Injury
-
Nine patients undergoing manipulation of Colles' fractures with varying doses of local anaesthetic injected into the fracture haematoma, were investigated by monitoring the arterial levels of lignocaine. Although the procedure was considered satisfactory by all patients, potentially toxic concentrations of lignocaine were found in the arterial circulation, reaching a maximum after manipulation of the fracture. A mean peak level of 2625 micrograms/l was found when 10 ml of 2 per cent lignocaine was used and a mean peak level of 846 micrograms/l in patients receiving 10 ml of 1 per cent lignocaine.
-
Comparative Study
Bipolar fixation of fractures of the distal end of the radius: a comparative study.
This paper reports a prospective study of the treatment of Colles' fractures, either by bipolar fixation or a forearm cast. Bipolar fixation reduced the degree of secondary displacement and no patient required a repeat manipulation. The functional results at 6 months, as assessed by the Scheck system, showed a strong trend in favour of bipolar fixation, but did not reach 95 per cent confidence limits. The technique of bipolar fixation proved to be safe and suitable for use in a busy district general hospital, without the necessity of elaborate equipment.
-
A case of fracture of the sternum in a patient suffering from osteogenesis imperfecta is presented. Internal fixation was carried out using a plate which was placed within the medulla. The described technique is simple and useful for the rarely indicated operative treatment of fractures of the sternum.
-
If ignited, an evaporated inflammable liquid remaining mixed with air in an oil or petrol drum may cause an explosion in which the top and bottom of the drum are blown off by the blast and act as projectiles causing extensive injuries to persons nearby. To analyse the occurrence of this type of accident and to study the injuries involved information was sought from all police districts in Denmark and all the departments of plastic surgery with a burns unit. The investigation revealed a total of 21 accidents caused by oil drum explosions over a period of 36 years with 16 injured within the last 5 years in a population of five million people. ⋯ Five victims received injuries to the lower limb and presented with a total of six open, comminuted fractures of the tibia. Nine men had burns covering from 2 to 50 per cent of the body surface, up to 30 per cent of the burns being full-thickness. This paper draws attention to the extreme danger of working on apparently empty oil or petrol drums with tools generating heat or sparks, unless specific precautions are taken.
-
Three cases with injury of the axillary artery and brachial plexus complicating a displaced proximal fracture of the humerus are presented. In two patients the arterial injury was not recognized on admission. ⋯ In two of the cases, the arterial injury may have been caused by an attempt at closed reduction of the fracture. The possibility of axillary arterial injury should be considered in proximal fractures of the humerus with severe medial displacement of the shaft of the humerus.