838 results match your criteria The Polytraumatized Patient


Transarterial embolization with n-butyl cyanoacrylate for the treatment of active abdominopelvic bleeding in the polytraumatized patient.

CVIR Endovasc 2021 May 6;4(1):39. Epub 2021 May 6.

Division of Interventional Radiology, Department of Radiology, Hematology and Oncology, Medical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14048-090, Brazil.

Purpose: An increasing number of polytraumatized patient presenting with active abdominal pelvic bleeding (APB) have been treated by endovascular selective embolization. However, reports on evaluate the efficacy, safety and complications caused by this technique have been limited. The aim of this study was to assess the safety and efficacy of embolization of APB using N-butyl cyanoacrylate glue (NBCA). Read More

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Polytrauma: update on basic science and clinical evidence.

OTA Int 2021 Mar 23;4(1):e116. Epub 2021 Feb 23.

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

The management of multiply injured or severely injured patients is a complex and dynamic process. Timely and safe fracture fixation is a critical component of the multidisciplinary care that these patients require. Effective management of these patients, and their orthopaedic injuries, requires a strong understanding of the pathophysiology of the response to trauma and indicators of patient status, as well as an appreciation for the dynamic nature of these parameters. Read More

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Age-Dependent Patient and Trauma Characteristics and Hospital Resource Requirements-Can Improvement Be Made? An Analysis from the German Trauma Registry.

Medicina (Kaunas) 2021 Apr 1;57(4). Epub 2021 Apr 1.

Committee on Emergency Medicine, Intensive Care and Trauma Management (Sektion NIS) of the German Trauma Society (DGU), 10623 Berlin, Germany.

The burden of geriatric trauma patients continues to rise in Western society. Injury patterns and outcomes differ from those seen in younger adults. Getting a better understanding of these differences helps medical staff to provide a better care for the elderly. Read More

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Alterations of Phagocytic Activity and Capacity in Granulocytes and Monocytes Depend on the Pathogen Strain in Porcine Polytrauma.

Front Med (Lausanne) 2021 6;8:645589. Epub 2021 Apr 6.

Experimental Radiology, Department of Radiology and Nuclear Medicine, Otto von Guericke University, Magdeburg, Germany.

Polytraumatized patients undergo a strong immunological stress upon insult. Phagocytes (granulocytes and monocytes) play a substantial role in immunological defense against bacteria, fungi and yeast, and in the clearance of cellular debris after tissue injury. We have reported a reduced monocytes phagocytic activity early after porcine polytrauma before. Read More

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Acute alcohol consumption increases systemic endotoxin bioactivity for days in healthy volunteers-with reduced intestinal barrier loss in female.

Eur J Trauma Emerg Surg 2021 Apr 11. Epub 2021 Apr 11.

Department of Trauma, Hand and Reconstructive Surgery, Goethe University, Frankfurt, Germany.

Objective: Trauma is the most common cause of death among young adults. Alcohol intoxication plays a significant role as a cause of accidents and as a potent immunomodulator of the post-traumatic response to tissue injury. Polytraumatized patients are frequently at risk to developing infectious complications, which may be aggravated by alcohol-induced immunosuppression. Read More

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The GERtality Score: The Development of a Simple Tool to Help Predict in-Hospital Mortality in Geriatric Trauma Patients.

J Clin Med 2021 Mar 25;10(7). Epub 2021 Mar 25.

Department of Traumatology, University Hospital of Zürich, 8091 Zürich, Switzerland.

Feasible and predictive scoring systems for severely injured geriatric patients are lacking. Therefore, the aim of this study was to develop a scoring system for the prediction of in-hospital mortality in severely injured geriatric trauma patients. The TraumaRegister DGU (TR-DGU) was utilized. Read More

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Modern Principles in the Acute Surgical Management of Open Distal Tibial Fractures.

J Am Acad Orthop Surg 2021 Mar 31. Epub 2021 Mar 31.

From the Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD (Shafiq), the Department of Orthopaedic Surgery, New York University School of Medicine, New York, NY (Hacquebord), and the Department of Orthopaedic Surgery, University of California, School of Medicine, Los Angeles, CA (Wright and Gupta).

