J Trauma
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Case Reports
Delayed hemothorax after blunt thoracic trauma: an uncommon entity with significant morbidity.
To describe the nature of delayed hemothorax occurring after blunt thoracic trauma and to identify the population at risk for this complication. ⋯ Delayed hemothorax after blunt trauma is a unique entity occurring in patients with multiple or displaced rib fractures. Vigilance for the recognizable prodrome in the high-risk population should allow early remediation of this complication.
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Since 1992, the Consultative Committee on Road Traffic Fatalities in Victoria, Australia, has identified problems including those contributing to death and the potential preventability of deaths in road fatalities who survived until at least the arrival of ambulance services. The present analysis examines the outcomes at a Level I trauma center compared with other hospital groups in Victoria. ⋯ Management of patients with major trauma at a Level I trauma center was associated with fewer problems contributing to death and fewer preventable and potentially preventable deaths than at the different hospital groups. A trauma system in Victoria, including bypass of major trauma patients to designated hospitals with 24-hour trauma services, is likely to decrease the frequency of problems, including the preventable death rates.
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Review Case Reports
Traumatic thoracobiliary fistula: report of a case successfully managed conservatively, with an overview of current diagnostic and therapeutic options.
Thoracobiliary fistula is a rare complication of hepatic trauma that may present a diagnostic and therapeutic challenge. We report a case of a thoracobiliary fistula complicating thoracoabdominal trauma. ⋯ Conservative therapy consists of a safe temporizing measure during the workup and may, on occasion, be the only therapy that is necessary provided that controlled drainage of the fistula is achieved. The current recommendation would be the exhaustion of nonoperative therapeutic modalities before resorting to surgical intervention.
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Randomized Controlled Trial Comparative Study Clinical Trial
Kapandji pinning or closed reduction for extra-articular distal radius fractures.
In a randomized prospective trial, closed reduction and plaster application was compared with Kapandji pinning. Closed reduction and plaster cast application was performed in 50 patients, Kapandji pinning in 48 patients. ⋯ In terms of maintenance of reduction and functional outcome at 1-year follow-up, no statistically significant differences were found between the two groups. We conclude, therefore, that both techniques can be applied to extra-articular fractures of the distal radius according to the characteristics of the forearm and the surgeon's or the patient's need.