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
Penetrating trauma on the rise- nine-year trends of severe trauma in Sweden.
Sweden has an established trauma system involving national trauma criteria and the Swedish trauma registry (SweTrau), since over a decade. Meanwhile, the injury panorama has evolved, with an increase in gang-related violence in the Swedish community. In this study, we aimed to investigate long-term trends in mortality, management and trauma type in two major Swedish trauma centers over a nine-year period. ⋯ In this trend analysis at two major Swedish trauma centers during 2013-2021, penetrating trauma increased with over 50% while traffic injuries decreased. The rise in mortality in patients with a TA and NISS < 15 is concerning and requires further evaluation, as do the reduction in ICU admissions.
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Eur J Trauma Emerg Surg · Dec 2024
Incidence and predictors of dorsal comminution in older adults with low-energy distal radius fracture.
To identify the incidence of dorsal comminution using computed tomography (CT) images and identify predictors of this phenomenon in older adults with low-energy distal radius fractures (DRFs). ⋯ The incidence of dorsal comminution is relatively high in patients with low-energy DRFs aged > 50 years. In particular, the presence of combined ulnar fractures is closely associated with dorsal comminution of DRFs. Thus, surgeons should exercise caution when evaluating this phenomenon.
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Eur J Trauma Emerg Surg · Dec 2024
Treatment of infected humeral shaft nonunion and presumed aseptic nonunion with positive intraoperative cultures: a retrospective single-center study.
The management of infected humeral shaft nonunion (HSN) remains challenging due to the lack of consensus and the potential for occult infection. The aim of this study was to evaluate a surgical strategy based on a two-stage treatment for suspected infection or a one-stage treatment for infection diagnosed retrospectively based on systematic bacteriological sampling. ⋯ This study confirms the relevance of one-stage surgery for HSN with occult infection and the value of systematic bacteriological sampling during the revision of humeral diaphyseal osteosynthesis.
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Eur J Trauma Emerg Surg · Dec 2024
Biomechanical evaluation of double-stranded knot configurations in high-strength sutures and tapes.
Recently, a new dynamic high-strength suture (DC) was introduced, also available in tape form (DT), featuring a salt-infused silicone core attracting water in a fluid environment to preserve tissue approximation. The aims of this study were to (1) assess the influence of securing throw number on knot security of two double-stranded knot configurations (Cow-hitch and Nice-knot) tied with either dynamic (DC and DT) or conventional (FW and ST) high-strength sutures and tapes, and (2) compare the ultimate force and knot slippage of the novel dynamic versus conventional sutures and tapes when used with their minimal number of needed securing throws. ⋯ The minimum number of securing throws required to achieve 100% security was 2 with DC, DT and ST for both Cow-hitch and Nice-knots configurations, in contrast to FW where 3 securing throws were needed. With these minimum numbers of securing throws, Nice-knots were associated with significantly higher ultimate forces when using DT and lower slippage with DC versus Cow-hitch knots.