Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Apr 2011
Small bowel obstruction: early parameters predicting the need for surgical intervention.
To study and identify early clinical and radiological findings that could help to predict operative intervention for small bowel obstruction. ⋯ The presence of two or more early predictive factors as defined above, available at admission, significantly correlates with a likelihood of complete obstruction and the need of surgical intervention.
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Eur J Trauma Emerg S · Apr 2011
Anterior column reconstruction in thoracolumbar injuries utilizing a computer-assisted navigation system.
Discectomy, corpectomy, and resection of isolated posterior wall fragments are technically demanding steps requiring maximum surgical precision during anterior reconstruction of the unstable thoracolumbar spine. ⋯ Computer-aided guidance in anterior reconstruction of the thoracolumbar spine is a technically feasible option that may aid in the performance of disc- and corpectomy, as well as the resection of isolated posterior wall fragments in cases with initial neurological compromise. However, total time for surgery is significantly prolongated by this technique. There were no differences in the precision of cage positioning between groups. However, during discectomy, the use of computer navigation may aid in the protection of adjacent endplates, as there was a trend towards fewer cases with cage subsidence in the navigated group.
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Polytrauma patients usually suffer from both life-threatening injuries, where early intervention is mandatory in order to prevent mortality from uncontrollable haemorrhage-especially during the "golden hour", and secondary injuries of lower priority which receive delayed referral or treatment. Non-life-threatening injuries can sometimes be overlooked and so remain untreated until a much later stage. The aim of this study was to investigate the incidence of eye (ocular and orbital) injuries in polytrauma (injury severity score >15) patients and describe their complexities and outcomes. ⋯ Polytrauma patients are at high risk for vision-threatening injuries, and an early multidisciplinary approach is essential for early detection and treatment.
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Eur J Trauma Emerg S · Apr 2011
O-arm(®)-based spinal navigation and intraoperative 3D-imaging: first experiences.
Since the first use of instrument-tracking techniques in the early 1990s, image-guided technologies became a leading topic in all branches of spine surgery. Today, navigation is a widely available tool in spine surgery and has become a part of clinical routine in many centers for a large variety of indications. Spinal navigation may not only contribute to more precision during surgery, but it may also reduce radiation exposure and fluoroscopy time, with advantages not only for the patient but also for the operating room personnel. ⋯ In combination with the Stealth(®) station system, navigation may start immediately after automated registration with already referenced instruments. After instrumentation, an additional scan may confirm intraoperatively the correct positioning of the instrumentation. The first experiences with the system are described in this paper.
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Eur J Trauma Emerg S · Apr 2011
Doppler ultrasound for the assessment of conservatively treated blunt splenic injuries: a prospective study.
The type and need for follow-up of non-operatively managed blunt splenic injuries remain controversial. The use of Doppler ultrasound to identify post-traumatic splenic pseudoaneurysms, considered to be the main cause of "delayed" splenic rupture, has not been well described. ⋯ Doppler ultrasound can be an effective and a safe noninvasive modality for evaluation and follow-up of patients with blunt splenic injury. The utility and cost-effectiveness of routine surveillance requires further study.