European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jun 2022
Short-term outcome of isolated lateral malleolar fracture treatment is independent of hospital trauma volume or teaching status: a nationwide retrospective cohort study.
In light of current discussions about centralisation and teaching in medicine, we wanted to investigate the differences in in-hospital outcomes after surgical treatment of isolated ankle fractures, taking into account high-volume centres (HVCs) and low-volume centres (LVCs) and teaching procedures. ⋯ We found significant differences between HVCs and LVCs in terms of in-hospital outcomes for ankle fractures. These differences could be explained due to a more severely ill patient population and more complex (also open) fracture patterns with resulting use of external fixation and longer duration of surgery. However, structural and organisational differences, such as an extended preoperative stays at HVCs and a higher teaching rate, were also apparent. No difference in mortality could be detected.
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Eur J Trauma Emerg Surg · Jun 2022
Advantages and limitations of intramedullary nailing for the surgical treatment of ipsilateral intertrochanteric and femoral shaft fractures: a retrospective comparative study based on propensity score matching.
The aim of the present study was to introduce surgical technique using long PFNA for the treatment of ipsilateral intertrochanteric and femoral shaft fractures, and evaluate the characteristics of this fracture by comparing its surgical outcomes with those of isolated intertrochanteric and femoral shaft fractures. ⋯ The surgical treatment of ipsilateral intertrochanteric and femoral shaft fractures using long PFNA was advantageous as it allowed both fractures on the same femur to be fixed in one go and showed good surgical outcomes. However, fixation of femoral shaft fractures might be insufficient depending on the fracture level and configuration, and can be a cause of hypertrophic non-union.
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Eur J Trauma Emerg Surg · Jun 2022
Results of revision intramedullary nailing with and without auxillary plate in aseptic trochanteric and subtrochanteric nonunion.
Aim of this study was to investigate whether limited open auxiliary angle stable plate fixation has an effect on functional and radiologic outcomes one year after revision intramedullary nailing in aseptic trochanteric and subtrochanteric fracture nonunion. ⋯ This study did not demonstrate significant differences in functional and radiologic outcomes following revision intramedullary nailing of aseptic trochanteric and subtrochanteric fracture nonunion. Limited open auxiliary plate fixation might be a reasonable option especially in cases of relevant varus axis deviation and comminuted or atypical fracture configurations, regardless of patients' age. Retrospectively registered with the German Clinical Trials Register (01/25/2021; ID: DRKS00024112).
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Eur J Trauma Emerg Surg · Jun 2022
Neurosurgical emergency management during the lockdown period in health care regions in Spain with different COVID-19 impact: lessons learned to improve outcomes on the future waves.
COVID-19 has overloaded health care systems, testing the capacity and response in every European region. Concerns were raised regarding the impact of resources' reorganization on certain emergency pathology management. The aim of the present study was to assess the impact of the outbreak (in terms of reduction of neurosurgical emergencies) during lockdown in different regions of Spain. ⋯ COVID-19 affected dramatically the neurosurgical emergency management. The most significant reduction in neurosurgical emergencies occurred on those regions that were hit unexpectedly by the pandemic, as resources were focused on fighting the virus. As a consequence, life-threating and non-life-threatening conditions' mortality raised. Results in regions who had time to prepare for the hit were congruent with an organized and sensible neurosurgical decision-making.
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Eur J Trauma Emerg Surg · Jun 2022
Relationship between door-to-embolization time and clinical outcomes after transarterial embolization in trauma patients with complex pelvic fracture.
While transarterial embolization (TAE) is an effective way to control arterial bleeding associated with pelvic fracture, the clinical outcomes according to door-to-embolization (DTE) time are unclear. This study investigated how DTE time affects outcomes in patients with severe pelvic fracture. ⋯ Shorter DTE time was associated with better survival in the first 24 h, as well as other clinical outcomes, in patients with complex pelvic fracture who underwent TAE. Efforts to minimize DTE time are recommended to improve the clinical outcomes in patients with pelvic fracture treated with TAE.