European journal of trauma and emergency surgery : official publication of the European Trauma Society
-
Eur J Trauma Emerg Surg · Dec 2021
Minimally displaced acetabulum fractures in geriatric patients: a comparison of open, percutaneous and non-operative treatment from the German Pelvic Injury Register data.
In elderly patients with minimally displaced acetabulum fractures, the patients' inability to partially weight-bear and the need for early mobilisation may trigger the decision towards a treatment with higher primary stability. The purpose of this study was to compare open reduction and internal fixation (ORIF), closed reduction and percutaneous fixation (CRPIF) and non-operative treatment in geriatric minimally displaced acetabulum fractures with regard to complications and quality of reduction. ⋯ Both operative methods reduced fracture gap displacement. CRPIF was associated with lower blood loss and shorter operative time compared to ORIF (p < 0.001). Hospital stay was 12.9 days in the non-operative group, 16.8 with CRPIF and 23.6 with ORIF (p < 0.001). Non-surgical general complications were more likely to occur following ORIF (22.2%) compared to CRPIF (8.1%) and non-operative treatment (8.4%, p < 0.001). The rate of surgical complications was not different for ORIF and CRPIF (p = 0.122) CONCLUSION: Both operative treatments improve fracture displacement and joint congruency in elderly patients with minimally displaced acetabulum fractures. Compared to ORIF, CRPIF achieves similar quality of reduction but is associated with fewer complications, smaller intraoperative blood loss, shorter operative time and shorter length of hospital stay.
-
Eur J Trauma Emerg Surg · Dec 2021
Open abdomen closure methods for severe abdominal sepsis: a retrospective cohort study.
The open abdomen (OA) procedure as part of damage control surgery represents a significant surgical advance in severe intra-abdominal infections. Major techniques used for OA are negative pressure wound therapy (NPWT) and non-NPWT. The aim of this retrospective study is to evaluate the effects of different abdominal closure methods and their outcomes in patients presenting with abdominal sepsis treated with OA. ⋯ NPWT is the best temporary abdominal closure technique to decrease mortality and colostomy rates in patients managed with OA for severe intra-abdominal infections.
-
Eur J Trauma Emerg Surg · Dec 2021
Risk factors of non-union in intramedullary stabilized diaphyseal long bone fractures: identifying the role of fracture stabilization strategies and concomitant injuries.
Concomitant chest injury is known to negatively affect bone metabolism and fracture healing, whereas traumatic brain injury (TBI) appears to have positive effects on bone metabolism. Osteogenesis can also be influenced by the timing of fracture stabilization. We aimed to identify how chest injuries, TBI and fracture stabilization strategy influences the incidence of non-union. ⋯ Our results indicate that the number of operations performed in patients with long bone fractures should be kept as low as possible and that the indication for and the timing of DCO treatment should be meticulously noted to minimize the risk of non-union development.
-
Eur J Trauma Emerg Surg · Dec 2021
Characteristics of stepladder fall injuries: a retrospective study.
Stepladders are used to work at heights in daily life, but their structure and usage differs from that of a ladder; stepladders can fold and stand without support, whereas ladders cannot fold and, thus, require support from other objects. We hypothesised that this difference made ladder and stepladder fall injuries to differ in characteristics. To clarify this hypothesis, we performed a retrospective cohort study on the stepladder fall injuries and compared their characteristics with that of ladder fall injuries. ⋯ The current study found that the number of females sustaining injuries due to a stepladder fall was significantly higher than those due to a ladder fall. Furthermore, the most frequent body parts that needed surgery following a ladder fall injury were spine and upper extremity, whereas the most frequent body parts that needed surgery following a stepladder fall injury was lower extremity. Our study indicated that stepladder falls cause severe injuries and physical disability and can be a huge financial burden.
-
Rib fractures (RF) occur in 10% of trauma patients; associated with significant morbidity and mortality. Despite advancing technology of surgical stabilization of rib fractures (SSRF), treatment and indications remain controversial. Lack of displacement is often cited as a reason for non-operative management. The purpose was to examine RF patterns hypothesizing RF become more displaced over time. ⋯ RF become more displaced over time. Pain regimens and SSRF considerations should be adjusted accordingly.