European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jun 2020
Epidemiology and treatment of distal radius fractures: current concept based on fracture severity and not on age.
A shift towards surgical treatment of distal radius fractures seems to be apparent. The purpose of the present study was to assess current epidemiological data, the fracture severity according to the AO classification and the changing trend in the treatment. ⋯ Our findings confirmed the increasing popularity of surgical intervention with open reduction and internal fixation. Contrary to previous studies, the fracture type profile showed an equal proportion of type A and C fractures and the indication for surgical treatment correlated with fracture severity and not age.
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Eur J Trauma Emerg Surg · Jun 2020
ReviewThe safety and efficacy of improvised tourniquets in life-threatening hemorrhage: a systematic review.
The increased incidence of mass casualty incident (MCI) with penetrating injuries in the civilian setting creates a call for implementing devices, such as a tourniquet (TQ), in civilian first aid. Bystanders could act as immediate responders after an MCI in order to prevent a victim from exsanguination using direct pressure or commercial tourniquets (C-TQ). Reports have shown that immediate access to C-TQs was not available and bystanders used objects available at the trauma scene to make an improvised tourniquet (I-TQ). The aim of this systematic review of literature was to summarize the existing literature on designs, efficacy and safety of I-TQs. ⋯ The use of- and training in I-TQ by civilian immediate responders is not recommended because of limited efficacy and safety concerns; direct pressure is a viable alternative. However, I-TQs may save lives when applied correctly with proper objects; therefore, future studies regarding the best design and training in application of effective and safe I-TQs should be encouraged.
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Eur J Trauma Emerg Surg · Jun 2020
Evaluation of new quality indicators for the TraumaRegister DGU® using the systematic QUALIFY methodology.
The TraumaRegister DGU® (TR-DGU) of the German Trauma Society (Deutsche Gesellschaft für Unfallchirurgie, DGU) enables the participating hospitals to perform quality management. For that purpose, nine so-called audit filters have existed, since its foundation, which, inter alia, is listed in the Annual Report. The objective of this study effort is a revision of these quality indicators with the aim of developing pertinent new and reliable quality indicators for the management of severely injured patients. ⋯ Not all the key figures published for the management of severely injured patients are suitable for use as quality indicators. It remains to be seen whether the quality indicators identified by experts using the QUALIFY process will meet the requirements in practice. Prior to the implementation of the assessed quality indicators in standardized quality assurance programs, a scientific evaluation based on national data will be required.
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Eur J Trauma Emerg Surg · Jun 2020
Multicenter Study Comparative StudyThe Amsterdam Wrist Rules to reduce the need for radiography after a suspected distal radius fracture: an implementation study.
While most patients with wrist trauma are routinely referred for radiography, around 50% of these radiographs show no fracture. To avoid unnecessary radiographs, the Amsterdam Wrist Rules (AWR) have previously been developed and validated. The aim of the current study was to evaluate the effect of the implementation of the AWR at the Emergency Department (ED). ⋯ Implementation of the AWR safely reduces the amount of wrist radiographs in selected patients and consequently reducing the length of stay in the ED.
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Eur J Trauma Emerg Surg · Jun 2020
Comparative StudyComparison of fracture healing and long-term patient-reported functional outcome between dorsal and volar plating for AO C3-type distal radius fractures.
This study aimed to evaluate the differences in long-term functional outcome and radiographic fracture healing between volar and dorsally approached comminuted intra-articular distal radius fractures (DRF) (AO C3-type). ⋯ Dorsal locking plating fixation in C3-type DRFs resulted in a minimal, but statistically significant, volar collapse of sagittal tilt compared with volar locking plating fixation. However, this difference in volar collapse did not significantly influence the long-term clinical outcome.