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https://read.qxmd.com/read/30900093/hybrid-stabilization-of-unstable-osteoporotic-thoracolumbar-vertebral-body-fractures-clinical-and-radiological-outcome-after-a-mean-of-4-years
#1
Ulrich J Spiegl, Christine Anemüller, Jan-Sven Jarvers, Nicolaus von der Höh, Christoph Josten, Christoph-Eckhard Heyde
PURPOSE: The aim of this study was to evaluate midterm results after hybrid stabilization of unstable osteoporotic fractures of the thoracolumbar junction. METHODS: This retrospective study was performed at a level I trauma center. A total of 113 patients aged 61 and older were stabilized using hybrid stabilization consisting of short-segmental posterior instrumentation and augmentation of the fractured vertebral body after suffering an unstable osteoporotic vertebral body fracture at the thoracolumbar spine...
March 21, 2019: European Spine Journal
https://read.qxmd.com/read/30899797/physician-based-on-scene-airway-management-in-severely-injured-patients-and-in-hospital-consequences-is-the-misplaced-intubation-an-underestimated-danger-in-trauma-management
#2
Orkun Özkurtul, Manuel F Struck, Johannes Fakler, Michael Bernhard, Silja Seinen, Hermann Wrigge, Christoph Josten
Background: Endotracheal intubation (ETI) is the gold standard for the out-of-hospital emergency airway management in severely injured patients. Due to time-critical circumstances, poor patient presentation and hostile environments, it may be prone for mechanical complications and failure. Methods: In a retrospective study (January 2011 to December 2013), all patients who underwent out-of-hospital ETI before admittance to a level 1 trauma center were analyzed consecutively...
2019: Trauma surgery & acute care open
https://read.qxmd.com/read/30899796/emergency-trauma-laparotomy-and-or-thoracotomy-in-the-emergency-department-risks-and-benefits
#3
Kaori Ito, Kahoko Nakazawa, Tsuyoshi Nagao, Hiroto Chiba, Yasufumi Miyake, Tetsuya Sakamoto, Takashi Fujita
Background: It is not mandatory for Japanese trauma centers to have an operating room (OR) and OR team available 24 hours a day/7 days a week. Therefore, emergency laparotomy/thoracotomy is performed in the emergency department (ED). The present study was conducted to assess the safety of this practice. Methods: The data were reviewed from 88 patients who underwent emergency trauma laparotomy and/or thoracotomy performed by our acute care surgery group during the period from April 2013 to December 2017...
2019: Trauma surgery & acute care open
https://read.qxmd.com/read/30899794/world-trauma-education-hemorrhage-control-training-for-healthcare-providers-in-india
#4
Lindsay Andrea Smith, Sarah Caughey, Susan Liu, Cassandra Villegas, Mohan Kilaru, Aakanksha Gupta, Robert J Winchell, Mayur Narayan
Background: Hemorrhage remains a major cause of death around the world. Eighty percent of trauma patients in India do not receive medical care within the first hour. The etiology of these poor outcomes is multifactorial. We describe findings from the first Stop the Bleed (StB) course recently offered to a group of medical providers in southern India. Methods: A cross-sectional survey of 101 participants who attended StB trainings in India was performed. Pre-training and post-training questionnaires were collected from each participant...
2019: Trauma Surgery & Acute Care Open
https://read.qxmd.com/read/30899789/national-estimates-of-the-use-and-outcomes-of-extracorporeal-membrane-oxygenation-after-acute-trauma
#5
Parker J Hu, Lauren Griswold, Lauren Raff, Rachel Rodriguez, Gerald McGwin Jr, Jeffrey David Kerby, Patrick Bosarge
Background: The use of extracorporeal membrane oxygenation (ECMO) as salvage therapy for patients with severe acute respiratory distress syndrome is gaining greater acceptance among trauma intensivists. The objective of this study was to review ECMO usage in trauma patients in the USA. Methods: The National Inpatient Sample (NIS) from years 2002 to 2012 was queried for patients aged 15 and older treated with ECMO who had one or more acute traumatic injuries as defined by the International Diagnostic Codes, Ninth Edition (ICD-9)...
