European Journal of Trauma and Emergency Surgery最新文献

{"title":"Risk of anterior interosseous nerve injury during forearm surgery: a cadaveric study.","authors":"Arnaud Walch, Hugo Despert, Clément Jubelin, Laurent Mathieu, Camille Brenac, Thibault Druel","doi":"10.1007/s00068-025-02869-9","DOIUrl":"https://doi.org/10.1007/s00068-025-02869-9","url":null,"abstract":"<p><strong>Purpose: </strong>The anterior interosseous nerve (AIN) is susceptible to injury during forearm surgery, particularly open reduction and internal fixation (ORIF) of radius fractures. This study aimed to analyze the anatomical relationships between the AIN and the radius to identify regions most vulnerable to iatrogenic injury.</p><p><strong>Methods: </strong>A cadaveric study was conducted on ten fresh, non-embalmed forearms. Standardized dissections were performed to assess the course of the AIN, its motor branches, and their proximity to bony landmarks. Measurements were taken using a graduated ruler, with reference to the radius, the bi-epicondylar and bi-styloid lines.</p><p><strong>Results: </strong>The AIN originated, on average, 13 mm from the radius, initially separated from the bone by the flexor digitorum profundus and flexor pollicis longus. The first branch to the flexor pollicis longus emerged at an average of 8 mm from the radius, marking the start of the nerve's close contact with the bone. The highest risk zone for AIN injury was identified at the junction of the proximal and middle thirds of the forearm.</p><p><strong>Conclusion: </strong>The AIN and its motor branches exhibit significant anatomical variability but consistently demonstrate proximity to the radius at the proximal-middle third junction. To minimize iatrogenic injury, care should be taken when exposing the anterior radius, particularly by avoiding excessive traction or deep retractor placement in this region.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"197"},"PeriodicalIF":1.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Absolute lymphocyte count trajectory predicts clinical outcome in severely injured patients.","authors":"Lena-Marie Reichardt, Bianca Hindelang, Lönna Süberkrüb, Kim Lena Hamberger, Jan A Graw, Konrad Schuetze, Elisabeth Zechendorf, Marco Mannes, Rebecca Halbgebauer, Lisa Wohlgemuth, Florian Gebhard, Markus Huber-Lang, Borna Relja, Christian B Bergmann","doi":"10.1007/s00068-025-02864-0","DOIUrl":"https://doi.org/10.1007/s00068-025-02864-0","url":null,"abstract":"<p><strong>Purpose: </strong>Lymphopenia is associated with adverse clinical outcome in trauma, but no immunomonitoring method is established to identify patients at risk. Absolute lymphocyte count (ALC) represents a promising biomarker and may support clinical decision-making in the intensive care unit (ICU). This study examined the temporal patterns of ALC in severely injured patients and their correlation with clinical outcomes.</p><p><strong>Methods: </strong>38 severely injured patients with an Injury Severity Score (ISS) of 18 and greater were enrolled. Blood samples were collected on admission and after 8, 24 and 48 h and 5 and 10 days. 38 healthy volunteers served as controls. Patients were classified into four groups after 48 h based on their dynamic ALC: persistent lymphopenia (PL), rapidly decreasing (RD), slowly rising (SR) and normal fluctuation (NF). The groups were compared regarding physical performative outcome - defined as unfavorable when patients died or new functional disability necessitated long term care, in-hospital mortality, ICU length of stay (LOS), and incidence of multi-organ dysfunction syndrome (MODS).</p><p><strong>Results: </strong>A significant reduction in ALC was observed in all patients over 10 days when compared to healthy volunteers, with all patients trending towards a recovery of their ALC after 10 days. PL and RD were associated with an unfavorable physical performative outcome, increased in-hospital mortality, ICU LOS and incidence of MODS.</p><p><strong>Conclusion: </strong>The dynamic course of ALC represents a cheap and clinically implementable approach for immunomonitoring within 48 h in severely injured patients. The ALC dynamic may early identify severely injured patients at risk, thus facilitating more informed clinical decision-making.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"190"},"PeriodicalIF":1.