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Angelini R, Rutolo F, Cozzolino G, D'Amario V, Spigonardo F. [Extremity vascular traumas]. Ann Ital Chir 2005; 76:167-73. [PMID: 16302656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE The Authors report on a series of 61 vascular traumas treated over a 7 years, separated in two groups. The first one includes 35 cases, that are street accidents, on the work and gunshot wounds. The second group includes 26 iatrogenic causes due to arterial catheterism. METHODS All patients underwent ecocolor Doppler directly in the operating theatre and, when this diagnostic procedure was not enough, pre-operating angiography was used (10 cases of complex traumas of the lower limb). RESULTS One death was reported far each groups (3.27%). In 55 cases (90.1%), limb savage was achieved. In the others 4 (6.93%) of the first group, limb demolition was necessary for different causes. In the first group, severe neurological sequelaes were observed in 2 cases and motor deficits caused by tendon lesions in 1 case. CONCLUSION The good results obtained are the result of the short ischemic interval between the acute event and treatment, thanks to a multidisciplinary approach of a specific equipe, that is rapid as possible.
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Menakuru SR, Behera A, Jindal R, Kaman L, Doley R, Venkatesan R. Extremity vascular trauma in civilian population: a seven-year review from North India. Injury 2005; 36:400-6. [PMID: 15710157 DOI: 10.1016/j.injury.2004.06.017] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/29/2004] [Indexed: 02/02/2023]
Abstract
This is a retrospective study of the experience with extremity vascular trauma at a tertiary level referral centre in North India where the majority of the population lives in villages and the incidence of high-speed automobile accidents and civilian violence is low. The aim was to study the aetiology, pattern of injuries and the mortality and morbidity rates due to vascular trauma in our population. Data relating to 148 patients presenting with vascular trauma requiring surgical intervention other than amputation between January 1996 and December 2002 were collected retrospectively. There were 132 males and 16 females with a mean age of 39 years presenting to the casualty with a median delay of 9.3 h after injury. Blunt trauma accounted for 84% of the injuries with extremities involved in 88%. The brachial artery was the most common artery injured with the femoral next most common. Repair without graft interposition was done in 74% and autogenous vein grafts were used in 23% of cases. Comparison of our results with those that would have been obtained, had the recommendations of Mangled Extremity Severity Score (MESS) been followed, showed that this scoring system had low sensitivity and specificity for prediction of salvageability of limbs. Eight percent patients died due to associated visceral organ injuries. Complications occurred in 32% patients and amputation was required in 6% of patients after an initial surgical repair mainly due to inadequate functional recovery. Eighty-eight percent of the survivors with salvaged limbs were able to achieve full functional recovery. Judicious selection and appropriate intervention can result in satisfactory limb salvage with good functional outcomes even with delayed presentations.
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Tahmasebi MN, Mohammad Naghi T, Kiani K, Kambiz K, Mazlouman SJ, Shahriar JM, Taheri A, Afshin T, Kamrani RS, Kamrani Reza S, Panjavi B, Behnam P, Harandi BA, Harandi Bahador A. Musculoskeletal injuries associated with earthquake. A report of injuries of Iran's December 26, 2003 Bam earthquake casualties managed in tertiary referral centers. Injury 2005; 36:27-32. [PMID: 15589909 DOI: 10.1016/j.injury.2004.06.021] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2004] [Indexed: 02/02/2023]
Abstract
This is a descriptive analysis, performed on victims of Iran's December 26, 2003 Bam earthquake that were referred to tertiary referral trauma management centre in Tehran. Two hundred and ten patients were included in this study. Associated musculoskeletal injuries and renal function of the patients were recorded. The mean time under rubble was 1.9 h in our patients with a mean rescue to first medical aid time of 13.5 h. We had 19 cases of compartment syndrome and 6.7% of patients had impaired renal function. The incidence of compartment syndrome had a direct relation to the time under rubble and the incidence of renal failure was directly related to rescue to first medical aid time. Axial skeleton fractures, amongst them the lateral compression type pelvic fractures, were particularly common. Fracture associated neural injuries were also common. Institution of renal protective protocols from the very first hours after injury more conservative approaches to treatment of fractures in these crush trauma patients are strongly recommended.
