European journal of trauma and emergency surgery : official publication of the European Trauma Society
-
Eur J Trauma Emerg Surg · Aug 2022
Randomized Controlled TrialCemented long versus standard femoral stem in proximal femoral metastasis: a noninferiority single-blinded quasi-randomized clinical trial.
Proximal femur is a common site for metastasis, it has a significant impact on patient's quality of life, and traditional treatment aims at protecting as much as possible from the femur. However, recent studies have demonstrated increased rate of complications and questioned the need for long stem in this high-risk group. Our purpose is to determine whether standard-length femoral stem is noninferior to long femoral stem in the treatment of proximal femoral metastasis. ⋯ NCT04660591.
-
Delayed Haemorrhage (DH) is a potential complication following liver trauma. Hepatic artery pseudoaneurysms (HAPAs) are also a frequently considered delayed complication of liver trauma, yet their incidence is rare. Furthermore, little is known about their natural history, with some observed to resolve spontaneously. Some authors postulate that DH following liver trauma may in fact originate from HAPAs. ⋯ DH and HAPA following liver trauma are rare. DH following liver trauma was not associated with HAPA on imaging. This study shows that HAPAs cause ongoing insidious bleeding and Hb decline, but we did not find evidence to support the commonly held perception of a risk of 'rupture' and catastrophic haemorrhage.
-
Eur J Trauma Emerg Surg · Aug 2022
Randomized Controlled TrialPercutaneous fixation of intraarticular joint-depression calcaneal fractures with different screw configurations - a biomechanical human cadaveric analysis.
The aim of this study was to assess the biomechanical performance of different screw configurations for fixation of Sanders type II B joint-depression calcaneal fractures. ⋯ From a biomechanical perspective, posterior facet support by means of buttress or superiorly inserted longitudinal screws results in less plantar movement between the calcaneal tuberosity and the anterior fragments. Inferiorly inserted longitudinal screws are associated with bigger interfragmentary movements.
-
Eur J Trauma Emerg Surg · Aug 2022
Age itself or age-associated comorbidities? A nationwide analysis of outcomes of geriatric trauma.
Geriatric trauma patients present physiological challenges to care providers. A nationwide analysis was performed to evaluate the roles of age alone versus age-associated comorbidities in the morbidity and mortality of elderly patients with blunt abdominal trauma (BAT). ⋯ In patients with BAT, age itself appeared to have an independent and deleterious effect on mortality, but age-associated comorbidity did not.
-
Eur J Trauma Emerg Surg · Aug 2022
Efficacy of two integrated geriatric care pathways for the treatment of hip fractures: a cross-cultural comparison.
Many studies have focussed on the implementation and outcomes of geriatric care pathways (GCPs); however, little is known about the possible impact of clinical practices on these pathways. A comparison was made between two traumageriatric care models, one Swiss (CH) and one Dutch (NL), to assess whether these models would perform similarly despite the possible differences in local clinical practices. ⋯ This cross-cultural comparison of GCPs for geriatric hip fracture patients showed that quality of care in terms of mortality was equal. The difference in complicated course was mainly caused by a difference in delirium diagnosis. Differences were seen in surgical techniques, operation duration and timing. These clinical practices did not influence the outcome.