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Crash helmet injuries
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Hepatic duct rupture A single case is reported. Jones K. B. and Thomas E. (1985) Traumatic rupture of the hepatic duct demonstrated by endoscopic retrograde cholangiography. J. Trauma 25, 448.
FRACTURES AND DISLOCATIONS ARDS and early fracture fixation Operations to fix fractures more than 24 hours after injury were five times more often complicated by respiratory disorder than were those performed within 24 hours. The injury severity score was of value in predicting the likelihood of respiratory complications. Johnson R. D., Cadambi A. and Seibert G. B. (1985) Incidence of adult respiratory distress syndrome in patients with multiple musculo-skeletal injuries: effect of early operative stabilization of fractures. J. Trauma 25, 375. Fluoridation and osteoporosis Studies of old persons in two comparable Finnish towns showed that fracture of the neck of the femur occurred with statistically significantly lower frequency in the town that added lmg fluoride per litre of drinking water than in the other, in which the amount of fluoride in drinking water was much less and corresponded with the national average. The beneficial effects occurred in both sexes but not below the age of 65. Simonen 0. and Laitinen 0. (1985) Does fluoridation of drinking-water prevent bone fragility and osteoporosis? Lancet 2, 432. Vaginal injuries following pelvic fracture Four cases are described among 114 women with broken pelvis and 23 others are referred to. Primary repair is advised but may be followed by sexual difficulties. Complications often follow delaved diagnosis and include ruvture of the urethra, fistulas, pelvic abscesses and osteomyelitis. Niemi T. A. and Norton L. W. (1985) Vaginal injuries in patients with pelvic fractures. J. Trauma 25, 547.
ORGANIZATION AND ACCIDENT PREVENTION Disaster planning and the media The recommendations are based on an exercise and the bombing in Brighton in October 1984. The key features are to provide a press room; to provide as much information as possible at stated periods; to call upon the region’s public relations officer and, in suitable cases, to allow the newshounds to interview victims and staff. Collaboration and mutual trust are the best ways of keeping control of persons that are notoriously irresponsible except to their news editors. Partington A. J. and Savage P. E. A. (1985) Disaster planning: managing the media. Br. Med. J. 291, 590. Accident flying squads The authors review the published accounts of the arguments for, and the work of, accident flying squads and conclude that the case for them has yet to be made by a dispassionate and factual appraisal of their work. The experience of their own service was inconclusive. Robertson C. and Steedman D. J. (1985) Are accident flying squads really cleared for ‘take-off’? Lancet 2, 434.
Injury: the British Journal of Accident Surgery (1986) Vol. 17/No. 3 Injuries to children in cars The compulsory wearing of seat belts by adults was not accompanied by a rise in the figure of about 25 per cent of motor cars that were fitted with restraints for children. However, banning unbelted children in front seats reduced fatal and serious injuries among children by 14 per cent in the year following 31 January 1983. Avery J. G. and Hayes H. R. M. (1985) Death and injury to children in cars in Britain. Br. Med. J. 291, 515. Crash helmet injuries Two crash helmets that were too large were driven down far and hard enough to break both first ribs. Hockstron H. J. and Kingma L. M. (1985) Bilateral first rib fractures induced by integral crash helmets. J. Trauma 25, 566.
MISCELLANEOUS High-pressure acid injection Fifteen per cent hydrochloric acid injected into the shoulder at 1500 lb/in* caused fractures of the scapula and clavicle and so damaged the soft tissues as to require amputation of the forequarter and extensive skin grafting. Bucklew P. S., Horner W. R. and Diamond D. L. (1985) High pressure acid injection. J. Trauma 25, 552. Alcohol intoxication and non-neurological injury When the blood alcohol exceeded 1OOmg per cent volume, blood pressure and pCOZ were lower than in sober patients but the two groups spent similar periods in hospital and had similar mortality rates. Elmer 0. and Lim R. C. (1985) Influence of acute alcohol intoxication on the outcome of severe non-neurologic trauma. Acta Chir. &and. 151, 305. Aspiration and obstructed airways in RTA deaths About 20 per cent of those dying at the accident or within 24 hours, had blood in their air passages but all except one had sustained inevitably fatal injuries. Ottosson A. (1985) Aspiration and obstructed airways as the cause of death in 158 consecutive traffic fatalities. J. Trauma 25, 538. Oesophageal obturation airway The dangers and disadvantages of this device are clearly set out. Gerther J. P., Cameron J. E., Shea K. and Baker C. C. (1985) The oesophageal obturation airway: obturation or obturator? J. Trauma 25, 424.
PLASTICS Scalp injuries Most of the 46 cases reported from Pakistan were caused when long hair was caught in agricultural machinery. Just over half the scalpings were complete and nearly half had the bone exposed. Split skin grafts were applied after removing the outer table but two-thirds of the grafts proved to be unstable, with a liability to malignant change. Feierabend T. C. and Bindra R. N. (1985) Injuries causing major loss of scalp. Plast. Reconstr. Surg. 76, 189.
