications, and distribution within CT-based classification systems.
Complex ankle fractures frequently include the posterior malleolus (PM). Despite advances in diagnostic and treatment strategies, PM fracture involvement still predisposes to worse outcomes. While not incorporated into the most common PM fracture classifications, the presence of an intercalary fragment (ICF) complicates treatment. This study aims to describe the incidence, morphology, and location of ICFs in PM fractures. ⋯ ICFs are frequently found in PM fractures; however, they are not incorporated into any of the common classifications. They are generally found in younger patients and associated with more complex PM fractures. As they can complicate reduction of the main fragment and may require direct exposure to restore joint congruency, ICFs should be considered in PM fracture classifications. Due to their location, the majority of ICFs are able to be accessed using a posterolateral approach.
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The purpose of this study was to assess trends in management of flail chest injuries over time and to determine impact on patient outcomes. ⋯ Over the past decade, we have seen increasing rates of regional anaesthesia and surgical rib fixation in the management of flail chest. This has resulted in lower requirements for and duration of invasive mechanical ventilation and intensive care unit stay but has not impacted mortality in this patient cohort.
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Eur J Trauma Emerg Surg · Apr 2023
Development and external validation of automated detection, classification, and localization of ankle fractures: inside the black box of a convolutional neural network (CNN).
Convolutional neural networks (CNNs) are increasingly being developed for automated fracture detection in orthopaedic trauma surgery. Studies to date, however, are limited to providing classification based on the entire image-and only produce heatmaps for approximate fracture localization instead of delineating exact fracture morphology. Therefore, we aimed to answer (1) what is the performance of a CNN that detects, classifies, localizes, and segments an ankle fracture, and (2) would this be externally valid? ⋯ II, Diagnostic imaging study.
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Eur J Trauma Emerg Surg · Apr 2023
Violence against women in Israel: injury mechanisms and clinical outcomes following hospitalization.
The objective of this study was to evaluate the relative contributions of different mechanisms of assault to injury and mortality in women in Israel. ⋯ Assault by mechanisms other than stabbing and shooting should be recognized as a source of severe morbidity and mortality in females.
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Eur J Trauma Emerg Surg · Apr 2023
Trochanter migrans: late complications due to displacement of the lesser trochanter in trochanteric fractures.
Complications associated with secondary displacement and migration of the lesser trochanter fragment in trochanteric fractures are rare. The complaints expressed by the patient may be misunderstood and attributed to implant-associated or patient-specific problems likely to occur after surgery. This series illustrates potentially dangerous late complications caused by secondary migration of the lesser trochanter. It may help focus the surgeon's attention on possible functional impairment and severe late complications caused by displacement of the lesser trochanter in trochanteric fractures that require prompt intervention.