J Trauma
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Randomized Controlled Trial Multicenter Study Clinical Trial
Treatment of complex tibial plateau fractures using the less invasive stabilization system plate: clinical experience and a laboratory comparison with double plating.
Bicondylar tibial plateau fractures are complex injuries, historically associated with high complication rates. The purpose of this study was: 1) to evaluate the clinical use L.I.S.S plating system for stabilization of bicondylar tibial plateau fractures. 2) To compare the biomechanics of this plating system with a double plate construct. ⋯ The L.I.S.S plating system provides stable fixation of complex bicondylar tibial plateau fractures allowing early range of knee motion with favorable clinical results.
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Review Case Reports
Splenic artery embolization for post-traumatic splenic artery pseudoaneurysm in children.
Although rare, traumatic splenic artery pseudoaneurysm (SAP) can be life threatening. The diagnostic approaches as well as the methods of treatment of SAP are yet to be determined. We present the case of a 10-year-old boy treated conservatively for a grade III blunt splenic injury (BSI). ⋯ Abdominal pain was the most frequent symptom of SAP, but three children were asymptomatic at the time of diagnosis. Therefore, the possibility of SAP should be investigated even in the asymptomatic child with mild splenic injury. When a splenic pseudoaneurysm is diagnosed, we believe splenic artery embolization is indicated.
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Seat belts and air bags have been shown to significantly reduce morbidity and mortality following MVCs. Research suggests that restraint use does not protect against lower extremity fracture; however, no population-based studies of this association exist. The purpose of this study is to compare the effectiveness of combined seat belt and airbag restraint systems with airbag alone, seat belt alone, and no restraints with respect to incidence and location of lower extremity fractures. ⋯ While airbags may reduce the risk of death when used alone or in combination with seat belts, the results of this study demonstrate that air bags increase the risk of lower extremity fractures when used as the sole method of passenger protection. Also, they may do so differentially according to skeletal region. This data strongly support the consideration of developing accessory knee bolster airbags to prevent the "submarining" or sliding under the airbag that may be responsible for this finding.
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The introduction of the ATLS course in The Netherlands in 1995 provided for an opportunity to compare data of trauma patients between a pre-ATLS and a post-ATLS period. ⋯ Using the opinion of an expert team, this study identified a significantly lower number of patients with inadequate management.