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1
Lee, Sang-Hie, Kenneth B. Hanks, and Joseph Schwartz. "Pianist's Rehabilitation: Three Cases." Medical Problems of Performing Artists 20, no. 1 (March 1, 2005): 35–39. http://dx.doi.org/10.21091/mppa.2005.1006.
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Three pianists, each with academic and performing credentials, shared their experiences of physical problems, treatment, and rehabilitation. Preparing for solo performance puts an inordinate demand on mental and physical functioning and family life for the pianist in academia. Pianists, who must demonstrate technical and artistic prowess while teaching heavy loads, can easily overuse their piano-playing mechanisms by playing difficult works without proper conditioning and necessary rest. This can result in gradual or sudden bodily pain and incapacitation. Minor pains and injuries of the pianists profiled here were overcome by applying proper piano techniques. More serious injuries needed medical attention, alternative therapies, and combined management programs. With good health care and proper technical approach all three pianists resumed active performing life.
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Chen, Amy Y., Michael G. Stewart, and Glenn Raup. "Penetrating Injuries of the Face." Otolaryngology–Head and Neck Surgery 115, no. 5 (November 1996): 464–70. http://dx.doi.org/10.1177/019459989611500519.
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We reviewed 78 consecutive cases of penetrating facial injuries treated at Ben Taub General Hospital in Houston, Texas, between 1992 and 1994, and we analyzed injury patterns on the basis of (1) the mechanism of injury, and (2) the entry zone of the wounds. We found that gunshot wounds were more likely to require emergent airway establishment than shotgun wounds or stab wounds ( p = 0.03). We noted a higher prevalence of globe injury among shotgun wounds than among gunshot wounds ( p = 0.02). Nine (12%) patients had intracranial penetration of a bullet or shotgun pellet. Patients with gunshot wounds required open reduction and internal fixation of facial bone fractures more frequently than patients with shotgun wounds ( p = 0.01). Thirty patients underwent arteriograms, and 10 demonstrated positive findings. Although there were only 3 deaths in our series, 29 (37%) patients overall had some complication caused by their penetrating facial trauma, including blindness in 12 patients. There was no significant difference in the prevalence of complications between gunshot, shotgun, and stab wounds ( p = 0.18). With these injury patterns in mind, we describe an algorithm for evaluation and management of penetrating injuries of the face.
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Maslyakov, VV, EV Krjukov, VG Barsukov, KG Kurkin, PA Dorzhiev, and VR Gorbelik. "Heart injuries: main clinical symptoms." Laboratory diagnostics, no. 1 (February 27, 2019): 53–56. http://dx.doi.org/10.24075/brsmu.2019.003.
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Injuries to the heart are uncommon in peacetime, yet they result in life-threatening conditions, which makes timely diagnostics a crucial factor in saving patients' lives. In this connection, it is important to define the main signs of heart injuries. This study aimed to analyze the basic clinical symptoms associated with various wounds to the heart. We have retrospectively analyzed such symptoms registered in 86 patients with varying chest injuries that affect the heart. All patients were treated in the emergency surgery unit of the Engels Town Hospital from 1991 to 2017. 41 (47.6%) patient had stab wounds, and there were 45 (52.3%) cases of gunshot wounds. 23 (26.7%) patients had chest injuries affecting heart exclusively, while for 63 (73.2%) the consequences were wounds to other organs. We found that the clinical picture depends on the kind of injury to the heart: stab and slash wounds translate into more pronounced symptoms, while gunshot wounds do not produce such an effect. Accepting patients, practitioners should take this fact into account. The misdiagnosis rate for stab and slash heart wounds is 9.7%, that for gunshot wounds — 17.7%, the latter being the result of vagueness of the clinical picture. The clinical signs are most pronounced in the cases of stab and slash wounds to the heart.
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Shields, Nora, and Sara Dockrell. "The Prevalence of Injuries among Pianists in Music Schools in Ireland." Medical Problems of Performing Artists 15, no. 4 (December 1, 2000): 155–60. http://dx.doi.org/10.21091/mppa.2000.4030.
