European journal of trauma and emergency surgery : official publication of the European Trauma Society最新文献

{"title":"Inhospital coagulation management and fluid replacement therapy in patients with multiple and/or severe injuries - a systematic review and clinical practice guideline update.","authors":"Heiko Lier, Käthe Goossen, Charlotte M Kugler, Erwin Strasser, Björn Hussmann, Marc Maegele, Peter Hilbert-Carius","doi":"10.1007/s00068-025-02919-2","DOIUrl":"10.1007/s00068-025-02919-2","url":null,"abstract":"<p><strong>Purpose: </strong>Our aim was to update the evidence-based and consensus-based recommendations for inhospital coagulation management and fluid replacement therapy in patients with multiple and/or severe injuries on the basis of current evidence. This guideline topic is part of the 2022 update of the German Guideline on the Treatment of Patients with Multiple and/or Severe Injuries.</p><p><strong>Methods: </strong>MEDLINE and Embase were systematically searched to May 2021. Further literature reports were obtained from clinical experts. Randomised controlled trials, prospective cohort studies, and comparative registry studies were included if they compared interventions for the prevention of acidaemia, hypocalcaemia and hypothermia, for coagulation management, fluid replacement therapy, blood product transfusions, viscoelastic assays, or central venous access in patients with multiple and/or severe 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>Fifty-nine new studies were identified. Interventions covered were blood products (n = 19 studies), coagulation management (n = 14), viscoelastic assays (n = 12), temperature management (n = 5), fluid replacement therapy (n = 4), base excess/lactate (n = 3), calcium (n = 1), and intravenous access (n = 1). Twelve recommendations were modified, and seven additional recommendations were developed. All achieved strong consensus.</p><p><strong>Conclusion: </strong>The key recommendations are summarised as follows. Trauma-induced coagulopathy (TIC) is a distinct clinical entity requiring early diagnostic and therapeutic interventions. Perform viscoelastic assays in order to aid in the diagnosis and treatment of TIC in severely bleeding trauma patients. Since only approximately 20% of trauma patients are hyperfibrinolytic and tranexamic acid is not beneficial in the absence of hyperfibrinolysis, TXA should not be indiscriminately used in all patients in the emergency department. Coagulation factor concentrates as well as TXA are indicated in patients with life-threatening haemorrhage and/or haemorrhagic shock.</p>","PeriodicalId":520620,"journal":{"name":"European journal of trauma and emergency surgery : official publication of the European Trauma Society","volume":"51 1","pages":"240"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change in resuscitation influenced development and severity of inflammatory complications in severely injured.","authors":"Karlijn J P van Wessem, Kim E M Benders, Luke P H Leenen, Falco Hietbrink","doi":"10.1007/s00068-025-02905-8","DOIUrl":"10.1007/s00068-025-02905-8","url":null,"abstract":"<p><strong>Introduction: </strong>Resuscitation strategies for severely injured patients have shifted toward reduced crystalloids and increased balanced blood product resuscitation, including Fresh Frozen Plasma (FFP) to reduce organ failure and mortality. However, FFP is associated with higher infection and sepsis risks. This study investigated the impact of resuscitation changes on inflammatory complications and mortality.</p><p><strong>Methods: </strong>This 11-year cohort study included severely injured patients (> 15 years) admitted to a Level-1 Trauma Center ICU. Exclusions included isolated head injuries, drowning, asphyxiation, burns, and deaths < 48 h. Data on demographics, resuscitation, inflammatory complications (MODS, ARDS, infections, thromboembolism), and mortality were collected.</p><p><strong>Results: </strong>Among 585 patients (median age 46,72% male, ISS 29, 94% blunt injuries), 18% developed MODS, 3% ARDS, 45% infections, 9% thromboembolism, and 14% died. Over time, crystalloids ≤ 24 h decreased while FFP ≤ 24 h increased, correlating with reduced ARDS but increased thromboembolic events. Crystalloids ≤ 24 h independently predicted MODS, infections, and mortality, while FFP ≤ 24 h was linked to MODS and thromboembolism. Causes of death other than neurological included MODS (5%), sepsis (3%), and ARDS (1%), with no deaths from thromboembolic complications.