Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Oct 2009
Pneumatosis intestinalis with gastric pneumatosis and hepatoportal venous gas in blunt abdominal trauma: A case report.
A case of transient pneumatosis intestinalis with gastric pneumatosis and hepatoportal venous gas following blunt abdominal trauma is described. The presence of intramural gas mostly implies intestinal necrosis, which needs emergent surgical exploration. This case demonstrates that conservative management with close clinical observation and follow-up computed tomography scan can be safely applied in selected cases of pneumatosis intestinalis with gastric pneumatosis and hepatoportal venous gas.
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Eur J Trauma Emerg S · Oct 2009
Treatment of nonunion of femoral neck fracture by valgus osteotomy in 33 cases.
In spite of advances in treatment, femoral neck fractures are complicated fractures with a relatively high incidence of nonunion. Between 1990 and 2004, 33 patients with nonunion of femoral neck fractures were treated by valgus osteotomy in our department. The mean age of patients at the time of operation was 38 years (range 16-60 years). ⋯ Postoperatively, the neckshaft angle was 140° (125°-160°), and shortening reduced to an average of 1 cm. Partial avascular necrosis of the femoral head developed in five patients after 6-12 months. Valgus osteotomy of the femur is a suitable procedure for treatment of femoral neck nonunion in young patients, since it is easy to perform and yields relatively good results.
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Eur J Trauma Emerg S · Oct 2009
Patient selection criteria for primary total hip Arthroplasty in displaced intracapsular hip fractures: Are they appropriate?
This study aims to determine, by outcome analysis, the appropriateness of current criteria employed to select patients for total hip arthroplasty (THA) as the primary treatment for displaced intracapsular hip fracture (DICHF). This study is intended to inform prospective randomised controlled trials investigating the efficacy of THA as a primary treatment. ⋯ If maintaining a high level of activity and independence is the expectation in patients considered for THA for DICHFs, then current selection criteria appear to be appropriate in identifying those capable of returning home, remaining independent and surviving to 1 year compared to the whole DICHF population. With a 75% 3-year survival, the postulated benefit of THA will not be realised in many patients and this needs to be considered. Cost-effectiveness trials are required before broad practice change occurs.
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Eur J Trauma Emerg S · Oct 2009
Development and validation of the revised injury severity classification score for severely injured patients.
Trauma scores are often used for prognostication and the adjustment of mortality data. The appropriate consideration of identified prognostic factors is mandatory for a valid score with good outcome prediction properties. The Trauma Registry of the German Society for Trauma Surgery (TR-DGU) initially used the Trauma and Injury Severity Score (TRISS) but various reasons led to the development of a new scoring system, the Revised Injury Severity Classification (RISC). ⋯ Outcome prediction including initial laboratory values was able to significantly improve the ability to discriminate between survivors and nonsurvivors. The adjustment of mortality rates should be based on the best available prediction model.