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At least 613 records · Page 34Linked to original sources
PubMed1975

Holster accidents: self-inflicted gunshot injuries of the knee and leg.

A man accidentally shot himself in the knee while holstering his own revolver. Although the pain was minimal, the wound "clean", and the joint flexible, angiography revealed a false aneurysm of the popliteal artery, a short segment of minimal tears below it, and a popliteal arteriovenus fistula slightly distal to the false aneurysm. Any penetrating wound of the popliteal fossa whose trajectory points to the vascular structures should be investigated angiographically.

Accidents↗
PubMed1986

The South African Defence Force physical training programme. Part III. Exertion-related injuries sustained at an SADF basic training centre.

The incidence and nature of exertion-related injuries were studied at a South African Defence Force basic training centre. A total of 404 separate injuries were sustained by 359 of 947 recruits during the 10-week basic training cycle. Of these injuries, 18,3% were sustained with (group 1) and 81,7% without (group 2) an obvious sudden precipitating event. Exertion-related injuries were responsible for a loss of 2711 recruit-days of basic training. While the knee sustained the largest number of group 2 injuries, lower leg trauma resulted in the greatest loss of basic training time. Forty-two separate radio-graphically confirmed stress fractures were incurred by 39 recruits, an incidence of 4,12%, which is considerably higher than that in the US Army. These data leave little doubt that the present training programme is costly in terms of training-time lost and may prevent large numbers of recruits from deriving the optimum conditioning benefits.

Adolescent↗
PubMed1989

Lower leg reconstruction using a sural fasciocutaneous flap.

The fasciocutaneous flap in the lower leg has been widely used since Pontén's 1981 report. The cutaneous artery running along the sural nerve--known as the superficial sural artery--has an important role in the blood supply of the fasciocutaneous flap in the lower leg as stated by Haertsch. The superficial sural artery has great variation with regard to its location and the origin of the vessel. The cutaneous artery is intimately connected to the sural nerve or the lateral sural nerve. It may run along the sural nerve or along the lateral sural nerve. We examined this vessel in 10 cadaver dissections and applied it in 17 clinical cases of pedicled, island, and free flaps. The island sural fasciocutaneous flap is particularly versatile for the reconstruction of the soft tissue defect around the knee joint. The operative procedure involving the island fasciocutaneous flap and the characteristics of this sural fasciocutaneous flap are described.

Adolescent↗
PubMed1993

Foot morphologic characteristics and risk of exercise-related injury.

OBJECTIVE: It is widely accepted that persons with flat or high-arched feet are at increased risk of exercise-associated injury, even though this purported association has not been scientifically evaluated. We evaluate the risk of exercise-associated injury among young men with flat, normal, and high-arched feet. DESIGN: A prospective study of 246 US Army Infantry trainees followed up over a rigorous 12-week training program. All subjects were evaluated prior to onset of training. Evaluation included photographs of the right, weight-bearing foot that were digitized and utilized to make several measures of arch height. SETTING: An army initial entry training center. SUBJECTS: All trainees beginning army training on 2 successive weeks were potential volunteers. There were no criteria for exclusion other than declining to participate (n = 3). The subjects were healthy, active young men with a mean age of 20.3 years. OUTCOME MEASURE: The occurrence of a lower-extremity musculoskeletal injury resulting in a visit to and a diagnosis by an army physician or physician assistant. Treating physicians and physician assistants were blind to participation status and were not study staff members. RESULTS: On univariate analysis, there was an association between arch height and risk of injury using several alternative operational definitions of foot type. The 20% with the flattest feet were at the lowest risk (reference group; odds ratio, 1.0), with adjusted odds ratios for any musculoskeletal injury of 3.0 (P < .05) for the middle 60% group and 6.1 (P < .05) for the highest 20% group. CONCLUSIONS: These findings do not support the hypothesis that low-arched individuals are at increased risk of injury, and they have implications for runners, exercise enthusiasts, and clinicians. It may be possible to prevent substantial morbidity among active populations by identifying individuals at high risk and advising alternate activities.

