European journal of trauma and emergency surgery : official publication of the European Trauma Society
-
Eur J Trauma Emerg Surg · Jun 2024
The pelvic vascular injury score (P-VIS): a prehospital instrument to detect significant vascular injury in pelvic fractures.
The purpose of this study was to identify predictive factors for peri-pelvic vascular injury in patients with pelvic fractures and to incorporate these factors into a pelvic vascular injury score (P-VIS) to detect severe bleeding during the prehospital trauma management. ⋯ The pelvic vascular injury score (P-VIS) allows an initial risk assessment for the presence of a vascular injury in patients with unstable pelvic injury. Thus, the management of these patients can be positively influenced at a very early stage, prehospital resuscitation performed safely targeted and further resources can be activated in the final treating Trauma Centre.
-
The aim of this study was to describe the incidence and a complex pathoanatomy of posterior malleolus fractures in a Maisonneuve fracture. ⋯ Our study has proved a high rate of posterior malleolus fractures associated with a Maisonneuve fracture, and documented their considerable variability in terms of involvement of the fibular notch, tibiotalar contact area, direction of displacement and frequency of intercalary fragments. Of no less importance is a combination of Tillaux-Chaput fractures with a Maisonneuve fracture.
-
Eur J Trauma Emerg Surg · Jun 2024
Functional outcomes after intramedullary nailing (C-Nail®) of severe calcaneal fractures with mean follow-up of 36 months.
Calcaneal fractures (CFs) are rare but potentially debilitating injuries. Apart from the open, far lateral or sinus tarsi approach, operative treatment can be performed minimally invasive and percutaneously with intramedullary nailing. In this study, we sought to investigate the functional outcome of severe CFs treated with the C-Nail® implant. ⋯ Intramedullary nailing of severe CFs with the C-Nail® implant can be considered a safe treatment alternative that yields acceptable results at mid-terms.
-
Eur J Trauma Emerg Surg · Jun 2024
Staged treatment of bicondylar tibial plateau fractures: influence of frame configuration and quality of reduction on outcomes.
Despite evolving treatment, the surgical management of high-energy tibial plateau fractures (TPF) remains challenging, associating high rates of complications. In recent decades, staged management has emerged as an encouraging option. The main goal of our study was to evaluate the influence of bridging external fixation (EF) frame configuration and the resultant quality of reduction (QOR) on outcomes after staged-treatment of bicondylar TPF. ⋯ Staged management of bicondylar TPF resulted in a reasonable rate of complications. A direct relationship between QORs obtained with EF and after ORIF was found. Squared frames were associated with faster and better reductions, regardless of the surgeon's background. Considering our results, we advocate for the wider use of squared EF configurations in these patients.
-
Eur J Trauma Emerg Surg · Jun 2024
Witnessed prehospital traumatic arrest: predictors of survival to hospital discharge.
Trauma patients are rapidly transported to the hospital for definitive care. Nonetheless, some are alive upon Emergency Medical Services (EMS) arrival but arrest on-scene or during transport. The study objective was to examine EMS-witnessed traumatic arrests to define patients who survived hospital discharge. ⋯ After EMS-witnessed traumatic cardiac arrest, survivors were more likely to be young, female, injured by blunt trauma, and less hypotensive/comatose on-scene. These findings may have implications for ED resuscitation or declaration of care futility and should be further investigated with a prospective multicenter study.