Non-fatal injuries sustained by seatbelt wearers: a comparative study. (1/342)

The injuries sustained by 969 drivers and front-seat passengers in road-traffic accidents were studied. Altogether 196 (20-2%) of the drivers and passengers were wearing seat belts and 773 (79-8%) were not. The injuries among the two groups differed greatly in both severity and distribution. A total of 54 (27-6%) of the seatbelt wearers sustained one or more fractures compared with 300 (38-8%) of the non-wearers, and 18 (9-2%) of the seatbelt wearers were severely injured compared with 300 (38-8%) of the non-wearers. Soft-tissue injuries to the face were sustained by only 29 (14-8%) of the seatbelt wearers compared with 425 (55%) of the non-wearers. Since wearing seatbelts may become compulsory, the type and pattern of injuries to be expected in wearers should be appreciated.  (+info)

Injuries caused by falling soccer goalposts in Denmark. (2/342)

OBJECTIVE: A falling soccer goalpost is associated with the potential risk of serious injury that can sometimes even be fatal. The aim of the study was to analyse the extent of the problem in Denmark and focus on the mechanism of injury and prevention. METHODS: Data were analysed for the period 1989-1997 from the European Home and Leisure Accident Surveillance System, which is an electronic register of the injuries seen in the casualty departments of the hospitals of five selected cities in Denmark representing 14% of the Danish population; in addition, fatal accidents in the whole of Denmark since 1981 were examined. Forty two injured persons were interviewed about the circumstances of the accident. Attempts were made to estimate the proportion of goalposts secured by counterweight in the five different regions, compared with the proportion secured with ground stakes and those that were unsecured, by analysing data from the largest producers of goalposts in Denmark. RESULTS: In the period 1981-1988, two fatal accidents were recorded. In the period 1989-1997, 117 people were injured by a falling goalpost; six of the injuries required hospitalisation. Some 88% of the injured were under the age of 15. In a telephone interview with 42 of the injured, 50% stated that the goalpost fell because someone was hanging on the crossbar. Comparing the five different regions with respect to the proportion of goalposts secured by counterweight and the number of accidents, the following relation was found. Areas in which a high percentage of the goalposts were secured by a counterweight correlated inversely with a high number of accidents (r = -0.9; p = 0.04). CONCLUSION: Soccer is a widely played sport and it is important to be aware that accidents caused by falling goalposts can occur and that they presumably can be prevented by proper use of goalposts, by using secure goalposts, and by securing old goalposts with a counterweight.  (+info)

Injury rates in Shotokan karate. (3/342)

OBJECTIVE: To document the injury rate in three British Shotokan karate championships in consecutive years. In these tournaments strict rules governed contact, with only "light" or "touch" contact allowed. Protective padding for the head, hands, or feet was prohibited. METHODS: Prospective recording of injuries resulting from 1770 bouts in three national competitions of 1996, 1997, and 1998. Details of ages and years of karate experience were also obtained. RESULTS: 160 injuries were sustained in 1770 bouts. The overall rate of injury was 0.09 per bout and 0.13 per competitor. 91 (57%) injuries were to the head. The average age of those injured was 22 years, with an average of nine years of experience in karate. CONCLUSIONS: The absence of protective padding does not result in higher injury rates than in most other series of Shotokan karate injuries. Strict refereeing is essential, however, to maintain control and minimise contact.  (+info)

Anatomical study of the perforating vessels of the lower leg. (4/342)

Difficulty of soft tissue defects of the lower leg demands the development of new methods to treat such defects. The aim of this study is the examination of perforators and the various ways of blood supply to the skin in the lower leg. Provided with certain regularity, we would be able to cure soft-tissue defects also in the difficult zone of the distal segment and on the dorsum of the foot not harming vessels and not affecting mobility of muscles. Subcutaneous island-flaps supplied by perforating vessels could replace free flaps. By saving the crural fascia of 10 lower legs we flayed layers of skin and fat, marked the perforating vessels with pins, and photographed and documented them. Specimens were divided into a proximal, an intermediate and a distal segment, each of them subdivided into a medial, lateral and dorsal section. The perforators, which can be classified as septocutaneous and musculocutaneous vessels, followed a reproducible pattern all over the lower leg. All vessels were sufficient in number as well as in size. Additionally these perforators can easily be identified by colour-coded sonography. The knowledge that perforators in the lower leg occur regularly enables the development of a new operative approach in therapy of soft-tissue defects in this region with the advantage, that the vessels used can be selected preoperatively.  (+info)

