Injury
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Two hundred and thirty-seven fractures of the ankle treated with non-rigid internal fixation were reviewed with regard to classification, congruency of joint surface, range of motion and the patients' subjective symptoms. The fractures were divided into either severe fractures consisting of two or more skeletal injuries or simple fractures consisting of only one skeletal injury. ⋯ Disability was significantly more frequent after severe fractures and with incongruent joints. This study shows that the operative technique using non-rigid internal fixation is not sufficient for treating severe fractures, as exact anatomical reconstruction of the joint was not obtained.
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Three cases of triplane fractures of the distal end of the tibia are presented. There are usually two or three fragments and it occurs in adolescents in whom there is little growth potential left; hence there is little growth disturbance despite premature closure of the physis. The key to successful treatment is to assess the degree of articular deformity and to restore articular congruity.
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Details are given of the injuries sustained by 402 car drivers, 209 front seat passengers and 147 back seat passengers involved in road accidents during the two 4-month periods before and after the introduction of the compulsory wearing of seat belts on 1 February 1983. Comparisons are made between the injury patterns in those wearing and not wearing seat belts and in back seat passengers.
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A total of 136 patients required an anaesthetic to enable distal fractures of the forearm to be reduced. There were no significant differences in the numbers requiring remanipulation between the three methods employed: haematoma block, Bier's block or general anaesthesia. The advantages of the haematoma block are discussed.
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Four cases of fracture of the body of the sternum associated with the use of a static type of seat belt are reported. We wish to draw attention to an easily missed fracture in patients surviving a road traffic accident.