Injury
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We report our experience of elastic stable intramedullary nailing (ESIN) of severely displaced proximal humeral fracture Type III and IV according to Neer in children. Thirty-five children (mean age 12.7 years) with 19 Salter-Harris Type II epiphyseal fractures and 16 children with metaphyseal fractures of the proximal humerus were treated with ESIN by one-nail or two-nail-technique. There were the following complications: two perforations of the nail at the head of the humerus with loss of position, one loss of position without nail perforation, one misplacement of a nail, one revision due to haematoma and two difficult removals of metal. ⋯ On average they gained 99 points. All children were able to resume their sporting activities as before. For the treatment of displaced proximal humeral fractures in children more than 10 years old the retrograde ESIN represents a safe minimal invasive surgical procedure.
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The issue of family violence and sexual abuse in Indigenous communities across Australia has attracted much attention throughout 2007, including significant intervention by the federal government into communities deemed to be in crisis. This paper critically examines the reporting and recording of Indigenous violence in Australia and reflects on what 'statistics' can offer as we grapple with how to respond appropriately to a problem defined as a 'national emergency'.
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In Alice Springs, assault and attempted homicide, self-harm and attempted suicide and transportation accidents contribute substantially to the burden of disease, especially among the aboriginal population who are poor and disadvantaged. While road traffic accidents and self-inflicted injuries are the leading causes of injury-related deaths worldwide, violence is a major factor in Alice Springs trauma. Violence accounted for more than half the annual trauma case load. ⋯ Solutions to the trauma epidemic in our Remote indigenous population must look past the Emergency and Surgical Departments that care for the injured to the individual, community, environmental, social and economic factors that underpin the traumas. Traumatic injury and death maybe the most preventable of all health issues. While tremendous resources are spent caring for injured patients in hospital, less attention is paid towards gaining a better understanding of injury prevention.
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This paper is an evaluation of an intercollegiate program that targeted specialist surgeons, obstetricians and gynaecologists treating Australian Indigenous patients. The program was a continuing professional development activity that was delivered through on-line modules and focussed on providing the specialist with practical skills to improve the health of Indigenous Australians in a clinical setting.