Objective： To comparatively analyze the medical records of patients with limb fractures as well as rescue strategy in Wenchuan and Yushu earthquakes so as to provide references for post-earthquake rescue. Methods： ...Objective： To comparatively analyze the medical records of patients with limb fractures as well as rescue strategy in Wenchuan and Yushu earthquakes so as to provide references for post-earthquake rescue. Methods： We retrospectively investigated 944 patients sustaining limb fractures, including 891 in Wenchuan earthquake and 53 in Yushu earthquake, who were admitted to West China Hospital （WCH） of Sichuan University. Results： In Wenchuan earthquake, WCH met its three peaks of limb fracture patients influx, on post-earthquake day （PED） 2, 8 and 14 respectively. Between PED 3-14, 585 patients were transferred from WCH to other hospitals out- side the Sichuan Province. In Yushu earthquake, the maxi- mum influx of limb fracture patients happened on PED 3, and no one was shifted to other hospitals. Both in Wenchuan and Yushu earthquakes, most limb fractures were caused by blunt strike and crush/burying. In Wenchuan earthquake, there were 396 （396/942, 42.0%） open limb fractures, includ- ing 28 Gustilo I, 201 Gustilo II and 167 Gustilo III injuries. But in Yushu earthquake, the incidence of open limb fracture was much lower （6/61, 9.8%）. The percent of patients with acute complications in Wenchuan earthquake （167/891,18.7%） was much higher than that in Yushu earthquake （5/53, 3.8%）. In Wenchuan earthquake rescue, 1 018 surgeries were done, composed of debridement in 376, internal fixation in 283, external fixation in 119, and vacuum sealing drainage in 117, etc. While among the 64 surgeries in Yushu earthquake rescue, the internal fixation for limb fracture was mostly adopted. All patients received proper treatment and sur- vived except one who died due to multiple organs failure in Wenchuan earthquake. Conclusion： Provision of suitable and sufficient medi- cal care in a catastrophe can only be achieved by construc- tion of sophisticated national disaster medical system, pre- diction of the injury types and number of injuries, and con- flrmation of participating hospitals＇ exact role. Based on the valuable rescue experiences after Wenchuan earthquake, the rescue was faster, more orderly and effective in Yushu earthquake. Nevertheless, there is still a long way to go in the development of a stronger emergent response to the disasters.展开更多
Objective： Although long bone fracture in children is not life-threatening, it may cause major disability, loss of working days and severe psychological distress. We conducted this study to determine the pattern of e...Objective： Although long bone fracture in children is not life-threatening, it may cause major disability, loss of working days and severe psychological distress. We conducted this study to determine the pattern of extremity fracture due to trauma in children. Methods： During one year in six general hospitals in Tehran, trauma patients who were hospitalized for more than 24 hours and sustained injuries within seven days before admission were included in the study. The records of children （≤16 years old） hospitalized in six general hospitals in Tehran due to trauma were reviewed prospectively. Results： During the study period, 1 274 children had sustained extremity fractures. Male to female ratio was 3.6/ 1, with the mean age of （10.3±4.2） years. Falls and traffic crashes were the main causes of injuries, with the percentages of 57.3 % and 37.1%, respectively. Simple fall （falling on the ground） consisted 60% of patients that sustained fall-related injuries. Pedestrians and bicycle riders comprised most of the cases that were injured due to traffic crashes. Of our cases, 56.8% sustained fractures in the upper extremities and 43.2% in the lower extremities. Forearm was the most common fracture site （34.1%）. Comparing our results in preschool and school-age children, falls were the main cause of injuries in both groups, but fractures of lower extremities were significantly more common in preschool children. Conclusions： Improvement of physical condition of sidewalks and crossings in roads will be necessary for prevention of injuries. More attention to safety of home environment should be paid for control of preschools＇ injury at home. Education of children and adults is necessary to reduce injuries resulting from road traffic crashes.展开更多