</p><p><strong>Conclusion: </strong>Resuscitation evolved toward less crystalloids and more FFP ≤ 24 h, likely reducing ARDS but increasing thromboembolic complications, while other outcomes remained comparable. Low mortality from inflammatory complications suggests these complications were mild. The anti-inflammatory, immune-modulating effect of FFP might have played a role in the attenuation of these complications, supporting current resuscitation strategies. However, improved identification of patients who require FFPs may help reduce thromboembolism. In the future, optimal FFP dosage should be determined to balance coagulopathy correction, blood volume restoration, and management of the inflammatory response following trauma.</p>","PeriodicalId":520620,"journal":{"name":"European journal of trauma and emergency surgery : official publication of the European Trauma Society","volume":"51 1","pages":"232"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is level 1 trauma care necessary for all severely injured older patients? Evaluating undertriage and feasibility of care in major and non-major trauma centres in the Netherlands.","authors":"Sara van Ameijden, Pieter Boele van Hensbroek, Doeke Boersma, Stefan van Zutphen, Martijn Poeze, Mariska de Jongh","doi":"10.1007/s00068-025-02897-5","DOIUrl":"10.1007/s00068-025-02897-5","url":null,"abstract":"<p><strong>Purpose: </strong>Undertriage remains a challenge within the severely injured older patients. The survival benefit in major trauma centres (MTCs) compared to non-major trauma centres (nMTCs) has been disputed. This study aimed to assess the differences in patient characteristics of severely injured older patients treated in MTCs and nMTCs and to regard whether these characteristics could be related to pre-hospital triage decisions and influence clinical outcomes in MTCs and nMTCs.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted, using the Dutch National Trauma Registry to identify all patients of 70 and above with an ISS ≥ 16 during 2016-2022. Patient characteristics and outcomes between MTCs, nMTCs and directly transferred patients were compared. Backward logistic regression analyses were performed to identify factors predicting mortality.</p><p><strong>Results: </strong>A total of 10,899 patients were included. Patients in nMTCs harboured more octo- and nonagenarians than MTCs (44.6% vs. 37.2% and 15.1% vs. 6.7% resp., p < 0.001). The ISS was significantly lower in nMTCs (median 19 [IQR 17-25] vs. 22 [17-27], p < 0.001), with severe head injury and a low GCS being more prevalent in MTCs. High energy falls were more often observed in MTCs (15.6% vs. 7.7%, p < 0.001). Mortality was significantly lower in nMTCs (OR 0.59, 95%-CI 0.54-0.65), with a GCS 3-8 strongly associated with an increased risk for mortality in both nMTCs and MTCs (OR 19.93, p < 0.001 and OR 7.87, p < 0.001 resp.).</p><p><strong>Conclusion: </strong>The differences in patients presented in MTCs and nMTCs indicate factors contributing to undertriage; severely injured older patients with recognizable injuries and trauma mechanisms are more likely to be presented in a MTC. Whether feasible care for severely injured older patients should be provided in MTCs or nMTCs should not only be dependent on ISS and mortality rates; patient-centred care goals harbouring broader perspectives as frailty and health- and quality-of-life benefit of aggressive injury treatment should also contribute in triage- and treatment decision-making.</p><p><strong>Level of evidence and study type: </strong>Level III, prognostic/epidemiological.