European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2021
The impact of polyethylene abrasion on the occurrence of periprosthetic proximal femoral fractures in patients with total hip arthroplasty.
In addition to abrasion-induced osteolysis and ensuing instabilities, the polyethylene (PE) abrasion of total hip arthroplasty (THA) inlays can also cause gait instability due to the decentralization of the hip joint. The current literature yields, as yet, insufficient findings whether these two factors are linked directly or indirectly to a higher risk for periprosthetic proximal femoral fractures (PPFF). The aim of our retrospective evaluation is to analyse the impact of PE abrasion on the pathology of PPFF in patients with THA. ⋯ PPFF patients showed significantly higher rates of inlay erosion, resulting in femoral head decentralization and osteolysis. The higher rate of fracture is likely caused by the increasing instability of the implant fixation due to abrasion-induced osteolysis and the associated degradation of bone quality. It is conceivable that the abrasion and decentralization of the THA can also lead to gait instability, and thus, a higher proneness to falls. Gait instability can also be aggravated by increased granulation tissue and effusion due to the inlay abrasion. Although this cannot be substantiated by the investigation. In patients with decentralization of the THA and osteolysis, a radiological follow-up should be performed, and in case of gait instability (femoral head and) inlay replacements should be considered.
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Eur J Trauma Emerg Surg · Feb 2021
ReviewMay the initial CT scan predict the occurrence of delayed hemothorax in blunt chest trauma patients?
To assess the impact of delayed hemothorax on outcomes in blunt chest trauma patients without life-threatening condition at admission and characterize the predictive value of predefined anatomical factors for delayed hemothorax. ⋯ Delayed hemothorax is a frequent complication associated with increased risk of pulmonary infection. The posterior location and the displacement of at least one rib fracture in the initial CT scan were independent risk factors for predicting the occurrence of delayed hemothorax.
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Eur J Trauma Emerg Surg · Feb 2021
Multicenter StudyLong-term follow-up of patients treated for traumatic injury regarding physical and psychological function and health-related quality of life.
Trauma patients often suffer for long time after their injury with physical and psychological problems. Patient-reported outcome measurements (PROM) help us to understand outcomes beyond mortality. The aim of the study was to describe a sample of Swedish trauma patients, regarding their physical function, psychological morbidity, and quality of life after trauma. ⋯ Trauma patients had decreased physical function and psychological morbidity up to 1 year after the initial injury. Incorporating PROM in the follow-up after trauma is important to understand the patient's perspective of care and treatment.
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Eur J Trauma Emerg Surg · Feb 2021
Randomized Controlled TrialGene expression analysis of vastus medialis cells after tourniquet-induced ischemia during total knee arthroplasty: a randomized clinical trial.
Postoperative quadriceps muscle strength was lowered after tourniquet application during total knee arthroplasty (TKA). Furthermore, tourniquet application results in higher proteolytic activity within vastus medialis cells, without influence on the amount and function of mitochondria. The effects of the commonly utilized intraoperative tourniquet on gene expression within the human skeletal muscle cells are barely examined. The purpose of the present study was to analyze the gene expression within the skeletal muscle cells after tourniquet-induced ischemia to identify differential expressed genes (DEGs) and pathways. ⋯ Level I.
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Eur J Trauma Emerg Surg · Feb 2021
ReviewIntraosseous access in the resuscitation of trauma patients: a literature review.
Intraosseous (IO) catheters continue to be recommended in trauma resuscitation. Their utility has recently been debated due to concerns regarding inadequate flow rates during blood transfusion, and the potential for haemolysis. The objective of this review was to examine the evidence for intraosseous catheters in trauma resuscitation, and to highlight areas for future research. ⋯ Intraosseous catheters have high insertion success rates and a low incidence of complications in trauma patients. Existing evidence suggests that IO transfusion is not associated with haemolysis, however, further studies in humans are needed. There is a paucity of flow rate data for blood transfusion via IO catheters in this population, although much anecdotal evidence advocating their use exists.