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Malunion of the clavicle
198
Injury: the Brltlsh Journal
there is a sudden drop in lactate. Acute glycogen depletion does reduce the strength of contraction ofboth muscle fibre types, but the effect is more evident in FT tibres, probably due to the ST fibres ability to utilize fat. Lipoprotein lipase (LPL) increases the availability of free fatty acids by hydrolysing plasma triglycerides. Muscle LPL activity has been found to be positively correlated with the percentage of ST tibres in skeletal muscle. Increasing fat and protein in the diet increases LPL activity, whereas a carbohydrate-rich diet decreases LPL activity to the same extent as it increases glycogen levels. Jacobs 1. (1981) Lactate, muscle glycogen and exercise performance in man. Acta Physiol. &and. Suppl. 495. Running injuries
This 36-page monograph covers the common injuries sustained by joggers, sprinters and long-distance runners. There is a detailed account ofthe normal running gait and an extensive section on history and examination. These parts are well worth reading, containing a lot of material that will be new to those of us who feel more comfortable dealing with relativeiy gross abnormalities in the unfit than with ‘minor’ abnormalities in the athlete. Most of the injuries discussed are the common ones seen in the lower limb. The mechanisms of injury are well explained but some of the sections on treatment are a little disappointing. There is an excellent chapter on the design of running shoes and the various modifications which may be required. The illustrations by Dr Netter are up to his usual high standard. Overall, this little book will be a valuable addition to the library of orthopaedic surgeons and general practitioners exposed to awkward questions from aspiring marathon runners and, increasingly, from jogging medical colleagues. Brodv D. M. (1980) Runnine iniuries. Clin. Svmo. I . 32,&A, No. 4: ’ - -
Vascular
iniuries
Neurovascular
traction
injuries
Eight cases of injury to the subclavian and axillary arteries are described. All were accompanied by injury to the brachial plexus. Arterial continuity was restored in all cases. Six young patients sustained high-velocity injuries and they showed no neurological improvement. Two elderly patients with low-velocity injuries recovered neurological function in the limb. Primary amputation should be considered when nerve damage is obviouslv verv severe. Batey N.-R. and Makin G. S. (1982) Neurovascular traction injuries of the upper limb root. Br. J. Surg. 69, 35. Measurement pressure
of
anterior
tibia1
compartment
The method is based upon the disappearance of the Korotkoff sounds over the anterior tibia1 artery at the
of Accident
Surgery Vol.
1~/NO.
2
front of the ankle; this indicates the diastolic arterial pressure. The limb is raised as far as possible and then lowered while the sounds are listened to. The pressure in the compartment is approximately the difference between the diastolic pressure and the height of the ankle above the horizontal. Willey R. F., Coral1 R. J. M. and French E. B. (I 982) Non-invasive method for the measurement ofanterior tibia1 comnartment oressure. Lancef 1. 595. Lacerations
from glass
Thirty of 62 children that needed treatment at hospital due to glass cuts had been injured by ‘building glass’ (doors, windows, etc.), mostly in houses. Cuts by broken bottles were less likely to damage nerves, blood vessels and joints. Jackson B. H. (1981) Lacerations from glass in childhood. Br. Med. J. 2, I3 10. Malunion
of the clavicle
This article reports a single case of intermittent pressure on the subclavian artery following malunion of the clavicle. Desoutter P., Chabouis Cl., Mordy M. (1981) Syndrome ischemique du membre superieur secondaire a une fracture de la clavicule. J. Traumatol. 2, 113. Organization
topics
and accident
prevention
Care of the injured
The report is based upon questionnaires sent to members of the Association; 224 replies were returned representing 35 per cent of the members. It discusses the roles ofthe various medical and related specialities at present involved in the care of the injured. Under staffing patterns, it was noted that in hospitals with under 500 beds the emergency physician staffed or had responsibility for staffing in 60 per cent, while in hosuitals with over 500 beds this drooned to 32.9 per cent. interestingly, 54 per cent felt an emergency physician should be in charge. Under personal presence of attending surgical staff in the emergency room, 44 per cent of attending surgeons routinely narticinated in the immediate care-of victims of serio&.injuryand 70 per cent advocated their routine presence in this situation. In 88 per cent of replies, attending surgeons were routinely present in the operating room with the seriously injured patient undergoing operation. This report could have interesting comparisons to the British system. Report to the American Association for the Surgery of Trauma from its Committee on Issues (198 1) J. Traumu 21,904. A prospective and retrospective study of 202 consecutive patients injured by a blunt object admitted to a single trauma centre. The authors concluded that commitment is a major factor in determining the effectiveness of any trauma system and they encouraged regionalization of trauma care and education of associated specialists in rapid transfer of high-risk patients to a major trauma centre.
