Injury
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One hundred and eighty one patients with chest injuries (145 with blunt injuries and 36 with penetrating injuries) were managed using a standardized protocol at the JIPMER Hospital between 1990 and 1995. The insertion of an intercostal tube drain, provision of analgesia and oxygen was sufficient in 80 per cent of patients. ⋯ Most patients with chest injuries do not require an operation and can be treated adequately at District General Hospitals. Those with penetrating injuries are more likely to need surgery than those with blunt injuries.
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Multicenter Study
Long-term results of unstable pelvic ring fractures in children.
Seventeen patients less than 12 years old sustained unstable pelvic ring fractures and were treated non-operatively. They were followed for 2 to 25 years. ⋯ Five patients complained about chronic back pain, two were functionally impaired by severe pelvic asymmetry. Healing of an unstable pelvic fracture in malposition with asymmetry causes poor results and must be prevented.
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The Glasgow Coma Score (GCS) is an important factor in the management and prognosis of a patient with neurosurgical pathology. We have found that there is often a disparity between the quoted and actual GCS of patients referred to this unit. ⋯ Forty-two (51%) out of a total of 82 patients had a correct GCS on referral. The proportion of patients referred with a correct GCS did not vary with either the grade or speciality of the referring doctor.
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We wanted to study epidemiology and the outcome of severe childhood trauma. A retrospective study was carried out of 347 severely injured children under 16 years of age, who required intensive care or died during a 10-year period in southern Finland. Of the severely injured children, 65.4 per cent were male. ⋯ The annual incidence of severe trauma was 14.1 per 100,000 children, and the annual mortality was 4.8 per 100,000. All the trauma deaths occurred immediately or within a few days of the accident. Late trauma deaths due to sepsis or multiple organ failure were not seen in children.
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Twenty six children with severely displaced supracondylar fractures were treated with closed reduction and vertical osseous traction with an olecranon screw. Four children required a second operation in the form of open reduction and K-wire fixation for failure to achieve a satisfactory reduction. After a mean follow up of 48 weeks, 20 children (91 per cent) had an excellent result with no significant loss of movement. ⋯ All four children who had a second operation had an excellent result. The average hospitalisation time was 19 days. The method of olecranon screw traction is technically easy to perform and carries few risks of complications.