J Trauma
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The results of treatment of 101 combat injuries of the upper extremities are reported. There were 84 acute injuries and 17 late complications. There was a high incidence of associated fractures (35%) and nerve lesions (51%). ⋯ There were no late amputations, but residual neurologic damage gave a less than perfect result in 32 extremities. Two injuries resulted in Volkmann's contracture. Fracture specific to the management of upper-extremity arterial injuries are outlined.
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Case Reports
Bilateral elbow dislocations with intra-articular displacement of the medial epicondyles.
Described is a case of bilateral epicondylar entrapment following fracture dislocations of elbows in a 13-year-old girl who fell while performing on parallel bars. Close manipulative reduction was unsuccessful. ⋯ Long-term follow-up in five previous cases has shown no evidence of tardy ulnar nerve palsy. The need for transposing the ulnar nerve is questioned.
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The spectrum of cardiac trauma resulting from blunt injuries to the chest or decelerating injuries is wide and ranges from mild cardiac contusion to cardiac rupture. Ventricular septal defect can result from such injuries, either immediate or delayed, and is best corrected electively, but severe cardiorespiratory disturbance may necessitate emergency operation. Repair is performed electively if possible, but emergency repair can be successfully accomplished when necessary and requires careful reinforcing of sutures and patches. This is a case report of a successful emergency repair of ventricular septal defect resulting from blunt chest injury.
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A case of complete posterior displacement of a Salter-Harris Type III distal medial femoral epiphysis fracture with posterior subluxation of the knee is reported. Invagination of the gastrocnemius muscle by the displaced fragment was blamed for failure of closed reduction. No significant ligamentous injury of the joint occurred.
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Direct and indirect trauma can cause injury to various portions of the pectoralis major muscle in varying degrees. Sprains and partial tears of the pectoralis major muscle are not uncommon. ⋯ Delayed diagnosis and delayed repair may prevent excellent results. A functional classification as presented here can aid in the diagnosis and treatment of these injuries.