J Trauma
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A patient was referred to the hand service for treatment of a ganglion of his left distal volar forearm. History and examination revealed the mass to be an aneurysm of the left radial artery. At surgery, a false aneurysm was resected and a vein graft interposed. This case illustrates arterial aneurysms, although uncommon, must be included in the differential diagnosis of masses about the hand and wrist.
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Case Reports
Syndrome of intramedullary gunshot wound with incomplete neurologic deficit: case report.
A patient with a gunshot wound to the spinal cord with an incomplete neurologic deficit is presented. The neurologic examination revealed a combination of a central cord injury and the Brown-Séquard Syndrome. The authors suggest that the Brown-Séquard portion of the syndrome was caused by compression of tracts within the spinal cord caused by the mass of the bullet and the central cord injury was produced by the kinetic energy of the bullet during penetration into the spinal canal. They conclude that with incomplete neurologic lesions following gunshot wounds the bullet be removed.
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The hospital or medical examiner records of 75 victims of traumatic aortic rupture (TAR) were reviewed retrospectively. Among the 75 victims, 51 (68%) died at the scene. ⋯ The incidence of death at the scene was significantly higher for patients with head injuries (p less than 0.01), victims with a second intrathoracic injury (p less than 0.025), and patients with associated intra-abdominal injury (p less than 0.001) compared to those without these injuries. A second fatal injury occurred in 51 (41.2%) of victims who died at the scene.
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A case report of a 10-year-old child with a central fracture-dislocation of the hip, managed by open reduction is presented, with a long-term result. The rarity of this injury in children is discussed, with the possible complications of inadequate joint congruity and potential growth injury.
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The results of 12 operatively treated displaced stress fractures of the femoral neck in young male adults are reported. The mean age of the patients was 19.8 years (range, 19-24 years) and the mean followup period 4.0 years (range, 1-9 years). Sliding hip compression screw was used in ten cases, Jewett nail in one and 130 degrees angled A0-plate in one case. ⋯ It was correlated with increased operative trauma in four patients: open reduction in two, reoperation in one, and osteotomy in one case. Nonunion developed in three cases and it was combined with AN in two cases. In six cases the results were acceptable, but for the last three patients the followup period was only 1-2 years.