European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2024
Comparative StudyRetrograde intramedullary nail fixation with oblique fixed angle screws versus locking plates in periprosthetic supracondylar fractures after total knee arthroplasty.
Common surgical procedures in the treatment of periprosthetic distal femur fractures (PPFF) include osteosynthesis with fixed angle locking plates (LP) and retrograde intramedullary nails (RIN). This study aimed to compare LPs to RINs with oblique fixed angle screws in terms of complications, radiographic results and functional outcome. ⋯ Fractures treated with RIN resulted in an increased recurvation of the femur however the rate of complications and the functional outcome were comparable between the groups. The need for implant replacements following complications was higher in the LP group.
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Eur J Trauma Emerg Surg · Aug 2024
Posterior perforator tibial artery flaps for soft tissue defects of limbs: a retrospective cohort study.
To investigate the clinical effect of posterior perforator tibial artery flaps on repairing soft tissue defects of limbs. ⋯ Posterior perforator tibial artery flaps have the advantages of relatively simple technique, few damage, few complications and satisfying appearance. It is a good choice for soft tissue defects of limbs.
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Eur J Trauma Emerg Surg · Aug 2024
Complex elbow fracture-dislocations- what factors are associated with a poor post-operative outcome?
Despite standardized treatment algorithms, patients with complex elbow fracture-dislocation frequently suffer from poor post-operative elbow function leading to reduced quality of life. Up to now, there is no valuable data regarding risk factors that lead to poor post-operative outcome after surgical reconstruction of complex elbow fracture-dislocations. ⋯ In most cases, good post-operative functional results can be achieved using standardized treatment protocols. However, complication and revision rates remain high. Patients older than 70 years of age or with a BMI over 35 kg/m2 are at risk for an inferior outcome and require close follow-up monitoring.
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Eur J Trauma Emerg Surg · Aug 2024
Costs of fracture-related infection: the impact on direct hospital costs and healthcare utilisation.
Fracture-Related Infection (FRI) is associated with high medical costs and prolonged healthcare utilization. However, limited data is available on the financial impact. The purpose of this study was to investigate the impact of FRI on direct hospital costs and healthcare utilization. ⋯ Direct healthcare costs of patients with single occurrence of FRI after long bone fracture treatment are three times higher compared to non-FRI patients. In case of FRI-recurrence, the differences in costs might even increase to sevenfold. To put this in perspective, cost of severely injured trauma patients were recently established at approximately 25.000 euros. Compared to non-FRI patients, increased costs in patients with FRI or recurrent FRI are due to respectively a fivefold or even tenfold prolonged length-of-stay, two or seven additional infection-related surgeries and 21 or 55 days of intravenous antibiotic treatment. Not only from patient perspective but also from a financial aspect, it is important to focus on prevention of (recurrent) FRI.
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Eur J Trauma Emerg Surg · Aug 2024
Use of direct-acting anticoagulants (DOACs) delays surgery and is associated with increased mortality in hip fracture patients.
Treatment with direct-acting oral anticoagulants (DOACs) is increasing among hip-fracture patients, with accompanying safety concerns regarding spinal anesthesia (SA). The aim of this study was to investigate if DOAC use is associated with increased waiting time before surgery, increased mortality, or other adverse events. ⋯ DOAC users had a longer waiting time to surgery, indicating postponement of surgery due to concerns of the safety of SA. The clinical practice should be changed to allow earlier surgery for DOAC patients.