The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Feb 2012
Randomized Controlled Trial Comparative StudyA comparison of absorbable screws and metallic plates in treating calcaneal fractures: a prospective randomized trial.
Intra-articular calcaneal fractures are more likely to suffer consequences in terms of pain and disability. Many studies have suggested that operative treatment for these fractures may result in better outcomes than nonoperative treatment. The metallic screws and plates are among the most common alternatives to stabilize calcaneal fractures. However, the complications of plating of calcaneal fractures are not uncommon. Complications such as infection, poor wound healing, and soft tissue irritation exist. With the advent of bioabsorbable screws, many reports have demonstrated favorable results in treating intra-articular fractures with these screws. The comparative outcomes of operative treatment of calcaneal fractures stabilized with plates and absorbable screws are rarely reported. The purpose of this study is to compare the clinical outcomes and complications related to fracture stabilization with plates and absorbable screws. ⋯ In this report, the outcomes of operative treatment with absorbable screws are comparable with the outcomes of operative treatment with plates. Both plates and absorbable screws showed favorable results in the surgical treatment of calcaneal fractures. However,the metallic plates were associated with increased complications. The stabilizations of displaced intra-articular calcaneal fractures with bioabsorbable screws are reasonable with advantages of fewer complications and without the need for screw removal.
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J Trauma Acute Care Surg · Feb 2012
Impact of isolated acetabular and lower extremity fractures on long-term outcome.
The long-term clinical status of surviving patients with multiple injuries has not been well described. The aim of this study was to evaluate the long-term outcome of acetabular and lower limb injuries. ⋯ Our results demonstrate a better long-term outcome in patients with femur shaft fractures, whereas patients with articular fractures and proximal femur fractures were associated with poorer outcomes. Fracture location is determining factor for long-term outcome
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J Trauma Acute Care Surg · Feb 2012
Acute kidney injury and posttrauma multiple organ failure: the canary in the coal mine.
Despite improved resuscitation strategies, acute kidney injury (AKI) remains an important cause of morbidity and high resource use among severely injured patients. Thus, we conducted a comprehensive evaluation of the epidemiology and outcomes of early AKI among severely injured patients as well as its impact on the development of postinjury multiple organ failure (MOF). ⋯ I, prognostic study.
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J Trauma Acute Care Surg · Feb 2012
Massive juxta-articular defects of the distal femur reconstructed by series connected double-strut free-vascularized fibular grafts.
We evaluate the clinical results of reconstructing massive juxta-articular defects of the distal femur (mean, 16.4 cm) with series-connected double-strut free-vascularized fibular grafting (FVFG) and external fixator fixation. ⋯ Massive juxta-articular defects of the distal femur are difficult and uncommon injuries. The results of this study indicate that the huge femoral defect reconstructed by series-connected double-strut FVFG provide good results in achieving bone union, reducing stress fracture rate, and achieving leg length equality.
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J Trauma Acute Care Surg · Feb 2012
Operating room or angiography suite for hemodynamically unstable pelvic fractures?
Few patients require angiography and therapeutic embolization for bleeding pelvic fractures, but they are risk for significant morbidity and mortality. In hemodynamically unstable trauma patients with pelvic fractures, the decision to proceed to the operating room (OR) to address intraabdominal bleeding, or angiography to address pelvic bleeding (ANGIO), is rarely straightforward. This study tested the hypothesis that outcomes are similar regardless if the sequence was OR-ANGIO or ANGIO-OR. ⋯ III, retrospective review.