[Diagnosis and Immediate Therapeutic Management of Limb Injuries. A Systematic Review of the Literature]
Overview
Authors
Affiliations
Objective: Limb injuries are often underestimated in the diagnostic procedures initiated in the resuscitation room. Missed diagnosis is therefore a frequent consequence in this issue. A systematic analysis of evidence-based procedures was therefore investigated in this paper.
Methods: Clinical trials were systematically collected (Medline, Cochrane and hand searches) and classified into evidence levels (1 to 5 according to the Oxford system).
Results: Following admission of a multiple trauma patient vital functions have to be established in first priority. After stabilization a systematic clinical investigation and consecutive specific radiological procedures should rule out extremity injuries. These are the only evidence-based criteria leading to a complete detection of all limb injuries. All other aspects are only based on clinical experience or the opinion of expert committees.
Conclusion: The quality of shock room management is mostly dependent on the experience of the " trauma team" (and especially of the trauma leader). Guidelines and specific trauma algorithms can provide a helpful instrument in this issue.
Schindler C, Sturm R, Horauf J, Marzi I, Stormann P EFORT Open Rev. 2023; 8(5):372-381.
PMID: 37158361 PMC: 10233799. DOI: 10.1530/EOR-23-0046.
Esmer E, Derst P, Lefering R, Schulz M, Siekmann H, Delank K Unfallchirurg. 2016; 120(5):409-416.
PMID: 26757729 DOI: 10.1007/s00113-015-0127-3.
Challenges of surgical trauma emergency admission.
Frink M, Mommsen P, Andruszkow H, Zeckey C, Krettek C, Hildebrand F Langenbecks Arch Surg. 2011; 396(4):499-505.
PMID: 21384186 DOI: 10.1007/s00423-011-0771-1.
[Algorithms for treatment of complex hand injuries].
Pillukat T, Prommersberger K Unfallchirurg. 2010; 114(7):575-86.
PMID: 21152885 DOI: 10.1007/s00113-010-1874-9.