European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2014
The impact of body mass index on treatment outcomes among traumatic brain injury patients in intensive care units.
Obesity is a risk factor in treatment outcomes of critically ill patients. This study was conducted to determine the impact of obesity on the likelihood of recovery from traumatic brain injury (TBI) in intensive care unit (ICU) patients. ⋯ Obesity was associated with increased ICU mortality and prolonged dependency on mechanical ventilation, ILOS, and HLOS in patients with TBI. However, further prospective studies with larger sample sizes are needed to substantiate these findings.
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As more children and adolescents are involved in sporting activities, the number of injuries to immature knees rises. We will focus on three entities: ruptures of the anterior cruciate ligament, patellar dislocation, and meniscal injuries. There is a trend in recent literature toward early reconstruction of the anterior cruciate ligament in children and adolescents. ⋯ We will show diagnostic steps and risk factors for recurrent patellar dislocation, discuss conservative and different operative therapy options, and present a modified technique to achieve a dynamic reconstruction of the medial patellofemoral ligament without damage to the growth plates. Meniscal tears and discoid menisci are rare in comparison to the other injuries. We will herein explain what specialities in the anatomy should be considered in children and adolescents concerning the menisci, and present the diagnostic steps and treatment options available.
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Eur J Trauma Emerg Surg · Feb 2014
The impact of ETOH intoxication on the development of admission coagulopathy after traumatic brain injury: a prospective evaluation.
Coagulopathy after severe traumatic brain injury (sTBI) results in a ten-fold increased risk of death. Our aim was to investigate the effect of ETOH intoxication on admission coagulopathy after sTBI. ⋯ ETOH intoxication is associated with a lower incidence of admission coagulopathy in patients with sTBI. Further research is warranted.
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Eur J Trauma Emerg Surg · Feb 2014
Elastic stable intramedullary nailing (ESIN) in the adolescent patient-perils, pearls, and pitfalls.
Elastic stable intramedullary nailing (ESIN) has become the treatment of choice for diaphyseal long-bone fractures in children. This paper reviews the complications and limitations of this method which can occur when applying this osteosynthesis to patients within the adolescent age group. ⋯ The best prophylaxis for failure of ESIN is a stable and symmetric construct with correctly sized implants. This holds even more true for the adolescent patient. Using ESIN in difficult situations such as longitudinally unstable fractures, patients with a body weight >50 kg, or away from the diaphysis should be considered and followed up carefully. If possible, these patients should be treated in specialized pediatric trauma centers.