[Care of injuries of the upper extremities within the context of a defensive war].
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Multiple neurovascular structures may be at risk during injuries or procedures about the elbow joint. An appreciation of the complex anatomy of the region, the appropriate evaluation procedures and processes to diagnose injury, and an understanding of treatment options are necessary for surgeons who treat elbow injuries. This article reviews the anatomy, diagnosis, and treatment options of injuries to neural structures about the elbow.
The insertion of an extra-anatomic bypass graft is an accepted operative technique in highly selected patients with atherosclerotic occlusive disease and contraindications to in situ grafting. In similar fashion, the technique should be considered in injured or septic patients with large soft tissue defects or wound infections overlying arterial repairs or involving native arteries. The combination of vigorous débridement of injured or infected soft tissue and insertion of an extra-anatomic bypass graft allows for appropriate care of the wound without concern for further injury to the now-displaced arterial repair.
In order to study tolerance transfer relationships between human and rhesus monkey elbow joints, torsional and bending tests were conducted on human and rhesus monkey elbow joints under the same condition, and the tolerance transfer relationships between their elbow joints were obtained by comparing and analysing their biomechanical properties. The results show that the mean load transfer ratios between human and rhesus monkey elbow joints were 3.65 and 4.28 for torsional and bending injury respectively.
A five-year-old boy was fatally injured by a stab and a cut to the throat. The suspected offender, an acquaintance of the victim's mother, stated that he had been disturbed by the boy while attempting suicide and had therefore killed the boy. The suspect showed superficial cuts on both wrists and three shallow stabs on the right-hand side of the abdomen. The purpose of the forensic investigations was to answer the question if the suspect's statement could be confirmed or if the attempted suicide took place after killing the boy. The blood-smeared blade of the knife was divided into different sectors with the cutting edge and the tip of the blade being examined separately from the sides. The blood traces from the different blade sectors were then typed in 12 different DNA regions by PCR (polymerase-chain-reaction). It could be demonstrated that the strong blood traces on the sides of the blade originated from the victim alone, whereas in the area of the edge and the tip of the blade the amount of the victim's blood was negligible compared with that of the suspected offender. The explanation for this finding is that in the areas of the edge and the tip of the knife the blood of the victim must have been replaced by the blood of the suspected perpetrator, which means that the suicidal injuries were the last to be caused by the knife.
BACKGROUND: The objective of this study was to evaluate whether a simple test of full elbow extension was a reliable indicator of bone/joint injury at the elbow joint. METHODS: In this prospective study, patients with acute elbow injuries were asked to fully extend the injured elbow. Radiologists blinded to the results of the extension test interpreted the radiographs. RESULTS: Of 114 patients with acute elbow injury entered into the study, 110 underwent adiographic evaluation. Inability to extend the elbow was found in 37 of 38 patients with bone injury. Only 1 of 54 patients who were able to fully extend the elbow was found to have bone/joint injury. The sensitivity and specificity of the elbow-extension test for identification of bone/joint injury was 97% and 69%, respectively. CONCLUSIONS: The elbow-extension test can be used as a sensitive clinical screening test for patients with acute elbow injuries.
A 23-year-old man suffered traumatic scapulothoracic dissociation (TSD) in a car-vs.-bicyclist accident. TSD is a devastating forequarter injury characterized by brachial plexus damage, major upper extremity musculoskeletal disruption, and exsanguinating hemorrhage: our patient survived a hematocrit of 7. Prompt recognition and aggressive management of TSD's multiple injuries are crucial.
During 1980 and 1988 a total of 29 male patients suffering from ruptures of the biceps tendons were treated operatively. In 21 cases the long tendon was involved, in two the short tendon, and in 6 cases the distal tendon. All ruptures of the long tendon and one of the short tendon had resulted from degeneration without any adequate trauma. Refixation of the long biceps tendon was performed with drill holes along the bicipital sulcus. In ruptures of the short and distal tendon various procedures were applied. Results of operative treatment were better in ruptures of the long biceps tendon than in ruptures of the short tendon. An operation may be successful even some months after injury.
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