Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Feb 2008
Evaluation of Factors Delaying Discharge in Acute Orthopedic Wards: a Prospective Study.
Prolonged hospitalization due to delayed discharge not only increases cost, it also increases the risk of medical complications e.g., hospital acquired infections. Length of stay (LOS) is one of the indicators that reflect total cost of care during hospitalization. The study was planned to evaluate the factors affecting delay in discharges from hospital and whether these factors are avoidable. ⋯ Older patients with co-morbidities are more prone to long stay due to de-conditioning requiring social input and nosocomial infection. The study thus proved the hypothesis and suggested that early identification of social issues and prompt discharge planning helps to avoid delay in discharge.
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Eur J Trauma Emerg S · Feb 2008
Long Term Outcomes after Arthroscopic Management of Tibial Plateau Fractures.
Tibial plateau fractures are efficiently treated using arthroscopy when limited to one condyle. Operative technique and early results are now well documented. However, long term results have not been widely reported. The goal of this study was to evaluate clinical and radiological outcomes of arthroscopically treated tibial plateau fractures in the long term. ⋯ Comparisons with historical long-term studies regarding open reduction and internal fixation show similar outcomes. No specific secondary degenerative problem would alleviate the advantages of the arthroscopic management of tibial plateau fractures in the early post-operative period.
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We present a case of a distal tibial fracture in a pregnant patient treated with an intermedullary device. The risks associated with operative treatment of fractures in pregnancy are discussed. ⋯ Surgical intervention allowed the mother to have a normal delivery. The patient had an excellent outcome with no adverse effects reported by either mother or baby.
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Eur J Trauma Emerg S · Feb 2008
Abdominal Compartment Syndrome in Severe Acute Pancreatitis - When to Decompress?
Intra-abdominal hypertension is increasingly reported in patients with severe acute pancreatitis, and is caused by several factors, including visceral edema and ascites associated with massive fluid resuscitation, paralytic ileus and retroperitoneal inflammation. There is a strong relation with early organ dysfunction and mortality in these patients, which makes intraabdominal hypertension an attractive target for intervention. ⋯ Several strategies to reduce IAP have been developed, and given the pathophysiology, percutaneous drainage of ascites is a first logical step. However, if conservative measures fail to reduce IAP in a setting with ongoing or worsening organ dysfunction, abdominal decompression is recommended.