Frostbite at the gym: a case report of an ice pack burn. (5/342)

The case is reported of a 59 year old woman who suffered a 1% total body surface area superficial partial thickness burn to her calf following the application of an ice pack. The cause, resulting injury, and subsequent management are discussed. It is possible that such injuries are common, but no similar reports were found in a literature search. Awareness of the risk of this type of injury is important for all those entrusted with advising patients on the treatment of minor soft tissue injuries.  (+info)

Vascular injuries of the limbs: a fifteen-year Georgian experience. (6/342)

OBJECTIVES: to analyse the causes of injury, surgical approaches, outcome and complication of vascular trauma of the upper and lower limbs in patients with vascular injuries operated on over a period between 1981 and 1995. PATIENTS: in 157 patients, the injuries were penetrating in 136 cases and blunt in 21. Isolated vascular trauma was present in 92 (58.6%) patients, 65 cases (41.4%) were aggrevated by concomitant bone fractures, severe nerve and soft tissue damage. The most frequently injured vessels were the superficial femoral (20. 6%) and brachial (19.1%) arteries. RESULTS: saphenous vein interposition grafting was applied with good results in 34 patients, polytetrafluoroethylene grafts were used in three cases, end-to-end anastomoses in 42 cases, venous bypasses in five cases, and venous patches in seven cases. Seventeen patients underwent arterial repair and nine, venous repair. Fasciotomy was used in 18 cases, and vessels were ligated in 14 cases. Blood flow was restored in 91 patients (58.0%), and collaterals compensated in 31 cases (19.7%). Fourteen primary and nine secondary amputations were performed. Twelve patients died. The limb salvage rate was 77.7% (84.1% among surviving patients). CONCLUSIONS: most vascular injuries associated with limb trauma can be managed successfully unless associated by severe concomitant damage to bones, nerves and soft tissues.  (+info)

Transcranial doppler detection of fat emboli. (7/342)

BACKGROUND AND PURPOSE: The fat embolism syndrome (FES) is characterized by the simultaneous occurrence of pulmonary and neurological symptoms as well as skin and mucosal petechiae in the setting of long-bone fractures or their surgical repair. Its pathophysiology is poorly understood, and effective treatments are lacking. We present 5 patients with long-bone fractures in whom in vivo microembolism was detected by transcranial Doppler. METHODS: Five patients with long-bone fractures were monitored with transcranial Doppler for microembolic signals (MESs) after trauma. Two patients also had intraoperative monitoring. A TC-2020 instrument equipped with MES detection software was used. Detected signals were saved for subsequent review. Selected signals satisfied criteria defined previously and were categorized as large or small. RESULTS: Cerebral microembolism was detected in all 5 patients and was transient, resolving within 4 days of injury. Intraoperative monitoring revealed an increase in MESs during intramedullary nail insertion. The characteristics of MESs after injury varied among patients, with large signals being more frequent in the only patient with a patent foramen ovale. CONCLUSIONS: Cerebral microembolism after long-bone fractures can be detected in vivo and monitored over time. These findings may have potential diagnostic and therapeutic implications.  (+info)

Patterns of single segment non-physeal extremity fractures in children. (8/342)

Five hundred and fifteen children with single segment non-physeal extremity fractures were retrospectively reviewed. The male to female ratio was 2.7:1. The average age of study group was 9.9+/-4.7 years; 273 fractures (53%) were on the left, 242 (47%) were on the right. A fall was the main cause of the injury in most of the cases (80%). The forearm was the most commonly seen fracture site. Summer was the season when the fracture incidence was the highest. Highest surgical treatment rate (50%) was seen in supracondylar humerus fractures. It has been stated in the literature that non-physeal fractures are far more common than physeal fractures. We assume that this study not only will help understanding of the injury patterns of single segment non-physeal fractures in children but also, be a base for future studies in prevention and treatment of this type of fracture.  (+info)