755 results match your criteria The Polytraumatized Patient


[SMART©-a new time-saving diagnostic emergency room management algorithm].

Chirurg 2019 Mar 19. Epub 2019 Mar 19.

Klinik und Poliklinik für Allgemein‑, Viszeral‑, Thorax- und Gefäßchirurgie, Universitätsklinikum Bonn, Bonn, Deutschland.

Background: Primary computed tomography (CT) plays an increasingly important role in diagnosing life-threatening conditions in polytrauma patients; however, it is associated with two major problems: suboptimal interobserver reliability with unstructured reports especially when the reporting is undertaken by physicians in training during working hours and a delay in beginning urgent surgical interventions, which is mainly due to the time taken until the CT report is available and less to the technical time necessary for the CT. This is why the clinical benefits of a primary CT scan in hemodynamically unstable patients after polytrauma is currently under interdisciplinary discussion.

Objective: The present study focused on the development and evaluation of a standardized imaging and reporting protocol for initial CT diagnostics of injuries that need immediate treatment after polytrauma. Read More

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http://dx.doi.org/10.1007/s00104-019-0811-xDOI Listing

[Influence of massive blood transfusion and traumatic brain injury on TIMP‑1 and MMP‑9 serum levels in polytraumatized patients].

Unfallchirurg 2019 Feb 26. Epub 2019 Feb 26.

Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität München, LMU München, Nußbaumstr. 20, 80336, München, Deutschland.

Background: The morbidity and mortality of polytrauma patients are substantially influenced by the extent of the posttraumatic inflammatory reaction. Studies have shown that TIMP‑1 and MMP‑9 play a major role in posttraumatic immune disorder in genome-wide mRNA microarray analyses. Furthermore, both showed differential gene expression profiles depending on the clinical parameters massive blood transfusion and traumatic brain injury. Read More

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http://dx.doi.org/10.1007/s00113-019-0623-yDOI Listing
February 2019
2 Reads

[Current treatment concepts for trauma-related cardiac arrest : Focal points, differences and similarities].

Anaesthesist 2019 Mar;68(3):132-142

Institut für Rettungs- und Notfallmedizin, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland.

Trauma-related deaths are not only a relevant medical problem but also a socioeconomic one. The care of a polytraumatized patient is one of the less commonly occurring missions in the rescue and emergency medical services. The aim of this article is to compare the similarities and differences between different course concepts and guidelines in the treatment of trauma-related cardiac arrests (TCA) and to filter out the main focus of each concept. Read More

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http://dx.doi.org/10.1007/s00101-019-0538-6DOI Listing

Risk factors for complications and adverse outcomes in polytrauma patients with associated upper extremity injuries.

Patient Saf Surg 2019 4;13. Epub 2019 Feb 4.

1Department of Trauma, Universitaetsspital, University of Zurich, Raemistr.100, 8091 Zurich, Switzerland.

Background: In terms of upper extremity fractures by patients with multiple injuires, a lot of studies have assessed the functional outcome following trauma to have less favorable outcomes in regards to functional recovery. We tested the hypothesis that differences in clinical outcome occur between shaft and articular injuries of the upper extremity, when patients that sustained neurologic deficits (e.g. Read More

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https://pssjournal.biomedcentral.com/articles/10.1186/s13037
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http://dx.doi.org/10.1186/s13037-019-0187-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360674PMC
February 2019
2 Reads

Long-Term Patient-Reported Functional Outcome of Polytraumatized Patients With Operatively Treated Pelvic Fractures.

J Orthop Trauma 2019 Feb;33(2):64-70

Department of Pelvic and Acetabular Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom.

Objectives: To report the long-term functional outcome of a cohort of patients with operatively treated unstable pelvic fractures using validated patient-reported outcome measures.

Design: Long-term observational study using prospective and retrospective data.

Setting: Tertiary referral pelvic trauma center, Bristol, United Kingdom. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001355DOI Listing
February 2019
1 Read

Fenestrated Endovascular Repair with Debranching Technique for Blunt Traumatic Isthmus Injury.

Ann Vasc Dis 2018 Dec;11(4):565-568

Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Thoracic endovascular repair (TEVAR) is a safe treatment alternative to open repair for blunt traumatic aortic injury (BTAI). A 29 year-old-female had multiple traffic injuries, including BTAI located in lesser curve of the isthmus close to the left common carotid artery with an isolated left vertebral artery. TEVAR with simple covering of the left subclavian artery was not adequate to prevent the endoleak. Read More

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http://dx.doi.org/10.3400/avd.cr.18-00088DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326042PMC
December 2018
3 Reads

Automatic rib cage unfolding with CT cylindrical projection reformat in polytraumatized patients for rib fracture detection and characterization: Feasibility and clinical application.

