European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2017
ReviewClinical research on postoperative trauma care: has the position of observational studies changed?
The postoperative care regimes of ankle fractures are studied for over 30 years and recommendations have shifted only slightly in the last decades. However, study methodology might have evolved. The aim of this study was to evaluate the changes in time in the design, quality and outcome measures of studies investigating the postoperative care of ankle fractures. ⋯ For postoperative care of ankle fractures, results of this study showed a relative decrease in the published number of RCTs. The overall quality of the published articles did not decline. In addition, a gradual shift from physician measured to patient-reported outcome variables was observed. However, it should be borne in mind that the findings are based on a small sample (n = 25).
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Eur J Trauma Emerg Surg · Feb 2017
ReviewOsteoporotic vertebral body fractures of the thoracolumbar spine: indications and techniques of a 360°-stabilization.
Unstable vertebral body fragility fractures of the thoracolumbar spine can occur with or without relevant trauma. Initially, a standardized diagnostic algorithm including magnetic resonance tomography is recommended to detect accompanied further vertebral body fractures, to interpret the individual fracture stability, and to screen for relevant traumatic intervertebral disc lesions. Aim of the therapy is to assure fast mobilization and to maintain spinal alignment. ⋯ With respect of type A fractures, a combined anterior-posterior approach including a primary cement-augmented posterior stabilization and anterior spondylodesis is indicated in those patients with relevant intervertebral lesions or in those suffering from high-energy accidents resulting in unstable burst-type fractures. The others will benefit from hybrid stabilizations including cement-augmented posterior stabilizations and cement augmentation (kyphoplasty) of the fractured level to gain a ventral transosseous stability. In addition, individually adapted antiosteoporotic therapy is essential.
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Eur J Trauma Emerg Surg · Feb 2017
ReviewConservative management of osteoporotic vertebral fractures: an update.
Adequate conservative management of osteoporotic vertebral fractures remains important in an aging population. ⋯ There is insufficient data to recommend the optimal conservative management for osteoporotic vertebral fractures. As such high-quality studies need to be conducted to establish a solid course of action.
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Eur J Trauma Emerg Surg · Feb 2017
Observational StudyTrauma team utilization of universal precautions: if you see something, say something.
The risks deriving from the lack of compliance with universal safety precautions (USPs) are unequivocal. However, the adoption of these prophylactic precautions by healthcare providers remains unacceptably low. We hypothesized that trauma teams are not routinely adhering to USPs and that a brief educational intervention, followed by real-time peer feedback, would substantially improve compliance rates. ⋯ Compliance with OSHA-required USPs during trauma team activations is unacceptably low, but can be dramatically improved through simple educational interventions, combined with real-time peer feedback.
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Eur J Trauma Emerg Surg · Feb 2017
Analysis of 41 suicide attempts by wrist cutting: a retrospective analysis.
Self-cutting injuries have a low mortality rate, but this type of injuries has special clinical significance because they have the potential of leading to devastating disability and repeated suicide attempts. The purpose of this study is to analyze the nature and outcomes of wrist-cutting injuries. ⋯ Level III, retrospective study.