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The purpose of this study was to determine the prevalence of injuries among pianists in music schools in Ireland. The main objectives of the study were to investigate the anatomical locations of these injuries, the most commonly reported symptoms, and possible risk factors for the development of playing-related injuries. A hand-delivered questionnaire was distributed to 182 students from seven participating music schools. The lifetime prevalence for a playing-related injury, which prevented piano playing for a period of 48 hours or longer, was 25.8%. The wrist was the most common location of injury (36.6%). Pain was the most commonly reported symptom among the respondents. No statistically significant difference in the rate of injury was found between the genders. It was concluded that further research is required into the prevalence of injury and to the predisposing factors of injury so that effective prevention programs can be put in place.
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Winspur, Ian, and Katherine Butler. "Restoring Wrist Rotation in Injured Pianists and Violinists." Medical Problems of Performing Artists 24, no. 2 (June 1, 2009): 88–90. http://dx.doi.org/10.21091/mppa.2009.2018.
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Wrist fractures are common injuries in musicians, and a number of these fractures heal in a mal-united position, interfering with wrist rotation. This can prevent musicians who play keyboard instruments and the smaller string instruments from assuming the required wrist positions. Resection of the distal ulna (Darrach procedure), while somewhat discredited for the general population, has proved to be the ideal operation for this problem in musicians and has been used successfully on five professional musicians. This procedure, the rationale for its use in musicians, and the important technical details are discussed.
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Maurin, Olga, Stanislas de Régloix, Stéphane Dubourdieu, Hugues Lefort, Stéphane Boizat, Benoit Houze, Jennifer Culoma, Guillaume Burlaton, and Jean-Pierre Tourtier. "Maxillofacial Gunshot Wounds." Prehospital and Disaster Medicine 30, no. 3 (April 14, 2015): 316–19. http://dx.doi.org/10.1017/s1049023x1500463x.
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AbstractThe majority of maxillofacial gunshot wounds are caused by suicide attempts. Young men are affected most often. When the lower one-third of the face is involved, airway patency (1.6% of the cases) and hemorrhage control (1.9% of the cases) are the two most urgent complications to monitor and prevent. Spinal fractures are observed with 10% of maxillary injuries and in 20% of orbital injuries. Actions to treat the facial gunshot victim need to be performed, keeping in mind spine immobilization until radiographic imaging is complete and any required spinal stabilization accomplished. Patients should be transported to a trauma center equipped to deal with maxillofacial and neurosurgery because 40% require emergency surgery. The mortality rate of maxillofacial injuries shortly after arrival at a hospital varies from 2.8% to 11.0%. Complications such as hemiparesis or cranial nerve paralysis occur in 20% of survivors. This case has been reported on a victim of four gunshot injuries. One of the gunshots was to the left mandibular ramus and became lodged in the C4 vertebral bone.MaurinO, de RégloixS, DubourdieuS, LefortH, BoizatS, HouzeB, CulomaJ, BurlatonG, TourtierJP. Maxillofacial gunshot wounds. Prehosp Disaster Med. 2015;30(3):14.
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de Rooster, H., O. Taeymans, H. van Bree, and M. Risselada. "Penetrating injuries in dogs and cats." Veterinary and Comparative Orthopaedics and Traumatology 21, no. 05 (2008): 434–39. http://dx.doi.org/10.3415/vcot-07-02-0019.
