J Trauma
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In a 4-year period, 17 consecutive patients with posttraumatic chronic regional pain syndrome were treated with a new technique, Movelat manipulation therapy. At average follow-up of 8 months, satisfactory results were achieved in 15 patients (88%), but 2 patients, 1 with digital nerve injury and 1 with ulnar nerve injury, did not respond to the therapy. ⋯ Complications were rare and mild (pain over the tourniquet site in 3%, temporary dizziness in 1%). This therapy is simple and safe and recommended for early treatment of chronic regional pain syndrome.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Hypertonic saline resuscitation of patients with head injury: a prospective, randomized clinical trial.
Experimental and clinical work has suggested that hypertonic saline (HTS) would be better than lactated Ringer's solution (LRS) for the resuscitation of patients with head injuries. No clinical study has examined the effect of HTS infusion on intracranial pressure (ICP) and outcome in patients with head injuries. We hypothesized that HTS infusion would result in a lower ICP and fewer medical interventions to lower ICP compared with LRS. ⋯ As a group, HTS patients had more severe head injuries. HTS and LRS used with other therapies effectively controlled the ICP. The widely held conviction that sodium administration will lead to a sustained increase in ICP is not supported by this work.
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To determine whether there is an association between criminal activity and preference for a particular class of handgun among young adults who purchase handguns legally. ⋯ In this population, criminal activity both before and after handgun purchase was associated with a preference for small, inexpensive handguns.
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Nonunion of the pelvic bones is uncommon. It may be under-diagnosed because of the difficulty in visualization of the fracture and interpretation with conventional radiography. The authors report four cases of nonunion involving the pelvic bones. ⋯ The two patients with nonunion of the anterior iliac crest had major displacement caused by muscle pull. Pain on weight-bearing and awkward gait were common symptoms. All patients required surgical management for symptomatic relief.