European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2024
Impact of early follow-up CT in the conservative management of traumatic brain injury on surgical decision making: A retrospective, single-center analysis with special respect to coagulopathy.
Initial management of traumatic brain injury (TBI) without immediate need for surgical therapy varies across centers. The additional value of routine repeat cranial computerized tomography (CT) to neurological monitoring is controversial. This retrospective study investigates the impact of routine follow-up CT after 6 h (CT6h) in initially conservatively managed TBI on surgical decision making. Furthermore, the impact of coagulopathy on lesion size and progression was examined. ⋯ Early routine follow-up CT does neither anticipate imminent neurological deterioration nor impact surgical decision making. A substantial number of patients with initially stable follow-up imaging need delayed surgery due to conservative treatment failure. If patients can be monitored clinically, surgical decision making depends on clinical status. Patients with coagulopathy do not present with larger lesions, but show a higher ratio of drastic increase in SDH in contrast to contusions.
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Eur J Trauma Emerg Surg · Dec 2024
Efficacy and outcomes of rescue screws in unstable pelvic ring injuries - A retrospective matched cohort study.
The emergency treatment of unstable pelvic ring injuries is still a challenge and requires surgical and anesthesiological resuscitation. Emergency fixation of the unstable pelvic ring with percutaneous sacroiliac (SI) screws, also known as "Rescue Screws", is an established treatment method. The aim of our study was to compare the outcome and complication rates of "Rescue Screws" with elective SI-screw fixations. ⋯ Treatment of unstable pelvic ring fractures with Rescue Screws appears as a feasible treatment option for emergency stabilization. Rescue Screws are not associated with elevated revision rates and increased complications rates. This minimally invasive technique enables safe emergency stabilization of the posterior pelvic ring. Prospective or randomized clinical trials are required to directly compare Rescue Screws with other competing emergency stabilization techniques.
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Eur J Trauma Emerg Surg · Dec 2024
Preoperative cardiology consultations for geriatric patients with hip fractures rarely provide additional recommendations and are associated with prolonged hospital stays and delayed surgery: a retrospective case control study.
Hip fractures are increasingly common among the elderly population, who often present with a high burden of comorbidities necessitating preoperative stabilization. As a result, preoperative cardiology consultations are frequently conducted in clinical practice. The aim of this study was to investigate the additional recommendations provided by preoperative cardiology consultations and the impact of consultations on the management and outcomes of elderly patients undergoing hip fracture surgery. ⋯ Preoperative cardiology consultations before hip fracture surgery rarely leads to a change in treatment. Additionally, these evaluations delay surgery and extend the hospital stay.
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Eur J Trauma Emerg Surg · Dec 2024
Risk factors and predictors of prolonged hospital stay in the clinical course of major amputations of the upper and lower extremity a retrospective analysis of a level 1-trauma center.
The objective was to analyze the treatment and complications of the patients after a major amputation of the upper and lower extremities. Risk factors and predictors of a prolonged hospital stay should be outlined. ⋯ Major amputations in trauma patients lead to a prolonged stay in hospital due to severe diseases and complications. Especially infections and surgical revisions cause such lengthenings.
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Eur J Trauma Emerg Surg · Dec 2024
Automatic virtual reconstruction of acetabular fractures using a statistical shape model.
Automatic virtual reconstruction of complex fractures would be helpful for pre-operative surgical planning. We developed a statistical shape model (SSM) which contains data of 200 intact 3D hemipelves. It allows for quantification of shape differences and is able to reconstruct abnormal shaped pelvises. We applied our SSM to reconstruct elementary and associate type acetabular fractures and assessed the reconstruction performance of the SSM, by comparing the reconstructed shape with the intact contralateral hemipelvis. ⋯ Using a statistical shape model allows for accurate virtual reconstructions of elementary and associate type acetabular fractures within a clinically acceptable range, especially within regions important for plate-fitting. SSM-based reconstructions can serve as a valuable tool for pre-operative planning in clinical practice, when a template of the contralateral hemipelvis is unavailable.