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Femoral fractures in spinal injury
142
Printedin Great Britain
Injury(1987)18,142-144
Abstracts THORACIC AND ABDOMINAL INJURIES lntrapericardial
diaphragmatic
hernia
One case is added to 58 already published. Laparotomy is recommended in preference to thoracotomy. The condition is diagnosable before operation is undertaken. van Leonhout R. M. M., Schiphorst T. J. M. J., Wittens C. H. A. and Pinckaers J. A. (1986) Traumatic intrapericardial diaphragmatic hernia. J. Trauma 26, 271.
Femoral fractures in spinal injury
Seven of eight such fractures united. One patient developed superficial infection and one had a cornminuted fracture. The method is recommended for cornminuted and for open fractures. Baird R. A., Kreiten Berg A. and Eltora I. (1986) External fixation of femoral shaft fractures in spinal cord injury patients. Paraplegia 24, 185. Radial head dislocation
ECG following
electrocution
Patients surviving accidental elecfrocution who have normal electrocardiograms on reaching hospital did not later develop abnormalities. Purdue G. F. and Hunt J. L. (1986) Electrocardiographic monitoring after electrical injury. J. Trauma 26, 166. Radiography
for abdominal
stab wounds
Most victims of stabbing who required exploration of the belly had normal X-ray appearances there. Even abnormal films played little part in influencing diagnosis or treatment. Radiography is not recommended as a matter of course after stab wounds of the belly. Kester D. E., Anderassy R. J. and Aust J. B. (1986) The value and cost effectiveness of abdominal roentgenograms in the evaluation of stab wounds to the abdomen. Surg. Gynecol. Obstet. 162. 337. Peritoneal
lavage of coma patients
Fifty-five of 100 patients in coma were suspected of having abdominal injuries and were subjected to lavage; 5 were explored promptly and 40 were not subjected to lavage because internal injury was not thought to be likely. Events supported this opinion. Reiner D. S., Hurd R., Smith K. and Kaminski D. L. (1986) Selective peritoneal lavage in the management of comatose blunt trauma patients. J. Trauma 26, 255. Ventilation
for tracheal
injury
This method of ventilation has the advantage of sparing the injured trachea from the pressure of a cuff on an endotracheal tube. Dreyfuss D., Jackson R. S., Coffin L. H., Deane R. S. D. and Shinozaki T. (1986) High-frequency ventilation in the management of tracheal trauma. J. Trauma 26, 287.
Seven cases are described; two were operated on with unsatisfactory results. Plaster with the elbow at a right angle and the forearm supinated is recommended. Hudson D. A. and de Beer J. de V. (1986) Isolated traumatic dislocation of the radial head in children. J. Bone Joint Surg. 68B. 378. Femoral neck fractures
The 26 patients reported were between 14 and 50 years old. Sixteen fractures were old and 10 fresh. All but one united. 4 already showed evidence of avascular necrosis, but none developed signs of it after not less than 2 years. Nagi 0. N., Gantam V. K. and Narya S. K. S. (1986) Treatment of femoral neck fractures with a cancellous screw and fibular graft. J. Bone Joint Surg. 68B, 387. Tibia1 condylar fractures
Whether operated on or not, few patients had more than mild symptoms after 10 years and some of those had improved after another 10 years. Operation is recommended only for knees that allow sideways movement when quite straight. Lansinger O., Bergman B., Korner L. and Andersson G. B. J. (1986) Tibia1 condylar fractures. J. Bone Joint Surg. 68A, 13. Cornminuted
distal radial fractures
The use of pins and plaster had a complication rate of 53 per cent and external fixation one of 62 per cent. Few fractures remained in the improved position that was at first achieved and many showed irregular articular surfaces. Infection was confined to fractures treated by external fixation but some pins became loose in both groups. Weber S. C. and Szabo R. M. (1986) Severely cornminuted distal radial fracture as an unsolved problem. J. Hand Surg. 1lA. 157.
HAND INJURIES Meralgia
FRACTURES AND DISLOCATIONS Fixation of disrupted
pelvic ring
Thirty-three fractures of the pelvis were fixed (15 within 72 hours of injury) with nuts and bolts for the sacrum and plates and screws elsewhere; back and front were dealt with under one anaesthetic. Rigid fixation was achieved in all cases, most were out of bed within 3 days. Two became infected, none developed respiratory complications. Long-term results have yet to be established. Goldstein A., Phillips T., Sclafani S. J. A., Scalea T., Duncan A., Goldstein J., Panetta T. and Shaftan G. (1986) Early open reduction and internal fixation of the disrupted pelvic ring. J. Trauma 26, 325.
paraesthetica
This is a condensed translation of the original description of the condition, in which the sensory branch of the radial nerve is trapped at the wrist. Ehrlich W., Dellon A. L. and Mackinnon S. E. (1986) Meralgia paraesthetica (entrapment of the radial sensory nerve). J. Hand Surg. llA, 196. Ruptured extensor tendon of thumb
All but 4 of the 25 thumbs regained active extension to the straight position. Mimra T., Nakamura R. and Toni S. (1986) Conservative treatment for a ruptured extensor tendon on the dorsum of the proximal phalanx of the thumb. J. Hand Surg. llA, 229.
