Injury
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Comparative Study Clinical Trial Controlled Clinical Trial
A comparison of the Milch and Kocher techniques for acute anterior dislocation of the shoulder.
Two methods of reduction for anterior dislocation of the shoulder were compared in 111 patients. Milch's technique was found to be atraumatic and relatively painless. ⋯ Milch's technique should be tried initially in patients fulfilling these criteria. In other cases Kocher's technique should be used first, especially in those of heavy build.
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Clinical Trial Controlled Clinical Trial
Use of sterile gloves in the management of sutured hand wounds in the A&E department.
In a single-blind, controlled, prospective trial of 242 sutured wounds of the hand in the A&E department there was increased late purulent infection in those treated without gloves. This difference is statistically significant. We recommend wearing of sterile gloves to suture all wounds in A&E departments.
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Three cases of pneumopericardium following blunt chest injury are presented. All three patients were victims of road traffic accidents and were managed at the University College Hospital, Ibadan, Nigeria. One of the patients had a tension pneumopericardium, which was relieved by pericardiocentesis. ⋯ The suspected mechanism of the pneumopericardium in the three patients is pleuropericardial rupture in the presence of an intrathoracic air leak. This is the first report of pneumopericardium following blunt injury of the chest in Nigeria. Only 16 previous cases have been reported in the world literature.
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Patients undergoing treatment for fractures of the upper end of the femur in a district general hospital over a 2-year period were analysed to identify preoperative illness, operative factors or postoperative complications associated with increased mortality. Both the mean age and mortality rate were higher than in many other reported series. The elderly diabetic was identified as a particularly high-risk patient. Dislocation following hemiarthroplasty was associated with advanced age and carried a formidable mortality.