Injury
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Comparative Study
Angular stable multiple screw fixation (Targon FN) versus standard SHS for the fixation of femoral neck fractures.
Head-preserving fracture care especially for the elderly may be complicated by acetabular screw penetration, cut out, delayed union or femoral head necrosis. The following comparative study analyses whether a new angular stable device may overcome these shortcomings. ⋯ The study revealed less subsidence of the head fragment, lower cut out rate and a lower rate of conversion to hemiarthroplasty after Targon FN fixation in comparison to a standard SHS fixation in a small number of patients with hip fractures. However, this was not accompanied by functional limitations in the SHS group.
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Road traffic crashes are responsible for a vast amount of death and disability in developing countries. This study uses a bottom up, micro-costing approach to determine the cost of road traffic related crashes in South Africa. ⋯ The cost of care of a RTC victim is significant. In light of the high numbers of RTC victims admitted over the course of the year this is a significant cost burden for a regional hospital to bear. This cost must be taken into account when allocating hospital budgets.
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Comparative Study
The ins and outs of terrorist bus explosions: Injury profiles of on-board explosions versus explosions occurring adjacent to a bus.
Terrorist explosions occurring in varying settings have been shown to lead to significantly different injury patterns among the victims, with more severe injuries generally arising in confined space attacks. Increasing numbers of terrorist attacks have been targeted at civilian buses, yet most studies focus on events in which the bomb was detonated within the bus. This study focuses on the injury patterns and hospital utilisation among casualties from explosive terrorist bus attacks with the bomb detonated either within a bus or adjacent to a bus. ⋯ Explosive terrorist attacks detonated within a bus generate more severe injuries among the casualties and require more urgent surgical and intensive level care than attacks occurring adjacent to a bus. The comparison and description of the outcomes to these terrorist attacks should aid in the preparation and response to such devastating events.
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Non-operative management for blunt splenic injuries was introduced to reduce the risk of overwhelming post splenectomy infection in children. To increase splenic preservation rates, splenic artery embolization (SAE) was added to our institutional treatment protocol in 2002. In the presence of clinical signs of ongoing bleeding, SAE was considered also in children. To our knowledge, the long term splenic function after SAE performed in the paediatric population has not been evaluated and constitutes the aim of the present study. ⋯ This case control study indicates preserved splenic function after SAE for splenic injury in children. Mandatory immunization to prevent severe infections does not seem warranted.
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Randomized Controlled Trial
Primary closure versus non-closure of dog bite wounds. A randomised controlled trial.
Dog bite wounds represent a major health problem. Despite their importance, their management and especially the role of primary closure remain controversial. In this randomised controlled trial, the outcome between primary suturing and non-closure was compared. ⋯ Primary suturing of wounds caused by dog bites resulted in similar infection rate compared to non-suturing. However, primary suturing exhibited improved cosmetic appearance. Time of management appeared to be critical, as early treatment resulted in lower infection rate and improved cosmetic appearance regardless suturing or not. Furthermore, wounds located at the head and face demonstrated better results.