Over the past two decades, management of open distal tibial fractures has evolved such that a staged approach, with external fixation and débridement during the index procedure, followed by definitive fixation and wound closure at a later date, is often considered the standard of care. Although definitive treatment of these complex injuries is often done by a multidisciplinary team of surgeons well versed in periarticular fracture repair and soft-tissue coverage in the distal extremity, the on-call orthopaedic surgeon doing the index procedure must understand the principles and rationale of the staged treatment algorithm to avoid compromising definitive treatment options and ensure the best possible patient outcome. The mechanism of injury, neurovascular status, size and location of soft-tissue injury, fracture pattern, and concomitant injuries in the polytraumatized patient should direct the treatment plan and anticipated outcomes. Read More

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Radiomics score predicts acute respiratory distress syndrome based on the initial CT scan after trauma.

Eur Radiol 2021 Mar 17. Epub 2021 Mar 17.

Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.

Objectives: Acute respiratory distress syndrome (ARDS) constitutes a major factor determining the clinical outcome in polytraumatized patients. Early prediction of ARDS is crucial for timely supportive therapy to reduce morbidity and mortality. The objective of this study was to develop and test a machine learning-based method for the early prediction of ARDS derived from the first computed tomography scan of polytraumatized patients after admission to the hospital. Read More

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Imaging in polytrauma - Principles and current concepts.

J Clin Orthop Trauma 2021 May 5;16:106-113. Epub 2020 Dec 5.

Dept. of Orthopaedics, Ganga Medical Centre & Hospitals Pvt. Ltd, Coimbatore, India.

Imaging forms a crucial component in reducing mortality of polytraumatized patients by aiding appropriate diagnosis and guiding the emergency and definitive treatment. With the exponential expansion in the radiological armamentarium and introduction of protocols like Extended focused assessment with sonography for trauma (EFAST) and Whole body Computed tomography (WBCT), the role of imaging has considerably increased. Emergency imaging protocols should be done for rapid diagnosis of life-threatening injuries allowing simultaneous evaluation and resuscitation. Read More

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Current updates in management of extremity injuries in polytrauma.

J Clin Orthop Trauma 2021 Jan 24;12(1):113-122. Epub 2020 Sep 24.

Dept of Orthopaedics, Trauma and Spine Surgery, Ganga Medical Centre & Hospitals Pvt Ltd, 313, Mettupalayam Road, Coimbatore, 641 043, Tamil Nadu, India.

Injury-related morbidity and mortality have been one of the most common causes of loss in productivity across all geographic distributions. It remains to be a global concern despite a continual improvement in regional and national safety policies. The establishment of trauma care systems and advancements in diagnostics and management have improved the overall survival of severely injured. Read More

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January 2021

Management of pelvic injuries in hemodynamically unstable polytrauma patients - Challenges and current updates.

J Clin Orthop Trauma 2021 Jan 6;12(1):101-112. Epub 2020 Oct 6.

Department of Orthopedics, All India Institute of Medical Science, New Delhi, 110029, India.

Pelvic injuries are notorious for causing rapid exsanguination, and also due to concomitant injuries and complications, they have a relatively higher mortality rate. Management of pelvic fractures in hemodynamically unstable patients is a challenging task and has been variably approached. Over the years, various concepts have evolved, and different guidelines and protocols were established in regional trauma care centers based mainly on their previous experience, outcomes, and availability of resources. Read More

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January 2021

Damage control orthopaedics in polytraumatized patients- current concepts.

J Clin Orthop Trauma 2021 Jan 6;12(1):72-82. Epub 2020 Nov 6.

Department for Traumatology, University Hospital Zurich, Switzerland.

The principles of fracture management in patients with multiple injuries continue to be of crucial importance. Early treatment of unstable polytraumatized patients with head, chest, abdomen or pelvic injuries, with blood loss followed by immediate fracture fixation (Early Total Care -ETC) may be associated with secondary life threatening posttraumatic systemic inflammatory response syndrome (SIRS). Development of SIRS is typically a function of the type and severity of the initial injury (the "first hit"). Read More

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January 2021

Thoracic Injuries in Pediatric Polytraumatized Patients: Epidemiology, Treatment and Outcome.

