Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Dec 2012
Invasive and surgical procedures in pre-hospital care: what is the need?
On occasion, advanced invasive procedures in pre-hospital care can be life saving. This study aimed to identify the contemporary use of these procedures on a regional doctor-led air ambulance unit, and to define the need, skill set and training requirements for a regional pre-hospital team in the UK. ⋯ A steady increase in the number of procedures was observed over time. Less invasive methods of airway and breathing support were frequently inadequate, though definitive surgical airway or chest decompression was effective each time it was performed. Thoracotomy was performed infrequently. There are implications for the training of pre-hospital doctors who work in the majority of the UK.
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Eur J Trauma Emerg S · Dec 2012
Treatment of radial head and neck fractures: in favor of anatomical reconstruction.
Radial head fractures represent the most common elbow fractures. Undisplaced fractures usually occur in isolation and can be treated nonsurgically. Displaced fractures should be treated surgically. ⋯ With the development of new locking plates especially designed for the maintenance of radial head fractures, the indications for osteosynthesis may be extended. As radial head fractures are complicated by a high percentage of ligamentous injuries and concomitant elbow fractures such as the coronoid, capitellum, and proximal ulna, these additional injuries have to be taken into account. The current treatment concepts are discussed within this paper.
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Acute elbow instability usually develops after injuries involving the bony or ligamentous stabilizers of the joint. It occurs frequently after dislocation and/or fracture-dislocation, but isolated valgus or varus overloading can also lead to ligament ruptures with subsequent instability. Chronic instability can result from incompletely healed acute injuries or from recurring microtrauma, for example after repetitive strain from participating in certain sports. ⋯ Stable conditions of the joint are essential for early functional post-traumatic or postoperative treatment of the elbow, as permanent mobility deficits may result otherwise. The following article gives an overview of the current understanding of these injuries and concepts in treatment.