Unfallchirurg最新文献

Background: The optimal timing of the implantation of a cemented hemiarthroplasty in the management of displaced medial femoral neck fractures is still the subject of current research. According to the current recommendations, these cases should be surgically treated within 24 h. The aim of this study was to evaluate the impact of the timing of surgery on operation-specific and nonspecific complications, intensive care treatment as well as mortality.

Material and methods: Overall, 152 cases were retrospectively investigated regarding several parameters (demographic data, comorbidities, surgery time, duration of hospital stay, intensive care treatment, general, bleeding, operation-specific and nonspecific complications). The statistical analysis was performed using the χ²-test and the unpaired Student's t‑test as well as logistic regression analyses.

Results: A total of 152 patients were included and 71.1% of the operations were performed within 24 h and the remaining 28.9% after 24 h. All groups showed a similar profile of comorbidities. The analysis of the intensive care treatment showed no significant differences between the individual groups. The rate of postoperative pneumonia was moderately higher among the patients with a procedure after 24 h; however, with no severe courses. There were no significant differences regarding all other complications and the mortality rate between the individual time points of surgery.

Conclusion: The present study demonstrated that patients operated on after 24 h showed no disadvantages regarding other complications, intensive care treatment or mortality, except from an increased postoperative pneumonia rate. These results could be taken into consideration for the next update of the treatment guidelines.

Background: For years e‑bike (Pedelec) sales have been steadily increasing. Therefore, the incidence of e‑bike-related injuries and deaths has been growing. Due to clinical experience, emergency personnel are suspecting that e‑bikers might be injured more severely compared to conventional bicyclists suffering from an accident. This topic has not yet been analyzed for Germany.

Objective: Analysis of injury severity and mortality following e‑bike and conventional bicycle accidents in a level I trauma center in Germany.

Material and methods: Data of patients treated after a bicycle accident at the accident and emergency department as well as the clinic for traumatology and orthopedics of the Evangelical Hospital (Evangelisches Krankenhaus) Oldenburg were gathered from 1 March 2017 to 1 March 2019.

Results: In this study 59 electric bicycle users (e-bikers) and 164 conventional cyclists were included. The average age of e‑bikers was 62 years compared to 48 years in the group of conventional cyclists. Comorbidities were significantly more frequent in the e‑bike group compared to classical cyclists. The e‑bikers were found to be significantly more severely injured than conventional bicyclists, the mean injury severity scores (ISS) were 5.2 and 3.4, respectively. E‑bikers were admitted to the hospital more often and for longer periods than the control group. There was no significant difference in mortality.

Conclusion: E‑bikers are more severely injured in accidents compared to conventional cyclists. Due to older age and comorbidity they form a sensitive trauma subgroup. Based on demographics, an increase of old age, more frail cyclists and a growing incidence of serious e‑bike accidents is to be expected. Preventive measures, such as helmet usage and riding lessons should be introduced, especially in e‑bikers. E‑bikers in the emergency department should be examined and treated with special care and aggressive diagnostics. A low threshold for an initial interdisciplinary assessment (shock room management) is advised.