J Trauma
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The Heimlich maneuver is a well-described emergency procedure for management of foreign body airway obstructions. Although rare, complications of the Heimlich maneuver do exist. ⋯ Additionally, we present a rare case of acute pancreatitis with associated pseudocyst formation after the administration of the Heimlich maneuver on a healthy 3-year-old boy. Although life saving, the Heimlich maneuver may be associated with significant complications; thus, symptomatic patients after this maneuver should be thoroughly evaluated with appropriate laboratory and radiographic studies.
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Dog bites are a significant public health problem among children. The purpose of this study was to examine the hospital incidence, hospital charges, and characteristics of dog bite injuries among children by age group and hospitalization status who were treated at our health care system to guide prevention programs and policies. ⋯ Dog bite visits comprised 1.5% of all pediatric injuries treated in our hospital system during the study period. The majority (91%) of all dog bite visits were treated and released from the emergency department. Injuries to the head/neck region increased the odds of requiring 23 hour observation (OR, 1.95) and age less than 5 years increased the odds of being admitted as an inpatient (OR, 3.3).
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Comparative Study
Fixation of extra-articular distal humerus fractures using one locking plate versus two reconstruction plates: a laboratory study.
To compare the strength and stiffness of standard double-plate fixation with that of a single-locking plate for comminuted extra-articular distal humeral fractures. ⋯ Double-plating provides a more rigid fixation than a single-locked plate for fixation of extra-articular comminuted distal humeral fractures. This could be clinically relevant in situations with 100% comminution as seen in gun shot injuries.
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This report deals with the advantages and disadvantages associated with the most commonly used methods of stabilization after a pathologic fracture of the humerus shaft. ⋯ Intramedullary stabilization is a reliable method for fixation of pathologic fractures of the humerus diaphysis for patients in the advanced stage of metastatic disease. ORIF are preferable to IM fixations for the treatment of metaphyseal fractures and for those patients with a solitary metastasis in the humerus or those with a better prognosis.
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It is generally agreed that a period of observation is appropriate for primary radial nerve palsy associated with humeral shaft fractures. There is no consensus, however, with regard to secondary radial nerve palsy, particularly when it is iatrogenic. Most texts state that surgical exploration is indicated for nerve palsy that occurs after fracture manipulation, but our experience suggests that it is not necessary for radial nerve palsy developing after operative management of humeral shaft fractures. ⋯ The timing and pattern of radial nerve recovery in this situation was similar to that seen in primary radial nerve palsy. There appears to be no advantage to early exploration of the radial nerve. In the absence of obviously misplaced instrumentation or fracture displacement, we treat it like a primary palsy and recommend observation for a minimum of 4 months before exploration.