Helvetica chirurgica acta
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Helvetica chirurgica acta · Sep 1993
[Load stable, minimal fibula osteosynthesis in Weber type B malleolar fracture by hemicerclage].
Simple lateral malleolar fractures type B according to Weber can be fixed with a hemicerclage alone. Technique and results at sixteen own cases are shown. At this indication the hemicerclage is regarded as a good alternative to common methods of osteosynthesis. Advantages are simplicity, minimal damage of soft tissue and bone, high interfragmentary compression and allowed full weight bearing.
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Helvetica chirurgica acta · Sep 1993
[Computerized tomography follow-up in the acute phase after craniocerebral trauma].
Because of methodological reasons, within the first day after a head trauma, CT scan often does not demonstrate all the pathological consequences of brain injury. Additionally, secondary sequelae are frequent events. In our series of 129 patients the findings on subsequent CT scans done during the posttraumatic course were worse compared to the initial CT in 45% of patients. ⋯ In the vast majority of cases, this happened within the first 2 weeks after the initial trauma. We conclude that an initially pathological CT should be repeated early in the posttraumatic period even in patients with mild to moderate head injury. In particular, we recommend that patients having sustained diffuse brain injuries should be transferred to neurotraumatology units for specialised management, even when there may not be immediately obvious indications for surgical intervention.
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Helvetica chirurgica acta · Sep 1993
[Quality of emergency admission (resuscitation, REA) and first aid in multiple trauma].
Undue delay between hospital admission and the beginning or urgent operative procedures is considered as a major mortality risk for polytraumatized patients in any trauma center. As part of a quality control study at our institution (Kantonsspital, University of Basel), the time spent for early resuscitation and diagnostic procedures was therefore prospectively recorded in 20 patients (mean age 38 years) with a mean ISS of 26.9 (range: 13 to 43). Time spent in the resuscitation room averaged 31.4 min (range: 10 to 50 min). ⋯ Diagnoses established during this period were both accurate and comprehensive, as detectable from the low rate of missed diagnosis (three minor fractures). Although our results match favorably with figures reported in the literature we feel that further improvements could be achieved by performing the conventional radiographic procedures simultaneously with the early resuscitation in the resuscitation room. At present time, for reasons of X-ray protection, this is not possible in our institution.