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Differences in head injuries of pedal cyclist and motorcyclist casualties in victoria
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INTERNATIONAL ABSTRACTS
no significant change while the debridement group had slight increases in the angle of kyphus.--M. G. H. S m i t h Surgical Treatment of Paralytic Scoliosis Associated with M y e l o m e n i n g o c e l e . W. R. Osebold, J. K. Mayfield, R. B. Winter, et al. J Bone Joint Surg 64A:841-857, (July), 1982.
Forty patients with myelomeningocele and associated paralytic scoliosis having surgical treatment were studied at the Twin Cities Scoliosis Center. The length of followup (with one patient exclusion because of death at 9 me), ranged from 1 to 9 yr. The authors conclude that the only elficacious technique of treating this difficult problem consists of both a posterior fusion with instrumentation combined with an anterior technique of either the Dwyer or Zielke systems. This combination achieved the best correction of the deformities with the lowest pseudarthrosis rate.--Anthony H. Alter Surgical Management of Resistant Congenital Talipes Equinovarus Deformities. H. Thompson, A. B. Richardson, and B. W. Westin. J Bone Joint Surg 64A:652-665, (June),
1982. Two-hundred-forty-four resistant congenital talipes equinovarus feet that had been treated surgically were reviewed. The minimum followup was 2 yr. In 66 children (93 feet), who had a complete postero-medial plantar release without internal fixation, 86% sustained excellent or good long-term results. Seventy-five children (112 feet), who had limited surgical procedures at the first effort, had only 42% good or excellent results. Twenty-three children, (39 feet), who had a n initial limited surgical procedure followed by the more complete postero-medial release, sustained 79% good or excellent results. The best results were obtained in children who were less than 1 yr of age at the time of surgery. The need for additional treatment was dramatically reduced in patients who had had complete repair done at the time of the initial surgery.--Anthony H. Alter Pelvic Obliquity and the Unstable Hip After Poliomyelitis. C. F. Eberle. J Bone Joint Surg 64-B:300-304, 1982.
The author challenges the generally held view that paralytic dislocation of the hip after poliomyelitis occurs as the result of muscle imbalance due to weakness of the abductors and extensors in the presence of functioning flexors and adductors. In 32 patients reviewed, the unstable hip was usually flail with no imbalance of muscle function, but was the "high" hip in the presence of contralateral abduction contracture. The procedure found to give satisfactory control of the unstable hip was radical release of the contralateral abduction contracture, followed by a program of stretching exercises to prevent recurrence. With the pelvis made level, the previously unstable high hip usually needed no further treatment to become stable for weight bearing.--M. G. H. Smith NERVOUS SYSTEM Differences in Head Injuries of Pedal Cyclist and Motorcyclist Casualties in Victoria. F. T. McDermott and G. L. Klug.
Med J Aust 2:30-32, 1982. There being no legal requirement in Victoria for pedal cyclists to wear crash helmets (and only few do so), the
authors tested the hypothesis that pedal cyclists are subject to significantly greater risk of head injury than motorcyclists, who are required by law to wear them. Injury data from 1975 to 1980 showed that there were three times more fatalities and reported nonfatal causalties among pedal cyclists. Head injuries, including fractured vault of skull, fractured base of skull, concussion, and intracranial injury, were significantly more frequent among pedal cyclist casualties (P < 0.001). The number of pedal cyclist casualties with solely head injury was twice that of motorcycle riders, and those pedal cyclist casualties had a significantly greater incidence of fractured vault of the skull. It is likely that risk of head injury for pedal cyclists would be significantly reduced if they wore protective helmets.--N. A. Myers Traumatic Closed Femoral Nerve Neuropathy. I, H. Brozin, J. Martfel, I. Goldberg et al. J Trauma 22:158-160, (Febru-
ary), 1982. The authors describe the diagnosis and management of a femoral nerve neuropathy in a 15-yr-old male following a groin injury while performing gymnastics. Femoral nerve neuropathy occurs most commonly in hemophilia (also described in patients on anticoagulants and in ruptured abdominal aneurysms). The etiology is felt to be due most often to compression by a hematoma in the iliopsoas muscle, but nerve sheath hemorrhage and stretch injuries may also play a role. The authors recommend surgical decompression when a hematoma is detected and nonoperative management when no hematoma can be detected (sonography or computed tomographic scanning).--Randall W. Powell NEOPLASMS Endobronchial T e r a t o m a . M. P. G. Jamieson and A. R.
McGowan. Thorax 37:157-159, (February), 1982.
This is the fourth reported instance of benign endobronchial teratoma. A girl first presented at the age of 5 yr with an acute febrile illness and consolidation of the left upper lobe of the lung. Appropriate treatment for pulmonary tuberculosis was instituted with apparent recovery apart from a persisting radiographic hilar opacity. She experienced a cough with pleuritic pain and hemoptysis at the age of 22 yr, and left upper Iobectomy was undertaken with uncomplicated recovery. Definitive diagnosis of this condition is not feasible before the lesion is excised.--J. F. R. Bentley Combination Chemotherapy (Vincristine, Adriamycin, Cyclophosphamide, and 5-Fluorouracil) in the Treatment of Children with Malignant Hepatoma. A. E. Evans, V. J, Land, W. A. Newton, et al. Cancer 50:821-826, (September),
1982. This study describes the experience of the two major pediatric oncology groups with primary malignant liver tumors between January 1976 and August 1978. Of the 62 patients entered in this study, 24 had resection of the tumors, and the chemotherapy (noted above) was employed as adjuvant therapy for 1 yr. Of these, 20/'24 have remained disease-free for periods from 8 to 42 me, with a median of 30 me. Sixteen of these patients had initial complete resection with microscopically tumor-free margins; and 15/16 of these
INTERNATIONAL ABSTRACTS
no significant change while the debridement group had slight increases in the angle of kyphus.--M. G. H. S m i t h Surgical Treatment of Paralytic Scoliosis Associated with M y e l o m e n i n g o c e l e . W. R. Osebold, J. K. Mayfield, R. B. Winter, et al. J Bone Joint Surg 64A:841-857, (July), 1982.
