J Trauma
-
In 1976 belt usage was made compulsory for front seat passengers in the Federal Republic of Germany. Since 1984, noncompliance incurs a fine of DM 40. In 1984 belt usage was also made compulsory for back seat passengers (noncompliance not being fined). ⋯ Approximately 15 to 20 percentage points of this change are probably due to this measure. Major injuries decreased noticeably as well, in particular injuries to the eyes. Belt usage on back seats is still unsatisfactory (20%), although here too, the effect on injuries of the belt is incontestable, taking into consideration occupant interaction.
-
A hemorrhagic-traumatic shock model in 20 domestic pigs (Sus scrofa) was used to evaluate the pharmacologic effect of methylprednisolone in preventing disseminated intravascular coagulation (DIC). Pairs of animals were anesthetized with thiopental and both femoral arteries cannulated. Four ml/kg-1 of blood were withdrawn, frozen, thawed, and returned to the animal. ⋯ Blood samples were analyzed for prothrombin time, partial thromboplastin time, fibrinogen level, and platelet count. The combination of hemorrhagic shock and hemolysis produced DIC and a fatal shock. Pharmacologic doses (30 mg/kg-1) of methylprednisolone significantly prevent the DIC.
-
We present a case of a splenic arteriovenous fistula (AVF) occurring postsplenectomy. The splenectomy was performed as a result of severe blunt abdominal trauma. ⋯ Splenic AVF are usually due to rupture of a pre-existing splenic artery aneurysm, post-traumatic, or iatrogenic. Diagnosis and treatment of a splenic AVF are necessary to prevent the development of hepatosclerosis and esophageal varices.
-
During the 10-year period from 1975 to 1985 20 patients suffering from causalgia were treated. There were 15 men and five women. Ages ranged from 17 to 45 years (mean, 23). ⋯ The diagnosis of causalgia was based on the characteristic clinical picture and was confirmed by sympathetic blocks. All patients were treated by sympathectomy and all had complete dramatic relief in the immediate postoperative period. Followup ranged from 4 months to 10 years (mean, 5.3 yr).
-
Immobilization of the spine is of prime concern during transportation of trauma patients to prevent neurologic compromise. In an attempt to study certain techniques of prehospital thoracolumbar spine immobilization, we radiographically evaluated the motion of the thoracolumbar spine in a volunteer with a stable spine, a cadaver with an unstable thoracolumbar spine, and a patient with a T12-L1 fracture dislocation. Both the backboard and the Scoop stretcher offered adequate stabilization for thoracolumbar spine instability. The logroll maneuver presented the greatest possibility for movement of the spine at the unstable thoracolumbar segment.