Return to duty after non-surgical treatment of a non-neurological thoracic or lumbar spine fracture in French military patients: a retrospective analysis of 54 patients.

Introduction: Non-surgical management of non-neurological thoracic or lumbar spine (TL) fractures seems to provide good results in the civilian population, leading to return to work in most cases. However, data on the military population are limited, particularly regarding return to duty. This study aimed to describe a population of French military patients with traumatic non-neurological TL fractures and the outcomes of non-surgical management regarding operational capacity.

Surgery for chronic pyothorax after failed amplatzer closure of bronchopleural fistula.

Background: Post-pneumonectomy bronchopleural fistula (BPF) is a life-threatening event whose treatment is not standardized.

Case Presentation: We report the management of a 28-year-old patient with a 3-year history of BPF complicating right pneumonectomy for congenital emphysema. Despite closure by an Amplatzer device, the patient had chronic pyothorax and severely deteriorated general health and quality of life.

Is pre-hospital haemoglobin an efficient marker of the need for transfusion and haemorrhagic shock in severe trauma patients? A retrospective observational study.

Background: Haemorrhagic shock is the leading cause of preventable death among trauma patients. Early detection of severe haemorrhage is essential for initiating timely resuscitation and mobilizing resources for massive transfusion (MT) protocols and damage control procedures. This study aimed to assess the predictive value of prehospital haemoglobin (Hb) levels for the need for transfusion at admission, the presence of haemorrhagic shock (HS), and the necessity for MT or haemostatic surgery.

Comparison of the lethal triad and the lethal diamond in severe trauma patients: a multicenter cohort.

Background: To reduce the number of deaths caused by exsanguination, the initial management of severe trauma aims to prevent, if not limit, the lethal triad, which consists of acidosis, coagulopathy, and hypothermia. Recently, several studies have suggested adding hypocalcemia to the lethal triad to form the lethal diamond, but the evidence supporting this change is limited. Therefore, the aim of this study was to compare the lethal triad and lethal diamond for their respective associations with 24-h mortality in severe trauma patients receiving transfusion.

The Anticipated Organ Donation Approach Increases the Number of Organ Donors.

Objective: Deficiency of organs for transplantation is a significant public health issue. French learned societies accept intensive care unit admission for patients with catastrophic neurological prognosis to optimize organs prior to probable brain death. We evaluated the implementation of a specific ethical care procedure for these patients.

Endovascular surgery in the French role 3 medical treatment facility: Is there a need? A 10-year retrospective analysis.

Objective: Vascular surgery for war-related traumatic injuries represents 3 to 17.6 % of all emergency surgical procedures, and around 5 % in French Medical Treatment Facilities (MTFs). Most of these lesions are treated by open surgery, but the role of endovascular surgery in French MTFs has not been assessed yet.

Crossed Brainstem Syndrome of the Tectal Plate's Inferior Colliculus Revealing Quadrigeminal Midbrain Cavernous Malformation.

Cavernous malformations are low-flow fragile vascular lesions prone to extralesional bleeding that can occur in the cerebral hemispheres, the brainstem, or the spinal cord. This paper reports the case of a 32-year-old right-handed man with acute-onset headaches associated with right-sided tinnitus, right-sided hemianesthesia, and binocular diplopia related to cranial nerve IV palsy. Neuroimaging displayed left-sided isolated cavernous malformation of the inferior tectal plate, with evidence of extralesional bleeding.

How I do it: spine jack expansion kyphoplasty for AO spine A4 complete burst fracture with neurological deficit.

Background: Some patients suffering from thoracolumbar complete burst fracture causing neurological deficit may be eligible for single-stage posterior-only three column reconstruction with spine jack expansion kyphoplasty.

Method: Short segment monoaxial pedicle screws are placed. Spine jack working channels are positioned in the comminuted vertebral body.

"Normal" Cervical Spine Radiographs and Computed Tomography Scans in the Emergency Department: Beware of Posttraumatic Instability of the Mobile Segment of the Lower Cervical Spine.

