Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Jun 2009
A Lethal Case of Fat Embolism Syndrome in a Nine-Year-Old Child: Options for Prevention.
We report a lethal case of fat embolism syndrome in a nine-year-old child after a direct blunt trauma leading to a pelvic fracture. On the second day, signs of bowel perforation and septic shock led to an acute aggravation of the pulmonary symptoms, cardiac arrest and death. Fat embolism is seldom thought to occur in pediatric trauma patients; however, this case illustrates it can lead to disastrous sequela. Since there is no specific treatment for it, prevention by early fracture stabilization is the only option.
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Eur J Trauma Emerg S · Jun 2009
Bone Mineral Density is Not Correlated with One-Year Functional Outcome in Distal Radial Fractures: A Preliminary Study.
The intrinsic stability of fractures related to soft tissue injury and the comminution of the metaphyseal part of the distal radius influence the chance of secondary displacement in distal radial fractures treated conservatively. A low bone mineral density may also contribute to this secondary displacement and could therefore play a role in functional outcome. This possible relation between functional outcome and bone mineral density is poorly studied. ⋯ The functional outcome of conservatively treated distal radial fractures in this study does not correlate with bone mineral density. Therefore, BMD measurement cannot be used to predict functional outcome in these patients.
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Eur J Trauma Emerg S · Jun 2009
Coordination of Emergency Medical Services for a Major Road Traffic Accident on a Swiss Suburban Highway.
On 9th April 2008 at 2:14 p.m., on the highway between Lausanne and Vevey in western Switzerland, there was a 72-car pileup including five trucks that caused one death and injured 26 others. The relatively light toll was attributed to reduced vehicular speeds on account of foggy weather, together with the quick actions and effectiveness of the first responders and the excellent collaboration between the various rescue groups (medical rescue services, fire and police departments). ⋯ Two hours after the accident, the last of the injured had been evacuated and first aid on the site had ended. This article describes how the Emergency Medical Services from the State of Vaud, Switzerland, handled the situation and how the binomial team is structured.
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Eur J Trauma Emerg S · Jun 2009
Minimally Invasive Anterior Plate Osteosynthesis in Humeral Shaft Fractures.
Twelve patients with shaft fractures of the humerus were treated with percutaneous anterior plate osteosynthesis using a deltoid-pectoral respectively brachialis splitting approach without exposure of the radial nerve. The implants used were PHILOS plates, locking compression plates 3.5 and 4.5, and a tibial metaphyseal plate (all by Synthes). ⋯ There was one pseudarthrosis caused by a plate that was too short; another fracture probably healed but the distal screws broke; and one patient was lost to follow-up. Minimally invasive anterior plate osteosynthesis in humeral shaft fractures is an operative alternative which may be indicated not only in delayed healing or complex shaft fractures.
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Eur J Trauma Emerg S · Jun 2009
Injury to the Thoracic Aorta Following Fatal Blunt Trauma: An Autopsy Study.
Transection of the thoracic aorta (TTA) remains a leading cause of death after blunt trauma. In this autopsy study, the natural history of this injury is reviewed. ⋯ This study demonstrates that TTA is a frequent cause of immediate deaths among blunt trauma victims. Patients with risk factors for TTA who reach the hospital alive need to be promptly investigated with a contrast CT scan. Evidence of mediastinal hematoma is suggestive for possible rapid evolution.