J Trauma
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The results of the selective management of 300 abdominal stab wound victims have been reviewed for a 5-year period. Initially the need for laparotomy was evaluated by sinography, later physical examination, and most recently by local wound exploration combined with peritoneal lavage. The use of sinography resulted in an unnecessary laparotomy rate of 38%. ⋯ In all other cass with intact peritoneum are discharged from the Emergency Department. If peritoneal violation is evident peri toneal lavage is performed. If the lavage is positive laparotomy is undertaken, and if negative the patient is hospitalized for an additional 24 hours of observation.
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Twenty-three patients with total complete brachial plexus injuries were reviewed an average of 5.5 years from the time of injury. Three different treatment approaches were used; no surgery (four), above-elbow amputation alone (14), and shoulder arthrodesis combined with above-elbow amputation (five). Return to gainful employment and prosthetic wearing habits were best achieved with early (within the first year) above-elbow amputation alone. There seemed little to recommend arthrodesis of the shoulder combined with above elbow amputation.