Injury
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Hand trauma may lead to multiple fingertip defects, causing functional restrictions. We evaluated the use of reverse-flow homodigital flap reconstruction of the distal phalanx and pulp defects associated with multiple finger injuries. ⋯ The reconstruction of multiple fingertip injuries with reverse-flow homodigital flaps is a safe, effective method that can be combined with other local finger flaps. These flaps can be applied to two consecutive fingers without reducing finger length or function.
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Multicenter Study
How to define severely injured patients?-An Injury Severity Score (ISS) based approach alone is not sufficient.
Multiple injured patients, polytrauma or severely injured patients are terms used as synonyms in international literature describing injured patients with a high risk of mortality and cost consuming therapeutic demands. In order to advance the definition of these terms, we analysed a large trauma registry. In detail, we compared critically ill trauma patients first specified on a pure anatomical base according to the ISS or NISS, second in the original "polytrauma definition" with two body regions affected and finally all of them combined with a physiological component. ⋯ In our opinion the principle of sharpening an anatomically based definition by a defined physiological problem will help to specify the really critically ill trauma patients.
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We evaluated whether the location of a ballistic femoral fracture helps predict the presence of arterial injury. We hypothesized that fractures located in the distal third of the femur are associated with a higher rate of arterial injury. ⋯ A fracture line in the distal third of the femur after ballistic injury is six times more likely to be associated with arterial injury and warrants careful evaluation. Our data show that fracture location can help alert clinicians to possible arterial injury after ballistic femoral fracture.
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This study assessed the long-term outcome (>6 months, with a mean of 46 months after injury) of the conservatively treated radial head fracture type 1 of the Broberg-Morrey (B-M) modification of the Mason classification. The main aim of this study is to assess the limitations in ADL activities on long term following a conservative treatment for B-M 1 radial head fractures. ⋯ It appears that a B-M type 1 radial head fracture is not always accompanied with regaining full function on long term. To what extent these observed limitations influence patient behaviour and how treatment modalities influence these limitations should be the base of future prospective research.