Injury 2021 Feb 17. Epub 2021 Feb 17.

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

Purpose: The purpose of the present study was to assess the influence and contribution, epidemiology, treatment and outcome of thoracic injuries in a cohort of pediatric and adolescent polytraumatized patients.

Material And Methods: All pediatric and adolescent (age < 18 years) polytraumatized patients with associated thoracic injuries were included in this study. Demographic data, mechanism of injury (MOI), injury severity score (ISS), Glasgow Coma Scale (GCS), hemodynamic parameters and pupillary response at ED admission, site of major injury (SOMI), associated chest and non-chest related injuries, length of hospital stay (LOS), procedures performed at the ED as well as outcome variables including mortality and cause of death. Read More

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February 2021

Anterior-posterior view by full-body digital X-ray to rule out severe spinal injuries in Polytraumatized patients.

BMC Emerg Med 2021 Mar 5;21(1):27. Epub 2021 Mar 5.

Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland.

Background: Spinal injuries are present in 16-31% of polytraumatized patients. Rapid identification of spinal injuries requiring immobilization or operative treatment is essential. The Lodox-Statscan (LS) has evolved into a promising time-saving diagnostic tool to diagnose life-threatening injuries with an anterior-posterior (AP)-full-body digital X-ray. Read More

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Initial Resuscitation of a Multisystem Trauma Patient Following a Fall From Height: A Complete Simulation Scenario for Medical Students.

Cureus 2021 Jan 30;13(1):e13013. Epub 2021 Jan 30.

Department of Clinical Sciences, Alabama College of Osteopathic Medicine, Dothan, USA.

Management of a complex trauma patient is a critical skill for medical students, particularly during a general surgery or emergency medicine clerkship. However, gaining proficiency with this skillset may be challenging without prior medical or simulation experience. The aim of this technical report is to present a comprehensive high-fidelity medical simulation of a polytraumatized patient with numerous injuries sustained from a 20-foot fall. Read More

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January 2021

Concomitant injuries in patients with thoracic vertebral body fractures-a systematic literature review.

Arch Orthop Trauma Surg 2021 Mar 1. Epub 2021 Mar 1.

Department of Trauma Surgery and Reconstructive Surgery, BG Klinikum Bergmannstrost, Halle, Germany.

Purpose: The aim of this study was to give a systematic overview over the rate and location of concomitant injuries, the probability of suffering from neurological deficits, and to give evidence of the timing of surgery in severely injured patients with unstable thoracic vertebral body fractures.

Methods: This review is based on articles retrieved by a systematic search in the PubMed and Web of Science database for publications up to November 2020 dealing with unstable fractures of the mid-thoracic spine.

Results: Altogether, 1109 articles were retrieved from the literature search. Read More

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Antegrade nailing in femoral shaft fracture patients - comparison of outcomes of isolated fractures, multiple fractures and severely injured patients.

Injury 2021 Feb 2. Epub 2021 Feb 2.

Department of Anesthesiology and Pain Medicine, Gachon University College of Medicine, 21 Namdong-daero, 774 beon-gil, Namdong-gu, Incheon 21565, Korea. Electronic address:

Introduction: Femoral shaft fractures in adults are high-energy fractures typically accompanied by additional fractures of the upper and lower extremities and brain, thoracic, or abdominal injuries. Intramedullary nailing enables early ambulation with a few complications, but rates of non-union remain high. Therefore, we aimed to compare bone union after femoral shaft fractures in adults (20-65 years old) depending on the injury severity and presence of multiple fractures. Read More

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February 2021

[Osteosynthesis of the unstable thoracic wall].

Oper Orthop Traumatol 2020 Dec 8. Epub 2020 Dec 8.

Klink für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.

Objective: Surgical stabilization of patients with flail chest, dislocated serial rib and sternal fractures, posttraumatic deformities of the thorax, symptomatic non-unions of the ribs and/or sternum, and weaning failure to biomechanically stabilize the thorax and avoid respirator-dependent complications.

