Injury
A questionnaire was used to gather information regarding the prevalence of minor back symptoms related to performing everyday tasks, including sitting, lifting, etc. in a population of hospital employees. We studied 175 subjects, of whom 111 had not suffered a back injury. Of this group, 68 (61.3 per cent) had suffered back discomfort during or after performing everyday tasks. Sixty-four reported...
We have examined the applicability of peroperative image documentation, in promoting early mobilization after osteosynthesis and saving the standard X-ray examination. One hundred and twenty-three patients with proximal femoral fractures were included in the investigation. Hard-copy reprints were recorded from peroperative fluoroscopy images by Fuji Film Thermal Imaging System FTI 200. These reprints...
A fracture of the shaft of the femur in adults is common after road traffic accidents. Until recently it was not known that a fracture of the femoral neck can occur while fixing the femoral shaft fracture with an intramedullary nail. We report three patients in whom femoral neck fractures occurred during femoral nailing. Fractures of the femoral neck were detected by routine postoperative radiographs...
Controversy surrounds the treatment of open femoral shaft fractures, especially in the multiply injured. We report on 54 patients with 57 open femoral shaft fractures. They were treated according to our policy which deals with the severity of the soft-tissue damage. Low-grade open femoral fractures were primarily treated with internal fixation. A temporary external fixator was used for high-grade...
Sixty-eight closed tibial shaft fractures were treated with an anterior unilateral external fixator over a 5 year period (1986-1991). Pin tract drainage and/or infection was seen in 71/380 pins. The total number of secondary operations, excluding planned pin extraction, during fracture healing was 61 (including 22 due to pin tract problems and 25 secondary corrections of alignment). Delayed union...
It has been suggested that all children with skull fractures require urgent CT scanning to exclude intracranial injury. Adhering to such a policy could both tax limited scanning facilities and result in unnecessary exposure to radiation. The aim of this study is to assess the level of consciousness in determining the need for urgent CT scanning, and the possible role of the mechanism of injury as...
We critically evaluated several diagnostic modalities (clinical criteria, subxiphoid pericardial window (SPW) and laparoscopy) used in the detection of occult cardiac injury in haemodynamically stable patients at high risk of cardiac injury. Over 5 years, 122 patients were admitted to a Level I trauma centre with such an injury. They sustained 69 stab wounds, and 53 gunshot wounds. Sites of penetration...
We have conducted a prospective, double blind trial of low level laser therapy (LLLT) in musculoskeletal injuries to assess its efficacy. We assigned patients with a variety of painful skeletal soft tissue conditions to one of two treatment groups, treatment from a functional machine, placebo treatment from an inactive machine. Both machines were identical and both appeared functional. The operative...
Exploratory coeliotomy is essential in the care of abdominal trauma, but negative operation has a reported morbidity rate as high as 18 per cent. Ancillary studies such as computerized tomography, diagnostic peritoneal lavage and abdominal ultrasound have improved both sensitivity and specificity of evaluation in blunt and penetrating trauma, thus decreasing the rate of negative coeliotomy. A retrospective...
Blast injury is uncommon in many parts of the world but sporadic cases occur. The ear is particularly susceptible to damage and easily forgotten in patients with multiple injuries. The aim of this review article is to draw together the more important aspects of blast ear injury for those who are unfamiliar with it and to serve as a reminder of the problems to others. It covers the interactions...
We have reviewed 162 consecutive cases of sternal fracture admitted to the Leicester Royal Infirmary over a 10 year period. There were no incidences of cardiogenic shock or arryhthmia developing in patients who had sustained an isolated sternal fracture, irrespective of the aetiology. There were three deaths, three ITU admissions and one arryhthmia, all occurring in patients with severe thoracic...