J Trauma
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Case Reports
Acute forearm compartment syndrome secondary to local arterial injury after penetrating trauma.
Acute compartment syndrome (ACS) is a well-described surgical emergency that requires an immediate diagnosis and emergent operative intervention. Failure to either make the diagnosis or to implement the appropriate treatment quickly can result in severe long-term morbidity. The purpose of this article is to document evidence that penetrating trauma which results in arterial injury may cause acute forearm compartment syndrome. As a result, this mechanism should alert surgeons to the possibility of acute compartment syndrome secondary to arterial injury. ⋯ This article establishes the incidence of a specific mechanism of ACS in our penetrating trauma population. As a result of these findings, a thorough evaluation of the forearm vasculature and a careful search for arterial injury is recommended at the time of fasciotomy. Securing a rapid diagnosis and executing early definitive management will result in fewer devastating long-term outcomes.
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Infections are a common acute and chronic complication of combat-related injuries; however, no systematic attempt to assess infections associated with US combat-related injuries occurring in Iraq and Afghanistan has been conducted. The Joint Theater Trauma Registry (JTTR) has been established to collect injury specific medical data from casualties in Iraq and Afghanistan. ⋯ Infections are common after combat-related injuries. Although the JTTR can provide general information regarding infections, improved data capture and more specific clinical information is necessary to improve overall combat-related injury infection care.
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The extremities remain the most common sites of wounding in conflict, are associated with a significant incidence of vascular trauma, and have a high complication rate (infection, secondary amputation, and graft thrombosis). ⋯ We have demonstrated that prognosis is worse after military vascular trauma if there is an associated fracture, probably due to higher energy transfer and greater tissue damage.
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The mechanisms of modern warfare unfortunately have lead to many ocular injuries. This study attempts to quantify the effect of military combat eye protection on the incidence of ocular injury among US service members engaged in current combat operations. ⋯ This study suggests that the military combat eye protection used by military personnel during current combat operations has resulted in significantly fewer and less severe ocular injuries. Further, results from this study may also suggest that Department of Defense educational programs may have been successful in increasing eye protection compliance.
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Short distance falls are a common false history provided in cases of child abuse. Falls are also a common occurrence in ambulating young children. The purpose of this study was to determine the risk of head injury in short distance feet-first free falls for a 12-month-old child. ⋯ Results show that fall dynamics play an important role in head injury outcome measures. Different fall heights and impact surfaces led to differences in head injury risk, but the risk of severe head injury across all tested scenarios was low for a 12-month-old child in feet-first free falls.