European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Oct 2021
Review Meta AnalysisMeta-analysis on surgical management of colonic injuries in trauma: to divert or to anastomose?
Primary repair or resection with anastomosis (PR/A) has been gaining increasing recognition for traumatic colonic injuries, with the need for faecal diversion (FD) especially those of penetrating etiology being questioned. However, the role of PR/A in critically ill patients is still controversial with concerns pertaining to safety and anastomotic leak. ⋯ This meta-analysis supports PR/A in stable patients with traumatic colonic injuries. FD should be considered in critically ill patients who require DC surgery as leak rates are significantly higher.
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Eur J Trauma Emerg Surg · Oct 2021
The role of a trauma review system and development of intra-operative checklists in improving the quality of fracture fixations in a high volume tertiary centre.
In high volume centres, audits are essential to ensure good surgical techniques and fracture fixations to avoid complications, revision surgeries and poor outcomes. A method to assess fixations for fractures of different regions employing different implants and surgical demands is a challenge. We present here a simple method of review and follow-up work flow of more than 6000 fixations every year that helped in improving outcomes and also provide training for residents and junior staff. ⋯ Level II.
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Eur J Trauma Emerg Surg · Oct 2021
Long-term results of reconstructing the joints' articular surface in the knee and ankle with the surgical diamond instrumentation (SDI).
The surgical diamond instrumentation (SDI), a precise wet-grinding technology, promised contact healing of press-fit inserted bone and even hyaline cartilage, lacks medium- and long-term results. This retrospective study was conducted to identify risk factors associated with the failure of the technique and the subjective patient outcome. ⋯ The SDI technique provides promising results with excellent joint survival rates and satisfying patient-reported outcomes. Failure of the technique might be associated with higher age.
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Eur J Trauma Emerg Surg · Oct 2021
Does increased acetabular depth affect safe infra-acetabular screw placement in acetabular fracture fixation?
Infra-acetabular screws enhance the fixation strength in acetabular fractures with separation of both columns. Placement without iatrogenic femoral head violation is challenging. ⋯ The virtual possibility to place an infra-acetabular screw was given in all patients. An increasing depth of the acetabulum correlated with a decrease in residual distances. As hip joint cartilage thickness was not considered in measurements, intraoperative rule-out of screw mispositioning especially in deep acetabular sockets and females is still of utmost importance.
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Eur J Trauma Emerg Surg · Oct 2021
The impact of delayed time to first CT head in traumatic brain injury.
Trauma team activation (TTA) criteria trigger early mobilization of resources for the sickest trauma patients. Patients with moderately depressed GCS who do not trigger the highest level activation are at risk for adverse outcomes, potentially from delayed time to intervention. The study objective was to define the impact of time to first CT Head (CTH) on outcomes among blunt trauma patients with moderately depressed GCS. ⋯ Immediate CTH for blunt trauma patients with moderately depressed GCS decreases time to intervention and reduces ED time. A protocol to shorten time to CTH may be beneficial for both patients and hospitals.