[The causes of death and risk factors in patients of war wound and trauma of extremities by logistic regression model].

OBJECTIVE: To explore the causes of death and risk factors in patients of war wound and trauma of extremities. METHODS: This retrospective study involved 352 patients of war wound and trauma of extremities admitted to 303rd Hospital of People's Liberation Army during the period between 1968 to 2002. All the data were reviewed and the causes of death of 15 patients were analyzed by autopsy, and a computer's logistic regression model analysis was performed to approach the risk factors of death. RESULTS: Fifteen of the three hundred and fifty-two patients were died (4.3 %). The causes of death included acute renal failure (ARF) (46.7%, 7/15), lung embolism (20.0%, 3/15), clostridial myonecrosis (20.0%, 3/15) and multiple organ system failure (MOSF) (13.3%, 2/15). In the univariate analysis, the risk of death increased by shock, time admitted to hospital, amputation, time of tourniquet, associated injury of head, thoracic region, abdomen or blood vessel (P < 0. 05). In the logistic regression model analysis, shock and amputation were the two factors most strongly associated with the death of patients of war wound and trauma. (P < 0. 05). CONCLUSION: Acute renal failure (ARF) was the main cause of death of patients of war wound and trauma of extremities. Its should be helpful for minimize the mortality of patients of war wound and trauma to manage the shock in time and have a correct choice of amputation promptly.

[Serial thin cross-sectional anatomy and computerized three-dimensional reconstruction of metacarpal fascial spaces of hand].

OBJECTIVE: To build three-dimensional (3-D) visible model for surgical treatment of infection of fascial spaces of hand. METHODS: Serial thin cross-sections (0.2 mm) of hand were made by cryomicrotome, and the thin cross-sections of metacarpal parts were observed. A personal computer was employed to reconstruct 3-D model of metacarpal fascial space. RESULTS: The shapes, locations and adjacent relations of the mid-palmar space, thenar space and metacarpal bones were displayed clearly from computerized 3-D model, which could be the cross-reference of the cross-sections expediently. CONCLUSION: The computerized 3-D reconstruction of metacarpal fascial spaces can provide some guidance for surgical treatment of infection and other diseases of metacarpal fascial spaces.