Injury: the Brltlsh Journal
there is a sudden drop in lactate. Acute glycogen depletion does reduce the strength of contraction ofboth muscle fibre types, but the effect is more evident in FT tibres, probably due to the ST fibres ability to utilize fat. Lipoprotein lipase (LPL) increases the availability of free fatty acids by hydrolysing plasma triglycerides. Muscle LPL activity has been found to be positively correlated with the percentage of ST tibres in skeletal muscle. Increasing fat and protein in the diet increases LPL activity, whereas a carbohydrate-rich diet decreases LPL activity to the same extent as it increases glycogen levels. Jacobs 1. (1981) Lactate, muscle glycogen and exercise performance in man. Acta Physiol. &and. Suppl. 495. Running injuries
This 36-page monograph covers the common injuries sustained by joggers, sprinters and long-distance runners. There is a detailed account ofthe normal running gait and an extensive section on history and examination. These parts are well worth reading, containing a lot of material that will be new to those of us who feel more comfortable dealing with relativeiy gross abnormalities in the unfit than with ‘minor’ abnormalities in the athlete. Most of the injuries discussed are the common ones seen in the lower limb. The mechanisms of injury are well explained but some of the sections on treatment are a little disappointing. There is an excellent chapter on the design of running shoes and the various modifications which may be required. The illustrations by Dr Netter are up to his usual high standard. Overall, this little book will be a valuable addition to the library of orthopaedic surgeons and general practitioners exposed to awkward questions from aspiring marathon runners and, increasingly, from jogging medical colleagues. Brodv D. M. (1980) Runnine iniuries. Clin. Svmo. I . 32,&A, No. 4: ’ - -
Vascular
iniuries
Neurovascular
traction
injuries
Eight cases of injury to the subclavian and axillary arteries are described. All were accompanied by injury to the brachial plexus. Arterial continuity was restored in all cases. Six young patients sustained high-velocity injuries and they showed no neurological improvement. Two elderly patients with low-velocity injuries recovered neurological function in the limb. Primary amputation should be considered when nerve damage is obviouslv verv severe. Batey N.-R. and Makin G. S. (1982) Neurovascular traction injuries of the upper limb root. Br. J. Surg. 69, 35. Measurement pressure
of
anterior
tibia1
compartment
The method is based upon the disappearance of the Korotkoff sounds over the anterior tibia1 artery at the
of Accident
Surgery Vol.
1~/NO.
2
front of the ankle; this indicates the diastolic arterial pressure. The limb is raised as far as possible and then lowered while the sounds are listened to. The pressure in the compartment is approximately the difference between the diastolic pressure and the height of the ankle above the horizontal. Willey R. F., Coral1 R. J. M. and French E. B. (I 982) Non-invasive method for the measurement ofanterior tibia1 comnartment oressure. Lancef 1. 595. Lacerations
from glass
Thirty of 62 children that needed treatment at hospital due to glass cuts had been injured by ‘building glass’ (doors, windows, etc.), mostly in houses. Cuts by broken bottles were less likely to damage nerves, blood vessels and joints. Jackson B. H. (1981) Lacerations from glass in childhood. Br. Med. J. 2, I3 10. Malunion
of the clavicle
This article reports a single case of intermittent pressure on the subclavian artery following malunion of the clavicle. Desoutter P., Chabouis Cl., Mordy M. (1981) Syndrome ischemique du membre superieur secondaire a une fracture de la clavicule. J. Traumatol. 2, 113. Organization
topics
and accident
prevention
Care of the injured
The report is based upon questionnaires sent to members of the Association; 224 replies were returned representing 35 per cent of the members. It discusses the roles ofthe various medical and related specialities at present involved in the care of the injured. Under staffing patterns, it was noted that in hospitals with under 500 beds the emergency physician staffed or had responsibility for staffing in 60 per cent, while in hosuitals with over 500 beds this drooned to 32.9 per cent. interestingly, 54 per cent felt an emergency physician should be in charge. Under personal presence of attending surgical staff in the emergency room, 44 per cent of attending surgeons routinely narticinated in the immediate care-of victims of serio&.injuryand 70 per cent advocated their routine presence in this situation. In 88 per cent of replies, attending surgeons were routinely present in the operating room with the seriously injured patient undergoing operation. This report could have interesting comparisons to the British system. Report to the American Association for the Surgery of Trauma from its Committee on Issues (198 1) J. Traumu 21,904. A prospective and retrospective study of 202 consecutive patients injured by a blunt object admitted to a single trauma centre. The authors concluded that commitment is a major factor in determining the effectiveness of any trauma system and they encouraged regionalization of trauma care and education of associated specialists in rapid transfer of high-risk patients to a major trauma centre.