Objective： Trauma in India is an increasingly significant problem, particularly in light of rapid development and increasing motorization. Social changes are resulting in alterations in the epidemiology of trauma. Th...Objective： Trauma in India is an increasingly significant problem, particularly in light of rapid development and increasing motorization. Social changes are resulting in alterations in the epidemiology of trauma. The aim of the study was to assess the various epidemiological parameters that influence the cause of injury in the patients admitted to a major trauma centre in northem India. Methods： An observational study of 748 patients chosen by random assortment was carried out over a peri- od of 1 year （August 2008 to July 2009）. Age, sex, injury type and pattern were noted. Injury mode of upper and lower limbs was also noted. Results： Injuries occur predominately in the age group of 15-30 years. Males incurred more injury with male to female ratio of 6：1. The most vulnerable group was motorcycle users. Among the injured, farmers were the most commonly involved. Blunt injuries （94.92%） were much more common than penetrating injuries. Among patients with head injury, two wheelers related accidents were the most common （40.3%）. Most spinal cord injuries were caused by falls from height （51.09%）. Most lower limb fractures were simple type. Compound fractures of the lower limb were more common than up- per limb fractures. Conclusion： Strict enforcement of traffic rules, combined with improved infrastructure and behavior change can decrease the burden of road traffic accidents in India and other developing countries. This study could assist in raising the profile of road traffic accidents as a public health problem which needs to be addressed as a preventable cause of mortality and morbidity, and plan- ning appropriate interventions for this major challenge. Preventive strategies should be made on the basis of these epidemiological trends.展开更多
OBJECTIVE: To assess the clinical curative effect of fuzi-cake-separated moxibustion at Zhongji(CV 3)and Guanyuan(CV 4) for preventing dysuria after internal fixation of lower limb fractures.METHODS: Sixty patients co...OBJECTIVE: To assess the clinical curative effect of fuzi-cake-separated moxibustion at Zhongji(CV 3)and Guanyuan(CV 4) for preventing dysuria after internal fixation of lower limb fractures.METHODS: Sixty patients conforming to the inclusion standards were randomly divided into a treatment group(n=30) and a control group(n=30).Fuzi-cake-separated moxibustion was performed at Guanyuan(CV 4) and Zhongji(CV 3), 20 min at a time, twice a day, for 3 days before operation in the treatment group. No fuzi-cake-separated moxibustion was performed in the control group. After treatment, the score for symptoms of first urination, urinary time, urinary volume, 24 h remaining urinary volume, incidence of uroschesis, and rate of controlling dysuria were compared to evaluate the curative effect of preventing post-operative dysuria.RESULTS: The score for symptoms of first urination,24 h remaining urinary volume(maximum 120 m L vs 250 m L, and less than 10 m L in 24 cases vs 15 cases), and the rate of controlling dysuria(83.34% vs30%) were significantly better(P<0.05, P<0.05, and P<0.001, respectively) in the treatment compared with the control group. There was no statistical difference(P>0.05) between the two groups in first post-operative urinary time, urinary volume, or incidence of 24 h uroschesis.CONCLUSION: Fuzi-cake-separated moxibustion at Zhongji(CV 3) and Guanyuan(CV 4) can better prevent post-operative dysuria, effectively promote the functional restoration of the urinary bladder,and control the incidence of post-operative dysuria.展开更多
Fall from height is a common cause of unintentional injuries in children and accounts for 6% of all trauma-related childhood deaths, usually from head injury. We report a case of a 2-year-old child with multiple fract...Fall from height is a common cause of unintentional injuries in children and accounts for 6% of all trauma-related childhood deaths, usually from head injury. We report a case of a 2-year-old child with multiple fractures of the bilateral lower limbs due to this reason. A child fell from a height of around 15 feet after toppling from a balcony. He developed multiple fractures involving the right femoral shaft, right distal femoral epiphysis (Salter Harris type 2), right distal metaphysis of the tibia and fibula, and undisplaced Salter Harris type 2 epiphyseal injury of the left distal tibia. There were no head, abdominal or spinal injuries. The patient was taken into emergency operation theatre after initial management which consisted of intravenous fluids, blood transfusion, and splintage of both lower limbs. Fracture of the femoral shaft was treated by closed reduction and fixation using two titanium elastic nails. Distal femoral physeal injury required open reduction and fixation with K wires. Distal tibia fractures were closely reduced and managed nonoperatively in both the lower limbs. All the fractures united in four weeks. At the last follow-up, the child had no disability and was able to perform daily activities comfortably. We also proposed the unique mechanism of injury in this report.展开更多
Scapulothoracic dissociation is a rare and complex injury pattern with varied presentation.Here we describe a case of a 32-year-old male who presented with scapulothoracic dissociation associated with brachial plexus ...Scapulothoracic dissociation is a rare and complex injury pattern with varied presentation.Here we describe a case of a 32-year-old male who presented with scapulothoracic dissociation associated with brachial plexus injury,along with scapholunate dissociation.We also propose an injury mechanism that might link the two injury patterns,suggesting that the association might be more than by chance.The patient was managed according to established trauma care and resuscitation protocols followed by open reduction and internal fixation of the clavicle fracture,and fixation of scapholunate dissociation and had a successful outcome at follow-up.展开更多