Adolescent↗
PubMed1991

Safety of a preadolescent basketball program.

A preadolescent youth basketball program was prospectively studied to determine injury rates and the kinds of injuries sustained. The overall injury rate was 7.6% (39 injuries among the 510 children aged 5 to 12 years). Girls had a higher injury rate than boys (P less than .02). Only 12 children (2.4%) suffered significant injuries as defined by the inability to play for at least one session. Most injuries were contusions (35.9%), followed by strains or sprains (28.2%), epistaxis (12.8%), lacerations (5.1%), and one finger fracture (2.6%), the most significant injury. Games were more likely to produce injuries than practice sessions; most injuries occurred in the second half of game play. This study documents a low injury rate in an organized preadolescent basketball program.

Basketball↗
PubMed1998

A critical reappraisal of indications for fasciotomy after extremity vascular trauma.

OBJECTIVE: To critically reevaluate the indications for fasciotomy in vascular trauma of the extremities. DESIGN: Case-control study. SETTING: Level I trauma center. MATERIALS AND METHODS: One hundred sixty-three vascular injuries to the extremeties were analyzed. Fasciotomy as an adjunct to vascular repair was performed in 45 limbs (28%), based either on the nature of injury or measured compartment pressure of greater than 35 mm Hg. MAIN OUTCOME MEASURES: Need for fasciotomy or limb amputation. RESULTS: Fasciotomy was performed for 29.5% of isolated arterial injuries, 15.2% of isolated venous injuries, and 31.6% of combined arterial and venous injuries, and was not related to venous repair or ligation. Seven delayed fasciotomies were performed either for vascular repair failure (5 patients) or compartment syndrome (2 patients). The highest incidence was for popliteal vessel injury (arterial 57%, combined 61%). Of the 33 lower-extremity fasciotomies, 58% were for popliteal vessel injury. In 51 combined injuries of the lower extremity, only 7 (19%) of 38 patients with injury above the knee required fasciotomy, as compared with 8 (62%) of 13 with injury to the popliteal vessels (P<.001), with or without venous repair. There were 3 amputations, all resulting from vascular repair failure. CONCLUSIONS: The presence of a combined vascular injury or the need for venous ligation does not necessitate routine fasciotomy. The need for fasciotomy may be maximal for injuries to popliteal vessels.

Adolescent↗
PubMed1980

Skiing lacerations. Preventability by the use of ski brakes.

Analysis of all ski injuries recorded at Vail, Colo, during the 1973-1974 season showed that 178 injuries occurred in which the skier was lacerated by his own ski. This represented approximately one out of every ten ski injuries--a ratio that remained constant during the six seasons from 1972 through 1978. Frequently these lacerations occurred about the head and face and were cosmetically serious in nature. It is believed that such injuries are largely preventable. The use of ski brakes as an alternative to runaway straps could appreciably lower the incidence of these injuries.

Arm Injuries↗
PubMed1994

Pattern of injury in those dying from traumatic amputation caused by bomb blast.

Traumatic amputation of limbs caused by bomb blast carries a high risk of mortality. This paper describes 73 amputations in 34 deaths from bomb blast in Northern Ireland. The principal aim was to determine the sites of traumatic amputation to provide a biophysical basis for the development of protective measures. Few amputations were through joints; nearly all were through the bone shafts. The most common site in the tibia was the upper third. The distribution of femoral sites resulting from car bombs differed from that characterizing other types of explosion. For car bombs the principal site of amputation was the upper third; for other types of device it was the lower third. It is concluded that flailing is not a notable contributor to limb avulsion. The pattern of amputation is consistent with direct local pressure loads leading to bone fracture; the amputation itself is a secondary event arising from the flow of combustion products.

Amputation, Traumatic↗
PubMed1994

Limb dystonia following electrical injury.

