Injury
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Brain injuries caused by airguns are serious. The optimal management is wound exploration, excision of contaminated tissues and removal of loose bone fragments. ⋯ Removal of the pellet is desirable only if easily accessible. We report five cases, of which four survived without deficits and one remained severely handicapped.
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Soft tissue cervical spinal injuries occurred in 179 out of 1197 consecutive victims of road traffic accidents who needed to attend hospital; an incidence of 15 per cent. It was most common in female (P less than 0.01), restrained car occupants (P less than 0.05) in the 40-49 years age group (P less than 0.025). ⋯ Most were victims of collisions from the rear but significant numbers also occurred in other types of accidents. The incidence of associated injuries was low.
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The treatment and results of a retrospective study are presented on 23 patients who underwent surgical treatment for a fracture of the base of the thumb metacarpal. The 12 patients with a Bennett fracture were not found to be suffering from limitations in their daily activities, work, sport or hobbies. ⋯ The results of the four patients with an extra-articular fracture were good. Owing to the favourable results obtained with closed reduction and Kirschner wire fixation, this technique should be given preference over the more difficult open reduction and internal fixation.
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Disruption of the radiocapitellar line (RCL) can be a useful sign in injured elbows in children. Although originally described only in the true lateral projection, it has become generally accepted to apply the sign to any radiographic projection. ⋯ In these cases, the elbow was not in the standard anteroposterior or lateral position. Radiologists and clinicians involved in trauma should be aware that radiographic positioning and normal bowing of the radial shaft can affect the validity of this sign and that it is best applied only to the true lateral projection as originally described.
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We reviewed 13 patients with monocondylar fractures of the femur. Undisplaced fractures may require extensive radiological investigation to visualize the fracture. ⋯ Joint line incongruity and resultant callus formation produces an abnormal condylar profile leading to early secondary osteoarthritis. We recommend internal fixation in all patients with monocondylar fractures.