J Trauma
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Case Reports
Central acetabular fracture-dislocation secondary to an epileptic seizure in a chronic renal patient.
An unusual mechanism of injury for a central acetabular fracture-dislocation is reported in a patient with chronic renal insufficiency. The combination of renal osteodystrophy and an epileptic seizure resulted in such an injury as a complication of renal dialysis. Skeletal traction and a prolonged period of non-weight bearing produced a satisfactory result.
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External counterpressure is a safe and effective method to treat shock and restore central circulation. Experience with the short-term use of MAST has been favorable. ⋯ The development of compartment syndrome requiring amputation is reported in two patients with associated leg fractures. This unfortunate experience suggests that the sustained use of MAST in patients with shock and comminuted lower extremity fractures may jeopardize limb survival.
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Several therapeutic modalities in the management of low-velocity gunshot wounds to extremities were investigated. Local excision of wound margins, irrigation, and primary or delayed primary closure without the use of the operating room or prophylactic antibiotics produced results which were comparable to those obtained with a more aggressive surgical protocol.
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A 20-year-old man injured in a motor vehicular accident sustained a nonpenetrating double blowout injury of the upper thoracic esophagus. A simultaneous membraneous rupture of the trachea occurred. Treatment was by operative primary closure. A collective review of blunt upper thoracic esophageal perforations reveals a nearly uniform occurrence of associated tracheal injury.