RESUMO
Thirty-two patients were treated for duodenal and associated injuries during the past five years. Fifty-nine per cent resulted from penetrating trauma, while 41 per cent were secondary to blunt injury. The incidence of blunt trauma represents a fourfold increase from previously published series. The morbidity rate still remains high at 47 per cent, with fistulas and infections being the most common complications. The mortality rate was 9.3 per cent, with death resulting from major intra-abdominal vascular injuries. Awareness of the potential injury to the duodenum, aggressive resuscitative measures, early operative management and improved postoperative care can lead to further reduction of these figures.
Assuntos
Duodeno/lesões , Traumatismos Abdominais/cirurgia , Idoso , California , Colo/lesões , Duodeno/cirurgia , Hematoma/cirurgia , Humanos , Perfuração Intestinal/cirurgia , Intestino Delgado/lesões , Fígado/lesões , Masculino , Métodos , Pâncreas/lesões , Complicações Pós-Operatórias , Ferimentos e Lesões/mortalidade , Ferimentos por Arma de Fogo/cirurgiaRESUMO
NMR is becoming an established diagnostic modality in many of the medical specialties. Seventy-four patients who underwent lumbar spine scans in this series were positive for herniated disk. Of that group, 35 underwent either traditional laminectomy with disk excision (19) or chemonucleolysis (16). All of the positive studies were confirmed at the time of the therapeutic procedure. Among the negative studies (78), three patients persisted in their complaints of pain and underwent subsequent myelogram enhanced CAT scans of the lumbar spine. All of these were negative. There are no known ill-effects of magnetic resonance imaging.
Assuntos
Deslocamento do Disco Intervertebral/diagnóstico , Imageamento por Ressonância Magnética , Humanos , Estudos RetrospectivosRESUMO
A case report of a 12-year-old boy who suffered a dislocated hip in a football game. He was unable to walk and was in severe pain when seen in the emergency room. Efforts at closed reduction of the displacement were complicated by the development of a transepiphyseal fracture.
Assuntos
Traumatismos em Atletas/terapia , Fraturas do Colo Femoral/etiologia , Luxação do Quadril/terapia , Manipulação Ortopédica/efeitos adversos , Pinos Ortopédicos , Criança , Epífises/lesões , Epífises/cirurgia , Fraturas do Colo Femoral/diagnóstico por imagem , Fraturas do Colo Femoral/cirurgia , Luxação do Quadril/diagnóstico por imagem , Humanos , Masculino , Manipulação Ortopédica/métodos , RadiografiaRESUMO
The authors, in performing anterior cruciate ligament reconstruction, have been using the central third of the patella tendon with a connected piece of patella for a transfer. In this paper they report a case in which the residual patella tendon itself ruptured and required a subsequent repair. The technique of repair is described. Diagnosis of the rupture was difficult. The authors also describe an experimental technique for assessing derangement of the knee.