Eur J Radiol 2019 Jan 13;110:121-127. Epub 2018 Nov 13.

Service d'Imagerie Guilloz, Hôpital Central, Centre Hospitalier Universitaire de Nancy, 29 Ave du Maréchal de Lattre de Tassigny, Nancy, 54035, France.

Objectives: To assess the use of CT with unfolded cylindrical projection (UCP) for rib fracture detection and characterization.

Methods: The images from 60 polytraumatized patients who underwent whole body CT were evaluated for the presence and characterization of rib fractures (displaced or not, single or multiple). Two readers independently evaluated conventional CT images and UCP images in two readout sessions at least one month apart. Read More

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http://dx.doi.org/10.1016/j.ejrad.2018.11.011DOI Listing
January 2019
4 Reads

Self-perceived limitations and difficulties by Primary Health Care Physicians to assist emergencies.

Medicine (Baltimore) 2018 Dec;97(52):e13819

The study was aimed to identify the training received in Emergency Medicine by physicians and the limitations and difficulties self-perceived by those physicians to assist in emergencies, as well as to analyze the differences according to the work context.Observational cross-sectional study made by a survey using a self-administered questionnaire to a representative simple random sample (with replacement) of 294 doctors (n) working at the Primary Health Care centers out of the total of 851 doctors (N) that form the staff of physicians of Primary Health Care system of Asturias (Spain).In rural areas, the most frequently mentioned reasons were the lack of practical skills (32. Read More

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http://dx.doi.org/10.1097/MD.0000000000013819DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314741PMC
December 2018
1 Read

Single-Incision Double-Plating Approach in the Management of Isolated, Closed Osteoporotic Distal Femoral Fractures.

Geriatr Orthop Surg Rehabil 2018 11;9:2151459318799856. Epub 2018 Nov 11.

Ain-Shams University, Cairo, Egypt.

Introduction: Distal femoral fractures in elderly population had recorded an increase in incidence in the last 2 decades. Lateral distal femoral locking plating is considered one of the best options especially when dealing with comminuted fractures but varus collapse of the medial femoral condyle occurs frequently in patients with osteoporosis. Anatomical reduction of the fracture with stable rigid fixation using double-plating approach allows early mobilization of geriatric population and prevents varus collapse minimizing the comorbidities in such fractures. Read More

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http://dx.doi.org/10.1177/2151459318799856DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6236632PMC
November 2018

Diagnostic Utility of Serum Neutrophil Gelatinase-Associated Lipocalin in Polytraumatized Patients Suffering Acute Kidney Injury: A Prospective Study.

Biomed Res Int 2018 6;2018:2687584. Epub 2018 Nov 6.

Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Austria.

Introduction: The incidence of acute kidney injury (AKI) considerably increases the mortality rate in polytrauma victims. Undoubtedly, early identification of patients at risk is crucial for timely implementation of preventive strategies in order to improve their prognosis. Therefore, we aimed to investigate if serum neutrophil gelatinase-associated lipocalin (sNGAL) may serve as a diagnostic biomarker of early AKI in polytrauma victims, especially considering patients needing renal replacement theory (RRT). Read More

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http://dx.doi.org/10.1155/2018/2687584DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6247699PMC
March 2019
3 Reads

Epidemiological study of bucomaxilofacial trauma in a Paraíba reference hospital.

Rev Col Bras Cir 2018 Nov 29;45(6):e1978. Epub 2018 Nov 29.

Universidade Federal de Campina Grande, Unidade Acadêmica de Ciências Biológicas, Patos, PB, Brasil.

Objective: to study the epidemiological data of patients suffering from buccomaxillofacial trauma treated at a referral hospital in the State of Paraíba.

Methods: we conducted a cross-sectional study of inductive approach, with a comparative statistical procedure and research technique by field direct documentation. The sample comprised hospital records obtained from January 2016 to December 2017 of patients attended by the Service of Buccomaxillofacial Surgery and Traumatology of this hospital, and consisted of 332 patients according to the study's eligibility criteria. Read More

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http://www.scielo.br/scielo.php?script=sci_arttext&pid=S
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http://dx.doi.org/10.1590/0100-6991e-20181978DOI Listing
November 2018
9 Reads

[Costs and proceeds from patients admitted via the emergency room with mild craniocerebral trauma].

Unfallchirurg 2018 Oct 10. Epub 2018 Oct 10.

Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Uniklinik Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.