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104
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Jack RJ. The effectiveness of using two different types of anti-vibration gloves compared to bare hand condition at dampening the frequencies associated with hand-arm vibration syndrome. Work 2005; 25:197-203. [PMID: 16179768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
The ability of a foam-padded and air-bladder glove to significantly attenuate hand-arm vibration compared to an individual's bare hands (after the effect of adipose content of the distal upper extremity had been removed) was studied. Subjects consisted of 3 male and 8 female university students' aged 20 to 22 years. After the effect of adipose content of the distal upper extremity was removed, the effect of the gloves on transmissibility was significant with F2,959 = 5.27, p<0.000. The effect of the frequencies was significant with F31,959 = 8.80, p<0.000. There was no significant interaction between the gloves and frequencies on transmissibility with F62,959 = 0.22, p = 1.000. Post-hoc analysis revealed that there was a significant difference was between bare hand and foam-padded glove conditions, F1,1052 = 8.13, p = 0.004, where foam-padded gloves had significantly greater transmissibility. Post-hoc analysis of the frequencies indicated that there were significant differences between frequencies at with the highest transmissibility occurring at 100 Hz.
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105
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Mazzolo GM, Desinan L. Sharp force fatalities: suicide, homicide or accident? A series of 21 cases. Forensic Sci Int 2005; 147 Suppl:S33-5. [PMID: 15694724 DOI: 10.1016/j.forsciint.2004.09.097] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Cases at study comprise 21 sharp force fatalities (9 suicides--7 m and 2 f; 8 homicides--5 m and 3 f; 2 accidental deaths--1 m and 1 f; 2 uncertain cases--2 m), examined from 1993 to 2002. Suicide age range was 17-75 years, mean 42.4; in seven cases the age was upper 40. Scene of death was at home in six cases, at open place in two, during hospitalisation in one. Incised wounds were pre-eminent in suicides. Homicides showed multiple stab wounds. The two accidents were caused by "glassing". Uncertain cases were a small stab wound to the chest and an eviration.
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106
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Macrokanis CJ, Hall NL, Mein JK. Irukandji syndrome in northern Western Australia: an emerging health problem. Med J Aust 2004; 181:699-702. [PMID: 15588216 DOI: 10.5694/j.1326-5377.2004.tb06527.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2004] [Accepted: 10/07/2004] [Indexed: 11/17/2022]
Abstract
OBJECTIVES (1) To assess the number and severity of episodes of Irukandji syndrome in Broome, Western Australia. (2) To correlate demographic, seasonal, geographic and climatic features of Irukandji stings. (3) To assess treatment of Irukandji syndrome at Broome Health Service. (4) To assess the public health impact. DESIGN AND SETTING (1) A retrospective analysis of jellyfish data forms and charts of 111 patients, identified from Broome Health Service Emergency Department with a discharge diagnosis of marine sting between 1 January 2001 and 1 July 2003. (2) Correlation between climate and Irukandji envenomation data. MAIN OUTCOME MEASURES Number of patients with Irukandji syndrome; their demographic and environmental features; the clinical syndrome; treatment requirements. RESULTS 111 patients were prospectively identified with marine stings; 88 were identified with Irukandji syndrome. Non-Irukandji syndrome data were excluded for analysis. The "jellyfish season" extends from January to May, although stings occur all year round. Only 38% of patients had vinegar applied to the sting site before hospital presentation. Signs and symptoms were variable between individuals, with 20% having no signs of sting at all and welts found in 16%. Fifty per cent of patients were hypertensive at presentation. Distress was found in the majority of patients, with 90% requiring opioid analgesia (morphine equivalent: mean, 20 mg; median, 13 mg) and 17% requiring admission. There was one evacuation to Perth with cardiotoxic marine envenomation resulting in pulmonary oedema, which necessitated 4 days in intensive care. Stings were significantly more common when the ambient median temperature was greater than 28.3 degrees C, after midday, on an incoming high tide and on windy days. CONCLUSION The rate of envenomation in northern WA is likely to be the highest currently documented in Australia. There is syndromic variability when compared with the north Queensland experience. This implies different causative jellyfish species that are not yet identified. Stings in Broome can be severe and life threatening; there are significant commercial and public health implications as a result. Management at Broome Hospital is contemporary and effective.
