Injury
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Ninety cases of bilateral dislocation of the shoulders, including seven previously unreported cases are discussed. Forty-nine per cent were due to convulsive seizures or electrocution, 23 per cent were traumatic and 36 per cent were atraumatic. This paper indicates that many attributed to trauma were probably due to unrecognized seizure, and neurological examination is indicated in all cases. Dislocations as a result of seizures or electrocution were often diagnosed late.
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Case Reports
Ipsilateral fracture of the head and neck of femur with partial fusion to the acetabulum.
A fracture of the head and neck of the right femur in a 50-year-old man was complicated by fusion of a large portion of one head fragment to the acetabulum as a result of prolonged walking on the fractured hip. This unexpected complication made management difficult as facilities for a total hip replacement were not immediately available.
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A case of lateral fracture dislocation of the fifth lumbar vertebra on the sacrum successfully treated by open reduction is described. The literature of this injury is reviewed.
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In order to illustrate our current pattern of use, 50 patients were reviewed who were examined by computerized tomography (CT) of the head during admission through the Accident and Emergency (A & E) Department. Fourteen (28 per cent) had no history of head injury but exhibited diminished conscious level, epilepsy, headache, or hemiplegia. The 36 cases of head injury were analysed in order to see whether they met certain criteria proposed by other authors, and to suggest the advantage to be gained when CT was available in a district general hospital (with teaching status).
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A series of 25 cases of pseudarthrosis of the humeral shaft is presented. These cases were treated by three different methods. ⋯ The best results are achieved in cases treated by compression plates and iliac bone grafts. Excision of the pseudarthrotic fibrous tissue with freshening of the bone end was done in all cases.