Symmetry of the left and right tibial plafond; a comparison of 75 distal tibia pairs.

Purpose: Tibia plafond or pilon fractures present a high level of complexity, making their surgical management challenging. Three-Dimensional Virtual Planning (3DVP) can assist in preoperative planning to achieve optimal fracture reduction. This study aimed to assess the symmetry of the left and right tibial plafond and whether left-right mirroring can reliably be used.

Prevalence of Rotational Malalignment After Infrapatellar Versus Suprapatellar Intramedullary Nailing of Tibial Shaft Fractures.

Background: Up to 30% of patients with a tibial shaft fracture sustain iatrogenic rotational malalignment (RM) after infrapatellar (IP) nailing. Although IP nailing remains the management of choice for most patients, suprapatellar (SP) nailing has been gaining popularity. It is currently unknown whether SP nailing can provide superior outcomes with regard to tibial RM.

Cast immobilization duration for distal radius fractures, a systematic review.

Purpose: The optimal duration of immobilization for the conservative treatment of non- or minimally displaced and displaced distal radius fractures remains under debate. This research aims to review studies of these treatments to add evidence regarding the optimal immobilization period.

Methods: A comprehensive database search was conducted.

European military surgical teams in combat theater: A survey study on deployment preparation and experience.

Introduction: Adequate (predeployment) training of the nowadays highly specialized Western military surgical teams is vital to ensure a broad range of surgical skills to treat combat casualties. This survey study aimed to assess the self-perceived preparedness, training needs, deployment experience, and post-deployment impact of surgical teams deployed with the Danish, Dutch, or Finnish Armed Forces. Study findings may facilitate a customized predeployment training.

Sex Differences in Outcome of Trauma Patients Presented with Severe Traumatic Brain Injury: A Multicenter Cohort Study.

The objective of this study was to determine whether there is an association between sex and outcome in trauma patients presented with severe traumatic brain injury (TBI). A retrospective multicenter study was performed in trauma patients aged ≥ 16 years who presented with severe TBI (Head Abbreviated Injury Scale (AIS) ≥ 4) over a 4-year-period. Subgroup analyses were performed for ages 16-44 and ≥45 years.

The past, present and future of the conservative treatment of distal radius fractures.

The distal radius fracture is a common fracture with a prevalence of 17% on the emergency departments. The conservative treatment of distal radius fractures usually consists of three to six weeks of plaster immobilization. Several studies show that one week of plaster immobilization is safe for non- or minimally displaced distal radius fractures that do not need reduction.

Are the non-weight bearing guidelines for the after treatment of calcaneal fractures still decisive? A Dutch survey among orthopaedic and trauma surgeons.

Purpose: The current rehabilitation for patients with surgically treated displaced intra-articular calcaneal fractures (DIACFs) consists of non-weightbearing for 8-12 weeks. The purpose of the present survey was to investigate the current pre-, peri- and post-operative practices among Dutch foot and ankle surgeons. Moreover, it aims to analyze whether surgeons comply to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) guidelines and which decision criteria were used in the determination of the start of weightbearing.

Sex Dimorphism in Outcome of Trauma Patients Presenting with Severe Shock: A Multicenter Cohort Study.

: The objective of this study was to determine the association between sex and outcome among severely injured patients who were admitted in severe shock. A retrospective multicenter study was performed in trauma patients (Injury Severity Score (ISS) ≥ 16) aged ≥ 16 presenting with severe shock (Shock Index > 1.3) over a 4-year period.

Quantifying the Differences between 3D Virtual Planning and Attained Postoperative Reduction on CT for Patients with Tibial Plateau Fractures; a Clinical Feasibility Study.

: Three-Dimensional Virtual Planning (3DVP) has been proven to be effective for limiting intra-articular screw penetration and improving the quality of reduction for numerous fractures. However, the value of 3DVP for patients with tibial plateau fractures has yet to be determined. : The research question of this study is: Can Computed Tomography Micromotion Analysis (CTMA) provide a reliable quantification of the difference between 3DVP and the postoperative reduction on CT for tibial plateau fractures? : Nine consecutive adult patients who received surgical treatment for a tibial plateau fracture and received pre- and postoperative CT scans were included from a level I trauma center in the Netherlands.

Effectiveness of Postoperative Physiotherapy Compared to Postoperative Instructions by Treating Specialist Only in Patients With an Ankle Fracture: A Systematic Review.

Background: In current literature, the benefit of postoperative physiotherapy versus postoperative instructions by treating specialist only remains unclear. The aim of this review is to systematically assess existing literature regarding the functional outcome of postoperative physiotherapy compared to postoperative instructions by treating specialist only in the rehabilitation of patients with an ankle fracture. The secondary aim is to determine if there is a difference in ankle range of motion, strength, pain, complications, quality of life, and patient's satisfaction between these 2 rehabilitation methods.

Accuracy of Prehospital Triage of Adult Patients With Traumatic Injuries Following Implementation of a Trauma Triage Intervention.

Importance: Adequate prehospital triage is pivotal to enable optimal care in inclusive trauma systems and reduce avoidable mortality, lifelong disabilities, and costs. A model has been developed to improve the prehospital allocation of patients with traumatic injuries and was incorporated in an application (app) to be implemented in prehospital practice.