The introduction of the diagnosis-related groups (DRG) in 2003 radically changed the billing of the treatment costs. From the very beginning, trauma surgeons questioned whether the introduction of the DRG could have a negative impact on the care of the severely injured. "Trauma centers in need" was the big catchword warning against shortfalls at trauma centers due to the billing via DRG. Read More

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http://link.springer.com/10.1007/s00113-018-0566-8
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http://dx.doi.org/10.1007/s00113-018-0566-8DOI Listing
October 2018
4 Reads

Distinct Dynamics of Stem and Progenitor Cells in Blood of Polytraumatized Patients.

Shock 2019 Apr;51(4):430-438

Institute of Molecular Medicine, Ulm University, Ulm, Germany.

Endogenously mobilized stem and progenitor cells (SPCs) or exogenously provided SPCs are thought to be beneficial for trauma therapy. However, still little is known about the synchronized dynamics of the number of SPCs in blood after severe injury and parameters like cytokine profiles that correlate with these numbers. We determined the number of hematopoietic stem cells, common myeloid progenitors, granulocyte-macrophage progenitors, and mesenchymal stem/stromal cells in peripheral blood (PB) 0 to 3, 8, 24, 48, and 120 h after polytrauma in individual patients (injury severity score ≥ 21). Read More

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http://Insights.ovid.com/crossref?an=00024382-900000000-9773
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http://dx.doi.org/10.1097/SHK.0000000000001198DOI Listing
April 2019
14 Reads

Surgical reduction technique (transpedicle) for unstable thoracolumbar burst fractures with retropulsion resulting in severe spinal canal stenosis: a preliminary case report.

AME Case Rep 2018 23;2:38. Epub 2018 Jul 23.

Orthopaedic Surgery Department, University Malaya Medical Centre, Kuala Lumpur, Malaysia.

Thoracolumbar burst fractures are common entity in polytraumatized patients. The retropulsed burst vertebral fracture may result in spinal canal invasion with or without neurological deficit. In this situation, early surgical stabilization with decompression is vital to restore neurological function. Read More

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http://acr.amegroups.com/article/view/4557/5302
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http://dx.doi.org/10.21037/acr.2018.07.02DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6155616PMC
July 2018
2 Reads

Assessment of clinical parameters of the polytraumatized patient as predictors of hospital expenditure and of its distribution.

Rev Esp Cir Ortop Traumatol 2018 Nov - Dec;62(6):408-414. Epub 2018 Aug 20.

Unidad de Investigación, Hospital 12 de Octubre, Madrid, España.

Introduction: Traumatic pathology continues to represent an important socio-health problem. The aim of the study was to assess the clinical predictors of total expenditure, as well as to analyze which components of the cost are modified with each clinical parameter of the polytraumatized patient.

Material And Methods: Retrospective study of 131 polytrauma patients registered prospectively. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18884415183008
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http://dx.doi.org/10.1016/j.recot.2018.05.005DOI Listing
August 2018
13 Reads

Assessment of polytraumatized patients according to the Berlin Definition: Does the addition of physiological data really improve interobserver reliability?

PLoS One 2018 23;13(8):e0201818. Epub 2018 Aug 23.

Department of Trauma, University Hospital Zurich, Zurich, Switzerland.

Background: Several new definitions for categorizing the severely injured as the Berlin Definition have been developed. Here, severely injured patients are selected by additive physiological parameters and by the general Abbreviated Injury Scale (AIS)-based assessment. However, all definitions should conform to an AIS severity coding applied by an expert. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0201818PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107114PMC
February 2019
22 Reads

Methylene Blue for Refractory Shock in Polytraumatized Patient: A Case Report.

J Emerg Med 2018 10 16;55(4):553-558. Epub 2018 Aug 16.

Department of Pediatrics, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.

Background: Methylene blue (MB) has been advocated for the treatment of shock refractory to standard measures. MB is proposed to increase blood pressure in shock by interfering with guanylate cyclase and nitric oxide synthase (NOS) activity. Several studies have evaluated the vasoconstrictive and positive inotropic effects of MB in septic shock patients. Read More

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http://dx.doi.org/10.1016/j.jemermed.2018.06.037DOI Listing
October 2018
32 Reads

Spinopelvic Dissociation: A Retrospective Case Study and Review of Treatment Controversies.

J Am Acad Orthop Surg 2018 Jul;26(14):e302-e312

From the Department of Trauma and Orthopaedics, Royal London Hospital, Bart's Health NHS Trust, London, UK.

Introduction: Spinopelvic dissociation is a rare injury resulting in discontinuity between the spine and pelvis. We review the English- language literature and discuss critical treatment controversies. We present a series of spinopelvic dissociation cases from a level I trauma center. Read More

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http://dx.doi.org/10.5435/JAAOS-D-16-00366DOI Listing
July 2018
2 Reads

Management of Talar Body Fractures.

Indian J Orthop 2018 May-Jun;52(3):258-268

Department of Orthopaedics, Ganga Hospital, Coimbatore, Tamil Nadu, India.

