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At least 109 records · Page 6Linked to original sources
PubMed1996

Medical aspects of the work of a moorland rescue team.

OBJECTIVE: To describe the work of a moorland rescue team and, in particular, the medical aspects of this work. METHODS: A retrospective study of 25 years of callouts of the Dartmoor Rescue Group (DRG)-the mountain rescue team (MRT) for Dartmoor. These were analysed by cause, year, month, day of the week, and time of day. Injuries and other medical problems in casualties are described. RESULTS: 276 callouts are described. The most common cause was searching for missing persons, but 62 callouts were to known casualties. The most common medical problem was cold exhaustion. The most common injuries were to the lower leg. However, a wide variety of other medical problems including heat exhaustion was also seen. CONCLUSIONS: The Mountain Rescue Council represents MRTs in mountainous regions and those covering lower hills and moorland. It produces an annual report containing details of the incidents attended by its affiliated teams. The work of the DRG is very different from that of the Mountain Rescue Council as a whole. Medical problems other than cold exhaustion and lower leg injuries are uncommon and moorland rescue teams do not need to equip themselves to treat other medical problems but in view of the wide variety of medical problems encountered a long way from a road, good first aid training of team members is essential.

Cause of Death↗
PubMed1993

[Pedestrian traffic injuries].

A group of 101 fatal traffic injuries of pedestrians was analyzed by type of encounter and vehicle, pedestrian's age, impact speed, direction of collision, height of bumper and leg injury. In collisions type A injuries of the spine, pelvis and lower extremities were relatively more frequent, while in collision C there were relatively more injuries of the skull, organs of the thoracic cavity and upper extremities. This difference is, however, significant only in leg injuries. The most threatened group of pedestrians are old people. There is a statistically significant substantially higher ratio of injuries of the thoracic aorta in older pedestrians. Head injuries, fractures of the extremities and pelvis are in cca 80% on the side where the vehicle hit the pedestrian's body. The height of the leg fracture does not correspond with the height of the bumper, neither on the side of the collision nor in contralateral fractures.

Accidents, Traffic↗
PubMed1992

Injuries in paragliding.

In a retrospective study, 376 paragliding accidents have been analysed. Leg injuries were most common, but a large number of spinal injuries also occurred. The causes were either misjudgement by the pilot or the influence of weather and terrain. Improvements in the instructor's knowledge and the pilot's training could have prevented most of the accidents. Analysis of the mechanisms of the crashes and the pattern of trauma help to produce an efficient approach to diagnosis and treatment.

Accidents, Aviation↗
PubMed1982

Depressed reflex vasomotor control of the burn wound.

Total leg blood flow was measured by venous occlusion plethysmography in five normals and 14 burned patients before and after 30 min of external heating. Leg surface temperatures were held constant, but rectal temperatures increased on the average of 0.4 to 0.5 degrees C in all subjects following this heat load. Leg blood flow increased by 56.0% in the controls, 63.2% in five patients with essentially no leg burn (mean burn size = 1.5% leg surface), and 9.6% in nine patients with major leg injuries (mean burn size 55% leg surface). Failure of reflex vasodilatation in the burned leg was evident up to 107 days postinjury even when the wound was well-healed. All subjects sweated freely from the unburned skin. In two patients, where arm and leg blood flows were measured simultaneously, flow to the uninjured arm increased while that to the injured leg remained unchanged. This lack of reflex vasodilatation in the burned limbs suggests either that wound vessels are denervated or that they are so dilated in the basal state that further dilatation is limited. The bulk of this and other data would support the denervation concept. This physical or chemical denervation could occur at the time of injury, be localised to the area of the wound, and result in loss of both neurogenic vasoconstrictor tone and active reflex vasodilatation.

Adult↗
PubMedDate not supplied

Pediatric pedestrian versus motor vehicle patterns of injury: debunking the myth.

INTRODUCTION: Mechanism of injury has been widely used to enhance the ability of EMS providers to recognize predictable injury patterns. One such pattern, referred to as "Waddell's triad," identifies a triad of injuries associated with pedestrian/motor vehicle collision (MVC), including trauma to the head, abdomen, and lower extremities. We questioned this choice as a common injury pattern for this mechanism. METHODS: A retrospective chart review of 4444 pediatric trauma patients admitted to a regional pediatric trauma center between 1992 and 1996. The source of this information was the medical center's trauma registry. RESULTS: Four-hundred-sixty-five patients suffered a pedestrian/MVC and were included in the study; 231 suffered head injury, and 78 experienced a combination of head and leg injury. Only 11 patients (2.4%) suffered the predicted "triad" of head, leg, and abdominal injury as a result of pedestrian/MVCs. Two of these children suffered minor head injury, and only one patient (0.2%) suffered injury as originally described by Waddell. CONCLUSION: Although the concept of Waddell's triad is logical, and a high index of suspicion should be maintained, the incidence of this predictable injury pattern is low. Educational emphasis should be placed on other aspects of mechanism of pedestrian injury.

