Minor Soft Tissue Injuries Research Articles

Cold Gel Reduced Pain and Disability in Minor Soft-Tissue Injury

1 Department of Orthopaedic Surgery, Johns Hopkins School of Medicine, JHOC #5251, 601 North Caroline Street, Baltimore, MD 21287. E-mail address: [email protected]

Micromechanics of Minor Cervical Spine Injuries.

Minor soft tissue injuries of the cervical spine are of increasing significance in public health. They may in particular be associated with long-term impairment. Such injuries are observed primarily in rear-end automobile collisions at low impact speeds and are attributed to a “whiplash”-type event. The question with respect to injury mechanisms of the cervical spine in cases of impacts of a low severity have raised controversial views in the past. Among proposed injury mechanisms, interactions between fluid and solid structures have been postulated: Viscous shear stresses or pressure gradients which arise in the deforming anatomical structures may have an adverse influence, e. g., on cellular membranes. In this communication, mathematical modeling approaches are presented which allow for a quantification of fluid/solid interactions under typical loading conditions of interest here. It is found, that the shear stresses caused by fluids and acting on accelerated surfaces of fluid-filled bodies depend largely on the size of the fluid space under consideration. Accelerations exhibit a stronger influence than their duration. It cannot be excluded that critical levels are reached even in a low speed impact scenario.

Serious Head Injury in Falls of Less than 20 Feet: Think Abuse

Source: Lallier M, Bouchard S, St-Vil D, et al. Falls from heights among children: a retrospective review. J Pediatr Surg. 1999:34;1060–1063.Lallier et al report on 64 patients from 1 to 18 years of age (mean age 7.4 years) who fell 10 feet or more as identified by retrospective chart review of 1,410 patients admitted after falls to Sainte-Justine Hospital in Montreal, Canada, from 1994–1997. Fifty (78%) fell from a height of 20 feet or less and 14 from a height of greater than 20 feet. Seventy percent (45) of the patients were male. Thirty-six percent of the patients were less than 4 years of age and 70% were less than 10 years old. Falls were from balconies (23%), windows (20%), and trees (14%). Two patients had minimal or no injuries, 55 (86%) sustained only a single major injury, and 7 had multiple system injuries. Head injuries were most frequent, occurring in 25 patients (39%), followed by extremity fractures (34%), abdominal injuries (12%), maxillofacial (8%), and spine injuries (6%). Twenty-two (88%) of the patients with head injuries were less than 10 years old and 48% were less than 5 years old. Among those with head trauma, 10 patients sustained skull fractures, 8 had concussion, and 7 had intra-cranial injuries. In contrast, abdominal injuries were more common in older children with 75% of these injuries occurring in children over 5 years of age. Abdominal injuries included splenic trauma in 5, kidney injury in 3, pancreatic trauma in 2, diaphragmatic injury in 2, and retro-peritoneal hematoma in 1.Of the 25 children sustaining head trauma, epidural hematoma occurred in 1 (4%) and subarachnoid hemorrhage occurred in 3 (12%). Concussion was seen in 8 (32%) and brain contusion seen in 3 (12%). There were no subdural hematomas. The only death in this series occurred after a 5-story, 50-foot fall. The authors’ conclusion was that significant injuries were infrequent in falls from less than 20 feet and most fall injuries in young children involved the head or musculoskeletal systems.More data are presented in this report to support the conclusion that children rarely sustain intra-cranial bleeding from falls under 20 feet.1,2 The only death in the series occurred after a plunge from 5 stories. Subdural hematoma was not recorded in any of the fall victims, and subarachnoid hemorrhage in only 2. Significant injuries (as opposed to linear skull fractures or minor soft tissue injuries) are not likely to be produced by short falls, and serious life-threatening injuries (with the exception of epidural hematomas) are virtually never caused by short falls. Abuse should be suspected in infants and young children who have significant head injuries—those involving subdural or subarachnoid hemorrhages—because these rarely occur in short falls.This is another in a series of papers on falls in children.3,4 The message from all of them is remarkably similar: serious injuries, especially serious head injuries, occurring in children are unlikely to be due to short (less than 20-foot) falls. Child abuse is a much more likely possibility.

Frostbite at the gym: a case report of an ice pack burn.

