Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Dec 2009
Effect of Intramedullary Nails in Tibial Shaft Fractures as a Factor in Raised Intracompartmental Pressures: a Clinical Study.
Tibial shaft fractures are the commonest cause of compartment syndrome. Intramedullary nails have been the most common treatment for such fractures. Raised pressures after nailing do not necessarily imply compartment syndrome, but are an important factor to consider when deciding on the appropriate treatment. ⋯ Reamed intramedullary nails can increase compartment pressures in tibial shaft fractures. The delta P value can influence the decision about whether to perform a fasciotomy. The diagnosis of compartment syndrome must be based on clinical findings. If there is any doubt, we recommend measuring the pressure and using a cut-off value for fasciotomy of delta P ≤ 40 mmHg. A delay in definitive treatment is suggested until pressure values are secure.
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Eur J Trauma Emerg S · Dec 2009
Post-traumatic Subserosal Small Bowel Herniation Leading to Obstruction in a Child with Acute Spinal Cord Injury.
The presentation of small bowel injury from lap belt use varies substantially, ranging from gross hemodynamic instability to insidious physiologic deterioration to simple failure of improvement. Rarely does small bowel injury manifest as an obstruction. This paper describes one such occurrence; in this case, herniation of intact mucosa/submucosa through a serosal tear caused a high-grade small bowel obstruction in a pediatric patient with an acute spinal cord injury and a virgin abdomen.