Electrical injuries of the extremities may cause paralysis, muscle atrophy, sensory deficit, causalgia, and reflex sympathetic dystrophy (RSD). Limb dystonia has rarely been reported following electrical injury to an extremity, although it may result from cerebral hemisphere electrical trauma. Following electrical injury to the upper extremity, three patients developed limb dystonia accompanied by severe pain and sensory symptoms in two patients and features of RSD in one patient. Two patients received botulinum toxin injections without functional benefit. The mechanism of dystonia following peripheral trauma is unknown but may relate to reorganization of central synaptic connections, possibly in the spinal cord.

Adult↗
PubMed1989

The free fascial forearm flap.

The unpleasant appearance of the donor site after harvesting a forearm flap limits its use in many centers. In this paper, the author records his experience with a modification of the standard fasciocutaneous forearm flap. Such modification involves the utilization of the fascial component of the flap sparing the skin of the forearm, which is closed as a longitudinal line. This fascial forearm flap (FFF) was used as a free flap in eight cases. All the flaps survived well, and the donor site appearance was excellent. The fascial forearm flap advantages and limitations are discussed with recommendations for further utilization of other fascial flaps.

Adolescent↗
PubMed1994

Major limb replantation in children.

After the first successful replantation of a completely amputated extremity in a 12-year-old boy undertaken by Ronald Malt at the Massachusetts General Hospital in 1962 (Malt and McKhann, Journal of the American Medical Association, 189:716-722, 1964) numerous series of major limb replantations have been reported in adults. The reports of major limb replantation in children are relatively rare and are usually included in adult series. During the last 14 years, 18 children with major limb amputations were treated at the Microsurgical and Replantation Unit of the Department of Orthopaedic Surgery at the University of Ioannina Medical School. Of these, 13 were complete amputations (11 upper extremity and 2 lower extremity), while 5 were incomplete nonviable amputations (3 upper extremity and 2 lower extremity). The success rate following replantation of the complete amputations was 76.9%, while for the incomplete, nonviable amputations success was 80%. Preoperative evaluation, operative management, postoperative care, and the results of this difficult but rewarding procedure are analysed and discussed in this review.

Adolescent↗
PubMed1998

Slow rehabilitation of a traumatic lower limb amputee.

A 65-year-old male (GM) was referred to the physiotherapy department of the regional limb fitting centre for outpatient rehabilitation following a right transfemoral amputation five weeks previously. He had been knocked down by a bus and suffered a crush injury to the right leg resulting in a stable fracture to the right pubic ramus, a fractured skull and orbital bone. Immediately following admission to the local district general hospital, his right leg was amputated at the transfemoral level. He was nursed post-operatively in ITU for three days and was ventilated during this time. GM was then transferred to the general orthopaedic ward. He received physiotherapy throughout his hospital stay by ward-based physiotherapists--not experts in amputee management but with access to specialist advice. Early physiotherapy was primarily concerned with respiratory care and maintenance of limb mobility and function in bed. Gentle, active stump exercises were commenced on the first post-operative day. GM sat out of bed on the sixth day and stood with the support of two people on the eighth day. His wound was healing well and treatment in the physiotherapy gym began the same day. Use of the pneumatic post-amputation mobility aid (PPAM aid) (Redhead, 1983; Marks, 1996) was started on day nine. However, progress with this early walking aid (EWA) was slow and GM achieved independent walking using parallel bars on the eighteenth post-operative day.

Aged↗
PubMed1990

Traumatic soft-tissue defects of the extremities. Implications and treatment guidelines.

The presence of traumatic soft-tissue defects in the extremity indicates serious damage that may compromise the systems of motion, circulation or sensibility and therefore jeopardize functional rehabilitation. This overview highlights the significance and the various causes of soft-tissue defects, of which several types may be distinguished. Principles for the selection of various flap procedures are outlined, in accordance with the need for elevation and early motion therapy. The requirements placed on flap tissue are described, such as surface characteristics, ability to restore sensibility, cosmesis, capacity to fill voids in the depth of defects and revascularization of adjacent areas.

Arm Injuries↗