摘要:

Refinements in injury scaling of blunt trauma and expansion to include penetrating injuries have resulted in the publication of the 1985 revision of the Abbreviated Injury Scale (AIS). To simplify use of this scale for Injury Severity Scoring in clinical practice, two 8Vfe“ x 11” charts, which can be included in the patient record, have been developed from the AIS dictionary. Separate charts apply to blunt and penetrating trauma. Previous experience with a condensed AIS chart (CAIS) using the 1980 revision of the dictionary suggests that such edited revisions can result in accurate injury scaling in more than 95% of patients presenting to a Level I Trauma Center. The availability of such charts assists in calculation of the ISS soon after admission, which may prove to be a valuable teaching tool and useful in resource allocation, audit, and assessment for prospective payment.

ISSN:0022-5282    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Statewide data from two sources were used to compare the pedestrian-vehicle collision injury and fatality rates for urban and rural areas of Washington State from 1981 through 1983. Although the rates of pedestrian injuries are higher in urban areas, the pedestrian fatality rate in rural areas is higher for nearly all age groups, and at all posted speeds. Multiple logistic regression was carried out to measure the risk of dying once involved in a pedestrian-vehicle collision in rural areas compared to the risk for urban areas. This relative risk was seen to be elevated (RR=2.3; 95% CI=2.0-2.6) even after controlling for the effects of age and sex of the pedestrian, and posted speed of the vehicle. When explored further it was seen that a larger proportion of fatalities died out of the hospital and within the first hour after injury in rural areas than in urban areas. It is possible that Emergency Medical Services care is less rapidly available and that accessibility to trauma centers is more limited in rural areas.

ISSN:0022-5282    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

All ski-related accidental deaths in Vermont during the 1979-1980 through 1985—1986 ski seasons are reported. Sixteen deaths occurred in downhill skiers at major ski areas. During the same period 24.17 million skier-days were logged for an estimated rate of one death per 1.5 million skier-days. Of the skiers 81% were male, and 62% were between the ages of 15 and 26 years. Fourteen of 16 cases resulted from collisions with objects, most commonly trees. The predominance of head and upper body injuries was striking, and fractures of the lower extremities were uncommon. Lethal head/neck injuries accounted for all but two of the deaths. Only one skier was wearing a helmet. Speed and loss of control were the two major contributing factors identified in these accidents. The need for research and development in the prevention of this class of ski accidents is emphasized.

ISSN:0022-5282    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The trapezoidal-shaped area of the neck bounded by the hyoid bone, cricoid cartilage, and medial borders of the sternocleidomastoid muscles is widely exposed to knife slash and stab injuries. Suicidal or homicidal throat slashes involving this area may produce serious horizontal laryngeal injuries, whereas homicidal stab wounds may produce serious vertical laryngeal or hypopharyngeal injuries. The extent of such injuries often cannot be predicted from the entrance wounds and presenting symptoms. Therefore special guidelines should be followed to insure the safety of selective exploration of knife wounds penetrating into the airspaces within this trapezium. In addition, repair of serious laryngeal injuries may require use of laryngoplasty or partial laryngectomy techniques rather than simple repair.

ISSN:0022-5282    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Patient charts and radiographs of 12 patients noted to have an incomplete fracture due to a penetrating injury were reviewed to evaluate the natural history of these fractures. One cortical chip fracture was due to a stab wound; the remainder were due to low-energy handguns. Morphologically, two patterns existed: drill hole fractures through the central metaphyseal region of long tubular bones, and divot fractures of the margins of long bone metaphyses and flat bones. Drill hole fractures and divot fractures complicated by fracture line extension required a weight bearing cast or functional brace while healing. The chip fracture and uncomplicated divot fractures were managed symptomatically. Chip, drill hole, and divot fractures followed a benign course and healed by formation of cortical bone along the defect rim.

ISSN:0022-5282    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Microsurgical techniques can augment the arterial blood supply of a distally based myocutaneous flap, by reanastomosis of the sural artery to a main artery of the leg, allowing the flap a greater length and arc of rotation to cover defects of the distal half of the leg. No venous anastomosis is required. This procedure was used in 17 patients with open tibial fractures. They all healed primarily without any early or late complications. The use of this augmented flap provides a simple and reliable method for reconstruction of difficult wounds of the distal lower leg. It is easier and safer than a free flap.

ISSN:0022-5282    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Observation, ligation of the splenic artery, repair of the spleen by simple suturing with or without the use of hemostatic agents, omentum, an absorbable net or ladder, and partial splenectomy have all been proposed as a means of preserving the injured spleen. A new technique of partial splenectomy with the use of a stapling instrument is presented. The instrument has been used with success experimentally in dogs and in two patients.

ISSN:0022-5282    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A case report of a complex pelvic fracture with associated severe intra-abdominal gynecologic injury is presented. The injury involved lacerations to the ovary, fallopian tube, and nonpregnant uterus. No previous reports of pelvic fractures with such visceral gynecologic injury have been found.

ISSN:0022-5282    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Toxic shock syndrome (TSS) associated with Staphylococcus occurs most commonly in menstruating women, although cases in both sexes have been reported. This report describes a severe case of TSS after a relatively minor stab wound. The male patient exhibited all of the major characteristics of this multisystem disease including anuric renal failure. TSS, which can be fatal, may result from surgical and traumatic wound infections and demands prompt recognition and treatment.

ISSN:0022-5282    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Erection converts the safe, flaccid penis into a vulnerable organ. During erection, the usually thick tunica albuginea becomes very thin and easily fracturable. Penile fracture is an under-reported urologic injury, with only approximately 100 cases reported in the world literature. We report on three cases, one with rupture of one corpus spongiosum and two with rupture of both corpora cavernosa associated with almost complete transection of the urethra. All three cases were treated surgically, with good outcome and no postoperative complications. The authors postulate that some cases of deviation of the penis are actually the result of some minor degree of penile fracture.

ISSN:0022-5282    

出版商:OVID    

年代:1988

数据来源: OVID