European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2021
Multicenter StudyPoor sporting abilities after tibial plateau fractures involving the posterior column: how can we do better?
Tibial plateau fractures with the involvement of the posterior column are an important prognostic factor towards poor functional outcome. We aimed to assess the sporting abilities postoperatively with special emphasis on the type of sports and sport-specific movements, as well as time needed to resume sports, restricting factors in sports engagement, and patient satisfaction. We aimed to provide prognostic information on return to sports. ⋯ 3.
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Eur J Trauma Emerg Surg · Feb 2021
Randomized Controlled Trial Multicenter StudyTranexamic acid in traumatic brain injury: an explanatory study nested within the CRASH-3 trial.
The CRASH-3 trial is a randomised trial of tranexamic acid (TXA) on death and disability in patients with traumatic brain injury (TBI). It is based on the hypothesis that early TXA treatment can prevent deaths from post-traumatic intracranial bleeding. The results showed that timely TXA treatment reduces head injury deaths in patients with reactive pupils and those with a mild to moderate GCS at baseline. We examined routinely collected CT scans in a sample of 1767 CRASH-3 trial patients to explore if, why, and how patients are affected by TXA. ⋯ Patients with reactive pupils and/or mild to moderate GCS may have benefited from TXA in the CRASH-3 trial because they had less intracranial bleeding at baseline. However, because bleeding occurs soon after injury, treatment delay reduces the benefit of TXA.
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Eur J Trauma Emerg Surg · Feb 2021
Observational StudyDigital replantation/revascularization: predictive factors to microsurgery success-a single-center study.
Success rate in replantation/revascularization digital surgery is one of the challenges of reconstructive surgery. For this reason, investigating prognostic factors for survival and improvement of outcomes is highly relevant. The goal of this study was to establish predictive factors of survival in replantation/revascularization digital surgery. ⋯ Success rate in traumatic digital surgery is greater when revascularization surgery is performed, rather than replantation. Preoperative ischemia time, length of surgery, postoperative complications and re-intervention requirement are the factors that affect survival rate.
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Eur J Trauma Emerg Surg · Feb 2021
Randomized Controlled TrialGene expression analysis of vastus medialis cells after tourniquet-induced ischemia during total knee arthroplasty: a randomized clinical trial.
Postoperative quadriceps muscle strength was lowered after tourniquet application during total knee arthroplasty (TKA). Furthermore, tourniquet application results in higher proteolytic activity within vastus medialis cells, without influence on the amount and function of mitochondria. The effects of the commonly utilized intraoperative tourniquet on gene expression within the human skeletal muscle cells are barely examined. The purpose of the present study was to analyze the gene expression within the skeletal muscle cells after tourniquet-induced ischemia to identify differential expressed genes (DEGs) and pathways. ⋯ Level I.
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Eur J Trauma Emerg Surg · Feb 2021
Weight-based enoxaparin with anti-factor Xa assay-based dose adjustment for venous thromboembolic event prophylaxis in adult trauma patients results in improved prophylactic range targeting.
Venous thromboembolism (VTE) is a common morbidity in trauma patients. Standard VTE chemoprophylaxis is often inadequate. We hypothesized that weight-based dosing would result in appropriate prophylaxis more reliably than fixed dosing. ⋯ Weight-based VTE prophylaxis with anti-Xa-based dose adjustment improves prophylactic range targeting relative to uniform dosing and eliminates variances secondary to BSA and weight in trauma patients.