Male adolescent with cardiac rupture after blunt thoracic trauma.

Blunt cardiac injury, including a rupture of the atria or ventricle, is most commonly caused by motor vehicle collisions and falls from great heights. A rupture of a cardiac chamber is an extremely rare diagnosis with a high mortality rate. The best chance at survival can only be accomplished with timely intervention.

Complications in the Treatment of Delayed Union and Underlying Chronic Osteomyelitis After Right Crural Fracture Treated With Anterolateral Thigh Flap and Double-Barrelled Vascularized Fibula Graft.

Background: Segmental bone defects pose a major, unsolved clinical challenge and may be the result of high-energy trauma, infection, and tumour resection or revision surgery. Several options exist to reconstruct, including Ilizarov bone transport, Masquelet technique, cylindrical mesh technique, allografts, and vascularized bone autografts. We present a patient with a delayed union of the tibia with concomitant chronic osteomyelitis treated with anterolateral thigh (ALT) flap and double-barrelled vascularized fibula graft.

Traumatic brain injury and alcohol intoxication: effects on injury patterns and short-term outcome.

Purpose: A significant number of patients with traumatic brain injuries (TBI) are diagnosed with elevated blood alcohol concentration (BAC). Recent literature suggests a neuroprotective effect of alcohol on TBI, possibly associated with less morbidity and mortality. Our goal is to analyze the association of different levels of BAC with TBI characteristics and outcome.

Perception of quality of intraoperative fluoroscopy and the influence on postoperative management: an international survey.

Purpose: Intraoperative precise visualization of fractures and assessment of the quality of reduction is essential in orthopedic trauma surgery. Fluoroscopic skills will lead to an increased detection rate of minimal abnormalities needing revision intraoperatively. The definition of fluoroscopic skills and the interpretation of acceptable "minimal abnormalities" remains somehow unclear.

[Conservative treatment of scaphoid fractures].

Considering that pseudoarthrosis, or non-union, often occurs in patients with scaphoid fractures it is very important to start adequate treatment as soon as possible. On the basis of the literature, we advise immobilisation in a below-elbow cast, whereby the thumb is not immobilised and the wrist is in a slightly extended position. Despite the fact that non-dislocated fractures, at the very least, are usually consolidated within 4 weeks, we advise an immobilisation period of 6 weeks followed by clinical or radiological evaluation.

Correction to: Differences in Characteristics and Outcome of Patients with Penetrating Injuries in the USA and the Netherlands: A Multi-institutional Comparison.

In the original article Dennis Den Hartog's name was tagged incorrectly. It is correct as reflected here.

Patient-reported outcomes after a distal radius fracture in adults: a 3-4 years follow-up.

Background and purpose - There are few reports on the outcome of distal radius fractures after 1 year. Therefore we investigated the long-term patient-reported functional outcome and health-related quality of life after a distal radius fracture in adults. Patients and methods - We reviewed 823 patients, treated either nonoperatively or operatively in 2012.

Is there a need for standardized postoperative radiographs after operative treatment of wrist or ankle fractures?

Purpose: The purpose of this study was to evaluate the frequency of changes in treatment plan due to standardized postoperative radiographs. A secondary aim was to compare our results with a national benchmark.

Methods: This is a single-center retrospective case series of 167 consecutive patients, operated with open reduction and internal fixation (ORIF) for distal radius or ankle fractures in 2014.

Differences in Characteristics and Outcome of Patients with Penetrating Injuries in the USA and the Netherlands: A Multi-institutional Comparison.

Introduction: The incidence and nature of penetrating injuries differ between countries. The aim of this study was to analyze characteristics and clinical outcomes of patients with penetrating injuries treated at urban Level-1 trauma centers in the USA (USTC) and the Netherlands (NLTC).

Methods: In this retrospective cohort study, 1331 adult patients (470 from five NLTC and 861 from three USTC) with truncal penetrating injuries admitted between July 2011 and December 2014 were included.

Polytrauma patients in the Netherlands and the USA: A bi-institutional comparison of processes and outcomes of care.

Background: Modern trauma systems differ worldwide, possibly leading to disparities in outcomes. We aim to compare characteristics and outcomes of blunt polytrauma patients admitted to two Level 1 Trauma Centers in the US (USTC) and the Netherlands (NTC).

Methods: For this retrospective study the records of 1367 adult blunt trauma patients with an Injury Severity Score (ISS) ≥ 16 admitted between July 1, 2011 and December 31, 2013 (640 from NTC, 727 from USTC) were analysed.

Plate fixation of the proximal humerus: an international multicentre comparative study of postoperative complications.

Objective: The primary aim was to evaluate the number of complications following locking plate fixation of proximal humeral fractures in country X and in country Y. The secondary aim was to identify risk factors for complications.

Methods: Multicentre retrospective case series of 282 consecutive patients with proximal humeral fractures, treated with a locking plate between 2010 and 2014.

Early CT scanning in the emergency department in patients with penetrating injuries: does it affect outcome?

Background: To be a level I trauma center in the Netherlands a computed tomography (CT) scanner in the emergency department (ED) is considered desirable, as it is presumed that this optimizes the diagnostic process and that therapy can be directed based on these findings. Aim of this study was to assess the effects of implementing a CT scanner in the ED on outcomes in patients with penetrating injuries.

Methods: In this retrospective descriptive study, patients with penetrating injuries (shot and/or stab wounds), presented between 2000 and 2014 were analysed using the hospital's electronic database, and data from the West Netherlands trauma registry and the financial department.

