European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jan 2025
Outcomes of cerclage wiring for intraoperative calcar fractures in cementless hemiarthroplasty in older patients with femoral neck fractures.
Cementless hip hemiarthroplasty is one of the options for the treatment of osteoporotic femoral neck fractures. Intraoperative periprosthetic femoral calcar fractures sometimes occur during the surgery, and the use of cerclage wiring to maintain the position and stability of the femoral stem and prevent the progression of the fracture. This study examines the outcomes of cerclage wiring to treat intraoperative periprosthetic calcar fractures in cementless hip hemiarthroplasty in osteoporotic femoral neck fractures. ⋯ Using cerclage wiring in treating intraoperative periprosthetic femoral calcar fractures provides adequate fixation for the stability of the femoral stem either above or below the lesser trochanter.
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Eur J Trauma Emerg Surg · Jan 2025
Greater distance traveled for renal trauma care is not associated with higher rates of intervention.
Trauma patients frequently may be transported significant distance to receive care at a level one trauma center. Increasing distance may cause delays in care. We sought to investigate whether distance traveled for level 1 trauma care affected rates of intervention for renal trauma. ⋯ Few studies have assessed distance traveled for trauma care and need for intervention. Our findings that an increased travel distance did not lead to a significantly increased risk for intervention are reassuring. Based on these findings, distance traveled for appropriate trauma care may not be a factor when deciding on transfers for renal trauma.
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Eur J Trauma Emerg Surg · Jan 2025
Patient-specific implants combined with 3D-printed drilling guides for corrective osteotomies of multiplanar tibial and femoral shaft malunions leads to more accurate corrections.
The aim of this study was to evaluate the feasibility of using patient-specific implants (PSI) for complex shaft corrective osteotomies in multiplanar deformities of long bones in the lower extremities. Additionally, it aimed to investigate the added value of these implants by quantifying surgical accuracy on postoperative CT, comparing their outcomes to two commonly used techniques: 3D virtual visualizations and 3D-printed surgical guides. ⋯ PSIs with 3D-printed drilling guides for complex multiplanar corrective osteotomies of femoral and tibial shaft malunions is feasible and achieves accurate corrections. This technique enables precise determination of the osteotomy plane, guides correction in all three planes, and ensures satisfactory implant fitting; thus accurately translating the virtual surgical plan into clinical practice. The 3D PSI method is beneficial for complex cases with significant multiplanar deformities in bone anatomy, particularly with rotational malalignment.
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Eur J Trauma Emerg Surg · Jan 2025
Dynamic pathophysiological features of early primary blast lung injury: a novel functional incapacity pig model.
While there is evidence supporting the use of ultrasound for real-time monitoring of primary blast lung injury (PBLI), uncertainties remain regarding the timely detection of early PBLI and the limited data correlating it with commonly used clinical parameters. Our objective is to develop a functional incapacity model for PBLI that better addresses practical needs and to verify the early diagnostic effectiveness of lung ultrasound in identifying PBLI. ⋯ We have successfully developed a novel, and highly reproducible animal model for assessing serious PBLI functional incapacity. This model displays immediate symptoms of hypoxia, decreased cardiac output, decreased blood volume, and abnormal lung ultrasound findings within 0.5 h of injury, with syptoms lasting for up to 6 h. Lung ultrasound evaluation is crucial for the early assessment of injuries, and is comparable to commonly used clinical parameters.
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Eur J Trauma Emerg Surg · Jan 2025
Postoperative accuracy quantification of corrective osteotomies: standardisation of Q3D-CT methodology.
Currently, no gold standard exists for 3D analysis of virtually planned surgery accuracy postoperatively. The aim of this study was to present a new, validated and standardised methodology for 3D postoperative assessment of surgical accuracy in patients undergoing 3D virtually planned and guided corrective osteotomies. ⋯ The proposed 3D CT technique provides an significant more accurate and objective method for assessment of surgical outcome of a guided corrective osteotomy. The present proposed novel methodology showed excellent inter- and intra-observer reliability with clinically acceptable absolute surgical outcome measurements.