Injury
-
Comparative Study
Comparative study of phrenic and intercostal nerve transfers for elbow flexion after global brachial plexus injury.
Global brachial plexus injuries (BPIs) are devastating events frequently resulting in severe functional impairment. The widely used nerve transfer sources for elbow flexion in patients with global BPIs include intercostal and phrenic nerves. ⋯ Phrenic nerve transfer had a higher proportion of good prognosis for elbow flexion than intercostal nerve transfer, but the effective and outstanding rate had no significant difference for biceps reinnervation between the two groups according to MRC grading, angle of elbow flexion, and EMG.
-
There is no definite radiographic landmark in plain radiographs for proximal humeral rotation, which is an important parameter for avoiding rotational malalignment during fracture fixation. Here, we used radiographic images of cadaveric humeri to determine whether the landmark of the crest of lesser tuberosity (CoLT) in plain radiographs could be used to determine humeral rotation. ⋯ The projection of the CoLT in plain radiographs can be used as an important landmark to assess humeral head rotation and will be a useful landmark for rotational control of fracture fixation.
-
There is a requirement in the Ministry of Defence for an objective method of comparing the area of coverage of different body armour designs for future applications. Existing comparisons derived from surface wound mapping are limited in that they can only demonstrate the skin entry wound location. The Coverage of Armour Tool (COAT) is a novel three-dimensional model capable of comparing the coverage provided by body armour designs, but limited information exists as to which anatomical structures require inclusion. The aim of this study was to assess the utility of COAT, in the assessment of neck protection, using clinically relevant injury data. ⋯ COAT demonstrated its ability to objectively quantify the potential effectiveness of different body armour designs in providing coverage of vulnerable anatomical structures from different shot line orientations. To improve its utility, it is recommended that COAT be further developed to enable weapon and tissue specific information to be modelled, and that clinically significant injuries to other body regions are also incorporated.
-
Case Reports
Intramedullary fixation of a femoral shaft fracture with preservation of an existing hip resurfacing prosthesis.
Femoral neck fractures have been reported as a cause for failure in patients with a hip resurfacing arthroplasty. However, the incidence and management of fractures of the femoral shaft with an ipsilateral hip resurfacing arthroplasty is relatively absent in current literature. Although, the gold standard for the fixation of a closed femoral shaft fracture is with the use of an intramedullary nail, this can be a challenge in the presence of a hip resurfacing arthroplasty. We describe the case of anterograde intramedullary nail fixation for a femoral shaft fracture in a patient with an ipsilateral hip resurfacing arthroplasty in situ.
-
To describe the characteristics of canyoning rescue operations (CRO), type and severity of injuries or illnesses, and on-site medical procedures. ⋯ The length and exposure to environmental factors validates the importance of emergency physicians and paramedics in CRO. Physicians and paramedics should be familiar with Pre-hospital Trauma Life Support, medical procedures related to environmental, topographical and logistical conditions, and helicopter rescue operations including winch operations.