Injury
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Biography Historical Article
Accident surgery--the life and times of William Gissane.
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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.
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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.
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A series of 148 cases of chest injuries is presented and their treatment and results are described. The study covered a period of 5 1/2 years and the significance of associated injuries is stressed.
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The diagnoses which were missed at patients' first attendance at an A & E Department over a 6-month period were noted and investigated. The most common cause of missed diagnosis was failure to interpret X-ray findings correctly; this and other causes are discussed. Recommendations as to how this can be improved are made.