J Trauma
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An osteochondral fracture in the posterolateral margin of the capitellum is recognized as being a cause of posterolateral rotatory instability (PLRI). ⋯ Osteochondral defect in the posterolateral aspect of the capitellum is an important indicator of PLRI; however, the result of this study suggests ligament reconstruction for those with a large bone defect may not be always successful.
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On January 31, 2009, a fuel tanker exploded in rural Kenya, killing and injuring hundreds of people. This article describes the care of >80 burn victims at a rural hospital in Kenya, Nakuru Provincial General Hospital, and provides lessons for care of a large number of burned patients in a resource-limited setting. ⋯ Mortality after mass burn disasters is high in Africa. In areas where referral to tertiary centers is not possible, district hospitals should have mass disaster plans that involve collaboration with other organizations to augment medical and psychologic services. Even for patients who do not survive, compassionate care with analgesics can be given.
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Eastern Association for the Surgery of Trauma guideline for the evaluation of blunt cerebrovascular injury (BCVI) states that pediatric trauma patients should be evaluated using the same criteria as the adult population. The purpose of our study was to determine whether adult criteria translate to the pediatric population. ⋯ Risk factors for BCVI in the pediatric trauma patient appear to mimic those of the adult patient.
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One of the important causes of death after blast injuries is reduced blood volume, which typically results from hemorrhage but may also result from nonhemorrhagic causes. Hemoconcentration is one such alternate cause of reduced blood volume, but its mechanism is unclear. Because blood is condensed after chest-abdomen blast injuries in rabbits, a series of experiments was conducted to clarify this phenomenon. ⋯ The preliminary results indicate that microvessels in the lungs and kidneys are the key targets of blast injuries. The damage to the microvessels leads to leakage of albumin, which is one of the important reasons for hemoconcentration in the absence of active bleeding after a blast injury. Treatment should be initiated in victims of blast injuries who are severely wounded as soon as possible after the explosion during the earliest stages of the injury to avoid the occurrence of shock or other severe complications.
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In a previous retrospective study, we demonstrated that pelvic radiographs (PXRs) in the evaluation of blunt trauma patients undergoing abdominal computed tomographic (CT) scanning have limited utility in the absence of hemodynamic instability and significant physical findings. The purpose of this study was to prospectively validate an algorithm defining indications for PXR in blunt trauma patients in the emergency department. ⋯ When objective evaluation of the abdomen is to be obtained via CT scanning, PXR in the emergency department is obsolete in the absence of hemodynamic instability and significant physical examination findings. Implementation of a selective algorithm in this patient population can result in significant cost savings without adverse patient outcomes.