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Severe soft-tissue injury following intravenous infusion of phenytoin. Patient and drug administration risk factors.

From April 8, 1982, through June 1984, 11 patients in a single hospital experienced 17 episodes of limb edema and discoloration after the intravenous (IV) administration of phenytoin sodium (Dilantin). One patient required a below-the-elbow amputation; all other patients recovered. No single drug lot was implicated. A case-control study was performed using three controls for each case; controls received IV infusions of phenytoin and were hospitalized close in time to the case patients. Compared with controls, patients with reactions were more often female and elderly and had underlying cardiovascular disease. Affected patients also received phenytoin through an IV catheter smaller than 20 gauge (50% vs 6%), at a rate greater than 25 mg/min (63% vs 19%), and in two or more IV infusions of phenytoin given "IV push" at the same site (81% vs 24%). High-risk patients require careful monitoring and stricter guidelines for the IV administration of phenytoin.

Age Factors↗

[Fractures of the extremities with open soft tissue injury. Complications and treatment concept].

In the history and also in the present time the open fractures of the extremities have a high rate of complications after the operative treatment. In our extract we will point the problems in this treatment. Also we want to show the effective ways to sink the complications. We describe the differences in the treatment of the open and closed fractures. With regard of the methods the osteosynthesis, the technique of the operative treatment and the after treatment of open fractures of the extremities we give directions for the universal and special treatment.

Anti-Bacterial Agents↗

Soft tissue injuries of the hand.

This article emphasizes the importance of good principles of wound management, including control of hemorrhage, the taking of a complete history, physical examination, assessment of vascular integrity, diagnosis of the presence of injured nerves, and closure of the wound. Also discussed are the following specific injuries: fingertip injuries, avulsion injuries, ring injuries, high pressure injection injuries, and burns.

Burns↗

Soft-tissue injuries about the elbow.

The most common elbow injuries include lateral and medial tennis elbow tendinitis, ulnar nerve dysfunction, and medial ligament sprain. Treatment includes proper rehabilitation and control of abuse. Surgery, when indicated, is directed to the correction of specific pathologic tissue change without harm to adjacent normal tissue.

Athletic Injuries↗

Soft-tissue injuries of the forearm and hand.

In general, musculotendinous injuries of the forearm are not uncommon and are generally self-limited. The fact that there are so many different modalities of treatment speaks well for the human body to repair itself under some very adverse circumstances. Rest and splinting of the part, elevation, and judicious use of analgesics is still the treatment of choice. The injudicious use of heat and cold and electrical appliances of various types usually indicate a therapist in search of a treatment.

Athletic Injuries↗