Delayed Primary Suture After Severe Injuries of the Hand

Author(s):  
H. Georg
Author(s):  
Yasir. B. Elshambaty

Purpose this study aims to show the patterns and outcome of pediatric injury among those living in Albaha region in Saudi Arabia Methods this is a cross-sectional descriptive household-based study, included children between 0-17 years old both male and female. The data were collected with structured questionnaire between 20 Nov – 20 Dec 2018 and  analyzed with SPSS version 25 Results the total of participants was 257 injured child. 199(77.4%) are male and 58(22.6%) are female. About 44%of them were injured at pre-school level and 56% were traumatized at school age. The least incidence of injury occurred in those less than 2 yrs and higher incidence in those between 3-10 yrs old. The most common mechanism of injury was falling from height. The most affected group age by RTA accidents was 11-17 yrs old. Approximately 83% of the injured children required hospital management. Only one third of the injuries were  associated complications. The most common injured anatomic part was the upper limb and the least affected part was the spine. Only 5% of the injuries were associated with a disability and the common was loss of organ or part of it. Paralysis occurred in less than 1% and head injury resulted in disabilities more than 1%. Conclusion the vast majority of the injuries in our participants are not serious. The severe injuries were associated with RTA-related trauma. Most of injuries due to falling from height are not serious. We recommend not to allow the children to drive cars. Keywords: pediatric injuries; injury patterns; household.


2018 ◽  
Vol 1 (2) ◽  
pp. 180
Author(s):  
Achmad Ardiansyah Akbar

<p>Immunization is a mandatory program by government for every child in Indonesia. In 2016, however, the vaccine used for children’s immunization was found under standardized or unqualified. It was mixed with particular substances which might lead the users into some allergies, minor or severe injuries, trauma, and even danger their lives. Parents certainly fully entrusted their children’s immunization to the competent. The crime of producing, distributing, and using non-standard vaccines involved many parties both individuals and corporations, ranging from the task of producing, distributing, and up to injecting the vaccines into children. With the enormous profits of the crime, however, only private parties were sued while the corporations were still free from any accusation and thus, it made them have potential chances to redo such crime, violating medical laws, consumer protection laws, Money laundering legislation, and up to brand and geographical indications.</p><p>This study was a legal research with statute and conceptual approaches. It aimed to investigate the provisions of producing and distributing non-standard vaccines by corporations and to analyze their liability on such crime. The results, conclusions, suggestions, and recommendations for the problem were discussed.</p>


Author(s):  
Carmine Petruzziello ◽  
Paolo Maurizio Soave

Introduction: Disk Battery Ingestion (DBI) is a cause of access to the emergency department (ED), especially in pediatric age. This problem, if not well managed, may lead to serious injuries, with several complications involving the gastrointestinal and respiratory tract. Objective: Aim of this review is to analyze the literature of the last 25 years to make a decisional flow-chart that may help the emergency physician. Methods: For this review 36 articles have been analyzed (8 articles and 28 case reports), from 1995 to 2019. Data considered from each study were: year of publication, type of study, population studied, type of battery, timing of ingestion, treatment, outcomes, complications. Results: A decisional flow-chart has been configured. X-ray should be performed as a first step in every stable patient, meanwhile CT scan should be performed in unstable patients. When the battery is still localized in the esophagus, endoscopy should be performed as soon as possible, meanwhile, when the battery is beyond the esophagus, it should be noted its diameter before taking a decision. Conclusion: The use of the flow-chart proposed may reduce the risk of consequences and severe injuries for the patients, helping the emergency physician in his decisional process.


Author(s):  
Ann Hyland

This chapter examines the breeding and sustaining of warhorses. Horses refer to power in military and economic fields, and were sacrificed to the Sun before battle. Xenophon described the ideal warhorse. It was important for warhorses to have a good temperament. Some horses went willingly and repeatedly into battle. In war, horses would encounter camels and elephants, which were often employed in the armies of the east. Army animals could have lameness, injury, endemic diseases, and various common ailments. Puncture wounds were the most severe injuries in these animals. Tack gave the rider control over his horse and consisted firstly of bitting, secondly of saddlery. Seat security over horse could be achieved through a hard treed saddle with retentive front and rear horns. It is observed that some cavalry were armored, both men and horses.


