Treatment of traumatic rib fractures: an overview of current evidence and future perspectives.

Operative management of rib fractures has gained significant popularity over the last years, however, it remains a controversial topic, due to the substantial heterogeneity among rib fracture patients with considerable differences in epidemiology. Hence, the present narrative review aims to provide an overview of the treatment and (long-term) outcomes of rib fractures, with an emphasis on the surgical treatment. Nowadays, computed tomography (CT) has been shown to be most practical and sensitive for detecting rib fractures, of which up to 50% is missed on other imaging modalities.

Permissive Weight Bearing in Proximal Humeral Fracture Management: A Survey-Based Inquiry in the Netherlands.

Purpose Proximal humeral fractures (PHF) are common, particularly among the elderly due to low-energy trauma. Adequate rehabilitation is essential for functional recovery, whether through conservative or surgical treatment. Permissive weight bearing (PWB) is a relatively new rehabilitation concept, characterized by earlier mobilization of the affected limb/joint after trauma.

Permissive Weight Bearing in Patients With Surgically Treated Periprosthetic Femoral Fractures Around Total Hip Arthroplasty: A Scoping Review.

Periprosthetic femoral fractures (PPFF) around total hip arthroplasty (THA) are one of the leading causes of hip revision. High mortality rates are observed after revision in case of PPFF around THA. To modify risk factors, early postoperative mobilization is necessary.

Effectiveness of permissive weight bearing in surgically treated trauma patients with peri- and intra-articular fractures of the lower extremities: a prospective comparative multicenter cohort study.

Purpose: The aim of the present study was to investigate the effectiveness of a novel approach involving permissive weight bearing (PWB) in surgically treated trauma patients with peri- and intra-articular fractures of the lower extremities.

Methods: Prospective comparative multicenter cohort study in one level 1 trauma center and five level 2 trauma centers. Surgically treated trauma patients with peri- and intra-articular fractures of the lower extremities were included.

Postoperative Load Bearing in Periprosthetic Femoral Fractures Around Hip Arthroplasty: A Survey Among Orthopedic Surgeons in the Netherlands.

Introduction: Permissive weight bearing (PWB) has relatively recently been implemented to optimize rapid clinical recovery and restoration of function in patients suffering lower extremity fractures. PWB shows outcome advantages in this patient category. Currently, there are no decisive recommendations on postoperative load-bearing management after surgically treated periprosthetic femoral fractures (PPFF) around hip arthroplasty.

The relationship between plate prominence and need for removal after volar plate osteosynthesis of distal radius fractures.

Purpose: This study aimed to assess the incidence of plate-related complications and the need for plate removal after volar plate osteosynthesis of the distal radius in relation to Soong classification.

Methods: All consecutive patients (age > 16 years) in our level II trauma center treated with plate osteosynthesis for distal radius fractures from January 2017 until June 2019 were retrospectively evaluated. The main outcome measures were volar plate positioning according to Soong classification and incidence of plate removal.

VATS-assisted surgical stabilization of rib fractures in flail chest: 1-year follow-up of 105 cases.

Objectives: Early surgical stabilization of flail chest has been shown to improve chest wall stability and diminish respiratory complications. The addition of video‑assisted thoracoscopic surgery (VATS) can diagnose and manage intrathoracic injuries and evacuate hemothorax. This study analyzed the outcome of our 7-year experience with VATS-assisted surgical stabilization of rib fractures (SSRF) for flail chest.

Delayed presentation of manubriosternal dislocation after thoracolumbar spondylodesis in a polytrauma patient - a case report.

Background: Manubriosternal dislocations are a rare entity and frequently associated with thoracic spine fractures and, in minority of cases, with cervical or thoracolumbar fractures.

Methods: Our case represents a 38-year-old male who fell from a height resulting in multiple fractures, amongst others of the first lumbar vertebra. At primary survey and computed tomography scan no manubriosternal injury was apparent.

First clinical results of 1-year follow-up of the femoral neck system for internal fixation of femoral neck fractures.

Background: Closed reduction and internal fixation (CRIF) is the preferred treatment to retain the native joint and maintain optimal functionality in femoral neck fractures. Sliding hip screw (SHS) and cannulated hip screws (CHS) are established CRIF options. SHS offer high biomechanical stability, whereas CHS are minimally invasive.

Diagnostic tools to evaluate ankle instability caused by a deltoid ligament rupture in patients with supination-external rotation ankle fractures: A systematic review and meta-analysis.

Aim: Supination-external rotation (SER) ankle fractures account for the majority of ankle fractures and can be divided into stable or unstable fractures, based on the state of the deltoid ligament. The objective of this review was to appraise the available literature concerning diagnostic tools to evaluate deltoid ligament integrity in patients with SER-type ankle fractures.

Methods: A comprehensive literature search of Pubmed and Embase was performed up to December 2020.

