Objective:There is no safer way to transport a child than a school bus.Fatal crashes involving occupants are extremely rare events in the US.In recent years,school bus transportation began to develop in China.We want ...Objective:There is no safer way to transport a child than a school bus.Fatal crashes involving occupants are extremely rare events in the US.In recent years,school bus transportation began to develop in China.We want to bring advanced experience on school bus safety in Western countries such as the US to developing countries. Methods:We searched the papers related to school bus safety from Medline,Chinese Scientific Journals Database and the Web of the National Highway Traffic Safety Administration(NHTSA). Results:There were only 9 papers related to school bus safety,which showed that higher levels of safety standards on school buses,school bus-related transportation and environmental laws and injury prevention were the primary reasons for the desired outcome.Few school bus is related to deaths and injuries in the developed countries. Conclusions:The developing countries should make strict environmental laws and standards on school bus safety to prevent children's injury and death.展开更多
Objective： To assess the therapeutic results of open reduction and internal fixation with crossed K-wires via lateral approach for displaced supracondvlar fractures of the humerus in children. Methods： We prospecti...Objective： To assess the therapeutic results of open reduction and internal fixation with crossed K-wires via lateral approach for displaced supracondvlar fractures of the humerus in children. Methods： We prospectively followed 52 children who presented with Gartland type 3 displaced supraeondylar fractures of the humerus and were managed by open reduction and internal fixation with crossed K-wires via lateral approach.There were 37 male and 15 female patients; average age was 7.39 years. The most common mechanism of trauma was fall while playing （n=23）, followed by fall from height （n=20）, road traffic accidents （n-5） and fall from standing height （n=2）. In 2 cases, mode of injury was not available. The mean follow-up was 12 months and patients were assessed according to Flynn＇s criteria. Results： Lateral approach provided an excellent view of the lateral column between two nervous planes and enabled an anatomical reduction in all cases. Immobilizing the elbow at 90 degrees or more of flexion was not needed after cross K-wire fixation. Majority of patients regained full range of motion within 6 weeks of pin removal. Two patients had postoperative ulnar nerve injuries that resolved after pin removal. The common late complication of cubitus varus was not seen in any patient. Delayed presentation to the emergency department, repeated manipulations by bone setters and massage with edible oil were responsible for stiffness in 5 patients. Superficial pin tract infection was noted in 5 patients that resolved with dressings and antibiotics. No deep infection occurred. A detailed clinical examination and radiographic analysis was done at final follow-up. They included measurement of carrying angle and range of movements of both operated and normal sides, and radiographs of both upper limbs for comparison. According to Flynn＇s criteria, 90.4% patients showed satisfactory results. Conclusion： Lateral approach for open reduction and internal fixation of the widely-displaced supracondylar fracture of the humerus is safe and straightforward, ensuring anatomical reduction and excellent function. The approach is easy and familiar to most orthopedic surgeons in our setup.展开更多
Objective： Head injury （HI） is the leading cause of mortality and life-long disability in infants. Infants have different anatomical and pathophysiological brain structures from other age groups. The aim of this st...Objective： Head injury （HI） is the leading cause of mortality and life-long disability in infants. Infants have different anatomical and pathophysiological brain structures from other age groups. The aim of this study was to survey infant HI patients admitted to Shahid Behest Hospital in Kashan, Iran from 2004 to 2010, and to identify the causes of His in this age group. Methods： In this retrospective study, all HI patients under the age of two who were hospitalized for more than 24 hours between January 2004 and January 2010 were enrolled in the study. Demographic, etiologic, and injury data were collected and a descriptive analysis was performed. Results： Infants comprised 20.8% of all children （under 15 years old） with His and 65.1% of the injuries occurred in the home. Falls were the most common cause of injury （63.4%）. In hospital mortality was 6.6 per 100 000 infants. A decreasing trend was seen in home events, but His caused by traffic accidents were increasing during the study period. The amount of HI infants resulting from car accidents has tripled from the years 2004 to 2010. Conclusion： Although home events and falling are the main causes of infant His and need attention, our study showed an increase of His caused by road traffic accidents, especially by car accidents, thus legislation for the implementation of protective equipment such as child safety seats and programs is urgently needed.展开更多
文摘Objective:There is no safer way to transport a child than a school bus.Fatal crashes involving occupants are extremely rare events in the US.In recent years,school bus transportation began to develop in China.We want to bring advanced experience on school bus safety in Western countries such as the US to developing countries. Methods:We searched the papers related to school bus safety from Medline,Chinese Scientific Journals Database and the Web of the National Highway Traffic Safety Administration(NHTSA). Results:There were only 9 papers related to school bus safety,which showed that higher levels of safety standards on school buses,school bus-related transportation and environmental laws and injury prevention were the primary reasons for the desired outcome.Few school bus is related to deaths and injuries in the developed countries. Conclusions:The developing countries should make strict environmental laws and standards on school bus safety to prevent children's injury and death.