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Avrahami R, Gabbay E, Bsharah B, Haddad M, Koren A, Dahn J, Zelikovsky A. Severe lymphedema of the arm as a potential cause of shoulder trauma. Lymphology 2004; 37:202-5. [PMID: 15693538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The aim of this study was to determine whether lymphedema of the arm is associated with traumatic injury to the shoulder and to assess the role of lymphatic physiotherapy in reducing disabling shoulder pain. The study group consisted of 10 women aged 58-81 years (mean 66.9) with arm lymphedema after surgery for breast cancer. The average interval between the operation and the appearance of lymphedema was 9.8 years. All patients complained of shoulder pain. Five patients had a tear in the supraspinatus muscle diagnosed by ultrasound examination, and 5 had chronic bursitis; the nonaffected arm showed no pathology. The mean volume of the affected arm was 568 ml greater. Treatment consisted of manual lymphatic drainage and intermittent sessions of pneumatic compression with the LymphaPress device. This led to an average decrease in arm volume of 170 ml, with improvement of arm mobility and a drastic reduction in shoulder pain. In conclusion, lymphedema of the arm can cause severe shoulder trauma, pain and disability. Proper physiotherapy can reduce these effects. Patients should be referred for early treatment and follow-up to avoid permanent damage to the shoulder muscles.
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Liang HW, Chen SY, Hsu JH, Chang CW. Work-related upper limb amputations in Taiwan, 1999-2001. Am J Ind Med 2004; 46:649-55. [PMID: 15551379 DOI: 10.1002/ajim.20098] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Work-related upper limb amputations account for a significant number of occupational injuries. This study analyzes the nationwide incidence of work-related amputations of upper limbs in Taiwan by using the workers' compensation database. METHODS A total of 2,950 cases were retrieved and analyzed from the database of workers' compensatory disability claims between the years 1999 and 2001. RESULTS The cases were workers with an average age of 39.1 years, of whom 23.0% were female, the highest percentage of cases was in the 30-49 age group, but the incidence based on insured population was the highest for those under 20 years old. About 96% of the cases involved finger amputation, and 85% of all amputations were related to common powered machines. The average annual incidence of disability claims due to occupational amputation of upper extremities was 12.5 per 100,000 workers. Claims were most prevalent among manufacturing workers and male workers. The male to female risk ratios ranged from 2.62 for manufacturing workers to 9.05 for transport, storage and communication workers by the Poisson regression analysis. CONCLUSIONS Young male manufacturing workers were at high risk of occupational amputation of upper extremities in Taiwan. These results provide an epidemiological base for developing a prevention strategy.
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Stevens EM, Vos GA, Stephens JP, Moore JS. Inter-rater reliability of the strain index. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2004; 1:745-751. [PMID: 15673095 DOI: 10.1080/15459620490521142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The Strain Index is one of several tools available to evaluate exposure to musculoskeletal stressors in the workplace in order to predict whether workers are at an increased risk of developing distal upper extremity disorders. The purpose of this study was to determine the inter-rater reliability of the Strain Index. Fifteen raters initially estimated or measured data for five Strain Index task variables: (1) intensity of exertion, (2) duration of exertion, (3) efforts per minute, (4) hand/wrist posture, and (5) speed of work, using a computer to view 61 video segments of single task jobs. Video segments were organized to provide a balanced number for each of the five variables under study, where each segment was used to provide data for a single variable. Raters then assigned rating values to each task according to published procedures. For an additional 12 segments, raters performed complete Strain Index analyses, including calculation of Strain Index scores, which were used to determine hazard classifications. Raters assessed the tasks both as individuals and as members of five three-person teams. Inter-rater reliabilities of the procedures leading to and including the Strain Index scores were assessed using an intraclass correlation coefficient, (ICC(2, 1)). Inter-rater reliability for the dichotomous hazard classification was assessed using Kuder-Richardson-20 (KR-20, an ICC for dichotomous data). For task variables and estimated data, ICC(2, 1) varied between 0.66-0.84 for individuals and 0.48-0.93 for teams. The Strain Index score had an ICC(2, 1) of 0.43 and 0.64 for individuals and teams, respectively. For the most important variable, hazard classification, KR-20 was 0.91 for the individuals and 0.89 for the teams.
