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
High bone union rate using a locking plate for proximal humeral fractures in patients older than 70 years: importance of the medial column.
This study aimed to evaluate the results of surgical treatment for proximal humeral fractures using a locking plate in patients aged > 70 years. ⋯ For the surgical treatment of proximal humeral fractures in patients aged > 70 years, using a locking plate helped achieve a high bone union rate with relatively satisfactory results. However, the prevalence of unstable medial column fracture was high. Clinical and radiological outcomes were poor in these patients. Therefore, it is necessary to accurately understand the fracture pattern prior to surgery, and various surgical methods, including conservative treatment, should be considered.
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Eur J Trauma Emerg Surg · Aug 2022
How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study.
Osteoporotic bone tissue appears to be an important risk factor for implant loosening, compromising the stability of surgical implants. However, it is unclear whether lumbar measured bone mineral density (BMD) is of any predictive value for stability of surgical implants at the pubic symphysis. This study examines the fixation strength of cortical screws in human cadaver specimens with different BMDs. ⋯ Higher lumbar BMD did not result in significantly higher pull-out forces at the symphysis. The high proportion of cortical bone near the symphyseal joint allows an increased contact of pubic screws and could explain sufficient fixation. This condition is not reflected by a compromised lumbar BMD in a qCT scan. Therefore, site-specific BMD measurement could improve individual fracture management.
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Eur J Trauma Emerg Surg · Aug 2022
Incidence and risk factors of preoperative deep venous thrombosis following hip fracture: a retrospective analysis of 293 consecutive patients.
This study investigated the incidence and risk factors of preoperative deep venous thrombosis (DVT) after an acute hip fracture. ⋯ The incidence of preoperative DVT after acute hip fracture in this Chinese cohort was approximately 20%. Increased age and extracapsular fracture were independent risk factors for preoperative DVT following acute hip fracture.
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Eur J Trauma Emerg Surg · Aug 2022
Plate-associated localized osteitis in mini-pig by biofilm-forming Methicillin-resistant Staphylococcus aureus (MRSA): establishment of a novel experimental model.
The increasing number of implant-associated infections during trauma and orthopedic surgery caused by biofilm-forming Staphylococcus aureus in combination with an increasing resistance of conventional antibiotics requires new therapeutic strategies. One possibility could be testing for different therapeutic strategies with differently coated plates. Therefore, a clinically realistic model is required. The pig offers the best comparability to the human situation, thus it was chosen for this model. The present study characterizes a novel model of a standardized low-grade acute osteitis with bone defect in the femur in mini-pigs, which is stabilized by a titanium locking plate to enable further studies with various coatings. ⋯ The study shows the successful induction of local osteitis with lysis of the bone and the lack of enzymatic activity to mineralize the bone. Therefore, this standardized mini-pig model can be used in further clinical studies, to investigate various coated implants, bone healing, biofilm formation and immune response in implant-associated osteitis.
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Eur J Trauma Emerg Surg · Aug 2022
Long-term outcome following blunt cerebrovascular injuries: occurrence of ischemic complications, treatment, and outcome.
Blunt cerebrovascular injuries (BCVI) are a rare but serious complication after trauma. Among patients with BCVI, neurological status is altered in 30% of cases and the prognosis seems to be associated with ischemic complications. The aim of this study was to assess the long-term outcome of BCVI-associated ischemic events. ⋯ Ischemic complications after BCVI are rare, occur within the first week and do not seem to impact independently the 1-year neurological prognosis.