European Journal of Trauma and Emergency Surgery最新文献

{"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":"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":2.2,"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":"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":2.2,"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":"Quality improvement program for the severely injured.","authors":"Isidro Martínez Casas, Ingo Marzi","doi":"10.1007/s00068-025-02826-6","DOIUrl":"10.1007/s00068-025-02826-6","url":null,"abstract":"<p><p>Over recent decades, advancements in trauma care have significantly reduced mortality rates among severely injured patients. These improvements are largely attributable to the establishment of trauma care systems, including prehospital management protocols and the creation of trauma centres with immediate surgical team availability. However, patient outcomes continue to vary, reflecting differences in the quality of trauma care influenced by organisational models and local practices. To address this, governments and scientific organisations have underscored the importance of evaluating care quality at local, national, and international levels. This chapter explores strategies for assessing quality of trauma care, establishing reliable quality indicators (QIs), and standardising auditing processes to guide improvements in patient outcomes and system performance.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"186"},"PeriodicalIF":2.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981478","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":"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":2.2,"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":"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":2.2,"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":"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":2.3,"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}

{"title":"Cardiopulmonary collapse in frail patients treated with cemented and uncemented hemiarthroplasty.","authors":"Thomas P Bosch, Max P L van der Sijp, Pieta Krijnen, Arthur H P Niggebrugge, Rachid Mahdad, Inger B Schipper","doi":"10.1007/s00068-025-02856-0","DOIUrl":"10.1007/s00068-025-02856-0","url":null,"abstract":"<p><strong>Background: </strong>Peri-operative cardiopulmonary collapse (CPC) poses an increased risk of in-hospital mortality, especially in frail patients. Bone Cement Implantation Syndrome (BCIS) is CPC following, cemented, arthroplasty, characterized by hypoxia and/or hypotension. The main objective of this study was to evaluate the association between cemented hemiarthroplasty and CPC, in patients with a femoral neck fracture (FNF) and increased pre-operative risk, and identify other risk factors for cardiopulmonary collapse.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with a FNF treated with a cemented or uncemented hemiarthroplasty, aged ≥ 80 years, with ASA score ≥ 3 and ≥ 1 cardiac or pulmonal comorbidity. CPC was defined as hypoxia/hypotension grade ≥ 2 according to Donaldson's criteria. Multivariable logistic regression analysis was used to adjust for confounding in the relation between cemented hemiarthroplasty and CPC, and to identify other risk factors for CPC in patients with a cemented hemiarthroplasty.</p><p><strong>Results: </strong>The incidence of CPC was 51.1% in 221 cemented hemiarthroplasty patients compared to 23.3% in 73 uncemented hemiarthroplasty patients (p < 0.001). The use of cement increased the risk for CPC almost threefold (adjusted odds ratio [aOR] 2.87, 95% confidence interval [CI] 1.46-5.64). Preoperative reduced left ventricle ejection fraction (aOR 3.03, 95% CI 1.50-6.14) was another independent risk factor for CPC.</p><p><strong>Conclusion: </strong>Cementation increases the risk of CPC in frail FNF patients treated with hemiarthroplasty. Emphasis on euvolemia and avoidance of excessive pressurization, and careful consideration of an indicated cemented hemiarthroplasty in frail hip fracture patients may be advised for patients with an increased preoperative risk for BCIS.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"181"},"PeriodicalIF":2.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973506","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":"Insights into orthopedic and trauma emergency care and current challenges in Germany.","authors":"Jonas Roos, Sophia Helm, Amadeo Touet, Davide Cucchi, Kristian Welle, Leonie Weinhold, Ingo Graeff, Martin Gathen","doi":"10.1007/s00068-025-02829-3","DOIUrl":"10.1007/s00068-025-02829-3","url":null,"abstract":"<p><strong>Background: </strong>The reform of emergency and acute care in Germany focuses on efficiently managing patient flows to reduce overcrowding in emergency departments, primarily caused by a rise in patients with low urgency and a lack of alternative care options. The aim of this work was to analyze the emergency care of orthopedic and trauma surgery patients in a Level I trauma center in order to improve patient care and manage resources more effectively.</p><p><strong>Material and methods: </strong>In this retrospective study, the data of orthopaedic and trauma surgery patients from the emergency department of a university in 2022 were analyzed. Data included demographics, triage levels, transport modes, diagnoses, and treatment outcomes. Process metrics like length of stay and time to medical contact were also evaluated. Descriptive and statistical analyses were conducted to examine patient distribution and resource use.</p><p><strong>Results: </strong>A total of 9414 patients (47.5% females; mean age 42.4 ± 24.1 years) were included, with 7500 treated for trauma and 1914 for orthopedic diagnoses. Most patients (79.6%) received outpatient care, while 21.3% were admitted as inpatients. Manchester Triage System distribution revealed 48.5% green, 31.0% yellow, 14.8% orange, and 0.8% red. The most common MTS flowcharts were limb problems (38.3%), falls (19.7%), and back pain (11.1%). Ambulance transport accounted for 33.7% of arrivals, while 65.1% presented independently. The average length of stay in the ED was 213 min, varying significantly across triage categories and working hours.</p><p><strong>Conclusion: </strong>This study highlights key challenges in orthopedic and trauma emergency care, emphasizing the prevalence of low-urgency cases contributing to overcrowding. Enhancing outpatient care capacity and implementing reforms like integrated emergency centers and optimized triage systems are crucial to improving efficiency and aligning resources with patient needs.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"180"},"PeriodicalIF":2.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997810","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":"Influencing factors for fragility fractures of the pelvis on length of stay and complication rate.","authors":"Andreas Termer, Olga Ruban, Anica Herlyn, Tim Fülling, Philip Gierer","doi":"10.1007/s00068-025-02861-3","DOIUrl":"10.1007/s00068-025-02861-3","url":null,"abstract":"<p><strong>Purpose: </strong>Increasing incidence of fragility pelvic ring fractures (FFP) is driven by demographic. An analysis of the patient population, along with the factors influencing total length of stay (LoS), and endpoints such as complications is essential for a better understanding and treatment of FFP injuries.</p><p><strong>Methods: </strong>This retrospective data analysis includes all inpatients treated from January 2018 to December 2022, with an FFP. Excluded were patients < 65 years, high-energy trauma, acetabular fractures, or pathological fractures. Collected data included demographics as well as information about comorbidities, diagnostics, therapy, LoS and complications.</p><p><strong>Results: </strong>A total of 363 patients were included, of which 14% (n = 52) were male and 86% (n = 311) female. The average age was 84.4 ± 6.6 years. While 31.1% (n = 113) were mobile without aid before onset of symptoms there was a significant (p < 0.01) decrease to 5.2% (n = 19) at discharge. Only 43.8% (n = 159) remained self-dependent at discharge, compared to 62.3% (n = 226) before injury (p < 0.01). Significantly longer LoS was found with higher FFP types (p < 0.01), higher number of complications (p < 0.01) as well as operative treatment (p < 0.01) and MRI diagnostics (p < 0.01). A significant increase on the number of complications was found with FFP IV (p = 0.02) and operative treatment (p < 0.01).</p><p><strong>Conclusion: </strong>Higher FFP types, higher number of complications, as well as operative treatment and MRI diagnostics prolonged the total LoS. FFP IV and operative treatment were associated with higher number of complications. By identifying specific factors influencing the inpatient stay, further prospective studies may show improved complication/ mortality rates by optimizing those factors.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"179"},"PeriodicalIF":2.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971333","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}