2019: Trauma Surgery & Acute Care Open
https://read.qxmd.com/read/30898290/analysis-of-transport-to-an-american-college-of-surgeons-level-i-trauma-center
#6
Daniel Hakakian, Karen Kong, Dorian Atanas Bogdanovski, Andrew Benvenuto, Louis Thomas DiFazio, Renay Durling-Grover, Rolando Hector Rolandelli, Zoltan H Nemeth
INTRODUCTION: Efficient patient transportation by ground emergency medical services (GEMS) or helicopter emergency medical services (HEMS) to a trauma center is vital for optimal care. We investigated differences between the modes of transport in terms of demographics, injury, scene location, and outcome. SETTING: Morristown Medical Center (MMC), Morristown, NJ METHODS: All 903 trauma admissions in 2016 by advanced life support (ALS) to MMC, a Level I Trauma Center, were retrospectively analyzed...
March 2019: Air Medical Journal
https://read.qxmd.com/read/30895819/initial-debridement-of-dorsal-hand-abscesses-in-the-operating-room-does-not-improve-outcomes
#7
John D Jennings, Colin Vroome, Justin A Ly, Joseph Thoder
BACKGROUND: Hand infections frequently involve the dorsal aspect of the hand and often develop secondary to some traumatic mechanism. Although Staphylococcus aureus is most commonly isolated, anaerobic and polymicrobial infections are not uncommon. To date, treatment is largely anecdotal, with some surgeons preferring a formal debridement in the operating room, while others opt for an initial debridement at the bedside. The goals of this study were to compare outcomes between treatment modalities and to identify the most common causative organisms...
March 21, 2019: Hand: Official Journal of the American Association for Hand Surgery
https://read.qxmd.com/read/30895463/a-surgical-algorithm-for-the-management-of-recalcitrant-distal-femur-nonunions-based-on-distal-femoral-bone-stock-fracture-alignment-medial-void-and-stability-of-fixation
#8
Raja Bhaskara Rajasekaran, Dheenadhayalan Jayaramaraju, Dhanasekara Raja Palanisami, Devendra Agraharam, Ramesh Perumal, Arun Kamal, Shanmuganathan Rajasekaran
BACKGROUND: Recalcitrant distal femur nonunions (RDFN) are a challenge in management due to factors including poor bone stock, multiple surgeries, metaphyseal bone loss, and joint contractures. There are no specific guidelines in the management of cases of RDFN. Based on our experience, we devised an algorithm and we present the results of 62 cases of RDFN managed following it. MATERIALS AND METHODS: Our algorithm was formulated after analyzing 34 cases of RDFN and it involved four factors which were hypothesized to influence outcomes namely: distal femoral bone stock, extent of medial void, alignment of the fracture, and stability of fixation...
March 20, 2019: Archives of Orthopaedic and Trauma Surgery
https://read.qxmd.com/read/30893573/evaluation-of-trauma-triage-criteria-performance-in-a-regional-trauma-system
#9
Nichole Bosson, Amy H Kaji, Marianne Gausche-Hill, Dennis Kim, Brant Putnam, Shira Schlesinger, George Singer, Roger J Lewis
OBJECTIVE: We evaluated the performance of individual trauma triage criteria using data from a regional trauma registry. METHODS: Los Angeles County (LAC) paramedics use triage criteria adapted from the 2011 Center for Disease Control (CDC) guidelines to triage injured patients to Trauma Centers (TCs). TCs report outcomes to a LAC EMS registry. We abstracted data for patients 15 years or older from 2013 to 2015 and identified all trauma triage criteria that were met for each encounter...
March 20, 2019: Prehospital Emergency Care
https://read.qxmd.com/read/30893571/dutch-prospective-observational-study-on-prehospital-treatment-of-severe-traumatic-brain-injury-the-brain-protect-study-protocol
#10
Sebastiaan M Bossers, Christa Boer, Sjoerd Greuters, Frank W Bloemers, Dennis Den Hartog, Esther M M Van Lieshout, Nico Hoogerwerf, Gerard Innemee, Joukje van der Naalt, Anthony R Absalom, Saskia M Peerdeman, Matthijs de Visser, Stephan Loer, Patrick Schober
BACKGROUND: Severe traumatic brain injury (TBI) is associated with a high mortality rate and those that survive commonly have permanent disability. While there is a broad consensus that appropriate prehospital treatment is crucial for a favorable neurological outcome, evidence to support currently applied treatment strategies is scarce. In particular, the relationship between prehospital treatments and patient outcomes is unclear. The BRAIN-PROTECT study therefore aims to identify prehospital treatment strategies associated with beneficial or detrimental outcomes...