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SummaryThe objective of this retrospective study was to assess radiographical and surgical findings, surgical management and outcome of penetrating injuries in dogs and cats by evaluating patient records. Sixteen patients were identified (15 dogs and one cat), four with gunshot wounds, and 12 with fight wounds (11 with bite wounds, one struck by a claw). The thoracic cavity was affected in six patients, the abdominal cavity in three cases. Both cavities were affected in five dogs and the trachea in two cases. All of the patients with fight wounds were small breed dogs. Multiple injuries to internal organs that required intervention were found surgically after gunshot wounds and a high amount of soft tissue trauma requiring reconstruction was present after fight wounds. Radiography diagnosed body wall disruption in two cases. All of the affected thoracic body walls in the fight group had intercostal muscle disruptions which was diagnosed surgically. Fourteen patients survived until discharge and had a good outcome. In conclusion, penetrating injuries should be explored as they are usually accompanied by severe damage to either the internal organs or to the body wall. A high level of awareness is required to properly determine the degree of trauma of intercostal muscle disruption in thoracic fight wounds.
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Rein, Susanne, Tobias Fabian, Hans Zwipp, Jan Heineck, and Stephan Weindel. "The Influence of Profession on Functional Ankle Stability in Musicians." Medical Problems of Performing Artists 25, no. 1 (March 1, 2010): 22–28. http://dx.doi.org/10.21091/mppa.2010.1005.
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OBJECTIVE: The aim of this study was to examine the influence of extensive work-related use of the feet on functional ankle stability among musicians. METHODS: Thirty professional organists were compared to professional pianists and controls. All participants completed a questionnaire. Range of motion (ROM), peroneal reaction time, and positional sense tests of the ankle were measured. The postural balance control was investigated with the Biodex Stability System for the stable level 8 and unstable level 2. Statistical analysis was done with the Kruskal-Wallis test, Mann-Whitney test with Bonferroni-Holm correction, and Fisher’s exact test. RESULTS: Nine of 30 organists compared to 5 of 30 pianists and controls reported ankle sprains in their medical history. Pianists had a significant increased flexion of both ankle joints compared to organists (p≤0.01) and increased flexion of the right ankle joint compared to controls (p=0.02). The positional sense test and postural balance control showed no significant differences among groups. The peroneal reaction time of the right peroneus longus muscle was significantly increased in pianists compared to controls (p=0.008). CONCLUSIONS: Organists have shown a high incidence of ankle sprains. Despite their extensive work-related use of the ankle joints, organists have neither increased functional ankle stability nor increased ROM of their ankle joints in comparison to controls. Pianists have increased flexion of the ankle joint, perhaps due to the exclusive motion of extension and flexion while using the pedals. To minimize injuries of the ankle and improve functional ankle stability as well as balance control, proprioceptive exercises of the ankle in daily training programs are recommended.
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Turner, Craig, Peter Visentin, and Gongbing Shan. "Wrist Internal Loading and Tempo-Dependent, Effort-Reducing Motor Behaviour Strategies for Two Elite Pianists." Medical Problems of Performing Artists 36, no. 3 (September 1, 2021): 141–49. http://dx.doi.org/10.21091/mppa.2021.3017.
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One of the greatest challenges in reducing high rates of performance injuries among musicians is in providing them usable tools to address playing-related musculoskeletal problems (PRMP) before they become disorders. Studies in biomechanics have the potential to provide such tools. In order to better understand the mechanisms through which PRMP manifest in pianists, especially in the distal segments of the upper limbs, the current study quantifies wrist internal loading (WIL) and wrist impact loading frequency. It does so while discussing pianists’ motor behaviours and observed effort-reduction strategies in the wrists as a function of anthropometry. This concept has great utility for performers. A VICON 3D motion capture system documented two expert pianists performing a B major scale, hands together, at 4, 6, 8, 9, and 10 notes/sec. Biomechanical modeling quantified WIL. Changes in motor behaviour were observed at 8 notes/sec. Individualized anthropometry influenced the range of motor strategies available to each pianist. The pianist with the larger hand span employed a flexion/extension wrist strategy as a compensatory means for effort reduction, while the pianist with the smaller hand span employed a radial/ ulnar deviation strategy. The current study provides a new perspective in addressing PRMP among pianists by rationalizing anthropometric potentials in terms of ergonomic parameters and documenting the availability and utility of effort-reduction strategies in the wrists during piano performance as performers consider PRMP risk and avoidance.
