RESUMEN
BACKGROUND: Community assault (CA) has been increasing in certain Cape Town suburbs over the past decade. There are limited CA-related imaging data. The aim of this study was to review CA-related advanced radiological investigations and findings at a Level 1 South African Trauma Centre. METHOD: A retrospective study at Tygerberg Hospital, Cape Town, from 1 January through 30 June 2013. All advanced radiological investigations performed on CA victims at the time of admission were retrieved and analysed by patient demographics, imaging investigations and radiological findings. RESULTS: Sixty-two patients (n=62) with a median age of 25 years were included; CT brain was acquired in 90% (n=56) and was abnormal in 68% (n=42). Craniofacial fractures were demonstrated in 60% (n=37), with involvement of the paranasal sinuses in 32% (n=20) and the base of skull in 19% (n=12). Almost half (n=28/62; 45%) had intracranial haemorrhage, which was intra-axial in 36% (n=22/62), extra-axial in 34% (n=21/62) and both intra- and extra-axial in 23% (n=14/62). Cerebral oedema was present in 29% (n=18/62), with herniation in 10% (n=6/62). Non-cranial CT was acquired in 52% (n=32/62), of whom 19 (n=19/32; 59%) also underwent CT brain. CT abdomen was acquired in approximately a quarter of the cohort (n=16/62, 26%), demonstrating abnormalities in 15 (24%). Fifteen cervical spine CTs were performed (n=15/62; 24%) demonstrating no acute bony injury. CONCLUSION: We recommend a high index of suspicion for severe intracranial injury in CA victims and urgent tertiary referral of those with a depressed level of consciousness. Prospective work is required to determine the long-term outlook for survivors.
Asunto(s)
Víctimas de Crimen , Heridas y Lesiones/diagnóstico por imagen , Adulto , Femenino , Humanos , Masculino , Estudios Retrospectivos , Sudáfrica , Centros de Atención TerciariaAsunto(s)
Bronconeumonía/microbiología , Candida/aislamiento & purificación , Candidiasis/diagnóstico , Fungemia/diagnóstico , Anciano , Antifúngicos/farmacología , Bronconeumonía/complicaciones , Candida/clasificación , Candidiasis/microbiología , Candidiasis/patología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/terapia , Fungemia/microbiología , Fungemia/patología , Humanos , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/terapia , Masculino , Pruebas de Sensibilidad Microbiana , Radiografía Torácica , Diálisis Renal/efectos adversos , Tomografía Computarizada por Rayos XAsunto(s)
Servicios Contratados/organización & administración , Servicio de Mantenimiento e Ingeniería en Hospital/organización & administración , Sistemas Multiinstitucionales/organización & administración , Ingeniería Biomédica , California , Servicios Contratados/economía , Ahorro de Costo , Recolección de Datos , Equipos y Suministros de Hospitales/economía , Servicio de Mantenimiento e Ingeniería en Hospital/economía , PropiedadRESUMEN
Fractures of the shaft of the ulna are described and a simple classification is proposed. Statistics are analysed in respect of mode of treatment and time of healing, and the unique mechanism of direct trauma is discussed. This survey showed that operative treatment has no place whatsoever in the treatment of these fractures.