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Ma D, Jones G. Soft drink and milk consumption, physical activity, bone mass, and upper limb fractures in children: a population-based case-control study. Calcif Tissue Int 2004; 75:286-91. [PMID: 15549642 DOI: 10.1007/s00223-004-0274-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2003] [Accepted: 02/20/2004] [Indexed: 10/26/2022]
Abstract
Carbonated beverages have been reported to increase fracture risk in children but the mechanism is unclear. The aim of this population-based case-control study was to investigate the association between soft drink and milk consumption, physical activity, bone mass, and upper limb fractures in children aged 9-16 years. A total of 206 fracture cases and 206 randomly selected individually matched controls were studied. There were 47 hand fractures; 128 wrist and forearm fractures, and 31 upper arm fractures. An interviewer-administered questionnaire was utilized to retrospectively assess last-year physical activity (including television, computer, and video watching) and to recall the average weekly consumption of milk, colas, and total carbonated drinks. Bone mass at the spine, hip, and total body was assessed by dual-energy X-ray absorptiometry (DXA) and metacarpal morphometry. For total fractures, none of the above drink types was significantly different between cases and controls. For wrist and forearm fractures, there was a positive association between cola drink consumption and fracture risk (OR 1.39/unit, 95% CI: 1.01, 1.91). Cola consumption was significantly correlated with television, computer, and video watching (r = 0.20, P = 0.001) but not bone mineral density or milk drinks. After adjustment for television, computer, and video watching and bone mineral density, the association between cola drinks and fracture risk became nonsignificant (OR 1.31/unit, 95% CI: 0.94, 1.83). No association with other fracture sites was observed. In conclusion, cola, but not total carbonated beverage consumption, is associated with increased wrist and forearm fracture risk in children. However, this association is not independent of other factors and appears to be mediated by television watching and bone mineral density but not by decreased milk intake.
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111
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Galambos B, Tamás L, Zsoldos P, Czigány T, Jakab L, Németh J, Csönge L. [Vascular injuries in everyday practice]. Zentralbl Chir 2004; 129:81-6. [PMID: 15106035 DOI: 10.1055/s-2004-816276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND It was the objective of this retrospective study to analyse the causes of injury, surgical approaches, outcome, and complications in patients with vascular trauma and to report our experience with vein homografts for arterial reconstruction in the upper and lower limbs and cervicothoracic region in patients operated on over a period between 1981-2001. PATIENTS In 128 patients with peripheral arterial injuries the mechanism was direct penetration in 90 cases and blunt injury in 20 cases. In 4 cases a chronic damage (false aneurysm, AV fistula) was observed. Isolated vascular trauma was present in 97 patients (75.8%), 31 cases (24.2%) were aggravated by concomitant bone fractures, and nerve or soft tissue damage. Most frequently injured vessels were the superficial femoral (22.6%), crural (22.6%), and ulnar and radial (13.2%) arteries. 16 patients with penetrating cervicothoracic arterial injuries were registered during this period. 