The case is reported of a 59 year old woman who suffered a 1% total body surface area superficial partial thickness burn to her calf following the application of an...

Fingertip trauma in children from doors.

Fingertip and nailbed trauma caused by doors is common in children, occurring when fingers are either shut in the door itself or are trapped in the hinge as the door is closed. An audit was carried out over five months of all fingertip and nailbed injuries due to trauma from a door. One hundred and eighty eight children, 2% of all attendances in this period, had sustained such trauma, 39% of these occurring in children under four years of age. One hundred and forty seven children (75%) had sustained relatively minor soft-tissue injury to the finger, However the remaining forty seven (25%) of the injuries sustained were more serious e.g. Avulsion of the nail from the nailbed or amputation of part of the fingertip and 29 (15%) of all the cases required a general anaesthetic for exploration, cleaning and repair. The Plastic Surgery department followed up these 29 children and 71 Accident & Emergency follow-up appointments were generated by the remaining injuries. The incidence of significant injury was higher than expected and caused considerable distress to both the children and their parents, It is suggested that home safety protocols should feature advice on how to avoid these injuries.

The acute management of minor soft tissue injuries.

The acute management of minor soft tissue injuries.

Risk Factors for Injurious Falls: a Prospective Study

We conducted a prospective study of the consequences of falls in 325 elderly community-dwelling persons, all of whom had fallen in the previous year. We contacted subjects every week for one year to ascertain falls and to determine the circumstances and consequences of falls. Only 6% of 539 falls resulted in a major injury (fracture, dislocation, or laceration requiring suture), but over half (55%) resulted in minor soft tissue injury. One in ten falls left the faller unable to get up for at least 5 minutes, and one in four falls caused subjects to limit their activities. The risk of injury per fall was about the same regardless of the number of falls a person had during follow-up. The risk of major injury was increased (age- and sex-adjusted odds ratio: 5.9, 95% confidence interval: 2.3-14.9) in falls associated with loss of consciousness compared to nonsyncopal falls. In multivariate analyses of nonsyncopal falls, the risk of major injury per fall was higher in persons having a previous fall with fracture (6.7; 2.1-21.5), a slower Trail Making B time (1.9; 1.1-3.2), and in Whites (18.4; 7.5-44.6). The risk that a nonsyncopal fall would result in minor injury (versus no injury) was increased in persons with a slower hand reaction time (1.8; 1.0-3.2) decreased grip strength (1.5; 1.0-2.3), in Whites (2.0; 1.0-3.7), in falls while using stairs and steps (2.2; 1.0-5.0), and turning around or reaching (3.5; 1.7-7.3). Our findings suggest that neuromuscular and cognitive impairment, as well as the circumstances of falls, affect the risk of injury when a fall occurs.

Management of civilian gunshot wounds in a Nigerian general hospital.

In a 3-year period (1981-1984), 52 male patients aged 10-60 years were treated for fresh gunshot wounds. The injuries varied from minor soft tissue injuries to major organ and tissue damage, and were all sustained by low-velocity missiles. Six of the patients (11.5%) died of their injuries or complications while 46 (88.46%) survived and were discharged after 1-15 weeks (a mean hospital time of 3 weeks). Some of the patients were treated before referral and for some there was a delay of more than 48 h before definitive specialist treatment. Mortality was related to the severity of wounding and the delay before treatment.

Thoracic emergencies. Indications for closed tube drainage and early open thoracotomy.

THE PROPER treatment of thoracic emergencies requires prompt and accurate diagnosis and well-supervised care. The early restoration of normal cardiopulmonary relationships and functions is the key to successful management of these cases. Needle aspiration, closed tube drainage, and the place for open thoracotomy are important decisions in the care of these patients. A progressive increase in the number of emergency chest cases seen at the University of Chicago Hospitals prompted a review of our recent case material and results. Civil disturbances and violence caused a large proportion of our cases. Case Material All thoracic emergencies seen in the emergency room of the University of Chicago Hospitals from 1960 through 1965 were reviewed. Excluded from this report were minor soft tissue injuries, such as bruises and superficial lacerations (Table 1). There were 238 patients ranging in age from 6 to 76 years with an average of 37.5 years. Males made up