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Proposal for a new treatment algorithm for proximal humerus fractures based on a clinical survey among 340 surgeons.
J Shoulder Elbow Surg
November 2024
Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany. Electronic address:
Background: The increasing incidence of proximal humeral fractures poses complex challenges in determining the optimal therapeutic strategies due to the diverse fracture patterns and individual patient characteristics. Traumatologists and orthopedic surgeons face significant decisions, as potential consequences such as pain, functional limitations, and complications may significantly affect patients' quality of life. Given the varying viewpoints on appropriate treatment modalities, a thorough examination of current care practices is crucial.
View Article and Find Full Text PDFMarkers of Futile Resuscitation in Traumatic Hemorrhage: A Review of the Evidence and a Proposal for Futility Time-Outs during Massive Transfusion.
J Clin Med
August 2024
Futile Indicators for Stopping Transfusion in Trauma (FISTT) Collaborative Group, Indiana University School of Medicine-South Bend, South Bend, IN 46617, USA.
The reduction in the blood supply following the 2019 coronavirus pandemic has been exacerbated by the increased use of balanced resuscitation with blood components including whole blood in urban trauma centers. This reduction of the blood supply has diminished the ability of blood banks to maintain a constant supply to meet the demands associated with periodic surges of urban trauma resuscitation. This scarcity has highlighted the need for increased vigilance through blood product stewardship, particularly among severely bleeding trauma patients (SBTPs).
View Article and Find Full Text PDFIntracapsular neck of femur fractures secondary to civilian gunshot injuries: an inter- and intra-observer agreement study on classification and treatment using the AO/OTA classification.
Eur J Orthop Surg Traumatol
August 2024
Orthopaedic Trauma Service, Division of Orthopaedic Surgery, University of Cape Town, Groote Schuur Hospital, University of Cape Town, H49 Old Main Building, Observatory, Cape Town, 7925, RSA.
Purpose: Numerous classification systems have been developed for neck of femur fractures, but none have been tested for reliability in gunshot injuries. Our primary objective was to assess the inter-observer and intra-observer reliability of the AO/OTA classification system when applied to intracapsular neck of femur fractures secondary to low-velocity civilian gunshots wounds (GSWs). Our secondary objective was to test the reliability of the AO/OTA classification system in guiding surgeon treatment choices for these fractures.
View Article and Find Full Text PDFFAST and Furious About Quality: Impact of Continuous Review and Feedback on Point-of-Care Ultrasound Examinations.
Am Surg
November 2024
Department of Surgery, St. Luke's University Health Network, Bethlehem, PA, USA.
Focused Assessment with Sonography in Trauma (FAST) examination is a point-of-care ultrasound study used to evaluate for abdominal hemorrhage, pneumothorax, or pericardial blood in trauma patients as an adjunct to their initial assessment. The quality of the image can be limited, and its diagnostic value is heavily dependent on operator skill. Our objective was to determine whether a standardized review process improved image quality and reduced incidence of nondiagnostic or insufficient imaging by 10% over a 6-month period.
View Article and Find Full Text PDFMedical care following earthquakes: Clinical, organizational, and logistic challenges.
Acta Orthop Traumatol Turc
November 2023
Humanitarian and Disaster Response Center, Sheba Medical Center, Tel Hashomer, Israel.
The orthopedic load following earthquakes exceeds that caused by any other disaster. This is due to the large number of musculoskeletal injuries due to falling debris, coupled with the widespread damage to general and medical infrastructure, causing a huge imbalance between surgical needs and the ability to address these needs, necessitating a switch in mindset and operational mode. Clinically, the operational mode will be that of damage control surgery, considering "life before limb" with only lifesaving and limb-saving procedures being performed during the acute phase of the event.
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