European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2021
Distribution of radiation exposure in patients with partially stable and unstable pelvic ring fractures: first-time use of highly accurate assessment by Monte Carlo calculations.
Radiological examinations including X-ray and CT play a critical role in the assessment and treatment of trauma patients. The ionizing radiation used is known to be carcinogenic. However, little is known about the total radiation exposure in trauma patients. The objective of this study was to accurately estimate radiation exposure of patients with severe pelvic ring fractures. ⋯ This study showed that a substantial number of patients with partially stable and unstable pelvic ring fractures have an increased cancer risk due to trauma-related medical imaging. Physicians should be aware of the amount of radiation their patients are exposed to, and minimize imaging related increase of cancer risks during initial assessment, treatment and follow-up.
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Eur J Trauma Emerg Surg · Aug 2021
CT controlled results of direct reduction and fixation of posterior malleolus in ankle fractures.
The aim of this study was to present outcomes of operative treatment of the posterior malleolus fractures of type four of the Bartoníček/Rammelt classification. ⋯ Outcomes of the study demonstrated good mid-term results in type four fractures of the posterior malleolus treated by direct reduction from posterior approaches. Postoperative CT examination allowed evaluation of the accuracy of reduction of all fractures and reduction of the distal fibula into the fibular notch. Based on postoperative CT examination, it will be possible to assess the effect of reduction of individual lesions on the functional results.
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Eur J Trauma Emerg Surg · Aug 2021
Thyroid-stimulating hormone (TSH) is associated with 30-day mortality in hip fracture patients.
The aim of this study is to assess the possible association between thyroid-stimulating hormone (TSH) and mortality in hip fracture patients. ⋯ The study demonstrates increased 30-day mortality in surgically treated hip fracture patients with plasma TSH levels above the median (1.41 mIU/L) at admission, even after adjusting for age, sex and CCI.
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Eur J Trauma Emerg Surg · Aug 2021
Survey on structural preparedness for treatment of thoracic and abdominal trauma in German-speaking level 1 trauma centers.
Increasing sub-specialization has reduced the number of general surgeons involved in the care of trauma patients in German-speaking countries (Germany, Austria and Switzerland) over the past decades. Thus, the aim of this study was to assess, to what extent level 1 trauma centers are still prepared to provide immediate emergency surgery in patients with thoracic or abdominal trauma. ⋯ The majority of level 1 trauma centers in Germany, Switzerland, and Austria in the TR-DGU seem to be well prepared to treat severe injuries of the abdominal and thoracic cavities. In some centers, however, a surgeon able to perform an emergency laparotomy or thoracotomy is not available within 30 min.
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Eur J Trauma Emerg Surg · Aug 2021
Ligamentous Lisfranc injuries: analysis of CT findings under weightbearing.
The aim of this study was to investigate the influence of different ligamentous Lisfranc injuries on computed tomography (CT) findings under weight-bearing and to emphasize the indications for surgical treatment of their various types. ⋯ Unequivocal instability is observed with simultaneous transection of the Lisfranc ligament with both plantar ligaments. On CT used as diagnostic tool, plantar injuries at the basis of the second and the third metatarsal are indirect signs of violation of the ligaments and represent an indication for surgical treatment. When using magnetic resonance imaging as diagnostic tool, a ruptured Lisfranc ligament alone without dislocation does not necessarily need surgical intervention.