J Trauma
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We have reported the case of an anterolateral dislocation of the proximal tibiofibular joint in a soccer player, apparently the second case in the literature. As in that reported by O'Rourke and McManus, this patient was attempting to gain his balance and this may indeed be an important contributing factor. ⋯ Treatment usually consists of closed reduction with 3 weeks of casting. In complicated cases, however, resection of the fibular head may be required.
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We developed a fixed-volume porcine hemorrhage model that simulates the rapid exsanguination of combat or civilian trauma victims. In this study we compared the ability of colloid resuscitation solutions to prevent death after an otherwise lethal hemorrhage in 100 swine. The shed blood was replaced in a 1:1 ratio with either autologous whole blood (WB), untyped swine fresh frozen plasma (FFP), typed FFP, 5% human serum albumin (ALB), or normal saline (NS). ⋯ Deaths in the ALB group steadily occurred for up to 2 1/2 hours after treatment. Analysis of hemodynamic, arterial blood gas, and acid-base data indicated that WB and FFP provided a better acid-buffering capacity in surviving animals than NS or ALB. We conclude that compatible FFP is a better resuscitation agent than ALB after an otherwise fatal hemorrhage because FFP is a better acid buffer.