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Leppäniemi, Ari, and Reijo Haapiainen. "Occult Diaphragmatic Injuries Caused by Stab Wounds." Journal of Trauma: Injury, Infection, and Critical Care 55, no. 4 (October 2003): 646–50. http://dx.doi.org/10.1097/01.ta.0000092592.63261.7e.
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Bingol, Hakan. "Abdominal Vascular Injuries Due to Missile Wounds." Journal of Academic Research in Medicine 4, no. 1 (May 2, 2014): 25–27. http://dx.doi.org/10.5152/jarem.2013.03.
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Richards, John T., Archie Overmann, Jonathan A. Forsberg, and Benjamin K. Potter. "Complications of Combat Blast Injuries and Wounds." Current Trauma Reports 4, no. 4 (August 18, 2018): 348–58. http://dx.doi.org/10.1007/s40719-018-0143-1.
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Lee, Sang-Hie. "Hand biomechanics in skilled pianists playing a scale in thirds." Medical Problems of Performing Artists 25, no. 4 (December 1, 2010): 167–74. http://dx.doi.org/10.21091/mppa.2010.4034.
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Pianists, who attend to the integral relationship of their particular musculoskeletal characteristics to the piano technique at hand, discover an efficient path to technical advancement and, consequently, to injury prevention. Thus, a study of pianist's hand biomechanics in relation to different piano techniques is highly relevant, as hand features may influence various techniques in different ways. This study addressed relationships between pianists' hand biomechanics and the performance of a scale in thirds, as a part of an ongoing series of studies examining relationships between hand biomechanics and performance data of primary techniques. The biomechanics of hand length and width, finger length, hand span, hand and arm weights, and ulnar deviation at the wrist were compared with tempo, articulation, and dynamic voicing (tone balance between two notes of the thirds). Pearson correlation analysis showed a positive association between ulnar deviation and tempo; the other biomechanical features showed no relationships with any of the performance criteria. Qualitative cross-sectional observation of individual profiles showed that experienced pianists perform with a higher degree of synchrony in two-note descent while pianists with organ training background play with a lesser degree of synchrony. All biomechanical features were closely related among one another with one exception: wrist ulnar deviation was not associated with any other biomechanical features; rather, data suggest possible negative associations. This study underscores the importance of wrist mobility in piano skills development. Further research using a complete set of prototype piano techniques and multiple-level pianist-subjects could provide substantive biomechanical information that may be used to develop efficient pedagogy and prevention strategies for playing-related injuries as well as rehabilitation.
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Madsen, AS, GL Laing, JL Bruce, and DL Clarke. "A comparative audit of gunshot wounds and stab wounds to the neck in a South African metropolitan trauma service." Annals of The Royal College of Surgeons of England 98, no. 7 (September 2016): 488–95. http://dx.doi.org/10.1308/rcsann.2016.0181.
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Introduction The aim of this comparative study of gunshot wounds (GSWs) and stab wounds (SWs) to the neck was to quantify the impact of the mechanism of injury on the outcome and management of penetrating neck injury (PNI). Methods A prospective trauma registry was interrogated retrospectively. Data were analysed pertaining to demographics and injury severity score (ISS), physiology on presentation, anatomical site of wounds and injuries sustained, investigations, management, outcome and complications. Results There were 452 SW and 58 GSW cases over the 46 months of the study. Patients with GSWs were more likely to have extracervical injuries than those with SWs (69% vs 63%). The incidence of a ‘significant cervical injury’ was almost twice as high in the GSW cohort (55% vs 31%). For patients with transcervical GSWs, this increased to 80%. The mean ISS was 17 for GSW and 11 for SW patients. Those in the GSW cohort presented with threatened airways and a requirement for an emergency airway three times as often as patients with SWs (24% vs 7% and 14% vs 5% respectively). The incidence among GSW and SW patients respectively was 5% and 6% for airway injuries, 12% and 8% for injuries to the digestive tract, 21% and 16% for vascular injuries, 59% and 10% for associated cervical injuries, 36% and 14% for maxillofacial injuries, 16% and 9% for injuries to the head, and 35% and 45% for injuries to the chest. In the GSW group, 91% underwent computed tomography angiography (CTA), with 23% of these being positive for a vascular injury. For SWs, 74% of patients underwent CTA, with 17% positive for a vascular injury. Slightly more patients with GSWs required operative intervention than those with SWs (29% vs 26%). Conclusions Patients with GSWs to the neck have a worse outcome than those with injuries secondary to SWs. However, the proportion of neck injuries actually requiring direct surgical intervention is not increased and most cases with PNI secondary to GSWs can be managed conservatively with a good outcome. Imaging should be performed for all GSWs to the neck.
