European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jul 2024
ReviewThe wide-awake local anesthesia no tourniquet (WALANT) technique in thumb injuries: a systematic review.
Human hands have a complex anatomical structure. The thumb, being an integral part of the hand, has an essential function in gripping. In this sense, thumb fractures account for 4% of all hand fractures (it may occur in association with fractures of the trapezium). The majority of hand fractures should be treated non-surgically and surgeons must avoid unnecessary surgery. Historically, hand surgery has used a combination of local/regional/general anaesthesia and a tourniquet. This study aims to carry out a systematic review to determine whether the WALANT technique is an advantageous alternative to conventional anaesthesia for surgical procedures on thumb injuries, in terms of patient function and pain. ⋯ WALANT is a convenient and favourable option in several studies. It has been demonstrated the benefits in terms of return to function and pain.
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Eur J Trauma Emerg Surg · Jul 2024
Lipopolysaccharide (LPS)-induced inflammation in RAW264.7 cells is inhibited by microRNA-494-3p via targeting lipoprotein-associated phospholipase A2.
Gram-negative bacterial lipopolysaccharide (LPS) is a major component of inflammation and plays a key role in the pathogenesis of sepsis. According to our previous study, the expression of lipoprotein-associated phospholipase A2 (Lp-PLA2) is significantly upregulated in septic patients and is positively correlated with the severity of this disease. Herein, we investigated the potential roles of Lp-PLA2-targeting microRNAs (miRNAs) in LPS-induced inflammation in murine mononuclear macrophages (RAW264.7 cells). ⋯ By targeting Lp-PLA2, miR-494-3p suppresses Lp-PLA2 secretion, thereby alleviating LPS-induced inflammation, which indicates that miR-494-3p may be a potential target for sepsis treatment.
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Eur J Trauma Emerg Surg · Jul 2024
Comparative clinical outcomes of irrigation techniques in burr-hole craniostomy for chronic subdural hemorrhage: a multicenter cohort study.
Chronic Subdural Hemorrhage(cSDH) is often treated with surgical blood drainage, but concerns about recurrence and outcomes persist. Surgical techniques, including irrigation, vary. This study compares the outcomes of irrigation in cSDH surgery. ⋯ Extensive irrigation may increase recurrence in cSDH drainage. Non-irrigation drainage had fewer recurrences, but unexpected complications arose. Careful drainage in non-irrigated cases is crucial.
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Eur J Trauma Emerg Surg · Jun 2024
Analysis of influential factors on surgical outcomes in pediatric femur neck fractures: a single-institution retrospective study.
This retrospective study aimed to evaluate surgical outcomes and identify influential factors in pediatric femoral neck fractures. ⋯ Surgical treatment yielded favorable clinical outcomes; however, limitations due to the study's retrospective design, limited sample size, and single-center approach underscore the necessity for larger multicenter studies. Our findings emphasize the need for comprehensive investigations to better understand and manage pediatric femoral neck fractures, especially regarding factors influencing AVN and long-term outcomes.
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Eur J Trauma Emerg Surg · Jun 2024
Assessment of the predictive factors and outcomes of surgically treated patients with depressed skull fracture at a tertiary hospital, Northwest Ethiopia.
Depressed skull fractures occur when a portion of the skull is displaced inward towards the brain, leading to complications such as intracranial hematoma, brain contusion, and intracranial infection. Managing these fractures necessitates a multidisciplinary approach, with postoperative management and rehabilitation playing crucial roles in optimizing patient outcomes. This study aimed to assess the predictive factors and outcomes of patients who underwent surgical treatment for depressed skull fractures. ⋯ The overall outcome of patients with depressed skull fracture was favorable. Factors associated with worse outcomes include compound fracture, low Glasgow Coma Scale at admission, presence of weakness, and presence of epidural hematoma. Complications associated with depressed skull fractures observed in our patients include wound infection, meningitis, brain abscess, osteomyelitis, PTSD, and hypocalcemia.