European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2022
Randomized Controlled TrialCemented long versus standard femoral stem in proximal femoral metastasis: a noninferiority single-blinded quasi-randomized clinical trial.
Proximal femur is a common site for metastasis, it has a significant impact on patient's quality of life, and traditional treatment aims at protecting as much as possible from the femur. However, recent studies have demonstrated increased rate of complications and questioned the need for long stem in this high-risk group. Our purpose is to determine whether standard-length femoral stem is noninferior to long femoral stem in the treatment of proximal femoral metastasis. ⋯ NCT04660591.
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Eur J Trauma Emerg Surg · Aug 2022
Randomized Controlled TrialPercutaneous fixation of intraarticular joint-depression calcaneal fractures with different screw configurations - a biomechanical human cadaveric analysis.
The aim of this study was to assess the biomechanical performance of different screw configurations for fixation of Sanders type II B joint-depression calcaneal fractures. ⋯ From a biomechanical perspective, posterior facet support by means of buttress or superiorly inserted longitudinal screws results in less plantar movement between the calcaneal tuberosity and the anterior fragments. Inferiorly inserted longitudinal screws are associated with bigger interfragmentary movements.
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Eur J Trauma Emerg Surg · Aug 2022
Nonunion of traumatic rib fractures: a suitable indication for surgery?
Nonunion of traumatic rib fractures is a clinical/radiological diagnosis caused by an alteration of bone healing reparative process. Since it is a painful condition, nonunion has a significative impact on patient's morbidity and quality of life. The aim of this study was to evaluate the outcomes after surgical stabilization of ribs affected by nonunion after traumatic fractures. ⋯ Surgical stabilization in patients affected by rib nonunion can be safely performed with few complications, good clinical outcomes and satisfactory quality of life.
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Sternal fractures (SF) are commonly associated with other injuries and their incidence is on the rise. The aim was to evaluate injury characteristics and outcomes in patients with all types of SF after blunt trauma. ⋯ SF are present in 2.1% of admissions to trauma centers. Geriatric patients account for half of SF patients and have higher mortality. Concomitant fractures of ribs are present in half and vertebrae fractures in one-third of the SF patients. CSF portend higher mortality and pulmonary co-injuries. The high incidence of concomitant rib and vertebra fractures requires additional diagnostic and treatment considerations.
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Eur J Trauma Emerg Surg · Aug 2022
Improving the protocol for whole-body CT scans in trauma patients.
While whole-body computed tomography is an established diagnostic method for the work up of polytraumatized patients, the protocols used differ between trauma centers. This study aimed to compare scan duration and estimated radiation of two protocols. Secondary aim was to assess if using the revised CT protocol reduced the number of additional images of the upper extremities. ⋯ Using a whole-body CT scan protocol in which the arms remain on a pillow ventral to the torso instead of one which requires a repositioning of the arms, both scan duration and estimated radiation dose can be reduced. Despite the arms being within the scanned area in the revised protocol, the number of additional imaging of the upper extremities could not be reduced.