</p>","PeriodicalId":520620,"journal":{"name":"European journal of trauma and emergency surgery : official publication of the European Trauma Society","volume":"51 1","pages":"230"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers of myocardial contusion: no one should stand alone.","authors":"Ayman El-Menyar","doi":"10.1007/s00068-025-02903-w","DOIUrl":"https://doi.org/10.1007/s00068-025-02903-w","url":null,"abstract":"","PeriodicalId":520620,"journal":{"name":"European journal of trauma and emergency surgery : official publication of the European Trauma Society","volume":"51 1","pages":"231"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aftercare following fatal traumatic injuries, needs and questions: a level 1 trauma center study and scoping review.","authors":"Nadia A G Hakkenbrak, Johan G H van den Brand, Sohaib Jaddi, Linda J Schoonmade, Frank W Bloemers","doi":"10.1007/s00068-025-02895-7","DOIUrl":"10.1007/s00068-025-02895-7","url":null,"abstract":"<p><strong>Purpose: </strong>Approximately 2,000 people die each year in the hospital due to accidental or inflicted traumatic injuries in the Netherlands. This has major emotional and socioeconomic consequences. Bereavement support is offered to prevent complicated grief, however, recommendations on adequate aftercare by the hospital are lacking.</p><p><strong>Methods: </strong>Patients with fatal traumatic injuries admitted to the Northwest Clinics, Alkmaar, or Amsterdam University Medical Center, VUMC, between January 1st 2021, and January 1st 2023, were assessed for eligibility (Injury Severity Score ≥ 16, in-hospital mortality). Their relatives were contacted, and a questionnaire was administered to evaluate their experiences with the aftercare provided by the hospital. In addition, a scoping review was performed to report on recommendations to improve aftercare.</p><p><strong>Results: </strong>A total of 1,131 articles were identified for the scoping review, of which 10 were selected for analysis (four questionnaires and six interview-based studies). The implementation of grief services by skilled professionals is recommended. The most frequently reported time between death and contact was 4-6 weeks, with contact conducted via telephone. During the study period, 110 patients met the inclusion criteria for the questionnaire. The median age of the deceased was 70 years (SD 20); 58% were male, with a median Injury Severity Score of 26 (range 16-75). Bereavement support was offered to 50% of the relatives, requested by 34%, and absent or lacking for 24%.</p><p><strong>Conclusion: </strong>Aftercare following traum-related in-hospital deaths remains inconsistent. Both the questionnaire and scoping review recommend structured aftercare. Aftercare, by telephone or face-to-face, conducted by a trained professional four weeks after the death, is suggested to favorably influence the course of bereavement or lead to timely referral for grief counseling.</p>","PeriodicalId":520620,"journal":{"name":"European journal of trauma and emergency surgery : official publication of the European Trauma Society","volume":"51 1","pages":"229"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive stabilization of the anterior pelvic ring in fragility fractures using a submuscularly implanted internal fixator - a retrospective case series of 34 geriatric patients.","authors":"Julia Lenz, Carmie Schneider, Ludwig Oberkircher, Vanessa Ketter, Tom Knauf, Steffen Ruchholtz, Juliana Hack","doi":"10.1007/s00068-025-02893-9","DOIUrl":"10.1007/s00068-025-02893-9","url":null,"abstract":"<p><strong>Purpose: </strong>Various surgical techniques for osteosynthesis in fragility fractures of the pelvis (FFP) are described. Since 2012, a submuscularly placed internal fixator has been used to stabilize the anterior pelvic ring. Indications for this procedure are a dislocation in the anterior pelvic ring and/or severe pain with associated immobility. This technique potentially has several advantages compared to subcutaneous procedures, including improved patient comfort, less irritation, and enhanced biomechanical stability due to the deeper rod placement.</p><p><strong>Methods: </strong>Digital files of patients aged ≥ 65 years, who were treated with an internal fixator at a Level I trauma center in Germany between 2012 and 2021, were retrospectively analyzed.</p><p><strong>Results: </strong>Thirty-four patients (median age 79 years, 77% female, 61.8% ASA III) were treated. Most fractures were caused by ground-level falls (64.7%), followed by road traffic accidents (11.8%). In patients with low impact trauma, the most common fracture types were FFP IIb (37.04%) and FFP IIIc (18.52%). Complications during surgery occurred in 4 patients (11.76%) and postoperative complications in 6 patients (17.6%), with hematoseroma being the most common. Non-surgical complications occurred in 20 patients (total: 58.8%; Clavien-Dindo type 2 in 70%). After 12 months, the majority of all patients had the same mobility level as before the fracture.