Objective: To evaluate the association between the implementation of a trauma triage (TT) intervention with an app and prehospital mistriage among adult trauma patients.

The prevalence of non-accidental trauma among children with polytrauma: A nationwide level-I trauma centre study.

Objective: We aimed to investigate the prevalence and characteristics of non-accidental trauma (NAT) in children with polytrauma treated at level-I trauma centres (TC).

Summary Of Background: Data 6-10% Of children who present at the emergency department with injuries, sustain polytrauma. Polytrauma may result from either accidental (AT) or NAT, i.

The symmetry of the left and right tibial plateau: a comparison of 200 tibial plateaus.

Purpose: This study aims to investigate the symmetry of the left and right tibial plateau in young healthy individuals to determine whether left-right mirroring can be reliably used to optimize preoperative 3D virtual planning for patients with tibial plateau fractures.

Methods: One hundred healthy subjects, without previous knee surgery, severe knee trauma, or signs of osteoarthritis were included for a previous dynamic imaging study of the knee. The subjects underwent a CT scan, scanning the left and right knee with a slice thickness of 0.

Prevalence of inflicted and neglectful femur shaft fractures in young children in national level I trauma centers.

Background: The prevalence of inflicted femur fractures in young children varies (1.5-35.2%), but these data are based on small retrospective studies with high heterogeneity.

Severe isolated injuries have a high impact on resource use and mortality: a Dutch nationwide observational study.

Purpose: The Berlin poly-trauma definition (BPD) has proven to be a valuable way of identifying patients with at least a 20% risk of mortality, by combining anatomical injury characteristics with the presence of physiological risk factors (PRFs). Severe isolated injuries (SII) are excluded from the BPD. This study describes the characteristics, resource use and outcomes of patients with SII according to their injured body region, and compares them with those included in the BPD.

Are 3D-printed Models of Tibial Plateau Fractures a Useful Addition to Understanding Fractures for Junior Surgeons?

Background: Tibial plateau fractures are often complex, and they can be challenging to treat. Classifying fractures is often part of the treatment process, but intra- and interobserver reliability of fracture classification systems often is inadequate to the task, and classifications that lack reliability can mislead providers and result in harm to patients. Three-dimensionally (3D)-printed models might help in this regard, but whether that is the case for the classification of tibial plateau fractures, and whether the utility of such models might vary by the experience of the individual classifying the fractures, is unknown.

The Detrimental Impact of the COVID-19 Pandemic on Major Trauma Outcomes in the Netherlands: A Comprehensive Nationwide Study.

Objective: To evaluate the impact of the COVID-19 pandemic on the outcome of major trauma patients in the Netherlands.

Summary Background Data: Major trauma patients highly rely on immediate access to specialized services, including ICUs, shortages caused by the impact of the COVID-19 pandemic may influence their outcome.

Methods: A multi-center observational cohort study, based on the Dutch National Trauma Registry was performed.

Operative Fixation of Lateral Malleolus Fractures With Locking Plates vs Nonlocking Plates: A Systematic Review and Meta-analysis.

Background: The exact benefit of locking plates over nonlocking plates in patients with lateral malleolus fractures remains unclear. The primary aim of this study was to compare the functional outcome of locking plates vs nonlocking plates in patients with a lateral malleolus fracture. The secondary aims were to compare the number of complications and hardware removals and to compare whether results differed for older patients and for patients treated with anatomical locking plates.

Cast-OFF Trial: One Versus 4 to 5 Weeks of Plaster Cast Immobilization for Nonreduced Distal Radius Fractures: A Randomized Clinical Feasibility Trial.

Background: Distal radius fracture is a common fracture of which the incidence appears to be increasing worldwide. This pilot study investigated whether 1 week of plaster cast is feasible for nonreduced (stable fractures including nondisplaced and displaced fractures) distal radius fractures.

Methods: The study was a multicenter randomized clinical feasibility trial including patients from regional acute care providers.

The impact of regionalized trauma care on the distribution of severely injured patients in the Netherlands.

Background: Twenty years ago, an inclusive trauma system was implemented in the Netherlands. The goal of this study was to evaluate the impact of structured trauma care on the concentration of severely injured patients over time.

Methods: All severely injured patients (Injury Severity Score [ISS] ≥ 16) documented in the Dutch Trauma Registry (DTR) in the calendar period 2008-2018 were included for analysis.

Satisfaction with Alignment After Reduction of a Displaced Distal Radial Fracture.

Background: Alignment adequate to offer nonoperative treatment after reduction of a distal radial fracture is a matter of opinion. This study addressed factors associated with interobserver reliability of satisfaction with alignment after the reduction of a distal radial fracture.

Methods: A survey sent to members of the Science of Variation Group divided the participants into 4 groups that each rated 24 sets of radiographs of adult patients with a distal radial fracture before and after manipulative reduction and cast or splint immobilization.

Evaluation of the Berlin polytrauma definition: A Dutch nationwide observational study.

Background: The Berlin polytrauma definition (BPD) was established to identify multiple injury patients with a high risk of mortality. The definition includes injuries with an Abbreviated Injury Scale score of ≥3 in ≥2 body regions (2AIS ≥3) combined with the presence of ≥1 physiological risk factors (PRFs). The PRFs are based on age, Glasgow Coma Scale, hypotension, acidosis, and coagulopathy at specific cutoff values.