It is uncommon for tire explosion related injuries on the lower extremity. The bilateral lower extremities were injured by tire explosion when the patient was seated in a bus. She sustained an open fracture with parti...It is uncommon for tire explosion related injuries on the lower extremity. The bilateral lower extremities were injured by tire explosion when the patient was seated in a bus. She sustained an open fracture with partial bone loss in the right calcaneus （a comminuted fracture in the right ankle joint） and a closed comminuted fracture in the left tibia and fibula. This damage was caused by uncontacted tire explosion, thanks to a thick floor between the exploded tire and the patient＇s feet. This type of injury on lower extremity caused by uncontacted tire explosion was uncommon.展开更多
文摘Objective： To comparatively analyze the medical records of patients with limb fractures as well as rescue strategy in Wenchuan and Yushu earthquakes so as to provide references for post-earthquake rescue. Methods： We retrospectively investigated 944 patients sustaining limb fractures, including 891 in Wenchuan earthquake and 53 in Yushu earthquake, who were admitted to West China Hospital （WCH） of Sichuan University. Results： In Wenchuan earthquake, WCH met its three peaks of limb fracture patients influx, on post-earthquake day （PED） 2, 8 and 14 respectively. Between PED 3-14, 585 patients were transferred from WCH to other hospitals out- side the Sichuan Province. In Yushu earthquake, the maxi- mum influx of limb fracture patients happened on PED 3, and no one was shifted to other hospitals. Both in Wenchuan and Yushu earthquakes, most limb fractures were caused by blunt strike and crush/burying. In Wenchuan earthquake, there were 396 （396/942, 42.0%） open limb fractures, includ- ing 28 Gustilo I, 201 Gustilo II and 167 Gustilo III injuries. But in Yushu earthquake, the incidence of open limb fracture was much lower （6/61, 9.8%）. The percent of patients with acute complications in Wenchuan earthquake （167/891,18.7%） was much higher than that in Yushu earthquake （5/53, 3.8%）. In Wenchuan earthquake rescue, 1 018 surgeries were done, composed of debridement in 376, internal fixation in 283, external fixation in 119, and vacuum sealing drainage in 117, etc. While among the 64 surgeries in Yushu earthquake rescue, the internal fixation for limb fracture was mostly adopted. All patients received proper treatment and sur- vived except one who died due to multiple organs failure in Wenchuan earthquake. Conclusion： Provision of suitable and sufficient medi- cal care in a catastrophe can only be achieved by construc- tion of sophisticated national disaster medical system, pre- diction of the injury types and number of injuries, and con- flrmation of participating hospitals＇ exact role. Based on the valuable rescue experiences after Wenchuan earthquake, the rescue was faster, more orderly and effective in Yushu earthquake. Nevertheless, there is still a long way to go in the development of a stronger emergent response to the disasters.
文摘Objective： Although long bone fracture in children is not life-threatening, it may cause major disability, loss of working days and severe psychological distress. We conducted this study to determine the pattern of extremity fracture due to trauma in children. Methods： During one year in six general hospitals in Tehran, trauma patients who were hospitalized for more than 24 hours and sustained injuries within seven days before admission were included in the study. The records of children （≤16 years old） hospitalized in six general hospitals in Tehran due to trauma were reviewed prospectively. Results： During the study period, 1 274 children had sustained extremity fractures. Male to female ratio was 3.6/ 1, with the mean age of （10.3±4.2） years. Falls and traffic crashes were the main causes of injuries, with the percentages of 57.3 % and 37.1%, respectively. Simple fall （falling on the ground） consisted 60% of patients that sustained fall-related injuries. Pedestrians and bicycle riders comprised most of the cases that were injured due to traffic crashes. Of our cases, 56.8% sustained fractures in the upper extremities and 43.2% in the lower extremities. Forearm was the most common fracture site （34.1%）. Comparing our results in preschool and school-age children, falls were the main cause of injuries in both groups, but fractures of lower extremities were significantly more common in preschool children. Conclusions： Improvement of physical condition of sidewalks and crossings in roads will be necessary for prevention of injuries. More attention to safety of home environment should be paid for control of preschools＇ injury at home. Education of children and adults is necessary to reduce injuries resulting from road traffic crashes.
