Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Dec 2011
Efficacy and safety of non-operative management of blunt liver trauma.
The liver is the most frequently affected organ during blunt abdominal trauma. Blunt liver trauma management has changed in the last two decades with the introduction of the computed tomography (CT) scan and non-operative management of stable patients. ⋯ Non-operative management is the treatment of choice for polytraumatized patients with blunt liver trauma who are hemodynamically stable. Non-operative management is an effective and safe treatment strategy. However, patients with an RTS score under 7.8 and other intra-abdominal non-liver injuries are at increased risk for an immediate surgical intervention.
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Eur J Trauma Emerg S · Dec 2011
Intramedullary femoral nailing through the trochanteric fossa versus greater trochanter tip: a randomized controlled study with in-depth functional outcome results.
In a level 1 university trauma center, an explorative randomized controlled study was performed to compare soft tissue damage and functional outcome after antegrade femoral nailing through a trochanteric fossa (also known as piriform fossa) entry point to a greater trochanter entry point in patients with a femoral shaft fracture. ⋯ Anatomical localization of the entry point seems to be important for per-operative soft tissue damage and subsequent functional impairment. However, the results of this study did not show appreciable differences between femoral nailing through the greater trochanter tip and nailing through the trochanteric fossa.
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Eur J Trauma Emerg S · Dec 2011
Effects on the ubiquitin proteasome system after closed soft-tissue trauma in rat skeletal muscle.
Previous studies have suggested that an increased catabolic stage of skeletal muscle in pathological situations is mainly a reflection of ubiquitin-proteasome system-controlled proteolysis. The proteolytic mechanisms that occur after local muscle trauma are poorly defined. We investigated the effects of closed soft-tissue trauma on ubiquitin-proteasome dependent protein breakdown in rats (n = 25). ⋯ Cellular levels of free and protein-conjugated ubiquitin were significantly elevated upon decreased proteolytic activity. Our data support an early-state anti-proteolytic role of the ubiquitin-proteasome pathway after local injury. This further implies that there is a yet-to-be elucidated complex regulatory mechanism of muscle regeneration that involves various proteolytic systems.
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Eur J Trauma Emerg S · Dec 2011
Partial liver herniation into the right chest following trauma: a delayed presentation as acute injury managed by laparoscopically assisted mini-thoracotomy.
Traumatic diaphragmatic rupture is a relatively uncommon occurrence, with an incidence of 0.8-5% reported in the literature. The reported percentage of missed diaphragmatic injuries that were discovered later ranges from 12 to 66%. Herniation of the liver through the right diaphragm has been reported in the literature after liver transplantation, and in trauma populations. ⋯ Right-sided diaphragmatic laceration, if diagnosed at the time of injury, may be repaired with the minimally invasive technique we describe here.