Smoking and microvascular repairs.
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Biomedical subjects
Publications and source records attributed to S L Oreck.
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Experience in all major conflicts in this century has shown that orthopedic surgical/musculoskeletal care is a major component of medical support for deployed combat forces. This care consists of treatment of injuries due to both war wound trauma and non-wound trauma, which may be secondary to enemy action of "accidental". Key considerations are that most orthopedic injuries will require evacuation to echelon-IV or -V facilities out of the combat zone, and that appropriate treatment in the combat zone (echelon II or III) will reduce morbidity and facilitate evacuation. The modern experience of orthopedics in the combat zone is reviewed, with emphasis on the Persian Gulf experience and current Deployable Medical Systems, and a plan for care is promulgated.
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Scapulothoracic dissociation, as manifested by lateral displacement of the scapula and acromioclavicular separation, is a previously unreported injury in which there is a complete disruption of the scapulothoracic articulation without an overlying partial or complete amputation through the soft tissue. Associated with the disruption of the scapulothoracic articulation are injuries to the brachial plexus and the subclavian artery and vein; multiple open and closed fractures of the ipsilateral upper extremity are often present also. In the patient with severe multiple injuries, scapulothoracic dissociation may not be recognized immediately, with potentially fatal consequences. In this paper we present the cases of three patients with radiographic and pathological evidence of scapulothoracic dissociation and review the literature on related injuries.