Indications: Combination of clinically and radiologically observed parameters, such as pattern of thoracic injuries, grade of fracture dislocation, pathological changes to breathing biomechanics, and failure of nonsurgical treatment.

Contraindications: Acute hemodynamical instability and signs of systemic infection. Read More

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December 2020

Biomechanics and clinical outcome after posterior stabilization of mid-thoracic vertebral body fractures: a systematic literature review.

Eur J Trauma Emerg Surg 2020 Dec 2. Epub 2020 Dec 2.

Department of Trauma Surgery and Reconstructive Surgery, BG Klinikum Bergmannstrost, Halle, Germany.

Purpose: The aim of this review is to systematically screen the literature for clinical and biomechanical studies dealing with posterior stabilization of acute traumatic mid-thoracic vertebral fractures in patients with normal bone quality.

Methods: This review is based on articles retrieved by a systematic search in the PubMed and Web of Science database for publications up to December 2018 dealing with the posterior stabilization of fractures of the mid-thoracic spine.

Results: Altogether, 1012 articles were retrieved from the literature search. Read More

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December 2020

[Nursing care on an external fixator].

Rev Infirm 2020 Nov 28;69(265):42-43. Epub 2020 Sep 28.

Service de chirurgie orthopédique, Hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France; Service de chirurgie orthopédique, Hôpital d'instruction des armées Saint-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France. Electronic address:

The external fixator is one of the treatments for fractures. It is classically used for serious fractures, polytraumatized patients or when there is a large influx of patients. The resulting paramedical care, which is often unknown, must be rigorous in order to avoid minor and frequent, or serious but less frequent, complications. Read More

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November 2020

[Do COVID-19 restrictions lead to a decrease in severely injured patients at a level 1 trauma center in Germany?]

Unfallchirurg 2021 May 30;124(5):352-357. Epub 2020 Nov 30.

Klinik und Poliklinik für Unfall‑, Hand‑, Plastische und Wiederherstellungschirurgie, Universitätsklinikum Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Deutschland.

Background: Intensive care and ventilator capacities are essential for treatment of COVID-19 patients. Severely injured patients are often in continuous need of intensive care and ventilator treatment. The question arises, whether restrictions related to COVID-19 have led to a decrease in severely injured patients and thus to an increase in intensive care unit (ICU) capacity. Read More

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Plate of ribs: single institution's matched comparison of patients managed operatively and non-operatively for rib fractures.

Trauma Surg Acute Care Open 2020 5;5(1):e000519. Epub 2020 Nov 5.

Surgical Critical Care, University of Tennessee Medical Center, Knoxville, Tennessee, USA.

Background: Rib fractures are associated with significant morbidity and mortality in polytraumatized patients. There is considerable variability in the management (operative vs. non-operative) and timing of operative intervention. Read More

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November 2020

Is There Any Difference in the Outcome of Geriatric and Non-Geriatric Severely Injured Patients?-A Seven-Year, Retrospective, Observational Cohort Study with Matched-Pair Analysis.

J Clin Med 2020 Nov 3;9(11). Epub 2020 Nov 3.

Department of Trauma, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.

Geriatric trauma is expected to increase due to the lifestyle and activity of the aging population and will be among the major future challenges in health care. Therefore, the aim of this study was to investigate differences between polytraumatized geriatric and non-geriatric patients regarding mortality, length-of-stay and complications with a matched pair analysis. We included patients older than 17 years with an Injury Severity Score (ISS) of 16 or more admitted to our level 1 trauma center between January 2008 and December 2015. Read More

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November 2020

Early local neutralization of CC16 in sepsis‑induced ALI following blunt chest trauma leads to delayed mortality without benefitting overall survival.

Int J Mol Med 2020 Dec 22;46(6):2207-2215. Epub 2020 Oct 22.

Department of Trauma, Hand and Reconstructive Surgery, Goethe University, D‑60590 Frankfurt, Germany.

