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
Comparative StudyEffects of osteosynthesis of the bony thorax in the context of polytrauma compared to conservative treatment: a systematic review.
Osteosynthesis seems to have effects regarding clinical outcomes in trauma patients. However, current knowledge on chest wall osteosynthesis in polytrauma patients is insufficient, leaving its potential unanswered. Therefore, the objective of this systematic review is to assess the safety and effects of chest wall osteosynthesis compared to conservative treatment on clinical outcomes in adult polytrauma patients. ⋯ There is limited evidence regarding chest wall osteosynthesis compared to conservative treatment in polytrauma patients. One RCT shows no effect of surgical rib fixation compared to conservative treatment regarding mortality and clinical status, but a potential benefit regarding ICU length of stay.
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Eur J Trauma Emerg Surg · Jan 2025
Single-stage intramedullary nailing for patients with multiple concurrent long-bone fractures in a low-resource setting: what factors contribute to prolonged operative duration?
To investigate the factors that prolonged the operative duration (OD) in patients who underwent single-stage locked intramedullary nailing of their multiple concurrent long-bone fractures (LBFs) using Surgical Implant Generation Network (SIGN) nails. ⋯ The study identified fracture fixation beyond five days, end-segment involvement, open reduction, use of standard and thinner nails, supplemental plating, and antegrade femoral nailing as factors that can prolong the OD during single-stage fixation of multiple concurrent LBFs in settings without modern fracture-care equipment. While some of these factors are unmodifiable on certain occasions, bearing them in mind can improve pre-operative planning and intra-operative efficiency to reduce OD.
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Eur J Trauma Emerg Surg · Jan 2025
Dual-energy CT in diagnosing sacral fractures: assessment of diagnostic accuracy and intra- and inter-rater reliabilities.
Evaluating sacral fractures is crucial in fragility fractures of the pelvis. Dual-energy CT (DECT) is considered useful for diagnosing unclear fractures on single-energy CT (SECT). This study aims to investigate the effectiveness of DECT in diagnosing sacral fractures. ⋯ Combined use of DECT with SECT improved the detection rate of sacral fractures and enhanced intra-rater and inter-rater reliability. High diagnostic accuracy was achieved regardless of the observer's experience. These results indicate that DECT is a useful imaging modality for diagnosing sacral fractures.
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Eur J Trauma Emerg Surg · Jan 2025
Post-discharge complications and follow-up timing after hospitalization for traumatic rib fractures.
To evaluate frequency and timing of post-discharge complications in patients with traumatic rib fractures undergoing operative or nonoperative management. ⋯ Post-discharge rib-related complications were rare in both groups, but occurred primarily within 2 weeks, suggesting concentrated earlier follow-up may be beneficial. These findings help inform recommendations for follow-up in this population.
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Eur J Trauma Emerg Surg · Jan 2025
The misleading terminology of minor amputation of the lower limb.
A pronounced loss of function of the lower limb of various origins, especially with an infection-related course, may require a minor (MIN) or major (MAJ) amputation of the lower limb. Our aim was to contrast the underlying etiology, including previous trauma, surgical procedure, and the subsequent function. ⋯ With MIN and MAJ results comparable in all scores and queries, it emphasizes the fact that even supposedly lower-limb MIN represents a considerable impairment of coping with daily life. If there is no prospect of preserving the limb, early transtibial amputation should be considered. However, our results support the good outcome despite lower-limb MAJ through modern prosthetic fitting.