Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Feb 2009
Reconstruction of Large Diaphyseal Defects of the Femur and the Tibia with Autologous Bone.
Post-traumatic segmental bone defects of the femur and the tibia above the critical size require special attention because conventional bone grafts result in high rates of nonunion. The biological and biomechanical aspects of this challenging surgery, as well as ongoing refinements to achieve mechanically stable bone healing with correct bone alignment are reviewed. ⋯ Three patients with successful bone reconstruction using two-stage reconstruction with cancellous bone graft, double-barrel free vascularized fibula transfer and distraction osteogenesis are described. Advantages and disadvantages of these methods are discussed in accordance with recent literature.
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Eur J Trauma Emerg S · Feb 2009
How to Cover Soft-Tissue Defects After Injuries to the Leg in Precarious Conditions.
In precarious conditions, bone exposure on the leg is synonymous with amputation. The authors describe their experiences with such injuries in 15 patients. ⋯ The pedicled flap is an essential technique for fighting against infection, especially in cases where only poor technical and medicinal resources are available. This simple and reliable technique allows most tissue defects on the leg to be covered.
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Eur J Trauma Emerg S · Feb 2009
Minimal Invasive PHILOS(®)-Plate Osteosynthesis in Proximal Humeral Fractures.
The anterior delto-pectoral approach is the standard approach for the fixation of proximal humeral fractures with the PHILOS(®)-Plate system. However, this approach can impair the vascular supply and can increase avascular necrosis. The objective of this study was to evaluate the results and complexity of surgery of proximal humeral fractures with a minimal invasive (MIPO) approach. ⋯ The minimal invasive PHILOS(®) plate osteosynthesis through an antero-lateral delta-split approach proved to be an elegant procedure for selected fractures of the proximal humerus with a low morbidity and good functional outcome.
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Eur J Trauma Emerg S · Feb 2009
The Value of the Trauma Mechanism in the Triage of Severely Injured Elderly.
The triage of trauma patients is currently based on the trauma mechanism. However, it is known that elderly patients can sustain severe injuries due to insignificant trauma mechanisms. As such, triage methods might be questionable. ⋯ In elderly people a low energy trauma may lead to severe consequences. Not only the trauma mechanism, but also age, co-morbidity, and the likelihood of a brain injury should be leading in the triage and subsequent management of severely injured elderly.
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Eur J Trauma Emerg S · Feb 2009
Historical Treatment Results of Pelvic Ring Fractures: A 12-year Cohort Study.
Since the Academic Medical Center Amsterdam was appointed as a level-1 trauma center in July 1997, the number of polytrauma patients who were presented has increased. This stimulated us to perform a retrospective analysis on the treatment results of patients with a pelvic ring fracture and to evaluate our treatment strategies. ⋯ Evaluating two consecutive patient groups shows an increase in the number of fractures. A more aggressive surgical treatment has lead to lower mortality, improved anatomical reduction, and lower rate of complications.