Fractures of talar body are uncommon injuries often associated with fractures of other long bones and in polytraumatized patients. The integrity of the talus is essential for the normal function of the ankle, subtalar, and midtarsal joints. The relative infrequency of this injury limits the number of studies available to guide treatment. Read More

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http://www.ijoonline.com/text.asp?2018/52/3/258/231959
Publisher Site
http://dx.doi.org/10.4103/ortho.IJOrtho_563_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5961263PMC
June 2018
20 Reads

A Novel Approach to Identify Polytraumatized Patients in Extremis.

Biomed Res Int 2018 17;2018:7320158. Epub 2018 Apr 17.

Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria.

Introduction: Due to the fact that early objective identification of polytraumatized patients in extremis is crucial for carrying out immediate life-saving measures, our objectives were to provide and scrutinize a definition that results in a particularly high mortality rate and to identify predictors of mortality in this group.

Materials And Methods: A polytraumatized patient (ISS ≥ 16) was classified "in extremis" if five out of seven parameters (arterial paCO > 50 mmHg, hemoglobin < 9.5 g/dl, pH value < 7. Read More

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http://dx.doi.org/10.1155/2018/7320158DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932503PMC
October 2018
10 Reads

Inferior Vena Cava Filter Strut Penetration into the Vertebral Column: A Case of 10-Year Clinical Follow Up.

Curr Probl Diagn Radiol 2018 Apr 18. Epub 2018 Apr 18.

Department of Diagnostic Radiology, Allegheny General Hosptial, Allegheny Health Network, Pittsburgh, PA.

Background: The rate of vena cava (IVC) filter placement has increased over the past decade, especially in the orthopaedic trauma patient population. With the increasing use of IVC filters, radiologists and referring clinicians must be familiar with potential complications.

Clinical Case: This case report presents an 18-year-old polytraumatized patient who had an IVC filter placed and required T8-L2 posterior spinal fusion. Read More

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http://dx.doi.org/10.1067/j.cpradiol.2018.04.006DOI Listing
April 2018
3 Reads

Influence of Entrapment on Prehospital Management and the Hospital Course in Polytrauma Patients: A Retrospective Analysis in Air Rescue.

J Emerg Med 2018 06 19;54(6):827-834. Epub 2018 Apr 19.

Trauma Department, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany; Department of General, Trauma, and Reconstructive Surgery, Ludwig-Maximilians-Universität München, Munich, Germany.

Background: Entrapment is a challenging and crucial factor in the prehospital setting. Few studies have addressed whether entrapment has an influence on on-scene treatment or on the following hospital course.

Objectives: Here we aimed to investigate the influence of entrapment on prehospital management and on the hospital course of polytrauma patients. Read More

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http://dx.doi.org/10.1016/j.jemermed.2018.02.030DOI Listing
June 2018
30 Reads

Bilateral Hip Dislocation: An Indicator for Emergent Full-Body Computed Tomography Scan in Polytraumatized Patients? A Case Report and Review of the Literature.

J Emerg Trauma Shock 2018 Jan-Mar;11(1):53-56

Department of Orthopaedic and Trauma Surgery, University of Bern, Inselspital, Bern, Switzerland.

We present a rare case of traumatic bilateral asymmetric hip dislocation with pelvic fractures and a traumatic diaphragmatic hernia. A 53-year-old machinist was transferred to our emergency department with the suspicion of a bilateral hip dislocation after he was trapped between an elevator and the roof. Immediate closed reduction of the hips was not performed because of the expected risk of increasing hemodynamic instability with muscular relaxation. Read More

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http://dx.doi.org/10.4103/JETS.JETS_12_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852918PMC
April 2018
4 Reads

Covariate determinants of effective dosing regimens for time-dependent beta-lactam antibiotics for critically ill patients.

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2018 Sep 27;162(3):219-226. Epub 2018 Mar 27.

Department of Surgery, University Hospital Hradec Kralove, Sokolska 581, 50005 Hradec Kralove, Czech Republic.

Aims: Critically ill patients undergoing aggressive fluid resuscitation and treated empirically with hydrosoluble time-dependent beta-lactam antibiotics are at risk for sub-therapeutic plasma concentrations. The aim of this study was to assess the impact of two covariates - creatinine clearance (Cl) and cumulative fluid balance (CFB) on pharmacokinetics/pharmacodynamics (PK/PD) target attainment within a week of treatment with meropenem (ME) or piperacillin/tazobactam (PIP/TZB).

Methods: In this prospective observational pharmacokinetic (PK) study, 18 critically ill patients admitted to a surgical Intensive Care Unit (ICU) were enrolled. Read More

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http://dx.doi.org/10.5507/bp.2018.011DOI Listing
September 2018
4 Reads

[Intramedullary nailing in bifocal leg fractures: about 16 cases].

