European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2022
Complications following regional anesthesia versus general anesthesia for the treatment of distal radius fractures.
Open reduction and internal fixation (ORIF) are commonly utilized for the repair of distal radius fractures (DRF). While general anesthesia (GA) is typically administered for ORIF, recent studies have also demonstrated promising results with the usage of regional anesthesia (RA) in the surgical treatment of distal radius fractures. This study will compare complication rates between the use of RA versus GA for ORIF of DRFs. ⋯ With similar safety profiles, RA is a safe and reasonable alternative to GA when managing DRFs surgically. RA may be the preferred anesthetic technique for ORIF of DRFs in patients at high risk with GA, such as those with reactions to GA in the past or with significant cardiopulmonary risk factors.
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Eur J Trauma Emerg Surg · Dec 2022
Process times of severely injured patients in the emergency room are associated with patient volume: a registry-based analysis.
Hospitals involved in the care of severely injured patients treat a varying number of such cases per year. Large hospitals were expected to show a better performance regarding process times in the emergency room. The present investigation analyzed whether this assumption was true, based on a large national trauma registry. ⋯ Process times in the emergency room decreased consistently with an increase of patient volume per year. This decrease, however, was associated with a longer prehospital time.
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Eur J Trauma Emerg Surg · Dec 2022
Remote ischemic postconditioning protects against crush-induced acute kidney injury via down-regulation of apoptosis and senescence.
Acute renal failure due to crush syndrome is one of the leading causes of death in disasters. Ischemic Postconditioning (IPC) is a potentially effective strategy to protect against ischemic reperfusion injury, but a few studies noted its protective effect in crush induced acute kidney injury (AKI). Hence, this study investigated the optimal IPC strategy to prevent crush induced AKI and reveal related cellular mechanisms. ⋯ Performing 5 cycles of 1-min IPC would be a convenient, time-saving, and effective method to prevent crush-induced AKI by attenuating the release of nephrotoxic substances after decompression and downregulation of the expression of apoptosis and cellular senescence biomarkers.
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Eur J Trauma Emerg Surg · Dec 2022
Outcomes of plate osteosynthesis for displaced 3-part and 4-part proximal humerus fractures with deltopectoral vs. deltoid split approach.
Three part and four-part fractures of the proximal humerus offer challenges in reduction and plate fixation, with considerable debate about use of Deltoid splitting (DS) and Delto-pectoral (DP) approaches, especially when they involving the greater tuberosity. We prospectively compared the results using DS approach and DP approach in these cases, with special focus on functional outcomes, complications, and ease of tuberosity reduction. ⋯ Although surgical time was reduced and greater tuberosity reduction was easier in DS group, the other outcomes were similar; either surgical approach can be used based, and can be based on the experience and comfort level of the surgeon.
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Eur J Trauma Emerg Surg · Dec 2022
Incidence and treatment of hand and wrist injuries in Dutch emergency departments.
The purpose of this study was to describe the epidemiology, treatment and costs of hand and wrist injuries presenting to the Dutch ED. With increasing medical costs and crowding of emergency departments (ED), a more detailed description of emergency department attendance of hand and wrist injuries and their treatment may help to facilitate more adequate allocation of health care services. ⋯ III.