Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Aug 2010
A Portable CT Scanner in the Pediatric Intensive Care Unit Decreases Transfer-Associated Adverse Events and Staff Disruption.
Computerized tomography (CT) is an important diagnostic tool in the management of critically ill children, especially those with neurosurgical problems such as traumatic brain injury. Traditionally, such scans require transfer to the radiology department (RD) at times of extreme physiological instability, such as incipient cerebral herniation, and exposes children with actual, or potential, spinal injuries to the risks of transfer. Moving children from pediatric intensive care (PIC), often overnight, also depletes units of senior staff. Portable CT (PCT) scanning offers a solution to this problem, and we assessed patient stability and staff time occupied during urgent CT scans before and after the introduction of a PCT scanner (CereTom(®)) in a regional neurosurgical pediatric intensive care unit (PICU). ⋯ PCT scanning is safe for unstable neurosurgical patients who need urgent diagnostic head CT, reducing the risks associated with transfer and the depletion of staff provision to the other children in the PICU. While this study did not specifically address image quality, all images were diagnostic regarding the indication for scanning.
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Eur J Trauma Emerg S · Aug 2010
Proximal Tibial Sleeve Fracture: Case Report of a Rare Injury and Review of the Literature.
A sleeve fracture occurs when a ''sleeve'' of cartilage or periosteum is avulsed with or without an osseous fragment, an injury most commonly reported in the patella. Proximal tibial sleeve fractures are extremely rare and we present a case in an adolescent male who had concomitant osteochondral as well as chondral fractures of his patella. ⋯ Given that the ''sleeve'' of the injury contains tissue with osteogenic potential, we recommend that displaced proximal tibial sleeve fractures should be managed operatively to avoid dysfunction of the extensor mechanism. These patients should also have perioperative assessment for occult osteochondral and chondral injuries that are potentially repairable and thus may have implications for prognosis.
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Eur J Trauma Emerg S · Aug 2010
The Kocher-Langenbeck Approach: Differences in Outcome of Transverse Acetabular Fractures Depending on the Patient's Position.
The Kocher-Langenbeck approach is most frequently used for open reduction and internal fixation of transverse acetabular fractures, the positioning of the patient still falling to the preference of the surgeon. The impact of 'prone' and 'lateral' positioning on radiographic outcome and postoperative complication rates was evaluated by this retrospective study. ⋯ The weight of the leg may make reduction more difficult in the lateral position, leading to a poorer radiographic outcome.
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Eur J Trauma Emerg S · Aug 2010
Disproportionate Acidosis After Traumatic Bladder Rupture: A Case-Control Study.
Traumatic bladder injury is rare and often missed on initial evaluation. We sought to identify early markers of bladder injury with a high sensitivity. ⋯ Disproportionate acidosis in the trauma patient is a sensitive indicator of bladder injury, especially with a pelvic fracture or hematuria. Fully resuscitated patients with persistent acidosis and an appropriate mechanism should be evaluated for bladder injury.