Pan Afr Med J 2017 13;28:139. Epub 2017 Oct 13.

Service d'Orthopédie et Traumatologie A, CHU Hassan II, Fès, Maroc.

We conducted a retrospective study of bifocal closed fractures of the tibia in order to assess the severity of this unusual lesion. We analyzed the entry point for intramedullary nailing as well as the different therapeutic options. Sixteen patients with AO type 42C2 bifocal leg fractures were treated in our Traumatology-Orthopedics Unit A at the University Hospital Hassan II, Fez. Read More

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http://dx.doi.org/10.11604/pamj.2017.28.139.3036DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5847053PMC
March 2018
6 Reads

Cerebral Arterial Compliance in Traumatic Brain Injury.

Acta Neurochir Suppl 2018 ;126:21-24

Department of Neurosurgery, University of New Mexico School of Medicine, 1 University of New Mexico, MSC 10 5615 Neurosurgery, Albuquerque, NM, 87131, USA.

Objective: The main role of the cerebral arterial compliance (cAC) is to maintain the stiffness of vessels and protect downstream vessels when changing cerebral perfusion pressure. The aim was to examine the flexibility of the cerebral arterial bed based on the assessment of the cAC in patients with traumatic brain injury (TBI) in groups with and without intracranial hematomas (IHs).

Materials And Methods: We examined 80 patients with TBI (mean age, 35. Read More

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http://dx.doi.org/10.1007/978-3-319-65798-1_5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344027PMC
July 2018
2 Reads

Respiratory Obstruction Due to Richards Type 4 Fracture.

J Craniofac Surg 2018 Jun;29(4):e358-e359

Department of Oral and Maxillofacial Surgery and Integrated Clinic, Araçatuba Dental School, UNESP, Araçatuba, Brazil.

Facial fractures can be potentially fatal in polytraumatized patients due to retropositioning tissues to upper airway obstruction. In the first aids, this situation can be reversed using a tracheostomy procedure to break out the airways. However, fractures leading to airway obstruction are rare and according to Richards Classification can be classified into 5 types. Read More

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http://dx.doi.org/10.1097/SCS.0000000000004332DOI Listing
June 2018
3 Reads

Diagnosis and Management of Polytraumatized Patients With Severe Extremity Trauma.

J Orthop Trauma 2018 Mar;32 Suppl 1:S1-S6

Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA.

Multiply injured patients with severe extremity trauma are at risk of acute systemic complications and are at high risk of developing longer term orthopaedic complications including soft-tissue infection, osteomyelitis, posttraumatic osteoarthritis, and nonunion. It is becoming increasingly recognized that injury magnitude and response to injury have major jurisdiction pertaining to patient outcomes and complications. The complexities of injury and injury response that affect outcomes present opportunities to apply precision approaches to understand and quantify injury magnitude and injury response on a patient-specific basis. Read More

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http://Insights.ovid.com/crossref?an=00005131-201803003-0000
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http://dx.doi.org/10.1097/BOT.0000000000001114DOI Listing
March 2018
9 Reads

[Abdominal injuries in polytraumatized adults : Systematic review].

Unfallchirurg 2018 Feb;121(2):159-173

Klinik für Traumatolgie, UniversitätsSpital Zürich, Rämistr. 100, 8091, Zürich, Schweiz.

Abdominal injuries are potentially life-threatening and occur in 20-25% of all polytraumatized patients. Blunt trauma is the main mechanism. The liver and spleen are most commonly injured and much less often the intestines. Read More

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http://dx.doi.org/10.1007/s00113-017-0456-5DOI Listing
February 2018
3 Reads

Increased serum concentrations of soluble ST2 are associated with pulmonary complications and mortality in polytraumatized patients.

Clin Chem Lab Med 2018 04;56(5):810-817

Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria.

Background: We sought to evaluate the role of soluble ST2 (suppression of tumorigenicity) serum concentrations in polytraumatized patients and its potential role as biomarker for pulmonary complications.

Methods: We included severely injured patients (injury severity score≥16) admitted to our level I trauma center and analyzed serum samples obtained on the day of admission and on day 2. Furthermore, patients with isolated thoracic injury and healthy probands were included and served as control groups. Read More

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http://dx.doi.org/10.1515/cclm-2017-0762DOI Listing
April 2018
12 Reads

[Chest injuries in polytraumatized children].