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the patient's plasma volume on the amount of fresh frozen plasma needed to normalize the thromboelastographic reaction time.","authors":"Mordechai Caplan, Natalia Torres-Acevedo, Patrizio Petrone, Lindsay Beach, Reddy H Srinivas, Anna Liveris, Corrado P Marini, John McNelis","doi":"10.1007/s00068-025-02870-2","DOIUrl":"https://doi.org/10.1007/s00068-025-02870-2","url":null,"abstract":"<p><strong>Introduction: </strong>Correction of a prolonged CK-TEG R-time requires the administration of fresh frozen plasma (FFP). However, the relationship between the volume required to normalize the R-time and the patient's plasma volume (PV_i) has not been investigated. This study investigated the impact of the PV_i on the amount of FFP needed to normalize the R-time.</p><p><strong>Methods: </strong>30 patients receiving FFP to normalize their R-times were analyzed from the standpoint of sex distribution and R-time response to the administration of FFP. PV_i was calculated as blood volume minus hematocrit (Hct). Data included age, sex, height, weight, Hct, changes in PV_i (ΔPV) and ΔR-time within 24 h of administration of FFP. Responders were divided in high and low based on a decrease in R-time > 5 min after the administration of FFP. Data presented as mean ± SD and median with interquartile range were analyzed with parametric and non-parametric tests as applicable.</p><p><strong>Results: </strong>Females had a smaller PV_i (2.6 ± 0.4 vs. 3.7 ± 0.6; p < 0.05), yielding a larger ΔPV (14.0 ± 7.0% vs. 10.6 ± 5.4% from 353 ± 141 vs. 381 ± 174 ml of FFP, respectively; p > 0.05). They required less FFP for a ΔR-time of one minute (80 ± 59 vs. 116 ± 64 ml; p > 0.05). There was a significant difference in the number of high responders between females and males (7/11 vs. 5/19; p < 0.05). The R-time response did not differ with respect to age, and the PV_i before transfusions but it was affected by the amount FFP and the resulting ΔPV (483 ± 173 vs. 296 ± 99 and 17.0% ± 6.6% vs. 8.6% ± 3.0%; p < 0.05).</p><p><strong>Conclusions: </strong>We conclude that: 1) The amount of FFP required to normalize the R-time is lower than the recommended dose of 10-20 ml/kg: 2) 6.8 ml/kg of FFP, corresponding to an initial administration of two units of FFP (~ 500 ml) will provide an increase of 15.6% in the concentration of coagulation factors sufficient to normalize the R-time: 3) The assessment of PV_i is the key element required to estimate the volume of FFP needed to correct a prolonged R-time.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"191"},"PeriodicalIF":1.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biochemical markers of myocardial contusion after blunt chest trauma.","authors":"Makhabbat Bekbossynova, Murat Mukarov, Perizat Kanabekova, Zhanerke Shaktybek, Madina Sugralimova, Arman Batpen, Anar Kozhakhmetova, Zhumagul Sholdanova, Aknur Zhanbolat","doi":"10.1007/s00068-025-02866-y","DOIUrl":"https://doi.org/10.1007/s00068-025-02866-y","url":null,"abstract":"<p><p>One of the most common manifestations of cardiac injury because of trauma is myocardial contusion. Today, the blurred definition and wide range of nonspecific clinical presentations led to absence in consensus of diagnostic pathways and criteria. Currently, the marker of cardiac injury measured at clinical level is troponin and instrumental diagnostic tool is ECG. The patients with elevated troponin level after the chest trauma should be suspected to have myocardial contusion as cardiogenic shock or arrhythmia might take place as a complication. The release of DAMPs after the trauma has been observed as a part of inflammatory response to it. HMGB1 protein and histone levels were found to be elevated in patients with trauma and associated to recruit the inflammation. In this review the potential of these molecules to be used as diagnostic markers of myocardial contusion is discussed. Moreover, the obstacles for implementing DAMPS to clinical protocols and future research directions are included.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"189"},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary stability of nailing versus low-profile dual plating of mid-clavicular fractures- a biomechanical cadaveric study.","authors":"Fabian Pretz, Ivan Zderic, Frank J P Beeres, Björn-Christian Link, Reto Babst, Yannic Lecoultre, Boyko Gueorguiev, Peter Varga, Torsten Pastor, Bryan J M van de Wall","doi":"10.1007/s00068-025-02854-2","DOIUrl":"https://doi.org/10.1007/s00068-025-02854-2","url":null,"abstract":"<p><strong>Introduction: </strong>Low-profile dual plating techniques have gained popularity for diaphyseal clavicula fractures due to their potential to reduce soft tissue irritation. Intramedullary nailing is also an established surgical option for treatment of diaphyseal clavicle fractures. The present study therefore aimed to evaluate whether a 2 × 2.0 mm dual plating system can achieve biomechanical performance comparable to intramedullary nailing while reducing implant-related complications.