European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Oct 2022
The significance of a concomitant clavicle fracture in flail chest patients: incidence, concomitant injuries, and outcome of 12,348 polytraumata from the TraumaRegister DGU®.
Isolated clavicle fractures (CF) rarely show complications, but their influence in the thorax trauma of the seriously injured still remains unclear. Some authors associate CF with a higher degree of chest injuries; therefore, the clavicle is meant to be a gatekeeper of the thorax. ⋯ Due to the relevance of a concomitant CF fracture in FC, diagnostics should focus on finding CFs or rule them out. Combined costoclavicular injuries are associated with a significantly higher degree of thoracic injuries and longer hospital stays.
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Eur J Trauma Emerg Surg · Oct 2022
Short and long-term impact of sarcopenia on outcomes from emergency laparotomy.
Emergency laparotomy (EL) carries a high risk of morbidity and mortality, that is greater among older patients. Sarcopenia refers to an age- or pathology-associated muscle loss and has been demonstrated to correlate with poorer outcomes in several surgical conditions. This study assessed the impact of sarcopenia on morbidity and mortality in elderly patients undergoing EL. ⋯ Sarcopenia does not provide useful short-term prognostic information in elderly EL patients.
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Eur J Trauma Emerg Surg · Oct 2022
The ARISCAT score is a promising model to predict postoperative pulmonary complications after major emergency abdominal surgery: an external validation in a Danish cohort.
Postoperative pulmonary complications (PPCs) occur in up to 30% of patients undergoing surgery and are a significant contributor to the overall risk of surgery. A preoperative risk prediction tool for postoperative pulmonary complications could succour clinical identification of patients at increased risk and support clinical decision making. This original study aimed to externally validate a risk model for predicting postoperative pulmonary complications (ARISCAT) in a cohort of patients undergoing major emergency abdominal surgery at a Danish University Hospital. ⋯ ARISCAT was a promising tool to predict PPCs in a high-risk surgical population undergoing major emergency abdominal surgery.
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Eur J Trauma Emerg Surg · Oct 2022
Retrograde tibial nailing of far distal tibia fractures: a biomechanical evaluation of double- versus triple-distal interlocking.
Retrograde tibial nailing using the Distal Tibia Nail (DTN) is a novel surgical option in the treatment of distal tibial fracture. Its unique retrograde insertion increases the range of surgical options in far distal fractures of the tibia beyond the use of plating. The aim of this study was to assess the feasibility of the DTN for far distal tibia fractures where only double rather than triple-distal locking is possible due to fracture localisation and morphology. ⋯ The DTN with a distal double locking can, therefore, be considered for far distal tibia fractures where nailing would be preferred over plating.
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Eur J Trauma Emerg Surg · Oct 2022
Clinical outcomes in prone positioning for percutaneous fixation of posterior column acetabular fractures.
Percutaneous retrograde fixation of posterior column acetabular fractures is becoming a commonly practiced technique. Prone positioning provides reliably reproducible intraoperative fluoroscopic images necessary for precise preparation of the osseous fixation corridor necessary for accurate and safe implant placement. Additionally, the prone position facilitates an open posterior approach if an open reduction is necessary. The purpose of this study was to analyze the radiographic and clinical outcomes of retrograde posterior column fixation utilizing the prone position. ⋯ Prone positioning is a versatile and effective approach for retrograde percutaneous fixation of posterior column acetabular fractures. This study is the first to report clinical outcomes utilizing this technique and contributes to a growing body of the literature supporting the value and safety of percutaneous fixation of acetabular fractures appropriate for this fixation strategy.