European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2024
Imaging risk factors for predicting postoperative complications of intramedullary nailing for tibial fracture.
The objective of this study was to analyze the ratio of fracture site diameter to tibial isthmus diameter (TFI ratio) as a predictor of postoperative complications, including malunion and delayed union, after tibial intramedullary nailing for middle and lower tibial fractures. ⋯ The results of this study suggest that a wider intramedullary diameter and a shorter fixed length at the fracture site are associated with a higher incidence of complications after tibial intramedullary nailing. The TFI ratio may be used as a reliable parameter for predicting complications after such surgery. In patients with a high TFI ratio (≥ 1.31), additional reduction and fixation techniques may be needed to obtain and maintain fracture reduction.
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Eur J Trauma Emerg Surg · Aug 2024
Outcomes and their predictors in suprapatellar nailing for tibia fractures. Multivariable analysis of 293 consecutive cases.
Intramedullary nailing of tibial fractures is one of the most common procedures in orthopedic surgery. It can be technically demanding in proximal or distal fractures, which may be facilitated using semi-extended approaches. The aim of this study is to identify outcomes and their predictors using a semi-extended suprapatellar approach for tibial fracture nailing. ⋯ The suprapatellar approach is a safe and useful technique for treating tibial fractures, leading to no less than correct reduction in almost all patients and achieving a high fracture healing rate, at very low rates of complications. Pre- and postoperative predictors identified must be taken into account to improve outcomes while treating these fractures.
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Eur J Trauma Emerg Surg · Aug 2024
Observational StudyPrediction of neurocritical care intensity through automated infrared pupillometry and transcranial doppler in blunt traumatic brain injury: the NOPE study.
This pilot study aimed to determine the capacity of automated infrared pupillometry (AIP) alone and in combination with transcranial doppler (TCD) on admission to rule out need for intense neuroAQ2 critical care (INCC) in severe traumatic brain injury (TBI). ⋯ This pilot study suggests a possible useful contribution of NPi to determine the need for INCC in severe blunt TBI patients on admission.
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Eur J Trauma Emerg Surg · Aug 2024
Coronary artery calcification detected by initial polytrauma CT in severely injured patients: retrospective single-center cohort study.
Coronary artery calcifications detected by computed tomography (CT) provide prognostic relevance for vascular disorders and coronary heart disease, whereas their prognostic relevance in severely injured trauma patients remains unclear. ⋯ CT-detected coronary calcification was a significant prognostic factor for 24-h- and 30-day-mortality in severely injured trauma patients requiring tracheal intubation, and influenced ICU LOS in survivors.
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Eur J Trauma Emerg Surg · Aug 2024
Comparative StudyComparison of the zonal distribution of calcium salt density and fat marrow in bone-healthy and osteoporotic sacra: an image data analysis using quantitative computed tomography and magnetic resonance imaging.
Pathogenesis of sacral fragility fractures is not fully understood. This study investigates zonal distribution of calcium salt and fat marrow in intact bone-healthy and osteoporotic pelvis. In addition, in unilateral sacral fractures, the fracture side was compared with the intact side. ⋯ The results suggest that in PEO sacral alae experience disproportionate skeletal rarefaction. This concerns the sacral ala at the S1 level (- 25 ± 55), whereby the calcium salt content is so low that it corresponds to the S3 level of healthy bone (- 20 ± 21 HU). This explains the occurrence of transalar fractures in the load-transmitting zone S1. In PEOFx, the calcium salt density was higher and the fat content was lower on the fractured side than on the intact side, indicating bony compacting due to lateral compression and fat displacement due to hematoma in the accident mechanism. This study makes an important contribution to the understanding of the development of sacral fragility fractures. Furthermore, impaction of the cancellous bone within the fracture can be demonstrated.