J Trauma
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The purpose of this study was to determine whether trauma patients who are intubated because of combativeness, and not because of medical necessity, have more complications resulting in longer lengths of stay. ⋯ The results from this study indicate that trauma patients who are intubated because of combativeness, and not because of medical necessity, have longer lengths of stay, increased incidence of pneumonia, and poorer discharge status when compared with matched controls. The outcomes of this group are similar to that of patients who are intubated because of medical necessity.
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The purpose of this study was to determine the percentage of amputee soldiers who sustained their injury during the current conflicts in Afghanistan and Iraq and have returned to duty. In addition, the authors plan to identify the factors that influence the amputee's likelihood to return to duty. ⋯ During the 1980s, 11 of 469 amputees returned to active duty (2.3%). The number of amputees returning to duty has increased significantly, from 2.3% to 16.5%, due to advancements in combat casualty care and the establishment of centralized amputee centers.
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For patients sustaining torso gunshot wounds (GSWs) who undergo a trial of nonoperative management (NOM), the optimal observation time required to exclude a hollow viscus injury before discharge is unknown. The purpose of this study was to analyze a continuous series of patients undergoing NOM after sustaining a GSW to the torso to determine the safe period of observation before discharge. ⋯ For patients undergoing NOM of their torso GSWs, all patients who failed and required a laparotomy did so within 24 hours of admission. Patients undergoing selective NOM required a minimum of 24 hours of close observation before discharge.
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The lack of knee flexion is an increasingly recognized complication of femoral and periarticular knee fractures. This is a significant challenge for both surgeon and patients. ⋯ Modified Thompson quadricepsplasty is a promising procedure with satisfactory results. It provides significantly results if it is performed earlier and in more severe extension contracture.
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Ultrasonography has been widely applied in clinical settings, and its role in the assessment of trauma has been approved. However, there are very few reports about its role in the management of mass casualties. ⋯ In our hospital, ultrasonography was widely used in the triage of earthquake victims, bedside examination of severe cases, and interventional treatments. The advantages of ultrasonography such as convenience, noninvasiveness, high accuracy, and repeatability have been sufficiently demonstrated in this mass casualty, where ultrasonography played a great role in the rescue of victims of Wenchuan earthquake.