</p><p><strong>Conclusion: </strong>The submuscularly placed internal fixator is an effective technique for stabilizing anterior pelvic ring fractures in geriatric patients, offering advantages in cases of high dorsoventral instability or persistent severe anterior pain.</p>","PeriodicalId":520620,"journal":{"name":"European journal of trauma and emergency surgery : official publication of the European Trauma Society","volume":"51 1","pages":"228"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes in fragility fractures of the pelvis; what can we tell our patients?","authors":"T J A Kooger, G W C M Beelen, B W K de Wit, D J Hofstee, P Joosse, S A I Loggers, K J Ponsen","doi":"10.1007/s00068-025-02898-4","DOIUrl":"https://doi.org/10.1007/s00068-025-02898-4","url":null,"abstract":"<p><strong>Introduction: </strong>Fragility fractures of the pelvis (FFP) can have a profound impact on the older patient, yet the subjective recovery after a FFP is still relatively understudied. The aim of this prospective study was to evaluate patient reported outcome measures such as HRQoL and degree of pain in older patients sustaining an FFP.</p><p><strong>Method: </strong>A prospective cohort study was conducted at the Northwest clinics in the Netherlands. Patients were included if they were aged 65 or older and sustained a FFP after a low impact trauma. Outcomes were the EuroQol 5D-5L (EQ-5D), pain, mobility, mortality, and complications. Data were acquired at day 1, day 7, day 30, and after 3- and 6-months post-trauma.</p><p><strong>Results: </strong>Fifty-one patients were included between November 1, 2019 and November 29, 2020 with a median age of 82 years (P25-P75 74-87). The EQ-5D utility score decreased from 1.00 [0.85-1.00] pre-trauma to 0.33 [0.23-0.49] on day one post-trauma (p-value < 0.001) and returned to 0.85 [0.77-0.92] in the patients still alive after six months (n = 38). At day 1 post-trauma the median pain score during mobilization was 8 [6-8] and decreased to 4 [2-6] after 4 weeks. After 3 months post trauma 7 (16%) patients still experienced pain at rest and 17 (38%) patients during mobilization. All but one patient were initially treated non-operatively. Out of the 36 patients admitted to the hospital, 23 (64%) were institutionalized upon hospital discharge. After four weeks 74% of the patients were able to mobilize, most of them with a walker or crutches (86%). More than half of the patients suffered an adverse event (53%).</p><p><strong>Conclusion: </strong>This study shows that HRQoL was significantly affected in patients with FFP. Also, it has a big impact on ambulation and independency of these patients. Both HRQoL and pain improve significantly after four weeks. This study provides valuable insights of the subjective recovery in patients with FFP and can be used for expectation management and to establish the natural course of FFP.</p>","PeriodicalId":520620,"journal":{"name":"European journal of trauma and emergency surgery : official publication of the European Trauma Society","volume":"51 1","pages":"224"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute shortening of upper extremity in orthopaedic patients: a scoping review.","authors":"Zhijian Sun, Gang Liu, Nikolaos K Kanakaris, Ting Li, Xinbao Wu, Peter V Giannoudis","doi":"10.1007/s00068-025-02904-9","DOIUrl":"10.1007/s00068-025-02904-9","url":null,"abstract":"<p><strong>Purpose: </strong>Acute shortening of the upper extremity could be used in patients with segmental bone loss or large soft tissue defects. The study aimed to review available evidence about acute shortening procedures of the upper extremities to evaluate the common indications and tolerable shortening length.</p><p><strong>Methods: </strong>All clinical studies involving acute shortening procedures of the upper extremity were considered eligible for inclusion. PubMed, Embase, Web of Science and Cochrane Library for English-language articles from inception to December 2024 were searched. Two reviewers independently charted data from each eligible article.