{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T18:13:30Z","timestamp":1774548810948,"version":"3.50.1"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Scand J Trauma Resusc Emerg Med"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>A selective non-operative management (SNOM) has found to be an adequate and safe strategy to assess and treat patients suffering from penetrating trauma of the extremities (PTE). With this SNOM comes a strategy in which adjuvant investigations or interventions are not routinely performed, but based on physical examination only.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>All subsequent patients presented with PTE at a Dutch level I trauma center from October 2000 to June 2011 were included in this study. In-hospital and long-term outcome was analysed in the light of assessment of these patients according to the SNOM protocol.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 668 patients (88.2% male; 33.8% gunshot wounds) with PTE presented at the Emergency Department of a level 1 traumacenter, of whom 156 were admitted for surgical treatment or observation. Overall, 22 (14%) patients that were admitted underwent exploration of the extremity for vascular injury. After conservative observation, two (1.5%) patients needed an intervention to treat (late onset) vascular complications. Other long-term extremity related complications were loss of function or other deformity (n\u2009=\u20099) due to missed nerve injury, including 2 patients with peroneal nerve injury caused by delayed compartment syndrome treatment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>A SNOM protocol for initial assessment and treatment of PTE is feasible and safe. Clinical examination of the injured extremity is a reliable diagnostic 'tool' for excluding vascular injury. Repeated assessments for nerve injuries are important as these are the ones that are frequently missed and result in long-term disability. Level of evidence: II \/ III, retrospective prognostic observational cohort study Key words Penetrating trauma, extremity, vascular injury, complications.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1757-7241-21-2","type":"journal-article","created":{"date-parts":[[2013,1,14]],"date-time":"2013-01-14T07:14:11Z","timestamp":1358147651000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Treatment of penetrating trauma of the extremities: ten years\u2019 experience at a dutch level 1 trauma center"],"prefix":"10.1186","volume":"21","author":[{"given":"Oscar JF","family":"Van Waes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther MM","family":"Van Lieshout","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wouter","family":"Hogendoorn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens A","family":"Halm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jefrey","family":"Vermeulen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2013,1,14]]},"reference":[{"key":"535_CR1","doi-asserted-by":"publisher","first-page":"1295","DOI":"10.1016\/j.injury.2008.02.043","volume":"39","author":"O Doody","year":"2008","unstructured":"Doody O, Given MF, Lyon SM: Extremities\u2013indications and techniques for treatment of extremity vascular injuries. 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