Rozhl Chir 2017 ;96(12):498-503

Chest injuries in children are part of polytrauma resulting from high-energy violence, most often caused by traffic accidents. Blunt chest injuries (95%) are significantly more frequent than penetrating injuries (5%). Lung contusion, rib fracture, pneumothorax or haemothorax, are the more common injuries, but tracheobronchial rupture, cardiac or diaphragmatic injuries may also occur. Read More

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January 2017
7 Reads

Trauma care in German-speaking countries: have changes in the curricula led to changes in practice after 10 years?

Eur J Trauma Emerg Surg 2018 Jan 6. Epub 2018 Jan 6.

Klinik für Orthopädie und Unfallchirurgie, Luzerner Kantonsspital, Lucerne, Switzerland.

Purpose: Traditionally, in the German-speaking countries, trauma patients are treated by general surgeons specialized in trauma surgery known as the Unfallchirurg. Over the last decade, a trend towards a lower influence of surgeons and a higher influence of subspecialties in the emergency department has been noted. With additional transformations in the health care system towards highly specialized medicine and the arising of new (sub-) specialties, diversification in the management of the trauma patient appears to occur. Read More

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http://dx.doi.org/10.1007/s00068-017-0894-3DOI Listing
January 2018
24 Reads

Predictive value of focused assessment with sonography for trauma (FAST) for laparotomy in unstable polytrauma Egyptians patients.

Chin J Traumatol 2017 Dec 23;20(6):323-328. Epub 2017 Nov 23.

Department of General Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

Purpose: The emergency physicians face significant clinical uncertainty when multiple trauma patients arrive in the emergency department (ED). The priorities for assessment and treatment of polytrauma patients are established in the primary survey. Focused assessment with sonography for trauma (FAST) is very essential clinical skill during trauma resuscitation. Read More

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http://dx.doi.org/10.1016/j.cjtee.2017.09.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5832486PMC
December 2017
8 Reads

Limited influence of blunt aortic injuries on the outcome of polytraumatized patients: a matched pair analysis.

Arch Orthop Trauma Surg 2018 Feb 15;138(2):211-218. Epub 2017 Nov 15.

Trauma Department, Hannover Medical School, Hannover, Germany.

Introduction: Traumatic lesions of great vessels such as the aorta are life-threatening injuries. There is limited evidence about the influence of traumatic aortic injuries in multiple trauma patients in particular with regard to posttraumatic complications. The aim of this study was to evaluate the influence of blunt thoracic aortic injuries in multiple trauma patients compared to a multiple trauma cohort without this specific injury. Read More

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http://dx.doi.org/10.1007/s00402-017-2842-4DOI Listing
February 2018
5 Reads

Thromboelastometric Profile and Acute Coagulopathy of the Polytraumatized Patient: Clinical and Prognostic Implications.

Cir Esp 2018 Jan 28;96(1):41-48. Epub 2017 Oct 28.

Servicio de Anestesiología y Reanimación, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España.

Introduction: About 25-35% of polytraumatized patients have a profound alteration of hemostasis on arrival at the hospital (acute traumatic coagulopathy [CAT]). Viscoelastic tests (ROTEM) measure the hemostatic capacity and provide an early detection of CAT. The objectives of this study are to describe the initial thromboelastogram of these patients and to determine the prevalence of CAT according to predefined thromboelastographic profiles. Read More

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http://dx.doi.org/10.1016/j.ciresp.2017.09.012DOI Listing
January 2018
9 Reads

An overview of cytokines and heat shock response in polytraumatized patients.

Cell Stress Chaperones 2018 07 3;23(4):483-489. Epub 2017 Nov 3.

Servicio de Cirugía Ortopédica y Traumatología, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Hospital General Universitario "Gregorio Marañón", Dr. Esquerdo 46, 28007, Madrid, Spain.

Early after injury, local tissue damage induces a local and systemic inflammatory response that activates the immune system and leads to the development of systemic inflammatory response syndrome (SIRS). This post-traumatic response often results in uncontrolled release of inflammatory mediators and over-activation of the immune system, which occasionally results in multiple organ dysfunction syndrome (MODS). In parallel, a state of immunosuppression develops. Read More

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http://dx.doi.org/10.1007/s12192-017-0859-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6045557PMC
July 2018
5 Reads

Elevated Serum Protein S100B and Neuron Specific Enolase Values as Predictors of Early Neurological Outcome After Traumatic Brain Injury.

J Med Biochem 2017 Oct 28;36(4):314-321. Epub 2017 Oct 28.

School of Medicine, University of Belgrade, Belgrade, Serbia.

Background: The objective of our study was to determine the serum concentrations of protein S100B and neuron specific enolase (NSE) as well as their ability and accuracy in the prediction of early neurological outcome after a traumatic brain injury.