8 patients underwent emergency exploration and 8 patients angiography prior urgent exploration. RESULTS Saphenous vein interposition grafting was applied with good results in 34 patients, polytetrafluoroethylene and Dacron grafts were used in eight cases, end to end anastomosis in 12 cases, venous bypasses in 5 cases, venous patches in 7 cases. 17 patients underwent arterial repair and 9 venous repair. Vein homografts as an arterial substitute were implanted in 8 patients. Five secondary amputations were performed and five patients died. The limb salvage rate was 95% and the primary patency rate of vein homografts was 75% (excluded primary amputations). The penetrating cervicothoracic injuries were all repaired with improvement in level of consciousness and neurological deficit when present. CONCLUSIONS Most vascular injuries of the extremities can be managed successfully unless associated with severe concomitant damage of the bones, nerves and soft tissues. In the absence of suitable autologous vein grafts, homografts appear to be an interesting alternative for arterial repair. In penetrating cervicothoracic vascular injuries immediate operative repair offers the best chance of recovery.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Amputation, Surgical
- Anastomosis, Surgical
- Aneurysm, False/diagnostic imaging
- Aneurysm, False/etiology
- Aneurysm, False/surgery
- Angiography
- Arm/blood supply
- Arm Injuries/diagnostic imaging
- Arm Injuries/etiology
- Arm Injuries/surgery
- Arteries/injuries
- Arteries/surgery
- Arteriovenous Fistula/diagnostic imaging
- Arteriovenous Fistula/etiology
- Arteriovenous Fistula/surgery
- Arteriovenous Shunt, Surgical
- Blood Vessel Prosthesis Implantation
- Child
- Female
- Follow-Up Studies
- Graft Occlusion, Vascular/surgery
- Humans
- Hungary
- Leg/blood supply
- Leg Injuries/diagnostic imaging
- Leg Injuries/etiology
- Leg Injuries/surgery
- Limb Salvage
- Male
- Middle Aged
- Multiple Trauma/diagnostic imaging
- Multiple Trauma/etiology
- Multiple Trauma/surgery
- Neck Injuries/diagnostic imaging
- Neck Injuries/etiology
- Neck Injuries/surgery
- Polyethylene Terephthalates
- Polytetrafluoroethylene
- Reoperation
- Retrospective Studies
- Thoracic Arteries/diagnostic imaging
- Thoracic Arteries/injuries
- Thoracic Arteries/surgery
- Thoracic Injuries/diagnostic imaging
- Thoracic Injuries/etiology
- Thoracic Injuries/surgery
- Veins/injuries
- Veins/transplantation
- Wounds, Nonpenetrating/diagnostic imaging
- Wounds, Nonpenetrating/etiology
- Wounds, Nonpenetrating/surgery
- Wounds, Penetrating/diagnostic imaging
- Wounds, Penetrating/etiology
- Wounds, Penetrating/surgery
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Abstract
This study aims to analyse various manifestations and to evaluate the clinical outcome in the patients who had exploratory procedures following blackthorn (Prunus spinosus) injury. We performed a retrospective review of a consecutive series of 18 patients admitted between April 1997 and March 2001 to a District General Hospital of the UK. In all the cases, the site of injury was the upper limb. The mean age at presentation was 39.1 years. There was a male predominance (83.33%) and a marginal right side preponderance. The majority of the patients (83.33%) presented between March and August, which correlates with hedge-cutting time. The mean delay in presentation was 3 days (range: 1-14 days). The final postoperative outcome was satisfactory in all cases. We conclude that conservative treatment alone failed to resolve the symptoms. We recommend that all patients presenting with a history of blackthorn injury should undergo an immediate and thorough exploration to avoid undue complications.
