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
Predictors of prolonged hospital stay of pelvic ring and acetabular fractures - a retrospective analysis in a 10-year period of a level 1 trauma center.
Pelvic ring and acetabular fractures are among the most complicated and severe injury patterns in orthopaedic trauma surgery. Inpatient treatment is not only costly but also very time-consuming. The aim of this study is to identify predictors leading to a prolonged length of hospital stay. ⋯ Pelvic fractures demonstrate a prolonged hospital stay. It depends on the severity of the injury. There are good predictors of a long length of stay at admission. These include the presence of multiple injury, the complexity of the fractures, haemoglobin levels, and the shock index.
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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
In the last 10 years, have our polytrauma patients become geriatric? The emergency trauma bay in the context of demographic change.
One of the key challenges trauma centres are currently facing is the management of polytraumata in an ageing population. The aim of this study is to assess the extent to which demographic changes are reflected in the trauma bay population and the impact on geriatric polytrauma patient outcomes. ⋯ The ageing trauma bay population presents new challenges for medical staff, because polypharmacy, multiple comorbidities and frailty become more significant in an ageing population. Enhanced interdisciplinary management, particularly between trauma and geriatric specialists, may mitigate rising mortality rates. Geriatric trauma centres or at least more geriatric expertise might be required to improve the treatment and outcome in this changing population.
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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.