Medium-sized posterior fragments in AO Weber-B fractures, does open reduction and fixation improve outcome? the POSTFIX-trial protocol, a multicenter randomized clinical trial.

Background: Guidelines for treatment of the posterior fracture fragment in trimalleolar fractures are scarce and show varying advices. Did the increasing size of the posterior fragment seem to relate to worse outcome in the past, nowadays this has changed to the amount of dislocation of the posterior fragment post-operatively. Despite many retrospective cohort studies and some prospective cohort studies, no consistent guideline could be derived from the current literature.

Inter-observer agreement between 2-dimensional CT versus 3-dimensional I-Space model in the Diagnosis of Occult Scaphoid Fractures.

Background: The I-Space is a radiological imaging system in which Computed Tomography (CT)-scans can be evaluated as a three dimensional hologram. The aim of this study is to analyze the value of virtual reality (I-Space) in diagnosing acute occult scaphoid fractures.

Methods: A convenient cohort of 24 patients with a CT-scan from prior studies, without a scaphoid fracture on radiograph, yet high clinical suspicion of a fracture, were included in this study.

Clinical evaluation vs magnetic resonance imaging of the skier's thumb: A prospective cohort of 30 patients.

Introduction: A skiers thumb, or a partial or complete rupture of the ulnar collateral ligament (UCL) is a clinical diagnosis. Swelling, pain, natural left-right difference and inexperience of a young physician can cause difficulty to correctly diagnose this injury. However, our theory is that any physician, given the correct instructions, should be able to diagnose this injury solely on clinical findings, without the necessity of additional imaging.

The value of CT compared to radiographs in the classification and treatment plan of trochanteric fractures.

Introduction: The clinical relevance of classification for trochanteric fractures is limited and little agreement exists on what type of implant should be used. It is unknown whether more advanced radio-diagnostics, such as CT, result in better agreement on the treatment. We assessed the effect of CT on agreement of classification and subsequent treatment for trochanteric fractures.

Reconstruction plates for midshaft clavicular fractures: A retrospective cohort study.

Background: For the fixation of displaced midshaft clavicular fractures different plates are available, each with its specific pros and cons. The ideal plating choice for this lesion remains subject to ongoing discussion. Reconstruction plates are cheap and easily bendable, but their strength and stability have been questioned.

Comparison of MRI, CT and bone scintigraphy for suspected scaphoid fractures.

Purpose: The best diagnostic modality for confirmation of the diagnosis of a scaphoid fracture that is not visible on the initial radiograph (occult scaphoid fracture) is still subject of debate. The aim of this study was to compare the accuracy of magnetic resonance imaging (MRI), computed tomography (CT) and bone scintigraphy (BS) for the diagnosis of these occult scaphoid fractures.

Patients And Methods: In a study period of 12 months, 33 consecutive patients with a clinically suspected scaphoid fracture without a fracture on the scaphoid radiographs were evaluated with MRI, CT and BS.

Interobserver variation in classification of malleolar fractures.

Objective: Classification of malleolar fractures is a matter of debate. In the ideal situation, a classification system is easy to use, shows good inter- and intraobserver agreement, and has implications for treatment or research.

Material And Methods: Interobserver study.

The surgeon's eye: a prospective analysis of the anteversion in the placement of hemiarthroplasties after a femoral neck fracture.

Introduction: Hip dislocation after hemiarthroplasty performed in elderly patients with a femoral neck fracture is associated with severe morbidity and costs. Optimal anteversion during the placement of the hemiarthroplasty might reduce the dislocation rate. We assessed the surgeons' intraoperative visual estimations of the femoral anteversion.

Unscheduled return visits to a Dutch inner-city emergency department.

Background: Unscheduled return visits to the emergency department (ED) may reflect shortcomings in care. This study characterized ED return visits with respect to incidence, risk factors, reasons and post-ED disposition. We hypothesized that risk factors for unscheduled return and reasons for returning would differ from previous studies, due to differences in health care systems.

Fracture prevalence during an unusual period of snow and ice in the Netherlands.

Background: The objective of the current study was to assess the effect of an unusual 10-day snow and ice period on the prevalence of fractures in an emergency department (ED) in the Netherlands. Furthermore, patients with fractures during the snow and ice period were compared to those in the control period with respect to gender, age, location of accident, length of stay, disposition, and anatomical site of the injury.

Methods: Fracture prevalence during a 10-day study period with snow and ice (January 14, 2013 until January 23, 2013) was compared to a similar 10-day control period without snow or ice (January 16, 2012 until January 25, 2012).

[Mallet finger: surgery versus splinting].

Mallet finger is a very common injury, but there is still much discussion about the best treatment. Mallet finger should be operated on if a fracture is larger than 1/3 of the articular surface or in volar subluxation, because otherwise the fracture may remain unstable or there may be loss of function. However, we believe that most mallet fingers can be treated conservatively.

Cast immobilization with and without immobilization of the thumb for nondisplaced and minimally displaced scaphoid waist fractures: a multicenter, randomized, controlled trial.

Purpose: The aim of this prospective randomized trial was to test the null hypothesis that there was no difference in the percentage of the fracture line of scaphoid waist fractures that demonstrated bridging bone on computed tomography (CT) 10 weeks after injury between patients treated in a below-elbow cast including or excluding the thumb.

Methods: A total of 62 patients with a CT or magnetic resonance image-confirmed nondisplaced or minimally displaced fracture of the scaphoid were enrolled in a prospective, multicenter, randomized trial comparing treatment in a below-elbow cast including or excluding the thumb. There were 55 waist and 7 distal fractures (owing to a miscommunication at 3 of the centers).