Olecranon fractures in children: treatment of a rare entity
AbstractBackgroundOlecranon fractures are a rare entity in children. The classification and treatment strategies are still discussed controversially.MethodsA retrospective chart review of all patients  
Source: European Journal of Trauma and Emergency Surgery - November 24, 2020 Category: Emergency Medicine Source Type: research

Induced membrane technique: a critical literature analysis and proposal for a failure classification scheme
AbstractThe reconstruction of long-bone segmental defects remains challenging, with the three common methods of treatment being bone transport, vascularized bone transfer, and the induced membrane technique (IMT). Because of its simplicity, replicability, and reliability, usage of IMT has spread all over the world in the last decade, with more than 300 papers published in the PubMed literature database on this subject so far. Most of the clinical studies have reported high rates of bone union, yet some also include more controversial results with frequent complications and revision surgeries. At the same time, various expe...
Source: European Journal of Trauma and Emergency Surgery - November 23, 2020 Category: Emergency Medicine Source Type: research

Surgical management of peripheral artery pseudoaneurysm following orthopedic trauma: a report of 14 cases
ConclusionEarly diagnosis of pseudoaneurysm requires knowledge and a high index of suspicion. Surgical reconstruction of major arteries should always be done and ligation of major vessels can lead to catastrophes. Excision of pseudoaneurysm can be done when minor arteries are involved with the presence of good collateral circulation.Level of StudyLevel IV Study. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - November 23, 2020 Category: Emergency Medicine Source Type: research

Incidence, impact and risk factors for multidrug-resistant organisms (MDRO) in patients with major trauma: a European Multicenter Cohort Study
AbstractIntroductionThe burden of MDRO in health systems is a global issue, and a growing problem. We conducted a European multicenter cohort study to assess the incidence, impact and risk factors for multidrug-resistant organisms in patients with major trauma. We conducted this study because the predictive factors and effects of MDRO in severely injured patients are not yet described. Our hypothesis is that positive detection of MDRO in severely injured patients is associated with a less favorable outcome.MethodsRetrospective study of four level-1 trauma centers including all patients after major trauma with an injury sev...
Source: European Journal of Trauma and Emergency Surgery - November 22, 2020 Category: Emergency Medicine Source Type: research

Potential use of peptic ulcer perforation (PULP) score as a conversion index of laparoscopic-perforated peptic ulcer (PPU) repair
AbstractBackgroundLaparoscopic repair is a well-accepted treatment modality for perforated peptic ulcer (PPU). However, intraoperative conversion to laparotomy is still not uncommon. We aimed to identify preoperative factors strongly associated with conversion.MethodsA retrospective review of records of all PPU patients treated between January 2011 and July 2019 was performed. Patients were divided into three groups: laparoscopic repair (LR), conversion to laparotomy (CL), and primary laparotomy (PL). Patient demographics, operative findings, and outcomes were compared between the groups. Logistic regression analyses were ...
Source: European Journal of Trauma and Emergency Surgery - November 21, 2020 Category: Emergency Medicine Source Type: research

Investigation of the relationship of the number, localization, and displacement of rib fractures with intrathoracic structures and abdominal solid organ complications using computed tomography
ConclusionThe presence of a displaced rib fracture is a strong predictor of intrathoracic complications. A more careful intrathoracic evaluation of rib fractures with more than 2  mm displacement will contribute to patient management. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - November 19, 2020 Category: Emergency Medicine Source Type: research

Effectiveness of surgical fixation for rib fractures in relation to its timing: a retrospective Japanese nationwide study
ConclusionEarly surgical rib fixation was associated with better in-hospital outcomes, whereas later surgical rib fixation was not. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - November 18, 2020 Category: Emergency Medicine Source Type: research