</p><p><strong>Methodology: </strong>Twelve paired human cadaveric clavicles with simulated unstable diaphyseal shaft fractures AO/OTA 15.2 C were stabilized via elastic nailing (Group 1) or dual plating using a superior and an anterior 2.0 mm plate (Group 2). Specimens underwent biomechanical testing with initial quasistatic superior-inferior and anterior-posterior bending, followed by cyclic superior-inferior loading to failure. Interfragmentary movements were monitored by optical motion tracking.</p><p><strong>Results: </strong>Dual plating demonstrated significantly higher initial construct stiffness in all bending directions and a reduced neutral zone compared to intramedullary nailing (p ≤ 0.016). In addition, fracture displacement amplitudes over all cycles were significantly higher in Group 1 versus Group 2 (p = 0.002). The number of cycles required to reach the test endpoint at a 45 mm displacement did not differ significantly between the groups (p = 0.160), with Group 1 averaging 24,420 cycles (SD ± 3,615) and Group 2 averaging 28,232 cycles (SD ± 5,417).</p><p><strong>Conclusion: </strong>Low-profile dual plating may offer improved initial stability of midshaft clavicle fractures without compromising their long-term performance, making it a promising alternative to elastic nailing. In selected patients with simpler unstable midshaft clavicle fractures, 2 × 2.0 mm dual plating may offer effective biomechanical stability.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"183"},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morbidity prediction in conservatively managed rib fracture patients.","authors":"Lovisa Ekestubbe, Maximilian Peter Forssten, Yang Cao, Babak Sarani, Shahin Mohseni","doi":"10.1007/s00068-025-02860-4","DOIUrl":"https://doi.org/10.1007/s00068-025-02860-4","url":null,"abstract":"<p><strong>Purpose: </strong>Rib fractures, common in blunt chest trauma, affect 10% of trauma patients and are linked to increased pulmonary morbidity and mortality. This study applies machine learning to identify predictors of complications in conservatively managed rib fracture patients.</p><p><strong>Methods: </strong>Data from the 2013-2021 American College of Surgeons' Trauma Quality Improvement Program included adults (≥ 18 years) with isolated thoracic injury from blunt trauma and conservatively managed rib fractures. Variables included demographics, comorbidities, injury severity, injury patterns, admission vitals, and complications. The permutation importance method identified top predictors of in-hospital complications.</p><p><strong>Results: </strong>Of 321,355 rib fracture patients, 183,303 (57.0%) had isolated rib fractures. The five primary predictors of complications in all rib fracture patients were age, Glasgow Coma Scale (GCS) on admission, Revised Cardiac Risk Index (RCRI), chronic obstructive pulmonary disease (COPD), and alcohol use disorder. For isolated rib fracture patients, the same predictors applied but in the order: age, RCRI, GCS, COPD, and alcohol use disorder. A logistic regression model using these predictors showed acceptable discriminative capacity for complications in the full cohort [AUC (95% CI): 0.72 (0.71-0.72)] and isolated rib fracture patients [AUC (95% CI): 0.72 (0.71-0.73)].</p><p><strong>Conclusion: </strong>Cardiovascular risk, age, and level of consciousness on admission are key predictors of complications in conservatively managed rib fracture patients. Though complication rates remain low overall, elderly patients with multiple cardiovascular risk factors face a heightened risk of deterioration.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"184"},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes after removal of rib stabilization hardware in patients with blunt chest trauma.","authors":"Maria B Svec, Helga Bachmann, Aljaz Hojski, Eric F Macharia-Nimietz, Sandrine V C Dackam, Didier Lardinois","doi":"10.1007/s00068-025-02858-y","DOIUrl":"https://doi.org/10.1007/s00068-025-02858-y","url":null,"abstract":"<p><strong>Purpose: </strong>The study aim was to investigate the long-term outcomes after hardware removal (HR) in patients with blunt chest trauma. We hypothesized that HR might be beneficial in indicated patients to improve patient health.