J Trauma
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A case of simultaneous traumatic bilateral anterior/posterior hip dislocations in a 28-year-old man is presented. The mechanism and treatment of this injury, as well as its complications, are discussed.
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To evaluate the impact of helmet use on injury severity, patient information was prospectively obtained for all bicyclists involved in collisions with motor vehicles seen at a level-I trauma center from January 1986 to January 1989. Two hundred ninety-eight patients were evaluated; in 284 (95.3%, study group) cases there was documentation of helmet use or nonuse. One hundred sixteen patients (40.9%) wore helmets and 168 (59.1%) did not. ⋯ In this group, 42 of 47 patients with an ISS greater than 15 (89.4%) were not wearing helmets. We conclude that helmet nonuse is strongly associated with severe injuries in this study population. This is true even when the patients without major head injuries are analyzed as a group; a finding to our knowledge not previously described.(ABSTRACT TRUNCATED AT 250 WORDS)
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Case Reports
The residual central venous catheter track--an occult source of lethal air embolism: case report.
Air embolization through a residual track after removal of a central venous catheter is an elusive mechanism of a treacherous problem. Prompt diagnosis is necessary for successful application of established therapy, as demonstrated by this case report. Awareness of this unusual mechanism of air embolism with utilization of simple prophylactic measures, however, remains the best treatment.
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Proximal upper extremity (subclavian and axillary) vascular injury (SAVI) and brachial plexus injury (BPI) occur uncommonly. However, BPI may be associated with SAVI and frequently is an important determinant of long-term disability. The medical records of patients with traumatic SAVI, BPI, or both over a 5-year period were reviewed. ⋯ An average of 2.8 and 3.3 associated injuries were observed in patients with SAVI (groups I and II) versus patients without SAVI (group III), respectively. No patient who had a complete BPI showed an improvement in neurologic status during a mean follow-up of 7.2 months. No late vascular sequelae occurred in group-III patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Case Reports
Closed depressed skull fracture in childhood reduced with suction cup method: case report.
A closed depressed skull fracture in a child was reduced with a suction cup. This method keeps the fracture closed and leaves no scar.