European Journal of Trauma and Emergency Surgery最新文献

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Predictors of 1-year mortality in a clinical cohort of hip fracture patients. 髋部骨折患者临床队列1年死亡率的预测因素。
IF 1.9 3区 医学
European Journal of Trauma and Emergency Surgery Pub Date : 2025-03-20 DOI: 10.1007/s00068-025-02812-y
Mads Sundet, Mette Martinsen, Maren Paus, Haldor Valland, Henriette Haugeli Halvorsen, Joseph Sexton, Ulf Sundin, Siri Lillegraven
{"title":"Predictors of 1-year mortality in a clinical cohort of hip fracture patients.","authors":"Mads Sundet, Mette Martinsen, Maren Paus, Haldor Valland, Henriette Haugeli Halvorsen, Joseph Sexton, Ulf Sundin, Siri Lillegraven","doi":"10.1007/s00068-025-02812-y","DOIUrl":"10.1007/s00068-025-02812-y","url":null,"abstract":"<p><strong>Purpose: </strong>Knowledge about factors associated with mortality after hip fracture is important both for analytical and clinical purposes. This study aimed to assess patient risk factors and commonly used composite scores for prediction of 1-year mortality in a large clinical cohort.</p><p><strong>Methods: </strong>Hip fracture patient data were prospectively recorded in a local hospital database. Consecutive fractures from 2006 to 2020 were included, 6040 fractures in 5496 patients. Associations between 1-year mortality and different exposures were estimated using univariate and two multivariate logistic regression models. ROC analysis was used to compare the ability of the Nottingham Hip Fracture Score (NHFS), Age-adjusted Charlson Comorbidity Index (ACCI) the American Society of Anesthesiologists score (ASA) and the Orthopedic Frailty Score (OFS) to predict 1-year mortality.</p><p><strong>Results: </strong>Females sustained 73.9% of the fractures. Total 1-year mortality was 24.8%. Patients with overweight and class 1 obesity had lower 1-year mortality rates than normal weight patients [overweight: adjusted OR 0.58 (0.45-0.77), class 1 obesity: adjusted OR 0.40 (0.21-0.75)]. Mortality was elevated in males (adjusted OR 2.04, 95% CI 1.76-2.36), and nursing home residents (adjusted OR 2.99, 95% CI 2.60-3.44). We found no significant association between waiting time before surgery and mortality. Models including ACCI (AUC 0.74), NHFS (AUC 0.75) and OFS (AUC 0.73) had a similar ability to predict 1-year mortality, while a model including ASA (AUC 0.71) had a significantly lower prediction ability than ACCI and NHFS.</p><p><strong>Conclusions: </strong>Sex, age, cognitive impairment, and residential status predicted 1-year mortality. The study found an apparent \"obesity paradox\", where overweight patients had a lower mortality rate than normal weight patients, but unmeasured confounding may have biased this analysis. ACCI and NHFS predicted mortality better than the combination of age, sex, and ASA.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"147"},"PeriodicalIF":1.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668770","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}
引用次数: 0
Intended and suicidal trauma to the anterior neck in Finnish young adults. 芬兰年轻人前颈部的蓄意和自杀性创伤。
IF 1.9 3区 医学
European Journal of Trauma and Emergency Surgery Pub Date : 2025-03-20 DOI: 10.1007/s00068-025-02813-x
Riikka E Mäkitie, Silja Kosola, Taru Ilmarinen
{"title":"Intended and suicidal trauma to the anterior neck in Finnish young adults.","authors":"Riikka E Mäkitie, Silja Kosola, Taru Ilmarinen","doi":"10.1007/s00068-025-02813-x","DOIUrl":"10.1007/s00068-025-02813-x","url":null,"abstract":"<p><strong>Purpose: </strong>Self-inflicted injuries are a leading cause of death in young adults. Trauma to the anterior neck, such as from cutting and hanging, can have serious consequences given the complex anatomy and closeness of critical structures. Considering the recent increase in intended and inter-personal violence, we evaluated the occurrence and clinical characteristics of self-harm neck injuries in young adults.</p><p><strong>Methods: </strong>We retrospectively reviewed all neck traumas treated at the Helsinki University Hospital in patients aged 18 to 30 years in 2005-2023. Patient records were systematically evaluated for cohort demographics, injury type, clinical characteristics, given treatment, follow-up, and possible psychiatric comorbidities.