Mark van Vledder

Trauma surgeon and HEMS physician @ Erasmus MC University Medical Center, Rotterdam, Netherlands.

[Netwerk Acute Zorg Zuidwest @NAZ_Zuidwest]

MMT Nederland lanceert nieuwe website en socials!
Volg ze voor meer informatie over de werkwijze van de MMT’s en nieuwsberichten rondom de laatste ontwikkelingen.
https://t.co/TtTMhgoxV3 en https://t.co/fzKCcXDo29
Foto: Jimmy van Drunen
@MMTNederland #lifeliner #MMT

[Alex Klotz @AlexanderRKlotz]

Everything, Everywhere, All On One Plot

[OrthoEvidence @OrthoEvidence]

The FixDT Trial: IM Nail vs. Locking Plate for Distal Tibia Fractures
Published in @JAMA_current

Distal tibia fractures can be tricky to operate on.

With intramedullary (IM) nail fixation, there are concerns about malalignment and penetration of the ankle joint. And with locking plates, the larger dissection opens up the risk of infection and tissue damage.

The FixDT trial aimed to compare the two methods to see which one provided the best clinical outcomes for patients!

🏗️METHODS
321 distal tibia fracture patients from 28 trauma centers in the 🇬🇧 were randomized to receive:

1⃣ Intramedullary nail fixation (n=161)
2⃣ Locking plate fixation (n=160)

The primary outcome of interest was function, as measured by the Disability Rating Index (DRI)

Secondary outcomes of interest included health-related quality of life measures (EQ-5D), pain and function at the ankle joint (Olerud-Molander Ankle Score [OMAS]), and complications.

Outcomes were assessed up to 12 months post-operation.

🔎RESULTS
At 3 months, there was a significantly better function in the nail group compared to the locking plate! No differences at 6 or 12 months were observed.

Pain and function at the ankle joint were also significantly better in the nail group at 3 and 6 months!

Moreover, quality of life was significantly better at 6 months in the nail group.

No differences in complication rates were observed between groups.

Lastly, more patients were fully weight-bearing in the nail group at 6 weeks compared to the plate group, and the need for further surgery was significantly lower in the nail group!

✅INTERPRETATION
IM nail fixation was superior to locking plate fixation for the treatment of distal tibia fractures, resulting in better pain, function, quality of life, and return to weight-bearing!

[Ville Sallinen @villesallinen]

Our PERFECT trial finally out in @TheLancet !

Pragmatic Nordic 🇫🇮🇳🇴 multicenter RCT comparing appendectomy within 24h versus 8h.

1803 patients!

No difference in rate of perforated appendicitis (9% vs 8%).

👉 Allows to postpone appendectomy to daytime.

https://t.co/AK77BsrTtG

[Mark van Vledder @markvanvledder]

https://t.co/tGMx0Af9uh

[Rutger Jongejan @Rutger_76]

Eerder moeten komen voor de nachtdienst. Langs politieblokkades om op mijn werk te kunnen komen. Steekwerende vesten paraat…. Het voelt surrealistisch, maar is nu helaas wel de keiharde realiteit.

We hadden het zonder dit ook al druk genoeg hoor.

#rellen #Rotterdam #dmvda

[Petra Hamm-van Bodegraven @petrahamm]

9 maart in de ochtend stond het hart van onze zoon, Matthijs, stil. Hij heeft het overleefd. We weten nu dat zijn luchtwegen nauw zijn. Door een verkoudheid kwam er slijm of voeding vast te zitten, waardoor er geen zuurstof meer naar zijn longen ging en zijn hart stopte. 1/17

[Sander de Hosson @shossontwits]

Angstrazeneca. Deze zomer in de bioscoop (als die open is). https://t.co/YVClZXPOR2

[Mark van Vledder @markvanvledder]

Aggressive prehospital resuscitation of patients with traumatic cardiac arrest (TCA) works! 3.9% survival in 915 patients with TCA, 13.7 % survival among those with ROSC on-scene.

https://t.co/bYNNyMo1WC

@HansvanSchuppen @pchgerritsen @edbarn @karimbrohi @gdiz12

[Mark van Vledder @markvanvledder]

@edelmetaalinfo First majestic silver corp

[Salim R. Rezaie, MD @srrezaie]

Put an End to Routine Chest Tubes via @emlitofnote https://t.co/IbsGwghMq6 #FOAMed

316pts randomized
Non-inferiority design

Full Expansion at 8wks
Chest Tube = 98.5%
No Chest Tube = 94.4%

No statistical difference

[Alessandra Gasior, DO,FACS @Dr_Alessandra_G]

Retired surgeons’ reflections on their careers: The most common thing they would have done differently was spending more time with family and taking better care of themselves (295 of 1233 [23.9%]) out of over 2200, only 19 were women. https://t.co/GneYTG30BD

[Tim Cook @doctimcook]

I’m interested in whether patients intubated pre-hospital without drugs have a realistic chance of survival

Dave Lockey 19 yrs ago recorded 1/492 surviving. That’s a 95% CI of around1%

Has the science moved on?

If you get tubed without drugs is there a prospect of survival?

[Mark van Vledder @markvanvledder]

@edbarn @HansvanSchuppen @Obidoc @pchgerritsen I agree. The best explanation for variation in reported survival after out of hospital TCA is probably the type of registry used and its criteria for inclusion.

[Mark van Vledder @markvanvledder]

@HansvanSchuppen @edbarn @Obidoc @pchgerritsen here is a link to our latest paper on decision making in prehospital traumatic cardiac arrest!https://t.co/G2EIBLtGzM

[Mark van Vledder @markvanvledder]

2 kaartjes voor Nils Frahm (Floor) op 15 februari 2019 te koop #ticketswap https://t.co/vuGp9pW7Qn

[Mark van Vledder @markvanvledder]

Op 15 september organiseren het Erasmus MC en de ongevalstichting de 5e Nationale Traumadag. Bekijk hier de promovideo of bezoek de website!

https://t.co/KdWRyutnVC

https://t.co/lRZ3QiFs5Q

@HansvanSchuppen @pchgerritsen @gerardfietst