European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jun 2014
Trauma care in Scotland: effect of rurality on ambulance travel times and level of destination healthcare facility.
The aim of this study was to determine the effect of rurality on the level of destination healthcare facility and ambulance response times for trauma patients in Scotland. ⋯ Trauma is relatively rare in rural areas, but patients injured in remote locations are doubly disadvantaged by prolonged pre-hospital times and admission to a hospital that may not be adequately equipped to deal with their injuries. These problems may be overcome by the regionalisation of trauma care, and enhanced retrieval capability.
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Eur J Trauma Emerg Surg · Jun 2014
Massive haemorrhage following minimally displaced pubic ramus fractures.
Fractures of the pubic rami are the most frequent osteoporotic pelvic fracture. Although generally innocuous, epidemiologic research demonstrated a decreased survival in patients with pubic rami fractures compared to healthy controls. Sporadic cases of potentially lethal bleedings have been reported. The aim of this study was to report a consecutive series and review of the literature of patients with severe bleeding following minimally displaced pubic ramus fractures. ⋯ Severe bleeding, mostly secondary to corona mortis avulsions, is a rare but potentially lethal complication of pubic ramus fractures. Physicians should be aware of this complication and actively look for symptoms of bleeding. Super-selective arterial embolisation seems safe and highly effective to control bleeding secondary to pubis rami fractures in elderly patients.
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Eur J Trauma Emerg Surg · Jun 2014
A holistic hip fracture approach: individualized diagnosis and treatment after surgery.
Secondary fracture prevention is of paramount importance in the clinical management of patients with hip fractures. However, in contrast to the excellent surgical care provided to these patients in the Western hemisphere and despite good medical options, causative treatment of the underlying osteopathy causing skeletal fragility remains an unmet medical need that urgently needs to be improved. This calls for a concerted action between orthopedic/trauma surgeons and osteologists, as outstanding hospitals not only treat fragility fractures, but also prevent fractures from recurring. Aiming for a holistic hip fracture approach, in this work we highlight aspects of (a) improved risk assessment and differential diagnosis, (b) optimized basic medical care, and