Injury
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Minimally Invasive Plate Osteosynthesis (MIPO) has gained popularity with satisfactory clinical outcomes in the treatment of long bone fractures. MIPO for humeral shaft fractures, however, could be a surgically dangerous procedure because of the risk of radial nerve injury. An anatomical study was performed to evaluate the feasibility of MIPO for the humeral shaft fractures, and to study the relationship between the radial nerve and the plate with the forearm in full pronation and in supination. ⋯ The results of this study showed that it is possible to treat humeral shaft fractures by the MIPO method using an anterior approach. To reduce the risk of radial nerve injury, the forearm must be kept in full supination during plate insertion, and excessive force should be avoided during retraction of the lateral half of the brachialis muscle together with the radial nerve in the distal incision. The results of using this MIPO approach for humeral shaft fractures in 4 patients were also reviewed.
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Recombinant factor VIIa (rFVIIa) is a novel haemostatic agent originally developed to treat bleeding in haemophiliacs. Several case reports suggest effectiveness of rFVIIa in the treatment of patients without pre-existing bleeding disorders. The aim of this study is to evaluate treatment with recombinant (rFVIIa) in blunt trauma patients with uncontrolled bleeding. ⋯ Treatment with rFVIIa reduced or stopped bleeding in all patients. No adverse events were registered. Prospective studies are mandatory to elucidate the role of rFVIIa in blunt trauma.