Injury
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To explore experiences of patients after injury and identify implications for clinical care and support within the hospital setting and primary care. ⋯ Trauma patients' recovery needs to be supported by information protocols. The social circumstances of patients need to be considered at the point of discharge and during recovery. There is a need to identify people who may be experiencing mental health issues for timely referral to assessment services and appropriate care. Signposting to support groups may also be helpful for those with life changing injuries. Improved pain management would help alleviate discomfort and stress. Physiotherapy has a key role to play in supporting patients in recovery.
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The Pietermaritzburg Metropolitan Trauma Service formerly lacked a robust computerised trauma registry. This made surgical audit difficult for the purpose of quality of care improvement and development. We aimed to design, construct and implement a computerised trauma registry within our service. Twelve months following its implementation, we sought to examine and report on the quality of the registry. ⋯ The construction and implementation of the computerised trauma registry was the beginning of an endeavour to continue improvements in the quality of care within our service. The registry provided a reliable audit at twelve months post implementation. Deficits and limitations were identified and new strategies have been planned to overcome these problems and integrate the trauma registry into the process of clinical care.
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The aim of this study was to determine the sensitivity and specificity of a J wave on the electrocardiogram (ECG) to detect an occult cardiac injury in patients following penetrating chest trauma. ⋯ The presence of a 'J' wave on ECG signifies a significant risk of an occult cardiac injury after penetrating thoracic trauma.
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Isolated small bowel injury (ISBI) related to abdominal blunt trauma is rare. Timely diagnosis could be difficult, especially in the absence of modern imaging and laparoscopic facilities. The determinants of mortality under such circumstances are unclear. ⋯ ISBI is seldom suspected. This causes delay in diagnosis and most cases present with a diffuse peritonitis. Early diagnosis and management in low income environment is likely to be improved by a greater awareness of clinicians about this injury, serial clinical assessment and repeated erect chest X-ray, rather than sophisticated tools such as CT scan or laparoscopy.
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Proximal plate fixation is a crucial factor in osteosynthesis of periprosthetic femur fractures. Stability and strength of different fixation concepts for proximal plate fixation were compared. ⋯ Bicortical screw anchorage improves proximal plate fixation in periprosthetic fractures. The cerclage-screw combination is a valuable alternative especially in osteoporotic bone.