</p><p><strong>Results: </strong>Out of 730 studies screened, 35 articles met the inclusion criteria. There were 24 case series and 11 case reports containing 355 acute shortening procedures. Acute shortening was reported in 12 articles for amputation, 15 for fracture nonunion, 2 for fresh or delayed fracture, 2 for tumor, 2 for brachial plexus injury and 2 for forearm deformity. The maximum shortening for replantation was 10 cm in the forearm and 12 cm in the humerus. Shortening up to 2.9 cm and 8 cm for fracture nonunion were reported for the forearm and humerus, respectively.</p><p><strong>Conclusions: </strong>The main indications for acute shortening of the upper limb were amputation for replantation and fracture nonunion. Aggressive bony shortening was recommended in the setting of amputations. Controversies existed about the tolerated shortening length for both the forearm and humerus.</p>","PeriodicalId":520620,"journal":{"name":"European journal of trauma and emergency surgery : official publication of the European Trauma Society","volume":"51 1","pages":"225"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers help identify critically injured patients with only moderate risk of severe injuries in trauma team activation.","authors":"Paul Hagebusch, Nils Scheidt, Daniel Koch, Alexander Klug, Uwe Schweigkofler, Philipp Faul","doi":"10.1007/s00068-025-02896-6","DOIUrl":"https://doi.org/10.1007/s00068-025-02896-6","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate trauma triage ensures timely and specialized care for potentially critically injured patients. Undertriage remains a concern, particularly for patients without obvious vital sign derangements. This study evaluates the potential of biomarkers such as lactate, base deficit (BD), and blood glucose to improve triage score accuracy in identifying patients with severe injuries (Injury Severity Score [ISS] > 15) and predicting intensive care unit (ICU) admission without a high risk of severe injury (HRSI).</p><p><strong>Methods: </strong>This retrospective, single-center cohort study (2017-2021) included trauma patients with trauma team activation (TTA) due to mechanism of injury(MOI) and therefore only patients with moderate risk of severe injury criteria(MRSI). Exclusion criteria were any HRSI-criterion such as advanced airway management, Glasgow Coma Scale < 12, systolic blood pressure < 90 mmHg, and specific injury patterns. Biomarkers were collected upon emergency department (ED) admission. Logistic regression and receiver operating characteristic (ROC) curve analyses evaluated biomarker predictive value alone and in combination with existing triage scores.</p><p><strong>Results: </strong>The study population included 3371 TTAs of which we were able to include 302 in our study-group. 15% had ISS > 15. These patients had significantly higher lactate (2.38 ± 1.2 vs. 1.57 ± 0.75 mmol/L, p < 0.05), BD (-0.2 ± 5.0 vs. 1.7 ± 2.7 mmol/L, p < 0.05), and blood glucose (144.8 ± 46.0 vs. 118 ± 37.9 mg/dL, p < 0.05). Augmenting triage scores with lactate improved predictive accuracy, with the highest AUC (0.774) observed for the age-lactate model. ICU admission prediction was less robust (AUC = 0.674).</p><p><strong>Conclusion: </strong>Our findings suggest that biomarkers such as lactate could strengthen trauma triage scores, but prospective, multicenter validation is essential to confirm these preliminary results.</p>","PeriodicalId":520620,"journal":{"name":"European journal of trauma and emergency surgery : official publication of the European Trauma Society","volume":"51 1","pages":"226"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical evaluation of cerclage wiring in plated tibia fractures using human and synthetic specimens.","authors":"Sabrina Sandriesser, Stefan Förch, Jan Reuter, Christoph Kern, Marianne Hollensteiner, Edgar Mayr, Peter Augat","doi":"10.1007/s00068-025-02894-8","DOIUrl":"10.1007/s00068-025-02894-8","url":null,"abstract":"","PeriodicalId":520620,"journal":{"name":"European journal of trauma and emergency surgery : official publication of the European Trauma Society","volume":"51 1","pages":"227"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}