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At least 1,081 records · Page 60Linked to original sources
PubMedDate not supplied

Outdoor winter activities of spinal cord-injured patients. With special reference to outdoor mobility.

Two hundred forty-seven patients with spinal cord injuries living in Hokkaido, the northern part of Japan, were mailed a questionnaire relating to winter outdoor activities. One hundred eight patients responded to the questionnaire, 98 males and 10 females, with ages ranging from 30 to 79 (mean, 53.3) yr. Injury levels of patients were: cervical in 23 patients, thoracic and thoracolumbar in 47, and lumbar in 38. All respondents were unable to walk independently because of quadriplegia or paraplegia. Approximately 90 percent of respondents found it necessary to go outside during the winter season. Eighty-five percent were outside during the coldest period. The most common reasons for outdoor activities were shopping and routine doctor's appointments. The main method of ambulating outside was a manual and/or electrically operated wheelchair, sometimes in conjunction with an automobile. However, there were many problems reported in using wheelchairs; for example, wheels and casters were very slippery on the snow and ice, casters were easily buried in the snow, and wheelchair rims were very cold to handle. It was also pointed out that exposure to cold weather induced physical problems such as muscle spasticity, pain, and numbness of lower extremities. This survey revealed that spinal cord-injured patients would benefit from a wheelchair specifically designed for winter conditions.

Accidental Falls↗
PubMedDate not supplied

Cold injury: a collective review.

Cold injury remains a crippling problem. Although research is opening new avenues of accurate diagnosis and expeditious treatment, the gold standard against which these methods must be measured continues to be conservative treatment.

Adolescent↗
PubMedDate not supplied

The protection against and treatment of a liquid propane freeze injury: an experimental model.

Liquid propane causes a severe, deep thermal injury in unprotected tissue. Delayed surgical intervention, as for thermal burns, has been the gold standard of treatment. An animal model of liquid-propane injury was devised to document injury, to demonstrate a better method of protection, and to define an appropriate management protocol. Twenty-eight rats were classified into four groups: unprotected tissue (n = 8), skin covered with wool (n = 8), skin covered with Neoprene (Wm. H. Horn & Brothers Inc., Philadelphia, Pa.) (n = 8), and skin covered with wool plus Neoprene (n = 4). Each group was subdivided into two exposure times: 6 seconds and 30 seconds. The mean temperatures +/- standard error of the mean of the various tissue levels initially and at 6 and 30 seconds of exposure were determined. Histologic examination demonstrated that full-thickness tissue necrosis occurred in unprotected and wool-covered tissue. Areas that were covered with Neoprene showed intact skin and subcutaneous tissue with underlying muscle necrosis. Examination of the tissue that was covered with wool plus Neoprene showed no histologic damage. There was no sign of tissue regeneration at the wound periphery, and there was no histologic difference in any group, whether the examination took place at 1 or 5 days after injury. This study demonstrated that the best form of protection appears to be a wool glove liner covered with a Neoprene glove. The histologic evidence suggests that a liquid-propane injury to unprotected tissue should be managed aggressively with early excision and grafting.

Animals↗
PubMed1985

Cold injury complicating burn therapy.

The immediate application of cool water to a burn provides prompt relief of pain; however, we must become aware of the complications associated with the use of ice and ice water in this regard. Two cases of extremity ischemia secondary to burn wound therapy are reported with a discussion of patient care. The most important aspect of this injury is prevention.

Adult↗
PubMed1999

Recognizing and treating common cold-induced injury in outdoor sports.

We briefly review the physiology of cold exposure, the spectrum and prevention of common cold-induced injuries (especially in athletes participating in outdoor sports), and the potentially harmful side effects of localized cryotherapy. Severe cold affects all organ systems and especially the central nervous and cardiovascular systems; many biochemical reactions and pathways become distorted or slowed at low body core temperatures and can thus affect athletic performance. Low body shell temperature, too, can interfere with athletic ability by weakening and slowing muscle contractions, by delaying nerve conduction time, and by facilitating injury. Cold-induced injuries may be local or systemic, but they can usually be prevented by knowledge, good physical condition, appropriate nutrition and equipment, and avoidance of moisture.

Athletic Injuries↗
PubMed1990

Improved technique for a one-stage repair of significant defects of the ear.

An improved technique for repair of severe acquired partial defects of the auricle in one stage is described. The common postauricular flap with its base on the margin of the auricular defect is usually unable to repair a severe partial auricular defect in one stage because of the limited length of the flap. The authors developed this technique by means of lengthening the flap with a piece of subcutaneous tissue of the scalp, so that the ear framework can be covered completely in one stage. All flaps in this group survived totally. Seven patients with severe acquired partial defects of the auricle underwent this procedure, and good results were obtained.

Adult↗
PubMed1994

The free-fillet flap for reconstruction of the upper extremity.

The pedicled fillet flap concept has been successfully applied in both the upper and lower extremities for the treatment of difficult wounds. However, in cases of complete extremity amputation, the transfer of pedicled flaps from the amputated part is not possible. In such instances, we have designed free-fillet flaps from the amputated limb to provide wound coverage when replantation of the amputated part was contraindicated. This technique allows immediate wound coverage and preservation of functional amputation stump length, without the morbidity of an additional donor site. We present three cases that demonstrate the utility of this technique as an additional reconstructive option in patients with unreplantable upper-extremity amputations.

Adult↗
PubMed1998

Analysis of the distribution of cutaneous perforators in cutaneous flaps.

An anatomic and statistical analysis was performed on the distribution of cutaneous perforators that perfuse the scapular, radial forearm, and lateral arm cutaneous flaps. Perforators were categorized as direct, terminal, and intransitive, depending upon perforator origin and termination site relative to the source artery. Statistical cluster analysis of perforator distributions was performed to determine the regions in which cutaneous perforators are consistently found. The scapular and radial forearm flaps could be divided into up to three well-perfused segments. The analysis predicted the possibility of dividing the lateral arm flap into as many as seven segments while maintaining perfusion. Clinical applications of this method for preoperative flap design and elevation as well as final results are shown.

Arm↗
PubMed2002

Simultaneous fracture of every cervical vertebra: a case study.

STUDY DESIGN: The case of a 14-year-old boy who sustained simultaneous fractures of every cervical vertebra in a high-energy snowmobile accident is reported. OBJECTIVE: To describe a case of multiple cervical spine fractures and their management. SUMMARY OF BACKGROUND DATA: Injuries from all-terrain vehicles and off-road vehicles, including snowmobiles, are increasing in severity and frequency. The reported case illustrates a result of high-impact loading in which the driver struck his head after being thrown from a snowmobile at high speed. METHODS: The 14-year-old boy in the reported case fractured C1-C7, but had no neurologic sequelae. RESULTS: The fractures were treated with a halo vest after traction and reduction of the displaced odontoid fracture. All the fractures healed with no residual cervical instability. CONCLUSIONS: This case report is the first to describe a patient of any age who sustained simultaneous fractures of every cervical vertebra. Treatment with a halo vest was successful in protecting the cervical spine until healing was complete.

Accidents↗
PubMed1997

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Frostbite↗