Abdominal Injuries↗
PubMed1995

Risk factors for chronic venous insufficiency: a dual case-control study.

PURPOSE: Most epidemiologic studies on chronic venous insufficiency (CVI) are cross-sectional surveys that suggest potential risk factors by describing their population. However, these relationships could be due to the CVI population's older age. We performed a dual case-control study with multivariate analysis to address this issue. METHODS: Ninety-three patients with venous ulcers, 129 patients with varicose veins (VV), and 113 general population control patients from two hospitals were interviewed by use of a standardized questionnaire covering medical history, patient demographics, medications, and lifestyle questions. Univariate and multivariate analyses were used to compare the groups. RESULTS: Univariate analyses showed CVI to be characterized by several factors, many of which were found to be age related after multivariate analysis. Age-adjusted relationships for CVI include male sex and obesity. Histories of serious leg injury or phlebitis were important associations resulting in a 2.4-fold and 25.7-fold increase in risk for CVI, respectively. After adjusting for age, subjects with VV tend to be younger and female, to more frequently have a history of phlebitis, and to report a family history of VV more frequently than control subjects. CONCLUSIONS: Many of the previously suggested associations found with CVI are in reality due to this population's greater age. Patients with CVI are older, male, obese, have a history of phlebitis, and have a history of serious leg injury. These results suggest that a prior deep vein thrombosis, either clinical or subclinical, may be a predisposing factor for CVI.

Age Distribution↗
PubMed2000

Interventions for preventing ankle ligament injuries.

BACKGROUND: Some sports, for example basketball and soccer, have a very high incidence of ankle injuries, mainly sprains. This contributes to ankle sprains being one of the most commonly treated injuries. OBJECTIVES: To assess the effects of interventions used for the prevention of ankle ligament injuries or sprains in physically active individuals from adolescence to middle age. SEARCH STRATEGY: We searched the Cochrane Musculoskeletal Injuries Group trials register, MEDLINE (1966 to July 1996), EMBASE (1980 to September 1996), CINAHL (1982 to June 1996), and bibliographies of study reports. We also contacted colleagues and some trialists. Date of the most recent search: March 1997. SELECTION CRITERIA: Randomised or quasi-randomised trials of interventions for the prevention of ankle sprains in physically active individuals from adolescence to middle age were included provided ankle sprains were recorded. Interventions include use of modified footwear and associated supports, adapted training programmes and health education. DATA COLLECTION AND ANALYSIS: At least four reviewers independently assessed methodological quality and extracted data. Wherever possible, results of outcome measures were pooled and sub-grouped by history of previous sprain. MAIN RESULTS: Five randomised trials with data for 3954 participants were included. All trials involved young, active, mostly male adults participating in high-risk, usually sporting, activities. With the exception of ankle disc training, all prophylactic interventions entailed the application of an external ankle support in the form of a semi-rigid orthosis, air-cast brace or high top shoes. There was a significant reduction in the number of ankle sprains in people allocated external ankle support (Peto odds ratio 0.49; 95% confidence interval 0.37 to 0.66). This reduction was greater for those with a previous history of ankle sprain, but still possible for those without prior sprain. There was no apparent difference in the degree of severity of the ankle sprain prevented nor any change to the incidence of other leg injuries. The protective effect of 'high-top' shoes remains to be established. There was limited evidence for reduction in ankle sprain for those with previous ankle sprains who did ankle disc training exercises. REVIEWER'S CONCLUSIONS: This review provides good evidence for the beneficial effect of ankle supports in the form of semi-rigid orthoses or air-cast braces to prevent ankle sprain during high-risk sporting activities (e.g. soccer, basketball). Participants with a history of previous sprain can be advised that wearing such supports may reduce the risk of incurring a future sprain. However, any potential prophylactic effect should be balanced against the baseline risk of the activity, the supply and cost of the particular device, and for some, the possible or perceived loss of performance. Further research is indicated principally to investigate other prophylactic interventions and general applicability.

Adolescent↗
PubMed1993

Knee articular cartilage injury in leg lengthening. Histological studies in rabbits.

The effect of lengthening the tibia, by callotasis on the articular cartilage in the knee, was investigated histologically in 18 rabbits. The distraction rate was 1 mm per day. On the right tibia, the distraction frequency was in 2 steps (0.5mm/12 hours), while on the left it was in 120 steps (0.0083 mm/12 minutes). The 18 animals were divided into 3 subgroups based on length gain. Cartilage and subchondral bone samples were examined by light and fluorescent microscopy. The incidence of cartilage degeneration on the 2-step side was 2/5, 5/6, and 6/7 at 10, 20, and 30 percent length increases. On the 120-step side it was 0/5, 1/6, and 1/7 at the same length increases. The intensity of tetracycline fluorescence of the subchondral plate on the 2-step side was higher than that on the 120-step side, showing 1.7, 2.0, and 2.3-fold increases at 10, 20, and 30 percent length increases. Our study suggests that increasing the frequency of distraction in callotasis can help to prevent damage to articular cartilage in adjacent joints.

Animals↗