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Siracuse, Jeffrey, Alik Farber, Thomas W. Cheng, Yi Zuo, Douglas W. Jones, Jeffrey Kalish, and Bindu Kalesan. "IP259. Analysis of Vascular Injuries After Gunshot Wounds." Journal of Vascular Surgery 67, no. 6 (June 2018): e155. http://dx.doi.org/10.1016/j.jvs.2018.03.214.
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Campion, T., and S. Cross. "The spectrum of injuries in buttock stab wounds." Clinical Radiology 72, no. 7 (July 2017): 543–51. http://dx.doi.org/10.1016/j.crad.2017.02.009.
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Bradic, Nikola, Drazen Cuculic, and Ervin Jancic. "Terrorism in Croatia." Prehospital and Disaster Medicine 18, no. 2 (June 2003): 88–91. http://dx.doi.org/10.1017/s1049023x00000819.
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AbstractIntroduction:This report illustrates Croatia's experience with the terrorist attack in the city of Rijeka in October 1995. Also, the intention of this report is to outline how emergency services were functioning in this sudden-onset situation.Methods:The medical documentation of 27 wounded citizens in the attack was analyzed and the appearance of bodily wounds, severity of wounds, and the mechanisms of injury are described. From the forensic medical report, the wounds and damages sustained by the terrorist also were analyzed. All findings were compared with similar cases from around the world.Results:In the 27 wounded citizens, three (11%) had head injuries, and injuries of the abdomen in only two cases (7%) were found. The most common injuries sustained involved one or more extremities: 16 (59%) persons had wounds of an upper or lower extremity or a combination of multiple wounds. The main cause of death of the terrorist was explosive wounds to the chest and abdomen with destruction of multiple inner organs (primarily kidneys, liver, abdomen, and lung). Furthermore, the terrorist had a fracture of the skull base and multiple injuries to the brain.Conclusion:Comparing the findings with other data from the literature, the distribution in the percentages of wounded is almost the same as reported in many bomb attacks. In this case, the walls of the building protected many citizens, which is why so few were seriously injured. Forensic examination of the terrorist's body showed all of the characteristics of blast injuries.
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Ramasamy, A., SE Harrisson, MPM Stewart, and M. Midwinter. "Penetrating Missile Injuries During the Iraqi Insurgency." Annals of The Royal College of Surgeons of England 91, no. 7 (October 2009): 551–58. http://dx.doi.org/10.1308/003588409x464720.
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INTRODUCTION Since the invasion of Iraq in 2003, the conflict has evolved from asymmetric warfare to a counter-insurgency operation. This study investigates the pattern of wounding and types of injuries seen in casualties of hostile action presenting to a British military field hospital during the present conflict. PATIENTS AND METHODS Data were prospectively collected on 100 consecutive patients either injured or killed from hostile action from January 2006 who presented to the sole coalition field hospital in southern Iraq. RESULTS Eighty-two casualties presented with penetrating missile injuries from hostile action. Three subsequently died of wounds (3.7%). Forty-six (56.1%) casualties had their initial surgery performed by British military surgeons. Twenty casualties (24.4%) sustained gunshot wounds, 62 (75.6%) suffered injuries from fragmentation weapons. These 82 casualties were injured in 55 incidents (mean, 1.49 casualties; range 1–6 casualties) and sustained a total 236 wounds (mean, 2.88 wounds) affecting a mean 2.4 body regions per patient. Improvised explosive devices were responsible for a mean 2.31 casualties (range, 1–4 casualties) per incident. CONCLUSIONS The current insurgency in Iraq illustrates the likely evolution of modern, low-intensity, urban conflict. Improvised explosive devices employed against both military and civilian targets have become a major cause of injury. With the current global threat from terrorist bombings, both military and civilian surgeons should be aware of the spectrum and emergent management of the injuries caused by these weapons.
