European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Apr 2016
ReviewOpen reduction and internal fixation versus percutaneous transverse Kirschner wire fixation for single, closed second to fifth metacarpal shaft fractures: a systematic review.
Open reduction and internal fixation (ORIF) of single, closed metacarpal shaft fractures is increasingly preferred over closed reduction and percutaneous fixation (K-wire). The aim of this systematic review is to determine whether the preference for ORIF can be substantiated based on the available literature regarding the functional outcome and complications after surgery. ⋯ Although for both techniques good functional outcomes were reported, the significance of the functional impairment after ORIF requiring reoperation suggests ORIF to be a less favorable technique for single, closed metacarpal shaft fractures.
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Eur J Trauma Emerg Surg · Apr 2016
The outcome after lateral tibial plateau fracture treated with percutaneus screw fixation show a tendency towards worse functional outcome compared with a reference population.
The objective of this study was to evaluate the functional and radiological outcome after lateral tibial plateau fractures (Müller AO classification (AO) 41-B1, B2 and B3) treated with minimal invasive bone tamp reduction and percutaneous screw fixation. ⋯ At 5.2-year follow-up, the patients reported a tendency towards worse KOOS and Eq5D-5L scores compared with established reference populations. This study shows a significant association between a decrease in muscle strength and worse KOOS outcome. Furthermore, a significant association between younger age at the time of surgery and worse KOOS outcome score was observed.
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Eur J Trauma Emerg Surg · Apr 2016
Tailored ultrasound learning for acute care surgeons: a review of the MUSEC (Modular UltraSound ESTES Course) project.
The European Society for Trauma and Emergency Surgery (ESTES) identified the need for general and trauma surgeons involved in the management of critically ill surgical patients to embrace and learn both basic and advanced US skills. A steering group was created to address this deficit. ⋯ MUSEC is an effective and original educational format, enjoyed by candidates, that fills an educational gap for tailored US education as a procedural skill to acute care surgeons. Ongoing revisions should reduce the current limitations and increase the educational value, in terms of number of modules and post-course credentialing.
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Eur J Trauma Emerg Surg · Apr 2016
ReviewGrade IV renal trauma management. A revision of the AAST renal injury grading scale is mandatory.
The AAST renal injury grading scale is currently the most important variable predicting the need for kidney repair or removal, morbidity and mortality after blunt or penetrating kidney injuries. The 2011 revised version included renal pelvis, uretero-pelvic junction and segmental vascular injuries as grade IV, limiting grade V to severe hilar injuries. However, patients requiring surgery cannot be properly identified because of hemodynamic instability due to grade IV renal injuries. This study proposes an add-on for the AAST grade IV renal injury scale to improve the management of these patients. ⋯ These elements should be included in future classification reassessment to efficiently determine the time for surgery in grade IV renal traumas, generally leading to nephrectomy.
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Eur J Trauma Emerg Surg · Apr 2016
ReviewFrom FAST to E-FAST: an overview of the evolution of ultrasound-based traumatic injury assessment.
Ultrasound is a ubiquitous and versatile diagnostic tool. In the setting of acute injury, ultrasound enhances the basic trauma evaluation, influences bedside decision-making, and helps determine whether or not an unstable patient requires emergent procedural intervention. ⋯ This article provides a synopsis of focused assessment with sonography for trauma (FAST) and the extended FAST (E-FAST) that incorporates basic thoracic injury assessment. The authors also review key pitfalls, limitations, controversies, and advances related to FAST, E-FAST, and ultrasound education.