March 20, 2019: Prehospital Emergency Care
https://read.qxmd.com/read/30893220/ultrasound-guided-nerve-blocks-as-analgesia-for-nonoperative-management-of-distal-radius-fractures-two-consecutive-randomized-controlled-trials
#11
Michiel Siebelt, Klaas A Hartholt, Daniëlle F M van Winden, Femke Boot, Dafni Papathanasiou, Bas C Verdouw, Mark R de Vries, Nina M Mathijssen, Gerald A Kraan
OBJECTIVES: To investigate whether a conventional fracture hematoma block (FHB) or an ultrasound-guided peripheral nerve block has more superior analgesic effect during nonoperative management of distal radius fractures in an emergency department setting. Two peripheral nerve block types were investigated, one at the level of the elbow, or cubital nerve block (CNB), and another an axillary nerve block (ANB). DESIGN: Two prospective randomized controlled studies were performed to compare the difference in pain intensity during closed reduction of a distal radius fracture between FHB-, CNB-, and, ANB-treated patients...
April 2019: Journal of Orthopaedic Trauma
https://read.qxmd.com/read/30893218/morphology-of-the-posterior-malleolar-fracture-associated-with-a-spiral-distal-tibia-fracture
#12
Phillip M Mitchell, Kelly A Harms, Adam K Lee, Cory A Collinge
OBJECTIVE: To define the pathoanatomy of the posterior malleolus fracture associated with a spiral distal tibia fracture to guide clamp and implant placement when treating these common injuries. DESIGN: Retrospective cohort. SETTING: Level I trauma center. PATIENTS/PARTICIPANTS: One hundred twenty-two spiral infraisthmal tibia fractures identified from a cohort of 922 tibia fractures undergoing intramedullary nailing over a 7-year period...
April 2019: Journal of Orthopaedic Trauma
https://read.qxmd.com/read/30893216/short-versus-long-intertan-fixation-for-geriatric-intertrochanteric-hip-fractures-a-multicentre-head-to-head-comparison
#13
Michael Sellan, Dianne Bryant, Christina Tieszer, Steven Papp, Abdel Lawendy, Allan Liew, Darius Viskontas, Mark MacLeod, Chad Coles, Tim Carey, Wade Gofton, Andrew Trenholm, Trevor Stone, Ross Leighton, David Sanders
OBJECTIVE: To determine if geriatric intertrochanteric hip fracture patients achieve equivalent postoperative functional status after management with either a short (180-200 mm) or a long (260-460 mm) InterTAN intramedullary device. DESIGN: Retrospective review of a prospective randomized control trial. SETTING: Four Level I Trauma Centers. PATIENTS/PARTICIPANTS: One hundred eight patients with OTA/AO classification 31A-1 and 31A-2 intertrochanteric hip fractures were included in the study...
April 2019: Journal of Orthopaedic Trauma
https://read.qxmd.com/read/30893215/delay-in-flap-coverage-past-7-days-increases-complications-for-open-tibia-fractures-a-cohort-study-of-140-north-american-trauma-centers
#14
Daniel Pincus, James P Byrne, Avery B Nathens, Anna N Miller, Philip R Wolinsky, David Wasserstein, Bheeshma Ravi, Richard J Jenkinson
OBJECTIVES: To measure time to flap coverage after open tibia fractures and assess whether delays are associated with inpatient complications. DESIGN: Retrospective cohort study. SETTING: One forty level I and II trauma centers in Canada and the United States. PATIENTS/PARTICIPANTS: Adult patients (≥16 years) undergoing surgery for (1) an open tibia (including ankle) fracture and (2) a soft-tissue flap during their index admission between January 1, 2012, and December 31, 2015, were eligible for inclusion...
April 2019: Journal of Orthopaedic Trauma
https://read.qxmd.com/read/30890497/is-routine-mri-of-the-spine-necessary-in-trauma-patients-with-ankylosing-spinal-disorders-or-is-a-ct-scan-sufficient
#15
Celeste Tavolaro, Samia Ghaffar, Haitao Zhou, Quynh Nguyen, Carlo Bellabarba, Richard Bransford
BACKGROUND: Ankylosing spinal disorder (ASD) patients are at a greater risk for spinal fractures due to osteoporosis and rigidity of the spinal column. These fractures are associated with a high risk of neurologic compromise resulting from delayed or missed diagnoses. Although CT is usually the initial imaging modality, MRI has been proposed as mandatory to help identify spinal injuries in ASD patients with unexplained neck or back pain or known injuries to help identify non-contiguous fractures...
