J Trauma
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Ninety-seven of 763 patients admitted to a burn center during a 3-year period had histologically confirmed bacterial or fungal burn wound invasion. Nine of these 97 patients survived and 88 died. ⋯ The variety of mycotic and bacterial organisms identified, however, suggests that the compromise of the host is the critical factor, and not any particular microorganism. A variety of combinations of treatments are described: the selection of treatment depends upon the type and extent of infection.
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Nineteen patients with displaced four-part fracture or fracture-dislocation of the proximal humerus were retrospectively studied to investigate the incidence of avascular necrosis and its clinical importance. The average followup duration was 23.6 months. ⋯ The treatment of choice for displaced four-part fracture or fracture-dislocation of the proximal humeral is early adequate open reduction and internal fixation rather than primary prosthetic replacement. The authors believe that a majority of the humeral heads in this injury develop avascular necrosis, but most of the humeral heads are quickly revascularized with creeping substitution.