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113
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Zellweger R, Hess F, Nicol A, Omoshoro-Jones J, Kahn D, Navsaria P. An analysis of 124 surgically managed brachial artery injuries. Am J Surg 2004; 188:240-5. [PMID: 15450827 DOI: 10.1016/j.amjsurg.2004.02.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2003] [Revised: 02/20/2004] [Indexed: 11/26/2022]
Abstract
BACKGROUND A 3-year review of surgically managed brachial artery injuries is presented. METHODS The medical records were analyzed for demographic data, mechanism of injury, associated injuries, treatment, and outcome. RESULTS There were 113 males and 11 females with a mean age of 28.7 years. The majority of the injuries were caused by stab and gunshot wounds in 57.3% and 29%, respectively. Primary anastomosis was possible in 47 patients, whereas 73 patients required vein interposition grafting. Lower arm fasciotomy was performed in 15 patients (12.1%). Associated injuries included peripheral nerve lesions in 77 (62.1%), nonpaired brachial vein injuries in 17 (13.7%), and concomitant humerus fracture in 12 (9.7%) patients. Thirty-nine patients (31.5%) had remote injuries. CONCLUSIONS The primary repair of penetrating brachial artery injuries was possible in approximately one third of the patients. Approximately two thirds of the patients had associated nerve lesions. Critical limb ischemia rarely occurred.
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Bluman EM, Tashjian RZ, Graves PF, Hughes TB. Subatmospheric pressure-induced compartment syndrome of the entire upper extremity. A case report. J Bone Joint Surg Am 2004; 86:2041-4. [PMID: 15342770 DOI: 10.2106/00004623-200409000-00026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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115
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Dale JC. School backpacks: preventing injuries. J Pediatr Health Care 2004; 18:264-6. [PMID: 15337926 DOI: 10.1016/j.pedhc.2004.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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116
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Oehlert K, Drescher W, Petersen W, Zantop T, Gross V, Hassenpflug J. [Injuries in Olympic handball tournaments: a video analysis]. SPORTVERLETZUNG-SPORTSCHADEN 2004; 18:80-4. [PMID: 15164293 DOI: 10.1055/s-2004-813031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The aim of the study was to achieve injury situations in European team handball with a video based method. METHODS A video tape containing 59 injuries of an Olympic handball tournament were analyzed by two observers (sports-scientist, orthopaedic surgeon). The analysis was based on a method previously published by Teitz, which was developed to analyze ACL-injuries. The parameters body region, field position, contact/non-contact, offense/defense, field player/goal keeper were mainly used. RESULTS The most injuries were localized at the head (N = 20), the lower limb (N = 15), thorax and abdomen (N = 9) and the upper limb (N = 9). Concerning the field, the most injuries were in the midfield (N = 20), followed by the left (N = 13) and right (N = 9) outside position. The injured players were mostly in the offense (84 %), and in the majority of cases the field players were affected (97 %). 86 % of the injuries accomplished by contact. CONCLUSION The head has a high risk, predominantly of contact injury. Contact-injuries could only be reduced by strict decisions of the referees. Non-contact injuries should be prevented by a special coordinative training.
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Oluwadiya KS, Oginni LM, Olasinde AA, Fadiora SO. Motorcycle limb injuries in a developing country. West Afr J Med 2004; 23:42-7. [PMID: 15171525 DOI: 10.4314/wajm.v23i1.28080] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Motorcycles have become a very popular means of transportation in Nigeria. This paper is a hospital based study of limb injuries resulting from motorcycle accidents in an urban centre in Nigeria. METHOD All patients reporting to the emergency department of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife with limb injuries resulting from motorcycle accidents between June 1998 and May 1999 were selected for this prospective study. RESULT One hundred and fifteen (79.3%) out of the 145 victims of motorcycle accidents that reported to the hospital had injuries involving their limbs. The Male: Female ratio was 2.8:1. The mean age was 31.9 +/- 16.7 (S. D.) years, and 20-29 years; the most commonly involved age group. 42.2% were due to collision with automobiles, 22% pedestrian while 8.7% were collisions between motorcycles. The use of protective/safety devices was practically non-existent. Seventy-six (66.1%) patients had lower limbs injuries, 25 (21.7%) patients had upper limb injuries while the remaining 14 (12.2%) injured both upper and lower limbs. The tibia was the most commonly fractured bone (32 patients, 27.8%) followed by the femur (25 patients, 21.7%). Eighty-six patients (74.8%) with fractures were managed by close reduction and splinting. Eighteen (15.7%) patients had internal fixation. CONCLUSION Motorcycle accident is an important cause of limb injuries in the developing worlds. Motorcyclists need to be encouraged to use protective/safety devices.