Blunt thoracic trauma (TxT) is a common injury pattern in polytraumatized patients. When combined with a secondary trigger, TxT often results in acute lung injury (ALI), which negatively affects outcomes. Recent findings suggest that ALI is caused by both local and systemic inflammatory reactions. Read More

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December 2020

Negative Whole-Body Computed Tomography Scans in Polytrauma Patients: A Retrospective Cohort Study.

Open Access Emerg Med 2020 23;12:305-313. Epub 2020 Oct 23.

Mount Sinai Medical Center, Department of Emergency Medicine, Miami Beach, Florida, USA.

Background: Whole-body computed tomography (WBCT) has been a mainstay and an integral part of the evaluation of polytrauma patients in trauma centers and emergency departments (ED) for a comprehensive evaluation of the extent of injuries. However, routine use of WBCT remains controversial since it exposes patients to radiation and exponentially increases financial expense. The primary objective was to determine the rate of negative WBCT in polytrauma patients. Read More

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October 2020

Age and traumatic brain injury as prognostic factors for late-phase mortality in patients defined as polytrauma according to the New Berlin Definition: experiences from a level I trauma center.

Arch Orthop Trauma Surg 2020 Oct 17. Epub 2020 Oct 17.

Department of Orthopedics and Trauma Surgery, Division of Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.

Background: The rationale of this study was to identify independent prognostic factors influencing the late-phase survival of polytraumatized patients defined according to the New Berlin Definition.

Methods: Retrospective data analysis on 173 consecutively polytraumatized patients treated at a level I trauma center between January 2012 and December 2015. Patients were classified into two groups: severely injured patients (ISS > 16) and polytraumatized patients (patients who met the diagnostic criteria for the New Berlin Definition). Read More

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October 2020

Electric Scooter Orthopaedic Injury Demographics at an Urban Level I Trauma Center.

J Orthop Trauma 2020 11;34(11):e424-e429

Department of Orthopaedic Surgery, University of California, San Diego, CA.

Objectives: This study highlights demographics and orthopaedic injuries of electric scooter-related trauma that presented to our institution over a 27-month period.

Design: Retrospective review.

Setting: Urban Level 1 trauma center. Read More

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November 2020

Endovascular Treatment of a Life-threatening Blunt Thoracic Aortic Injury in Polytraumatized Patients - A Single Center Experience.

Prague Med Rep 2020 ;121(3):142-152

Department of Cardiovascular Surgery, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.

A retrospective analysis of our group of patients, efficacy, safety and the results of endovascular treatment of descending thoracic aorta by using stentgraft implantation in polytraumatized patients. In the period between 6/2006 and 2/2020, in the processing of data, we analysed retrospectively patients with polytrauma diagnosed with thoracic aortic rupture or transection (TAT) and treated with multiple injuries. Clinical characteristics, complications, pathological features, and hospital follow-up data were retrieved from our group. Read More

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December 2020

Complement C5a Induces Pro-inflammatory Microvesicle Shedding in Severely Injured Patients.

Front Immunol 2020 2;11:1789. Epub 2020 Sep 2.

Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany.

Initially underestimated as platelet dust, extracellular vesicles are continuously gaining interest in the field of inflammation. Various studies addressing inflammatory diseases have shown that microvesicles (MVs) originating from different cell types are systemic transport vehicles carrying distinct cargoes to modulate immune responses. In this study, we focused on the clinical setting of multiple trauma, which is characterized by activation and dysfunction of both, the fluid-phase and the cellular component of innate immunity. Read More

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Consequencies of therapeutic decision-making based on FAST results in trauma patients with pelvic fracture.

Cir Esp 2020 Sep 21. Epub 2020 Sep 21.

Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Parc Taulí, Sabadell, Barcelona, España.

Introduction: FAST is essential to decide if trauma patients need laparotomy, but has a notably decrease in accuracy in patients with pelvic fracture. Our objective is to analyze the consequences of therapeutic decision-making based on the FAST results in trauma patients with pelvic fracture.

Methods: Descriptive study that includes trauma patients older than 16 with a pelvic fracture admitted to the critical care area or who were fallecimiento. Read More

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September 2020