Methods: A total of 130 polytraumatized patients with the associated traumatic brain injuries were included in this prospective cohort study. Serum protein S100B and NSE levels were measured at 6, 24, 48 and 72 hours after the injury. Read More

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http://dx.doi.org/10.1515/jomb-2017-0018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294083PMC
October 2017
6 Reads

Is Systemic Inflammatory Response Syndrome Relevant to Pulmonary Complications and Mortality in Multiply Injured Children?

J Pediatr Orthop 2017 Oct 9. Epub 2017 Oct 9.

The Children's Hospital of Philadelphia, Philadelphia, PA.

Background: Systemic inflammatory response syndrome (SIRS) is a well-recognized phenomenon in adult trauma populations. The "initial hit" of the traumatic event is often coupled with a systemic immune response characterized by changes in vital signs and laboratory indicators. A "second hit" from surgery during this time frame often results in acute lung injury, along with deterioration of the patient's clinical condition. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001085DOI Listing
October 2017
29 Reads

Mesenchymal stem cells in peripheral blood of severely injured patients.

Eur J Trauma Emerg Surg 2018 Aug 6;44(4):627-636. Epub 2017 Oct 6.

Department of Orthopedics, Division for Biochemistry of Joint and Connective Tissue Diseases, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany.

Purpose: Mesenchymal stem cells (MSCs) are primarily stromal cells present in bone marrow and other tissues that are crucial for tissue regeneration and can be mobilized into peripheral blood after different types of organ damage. However, little is known about MSC appearance in blood in the setting of polytrauma.

Methods: We conducted a monocentered and longitudinal observational clinical study in 11 polytraumatized patients with an injury severity score (ISS) ≥ 24 to determine the numbers of MSCs in peripheral blood. Read More

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http://dx.doi.org/10.1007/s00068-017-0849-8DOI Listing
August 2018
4 Reads

Hypertension, Acute Stent Thrombosis, and Paraplegia 6 Months after Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury in a 22-Year-Old Patient.

Ann Vasc Surg 2018 Feb 9;47:281.e5-281.e10. Epub 2017 Sep 9.

Department of General Surgery, Surgical Specialties and Organ Transplantation "Paride Stefanini", Policlinico "Umberto I" Hospital, "Sapienza" University, Rome, Italy.

Thoracic endovascular aortic repair (TEVAR) is a less invasive option for managing traumatic injuries of the descending aorta in polytraumatized patients. Concerns arise when treating young patients with TEVAR. A 22-year-old male was admitted to the emergency department following a high-impact road traffic collision. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08905096173098
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http://dx.doi.org/10.1016/j.avsg.2017.08.041DOI Listing
February 2018
9 Reads

Does the applied polytrauma definition notably influence outcome and patient population? - a retrospective analysis.

Scand J Trauma Resusc Emerg Med 2017 Aug 31;25(1):87. Epub 2017 Aug 31.

Department of Trauma Surgery, Medical University of Vienna, Waehringer Gürtel 18-20, 1090, Vienna, Austria.

Background: Although the term "polytrauma" has been in use for decades, no generally accepted definition exists. The aim of this study was to demonstrate that different polytrauma definitions applied to a specific patient population result in diverse subgroups of individuals, who in turn present a varying outcome.

Methods: All patients (≥18 years) treated at our level I trauma center within a time period of three years were classified according to 11 selected polytrauma definitions and included in our study, if they were rated "polytraumatized" by at least one of these definitions. Read More

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http://dx.doi.org/10.1186/s13049-017-0400-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577783PMC
August 2017
18 Reads

Fibular Strut Graft for Posterior Pelvic Ring Nonunion - a Case Report.

Acta Chir Orthop Traumatol Cech 2017 ;84(3):211-214

Department of Surgery, University Hospital Hradec Králové, Czech Republic.

Posttraumatic pelvic nonunions in combination with malposition are uncommon in the present-day era of modern pelvic surgery. The case describes a new surgical technique for treatment of the nonunion localized to iliosacral joint. A 42-year-old polytraumatized male presented with a pelvic fracture (type 61-C2. Read More

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January 2018
5 Reads

Double-plating fixation of comminuted femoral shaft fractures with concomitant thoracic trauma.

J Int Med Res 2018 Jan 31;46(1):440-447. Epub 2017 Jul 31.

Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital affiliated to Shanghai Jiaotong University, People's Republic of China.

Objective This study was performed to evaluate the clinical outcomes in adult polytraumatized patients with thoracic injury and femoral shaft fractures treated with double-plating fixation. Methods From November 2010 to October 2014, 15 polytraumatized patients with femoral shaft fractures were enrolled in this retrospective study. Radiographic findings and functional outcomes were assessed at 1, 3, 6, and 12 months postoperatively. Read More

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http://dx.doi.org/10.1177/0300060517720317DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6011299PMC
January 2018
2 Reads

Delayed recognition of an ipsilateral femoral neck and shaft fracture leading to preventable subsequent complications: a case report.