Traumatic brain injury with concomitant injury to the spleen: characteristics and mortality of a high-risk trauma cohort from the TraumaRegister DGU ®
AbstractPurposeBased on the hypothesis that systemic inflammation contributes to secondary injury after initial traumatic brain injury (TBI), this study aims to describe the effect of splenectomy on mortality in trauma patients with TBI and splenic injury.MethodsA retrospective cohort analysis of patients prospectively registered into the TraumaRegister DGU® (TR-DGU) with TBI (AISHead ≥ 3) combined with injury to the spleen (AISSpleen ≥ 1) was conducted. Multivariable logistic regression modeling was performed to adjust for confounding factors and to assess the independent effect of sp...
Source: European Journal of Trauma and Emergency Surgery - November 18, 2020 Category: Emergency Medicine Source Type: research

Mass Casualty Incident (MCI) training in a metropolitan university hospital: short-term experience with MAss Casualty SIMulation system MACSIM ®
AbstractAimThe aim of this study was to test and validate a new hospital Mass Casualty Incident (MCI) training using MACSIM® (MAss Casualty SIMulation) system adapted to the specifications and MCI plan of a single hospital.MethodsThe original MCI training format called MACSIM-PEMAF (Piano di Emergenza per il Massiccio Afflusso di Feriti, i.e., hospital disaster plan for massive influx of casualties) was developed for the Italian Society for Trauma and Emergency Surgery (SICUT) in 2016. It uses MACSIM®, a simulation tool for the training and assessment of healthcare professionals in MCI management. Between 2016 and ...
Source: European Journal of Trauma and Emergency Surgery - November 18, 2020 Category: Emergency Medicine Source Type: research

Open abdomen in the trauma ICU patient: who? when? why? and what are the outcome results?
This study reviewed 188 cases, 46.8% (88) arrived from elsewhere with an open abdomen while 53.2% (100) did not; 46.8% suffered blunt trauma, 45.2% suffered gunshots, while 8.0% were stabbed. Ninety deaths (47.9%) occurred during the index admission with 57 (30.3%) within the first 30  days. For both death within 30 days and death as final outcome, the majority were blunt abdominal trauma, 51.1 and 52.6%, respectively. Out of 188 patients, 27.1% had definitive fascial closure and 26.6% remained with an open abdomen. The relevant variables related to failure to achieve fascial c losure were hypoalbuminemia (p&thin...
Source: European Journal of Trauma and Emergency Surgery - November 17, 2020 Category: Emergency Medicine Source Type: research

Prone ventilation as treatment of acute respiratory distress syndrome related to COVID-19
AbstractProne ventilation refers to the delivery of mechanical ventilation with the patient lying in the prone position. The improvement of oxygenation during prone ventilation is multifactorial, but occurs mainly by reducing lung compression and improving lung perfusion. CT imaging modeling data demonstrated that the asymmetry of lung shape leads to a greater induced pleural pressure gravity gradient when supine as compared to prone positioning. Although proning is indicated in patients with severe ARDS who are not responding to other ventilator modalities, this technique has moved away from a salvage therapy for refracto...
Source: European Journal of Trauma and Emergency Surgery - November 17, 2020 Category: Emergency Medicine Source Type: research

Biomechanical aspects of the posteromedial split in bicondylar tibial plateau fractures —a finite-element investigation
ConclusionsThe results indicate that the additional fixation of a posteromedial split fracture by plate osteosynthesis might be advantageous in bicondylar tibial plateau fractures treated with lateral plating. This might be even more important in patients with low bone quality. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - November 11, 2020 Category: Emergency Medicine Source Type: research

Thoracoabdominal injuries after a bomb explosion: blast injuries and their clinical effects
AbstractPurposeTo report the types and effects of injuries to the thoracoabdominal region caused by blast and emphasize the importance of the early detection of primary blast injuries.MethodsOf the 98 patients injured as a result of a bomb explosion, 31 with thoracoabdominal injuries were included in the study. The demographic and laboratory data, operations performed, and radiological findings were obtained from the electronic records of the patients. The injuries caused by the explosion were divided into four categories as primary, secondary, tertiary, and quaternary. The patients with a new injury severity score (NISS) ...
Source: European Journal of Trauma and Emergency Surgery - November 11, 2020 Category: Emergency Medicine Source Type: research

