J Trauma
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Reviewing the current literature, very few reports are given on simultaneous bilateral radial head and neck fractures. There are no reports on this entity's incidence. Thus, the purpose of this study was to analyze the incidence and outcome of simultaneous bilateral radial head fractures. ⋯ Reviewing the literature, the frequency of this injury was assessed for the first time. An incidence of 1.48% of all radial head fractures was explored. Our material was representative and included 2,296 injuries covering a 15-year period.
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: On May 12, 2008, an earthquake of magnitude 8.0 on Richter scale struck Sichuan Province of China and destroyed Wenchuan County. Two days later, a field hospital from the Second Military Medical University (Shanghai, China) arrived at Anxian County near the epicenter as a reinforcement hospital before rehabilitation of the local medical facilities. Surgical services in the field hospital were supplied by general, orthopedic, plastic, anesthetic, obstetrical surgeons, and two physicians. The plastic surgeons were responsible for assessment of all soft tissue injuries at the hospital and patient needs for plastic surgery services in a crisis intervention field hospital. ⋯ : Plastic surgery services at a field hospital play a prominent and irreplaceable role in rescuing casualties in formidable conditions especially in a serious earthquake situation.
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Intramedullary reaming and nailing increases intramedullary pressure. This may cause intravasation of bone marrow contents, leading to bone marrow embolization and altered cardiopulmonary function. Possible beneficial effects of attenuation of the intramedullary pressure increase by the use of a reamer-irrigator-aspirator (RIA) system were studied with the hypothesis that the RIA technique would cause lower numbers of pulmonary embolisms (PEs) and lesser cardiopulmonary affection than traditional reaming (TR). ⋯ The pattern of the procedure-related hemodynamic and pulmonary effects did not differ significantly between the RIA and the TR groups. The RIA group had lower numbers (ns) of embolisms per square centimeter lung area than the TR group. After reaming with the TR device, two animals died of PEs, the first postoperative day. The patients with femoral shaft fracture and additional cardiopulmonary injury or preexisting reduced cardiopulmonary function, however, need special attention, and the use of RIA may, in these cases, represent a better operative alternative with a lesser operative burden.