Pelvic trauma : WSES classification and guidelines

Complex pelvic injuries are among the most dangerous and deadly trauma related lesions. Different classification systems exist, some are based on the mechanism of injury, some on anatomic patterns and some are focusing on the resulting instability requiring operative fixation. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic impairment of pelvic ring function and the associated injuries. The management of pelvic trauma patients aims definitively to restore the homeostasis and the normal physiopathology associated to the mechanical stability of the pelvic ring. Thus the management of pelvic trauma must be multidisciplinary and should be ultimately based on the physiology of the patient and the anatomy of the injury. This paper presents the World Society of Emergency Surgery (WSES) classification of pelvic trauma and the management Guidelines.Peer reviewe

Ecosystem models of bivalve aquaculture: Implications for supporting goods and services

In this paper we focus on the role of ecosystem models in improving our understanding of the complex relationships between bivalve farming and the dynamics of lower trophic levels. To this aim, we review spatially explicit models of phytoplankton impacted by bivalve grazing and discuss the results of three case studies concerning an estuary (Baie des Veys, France), a bay, (Tracadie Bay, Prince Edward Island, Canada) and an open coastal area (Adriatic Sea, Emilia-Romagna coastal area, Italy). These models are intended to provide insight for aquaculture management, but their results also shed light on the spatial distribution of phytoplankton and environmental forcings of primary production. Even though new remote sensing technologies and remotely operated in situ sensors are likely to provide relevant data for assessing some the impacts of bivalve farming at an ecosystem scale, the results here summarized indicate that ecosystem modelling will remain the main tool for assessing ecological carrying capacity and providing management scenarios in the context of global drivers, such as climate change

Die Marknagelung der Humerusschaftfraktur. [Intramedullary nailing of the humerus shaft fracture]

The current retrospective study refers to 61 fractures and nonunions of the humeral shaft that were treated operatively between 1980 and 1990 in the Department of Surgery of the University of Zurich Medical School. All fractures were stabilized with thin noninterlocking AO tibial nails. The follow-up included 48/61 patients. The predominant fracture localization was the middle third of the humeral shaft (52 consecutive cases), and most of these fractures were of the simple transverse type A3 according to the AO classification (29 cases). The incidence of initial radial nerve palsy was 9/61 and that of postoperative palsy 1/61. No preoperative evaluation of radial nerve function was obtained in 4 multiply injured patients. Upon follow up, the function was found to have returned to normal in 8 patients. No infectious complications were observed. In 4/56 patients the final result was nonunion. In 41/48 a good result was obtained in terms of shoulder function. There were 7 patients (5 of them multiply injured) with poor shoulder motion with less than 100 degrees in abduction and anteversion

Bilaterale anteriore Schulterluxationsfraktur nach epileptischem Anfall. Ein kasuistischer Beitrag. [Bilateral anterior shoulder dislocation fracture after an epileptic seizure. A case report]

Fractures can occur during violent muscular violence such as occur in the course of epileptic seizures, though this is rare (0.3%). The proximal part of the humerus is most frequently affected. The typical lesion is bilateral posterior dislocation or fracture-dislocation. We present a rare case of bilateral anterior fracture-dislocation of the shoulder sustained as the result of an epileptic fit. The treatment given was open reduction, refixation of the anterior labrum and screw fixation of the fragments. A review of the literature revealed only 18 cases of bilateral anterior dislocations caused by convulsive seizures

Ergebnisse der Marknagelung bei Humerusschaftfrakturen. [Results of intramedullary nailing in humerus shaft fractures]

We present an analysis of a retrospective study of 61 humeral shaft fractures, stabilized with a thin AO tibial nail. All fractures were analysed according to the AO-classification. Follow-up included 48/61 patients and averaged 82 months. Local complications were postoperative radial nerve palsy in 1/61, infection in 0/61 and non-union in 4/56. A good result in shoulder function was obtained in 41/48 cases