European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Apr 2021
Prolonged pain in patients with fragility fractures of the pelvis may be due to fracture progression.
Most fragility fractures of the pelvis (FFPs) are conservatively treated in the early phase. However, the definition of conservative treatment failure and the subsequent treatment protocol is controversial. Fracture progression (FP) sometimes occurs during conservative treatment of FFPs. This study aimed to assess the association between FP and prolonged pain in patients with FFPs receiving conservative treatment. ⋯ In patients with FFPs, prolonged pain was associated with FP (p = 0.022, OR 8.12). The presence of prolonged pain might help identify FP. If FP is identified, surgical treatment may be required with cautious follow-up particularly in cases, where FFP progresses to type III or IV fracture.
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Eur J Trauma Emerg Surg · Apr 2021
Different approaches towards geriatric trauma care for hip fracture patients: an inter-hospital comparison.
Hip fractures in geriatric patients have high morbidity and mortality rates. The implementation of a multidisciplinary geriatric care pathway (GCP) may improve treatment for this patient population. This study focusses on two level II hospitals with a different treatment protocols. A comparison was made between a multidisciplinary GCP and extensive standard care with a focus on geriatric hip fracture patients to assess if a multidisciplinary GCP leads to lower mortality and morbidity. ⋯ Mortality, major complications, HLOS and the amount of secondary surgical interventions showed no differences between both hospitals. This inter-hospital comparison of two types of geriatric care models showed no outcome that favours one specific geriatric care model over another. This provides opportunities for future studies to get a better understanding of what specific factors of geriatric care models contribute most to an improvement in the treatment of this patient population and decide which approach is most cost effective.
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Eur J Trauma Emerg Surg · Apr 2021
Fractures in Parkinson's Disease: injury patterns, hospitalization, and therapeutic aspects.
The primary aim of this study was to analyze the frequency and characteristic patterns of fall-related fractures as well as consecutive hospitalization and management relating to such fractures. In addition, important pathognomonic and therapeutic aspects are discussed. ⋯ Fall-related fractures are a common and relevant complication in PD patients leading to increased immobility, frequent hospitalization, and immediate surgical care. Fractures of the lower extremities and trunk were the most common in the cohort for this study. A PD patient presenting to the emergency room or at the general practitioner with a fracture should always be checked for osteoporosis and a fall-related injury should be seen as a red flag for reviewing a patient's individual therapeutic regime.
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Eur J Trauma Emerg Surg · Apr 2021
Observational StudyCentral venous oxygen saturation/lactate ratio: a novel predictor of outcome following emergency open laparotomy.
Emergency laparotomy is associated with high rates of morbidity and mortality. The need for highly sensitive readily prognostic biomarkers is necessary to improve the outcome. We investigated the usefulness of post-operative arterial lactate and ScvO2/lactate ratio as predictors of outcome after post-operative emergency open laparotomy. To the best of our knowledge, the novel ScvO2/lactate ratio was not investigated before in emergency open laparotomy patients. ⋯ Serial blood lactate as well as the novel ScvO2/lactate ratio can be useful for early predictors of mortality at 7 days. Serial lactate levels correlate to admission ICU scores APACHE II; MODS and SOFA in post-operative emergency open laparotomy patients.
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Eur J Trauma Emerg Surg · Apr 2021
Treatment of nonunion after forearm fractures in children: a conservative approach.
Nonunions are a very rare complication after surgical treatment of displaced forearm fractures in children, but can occur in both the radius or ulna. The aim of this study is to evaluate predisposing factors for non-unions and to discuss treatment options. ⋯ Open reduction and technical problems seem to be influencing factors. A conservative approach can be adopted in asymptomatic patients, otherwise an operative management, constituting plate osteosynthesis with or without bone grafting, should be performed.