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Stekolnikov, A. A., and M. A. Ladanova. "TECHNOLOGICAL INJURIES IN INDUSTRIAL PIG FARMING." International bulletin of Veterinary Medicine 1 (2020): 135–39. http://dx.doi.org/10.17238/issn2072-2419.2020.1.135.
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Industrial injuries in pig farms of closed type are a very common pathology. Howev-er, nowadays, injury prevention and treat-ment of sick animals in the conditions of industrial pig breeding complex do not bring good results and require improvements. Ac-cording to the literature, there is no infor-mation about the results of the use of oint-ments and immuno- stimulators in the treat-ment of pigs with bitten wounds of the ears, tails and other parts of the body. In this re-gard, we have set a goal to develop therapeu-tic measures for injuries of piglets in a pig breeding complex of a closed type. We ana-lyzed the prevalence of industrial injuries in pigs. During the clinical examination, we studied the specific structures of injuries. The main cause of pigs injuries in industrial farming is cannibalism. In 28 days, 60% of pigs in the second experimental group, showed complete cicatrization of the wound, and 40% of animals showed this process regenerated on 85-95%, meanwhile 2 days they also had complete scarring of the wound. In 28 days, 50% of pigs of the third experimental group had a complete cicatriza-tion of the wound, and for 50% were ob-served scarring of the wound by 75-85%, and only after 4 days they demonstrated the complete scaring of the defect. For the treatment of bitten wounds as a result of developing cannibalism, it is recommended, to use local treatment of wounds with chlor-hexidine solution and argosulfan ointment daily 2 times a day and also to use the im-munostimulator “Ferrovir” in a dose of 1.0 ml/m2 per week. Such scheme of treatment of bitten wounds gives the best therapeutic effect.
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Yamamoto, Ryo, Mark Muir, and Alicia Logue. "Colon Trauma: Evidence-Based Practices." Clinics in Colon and Rectal Surgery 31, no. 01 (December 19, 2017): 011–16. http://dx.doi.org/10.1055/s-0037-1602175.
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AbstractColon injury is not uncommon and occurs in about a half of patients with penetrating hollow viscus injuries. Despite major advances in the operative management of penetrating colon wounds, there remains discussion regarding the appropriate treatment of destructive colon injuries, with a significant amount of scientific evidence supporting segmental resection with primary anastomosis in most patients without comorbidities or large transfusion requirement. Although literature is sparse concerning the management of blunt colon injuries, some studies have shown operative decision based on an algorithm originally defined for penetrating wounds should be considered in blunt colon injuries. The optimal management of colonic injuries in patients requiring damage control surgery (DCS) also remains controversial. Studies have recently reported that there is no increased risk compared with patients treated without DCS if fascial closure is completed on the first reoperation, or that a management algorithm for penetrating colon wounds is probably efficacious for colon injuries in the setting of DCS as well.
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Sizyi, M. Yu. "Septic complications in patients with neck wounds." Експериментальна і клінічна медицина 84, no. 3 (August 21, 2020): 64–66. http://dx.doi.org/10.35339/ekm.2019.84.03.10.