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Ma D, Morley R, Jones G. Risk-taking, coordination and upper limb fractures in children: a population based case-control study. Osteoporos Int 2004; 15:633-8. [PMID: 14735299 DOI: 10.1007/s00198-003-1579-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2003] [Accepted: 12/08/2003] [Indexed: 11/30/2022]
Abstract
The aim of this population based case-control study was to examine the association between risk-taking behaviour, motor coordination and upper limb fractures in children aged 9-16 years. A total of 321 fracture cases and 321 randomly selected individually matched controls were studied. The number for different types of upper limb fractures was 91 for hand, 190 for wrist and forearm and 40 for upper arm. Risk-taking behaviour was determined by a 5-item interview-administered questionnaire. Motor coordination was assessed by the 8-point movement ABC that tests manual dexterity, ball skills as well as static and dynamic balance. Bone mass was assessed by dual energy X-ray absorptiometry (DXA) and metacarpal morphometry. In general, there was heterogeneity by fracture site with regard to associations. Risk-taking behaviour was associated with hand fracture risk but not other fracture sites for downhill cycling behaviour (OR: 2.0/category, 95% CI: 1.1-3.7), dare behaviour (OR: 3.3/category, 95% CI: 1.1-10.0) and total risk-taking score (OR: 2.6/category, 95% CI: 1.3-5.7). Conversely, coordination measures were associated with wrist and forearm fractures only: cutting/threading (OR: 1.2/unit, 95% CI: 1.0-1.4); flower trail (OR: 1.2/unit, 95% CI: 1.0-1.4) and dynamic balance score (OR: 1.1/unit, 95% CI: 1.0-1.2). Backward stepwise analysis selected total risk taking score for hand fracture, and dynamic balance score for wrist and forearm fracture. None of the risk-taking or coordination scores were associated with upper arm fractures. These associations were unchanged following adjustment for bone mass. In conclusion, the propensity to take risks is most strongly associated with hand fracture risk while dynamic balance is most strongly associated with wrist and forearm fracture risk in children. These results inform the development of fracture prevention strategies in children.
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Meister K, Buckley B, Batts J. The posterior impingement sign: diagnosis of rotator cuff and posterior labral tears secondary to internal impingement in overhand athletes. AMERICAN JOURNAL OF ORTHOPEDICS (BELLE MEAD, N.J.) 2004; 33:412-5. [PMID: 15379239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
We conducted this study to determine whether a test, the posterior impingement maneuver, could be used to prospectively identify articular side tears of the rotator cuff and/or posterior labrum. Sixty-nine athletes presented with posterior shoulder pain that developed during overhand athletics. Injured shoulders were placed into 90 degrees to 110 degrees of abduction, slight extension, and maximum external rotation, and an effort was made to elicit pain deep within the posterior aspect. Overall sensitivity of the test was 75.5%, and specificity was 85%. When only athletes with noncontact injuries (gradual onset of pain) were considered, sensitivity was 95% and specificity was 100%. A positive posterior impingement sign correlated highly with undersurface tearing of the rotator cuff and/or tearing of the posterior labrum in athletes with gradual onset of posterior shoulder pain during overhand athletics.
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Abstract
In this study we analysed technique, ball speed and trunk injury data collected at the Australian Institute of Sport (AIS) from 42 high performance male fast bowlers over a four year period. We found several notable technique inter-relationships, technique and ball speed relationships, and associations between technique and trunk injuries. A more front-on shoulder alignment at back foot contact was significantly related to increased shoulder counter-rotation (p < 0.001). Bowlers who released the ball at greater speeds had an extended front knee, or extended their front knee, during the front foot contact phase (p < 0.05). They also recorded higher braking and vertical impact forces during the front foot contact phase and developed those forces more rapidly (p < or =0.05). A maximum hip-shoulder separation angle occurring later in the delivery stride (p = 0.05) and a larger shoulder rotation to ball release (p = 0.05) were also characteristics of faster bowlers. Bowlers suffering lower back injuries exhibited typical characteristics of the 'mixed' technique. Specifically, the hip to shoulder separation angle at back foot contact was greater in bowlers who reported soft tissue injuries than in non trunk-injured bowlers (p = 0.03), and shoulder counter-rotation was significantly higher in bowlers who reported lumbar spine stress fractures than non trunk-injured bowlers (p = 0.01). The stress fracture group was also characterised by a larger hip angle at front foot contact and ball release, whereas a more flexed front knee at ball release characterised the non trunk-injured group.
