European journal of trauma and emergency surgery : official publication of the European Trauma Society
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The number of geriatric patients is increasing. These patients exhibit specific characteristics, which influence the type of fracture care. Many patients have comorbidities, which make them more vulnerable to surgical procedures. ⋯ The implants, which are used, are inserted through small incisions, placed deep under the skin and use long anatomic or osseous corridors. Intramedullary devices have important advantages. This paradigm shift takes the special challenges and requirements of geriatric patients into account.
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Eur J Trauma Emerg Surg · Apr 2019
Multicenter StudySimultaneous common bile duct clearance and laparoscopic cholecystectomy: experience of a one-stage approach.
The timing and optimal method for common bile duct (CBD) clearance and laparoscopic cholecystectomy remains controversial. Several different approaches are available in clinical practice. The current study presents the experience of two European hospitals of simultaneous laparoscopic cholecystectomy (LC) and intra-operative endoscopic retrograde cholangiopacreatography (IO-ERCP) done by surgeons. ⋯ Simultaneous LC + IO-ERCP is associated with few complications. Further studies investigating cost-benefit and patient satisfaction are warranted.
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Eur J Trauma Emerg Surg · Apr 2019
Minimally invasive surgical treatment using 'iliac pillar' screw for isolated iliac wing fractures in geriatric patients: a new challenge.
There have been no prior case series of isolated iliac wing fracture (IIWF) due to low-energy trauma in geriatric patients in the literature. The aim of this study was to describe the characteristics of IIWF in geriatric patients, and to present a case series of IIWF in geriatric patients who underwent our minimally invasive screw fixation technique named 'iliac pillar screw fixation'. ⋯ Geriatric patients can have a form of IIWF caused by low-energy trauma that is a type of fragility fracture of the pelvis. Because subsequent deterioration of their walking status followed by a long period of non-weight bearing in geriatric patients could be as threatening as the fracture itself, the treatment paradigm for IIWF due to low-energy trauma in geriatric patients should differ from that due to high-energy trauma in most patients. In these types of fractures, minimally invasive surgical management that includes iliac pillar screw fixation can lead to good outcomes.
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Eur J Trauma Emerg Surg · Apr 2019
Clinical characteristics and prognosis of traumatic head injury following road traffic accidents admitted in ICU "analysis of 694 cases".
The aim of the present study is to analyze the clinical and epidemiological characteristics of Traumatic Brain Injury (TBI) following Road Traffic Accidents (RTAs). Moreover, we aim to evaluate the outcome of the TBI victims referred to our medico-surgical Intensive Care Unit (ICU), and to define predictive factors associated with poor prognosis. ⋯ In Tunisia, traumatic brain injury due to RTAs is a frequent cause of ICU admission, especially among young adults, and is associated with high mortality and morbidity rates. The majority of the victims were motorcycle riders and/or passengers and pedestrians. The factors associated with a poor outcome were: age > 38 years, Glasgow Coma Scale score < 8, subdural hematoma, and development of secondary systemic insults (respiratory, circulatory, and metabolic). As a consequence, prevention is highly warranted.
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Eur J Trauma Emerg Surg · Apr 2019
Radiological classification of retroperitoneal hematoma resulting from lumbar vertebral fracture.
Lumbar vertebral fracture (LVF) infrequently produces massive retroperitoneal hematoma (RPH). This study aimed to systematically review the clinical and radiographic characteristics of RPH resulting from LVF. ⋯ LVF can directly produce massive RPH leading to hemorrhagic death. A major survey of such pathology should be conducted to establish appropriate diagnosis and treatment.