March 16, 2019: Spine Journal: Official Journal of the North American Spine Society
https://read.qxmd.com/read/30889243/evaluation-of-multidisciplinary-collaboration-in-pediatric-trauma-care-using-ehr-data
#16
Ashimiyu B Durojaiye, Scott Levin, Matthew Toerper, Hadi Kharrazi, Harold P Lehmann, Ayse P Gurses
OBJECTIVES: The study sought to identify collaborative electronic health record (EHR) usage patterns for pediatric trauma patients and determine how the usage patterns are related to patient outcomes. MATERIALS AND METHODS: A process mining-based network analysis was applied to EHR metadata and trauma registry data for a cohort of pediatric trauma patients with minor injuries at a Level I pediatric trauma center. The EHR metadata were processed into an event log that was segmented based on gaps in the temporal continuity of events...
March 19, 2019: Journal of the American Medical Informatics Association: JAMIA
https://read.qxmd.com/read/30889142/an-analysis-of-pediatric-trauma-center-undertriage-in-a-mature-trauma-system
#17
Amelia T Rogers, Michael A Horst, Tawnya M Vernon, Barbara A Gaines, Eric H Bradburn, Shreya Jammula, Frederick B Rogers
BACKGROUND: Improved mortality as a result of appropriate triage has been well established in adult trauma and may be generalizable to the pediatric trauma population as well. We sought to determine the overall undertriage rate (UTR) in the pediatric trauma population within Pennsylvania (PA). We hypothesized that a significant portion of pediatric trauma population would be undertriaged. METHODS: All pediatric (age <15) admissions meeting trauma criteria (ICD-9: 800-959) from 2003-2015 were extracted from the Pennsylvania Health Care Cost Containment Council (PHC4) database and the Pennsylvania Trauma Systems Foundation (PTSF) registry...
March 15, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30889141/4-factor-prothrombin-complex-concentrate-is-associated-with-improved-survival-in-trauma-related-hemorrhage-a-nationwide-propensity-matched-analysis
#18
Muhammad Zeeshan, Mohammad Hamidi, Ara J Feinstein, Lynn Gries, Faisal Jehan, Joseph Sakran, Ashley Northcutt, Terence OʼKeeffe, Narong Kulvatunyou, Bellal Joseph
INTRODUCTION: Post-traumatic hemorrhage is the most common preventable cause of death in trauma. Numerous small single-center studies have shown the superiority of 4-factor prothrombin complex concentrate(4-PCC) along with fresh frozen plasma (FFP) over FFP-alone in resuscitation of trauma patients. The aim of our study was to evaluate outcomes of severely injured trauma patients who received 4-PCC+FFP compared to FPP-alone. METHODS: 2-year(2015-2016) analysis of the American College of Surgeons-Trauma Quality Improvement Program database...
March 15, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30887219/spinal-injuries-in-airborne-accidents-a-demographic-overview-of-148-patients-in-a-level-1-trauma-center
#19
Henrik C Bäcker, J Turner Vosseller, Lorin Benneker, Markus Noger, Fabian Krause, Sven Hoppe, Moritz C Deml
PURPOSE: The purpose of this study was to investigate the type and severity of spinal injury in airborne sports, as well as patients demographics in this unique set of athletes. Paragliding is one of the most popular airborne sports in Switzerland, which thought to be no less dangerous with a high potential for spinal injury. Few studies on spinal column injuries have been performed in these high-risk athletes with only inconsistent findings. METHODS: Patient charts were analyzed for all airborne sports injuries affecting the spine from 2010 to 2017 at a level-1 trauma center in Switzerland...
March 18, 2019: European Spine Journal
https://read.qxmd.com/read/30886762/palliative-management-of-nonoperative-femoral-neck-fractures-with-continuous-peripheral-indwelling-catheters-case-control-series
#20
Christopher H Rashidifard, Nicholas Romeo, Mark Richardson, Paul Muccino, Thomas DiPasquale, Chelsea M Bush
Introduction: This case-control study evaluates the success of indwelling pain catheters in nonoperatively treated femoral neck fractures (FNFs) for end-of-life pain management. Methods: Patients older than 65 years with nonoperatively treated FNFs were retrospectively identified at a level 1 trauma center between March 2012 and September 2015. Twenty-three received indwelling continuous peripheral pain catheters (experimental) and 10 received traditional pain control modalities (control)...
2019: Geriatric Orthopaedic Surgery & Rehabilitation
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