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Jetzer T, Haydon P, Reynolds D. Effective intervention with ergonomics, antivibration gloves, and medical surveillance to minimize hand-arm vibration hazards in the workplace. J Occup Environ Med 2004; 45:1312-7. [PMID: 14665818 DOI: 10.1097/01.jom.0000099981.80004.c9] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Medical surveillance was used in the workplace to determine and monitor the level of hand-arm vibration syndrome (HAVS) and carpal tunnel syndrome (CTS) present in workers exposed to upper extremity vibration. Ergonomic intervention in the form of new tools with lower vibration levels and the use of International Standards Organizaiton (ISO) 10819 antivibration gloves were associated with a decrease in the pathologic findings and symptoms in these workers. Workers without such intervention were more likely to show progression of symptoms and findings. These findings suggest that ergonomic intervention can be effective in controlling the workplace hazard of tool vibration.
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Harris PC, Atkinson D, Moorehead JD. Bilateral partial rupture of triceps tendon: case report and quantitative assessment of recovery. Am J Sports Med 2004; 32:787-92. [PMID: 15090398 DOI: 10.1177/0363546503258903] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Lin L, Zhang CZ, Zhang Q. [Progress in studies on hand-arm vibration disease in China]. ZHONGHUA LAO DONG WEI SHENG ZHI YE BING ZA ZHI = ZHONGHUA LAODONG WEISHENG ZHIYEBING ZAZHI = CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES 2004; 22:146-8. [PMID: 15130454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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van Eijsden-Besseling MDF, Peeters FPML, Reijnen JAW, de Bie RA. Perfectionism and coping strategies as risk factors for the development of non-specific work-related upper limb disorders (WRULD). Occup Med (Lond) 2004; 54:122-7. [PMID: 15020731 DOI: 10.1093/occmed/kqh003] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The incidence of non-specific work-related upper limb disorders (WRULD) is rising throughout western society. Literature and our own WRULD file (>1200 patients) revealed that both physical and psychosocial work-related factors are major causes of non-specific WRULD. It also appeared that non-specific WRULD was more likely to develop in patients with neurotic-perfectionist personalities. AIM To see if, alongside physical and psychosocial work-related factors, personality factors play an important role in developing non-specific WRULD. METHOD This was a case-control study with two control groups, comparing 45 computer workers with non-specific WRULD with 45 computer workers free from upper limb disorder (first control group) and 42 chronic pain patients (second control group). Main questionnaires administered were: the Utrecht Coping List (UCL), measuring coping-styles; the Multidimensional Perfectionism Scale (MPS), measuring neurotic perfectionism; and the Symptom Check List (SCL-90), measuring general psychological complaints (psychoneuroticism). The SCL-90 was added because of its known high correlation with neurotic perfectionism. RESULTS Logistic regression analysis revealed significant differences in SCL-90 scores (chi(2) = 17.2, P < 0.0001), thereby potentially negating the significance of the higher neurotic perfectionism in the non-specific WRULD group. A second control group of chronic pain patients, with prospective high score on the SCL-90, was added. Logistic regression showed that, after controlling for psychoneuroticism, non-specific WRULD patients had more neurotic perfectionist traits (chi(2) = 22.83, P < 0.0001). There were no significant differences in mean UCL scores (P > 0.05). CONCLUSION Alongside physical and psychosocial work-related factors, psychoneuroticism and neurotic perfectionism appear to be important risk factors for developing non-specific WRULD.
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