European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2014
Clinical and functional outcomes of internal fixation with intertrochanteric antegrade nail in older patients with proximal extracapsular femoral fractures.
The intertrochanteric Trigen Intertan(®) nail (Smith & Nephew, Memphis, TN) is a popular fixation device for proximal extracapsular femoral fractures (PEFFs). We evaluated clinical and functional outcomes in patients with PEFFs treated with Trigen Intertan(®) nail. ⋯ Trigen Intertan(®) produces highly satisfactory clinical and functional results in older patients with PEFFs. Complete functional recovery is obtained on average 6 months after surgery.
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Eur J Trauma Emerg Surg · Aug 2014
Proper coding of the Abbreviated Injury Scale: can clinical parameters help as surrogates in estimating blood loss?
The Abbreviated Injury Scale (AIS) requires the estimation of the lost blood volume for some severity assignments. This study aimed to develop a rule of thumb for facilitating AIS coding by using objective clinical parameters as surrogate markers of blood loss. ⋯ We failed to develop a rule of thumb for facilitating a proper future AIS coding using the example of pelvic ring fractures. The estimation of blood loss for severity assignment still remains a noteworthy weakness in the AIS coding of traumatic injuries.
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Eur J Trauma Emerg Surg · Aug 2014
Challenges in the training of military surgeons: experiences from Dutch combat operations in southern Afghanistan.
To improve care for battle casualties, we analyzed the surgical workload during the Dutch deployment to Uruzgan, Afghanistan. This surgical workload was compared with the resident surgical training and the pre-deployment medical specialist program. ⋯ The injuries treated at the Dutch Role 2 MTF were often severe, and exposure to pediatric cases was much higher than reported for other combat hospitals in Iraq and in Afghanistan. The current civilian resident training does not equip the trainees with the minimally required competences of a fully trained military surgeon. The recognition in the Netherlands of military surgery as a subspecialty within general (trauma) surgery, with a formal training curriculum, should be considered. The introduction of a North Atlantic Treaty Organization Military (and Disaster) Surgery standard may facilitate the achievement of this aim.
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Eur J Trauma Emerg Surg · Aug 2014
Surgical stabilization of flail chest: the impact on postoperative pulmonary function.
Flail chest results in significant morbidity. Controversies continue regarding the optimal management of flail chest. No clear guidelines exist for surgical stabilization. Our aim was to examine the association of bedside spirometry values with operative stabilization of flail chest. ⋯ Operative stabilization of flail chest improved pulmonary function compared with preoperative results. This improvement was sustained at three months follow-up.
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Eur J Trauma Emerg Surg · Aug 2014
Wounds of war in the civilian sector: principles of treatment and pitfalls to avoid.
Terror attacks with explosive devices or mass shootings have introduced a new pattern of injuries into the civilian sector. The aim of this short review on the treatment principles for so-called penetrating war wounds is to remind surgeons who are not normally confronted with them of some basic rules to follow and pitfalls to avoid. ⋯ Certain knowledge of the treatment of war wounds is necessary in all civilian hospitals that receive patients injured in terror attacks.