</p><p><strong>Results: </strong>In total 169 events were recorded, with an evident increase in the recent years (45% of all in 2020-2023) and particularly in females. Females were younger than males (p = 0.010) and their trauma generally milder, often managed in outpatient care (82%). Severe penetrating injuries occurred primarily in males (p = 0.005) who were older (p = 0.004) and without prior suicidal events (p = 0.005). They required surgical interventions and prolonged in-house treatment. Overall, the cohort was characterized by a heavy burden of psychiatric comorbidities (98%) and substance abuse (53%); 78% had other suicidal events. Four patients (2.9%) deceased from a recorded suicide during the study period.</p><p><strong>Conclusions: </strong>We report an alarming increase in suicidal self-harm especially among young females and severe intended neck traumas in older males without preceding suicidal behavior. Our findings warrant timely preventative actions on an individual and societal level and call for refined guidelines for clinical management.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"146"},"PeriodicalIF":1.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669567","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}
引用次数: 0
Preventing the disaster: severe abdominal injury in child passengers of motor vehicle accidents often indicate even more serious trauma. 预防灾难:车祸中儿童乘客的严重腹部损伤往往预示着更严重的创伤。
IF 1.9 3区 医学
European Journal of Trauma and Emergency Surgery Pub Date : 2025-03-20 DOI: 10.1007/s00068-025-02811-z
Christopher Spering, R Lefering, D Bieler, L Hackenberg, C C Dobroniak, G Müller, W Lehmann, Rüther H
{"title":"Preventing the disaster: severe abdominal injury in child passengers of motor vehicle accidents often indicate even more serious trauma.","authors":"Christopher Spering, R Lefering, D Bieler, L Hackenberg, C C Dobroniak, G Müller, W Lehmann, Rüther H","doi":"10.1007/s00068-025-02811-z","DOIUrl":"10.1007/s00068-025-02811-z","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess severe abdominal injury in child passengers of different ages of motor vehicle accidents and analyze the concomitant pattern of injury regarding injury severity, trauma management and outcome.</p><p><strong>Method: </strong>Data acquisition from Trauma Register DGU<sup>®</sup> (TR-DGU) in a 10-years period (2010-2020) of seriously injured children (max. AIS 2+ / intensive care) 0-15 years of age, as motor vehicle passengers (cMVP) (n = 1,035). Primarily treated in or transferred to a German Trauma Center. Matched pairs analysis with adult severely injured motor vehicle passengers (aMVP) (age 20-50 years, n = 26,218), matching 1:4 (child: adult), was performed to identify causes of mortality.</p><p><strong>Results: </strong>The study group (cMVP) included 1,035 children. The mean age was 9.5 years, 50.5% were male and the mean Injury Severity Score (ISS) was 18.7 points. 93.0% were transported from scene directly to the final trauma center. Transferred patients showed a higher ISS (26 vs. 18 points), higher rate of severe traumatic brain injury (TBI), a higher rate of serious abdominal injury and a higher mortality rate (12.5% vs. 7.4%). Most of the severe abdominal injuries occurred after the third year of age (first peak between 8 and 9 years; second peak 14-15 years). Serious injuries to the pelvis show a similar distribution but less often, the same applies to thoracical injuries. Severe brain and head injuries show an antiproportional distribution to the age groups with the highest rate in the 0-1 year old (78%) and the lowest in the 14-15 year old (40%). The highest mortality rate was shown in the youngest age groups, related to TBI (AIS<sub>TBI</sub> ≥ 3; 62% in 0-1 years). The matched pairs analysis shows a higher mortality rate of cMVP compared to aMVP within the first 24 h after hospital admission and a significantly higher rate of shock and unconsciousness, while the intubation rate is significantly lower.</p><p><strong>Conclusion: </strong>Child passengers of motor vehicle accidents are in need of a specific and age-related attention towards security systems. Severe injuries in children are rare, yet life threatening. The highest mortality rate is related to severe TBI, especially in the youngest children. But also severe abdominal as well as thoracic injuries their concomitant trauma need to be prevented and are indicators for even more severe injuries. It seems to be favorable for cMVP to be directly transported to designated special centers with sufficient capacity and competency to treat and manage severely injured children.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"145"},"PeriodicalIF":1.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668744","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}
