Injury
-
The resuscitation of the severely injured in the accident and emergency department--a medical audit.
An audit of the medical care of the severely injured was conducted in the Accident and Emergency Department of the Royal Victoria Hospital, Belfast. Over a 6-month period the management of all patients admitted with an Injury Severity Score of 16 or over was critically assessed. ⋯ They were mainly related to the fact that 78 per cent of the patients arrived outside normal office hours when only inexperienced junior doctors staffed the department. The findings have drawn our attention to the need for both altering staffing arrangements and improving training in our department.
-
One hundred and sixteen cases of ankle fractures were classified by the AO system and treated by open reduction and internal fixation in accordance with the AO principles. The stabilization of the lateral malleolus was emphasized. Ninety-six cases were available for functional assessment with an average follow-up of 39 months. ⋯ There was no death or non-union. Local complications included wound infection (8.6 per cent) and skin necrosis (3 per cent). This study illustrates the importance of exact anatomical reduction and stable internal fixation to allow early movement after an intra-articular fracture of the ankle.
-
Biography Historical Article
Accident surgery--the life and times of William Gissane.
-
Case Reports
Myocardial contusion associated with fracture of the sternum: important features of the seat belt syndrome.
Recent legislation has led to increasing numbers of car occupants wearing seat belts and presumably the number of injuries attributable to seat belts will also increase. The commonest such injury is a fracture of the sternum, and blunt myocardial damage is a logical sequel although often unsuspected and therefore unsought. ⋯ In three consecutive patients admitted with a fractured sternum we found raised blood levels of CK-MB (creatine kinase-myocardial band) and believe these indicate myocardial contusion. We therefore feel that an isolated fracture of the sternum should be considered a more serious injury than is initially apparent, as these patients are at risk of developing cardiac complications.
-
The wearing of seat belts was made compulsory for all front seat car occupants at the beginning of February 1983. A survey carried out at the Royal Berkshire Hospital, Reading, a District General Hospital serving the West Berkshire area, has allowed assessment of the effect of legislation on the pattern of injuries sustained by car occupants involved in road traffic accidents, and of the effect it has had on the work-load of the Casualty Department and trauma wards. These preliminary findings show that there has been a change in the pattern of injuries sustained by car occupants in road traffic accidents following the introduction of compulsory seat belt use, but there has not been a significant drop in the work-load of the Trauma Department.