文摘Objective： Trauma in India is an increasingly significant problem, particularly in light of rapid development and increasing motorization. Social changes are resulting in alterations in the epidemiology of trauma. The aim of the study was to assess the various epidemiological parameters that influence the cause of injury in the patients admitted to a major trauma centre in northem India. Methods： An observational study of 748 patients chosen by random assortment was carried out over a peri- od of 1 year （August 2008 to July 2009）. Age, sex, injury type and pattern were noted. Injury mode of upper and lower limbs was also noted. Results： Injuries occur predominately in the age group of 15-30 years. Males incurred more injury with male to female ratio of 6：1. The most vulnerable group was motorcycle users. Among the injured, farmers were the most commonly involved. Blunt injuries （94.92%） were much more common than penetrating injuries. Among patients with head injury, two wheelers related accidents were the most common （40.3%）. Most spinal cord injuries were caused by falls from height （51.09%）. Most lower limb fractures were simple type. Compound fractures of the lower limb were more common than up- per limb fractures. Conclusion： Strict enforcement of traffic rules, combined with improved infrastructure and behavior change can decrease the burden of road traffic accidents in India and other developing countries. This study could assist in raising the profile of road traffic accidents as a public health problem which needs to be addressed as a preventable cause of mortality and morbidity, and plan- ning appropriate interventions for this major challenge. Preventive strategies should be made on the basis of these epidemiological trends.
基金Supported by Shaoxing's Science and Technology Plan(No.2012D10020):Clinical research of fuzi-cake-separated moxibustion for preventing dysuria after operation for fracture
文摘OBJECTIVE: To assess the clinical curative effect of fuzi-cake-separated moxibustion at Zhongji(CV 3)and Guanyuan(CV 4) for preventing dysuria after internal fixation of lower limb fractures.METHODS: Sixty patients conforming to the inclusion standards were randomly divided into a treatment group(n=30) and a control group(n=30).Fuzi-cake-separated moxibustion was performed at Guanyuan(CV 4) and Zhongji(CV 3), 20 min at a time, twice a day, for 3 days before operation in the treatment group. No fuzi-cake-separated moxibustion was performed in the control group. After treatment, the score for symptoms of first urination, urinary time, urinary volume, 24 h remaining urinary volume, incidence of uroschesis, and rate of controlling dysuria were compared to evaluate the curative effect of preventing post-operative dysuria.RESULTS: The score for symptoms of first urination,24 h remaining urinary volume(maximum 120 m L vs 250 m L, and less than 10 m L in 24 cases vs 15 cases), and the rate of controlling dysuria(83.34% vs30%) were significantly better(P<0.05, P<0.05, and P<0.001, respectively) in the treatment compared with the control group. There was no statistical difference(P>0.05) between the two groups in first post-operative urinary time, urinary volume, or incidence of 24 h uroschesis.CONCLUSION: Fuzi-cake-separated moxibustion at Zhongji(CV 3) and Guanyuan(CV 4) can better prevent post-operative dysuria, effectively promote the functional restoration of the urinary bladder,and control the incidence of post-operative dysuria.
文摘Fall from height is a common cause of unintentional injuries in children and accounts for 6% of all trauma-related childhood deaths, usually from head injury. We report a case of a 2-year-old child with multiple fractures of the bilateral lower limbs due to this reason. A child fell from a height of around 15 feet after toppling from a balcony. He developed multiple fractures involving the right femoral shaft, right distal femoral epiphysis (Salter Harris type 2), right distal metaphysis of the tibia and fibula, and undisplaced Salter Harris type 2 epiphyseal injury of the left distal tibia. There were no head, abdominal or spinal injuries. The patient was taken into emergency operation theatre after initial management which consisted of intravenous fluids, blood transfusion, and splintage of both lower limbs. Fracture of the femoral shaft was treated by closed reduction and fixation using two titanium elastic nails. Distal femoral physeal injury required open reduction and fixation with K wires. Distal tibia fractures were closely reduced and managed nonoperatively in both the lower limbs. All the fractures united in four weeks. At the last follow-up, the child had no disability and was able to perform daily activities comfortably. We also proposed the unique mechanism of injury in this report.
文摘Scapulothoracic dissociation is a rare and complex injury pattern with varied presentation.Here we describe a case of a 32-year-old male who presented with scapulothoracic dissociation associated with brachial plexus injury,along with scapholunate dissociation.We also propose an injury mechanism that might link the two injury patterns,suggesting that the association might be more than by chance.The patient was managed according to established trauma care and resuscitation protocols followed by open reduction and internal fixation of the clavicle fracture,and fixation of scapholunate dissociation and had a successful outcome at follow-up.
文摘It is uncommon for tire explosion related injuries on the lower extremity. The bilateral lower extremities were injured by tire explosion when the patient was seated in a bus. She sustained an open fracture with partial bone loss in the right calcaneus （a comminuted fracture in the right ankle joint） and a closed comminuted fracture in the left tibia and fibula. This damage was caused by uncontacted tire explosion, thanks to a thick floor between the exploded tire and the patient＇s feet. This type of injury on lower extremity caused by uncontacted tire explosion was uncommon.