Thromboelastography is predictive of mortality, blood transfusions, and blood loss in patients with traumatic pelvic fractures: a retrospective cohort study
AbstractPurposeIn patients with traumatic pelvic fractures, thromboelastography (TEG) is a useful tool to rapidly evaluate and identify coagulation disturbances. The purpose of this study was to examine the coagulation kinetics of patients with traumatic pelvic fractures (pelvic ring and/or acetabulum) by analyzing the TEG results at initial presentation and its relationship with mortality and blood loss.MethodsA retrospective review at our Level-1 trauma center was conducted to identify Full Trauma Team activations (FTTa) with traumatic pelvic and/or acetabular fractures who were evaluated with a TEG on initial presentati...
Source: European Journal of Trauma and Emergency Surgery - November 11, 2020 Category: Emergency Medicine Source Type: research

Endovascular repair is a feasible option for superficial femoral artery injuries: a comparative effectiveness analysis
AbstractPurposeTo compare outcomes between open (OR) and endovascular repair following superficial femoral artery (SFA) injuries.MethodsThis is a cross-sectional study querying the 2012 –2014 National Inpatient Sample for SFA injuries. Patients were grouped into OR and stent-graft placement (SGP). Primary outcome was in-hospital mortality. Secondary outcomes included hospital length of stay (HLOS), fasciotomy and amputation rate, and cost. Wilcoxon rank-sum, Kruskal–Wallis, Chi -squared test with Bonferroni adjustment were used as appropriate;p 
Source: European Journal of Trauma and Emergency Surgery - November 5, 2020 Category: Emergency Medicine Source Type: research

Bone metabolism is a key factor for clinical outcome of tibial plateau fractures
ConclusionThis study demonstrated that potential IBM was an independent risk factor for a poor-to-fair clinical outcome. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - November 5, 2020 Category: Emergency Medicine Source Type: research

Prediction of culture-positive sepsis and selection of empiric antibiotics in critically ill patients with complicated intra-abdominal infections: a retrospective study
AbstractPurposeTo compare the mortality rates between culture-positive and culture-negative sepsis in complicated intra-abdominal infections (cIAI) and investigate the predictors of culture-positivity and their causative microorganisms.Materials and methodsThe medical records of 1581 adult patients who underwent emergency gastrointestinal surgery between January 2013 and December 2018 were reviewed retrospectively. A total of 239 patients with sepsis or septic shock who were admitted to an emergency department, underwent emergency surgery for cIAI, and needed postoperative intensive care unit care were included and divided...
Source: European Journal of Trauma and Emergency Surgery - November 3, 2020 Category: Emergency Medicine Source Type: research

Comparison between infrapatellar and suprapatellar approaches for intramedullary nailing for the fractures of the tibial shaft
This study aimed to compare the outcomes at the clinical and functional levels of suprapatellar (SP) and infrapatellar (IP) approaches for intramedullary nailing in treating tibial shaft fracture.MethodsPatients who underwent tibial shaft fracture intramedullary nailing by the SP approach or IP approach in a trauma center were retrospectively reviewed. The demographics, intraoperative fluoroscopy time, operation time, blood loss, irrigation volume, postoperative X-ray alignment, and complications of patients were compared between the two groups under different approaches. Lysholm knee score, visual analog score (VAS), and ...
Source: European Journal of Trauma and Emergency Surgery - November 3, 2020 Category: Emergency Medicine Source Type: research

Effects of COVID-19 pandemic on general surgical emergencies: are some emergencies really urgent? Level 1 trauma center experience
ConclusionIn this and similar pandemics, we suggest that a new algorithm is necessary to approach emergencies and the results of this study can contribute to that end. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - November 2, 2020 Category: Emergency Medicine Source Type: research

Comparison of the feasibility of 3D printing technology in the treatment of pelvic fractures: a systematic review and meta-analysis of randomized controlled trials  and prospective comparative studies
ConclusionsThe 3D group showed shorter operation time, less intraoperative blood loss, less complications, better quality of fracture reduction and fast function recovery. Therefore, compared with conventional ORIF, ORIF assisted by 3D printing technology should be a more appropriate treatment of pelvic fractures. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - November 1, 2020 Category: Emergency Medicine Source Type: research

