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简介：Objective:Theextremityinjurypatternafteramajorearthquakeisnotwellunderstoodbecausedataonthistypeofinjuryandmanagementarelimited.Theaimofthisstudywastoanalyzethedataoftraumapatientswithex-tremityinjuryintheearthquakeofBarnIran,registering6.6ontheRichterscale.Methods:Wereviewedmedicalrecordsof486patientsadmittedtohospitalsofTehranUniversityofMedicalSciences.Amongthem,274patientssustainedextremityinjuries.Thisgroupwascomposedof138females(50.4%)and136males(49.6%)and213cases(77.7%)wereunder40yearsofage.Results:Fracturewasthemajortypeofinjury(58.4%ofextremityinjuries).Themostcommonsitesofinjurywerelowerextremities(185patients,67.5%ofallvictims).Pelvic&ribfracturesandabdominalinjurieswerethemostfre-quentlyassociatedinjuries.ThemeanISSwas6.2±4.0,and61%ofthepatientshadISS≤7.Amputationanddeathoccurredin2.9%and2.5%ofcases,respectively.Conclusions:Specialattentionshouldbegiventodeal-ingwithorthopedicinjuriesinsimilardisastersinthefuture.

简介：Thoughthebumperofavehicleplaysamajorroleinprotectingthevehiclebodyagainstdamageinlowspeedimpacts,manybumpers,particularlyinlargevehicles,aretoostiffforpedestrianprotection.Indesigningabumperforanautomobile,pedestrianprotectionisasimportantasbumperenergyabsorptioninlowspeedcollisions.Topreventlowerextremityinjuriesincar-pedestriancollisions,itisimportanttodeterminetheloadingsthatcarfrontstructuresimpartonthelowerextremitiesandthemechanismsbywhichinjuryiscausedbytheseloadings.Thepresentworkwasfocusedongainingmoreinsightintotheinjurymechanismsleadingtobothligamentdamageandbonefractureduringbumper-pedestriancollisions.TheEuropeanEnhancedVehicle-safetyCommittee(EEVC)legformimpactormodelwasintroducedandvalidatedagainstEEVC/WG17criteria.ThecollisionmechanismbetweenabumperandthislegformimpactorwasinvestigatednumericallyusingLS-DYNAsoftware.Toidentifytheeffectofthebumperbeammaterialonleginjuries,fouranalyseswereperformedonbumpersthathadthesameassemblybutweremadefromdifferentmaterials.

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简介：AbstractPost-burn contractures are common entities seen in developing countries. There are multiple reasons for the development of contractures, most are preventable. In extensive contractures, a strategic plan is necessary to release all contractures and yet not antagonize post-operative positions. It is also necessary to be cost-effective and minimize the number of surgeries needed. Conventionally the release sequence in extensive burn contractures is proximal to distal. In this case report, we discuss an unusual sequence where we released distal contractures before the proximal to achieve optimum results. A 3-year-old child with post-burn contracture of hand, wrist, elbow, and axilla was treated in 2 stages, with the release of wrist contracture and cover with pedicled abdominal flap in the first stage and division of pedicled flap with the release of axilla and elbow contracture in the second stage. Thus, the release of all contractures was achieved without antagonizing post-operative positions and minimized the number of surgeries. A case-based approach may be crucial in making a strategic surgical plan to minimize the rehabilitation phase, rather than following known dictums.

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简介：摘要ObjectivesTo investigate whether botulinum toxin type A (BTX-A) injection is more effective than radial extracorporeal shock wave therapy in reducing plantar flexor muscle spasticity in subjects with cerebral palsy.MethodsA total of 68 subjects with cerebral palsy were randomly allocated to BTX-A injection (Group 1) or radial extracorporeal shock wave therapy (Group 2) (first experiment; E1). Outcome was evaluated using the Tardieu V1 and V3 stretches, at 3 weeks, 2 months (M2) and M3 after baseline. At M6 subjects in Group 1 received radial extracorporeal shock wave therapy and subjects in Group 2 received BTX-A injection (second experiment; E2); outcome was evaluated as in E1. Treatment success was defined as improvement in foot dorsiflexion ≥10° when performing the V3 stretch at M2 in both experiments.ResultsIn both experiments mean V1 and V3 significantly improved over time. In E1 both treatments resulted in similar treatment success. In E2 fewer subjects treated with BTX-A injection reached the criteria of treatment success than did subjects treated with radial extracorporeal shock wave therapy, which was due to a carry-over effect from E1. No significant complications were observed.ConclusionBTX-A injection is not superior to radial extracorporeal shock wave therapy in the treatment of plantar flexor muscle spasticity in subjects with cerebral palsy.