Injury
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A 34-year-old man was stabbed in the heart with the loss of all signs of life at the site of the incident. A resuscitative thoracotomy was performed at the roadside rather than transport a lifeless patient to hospital. ⋯ He recovered and was discharged at 25 days with normal neurology and mentation. Pre-hospital thoracotomy on a patient who had lost signs of life following a penetrating chest wound is an alternative to a "scoop and run' policy.
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Eighty missed musculoskeletal injuries in 51 patients in King Khalid University Hospital are analysed. The diagnostic failure rate was 0.6 per cent of all injured patients seen in the emergency room and 6 per cent of admissions under orthopaedic care. ⋯ In 48 of these patients (60 per cent) there were one or more complaints related to the missed injury. Factors responsible for inadequate diagnosis included breaking of clinical routine, inadequate clinical examination, ignoring the patient's complaints and positive physical signs, and lack of or misinterpreted and inadequate X-rays.
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Rollerblading is increasingly popular in the UK. Over 12 weeks, we treated 29 patients of whom 34 per cent required operative intervention. There was a wide range of injuries, those of the radius being most common, and some (e.g. femoral and pelvic fractures) being quite severe. The value of protective equipment is discussed.
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Comminuted fractures of the proximal ulna, particularly in combination with dislocation of the radial head, represent complex injuries which threaten both elbow and forearm motion. Thirty-seven complex proximal ulna fractures were treated with a dorsally applied, limited-contact titanium plate, contoured to fit the anatomy of the olecranon and proximal ulna. Twenty-four patients had Monteggia fracture/dislocations, and 13 had isolated but complex fractures of the proximal ulna. After an average follow up of 24 months, good or excellent functional results were achieved in 27 patients.
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This is a study of all people presenting to ski patrollers with ski and snowboard injuries during the 1995 season. There were 476 casualties of whom 396 were skiers and 57 were snowboarders. Information was collected retrospectively on the mechanism, region and injury, and also personal details of the casualties. ⋯ They most commonly sustained ligament strains, dislocations and fractures, with the hand and forearm and shoulder most affected. Skiers sustained more ligament strains and soft tissue bruising, particularly of the knee and thumb. Snowboarders sustain a different pattern of injuries compared with skiers, and this has important implications for preventing accidents in the instruction of novices.