Increased and unjustified CT usage in paediatric C-spine clearance in a level 2 trauma centre
ConclusionRadiographic imaging is frequently performed when clearing the paediatric cervical spine, although cervical spine injury is rare. Particularly CT scan usage has wrongly been emerging over time. Stricter adherence to current protocols could limit overuse of radiographic imaging, but ultimately there is a need for an accurate rule predicting which children really are at risk of injury. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - October 27, 2020 Category: Emergency Medicine Source Type: research

Minimally invasive posterior locked compression plate osteosynthesis shows excellent results in elderly patients with fragility fractures of the pelvis
ConclusionWe showed that MIPLCP osteosynthesis is a safe surgical alternative in patients with FFP 3 and FFP 4. This treatment is another way of maintaining a high level of stability in the osteoporotic pelvic ring with a relatively low complication rate, low radiation and moderate operation time and a good functional outcome. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - October 26, 2020 Category: Emergency Medicine Source Type: research

Nasogastric tube after small bowel obstruction surgery could be avoided: a retrospective cohort study
ConclusionsEarly NGT removal after ASBO surgery seemed to be feasible, safe and efficient, at least in selected patients. This primary study represents the initial foundations for building the implementation of ERAS protocols after ASBO surgery. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - October 23, 2020 Category: Emergency Medicine Source Type: research

An increasing trend in geriatric trauma patients undergoing surgical stabilization of rib fractures
AbstractPurposeThe proportion of geriatric trauma patients (GTPs) (age  ≥ 65 years old) with chest wall injury undergoing surgical stabilization of rib fractures (SSRF) nationally is unknown. We hypothesize a growing trend of GTPs undergoing SSRF, and sought to evaluate risk of respiratory complications and mortality for GTPs compared to younger adults (18–64  years old) undergoing SSRF.MethodsThe Trauma Quality Improvement Program (2010 –2016) was queried for patients with rib fracture(s) who underwent SSRF. GTPs were compared to younger adults. A multivariable logistic regression an...
Source: European Journal of Trauma and Emergency Surgery - October 23, 2020 Category: Emergency Medicine Source Type: research

Tibial plateau fractures in Belgium: epidemiology, financial burden and costs curbing strategies
ConclusionSince length-of-stay is the main driver of the total healthcare costs of tibial plateau fractures, guidelines on appropriate length-of-stay can help to decrease variability and curb the total healthcare costs, particularly of the non-operatively treated patients. Our performance was in line with this.Level of evidenceLevel IV. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - October 23, 2020 Category: Emergency Medicine Source Type: research

Drain versus no drain after hip hemi-arthroplasty for femoral neck fractures; differences in clinical outcomes
This study cohort included 900 patients (68% female), with a median age of 83.5 (IQR 78 –88), of which 544 (60%) had a wound drain. Patients with a wound drain needed more days to be ready for discharged (10.0 days (SD ± 43.3),P =  
Source: European Journal of Trauma and Emergency Surgery - October 21, 2020 Category: Emergency Medicine Source Type: research

Correction to: Effect of fracturoscopy on the incidence of surgical site infections post tibial plateau fracture surgery
The original version of this article unfortunately contained a mistake. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - October 20, 2020 Category: Emergency Medicine Source Type: research

More medications, more problems: results from the Sedation Level after Emergent Exlap with Packing for TRAUMA (SLEEP-TRAUMA) study
AbstractPurposeSedation management of trauma patients after damage control laparotomy (DCL) has not been optimized. We evaluated if shorter sedation exposure was associated with increased proportion of delirium-free/coma-free (DF/CF-ICU) days and change in time to definitive fascial closure (DFC).MethodsWe reviewed trauma DCL patients at an ACS-verified level I center over 5  years as shorter (SE) or longer than median (LE) sedation exposure. We compared demographics, injury patterns, hemodynamic parameters, and injury severity between groups. We calculated the propensity for each patient to achieve DFC using age, gen...
Source: European Journal of Trauma and Emergency Surgery - October 19, 2020 Category: Emergency Medicine Source Type: research

