European journal of trauma and emergency surgery : official publication of the European Trauma Society
-
Eur J Trauma Emerg Surg · Aug 2020
ReviewInjury-related variation in patient-reported outcome after musculoskeletal trauma: a systematic review.
The purpose of this study was to explore injury-related characteristics that differentiate between patient-reported outcomes (PROs) following traumatic musculoskeletal injury. ⋯ Based on the included studies, we propose a framework where musculoskeletal injuries occur in one of 4 scenarios that is associated with a different context-dependent outcome: (1) polytrauma with neurotrauma, (2) polytrauma without neurotrauma, (3) high-energy monotrauma, and (4) low-energy monotrauma. Our results suggest that standardization of outcome instruments is needed to facilitate future meta-analyses that assess PROs in this population.
-
Eur J Trauma Emerg Surg · Aug 2020
Clinical and radiological short-term outcomes of pubic symphysis diastasis treated with modified pedicle screw-rod fixation.
Pubic symphysis diastasis with an incidence of approximately 20% in pelvic fractures is a severe lesion which needs to be treated properly. The objective of this retrospective study was to describe and evaluate the clinical and radiological outcomes including its advantages and limitations of this modified minimal invasive technique. ⋯ Modified PSRF can be performed as an alternative to manage pubic symphysis diastasis due to its merits of minimal invasive, less blood loss, less soft tissue injuries as well as shorter operation time, even with the early weight-bearing.
-
Eur J Trauma Emerg Surg · Aug 2020
Ankle torque-related fractures and its echo-fast diagnosis protocol.
Ankle torque is the most frequent injury mechanism encountered in traumatology. It usually develops as an ankle sprain, and often produces an ankle fracture. Signs and symptoms are very unspecific on the differential diagnosis, and conventional radiographs must be obtained to confirm it. ⋯ An ultrasound is at least as effective as conventional X-ray images when used in diagnosing ankle sprain-related fractures, regardless of age or sex and could in fact be better. The use of echography could reduce the number of radiographies performed when diagnosing these kinds of fractures, thereby reducing the amount of radiation exposure and expediting the diagnostic process as well as the "in situ diagnosis". Level of clinical evidence 2 [prospective cohort (N > 30 patients) study].
-
Eur J Trauma Emerg Surg · Aug 2020
Comparative Study Observational StudyA clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study.
Appendectomy is one of the most common operations. Laparoscopic appendectomy (LA) is considered first-line treatment, but the use of LA for treatment of complicated appendicitis remains controversial. Here, we performed a retrospective analysis to compare clinical outcomes between patients treated with LA and those who underwent open appendectomy (OA). ⋯ These results suggest that LA is a safe and efficient operative procedure that provides clinically beneficial advantages in comparison with OA. Thus, when possible, appendectomy for complicated appendicitis should be attempted using a laparoscopic approach.
-
Eur J Trauma Emerg Surg · Aug 2020
Smoking is associated with an improved short-term outcome in patients with rib fractures.
Smokers with cardiovascular disease have been reported to have decreased mortality compared to non-smokers. Rib fractures are associated with significant underlying injuries such as lung contusions, lacerations, and/or pneumothoraces. We hypothesized that blunt trauma patients with rib fractures who are smokers have decreased ventilator days and risk of in-hospital mortality compared to non-smokers. ⋯ Despite having more severe injuries and increased rates of pneumonia, smokers with rib fractures were associated with nearly a 40% decreased risk of in-hospital mortality and one less ventilator day compared to non-smokers. The long-term detrimental effects of smoking have been widely established. However, the biologic and pathophysiologic adaptations that smokers have may confer a survival benefit when recovering in the hospital from chest wall trauma. This study was limited by the database missing the number of pack-years smoked. Future prospective studies are needed to confirm this association and elucidate the physiologic mechanisms that may explain these findings.