Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
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Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
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Introduction The European guideline on the management of major bleeding and coagulopathy following trauma is one of the most relevant sources for diagnostic and treatment algorithms in multiple injured patients ( 1 ). As trauma
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. 3 German studies demonstrate that around 15% receive phenprocoumon and over 50% are on aspirin. 4 , 5 With timing of hip fracture surgery playing an important role in reducing morbidity and mortality, adequately managing coagulopathy in this
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that reversal of warfarin-associated coagulopathy with vitamin K and/or FFP is not associated with a greater rate of post-operative complications in the high-risk geriatric population of patients with hip fractures and was found to be a safe alternative
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Computed Tomography Research Group, University of Applied Sciences Upper Austria, Wels, Austria
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Extracorporeal shock wave therapy (ESWT) is a safe therapy and there are only a few side effects known (such as pain during ESWT and minor haematomata), but no severe complications are to be expected if it is performed as recommended.
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Contraindications are severe coagulopathy for high-energy ESWT, and ESWT with focus on the foetus or embryo and focus on severe infection.
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The effect mechanism of ESWT is still a component of diverse studies, but as far as we can summarize today, it is a similar process to a cascade triggered by mechano-transduction: mechanical energy causes changes in the cellular skeleton, which provokes a reaction of the cell core (for example release of mRNA) to influence diverse cell structures such as mitochondria, endoplasmic reticulum, intracellular vesicles, etc., so the enzymatic response leads to the improvement of the healing process.
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The usage of ESWT should be taught, to improve the outcome. Courses should be organized by national societies, since the legal framework conditions are different from one country to another.
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In this update the musculoskeletal indications are addressed (mainly bone and tendons): pseudoarthrosis, delayed fracture healing, bone marrow oedema and osteonecrosis in its early stages, insertional tendinopathies such as plantar fasciitis and Achilles tendon fasciitis, calcifying tendonitis of the rotator cuff, tennis elbow, and wound healing problems.
Cite this article: EFORT Open Rev 2020;5:584-592. DOI: 10.1302/2058-5241.5.190067
Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, United Kingdom
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Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, United Kingdom
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Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, United Kingdom
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Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, United Kingdom
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Coagulopathy: INR ≥ 1.4, or aPTT ≥ 40sec AIS, Abbreviated Injury Scale; aPTT, arterial partial thromboplastin time; GCS, Glasgow coma scale; INR, international normalised ratio; SBP, systolic blood pressure.. In the United Kingdom, a
Department of Pharmaceutical, Lanzhou University Second Hospital, Lanzhou, Gansu province, P.R. China
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procedures Comorbidities TXA administration Transfusion criteria DVT prophylaxis Sample size Mean age Goh et al. ( 11 ) USA CS 240/1883 65.3/68.6 TKA, THA Coagulopathy i.v. 15 mg/kg Hb < 7.5 g/dL LMWH Heller
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causes. 6 Comorbidities such as coagulopathy, renal failure, diabetes, lupus erythematosus, rheumatoid arthritis, intra-articular steroid injections and corticosteroid therapy increase the risk of periprosthetic shoulder infection (PSI). 7 PSI
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in patients with haemophilia A, 9.9% in haemophilia B, 18% in VWD, and 12.1% in other coagulopathies. 23 Other authors have reported all occurrences being in patients with haemophilia A. 16 Bleeding may produce swelling, pain, and, with
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vertebral body osteomyelitis; and irreversible coagulopathy. Relative contraindications were: presence of radiculopathy; bone retropulsion against neural structures; > 50% collapse of vertebral body height; and multiple pathological fractures. The retained
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mucosal epithelium. 14 , 15 Risk factors for SRMD Risk factors for SRMD include critical illness, mechanical ventilation for more than 48 hours, coagulopathy, septic shock, renal failure, hepatic failure, head injury, major trauma, cigarette