Patient Saf Surg 2017 10;11:20. Epub 2017 Jul 10.

Klinik für orthopädische und Unfallchirurgie, CHARITÉ - Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.

Background: Ipsilateral femoral shaft and neck fractures are rare injuries, affecting mostly young patients who sustained high-energy traumas. In 19-50% of cases, the femoral fracture is misdiagnosed or overlooked at the initial presentation, with reportedly increased risk of complications such as non-union and avascular necrosis. We present a case of an ipsilateral femoral neck and shaft fracture, which was missed at initial presentation despite radiographic and computed tomography (CT) scan evaluation. Read More

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http://dx.doi.org/10.1186/s13037-017-0134-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504794PMC
July 2017
11 Reads

Quality and Dose Optimized CT Trauma Protocol - Recommendation from a University Level-I Trauma Center.

Rofo 2017 Sep 26;189(9):844-854. Epub 2017 Jun 26.

Department of Radiology, Charité School of Medicine and University Hospital, Berlin, Germany.

 As a supra-regional level-I trauma center, we evaluated computed tomography (CT) acquisitions of polytraumatized patients for quality and dose optimization purposes. Adapted statistical iterative reconstruction [(AS)IR] levels, tube voltage reduction as well as a split-bolus contrast agent (CA) protocol were applied.  61 patients were split into 3 different groups that differed with respect to tube voltage (120 - 140 kVp) and level of applied ASIR reconstruction (ASIR 20 - 50 %). Read More

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http://dx.doi.org/10.1055/s-0043-108996DOI Listing
September 2017
11 Reads

The Care of Thermally Injured Patients in Operational, Austere, and Mass Casualty Situations.

Wilderness Environ Med 2017 Jun;28(2S):S103-S108

US Army Institute of Surgical Research, San Antonio, TX.

Burn injury affects a half million people in the United States annually. The severe thermal injury can have long-term debilitating effects. The management of burn patients in austere and operational environments is more complex. Read More

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http://dx.doi.org/10.1016/j.wem.2017.03.011DOI Listing
June 2017
11 Reads

Functional outcomes and quality of life in patients with subtalar arthrodesis for posttraumatic arthritis.

Injury 2017 Jul 16;48(7):1696-1700. Epub 2017 May 16.

Department of Surgery, University Medical Center Utrecht, The Netherlands.

Introduction: Subtalar arthrodesis is a common salvage operation for posttraumatic subtalar arthritis, a condition frequently seen in patients who suffered major trauma. Functional outcomes in trauma patients may be influenced by concomitant injuries and the severity of the initial trauma. The aim of this study was to evaluate quality of life and functional outcomes of subtalar arthrodesis for posttraumatic arthritis in patients with severe or complex foot injuries. Read More

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http://dx.doi.org/10.1016/j.injury.2017.05.018DOI Listing
July 2017
16 Reads

Multiple-level Replantation in Elderly Patients: Risk Versus Benefit.

Plast Reconstr Surg Glob Open 2017 Apr 27;5(4):e1313. Epub 2017 Apr 27.

Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Wuerzburg, Wuerzburg, Germany.

Multiple-level amputations of the upper extremity represent a surgical challenge generally only attempted in young patients. This case demonstrates a successful replantation in an elderly woman. The postoperative course was complicated by disseminated intravascular coagulopathy most likely due to inadequate resuscitation. Read More

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http://Insights.ovid.com/crossref?an=01720096-201704000-0003
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http://dx.doi.org/10.1097/GOX.0000000000001313DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5426891PMC
April 2017
3 Reads

Unusual combination of femoral head dislocation associated acetabular fracture with multipart femoral fractures: Case report.

Int J Surg Case Rep 2017 27;34:32-35. Epub 2017 Feb 27.

Department of Orthopedic and Traumatology, Ahi Evran University, Kırşehir, Turkey.

Introduction: Traumatic hip dislocation associated with femur intertrocanteric fracture is a rare and severe injury and it frequently occurs following a high energy trauma, Associated acetabular fractures with this injury are even more rare and potentially cause devastating consequences including avascular necrosis of the femoral head and subsequent early secondary osteoarthritis of the hip joint.

Presentation Of Case: In this case report, we present a 20year old polytraumatized patient with traumatic hip dislocation associated with ipsilateral acetabulum fracture and simultaneous fractures of the ipsilateral femur.

Discussion: Traumatic hip dislocation associated with femur intertrochanteric fracture is a rare and severe injury and it frequently occurs following a high energy trauma. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S22102612173011
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http://dx.doi.org/10.1016/j.ijscr.2017.02.043DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394188PMC
February 2017
10 Reads