Author(s):  
Miao Yu ◽  
Jinxing Shen ◽  
Changxi Ma

Because of the high percentage of fatalities and severe injuries in wrong-way driving (WWD) crashes, numerous studies have focused on identifying contributing factors to the occurrence of WWD crashes. However, a limited number of research effort has investigated the factors associated with driver injury-severity in WWD crashes. This study intends to bridge the gap using a random parameter logit model with heterogeneity in means and variances approach that can account for the unobserved heterogeneity in the data set. Police-reported crash data collected from 2014 to 2017 in North Carolina are used. Four injury-severity levels are defined: fatal injury, severe injury, possible injury, and no injury. Explanatory variables, including driver characteristics, roadway characteristics, environmental characteristics, and crash characteristics, are used. Estimation results demonstrate that factors, including the involvement of alcohol, rural area, principal arterial, high speed limit (>60 mph), dark-lighted conditions, run-off-road collision, and head-on collision, significantly increase the severity levels in WWD crashes. Several policy implications are designed and recommended based on findings.


2021 ◽  
Vol 36 (3) ◽  
pp. 251-259
Author(s):  
Michael Rozenfeld ◽  
Kobi Peleg ◽  
Adi Givon ◽  
Miklosh Bala ◽  
Gad Shaked ◽  
...  

AbstractIntroduction:Injury patterns are closely related to changes in behavior. Pandemics and measures undertaken against them may cause changes in behavior; therefore, changes in injury patterns during the coronavirus disease 2019 (COVID-19) outbreak can be expected when compared to the parallel period in previous years.Study Objective:The aim of this study was to compare injury-related hospitalization patterns during the overall national lockdown period with parallel periods of previous years.Methods:A retrospective study was completed of all patients hospitalized from March 15 through April 30, for years 2016-2020. Data were obtained from 21 hospitals included in the national trauma registry during the study years. Clinical, demographic, and circumstantial parameters were compared amongst the years of the study.Results:The overall volume of injured patients significantly decreased during the lockdown period of the COVID-19 outbreak, with the greatest decrease registered for road traffic collisions (RTCs). Patients’ sex and ethnic compositions did not change, but a smaller proportion of children were hospitalized during the outbreak. Many more injuries were sustained at home during the outbreak, with proportions of injuries in all other localities significantly decreased. Injuries sustained during the COVID-19 outbreak were more severe, specifically due to an increase in severe injuries in RTCs and falls. The proportion of intensive care unit (ICU) hospitalizations did not change, however more surgeries were performed; patients stayed less days in hospital.Conclusions:The lockdown period of the COVID-19 outbreak led to a significant decrease in number of patients hospitalized due to trauma as compared to parallel periods of previous years. Nevertheless, trauma remains a major health care concern even during periods of high-impact disease outbreaks, in particular due to increased proportion of severe injuries and surgeries.


2021 ◽  
pp. 194173812110129
Author(s):  
Kevin K. Chen ◽  
Jimmy J. Chan ◽  
William Ranson ◽  
Nicholas Debellis ◽  
Hsin-Hui Huang ◽  
...  

Background: Extensor mechanism injuries involving the quadriceps tendon, patella, or patellar tendon can be a devastating setback for athletes. Despite the potential severity and relative frequency with which these injuries occur, large-scale epidemiological data on collegiate-level athletes are lacking. Study Design: Descriptive epidemiology study. Level of Evidence: Level 4. Methods: Knee extensor mechanism injuries across 16 sports among National Collegiate Athletic Association (NCAA) men and women during the 2004-2005 to 2013-2014 academic years were analyzed using the NCAA Injury Surveillance Program (NCAA-ISP). Extensor mechanism injuries per 100,000 athlete-exposures (AEs), operative rate, annual injury and reinjury rates, in-season status (pre-/regular/postseason), and time lost were compiled and calculated. Results: A total of 11,778,265 AEs were identified and included in the study. Overall, 1,748 extensor mechanism injuries were identified, with an injury rate (IR) of 14.84 (per 100,000 AEs). N = 114 (6.5%) injuries were classified as severe injuries with a relatively higher median time loss (44 days) and operative risk (18.42%). Male athletes had higher risk of season-ending injuries in both all (3.20% vs 0.89%, P < 0.01) and severe (41.54% vs 16.33%, P < 0.01) extensor mechanism injuries. Similarly, contact injuries were more frequently season-ending injuries (4.44% vs 1.69%, P = 0.01). Women’s soccer (IR = 2.59), women’s field hockey (IR = 2.15), and women’s cross country (IR = 2.14) were the sports with the highest rate of severe extensor mechanism injuries. Conclusion: Extensor mechanism injuries in collegiate athletes represent a significant set of injuries both in terms of volume and potentially to their athletic careers. Male athletes and contact injuries appear to have a greater risk of severe injuries. Injuries defined as severe had a higher risk of operative intervention and greater amount of missed playing time. Clinical Relevance: Knowledge of the epidemiology of extensor mechanism injuries may help clinicians guide their athlete patients in sports-related injury prevention and management.


Hand Clinics ◽  
2001 ◽  
Vol 17 (3) ◽  
pp. 343-350
Author(s):  
Isam Atroshi ◽  
Hans-Eric Rosberg
Keyword(s):  

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