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
Review Meta AnalysisSciatic nerve injury after acetabular fractures: a meta-analysis of incidence and outcomes.
To investigate the incidence and the outcome of post-traumatic and iatrogenic sciatic nerve palsy (SNP) associated with fractures of the acetabulum. The results of sciatic nerve grafting for treatment were also investigated. ⋯ A favorable outcome of both post-traumatic and iatrogenic SNP related to acetabular fractures has been found. Due to the poor results of sciatic nerve grafting, a "wait and see" approach may be the best option, in cases of a contused but anatomically intact sciatic nerve.
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Eur J Trauma Emerg Surg · Aug 2022
Review Meta AnalysisTotal hip arthroplasty compared to bipolar and unipolar hemiarthroplasty for displaced hip fractures in the elderly: a Bayesian network meta-analysis.
Displaced femoral neck fractures (FNF) usually require surgical treatment with either a total hip arthroplasty (THA), unipolar hemiarthroplasty (U-HHA), or bipolar hemiarthroplasty (B-HHA). However, there is still controversy regarding the optimal implant. This network meta-analysis compared the outcomes and complication rates of THA versus B-HHA and versus U-HHA in elderly patients with FNF. ⋯ I, Bayesian network meta-analysis of RCTs.
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Eur J Trauma Emerg Surg · Aug 2022
Review Meta AnalysisOpen plate fixation versus nailing for humeral shaft fractures: a meta-analysis and systematic review of randomised clinical trials and observational studies.
This meta-analysis compares open reduction and internal fixation with a plate (ORIF) versus nailing for humeral shaft fractures with regard to union, complications, general quality of life and shoulder/elbow function. ⋯ Nailing carries a lower risk of infection, postoperative radial nerve palsy, has a shorter operation duration and possibly a shorter time to union. Shoulder impingement requiring re-intervention, however, is an inherent disadvantage of nail fixation. Notably, absolute differences are small and almost all patients with radial nerve palsy recovered spontaneously. Satisfactory results can be achieved with both treatment modalities.
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Eur J Trauma Emerg Surg · Aug 2022
Review Meta AnalysisShock index as a predictor for mortality in trauma patients: a systematic review and meta-analysis.
The primary aim was to determine whether a shock index (SI) ≥ 1 in adult trauma patients was associated with increased in-hospital mortality compared to an SI < 1. ⋯ This systematic review found a fourfold increased risk of in-hospital mortality in adult trauma patients with an initial SI ≥ 1 in the emergency department or trauma center.
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Eur J Trauma Emerg Surg · Aug 2022
Meta AnalysisPrehospital traumatic cardiac arrest: a systematic review and meta-analysis.
Circulatory arrest after trauma is a life-threatening situation that mandates urgent action. The aims of this systematic review and meta-analysis on prehospital traumatic cardiac arrest (TCA) were to provide an updated pooled mortality rate for prehospital TCA, to investigate the impact of the time of patient inclusion and the type of prehospital trauma system on TCA mortality rates and neurological outcome, and to investigate which pre- and intra-arrest factors are prognostic for prehospital TCA mortality. ⋯ Approximately 1 in 20 patients with prehospital TCA will survive; about 40% of survivors have favorable neurological outcome.