文摘Objective： To assess the therapeutic results of open reduction and internal fixation with crossed K-wires via lateral approach for displaced supracondvlar fractures of the humerus in children. Methods： We prospectively followed 52 children who presented with Gartland type 3 displaced supraeondylar fractures of the humerus and were managed by open reduction and internal fixation with crossed K-wires via lateral approach.There were 37 male and 15 female patients; average age was 7.39 years. The most common mechanism of trauma was fall while playing （n=23）, followed by fall from height （n=20）, road traffic accidents （n-5） and fall from standing height （n=2）. In 2 cases, mode of injury was not available. The mean follow-up was 12 months and patients were assessed according to Flynn＇s criteria. Results： Lateral approach provided an excellent view of the lateral column between two nervous planes and enabled an anatomical reduction in all cases. Immobilizing the elbow at 90 degrees or more of flexion was not needed after cross K-wire fixation. Majority of patients regained full range of motion within 6 weeks of pin removal. Two patients had postoperative ulnar nerve injuries that resolved after pin removal. The common late complication of cubitus varus was not seen in any patient. Delayed presentation to the emergency department, repeated manipulations by bone setters and massage with edible oil were responsible for stiffness in 5 patients. Superficial pin tract infection was noted in 5 patients that resolved with dressings and antibiotics. No deep infection occurred. A detailed clinical examination and radiographic analysis was done at final follow-up. They included measurement of carrying angle and range of movements of both operated and normal sides, and radiographs of both upper limbs for comparison. According to Flynn＇s criteria, 90.4% patients showed satisfactory results. Conclusion： Lateral approach for open reduction and internal fixation of the widely-displaced supracondylar fracture of the humerus is safe and straightforward, ensuring anatomical reduction and excellent function. The approach is easy and familiar to most orthopedic surgeons in our setup.
文摘Objective： Head injury （HI） is the leading cause of mortality and life-long disability in infants. Infants have different anatomical and pathophysiological brain structures from other age groups. The aim of this study was to survey infant HI patients admitted to Shahid Behest Hospital in Kashan, Iran from 2004 to 2010, and to identify the causes of His in this age group. Methods： In this retrospective study, all HI patients under the age of two who were hospitalized for more than 24 hours between January 2004 and January 2010 were enrolled in the study. Demographic, etiologic, and injury data were collected and a descriptive analysis was performed. Results： Infants comprised 20.8% of all children （under 15 years old） with His and 65.1% of the injuries occurred in the home. Falls were the most common cause of injury （63.4%）. In hospital mortality was 6.6 per 100 000 infants. A decreasing trend was seen in home events, but His caused by traffic accidents were increasing during the study period. The amount of HI infants resulting from car accidents has tripled from the years 2004 to 2010. Conclusion： Although home events and falling are the main causes of infant His and need attention, our study showed an increase of His caused by road traffic accidents, especially by car accidents, thus legislation for the implementation of protective equipment such as child safety seats and programs is urgently needed.