引用次数: 0
Trauma systems in Europe / hospital categories. 欧洲创伤系统/医院分类。
IF 1.9 3区 医学
European Journal of Trauma and Emergency Surgery Pub Date : 2025-03-19 DOI: 10.1007/s00068-025-02828-4
Inger B Schipper, Hans-Peter Simmen, Roman Pfeifer
{"title":"Trauma systems in Europe / hospital categories.","authors":"Inger B Schipper, Hans-Peter Simmen, Roman Pfeifer","doi":"10.1007/s00068-025-02828-4","DOIUrl":"10.1007/s00068-025-02828-4","url":null,"abstract":"<p><p>Trauma systems are vital components of healthcare infrastructure, addressing the significant burden of severe injuries across Europe. Effective trauma systems improve patient outcomes and reduce mortality by providing timely, specialised care. However, significant disparities remain between countries, with only a few well-structured and maintained systems currently operating in Europe.Developing trauma systems requires collaboration among healthcare providers, emergency services, and government agencies. Standardised protocols for triage, transport, and treatment are essential, supported by robust infrastructure, public education, and injury prevention initiatives.Trauma systems comprise four core components:• Injury Prevention.• Pre-Hospital Care.• Facility Care.• Post-Hospital Care/Rehabilitation.These components rely on key elements such as leadership, professional resources, education, quality improvement, and funding. Political commitment, geographical considerations, and the efforts of dedicated clinicians are crucial for ensuring system success.Trauma systems across Europe are evolving under diverse healthcare structures. Over recent decades, dedicated clinicians, often with support from national medical societies, have initiated and sustained these systems. Typically, trauma hospitals, or trauma centres (TCs), are categorised into two or three levels, with the highest being 'Level I TC' or 'Major TC,' capable of managing the most complex cases. This chapter outlines general requirements for these categories, leaving individual nations to tailor standards to their healthcare systems.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"143"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662758","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}
引用次数: 0
Engineering the bone reconstruction surgery: the case of the masquelet-induced membrane technique. 骨重建手术的工程化:假面诱导膜技术的案例。
IF 1.9 3区 医学
European Journal of Trauma and Emergency Surgery Pub Date : 2025-03-18 DOI: 10.1007/s00068-025-02815-9
Marjorie Durand, Laurent Mathieu, Julien Venant, Alain-Charles Masquelet, Jean-Marc Collombet
{"title":"Engineering the bone reconstruction surgery: the case of the masquelet-induced membrane technique.","authors":"Marjorie Durand, Laurent Mathieu, Julien Venant, Alain-Charles Masquelet, Jean-Marc Collombet","doi":"10.1007/s00068-025-02815-9","DOIUrl":"10.1007/s00068-025-02815-9","url":null,"abstract":"<p><p>The reconstruction of large bone defects remains challenging for orthopedic surgeons. Autologous bone grafts (ABGs) are the gold standard treatment for limited size defects, but larger bone defects (> 5 cm) require the use of more sophisticated techniques, such as the Masquelet technique. Over the last three decades, the Masquelet or induced membrane technique (IMT) has become increasingly popular as it does not require high-precision microsurgery skills and the time taken to achieve bone consolidation is independent of the length of the defect. IMT is a two-stage procedure. In the first stage, a polymethylmethacrylate (PMMA) cement spacer is implanted into the bone lesion and a physiological immune reaction initiates the formation of a fibrotic induced membrane (IM) with both angiogenic and osteogenic properties. The second stage, performed several weeks later, involves removal of the spacer followed by the implantation of a standard ABG in the preserved IM cavity for subsequent bone repair. In this extensive review, we explain how the success of this surgical procedure can be attributed to the synergy of four key components: the inducer (the PMMA cement), the recipient (the IM), the effector (the bone graft) and the modulator (the mechanical environment). Conversely, we then explain how each key component can contribute to the failure of such treatment. Finally, we discuss existing or emerging innovative and biotechnology-oriented strategies for optimizing surgical outcome with respect to the four components of IMT described above.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"138"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656529","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}