Printedin Great Britain
Injury(1987)18,142-144
Abstracts THORACIC AND ABDOMINAL INJURIES lntrapericardial
diaphragmatic
hernia
One case is added to 58 already published. Laparotomy is recommended in preference to thoracotomy. The condition is diagnosable before operation is undertaken. van Leonhout R. M. M., Schiphorst T. J. M. J., Wittens C. H. A. and Pinckaers J. A. (1986) Traumatic intrapericardial diaphragmatic hernia. J. Trauma 26, 271.
Femoral fractures in spinal injury
Seven of eight such fractures united. One patient developed superficial infection and one had a cornminuted fracture. The method is recommended for cornminuted and for open fractures. Baird R. A., Kreiten Berg A. and Eltora I. (1986) External fixation of femoral shaft fractures in spinal cord injury patients. Paraplegia 24, 185. Radial head dislocation
ECG following
electrocution
Patients surviving accidental elecfrocution who have normal electrocardiograms on reaching hospital did not later develop abnormalities. Purdue G. F. and Hunt J. L. (1986) Electrocardiographic monitoring after electrical injury. J. Trauma 26, 166. Radiography
for abdominal
stab wounds
Most victims of stabbing who required exploration of the belly had normal X-ray appearances there. Even abnormal films played little part in influencing diagnosis or treatment. Radiography is not recommended as a matter of course after stab wounds of the belly. Kester D. E., Anderassy R. J. and Aust J. B. (1986) The value and cost effectiveness of abdominal roentgenograms in the evaluation of stab wounds to the abdomen. Surg. Gynecol. Obstet. 162. 337. Peritoneal
lavage of coma patients
Fifty-five of 100 patients in coma were suspected of having abdominal injuries and were subjected to lavage; 5 were explored promptly and 40 were not subjected to lavage because internal injury was not thought to be likely. Events supported this opinion. Reiner D. S., Hurd R., Smith K. and Kaminski D. L. (1986) Selective peritoneal lavage in the management of comatose blunt trauma patients. J. Trauma 26, 255. Ventilation
for tracheal
injury
This method of ventilation has the advantage of sparing the injured trachea from the pressure of a cuff on an endotracheal tube. Dreyfuss D., Jackson R. S., Coffin L. H., Deane R. S. D. and Shinozaki T. (1986) High-frequency ventilation in the management of tracheal trauma. J. Trauma 26, 287.
Seven cases are described; two were operated on with unsatisfactory results. Plaster with the elbow at a right angle and the forearm supinated is recommended. Hudson D. A. and de Beer J. de V. (1986) Isolated traumatic dislocation of the radial head in children. J. Bone Joint Surg. 68B. 378. Femoral neck fractures
The 26 patients reported were between 14 and 50 years old. Sixteen fractures were old and 10 fresh. All but one united. 4 already showed evidence of avascular necrosis, but none developed signs of it after not less than 2 years. Nagi 0. N., Gantam V. K. and Narya S. K. S. (1986) Treatment of femoral neck fractures with a cancellous screw and fibular graft. J. Bone Joint Surg. 68B, 387. Tibia1 condylar fractures
Whether operated on or not, few patients had more than mild symptoms after 10 years and some of those had improved after another 10 years. Operation is recommended only for knees that allow sideways movement when quite straight. Lansinger O., Bergman B., Korner L. and Andersson G. B. J. (1986) Tibia1 condylar fractures. J. Bone Joint Surg. 68A, 13. Cornminuted
distal radial fractures
The use of pins and plaster had a complication rate of 53 per cent and external fixation one of 62 per cent. Few fractures remained in the improved position that was at first achieved and many showed irregular articular surfaces. Infection was confined to fractures treated by external fixation but some pins became loose in both groups. Weber S. C. and Szabo R. M. (1986) Severely cornminuted distal radial fracture as an unsolved problem. J. Hand Surg. 1lA. 157.
HAND INJURIES Meralgia
FRACTURES AND DISLOCATIONS Fixation of disrupted
pelvic ring
Thirty-three fractures of the pelvis were fixed (15 within 72 hours of injury) with nuts and bolts for the sacrum and plates and screws elsewhere; back and front were dealt with under one anaesthetic. Rigid fixation was achieved in all cases, most were out of bed within 3 days. Two became infected, none developed respiratory complications. Long-term results have yet to be established. Goldstein A., Phillips T., Sclafani S. J. A., Scalea T., Duncan A., Goldstein J., Panetta T. and Shaftan G. (1986) Early open reduction and internal fixation of the disrupted pelvic ring. J. Trauma 26, 325.
paraesthetica
This is a condensed translation of the original description of the condition, in which the sensory branch of the radial nerve is trapped at the wrist. Ehrlich W., Dellon A. L. and Mackinnon S. E. (1986) Meralgia paraesthetica (entrapment of the radial sensory nerve). J. Hand Surg. llA, 196. Ruptured extensor tendon of thumb
All but 4 of the 25 thumbs regained active extension to the straight position. Mimra T., Nakamura R. and Toni S. (1986) Conservative treatment for a ruptured extensor tendon on the dorsum of the proximal phalanx of the thumb. J. Hand Surg. llA, 229.