</p><p><strong>Methods: </strong>We performed a retrospective single-center study between 2017 and 2023. Descriptive statistics were used for the analysis. One study-specific follow-up visit was conducted, 28 months (range 3-72) after HR. The study-specific health survey used, consisted of four functional dimensions (mobility, self-care, usual activities, mental health) and two symptom dimensions (thoracic pain, chest tightness) which were rated on a numerical scale and compared to the status before HR in four categories (much better to worse).</p><p><strong>Results: </strong>Of the 28 patients, the average age was 59 years (range 29-83), 12 fractures (1-39) were fixed, and 4 implants (1-11) were used. The indications for HR were persistent thoracic pain (36%), discomfort (25%), chest tightness (21%), hardware dislocation (11%) and hardware infection (7%). HR was performed 18 months (5 days-104 months) after surgery for trauma. Patients with chest tightness and infection exhibited the greatest improvement in symptoms (75%), followed by those with hardware dislocation (61%). The improvement rate in the other 2 groups was 58%. All patients who experienced chest tightness, hardware dislocation and infection were completely satisfied and would undergo HR again.</p><p><strong>Conclusion: </strong>HR is safe and feasible, resulting in significant symptom relief and improvement in health status in approximately two-thirds of patients. In indicated patients, HR might be performed earlier and more liberally if symptoms are disabling.</p><p><strong>Clinical trial registration number: </strong>NCT06003595 registered on July 18, 2023.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"187"},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The burden of injuries associated with accidents involving passengers carried in open bed pickup trucks - a review of 371 patients managed in a major trauma centre in South Africa.","authors":"William Yeung, Victor Kong, Jonathan Ko, Reuben He, Jim Wang, Cynthia Cheung, Vasil Manchev, John Bruce, Grant Laing, Damian Clarke","doi":"10.1007/s00068-025-02857-z","DOIUrl":"https://doi.org/10.1007/s00068-025-02857-z","url":null,"abstract":"<p><strong>Introduction: </strong>Although the transportation of passengers in the open back area of pickup trucks is associated with significant risk of injury, this practice remains ubiquitous in South Africa. This study reviews the spectrum of injury and clinical outcome of these patients in a large city in South Africa The intention of the study is to highlight the inherent dangers associated with the practice and hence provide impetus to legislators and authorities to attempt to restrict and ultimately eliminate this practice.</p><p><strong>Materials and methods: </strong>This was a retrospective study conducted over a decade (Jan 2012-Dec 2023) at a major trauma centre in South Africa.</p><p><strong>Results: </strong>A total of 371 patients were included (male: 53%, mean age: 25 years). The mean Injury Severity Score (ISS) was 11. The most common anatomical region injured was head, followed by face and thorax. All patients underwent radiological investigations. 15% percent required operative intervention, with laparotomy and wound debridement being the most common. 9% required intensive care unit admission. The mean length of hospital stay was four days. The overall morbidity was 8%. The overall mortality was 4% and 71% of all mortalities were related to severe traumatic brain injury.</p><p><strong>Conclusions: </strong>Transporting passengers in the load area of a pickup truck is dangerous and results in preventable morbidity and mortality. Attention should be given in South Africa to developing legislation in order to prevent this activity and to enforce these rules once passed.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"188"},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial surgical management of injuries to the urogenital tract in patients with polytrauma and/or severe injuries: a systematic review and clinical practice guideline update.","authors":"Christian Ruf, Luis Kluth, Sarah Wahlen, Jessica Breuing, Tim Nestler","doi":"10.1007/s00068-025-02847-1","DOIUrl":"10.1007/s00068-025-02847-1","url":null,"abstract":"<p><strong>Purpose: </strong>Our aim was to update evidence-based and consensus-based recommendations for the initial surgical management of urogenital injuries in patients with polytrauma and/or severe injuries based on current evidence. This guideline topic is part of the 2022 update of the German Guideline on the Treatment of Patients with Polytrauma and/or Severe Injuries.