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Comparison of analgesic efficacy of ibuprofen and dexketoprofen in pain management of long bone fractures: a prospective, randomized, double-blind study
ConclusionIbuprofen 800 mg demonstrated superior analgesic efficacy at 60 and 120 min compared to Dex in long bone fractures. These findings suggest ibuprofen ’s potential as an effective pain management option in emergency departments. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - April 23, 2024 Category: Emergency Medicine Source Type: research

Advancing pain management for extremity trauma: the evolution of ultrasound-guided nerve blocks for patients in the supine position in trauma centers
ConclusionUltrasound-guided nerve blocks present a promising avenue for early pain management in extremity trauma patients positioned supinely. Their implementation can lead to improved patient outcomes by alleviating pain severity, reducing opioid consumption, and cutting down healthcare costs. Further research and clinical integration of these techniques is imperative to enhance pain management protocols in trauma centers. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - April 22, 2024 Category: Emergency Medicine Source Type: research

No trauma-related diagnosis in emergency trauma room whole-body computer tomography of patients with inconspicuous primary survey
ConclusionNot one of the clinically asymptomatic patients had an imageable injury after WBCT diagnostics in this study. WBCT should only be performed in severely injured patients after clinical assessment regardless of “trauma mechanism.” According to guidelines and ATLS®, the clinical examination seems to be a safe and reliable method for reasonable and responsible decision-making regarding the realization of WBCT with all well-known risk factors. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - April 18, 2024 Category: Emergency Medicine Source Type: research

Comparison of the zonal distribution of calcium salt density and fat marrow in bone-healthy and osteoporotic sacra: an image data analysis using quantitative computed tomography and magnetic resonance imaging
ConclusionThe results suggest that in PEO sacral alae experience disproportionate skeletal rarefaction. This concerns the sacral ala at the S1 level ( − 25 ± 55), whereby the calcium salt content is so low that it corresponds to the S3 level of healthy bone (− 20 ± 21 HU). This explains the occurrence of transalar fractures in the load-transmitting zone S1. In PEOFx, the calcium salt density was higher and the fat content was low er on the fractured side than on the intact side, indicating bony compacting due to lateral compression and fat displacement due to hematoma in the accident mechanism.This study ...
Source: European Journal of Trauma and Emergency Surgery - April 17, 2024 Category: Emergency Medicine Source Type: research

Epidemiology and risk factors for fat embolism in isolated lower extremity long bone fractures
ConclusionFES increases mortality by seven times. Young age, obesity, and diabetes  mellitus are significant independent risk factors for FES. Early fixation is independently associated with a reduced risk of FES.Level of evidenceLevel III.Study typePrognostic study. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - April 17, 2024 Category: Emergency Medicine Source Type: research

Should the level of the posterior instrumentation combined with the intermediate screw be a short segment or a long segment in thoracolumbar fractures with fusion to the fractured segment?
ConclusionLSPI provides better postoperative kyphosis correction of the fractured vertebra than SSPI. Regarding the segment level of posterior instrumentation, there was no difference between the two groups in terms of the loss of achieved correction of VCA, ABH, and PBH at 1-year follow-up. Operating a thoracolumbar fracture with LSPI will lengthen the operation and increase the number of intraoperative fluoroscopies compared to SSPI. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - April 15, 2024 Category: Emergency Medicine Source Type: research

Interobserver variability in preclinical assessment of collision variables following traffic accidents
ConclusionSignificant differences in the assessment quality of technical accident parameters were observed based on technical and medical expertise. After user training, interdisciplinary differences were reconciled, and all professional groups yielded comparable results, indicating that training can enhance the assessment abilities of all participants in the rescue chain, while the time required for assessing accident parameters was significantly reduced with training. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - April 13, 2024 Category: Emergency Medicine Source Type: research

Elbow coverage by the descending superficial radial artery flap: a clinical series and literature review
ConclusionThe DSRA flap with an adipofascial pedicle is a simple, reliable, and reproducible method for reconstruction of small to moderate-sized defect on the posterior aspect of the elbow. Its use is easier for defects on the posterolateral side, but it can reach the medial olecranon. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - April 13, 2024 Category: Emergency Medicine Source Type: research

Anterolateral versus anteromedial plate osteosynthesis of midshaft humeral fractures; is there a difference in the rates of iatrogenic radial nerve palsy?
ConclusionThis study found that (in contrast to previous studies) there was no significant difference in the rates of IRNP following either open anterolateral or anteromedial plate osteosynthesis of midshaft humeral fractures through the anterolateral approach. Orthopaedic surgeons should therefore remain cautious when obtaining consent for surgery as well as when performing internal fixation of midshaft humeral fractures to limit medicolegal disputes that may arise from IRNP. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - April 11, 2024 Category: Emergency Medicine Source Type: research

Beyond expectations: safinamide ’s unprecedented neuroprotective impact on acute spinal cord injury
ConclusionThis study revealed that safinamide has neuroprotective effects against SCI due to its anti-inflammatory, antiapoptotic, and antioxidant activities. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - April 11, 2024 Category: Emergency Medicine Source Type: research

Incidence of adult rib fracture injuries and changing hospitalization practice patterns: a 10-year analysis
ConclusionThe incidence of rib fractures and the associated hospitalization rates are both increasing nationally, with half of cases occurring in patients aged 65  years or older. Our findings emphasize the urgent need to implement evidence-based preventive measures and current management guidelines when managing the increasing caseload of rib fracture injuries. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - April 9, 2024 Category: Emergency Medicine Source Type: research

A retrospective chart analysis with 5-year follow-up of early care for geriatric hip fracture patients: why we should continue talking about hip fractures
ConclusionWe have been able to maintain the early surgery hip fracture protocol in approximately 90% of the patients. Comorbidities and anticoagulant use were responsible for delayed surgery in the majority of the patients. Correct implementation of the existing protocol on anticoagulant use could lead to a one-third decrease in the number of delayed surgeries. Subsequently, since the LOS and ICU stay in the delayed surgery group were significantly longer, a further increase of early surgery will lower the current economic burden. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - April 9, 2024 Category: Emergency Medicine Source Type: research

Multi-centric study on organ donation after trauma: a cluster analysis
(Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - April 9, 2024 Category: Emergency Medicine Source Type: research

Costs of fracture-related infection: the impact on direct hospital costs and healthcare utilisation
ConclusionDirect healthcare costs of patients with single occurrence of FRI after long bone fracture treatment are three times higher compared to non-FRI patients. In case of FRI-recurrence, the differences in costs might even increase to sevenfold. To put this in perspective, cost of severely injured trauma patients were recently established at approximately 25.000 euros. Compared to non-FRI patients, increased costs in patients with FRI or recurrent FRI are due to respectively a fivefold or even tenfold prolonged length-of-stay, two or seven additional infection-related surgeries and 21 or 55 days of intravenous antibiot...
Source: European Journal of Trauma and Emergency Surgery - April 9, 2024 Category: Emergency Medicine Source Type: research

Cranio-cervical and traumatic brain injury patterns —do they differ between electric bicycle, bicycle, and motorcycle-induced accidents?
ConclusionThe overall pattern of head and cervical injuries in E-bikers resembles more to that of motorcyclists than that of bicyclists. As they are used by a more senior population, multiple risk factors apply in terms of complications and secondary intracranial bleeding. Our study suggests that preventive measures should be reinforced, i.e., use of helmets to prevent from intracranial injury. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - April 9, 2024 Category: Emergency Medicine Source Type: research