Injury
-
Disruption of the radiocapitellar line (RCL) can be a useful sign in injured elbows in children. Although originally described only in the true lateral projection, it has become generally accepted to apply the sign to any radiographic projection. ⋯ In these cases, the elbow was not in the standard anteroposterior or lateral position. Radiologists and clinicians involved in trauma should be aware that radiographic positioning and normal bowing of the radial shaft can affect the validity of this sign and that it is best applied only to the true lateral projection as originally described.
-
A total of 34 children with ipsilateral supracondylar fractures of the humerus and forearm were studied over an 8-year period. Of these, 19 patients had fractures of the distal quarter of the forearm bones while eight patients had a distal radial epiphyseal injury. Five of the patients had undisplaced supracondylar fractures. ⋯ All forearm fractures were treated by closed reduction. Nine displaced supracondylar fractures which could not be reduced by closed manipulation were treated by olecranon pin traction in two cases and by percutaneous pinning in seven cases. Excellent or good results were found in 29 children after an average follow-up of 3.8 years.
-
Two cases of tension pneumopericardium following stab wounds to the chest are reported. The first presented with delayed onset respiratory distress and a precordial systolic murmur, and was treated by thoracotomy. The second presented with acute cardiac tamponade and was treated by needle aspiration. The clinical and radiological features of tension pneumopericardium and its treatment are reviewed.
-
By the TRISS methodology, probability of survival in injury can be estimated. It is based on a statistical analysis of outcome which is influenced by the severity of the injuries as expressed in the Injury Severity Score (ISS), the physiological function as expressed in the Trauma Score (TS) and the patient's age. We have used the TRISS formula in 206 patients with penetrating injury. ⋯ All the fatal cases had serious predisposing conditions: chronic pulmonary disease, alcoholism, and psychiatric illness. In penetrating injury, the patient's functional status at the start of treatment is of greater importance for the outcome than the anatomical severity. The concept of the methodology of TRISS for assessment of probability of survival seems useful for review and comparison in injury care.