Comparison of surgical fixation and non-operative management in patients with traumatic sternum fracture
AbstractPurposeThe incidence of sternal fractures in blunt trauma patients lies between 3 and 7%. The role, timing and indications for surgical management are not well delineated and remain controversial for patients undergoing surgical stabilization of sternum fracture (SSSF). We sought to identify the national rate of SSSF in patients with a sternum fracture hypothesizing patients undergoing SSSF will have a decreased rate of mortality and complications.MethodsThe Trauma Quality Improvement Program (2015 –2016) was queried for patients with sternum fracture. Propensity scores were calculated to match patients under...
Source: European Journal of Trauma and Emergency Surgery - October 19, 2020 Category: Emergency Medicine Source Type: research

mTICCS and its inter-rater reliability to predict the need for massive transfusion in severely injured patients
ConclusionIn summary, reliability values need to be considered when making clinical decisions based on scoring systems. Due to its easy applicability and its almost perfect inter-rater reliability, even with non-specialists, the mTICCS might therefore be a useful tool to predict the early need for MT in multiple trauma. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - October 14, 2020 Category: Emergency Medicine Source Type: research

International cooperation group of emergency surgery during the COVID-19 pandemic
ConclusionSurgical team members have responded with leadership to the COVID-19 pandemic, with crisis management principles. Social media and videoconference have been used by the vast majority to access guidelines or to communicate during social distancing. The level of adoption of current recommendations is high for organizational aspects and surgical management, but not so for PPE training and availability, and anesthesiologic considerations. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - October 13, 2020 Category: Emergency Medicine Source Type: research

A novel lower bound for tip-apex distance
This study aims to demonstrate that TAD 
Source: European Journal of Trauma and Emergency Surgery - October 10, 2020 Category: Emergency Medicine Source Type: research

Pelvic angioembolization: how urgently needed?
ConclusionsTime to AE did not improve. Patients referred from CT are physiologically different from CS and should be analyzed accordingly, with CS resulting in faster time to AE in sicker patients. Contemporary resuscitation challenges the need for hyperacute AE as no patients exsanguinated despite time to AE of more than 2  h. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - October 9, 2020 Category: Emergency Medicine Source Type: research

Epidemiology and treatment of acute elbow dislocations: current concept based on primary surgical ligament repair of unstable simple elbow dislocations
ConclusionAcute elbow dislocations need identification of the precise injury pattern and instability after reduction of the elbow joint. To achieve a congruent and stable joint, we recommend primary surgical repair as first-line treatment for patients with unstable simple and complex elbow dislocation independent of age. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - October 9, 2020 Category: Emergency Medicine Source Type: research

Anterior supra-acetabular external fixation for tile C1 pelvic fractures: a digital anatomical study and a finite element analysis
AbstractObjectiveInvestigating the anatomical characteristics of supra-acetabular screw corridor as well as comparing the biomechanical stability between semi- and full-length screw external fixations for Tile C1 pelvic fractures.Methods50 male and 50 female uninjured pelvic CT data were converted into three-dimensional models and the supra-acetabular corridors were reconstructed by the Mimics software. The horizontal slice was redefined passing through the bilateral anterior inferior iliac spine and bilateral posterior superior iliac spine at the same time. On every horizontal slices, a 5  mm diameter virtual screw w...
Source: European Journal of Trauma and Emergency Surgery - October 8, 2020 Category: Emergency Medicine Source Type: research

The effect of postoperative respiratory and mobilization interventions on postoperative complications following abdominal surgery: a systematic review and meta-analysis
ConclusionThe use of postoperative expiratory resistance modalities (CPAP, EPAP, BiPAP, NIV) after abdominal surgery might prevent pulmonary complications and it seems the preventive abilities were largely driven by postoperative treatment with CPAP. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - October 6, 2020 Category: Emergency Medicine Source Type: research