引用次数: 0
The influence of hemorrhagic shock on brain perfusion in a swine model of raised intracranial pressure. 出血性休克对颅内压升高猪模型脑灌注的影响。
IF 1.9 3区 医学
European Journal of Trauma and Emergency Surgery Pub Date : 2025-03-18 DOI: 10.1007/s00068-025-02819-5
Hossam Abdou, Rebecca Treffalls, Grzegorz Jodlowski, Noha Elansary, Thomas Ptak, Patrick F Walker, Jonathan J Morrison
{"title":"The influence of hemorrhagic shock on brain perfusion in a swine model of raised intracranial pressure.","authors":"Hossam Abdou, Rebecca Treffalls, Grzegorz Jodlowski, Noha Elansary, Thomas Ptak, Patrick F Walker, Jonathan J Morrison","doi":"10.1007/s00068-025-02819-5","DOIUrl":"10.1007/s00068-025-02819-5","url":null,"abstract":"<p><strong>Purpose: </strong>In patients with hemorrhagic shock and an intracranial space occupying lesion (SOL), brain perfusion is severely compromised due to raised intracranial pressure (rICP), significantly worsening outcomes. This study aims to develop a swine model of a SOL with rICP and shock and characterize the effect on brain perfusion.</p><p><strong>Methods: </strong>Ten male swine were divided into two groups- normal ICP (nICP) and rICP. rICP animals had an intracranial Fogarty balloon catheter inserted, which was infused with saline to simulate a SOL. Animals underwent hemorrhage to systolic blood pressures (SBP) of 60, 40, and 20mmHg. Cerebral blood flow (CBF) and cerebral blood volume (CBV) were measured using CT perfusion.</p><p><strong>Results: </strong>The CBF/Mean arterial pressure (MAP) and CBV/MAP curves were modeled using non-linear regression, with both groups demonstrating a sigmoid relation. In both the CBF/MAP and CBV/MAP curves, animals with rICP had loss of autoregulation at a higher MAP compared to nICP. The curves were an excellent fit for CBF (nICP R<sup>2</sup> = 0.95; rICP R<sup>2</sup> = 0.77) and CBV (nICP R<sup>2</sup> = 0.96; rICP R<sup>2</sup> = 0.78).</p><p><strong>Conclusions: </strong>This study aids in quantifying the compounding insult of raised ICP and hemorrhage with regard to brain perfusion. Raised ICP results in autoregulatory failure at a higher MAP compared to animals with nICP. These results can help inform future studies that should be aimed at evaluating novel interventions for this complex clinical scenario.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"137"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656573","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}
引用次数: 0
Operating room (OR) requirements. 手术室要求。
IF 1.9 3区 医学
European Journal of Trauma and Emergency Surgery Pub Date : 2025-03-18 DOI: 10.1007/s00068-025-02823-9
Roman Pfeifer, Frank Hildebrand, Sascha Halvachizadeh
{"title":"Operating room (OR) requirements.","authors":"Roman Pfeifer, Frank Hildebrand, Sascha Halvachizadeh","doi":"10.1007/s00068-025-02823-9","DOIUrl":"10.1007/s00068-025-02823-9","url":null,"abstract":"<p><p>The International Health Facility Guidelines 2023 provide critical recommendations for operating room (OR) design and management, addressing layout, equipment specifications, and safety protocols. By adhering to these guidelines, healthcare facilities can ensure optimal conditions for surgical procedures, minimise risks to patients and staff, and enhance overall efficiency. These recommendations serve as a vital resource for healthcare administrators, architects, and medical personnel, facilitating high-quality surgical care and improved outcomes for trauma patients.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"135"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656531","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}
引用次数: 0
Trauma room requirements. 创伤室要求。
IF 1.9 3区 医学
European Journal of Trauma and Emergency Surgery Pub Date : 2025-03-18 DOI: 10.1007/s00068-025-02820-y
Falco Hietbrink, Frank Hildebrand, Klemens Horst
