Accidental falls among residents of homes for the elderly have only received scanty notice in the literature. During a period of 15 months, 296 falls among 1,856 residents of homes for the elderly were analyzed prospectively. The age-specific incidences for falls and fractures of the neck of the femur which are treated in hospital were found to be higher for residents of homes for the elderly as compared with elderly persons living at home in the age group 65-85 years. Residents of homes for the elderly who constitute 7% of all ages over 65 years are responsible for 21% of all accidental falls and 32% of all the lower limb fractures treated in hospital.
At the Centre for Torture and Trauma Survivors in Stockholm, 201 subjects from 34 countries were documented during a period of five years. Torture reports differed little between individuals from the same countries or regions, regarding methods and circumstances. Africans from Uganda (n = 22) reported brutal torture and manifested extensive scarring (mean number of scars, 20; range 4-65), whereas subjects from Syria (n = 28) reported falaka (i.e., bastinade), whipping and suspension, but manifested few or no scars (mean number 5, range 0-17). Of the subjects examined, 17% were women, of whom 79% reported having been raped during torture. Chronic back pain was the most common complaint at the time of examination. Correlation was found to exist between sexual torture and genito-urinary symptoms, bastinade and neural symptoms, and electrical torture and symptoms from the joints and gastro-intestinal tract. Severity of physical torture was a correlate of post-traumatic stress disorder. However, the forensic report had no effect on the verdict of immigration authorities regarding individual asylum applications.
Among 69 persons involved in a train crash, 53 were injured. Twenty-two persons were admitted to hospital. No-one was killed. There was a significantly increased risk of getting hurt when facing forward in the moving train. The mechanism of injury for the majority was being thrown forward and thereby hitting parts of the seats in front. The iron frames of the seats became exposed as some parts of the seats were only loosely attached. Arrangements to reduce injuries in train crashes could be an improved maintenance of the seats and their frames and the use of safety belts.
To describe the lessons learned from treatment of war casualties at a public hospital in Denmark.
A retrospective review of soldiers who underwent free flap reconstruction at Rigshospitalet, Denmark, between January 2006 and December 2010.
Nine patients were treated using free flaps. The age distribution was 21-34 years. Extremity fractures associated with considerable soft tissue loss were seen in all cases. The mean time from injury to reconstruction was 13.2 days. A total of 11 free flaps were used, the majority of which were latissimus dorsi flaps (seven out of 11). Flap-loss occurred in one patient, presumably due to leakage at the anastomotic site, which necessitated another free flap procedure. All patients received rehabilitation services following discharge from the inpatient unit, including prosthetic fitting. The mean follow-up time was 26 months.
This report is the first to detail the reconstructive procedures in soldiers treated at a public hospital in Denmark. The treatment of war casualties has not only been a challenge to the surgeons tasked with managing these devastating injuries, but also to Danish healthcare in general. The outcome of multidisciplinary treatment, combining the expertise of various specialties, is highly encouraging. The rate of complications was low, and the aesthetic appearance of the reconstructed limbs and the functional recovery were satisfactory. We therefore recommend the use of free flaps to reconstruct defects resulting from battlefield trauma.
AIMS: The aim of this study was to investigate how long the effect of peer victimization on the occurrence of physical injury lasts and whether the effect varies according to how frequently an injured child is victimized. METHODS: A case-crossover design was employed. Children aged 10-15 years residing in Stockholm County during two consecutive school years were eligible as cases. Further inclusion criteria were that the children had been hospitalized or called back for a medical check-up due to a physical injury. Information on children's exposure to peer victimization at school was gathered in interviews, and on their social characteristics through a questionnaire filled in by parents. A total of 575 children were included. RESULTS: Our analyses show that there is an increase in risk of unintentional injury after an episode of peer victimization shortly after the end of exposure to victimization (RR = 5.5) but not thereafter. The risk is substantially higher among children seldom victimized (RR = 49.9) than among those victimized on a more regular basis (RR = 2.5). The extent to which family social circumstances modify the risk is difficult to establish from the material at hand. CONCLUSION: Peer victimization may trigger the occurrence of unintentional injuries in childhood and the effect is short lasting. The results need to be replicated and special attention should be given to separating lesson time from break time to avoid confounding by time of day.
Prehospital undertriage occurs when the required level of care for a major trauma patient is underestimated and the patient is transported to a lower-level emergency care facility. One possible reason is that the pattern of injuries exceeding a certain severity threshold is not easily recognizable in the field. The present study aims to examine whether the injury patterns of major road trauma patients are associated with trauma centre transport decisions in Sweden, controlling for the distance from the crash to the nearest trauma centre and other patient characteristics.
The Swedish Traffic Accident Data Acquisition (STRADA) database was queried from April 2011 to March 2017. Teaching hospitals with neurosurgery capabilities were classified as trauma centres (TC), all other hospitals were classified as other emergency departments (ED). Injury Severity Score?=?13 was used as the threshold for major trauma. Ten common injury patterns were derived from the STRADA data; six patterns included serious neuro trauma to the head or spine. The remaining four patterns were: other severe injuries, moderate to serious abdomen injuries, serious thorax injuries and all other remaining injury patterns. Logistic regression was used to analyse the effect of injury patterns, age, sex and distance from crash to nearest TC on transport decision (TC or ED).
Of the 2542 patients, 38.0% were transported to a TC, equating to a prehospital undertriage of 62%. Over half (59.4%) of the patients had four or more Abbreviated Injury Scale (AIS) 2+ injuries. After controlling for age, sex and distance to nearest TC, only patients sustaining serious head injuries together with other severe injuries had significantly higher odds of being transported to a TC (OR?=?4.18, 95% CI: 2.03, 8.73). The odds of being transported to a TC decreased by 5% with every kilometre further away the crash location was to the nearest TC.
These results highlight that there is considerable prehospital undertriage in Sweden and suggest that distance to nearest TC is more influential in transport decisions than injury pattern. These results can be used to further develop prehospital transportation guidelines and designation of trauma centres.
On 3 December, 1999, at 15.00 pm, hurricane Adam struck Esbjerg (Denmark). Wind velocity exceeded 33 m/s, the strongest hurricane ever recorded in Denmark during the last century. This article describes and analyses the orthopaedic impact of the hurricane on a local hospital in Esbjerg.
We examined retrospectively all the patients treated at the Emergency Department from 3 pm on 3 December and for the following 24 hours. For comparison, we used the records of all patients treated at the Emergency Department in the same time interval on the first three Fridays in December from 1994 to 1998.
No hurricane-associated deaths were recorded, but the number of patients treated on 3 December was significantly higher than that recorded in the period 1994-1998 (159 versus 74, p