Injury
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We retrospectively studied the complications associated with a displaced supracondylar fracture of the humerus in children and its treatment. Between 1978 and 1997, 200 displaced fractures were treated by operative means. In 190 cases closed reduction and percutaneous pinning was performed. ⋯ All recovered without sequelae, except for one case with persistent radial nerve palsy which recovered after a sural nerve interposition graft. Transient neurological problems are common in this fracture. A mini-open procedure is recommended for the ulnar Kirschner wire (K-wire) to prevent iatrogenic ulnar nerve injury.
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In the Accident and Emergency Department, the management of patients who have sustained head injuries (HI) is often made more complicated by the suspicion of a cervical spine injury (CSI). This study aimed to evaluate the incidence of CSI in patients sustaining blunt head injuries in a Scottish population. ⋯ The risk of CSI in patients with blunt head trauma and an admission GCS of > or =4 does not decrease as GCS increases. Patients with blunt head injuries who present with a GCS of 3 are much more likely to have a concomitant CSI. The overall incidence of 5.3% compares with published series from other countries.