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Nowadays, we have been a steady increase in injuries as the social conditions of life and have changed. Statistically found that 54.0 % of people of car accidents have injuries to the head and neck. According to the literature, mortality in patients with neck injury which is complicating by pyoinflammatory persists up to 30.0-76.0 %. The management of neck trauma can be challenging and sometimes overwhelming, as this anatomical region contains many vital structures. These structures may pose a diagnostic and therapeutic dilemma. Our research based on the results of diagnosis and treatment of 124 patients with a purulent mediastinitis, complicating traumatic injuries of the neck organs. Among these men – 92 (74.2 %), women – 32 (25.8 %). The results of treatment depend on timely diagnosis, hospitalization in a specialized compartment and conducting active surgical tactics
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Park, So-Hyun, Sun-Young Ihm, Aziz Nasridinov, and Young-Ho Park. "A Feasibility Test on Preventing PRMDs Based on Deep Learning." Proceedings of the AAAI Conference on Artificial Intelligence 33 (July 17, 2019): 10005–6. http://dx.doi.org/10.1609/aaai.v33i01.330110005.
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This study proposes a method to reduce the playing-related musculoskeletal disorders (PRMDs) that often occur among pianists. Specifically, we propose a feasibility test that evaluates several state-of-the-art deep learning algorithms to prevent injuries of pianist. For this, we propose (1) a C3P dataset including various piano playing postures and show (2) the application of four learning algorithms, which demonstrated their superiority in video classification, to the proposed C3P datasets. To our knowledge, this is the first study that attempted to apply the deep learning paradigm to reduce the PRMDs in pianist. The experimental results demonstrated that the classification accuracy is 80% on average, indicating that the proposed hypothesis about the effectiveness of the deep learning algorithms to prevent injuries of pianist is true.
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Kaufman, Howard H. "Treatment of head injuries in the American Civil War." Journal of Neurosurgery 78, no. 5 (May 1993): 838–45. http://dx.doi.org/10.3171/jns.1993.78.5.0838.
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✓ At the time of the American Civil War (1861–1865), a great deal was known about closed head injury and gunshot wounds to the head. Compression was differentiated from concussion, but localization of lesions was not precise. Ether and especially chloroform were used to provide anesthesia. Failure to understand how to prevent infection discouraged physicians from aggressive surgery. Manuals written to educate inexperienced doctors at the onset of the war provide an overview of the advice given by senior surgeons. The Union experiences in the treatment of head injury in the Civil War were discussed in the three surgical volumes of The Medical and Surgical History of the War of the Rebellion. Wounds were divided into incised and puncture wounds, blunt injuries, and gunshot wounds, which were analyzed separately. Because the patients were not stratified by severity of injury and because there was no neuroimaging, it is difficult to understand the clinical problems and the effectiveness of surgery. Almost immediately after the war, increased knowledge about cerebral localization and the development of antisepsis (and then asepsis) permitted the development of modern neurosurgery.
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Oosthuizen, GV, VY Kong, T. Estherhuizen, JL Bruce, GL Laing, JJ Odendaal, and DL Clarke. "The impact of mechanism on the management and outcome of penetrating colonic trauma." Annals of The Royal College of Surgeons of England 100, no. 2 (February 2018): 152–56. http://dx.doi.org/10.1308/rcsann.2017.0147.
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Introduction In light of continuing controversy surrounding the management of penetrating colonic injuries, we set out to compare the outcome of penetrating colonic trauma according to whether the mechanism of injury was a stab wound or a gunshot wound. Methods Our trauma registry was interrogated for the 5-year period from January 2012 to December 2016. All patients over the age of 18 years with penetrating trauma (stab or gunshot) and with intraoperatively proven colonic injury were reviewed. Details of the colonic and concurrent abdominal injuries were recorded, together with the operative management strategy. In-hospital morbidities were divided into colon-related and non-colon related morbidities. The length of hospital stay and mortality were recorded. Direct comparison was made between patients with stab wounds and gunshot wounds to the colon. Results During the 5-year study period, 257 patients sustained a colonic injury secondary to penetrating trauma; 95% (244/257) were male and the mean age was 30 years. A total of 113 (44%) sustained a gunshot wound and the remaining 56% (144/257) sustained a stab wound. Some 88% (226/257) of all patients sustained a single colonic injury, while 12% (31/257) sustained more than one colonic injury. A total of 294 colonic injuries were found at laparotomy. Multiple colonic injuries were less commonly encountered in stab wounds (6%, 9/144 vs. 19%, 22/113, P < 0.001). Primary repair was more commonly performed for stab wounds compared with gunshot wounds (118/144 vs. 59/113, P < 0.001). Patients with gunshot wounds were more likely to need admission to intensive care, more likely to experience anastomotic failure, and had higher mortality. Conclusions It would appear that colonic stab wounds and colonic gunshot wounds are different in terms of severity of the injury and in terms of outcome. While primary repair is almost always applicable to the management of colonic stab wounds, the same cannot be said for colonic gunshot wounds. The management of colonic gunshot wounds should be examined separately from that of stab wounds.
