摘要:

Three hundred thirty chain saw injury patients arriving at the emergency clinic of a community hospital in the southeast United States between 1972 and 1979 were reviewed. Forty-eight patients were admitted to the hospital with severe injuries requiring extensive repair; another was dead on arrival at the emergency clinic. The retrospective study reveals a typical pattern to chain saw injuries as injuries caused by other power tools have typical patterns: the majority of the injuries occur on the left side. Most injuries are caused by saw kickback, upward or downward; the face (not usually eyes), neck, hands and feet are most frequently injured. The findings suggest that many of these extensive, expensive injuries can be prevented by proper equipment and training, and by operator compliance with safety procedures. An automatic motor brake is now being installed on many saws, and laws are being prepared to make its use mandatory.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Blunt injury to heart muscle can result in a variety of dysrhythmias and mechanical dysfunction. In the present studies of 24 open-chest, working swine hearts with controlled perfusion of the left anterior descending (LAD) coronary artery, changes in proximal and distal coronary vascular resistance (CVR), small-vessel perfusion (using radioactively-labeled microspheres), and regional and global mechanical function and metabolism (myocardial oxygen consumption [MVO2] and lactate extraction) were observed before and for 1 hour following a single impact involving the LAD artery. Trauma caused no spasm, thrombosis, hemorrhage, or laceration of the LAD artery but resulted in significant perfusion redistributions of small vessels. Within minutes of the impact, epicardial/endocardial flow ratios in the myocardial tissue perfused by the traumatized vessel increased (p< 0.005) and were associated with a significant decrease in the distal CVR (p< 0.001). In this same region, significant decreases were also observed in an index of regional work (p< 0.01), shortening (p< 0.005), MVO2 (p< 0.001), and per cent lactate extraction (p< 0.01). Also noted were declines in left ventricular (LV) pressure development and contractility (LV max dp/dt). The regional changes in flow patterns and function in general persisted throughout the course of perfusion. These data suggest that cardiae trauma can induce major changes in vasomotor tone and perfusion distributions of the eoronary vasculature, and demonstrate how blunt cardiac-coronary trauma can result in some of the hemodynamic and electrocardiographic abnormalities previously reported.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Twenty patients with tibial fractures had measurements of tissue pressure in the anterior compartment acutely and for the first 72 hours following injury. Measurements were made using a mercury monometric indicator similar to that described by Whitesides. Patients with fractures of the proximal third of the tibia, those with displacement of the fracture fragments greater than 50%, and those whose injury was the result of high-energy trauma developed higher compartment pressures and we conclude that such patients should be observed closely for the development of a compartment syndrome. In normotensive patients in this series fasciotomy was not necessary for tissue pressures less than 50 mm Hg in the absence of any sensory or motor compromise.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Plasma and lung lymph β-glucuronidase and aryl sulfatase A specific activity were measured before and for 48 hours after a 50% full-thickness burn in the adult sheep. We noted a significant increase in plasma activity of both enzymes with maximum increase occurring 3 hours postburn, with levels returning toward baseline at 48 hours. Increase in plasma activity correlated in time course with increases in pulmonary vascular resistance. Lung lymph specific activity increased to levels identical to that in plasma but the time course lagged behind by 1 to 3 hours.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The authors report 30 cases of extradural hematomas with prolonged course: the interval between injury and development of clinical signs was more than 48 hours. Twenty-nine were operated upon. These delayed cases have a mild clinical course and a better prognosis than the acute. Contrary to the reports that many subacute and chronic epidural hematomas are located other than temporally, the present series shows the high incidence (83%) of temporal lesions. Of the patients 74% recovered and returned to their previous occupations: the two deaths were from causes not directly related to the injury and hematoma. We conclude that most subacute hematomas arise from various, often combined, low-tension sources of bleeding. The importance of recognizing gradual neurologic deterioration and performing craniotomy in these patients is emphasized.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Two case reports presented describe situations in which a patient presented in trauma due to an accident which masked a suicide attempt. Factors which obscure the suicide intent of an ‘accident’ include a dangerous vocation, lifestyle, or hobby, and absence of overt depression. These factors may aid in the identification of and appropriate intervention methods for patients presenting with masked suicide attempts.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

A patient with a tracheoesophageal fistula from blunt chest trauma is presented and the literature is reviewed. A common pathophysiologic factor is the involvement of a young male in a deceleration injury. Early surgical intervention with division of the fistula and repair of the tracheal and esophageal defects is recommended.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

A 21-year-old man sustained lacerations of spleen, liver, and right hemidiaphragm from blunt trauma. Exposure and repair of the liver and right hemidiaphragm were facilitated by sternal extension of a midline abdominal incision. This operative plan is recommended in severe torso trauma with suspicion of hepatic and/or diaphragmatic injury.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Isolated gunshot wounds of the orbital contents are relatively rare, and therefore their management deserves updating in terms of current practices. Two cases of isolated gunshot wounds to the orbital contents are presented, and the diagnosis, management, and prognosis are reviewed. In general, in the absence of light perception, enucleation within a planned timetable is the treatment of choice to prevent sympathetic ophthalmia from destroying sight in the uninjured eye. If light perception is present, every attempt should be made to preserve the injured eye. Enucleation of a blind injured eye is the treatment of choice because it is a more complete eradication of the potential for sympathetic ophthalmia. In selected cases, evisceration can be successfully substituted.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

A case of direct traumatic inguinal hernia resulting when a young man was thrown forward against the handlebar in a motorcycle accident is described. Three weeks earlier this patient had had an appendectomy through a McBurney incision. Two criteria for such traumatic hernias are: immediate appearance after injury; and medical confirmation.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID