Injury
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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.
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Thirty-two cases of penetrating injuries of the diaphragm are reviewed. The problems of clinical and radiological diagnosis are outlined and the pitfalls of barium contrast studies are illustrated. ⋯ Surgical access via laparotomy is recommended in both acute and chronic cases and where additional thoracotomy is necessary, separate abdominal and thoracic incisions are advised. The presence of colonic injury is shown to increase the risk of both wound sepsis and empyema postoperatively, whilst other visceral injuries do not appear to affect postoperative morbidity.