European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2022
Risk factors of hospitalization costs and length of stay for tibial plateau fractures.
This study aimed to analyze the factors influencing the length of stay (LOS) and the cost of hospital stay in patients with tibial plateau fractures (TPFs). ⋯ In this study, hypoproteinemia and the Schatzker classification appeared to be a useful indicator for predicting hospitalization costs for TPFs patients; Male hemoglobin level appears to be an independent risk factor for hospital cost and LOS.
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Eur J Trauma Emerg Surg · Aug 2022
Is it possible to improve prediction of outcome and blood requirements in the severely injured patients by defining categories of coagulopathy?
It has been suggested to define the Trauma-induced coagulopathy (TIC) with a PTratio threshold of 1.20. We hypothesized that a more pragmatic classification would grade severity according to the PTratio (or corresponding ROTEM clotting time: EXTEM-CT), and that this would correlate better with the need for blood products (BP) and prognosis. ⋯ In this study, we have described a pragmatic classification of coagulopathy utilizing PTratio and EXTEM-CT where increasing severity was associated with prognosis and the amount of BP administered. This could allow clinicians to better predict the outcome and anticipate the need for blood products.
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Eur J Trauma Emerg Surg · Aug 2022
Nonunion of traumatic rib fractures: a suitable indication for surgery?
Nonunion of traumatic rib fractures is a clinical/radiological diagnosis caused by an alteration of bone healing reparative process. Since it is a painful condition, nonunion has a significative impact on patient's morbidity and quality of life. The aim of this study was to evaluate the outcomes after surgical stabilization of ribs affected by nonunion after traumatic fractures. ⋯ Surgical stabilization in patients affected by rib nonunion can be safely performed with few complications, good clinical outcomes and satisfactory quality of life.
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Eur J Trauma Emerg Surg · Aug 2022
New ways of treatment of fractures of the humeral shaft: does the combination of intramedullary nail osteosynthesis and cerclage improve the healing process?
The humeral shaft fracture is a rare fracture of the long bones with various treatment options. Dreaded complications such as lesions of the radial nerve or non-unions make the decision for what kind of therapy option more difficult. Biomechanically the upper arm is mostly exposed to rotational forces, which affect intramedullary nail osteosynthesis. Additive cerclage may compensate for these in spiral fractures. The aim of this study is to investigate what effect a combination of intramedullary nail osteosynthesis and limited invasive cerclage has on the rate of healing. In addition, this study addresses the question if complications arise as a result of cerclage. ⋯ The healing process shows a non-union rate of 2.6%, and complications such as secondary radial nerve lesions of 4.6%. The antegrade intramedullary nail osteosynthesis with limited invasive, additive cerclage reduces the risk of non-union and does not lead to an increased risk of iatrogenic damage to the radial nerve. Wound healing was not impaired and there were no infections through the cerclage in our patient cohort.
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Eur J Trauma Emerg Surg · Aug 2022
Risk and prognostic factors of replantation failure in patients with severe traumatic major limb mutilation.
Traumatic mutilation of major limbs can result in limb loss, motor disability, or death. Patients who had replantation failure needed to undergo additional surgeries (even amputation) and had a longer length of hospital stay. Here, we determined the risk and prognostic factors of replantation failure in patients with traumatic major limb mutilation. ⋯ Lower limb trauma, mangled extremity severity scores, and cumulative water balance were associated with replantation failure, implying that fluid management is necessary for major limb salvage. More studies are needed to explore the predictive power of indicators related to tissue oxygenation and wound healing for replantation failure.