Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · Nov 1996
Postoperative radiographs or thermal prints after internal fixation of fractures? A study of DHS fixation of hip fractures.
Immediate postoperative radiographs confirm the quality of reduction and fixation of fractures. This information is already available from the image intensifier and can be saved as hard copy thermal prints. ⋯ In this retrospective study of 20 hip fractures treated by dynamic hip screw (DHS) fixation, plain radiographs and thermal prints were compared for the patient and clinical information they contained. Thermal prints were found to be deficient in some areas but, nevertheless, can potentially replace postoperative radiographs in many orthopaedic procedures saving time, money and radiation exposure.
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We have studied the use of image intensification in a trauma theatre over a period of 6 months with particular reference to the acquisition of intraoperative image intensifier thermal prints instead of formal radiographs. The quality of the prints and the savings generated have been assessed. During the study period, 476 patients underwent orthopaedic trauma procedures. ⋯ In 68 patients, the printout was insufficient in its coverage of the operated area, and a check radiograph was also obtained. In no case did the clarity of the thermal image hinder accurate interpretation. We believe that thermal images are a useful substitute for formal postoperative radiographs in many trauma cases, and that, with notable exceptions, their use could decrease costs, reduce patient discomfort and radiation dose and spare overloaded radiology services.
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This is a retrospective study of 74 patients with penetrating injuries of the abdominal inferior vena cava; the cause of injury was gunshot in 91% and stabbing in 9%. Of the patients, 77% underwent lateral venorrhaphy, 5% underwent infrarenal ligation of the inferior vena cava (IVC), and 18% died perioperatively before any caval repair could be carried out. ⋯ Persistent shock, the site of the venous injury, particularly in the retrohepatic position, and the number of associated vascular injuries were directly related to mortality. Irrespective of the improvements in resuscitation and the various operative methods available, penetrating trauma of the abdominal IVC remains a life-threatening injury.