Reviparin after leg injury requiring immobilization.
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Explore the source record for details and available documents.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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In the 3 years up to the end of 1988, 18 of the 46 patients admitted with lower limb fractures following a motorcycle accident were despatch riders. Ten of the despatch riders were injured in the final year of the study. The nature of the injuries sustained, the reasons for their apparent frequent incidence and possible preventive measures are discussed.
In this report an electrically driven training splint is described and shown in its practical use. This appliance, which can be controlled by the patient himself, has proved very well as useful complement concerning the gymnastics as part of treatment.
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Problems relating to the management of traumatic skin loss of the lower extremity and methods of replacement are discussed with emphasis on several new methods namely, muscle flaps. foot flaps carried on its own blood vessels are nerve as an island flap and free microvascular flaps. Cases treated by these methods are illustrated.
A well-established belief is that with crushed and contaminated wounds closure should be delayed. However, an emergency procedure involving very thorough debridement, complete reconstruction of all injured tissues, and cover by a latissimus dorsi free flap in the same operation is evaluated in 15 children presenting with severe injuries to the lower limb. It is felt that the procedure is superior to the established method because it is a one-stage procedure that minimizes the danger of infection, prevents growth impairment, shortens hospitalization, and allows early mobilization, thus being, in some cases, a limb-saving procedure.
Post-traumatic preoperative deep vein thrombosis (DVT) was studied by routine bilateral venography in 98 orthopaedic patients admitted more than 48 h (mean: 7 days) after the limb trauma, who had not been given prophylactic anticoagulation. All these patients had undergone long distance travel under medical supervision, having been injured a long way from the medical centre. Ages ranged from 15 to 77 years (mean age: 38 years). 85 patients had been previously free of any of the usual risk factors for DVT. Routine venography showed up DVT in 39 patients (40%). Four DVT were bilateral; only seven were symptomatic. When DVT was proved, heparin treatment by infusion pump was given for 15 days before surgery was performed.
Acute compartment syndromes often develop insidiously and are often recognised too late to prevent permanent disability. Management is difficult as the compartment involved is seldom clinically apparent. By continuously monitoring the intracompartmental pressure these problems can be avoided: transient compartment syndromes can be differentiated from established ones and the correct compartment can be surgically decompressed. Pressure monitoring techniques were used in 28 patients; three developed a compartment syndrome requiring surgical intervention, seven had a temporary increase of pressure and in 18 the pressure remained unaltered. Of the three with compartment syndromes, one was unusual in that it affected the thigh and another, unique in our experience, affected both the thigh and the calf. Intracompartmental pressure monitoring significantly altered the management of two cases giving successful results with minimal intervention.