</p><p><strong>Methods: </strong>MEDLINE and Embase were systematically searched to June 2021. Randomised controlled trials, prospective cohort studies, and comparative registry studies were included if they compared surgical and/or therapeutic interventions for urogenital injuries in the hospital setting. We considered patient-relevant clinical outcomes such as mortality and bleeding control, or coagulation parameters as surrogate outcomes. Risk of bias was assessed using NICE 2012 checklists. The evidence was synthesised narratively, and expert consensus was used to develop recommendations and determine their strength.</p><p><strong>Results: </strong>Two new studies were identified. The topics covered were the comparison of outcomes after surgical and nonsurgical management as well as the use of surgical repair versus catheter drainage in patients with extraperitoneal bladder injuries. Three recommendations were modified, one of which for editorial reasons. All achieved strong consensus.</p><p><strong>Conclusion: </strong>The following key recommendations are made. 1. Renal artery injuries can be managed using an endovascular approach. 2. Depending on the type and severity of the injury and concomitant injuries, renal injuries should be managed with the intent to preserve the organ. 3. Extraperitoneal bladder ruptures without involvement of the bladder neck should be conservatively treated with catheterisation.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"182"},"PeriodicalIF":2.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of treatment approaches on renal function in renal trauma patients.","authors":"Serhat Yentur, Ibrahim Ogulcan Canitez, Adem Gokce, Ali Rojhat Kaya, Hakan Polat, Alper Bitkin, Ismail Engin Kandirali","doi":"10.1007/s00068-025-02863-1","DOIUrl":"https://doi.org/10.1007/s00068-025-02863-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Renal injuries account for 5% of all traumatic injuries, with blunt trauma being the most common cause (82-95%) [Meng, M.V., S.B. Brandes, and J.W. McAninch,, Renal trauma: indications and techniques for surgical exploration (17) 1999, Wessells, H., et al., Renal injury and operative management in the United States: results of a population-based study, 54(3) 2003]. Motor vehicle collisions (MVCs), pedestrian-vehicle accidents (PVAs), and falls often cause blunt renal injuries, frequently associated with intra-abdominal or thoracic trauma [Santucci, R., et al., Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee, 93(7) 2004]. Penetrating injuries, more common in urban areas, are typically severe and linked to firearm or sharp object incidents [Najibi, S., M. Tannast, and J.M. Latini, Civilian gunshot wounds to the genitourinary tract: incidence, anatomic distribution, associated injuries, and outcomes, 76(4) 2010]. Conservative management is generally recommended for grades 1-4 injuries [DiGiacomo, J.C., et al., The role of nephrectomy in the acutely injured 2001 136(9), Sujenthiran, A., et al., Is nonoperative management the best first-line option for high-grade renal trauma? A systematic review 2019 5(2)], and there is an increasing trend toward nonoperative management even for grade 5 injuries, though this remains a topic of debate [Keihani, S., et al., Contemporary management of high-grade renal trauma: results from the American Association for the Surgery of Trauma Genitourinary Trauma study 2018. 84(3), Moudouni, S., et al., Management of major blunt renal lacerations: is a nonoperative approach indicated? 2001 40(4)]. Our study aims to evaluate the impact of different treatment strategies on renal function outcomes in renal trauma patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This multicenter, retrospective study reviewed data from 65 renal trauma patients, including clinical notes, radiology, and pathology reports. We analyzed demographics, trauma mechanisms, injury grades, associated injuries, transfusion needs, and long-term renal function assessed via DMSA scintigraphy. Angioembolization's impact on clinical stability, transfusion needs, and renal function preservation was specifically evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Blunt trauma was the predominant mechanism (67.7% of cases). Angioembolization was performed in 10 patients, significantly reducing transfusion needs and preserving renal function (40% vs. 25% without; p = 0.009). Grade 5 injuries showed significant renal function decline, and conservative management increased the risk of severe complications. Urinoma developed in five cases, predominantly in high-grade injuries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Angioembolization improves outcomes in severe renal trauma by stabilizing clinical conditions, reducing blood transfusion needs, and preserving renal function better than conserva","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"185"},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}