Operative stabilisation versus non-operative management of mid-shaft clavicle fractures.

INTRODUCTION: Fractures of the mid-shaft clavicle are commonly encountered in clinical practice. These can be managed either by conservative method or operative by internal fixation. This study aims to compare the outcomes of conservative and operative management. METHODS: Forty patients with displaced and comminuted mid-shaft clavicle fractures were included in the study, among which twenty-five patients were treated conservatively and 15 patients underwent surgery and were followed up for a period of 1 year. Time taken for union, functional outcome, complications, and patient satisfaction were compared. RESULTS: In the non-operative group, 28% of the fractures took less than twelve weeks to unite, whereas in the operative group 60% of them took less than 12 weeks to unite. At the end of 1 year, there was no statistical difference in mean UCLA (University of California and Los Angeles) score and the mean DASH score of the non-operative group and operative group. There were more complications in the operative group. Re-operative rate in the operative group was 40%. Patient satisfaction was 80% in the non-operative group, whereas 48% of patients were satisfied in the operative group. CONCLUSION: Displaced and comminuted mid-shaft clavicle fractures treated conservatively have more advantages when compared to surgically treated fractures.

Postmortem diagnosis of acute haemorrhagic pancreatitis.

Forensic pathologists can help in the investigation of sudden unexpected deaths in co-operation with the officials responsible for the maintenance of law and order to administer justice. Sudden unexpected deaths form the subject of medicolegal investigation if they occur in apparently healthy individuals, wherein an autopsy would shed light regarding the cause of death. A 4 year retrospective review of autopsy files at the Department of Forensic Medicine, Kasturba Medical College, Mangalore, South India was undertaken for cases of sudden unexpected deaths due to acute haemorrhagic pancreatitis occurring between May 2004 and April 2008. A total of seven cases of acute haemorrhagic pancreatitis diagnosed at autopsy as the cause of sudden unexpected death during the study period are discussed herein.

Forensic evaluation of occupational marks in establishing identity--a case report.

The livings have responsibilities for the dead; and in particular, civilized societies recognize the need for identity both during life and at death, particularly in circumstances when an unknown body is summoned for medico-legal autopsy. There are numerous tools for identification of an unknown body which includes visual identification, fingerprints, medical prostheses, odontological techniques, DNA fingerprints and to include in the list is the occupational marks over the body sustained during the course of his or her profession. The medico-legal investigators should possess comprehensive knowledge of such occupational marks, which aid in identification. We are highlighting a case of rare entity, where a forensic evaluation of occupational marks was done to establish the identity of an unknown elderly male, who committed suicide by ligature hanging.

'Rib betrays heart'--a case report.

Penetrating or stab injuries of the chest are not uncommon and could be accidental, suicidal or homicidal. However, the present case discusses the importance of a careful examination of an unusual presentation in a motor vehicle accident. The case presented with haemopericardium and haemothorax due to penetrating rib injury to the heart, subsequent to blunt force trauma on the posterior chest wall. This case is highlighted, so that it becomes a necessary tool for the forensic experts to have an unprejudiced approach at autopsy and come to a reasonable conclusion.