Survey of trauma patients injured by falling or flying objects in Japan based on the Japan Trauma Data Bank
ConclusionThis is the first report to analyze trauma patients injured by falling/flying objects using the JTDB. Public health and emergency providers can use this information to anticipate the health-care needs after falling/flying object injuries. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - October 6, 2020 Category: Emergency Medicine Source Type: research

Epidemiology and predictors of traumatic spine injury in severely injured patients: implications for emergency procedures
This study aimed to identify the prevalence and predictors of spinal injuries that are suitable for immobilization.MethodsRetrospective cohort study drawing from the multi-center database of the TraumaRegister DGU®, spinal injury patients  ≥ 16 years of age who scored ≥ 3 on the Abbreviated Injury Scale (AIS) between 2009 and 2016 were enrolled.ResultsThe mean age of the 145,833 patients enrolled was 52.7  ± 21.1 years. The hospital mortality rate was 13.9%, and the mean injury severity score (ISS) was 21.8 ± 11.8. Seventy percent of ...
Source: European Journal of Trauma and Emergency Surgery - October 5, 2020 Category: Emergency Medicine Source Type: research

Impact of scaffold granule size use in Masquelet technique on periosteal reaction: a study in rat femur critical size bone defect model
ConclusionThe size of Herafill® granules has significant impact on the development of periosteal-like structures around the defect using Masquelet ’s induced membrane technique. Small granules show significantly increased regrowth of periosteum and improved bone formation adjacent to the induced membrane. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - October 5, 2020 Category: Emergency Medicine Source Type: research

The impact of a qualified medical documentation assistant on trauma room management
In this study, we analyzed the effect of a medical documentation assistant on documentation completeness in trauma room management in comparison to documentation by physicians involved in direct patient treatment.MethodsWe included all patients treated in the trauma room from 2016/01/01 to 2016/12/31 that were documented with the trauma module of the German Emergency Department Medical Record V2015.1. We divided the data into documentation by medical documentation assistant (DA, 07:00 to 17:00), physician in daytime (PD, 07:00 to 17:00), and physician at night (PN, 17:00 to 07:00). Data were analyzed for completeness (prim...
Source: European Journal of Trauma and Emergency Surgery - October 5, 2020 Category: Emergency Medicine Source Type: research

Current treatment and outcomes of traumatic sternovertebral fractures: a systematic review
ConclusionLiterature on traumatic sternovertebral fracture treatment is sparse. Findings indicate that in most patients, sternal fixation is not required to achieve sternal and spinal stability. However, results of the current review should be cautiously interpreted, since most included studies were of poor quality. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - September 30, 2020 Category: Emergency Medicine Source Type: research

Epidemiology of trauma presentations to a major trauma centre in the North West of England during the COVID-19 level 4 lockdown
ConclusionTrauma continues during lockdown, our MTC has continued to provide a full service during lockdown. However, trauma patterns have changed and departments should adapt to balance these alongside the COVID-19 pandemic. As the U.K. starts its cautious transition out of lockdown, trauma services are required to be flexible during changes in national social restrictions and changing trauma patterns. COVID-19 and lockdown state were found to have no significant impact on survival outcomes for trauma. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - September 29, 2020 Category: Emergency Medicine Source Type: research

Detailed information gain and therapeutic impact of whole body computed tomography supplementary to conventional radiological diagnostics in blunt trauma emergency treatment: a consecutive trauma centre evaluation
AbstractPurposeThe indication of whole body computed tomography (WBCT) in the emergency treatment of trauma is still under debate. We were interested in the detailed information gain obtained from WBCT following standardized conventional imaging (CI).MethodsProspective study including all emergency trauma centre patients examined by CI (focused assessment of sonography in trauma, chest and pelvic X-ray) followed by WBCT from 2011 to 2017. Radiology reports were compared per patient for defined body regions for number and severity of injuries (Abbreviated Injury Scale, AIS; Injury Severity Score, ISS), incidental findings a...
Source: European Journal of Trauma and Emergency Surgery - September 29, 2020 Category: Emergency Medicine Source Type: research