Hepatic duct rupture A single case is reported. Jones K. B. and Thomas E. (1985) Traumatic rupture of the hepatic duct demonstrated by endoscopic retrograde cholangiography. J. Trauma 25, 448.
FRACTURES AND DISLOCATIONS ARDS and early fracture fixation Operations to fix fractures more than 24 hours after injury were five times more often complicated by respiratory disorder than were those performed within 24 hours. The injury severity score was of value in predicting the likelihood of respiratory complications. Johnson R. D., Cadambi A. and Seibert G. B. (1985) Incidence of adult respiratory distress syndrome in patients with multiple musculo-skeletal injuries: effect of early operative stabilization of fractures. J. Trauma 25, 375. Fluoridation and osteoporosis Studies of old persons in two comparable Finnish towns showed that fracture of the neck of the femur occurred with statistically significantly lower frequency in the town that added lmg fluoride per litre of drinking water than in the other, in which the amount of fluoride in drinking water was much less and corresponded with the national average. The beneficial effects occurred in both sexes but not below the age of 65. Simonen 0. and Laitinen 0. (1985) Does fluoridation of drinking-water prevent bone fragility and osteoporosis? Lancet 2, 432. Vaginal injuries following pelvic fracture Four cases are described among 114 women with broken pelvis and 23 others are referred to. Primary repair is advised but may be followed by sexual difficulties. Complications often follow delaved diagnosis and include ruvture of the urethra, fistulas, pelvic abscesses and osteomyelitis. Niemi T. A. and Norton L. W. (1985) Vaginal injuries in patients with pelvic fractures. J. Trauma 25, 547.
ORGANIZATION AND ACCIDENT PREVENTION Disaster planning and the media The recommendations are based on an exercise and the bombing in Brighton in October 1984. The key features are to provide a press room; to provide as much information as possible at stated periods; to call upon the region’s public relations officer and, in suitable cases, to allow the newshounds to interview victims and staff. Collaboration and mutual trust are the best ways of keeping control of persons that are notoriously irresponsible except to their news editors. Partington A. J. and Savage P. E. A. (1985) Disaster planning: managing the media. Br. Med. J. 291, 590. Accident flying squads The authors review the published accounts of the arguments for, and the work of, accident flying squads and conclude that the case for them has yet to be made by a dispassionate and factual appraisal of their work. The experience of their own service was inconclusive. Robertson C. and Steedman D. J. (1985) Are accident flying squads really cleared for ‘take-off’? Lancet 2, 434.
Injury: the British Journal of Accident Surgery (1986) Vol. 17/No. 3 Injuries to children in cars The compulsory wearing of seat belts by adults was not accompanied by a rise in the figure of about 25 per cent of motor cars that were fitted with restraints for children. However, banning unbelted children in front seats reduced fatal and serious injuries among children by 14 per cent in the year following 31 January 1983. Avery J. G. and Hayes H. R. M. (1985) Death and injury to children in cars in Britain. Br. Med. J. 291, 515. Crash helmet injuries Two crash helmets that were too large were driven down far and hard enough to break both first ribs. Hockstron H. J. and Kingma L. M. (1985) Bilateral first rib fractures induced by integral crash helmets. J. Trauma 25, 566.
MISCELLANEOUS High-pressure acid injection Fifteen per cent hydrochloric acid injected into the shoulder at 1500 lb/in* caused fractures of the scapula and clavicle and so damaged the soft tissues as to require amputation of the forequarter and extensive skin grafting. Bucklew P. S., Horner W. R. and Diamond D. L. (1985) High pressure acid injection. J. Trauma 25, 552. Alcohol intoxication and non-neurological injury When the blood alcohol exceeded 1OOmg per cent volume, blood pressure and pCOZ were lower than in sober patients but the two groups spent similar periods in hospital and had similar mortality rates. Elmer 0. and Lim R. C. (1985) Influence of acute alcohol intoxication on the outcome of severe non-neurologic trauma. Acta Chir. &and. 151, 305. Aspiration and obstructed airways in RTA deaths About 20 per cent of those dying at the accident or within 24 hours, had blood in their air passages but all except one had sustained inevitably fatal injuries. Ottosson A. (1985) Aspiration and obstructed airways as the cause of death in 158 consecutive traffic fatalities. J. Trauma 25, 538. Oesophageal obturation airway The dangers and disadvantages of this device are clearly set out. Gerther J. P., Cameron J. E., Shea K. and Baker C. C. (1985) The oesophageal obturation airway: obturation or obturator? J. Trauma 25, 424.
PLASTICS Scalp injuries Most of the 46 cases reported from Pakistan were caused when long hair was caught in agricultural machinery. Just over half the scalpings were complete and nearly half had the bone exposed. Split skin grafts were applied after removing the outer table but two-thirds of the grafts proved to be unstable, with a liability to malignant change. Feierabend T. C. and Bindra R. N. (1985) Injuries causing major loss of scalp. Plast. Reconstr. Surg. 76, 189.