The Australian and New Zealand journal of surgery
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Three cases of great vessel injury resulting from blunt chest trauma and associated with posterior dislocation of the sternoclavicular joint are presented. The diagnosis and management including the surgical approach to this uncommon injury are discussed.
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Twenty-two patients with acute perforations of the small intestine due to tuberculosis were operated upon at Irwin Hospital, New Delhi between 1971 and 1976. Most of them (85.36%) presented with features of peritonitis. Radiologically, evidence of pneumoperitoneum was found in six patients. ⋯ The overall mortality was 45.45%. Mortality was significantly higher (P less than 0.05) in patients with multiple perforations and in those who had multiple strictures. The high mortality and difficulty of correct pre-operative diagnosis have been stressed.
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A case of delayed intracerebral haematoma following closed head injury in a young male is reported. The patient was treated surgically with a satisfactory result. The problem of the unsuspected delayed traumatic intracerebral haematoma is highlighted.
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Two atypical patients with spontaneous aortocaval fistulae with a successful outcome, are presented. Lack of physician awareness is considered an important contributor to diagnostic delay. A finding at cardiac catheterization is described. Review of the English literature shows that satisfactory results in the management of this condition can now be expected.
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Twenty-eight patients with thoracolumbar fractures treated by open reduction and internal fixation with Harrington instrumentation are reviewed. An unresolved problem is the selection of patients for surgical management. It is a major operation requiring a surgeon experienced in both the care of spinal cord injuries and the use of spinal instrumentation. The technique permits more rapid mobilization, retraining and rehabilitation than nonoperative management.