Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Feb 2013
Prehospital care in patients with severe traumatic brain injury: does the level of prehospital care influence mortality?
The controversy between the "scoop and run" versus the "stay and play" approach in severely injured trauma patients has been an ongoing issue for decades. The present study was undertaken to investigate whether changes in prehospital care for patients with severe traumatic brain injury in the Netherlands have improved outcome. ⋯ Despite more on-site ALS in severely head injured patients nowadays compared to the historic cohort, there was no reduction in mortality.
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Eur J Trauma Emerg S · Feb 2013
The prognostic reliability of the Glasgow coma score in traumatic brain injuries: evaluation of MRI data.
To clarify the predictive power of the Glasgow coma score (GCS) after traumatic brain injury (TBI) and in the context of brain stem lesions. ⋯ We only recommend the use of the GCS for prognostic evaluation in a multidimensional model. Study protocols should contain additional brain stem function parameters (BCS, pupil condition, MRI).
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Eur J Trauma Emerg S · Feb 2013
Occult hemopneumothorax following chest trauma does not need a chest tube.
The increasing use of thoracic computed tomography (CT) in trauma patients has led to the recognition of intrapleural blood and air that are not initially evident on admission plain chest X-ray, defining the presence of occult hemopneumothorax. The clinical significance of occult hemopneumothorax, specifically the role of the tube thoracostomy, is not clearly defined. ⋯ Occult hemopneumothorax can be successfully managed without tube thoracostomy in most cases. Patients with a high ISS score, need for mechanical ventilation, and CT-detected blood collection measuring >1.5 cm increased the likelihood of need for tube thoracostomy. The size of the pneumothorax did not appear to be significant in determining the need for tube thoracostomy.
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Eur J Trauma Emerg S · Feb 2013
Reamed intramedullary nailing of diaphyseal tibial fractures: comparison of compression and non-compression nailing.
Modern intramedullary implants provide the option to perform compression at the fracture gap in long bone fractures via a compression screw mechanism. The aim of this study was to assess if the application of interfragmentary compression in the intramedullary nailing of tibia fractures could increase the union rate and speed of fracture healing. ⋯ The results show that additional compression of the fracture gap can improve healing outcome in simple transverse tibial shaft fractures treated with reamed nailing.