The NEXUS criteria have been introduced in the 1990s to assist emergency department physicians to decide whether to perform radiographic work-up following cervical whiplash injury. Four criteria have been described on these profile radiographs of the cervical spine including angulation between cervical endplates, 3-mm listhesis, posterior facet joints overlap, and widened interspinous space. Although these criteria could help to detect patients suffering from unstable trauma of the mobile segment if the lower cervical spine, the radiographic signs may be so subtle that even specifically trained physicians like spine surgeons and neuroradiologists may miss them, especially during after-hour shifts.

Psychological first aid in operation for military healthcare providers : a study on pre-deployment training.

Introduction: During operational missions, while the management of physical injuries in the field remains the priority, the identification of operational incapacity of psychological origin is necessary as it is equally crucial for the safety of the individual, the group and the mission. The French Military Health Service has developed a Psychological First Aid Training in Operation (PFATO) course based on relational simulations, for military service members. The aim is to identify the early signs of psychological distress in a comrade and to adopt an adapted and protective attitude.

How I do it: en-bloc thoracic vertebrectomy.

Background: Some young patients with preserved functional status suffering from aggressive isolated neoplastic disease of the thoracic spine may be eligible from curative en-bloc vertebrectomy surgical treatment.

Method: Long-segment posterior pedicle screw fixation is performed. Complete excision of the posterior arch and of ribs posterior aspect is performed.

Epidemiology of civilian's gunshot wound injuries admitted to intensive care unit: A retrospective, multi-center study.

Background: Few studies investigated the outcome of patients admitted to intensive care unit (ICU) for gunshot wounds (GSW). The purpose of this study was to determine the 28-day mortality, and to analyze the impact of variables on the mortality of patients admitted to ICU with GSW in four French University Hospitals level-1 regional trauma centers.

Method: All medical files of adult patients (above fifteen years old) admitted to four French University Hospitals level-1 regional trauma centers for GSW were retrospectively analyzed from January 1st 2015 to June 30th 2021.

Accuracy and Safety of Freehand Placement of Upper Thoracic Pedicle Screws Supported Solely by Anteroposterior, i.e., Frontal, X-Ray Fluoroscopy (C-Arm): Technical Note Including 23 Patients.

Background: Biomechanical resistance and surgical morbidity of spinal posterior pedicle screw fixation depend on the intraosseous position of the implants. Upper thoracic pedicle screws are particularly demanding given their convergence and thin character. We present our experience as military surgeons of freehand placement of upper thoracic pedicle screws supported solely by anteroposterior, i.

French practice of emergency resuscitative thoracotomy. A study based on the Traumabase Registry.

Aim Of The Study: Emergency resuscitative thoracotomy (ERT) has been described as a potentially life-saving procedure for trauma patients who have been admitted in refractory shock or with recent loss of sign of life (SOL). This nationwide registry analysis aimed to describe the French practice of ERT.

Patients And Methods: From 2015 to 2021, all severe trauma patients who underwent ERT were extracted from the TraumaBase→ registry.

Lessons learned from the war in Ukraine for the anesthesiologist and intensivist: A scoping review.

Background: The war in Ukraine provides purposefully anesthesiologists and intensivists with important data for improving the management of trauma patients. This scoping review aims to investigate the specific management of war-related trauma patients, during the war in Ukraine, through an objective and comprehensive analysis.

Methods: A comprehensive search of the Embase, Medline, and Open Grey databases from 2014 to February 2024 yielded studies focusing on anesthesia and surgery.

Triangular spinopelvic fixation for U-shaped sacral fractures and tile C pelvic disruptions: counter-nutation (anteflexion and rotation) load-bearing instability requires complementary anterior pelvic ring fixation.

Unstable trauma lesion of the spinopelvic junction, including U-shaped sacral fractures and Tile C pelvic ring disruptions, require surgical stabilization in order to realign the bone arches of the pelvis thus reducing the upcoming orthopaedic impairment during sitting, standing, and walking positions, decompress the nerves roots of the cauda equina in a view of reducing neurological impairment, and allow early weight bearing. Even though posterior open modified triangular spinopelvic fixation is particularly efficient for treating unstable trauma lesions of the spinopelvic junction, it may not be sufficient alone in order to prevent long-term counter-nutation, i.e.