Forty patients with myelomeningocele and associated paralytic scoliosis having surgical treatment were studied at the Twin Cities Scoliosis Center. The length of followup (with one patient exclusion because of death at 9 me), ranged from 1 to 9 yr. The authors conclude that the only elficacious technique of treating this difficult problem consists of both a posterior fusion with instrumentation combined with an anterior technique of either the Dwyer or Zielke systems. This combination achieved the best correction of the deformities with the lowest pseudarthrosis rate.--Anthony H. Alter Surgical Management of Resistant Congenital Talipes Equinovarus Deformities. H. Thompson, A. B. Richardson, and B. W. Westin. J Bone Joint Surg 64A:652-665, (June),
1982. Two-hundred-forty-four resistant congenital talipes equinovarus feet that had been treated surgically were reviewed. The minimum followup was 2 yr. In 66 children (93 feet), who had a complete postero-medial plantar release without internal fixation, 86% sustained excellent or good long-term results. Seventy-five children (112 feet), who had limited surgical procedures at the first effort, had only 42% good or excellent results. Twenty-three children, (39 feet), who had a n initial limited surgical procedure followed by the more complete postero-medial release, sustained 79% good or excellent results. The best results were obtained in children who were less than 1 yr of age at the time of surgery. The need for additional treatment was dramatically reduced in patients who had had complete repair done at the time of the initial surgery.--Anthony H. Alter Pelvic Obliquity and the Unstable Hip After Poliomyelitis. C. F. Eberle. J Bone Joint Surg 64-B:300-304, 1982.
The author challenges the generally held view that paralytic dislocation of the hip after poliomyelitis occurs as the result of muscle imbalance due to weakness of the abductors and extensors in the presence of functioning flexors and adductors. In 32 patients reviewed, the unstable hip was usually flail with no imbalance of muscle function, but was the "high" hip in the presence of contralateral abduction contracture. The procedure found to give satisfactory control of the unstable hip was radical release of the contralateral abduction contracture, followed by a program of stretching exercises to prevent recurrence. With the pelvis made level, the previously unstable high hip usually needed no further treatment to become stable for weight bearing.--M. G. H. Smith NERVOUS SYSTEM Differences in Head Injuries of Pedal Cyclist and Motorcyclist Casualties in Victoria. F. T. McDermott and G. L. Klug.
Med J Aust 2:30-32, 1982. There being no legal requirement in Victoria for pedal cyclists to wear crash helmets (and only few do so), the
authors tested the hypothesis that pedal cyclists are subject to significantly greater risk of head injury than motorcyclists, who are required by law to wear them. Injury data from 1975 to 1980 showed that there were three times more fatalities and reported nonfatal causalties among pedal cyclists. Head injuries, including fractured vault of skull, fractured base of skull, concussion, and intracranial injury, were significantly more frequent among pedal cyclist casualties (P < 0.001). The number of pedal cyclist casualties with solely head injury was twice that of motorcycle riders, and those pedal cyclist casualties had a significantly greater incidence of fractured vault of the skull. It is likely that risk of head injury for pedal cyclists would be significantly reduced if they wore protective helmets.--N. A. Myers Traumatic Closed Femoral Nerve Neuropathy. I, H. Brozin, J. Martfel, I. Goldberg et al. J Trauma 22:158-160, (Febru-
ary), 1982. The authors describe the diagnosis and management of a femoral nerve neuropathy in a 15-yr-old male following a groin injury while performing gymnastics. Femoral nerve neuropathy occurs most commonly in hemophilia (also described in patients on anticoagulants and in ruptured abdominal aneurysms). The etiology is felt to be due most often to compression by a hematoma in the iliopsoas muscle, but nerve sheath hemorrhage and stretch injuries may also play a role. The authors recommend surgical decompression when a hematoma is detected and nonoperative management when no hematoma can be detected (sonography or computed tomographic scanning).--Randall W. Powell NEOPLASMS Endobronchial T e r a t o m a . M. P. G. Jamieson and A. R.
McGowan. Thorax 37:157-159, (February), 1982.
This is the fourth reported instance of benign endobronchial teratoma. A girl first presented at the age of 5 yr with an acute febrile illness and consolidation of the left upper lobe of the lung. Appropriate treatment for pulmonary tuberculosis was instituted with apparent recovery apart from a persisting radiographic hilar opacity. She experienced a cough with pleuritic pain and hemoptysis at the age of 22 yr, and left upper Iobectomy was undertaken with uncomplicated recovery. Definitive diagnosis of this condition is not feasible before the lesion is excised.--J. F. R. Bentley Combination Chemotherapy (Vincristine, Adriamycin, Cyclophosphamide, and 5-Fluorouracil) in the Treatment of Children with Malignant Hepatoma. A. E. Evans, V. J, Land, W. A. Newton, et al. Cancer 50:821-826, (September),
1982. This study describes the experience of the two major pediatric oncology groups with primary malignant liver tumors between January 1976 and August 1978. Of the 62 patients entered in this study, 24 had resection of the tumors, and the chemotherapy (noted above) was employed as adjuvant therapy for 1 yr. Of these, 20/'24 have remained disease-free for periods from 8 to 42 me, with a median of 30 me. Sixteen of these patients had initial complete resection with microscopically tumor-free margins; and 15/16 of these