Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Aug 2007
Fixation of Proximal Humeral Fractures with an Intramedullary Nail: Tipps and Tricks.
Antegrade interlocking nailing has been established as a valid option of treatment in proximal humeral fractures which follows the principles of minimum invasive surgery. The introduction of angular stability into intramedullary nailing has increased the stability of reconstruction even in osteoporotic fractures. ⋯ The creation of the correct nail entry point is crucial for anatomic reduction and stability of the reconstruction, as well. The knowledge on intraoperative reduction aids and additional tools of enhancing the stability of the reconstruction alleviates a mechanically sound application of antegrade intramedullary nailing in most highly unstable proximal humeral fractures.
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Eur J Trauma Emerg S · Aug 2007
Perioperative Application of a Serum Protein Solution (Biseko(®)) After Proximal Femur Fracture of Elder Patients.
Fractures of the proximal femur are frequently seen in elderly people and will increase due to the demographic development of most industrialized countries. Early operation of dislocated fractures with either osteosynthesis or hemiprothesis has become a standard treatment for this type of injury. The high co-morbidity often leads to secondary complications like infections still resulting in a perioperative mortality rate of 11%. ⋯ Concerning IL-6, IL-8, IL-10 and serum leukocytes no significant differences were observed. The result shows a beneficial influence of the serum protein solution Biseko(®) concerning the number of perioperative complications. The design of this study and the small number of patients does not yet allow any conclusion concerning the effectiveness of this treatment.
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The surgical treatment of proximal humeral fractures constitutes a great challenge. Not all fracture types can be successfully reconstructed. Indications for a primary joint replacement arise from critical fracture patterns and defined ischemia-predicting criteria in the elderly. ⋯ Multicenter studies observed an averaged Constant Murlay Score of 56 to 73.5 points. 79% of the patients had no or only mild pain in the follow up, ROM was acceptable (41.9% Anteversion >90°, 34.7% Abduction >90°). Generally, subjective evaluations are much better than objective results. The incidence of complications after primary humeral head replacement is still relatively high, whereas the 10-year-survival-rate of shoulder hemiarthroplasties was found to be 100%, currently.
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Eur J Trauma Emerg S · Aug 2007
Stent Grafts for Acute Traumatic Injury of the Thoracic Aorta: A Single-Centre Experience.
The presented study reveals the single centre experiences with the minimally invasive endovascular repair for acute traumatic thoracic aortic lesions in the care of multitrauma patients. ⋯ The endovascular approach to acute traumatic thoracic aortic lesions is feasible, safe, and effective in multitrauma patients. The low endovascular therapy-related morbidity and mortality in the postoperative period is encouraging. The results seem to be favorable to those published of open emergency repair.
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Traumatic facial diplegia is an uncommon pathology, and is usually associated with bitemporal bone fractures. Traumatic Horner syndrome is mostly associated with carotid artery dissection. ⋯ The patient had developed his neurological deficits 9 days following trauma. We discuss the mechanisms of the facial palsy and Horner syndrome and the importance of their diagnosis.