{"title":"Trauma room requirements.","authors":"Falco Hietbrink, Frank Hildebrand, Klemens Horst","doi":"10.1007/s00068-025-02820-y","DOIUrl":"10.1007/s00068-025-02820-y","url":null,"abstract":"<p><p>Effective shock (or trauma) room management requires thorough preparation, staff competence, dedicated infrastructure and organised protocols. Shock rooms must be sufficiently equipped according to the hospital's designated level of care. This chapter outlines essential aspects, including equipment and facilities, staff qualifications and composition, and communication practices. Key areas including initial assessment, diagnostic procedures, emergency interventions, and future aspects in the care of severely injured patients are addressed, along with emerging innovations in trauma care.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"139"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656589","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}
引用次数: 0
Combined apophyseal and epiphyseal fixation of Ogden type IIIA/IV tibial tubercle avulsion fractures provides favorable stability compared to isolated apophyseal screw fixation - a biomechanical study. 一项生物力学研究表明,与孤立的椎弓根螺钉固定相比,Ogden IIIA/IV型胫骨结节撕脱骨折的椎弓根和骨骺联合固定提供了更好的稳定性。
IF 1.9 3区 医学
European Journal of Trauma and Emergency Surgery Pub Date : 2025-03-18 DOI: 10.1007/s00068-025-02814-w
Christian Peez, Ivan Zderic, R Geoff Richards, Ludmil Drenchev, Hristo K Skulev, Boyko Gueorguiev, Christoph Kittl, Michael J Raschke, Elmar Herbst
{"title":"Combined apophyseal and epiphyseal fixation of Ogden type IIIA/IV tibial tubercle avulsion fractures provides favorable stability compared to isolated apophyseal screw fixation - a biomechanical study.","authors":"Christian Peez, Ivan Zderic, R Geoff Richards, Ludmil Drenchev, Hristo K Skulev, Boyko Gueorguiev, Christoph Kittl, Michael J Raschke, Elmar Herbst","doi":"10.1007/s00068-025-02814-w","DOIUrl":"10.1007/s00068-025-02814-w","url":null,"abstract":"<p><strong>Purpose: </strong>Current literature lacks recommendations regarding proper fixation of tibial tubercle avulsion fractures involving the proximal tibial epiphysis (Ogden fractures). Therefore, the aim of this study was to compare isolated apophyseal screw fixation and additional fixation techniques in Ogden fractures.</p><p><strong>Methods: </strong>Two different types of apoepiphyseal tibial tubercle avulsion fractures were created in 40 proximal tibiae according to the modified Ogden classification: (1) Ogden type IIIA and (2) Ogden type IV. The fractures were fixed with either isolated apophyseal screws or additionally with a medial plate or epiphyseal screws. All specimens were biomechanically tested under progressively increasing cyclic loading until failure, while capturing the interfragmentary movements with motion tracking.</p><p><strong>Results: </strong>Augmentation of apophyseal screw osteosynthesis by a medial plate in Ogden IV fractures or epiphyseal screws in Ogden IIIA fractures exhibited significantly higher cycles to failure and failure loads (P< 0.05), and significantly less axial displacement (P < 0.05) compared to isolated apophyseal screw fixation. Fixation of Ogden type IIIA fractures resulted in significantly less axial displacements and higher construct stiffness, cycles to failure and failure loads compared to Ogden type IV fracture (P < 0.001). Fracture gap opening did not differ significantly between the fixation techniques.</p><p><strong>Conclusions: </strong>Augmented apophyseal screw fixation of apoepiphyseal tibial tubercle avulsion fractures provides greater biomechanical stability than isolated apophyseal screw fixation. Regardless of fixation technique, Ogden type IV fractures are more unstable than Ogden type IIIA fractures, so an individualized treatment strategy based on fracture morphology is crucial. In case of an Ogden type IIIA or Ogden type IV fracture, surgeons should consider adding epiphyseal screws or a medial plate osteosynthesis to apophyseal screw fixation to best neutralize forces of the extensor mechanism, as long as the often compromised soft tissue envelope can tolerate greater surgical invasiveness.</p>","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":"51 1","pages":"136"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656526","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}
引用次数: 0
Criteria for trauma team activation and staffing requirements for the management of patients with (suspected) multiple and/or severe injuries in the resuscitation room- a systematic review and clinical practice guideline update. 在复苏室管理(疑似)多发和/或严重损伤患者的创伤小组启动标准和人员配备要求——系统回顾和临床实践指南更新。
IF 1.9 3区 医学
European Journal of Trauma and Emergency Surgery Pub Date : 2025-03-18 DOI: 10.1007/s00068-025-02817-7
Christian Alexander Kühne, Alina Weise, Nadja Könsgen, Uwe Schweigkofler, Arnold Kaltwasser, Sabrina Pelz, Tobias Becker, Christopher Spering, Frithjof Wagner, Dan Bieler
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