J Trauma
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Randomized Controlled Trial Comparative Study
Does the choice of approach for hip hemiarthroplasty in geriatric patients significantly influence early postoperative outcomes? A randomized-controlled trial comparing the modified Smith-Petersen and Hardinge approaches.
Minimally invasive surgical approaches for total hip replacement, such as the modified Smith-Petersen approach, have been reported to be advantageous over alternative techniques because of reduced soft tissue damage and improved immediate postoperative rehabilitation. This study compares the advantages of the Smith-Petersen approach against the lateral Hardinge approach for femoral neck fractures in geriatric patients. ⋯ Despite early postoperative differences, postoperative mobility does not seem to be greatly influenced by the choice of either an anterior modified Smith-Petersen or a lateral Hardinge approach for hip hemiarthroplasty. Operative time was significantly linked to postoperative complications. In this respect, it can be concluded that it is not be the approach itself that determines the early postoperative result, but the routine the individual surgeon has with it.
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Randomized Controlled Trial Comparative Study
A survey of American Association for the Surgery of Trauma member practices in the management of blunt splenic injury.
Conflicting data exist regarding pseudoaneurysm screening (PSA-S), initial angioembolization (IE), deep venous thrombosis prophylaxis (DVT-P), and activity limitation after hemodynamically stable blunt splenic injury (BSI). To determine whether there was consensus regarding BSI management, the multi-institutional trial committee of the American Association for the Surgery of Trauma (AAST) approved a survey of member practice patterns regarding BSI management. ⋯ There is considerable variation in the opinions of AAST members regarding BSI management, particularly for high-grade injuries. These results will aid in the design of prospective observational and random trials to determine optimal BSI management.
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Randomized Controlled Trial Comparative Study
Removing a patient from the spine board: is the lift and slide safer than the log roll?
After spine board immobilization of the trauma victim and transport to the hospital, the patient is removed from the spine board as soon as practical. Current Advanced Trauma Life Support's recommendations are to log roll the patient 90 degrees, remove the spine board, inspect and palpate the back, and then log roll back to supine position. There are several publications showing unacceptable motion in an unstable spine when log rolling. ⋯ Spine boards can be removed using a lift-and-slide maneuver with less motion and potentially less risk to the patient's long-term neurologic function than expected using the log roll.
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Randomized Controlled Trial Multicenter Study Comparative Study
Postinjury resuscitation with human polymerized hemoglobin prolongs early survival: a post hoc analysis.