Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Oct 2011
Thromboprophylaxis following major skeletal trauma: a systematic review.
Venous thromboembolic disease following skeletal polytrauma is a major issue for trauma surgeons, but there is no consensus of opinion regarding the optimal form of prophylaxis. The purpose of this paper was to compare the incidence of venous thromboembolic events (VTE) after major skeletal trauma managed with different prophylactic methods and their combinations. ⋯ There is currently insufficient research to be able to inform trauma surgeons as to the optimal method of thromboprophylaxis for patients following major skeletal trauma.
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Eur J Trauma Emerg S · Oct 2011
Influence of timing and oral anticoagulant/antiplatelet therapy on outcomes of patients affected by hip fractures.
Patients undergoing surgical procedures are usually asked to discontinue any anticoagulant/antiplatelet therapy and delay surgery for at least 5 days to reduce the risk of major bleeding and spinal hematoma. ⋯ The "discontinue drug, and delay surgery" strategy is not suitable for patients on anticoagulant (warfarin) therapy affected by a hip fracture.
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Eur J Trauma Emerg S · Oct 2011
Correlation between risk factors and subsequent surgical management following internal fixation of intracapsular femoral neck fractures in patients under the age of 60 years.
Regarding intracapsular femoral neck fractures, the main focus of research is the correlation between fracture-related complications and prognostic factors. To evaluate the correlation between complications required surgery (fracture-related treatment) and, among others, several less extensively investigated prognostic factors (day of surgery, co-morbidities, hospital type) in a 2-year period following internal fixation in patients under the age of 60 years with intracapsular femoral neck fracture. ⋯ To reduce the influence of risk factors, standardization of the substantive traumatologic and orthopedic professional guidelines, as well as the introduction of the "common orthopedic-trauma patient care" (British model) are suggested. To achieve high-quality standardized patient management, personal and material conditions are required to be accessible every day of the week. In the presence of co-morbidities, reduction of their harmful effects should be a major consideration by focusing on the patient in the peri-operative periods.
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Eur J Trauma Emerg S · Oct 2011
Brachial vessel injuries: high morbidity and low mortality injuries.
Reports of arterial injuries from both the civilian and military arenas report the brachial artery as the most frequently injured vessel, accounting for approximately 25-33% of all peripheral arterial injuries. The brachial artery is surrounded by important peripheral nerves -the median, ulnar and radial, and also parallels the humerus and associated veins. Due to its close proximity to these structures, associated nerve and osseous injuries are frequent with residual neuropathy from such nerve injuries, often the main sources of permanent disability. ⋯ The morbidity and mortality rates associated with brachial artery injuries depend on the cause of the injury itself, which vein or tendon is injured, and whether musculoskeletal and nerve injuries are also present. During the last 20 years, amputation associated with upper extremity arterial injuries has decreased to a rate of 3% because of advances in the treatment of shock, the use of antibiotic therapy, and increased surgical experience.
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Eur J Trauma Emerg S · Oct 2011
Subclavian vessel injuries: difficult anatomy and difficult territory.
Thoracic and thoracic related vascular injuries represent complex challenges to the trauma surgeon. Subclavian vessel injuries, in particular, are uncommon and highly lethal. Regardless of the mechanism, such injuries can result in significant morbidity and mortality. ⋯ These injuries are associated with significant morbidity and mortality. Patients who survive transport are subject to potentially debilitating injury and possibly death. Management of these injuries varies, depending on hemodynamic stability, mechanism of injury, and associated injuries. Despite significant advancements, mortality due to subclavian vessel injury remains high.