Anatomic reduction of the sacroiliac joint in unstable pelvic ring injuries and its correlation with functional outcome
ConclusionsAnatomic reduction was achieved in over 80% of patients in this study. When comparing the long-term well-being of patients with and without anatomic reduction of the posterior pelvis after sacroiliac joint disruptions, the results suggest that anatomical restoration of the joint is beneficial for the patients. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - September 29, 2020 Category: Emergency Medicine Source Type: research

Supplemental cerclage wiring in angle stable plate fixation of distal tibial spiral fractures enables immediate post-operative full weight-bearing: a biomechanical analysis
AbstractPurposeDistal tibial fractures generally require post-operative weight-bearing restrictions. Especially geriatric patients are unable to follow these recommendations. To increase post-operative implant stability and enable early weight-bearing, augmentation of the primary osteosynthesis by cerclage is desirable. The purpose of this study was to identify the stabilizing effects of a supplemental cable cerclage following plate fixation of distal tibial spiral fractures compared to solitary plate osteosynthesis.MethodsIn eight synthetic tibiae, a reproducible spiral fracture (AO/OTA 42-A1.1c) was stabilized by angle s...
Source: European Journal of Trauma and Emergency Surgery - September 27, 2020 Category: Emergency Medicine Source Type: research

Acute-on-chronic subdural hematoma: a new entity for prophylactic anti-epileptic treatment?
ConclusionAcSDH has a high risk for ASz, including status epilepticus, and is associated with unfavorable outcomes and high mortality. Thus, prophylactic treatment with antiepileptic drugs should be considered among this specific cohort of patients. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - September 27, 2020 Category: Emergency Medicine Source Type: research

Clinical results after surgical treatment of posterolateral tibial plateau fractures ( “apple bite fracture”) in combination with ACL injuries
ConclusionsPosterolateral tibial plateau fractures in combination with an ACL-tear, can cause persistent instability and increase rotational instability. Indication for treatment of these fractures is still under debate. From the biomechanical aspect the lack of more than 50% of the posterior horn of the lateral meniscus and dislocation/depression of more than 2  mm results in an increased rotational instability of the ACL deficient knee. Combined surgical treatment with ACL repair or reconstruction is a safe procedure that results in good, short-term clinical outcome, if our algorithm is followed. In addition this st...
Source: European Journal of Trauma and Emergency Surgery - September 25, 2020 Category: Emergency Medicine Source Type: research

Functional outcome predictors after spinal accessory nerve to suprascapular nerve transfer for restoration of shoulder abduction in traumatic brachial plexus injuries in adults: the effect of time from injury to surgery
ConclusionsExcellent or good functional outcomes for shoulder abduction were achieved by almost sixty percent of adults who underwent SAN-to-SSN transfer for reconstruction of traumatic brachial plexus injuries, associated or not with axillary nerve reconstruction strategies. Longer delays from injury to surgery predicted worse outcomes, and the best time frame seemed to be less than 6  months. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - September 25, 2020 Category: Emergency Medicine Source Type: research

The role of bed-side laparoscopy in the management of acute mesenteric ischemia of recent onset in post-cardiac surgery patients admitted to ICU
ConclusionsPost-cardiosurgical patients admitted to ICU have a relatively high rate of NOMI, in which CT-scan is often initially non-conclusive. Our data and those from the literature seem to show that in such cases bed-side DL may be an advantageous and safe procedure to avoid needless laparotomy and enables a more tailored open surgery. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - September 18, 2020 Category: Emergency Medicine Source Type: research

Transarterial embolisation is associated with improved survival in patients with pelvic fracture: propensity score matching analyses
ConclusionsTAE use was associated with improved survival at 28  days in patients with pelvic fracture and should therefore be considered in the management of severely injured patients with pelvic fracture. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - September 18, 2020 Category: Emergency Medicine Source Type: research