Bone suture anchor repair and functional outcome of a triceps tendon rupture, a rare clinical entity.

Triceps tendon rupture is rare and easily missed on presentation. A 58-year-old man was seen in our accident and emergency department with an inability to extend his right elbow against gravity after he fell. Ultrasound and MRI confirmed the suspected diagnosis of a traumatic triceps tendon rupture and excluded additional injuries.

Management of two-level proximal femoral fractures.

We present the case of an 82-year-old female, who experienced a ground-level fall on the trochanter of the right femur. X-rays showed a proximal femoral fracture (PFF) with an unclear and unusual fracture pattern. Three-dimensional CT images were obtained and showed a displaced femoral neck fracture and ipsilateral fracture of the greater trochanter.

Thoracoabdominal computed tomography in trauma patients: a cost-consequences analysis.

Background: CT is increasingly used during the initial evaluation of blunt trauma patients. In this era of increasing cost-awareness, the pros and cons of CT have to be assessed.

Objectives: This study was performed to evaluate cost-consequences of different diagnostic algorithms that use thoracoabdominal CT in primary evaluation of adult patients with high-energy blunt trauma.

Selective computed tomography (CT) versus routine thoracoabdominal CT for high-energy blunt-trauma patients.

Background: Trauma is the fifth leading cause of death worldwide, and in people younger than 40 years of age, it is the leading cause of death. During the resuscitation of trauma patients at the emergency department, there are two different commonly used diagnostic strategies. Conventionally, there is the use of physical examination and conventional diagnostic imaging, potentially followed by selective use of computed tomography (CT).

An evidence based blunt trauma protocol.

Objective: Currently CT is rapidly implemented in the evaluation of trauma patients. In anticipation of a large international multicentre trial, this study's aim was to evaluate the clinical feasibility of a new diagnostic protocol, used for the primary radiological evaluation in adult blunt high-energy trauma patients, especially for the use of CT.

Methods: An evidence-based flow chart was created with criteria based on trauma mechanism, physical examination and laboratory analyses to indicate appropriateness of conventional radiography (CR), sonography and CT of head, cervical spine and trunk.

Effects on mortality, treatment, and time management as a result of routine use of total body computed tomography in blunt high-energy trauma patients.

Background: Currently, total body computed tomography (TBCT) is rapidly implemented in the evaluation of trauma patients. With this review, we aim to evaluate the clinical implications-mortality, change in treatment, and time management-of the routine use of TBCT in adult blunt high-energy trauma patients compared with a conservative approach with the use of conventional radiography, ultrasound, and selective computed tomography.

Methods: A literature search for original studies on TBCT in blunt high-energy trauma patients was performed.

Osteosynthesis of distal radius fractures with the Micronail.

Introduction: The Micronail(®) is a minimally invasive intramedullar titanium locking screw fixation for two-part dislocated extra-articular fractures and average displaced intra-articular fractures.

Patients And Methods: In a retrospective study we analyzed the outcome of 20 distal radius fractures in 18 patients (17 female, mean age 78 years), which were treated by Micronail(®). Average follow-up time was 4 months.

Incidental Findings on Routine Thoracoabdominal Computed Tomography in Blunt Trauma Patients.

BACKGROUND:: Thoracoabdominal MultiDetector-row Computed Tomography (MDCT) is frequently used as a diagnostic tool in trauma patients. One potential side-effect of performing MDCT is the detection of incidental findings and their subsequent consequences on medical treatment. The objective was to evaluate frequency and effects of incidental findings in trauma patients.

(Semi-)closed endarterectomy in occlusive aortoiliac disease.

Background: Evaluation of the long-term results of a (semi-) closed endarterectomy of the aortoiliac segment with the use of the arterial disobliteration device.

Methods: From 1984 until 2005, a total of 157 patients (mean age, 53 years) with aortoiliac occlusive disease underwent a (semi-)closed endarterectomy of the aortoiliac segment. The primary operation indication was disabling claudication in 60.

Embolization as treatment of choice for bleeding peptic ulcers in high-risk patients.

Background/aim: Peptic ulcers are the most common cause of acute upper gastrointestinal bleedings in the digestive tract. Most patients are poor surgical candidates. The aim was to describe the efficacy of embolization as the treatment of choice for bleeding peptic ulcers in high-risk patients when endoscopic treatment failed.

The value of indicated computed tomography scan of the chest and abdomen in addition to the conventional radiologic work-up for blunt trauma patients.

Background: Multidetector computed tomography (CT) is more sensitive and specific in detecting traumatic injuries than conventional radiology is. However, still little is known about the diagnostic value and the therapeutic impact of indicated thoraco-abdominal CT scan when it is performed in addition to the complete conventional radiologic work-up for blunt trauma patients.

Methods: Clinical and radiologic data from 106 consecutive blunt trauma patients were reviewed.