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Bhandari, Prem Singh, Mrinal Kanti Mukherjee, and Sanjay Maurya. "Reconstructive challenges in war wounds." Indian Journal of Plastic Surgery 45, no. 02 (May 2012): 332–39. http://dx.doi.org/10.4103/0970-0358.101316.
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ABSTRACTWar wounds are devastating with extensive soft tissue and osseous destruction and heavy contamination. War casualties generally reach the reconstructive surgery centre after a delayed period due to additional injuries to the vital organs. This delay in their transfer to a tertiary care centre is responsible for progressive deterioration in wound conditions. In the prevailing circumstances, a majority of war wounds undergo delayed reconstruction, after a series of debridements. In the recent military conflicts, hydrosurgery jet debridement and negative pressure wound therapy have been successfully used in the preparation of war wounds. In war injuries, due to a heavy casualty load, a faster and reliable method of reconstruction is aimed at. Pedicle flaps in extremities provide rapid and reliable cover in extremity wounds. Large complex defects can be reconstructed using microvascular free flaps in a single stage. This article highlights the peculiarities and the challenges encountered in the reconstruction of these ghastly wounds.
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Till, Sophie. "The Taubman/Golandsky Approach to the Violin." Public Voices 12, no. 2 (November 23, 2016): 7. http://dx.doi.org/10.22140/pv.81.
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Three years ago Sophie Till started working with pianist Edna Golandsky, the leading exponent of the Taubman Piano Technique, an internationally acclaimed approach that is well known to pianists, on the one hand, for allowing pianists to attain a phenomenal level of virtuosity and on the other, for solving very serious piano-related injuries. Till, a violinist, quickly realized that here was a unique technical approach that could not only identify and itemize the minute movements that underlie a virtuoso technique but could show how these movements interact and go into music making at the highest level. Furthermore, through the work of the Golandsky Institute, she saw a pedagogical approach that had been developed to a remarkable depth and level of clarity. It was an approach that had the power to communicate in a way she had never seen before, despite her own first class violin training from the earliest age. While the geography and “look” on the violin are different from the piano, the laws governing coordinate motion specifically in playing the instrument are the same for pianists and violinists. As a result of Till’s work translating the technique for violin, a new pedagogical approach for violinists of all ages is emerging; the Taubman/Golandsky Approach to the Violin. In reflecting on these new developments, Edna Golandsky wrote, “I have been working with the Taubman Approach for more than 30 years and have worked regularly with other instrumentalists. However, Sophie Till was the first violinist who asked me to teach her with the same depth that I do with pianists. With her conceptual and intellectual agility as well as complete dedication to helping others, she has been the perfect partner to translate this body of knowledge for violinists. Through this collaboration, Sophie is helping develop a new ‘language’ for violinist that will prevent future problems, solve present ones and start beginners on the right road to becoming the best they can be. The implications of this new work for violinists are enormous.”
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HAIDER RIZVI, SYED IJLAL, Khurram Sohail, MUHAMMAD ASLAM, and Humaira Arshad. "FIREARM WOUNDS." Professional Medical Journal 17, no. 01 (March 10, 2010): 68–72. http://dx.doi.org/10.29309/tpmj/2010.17.01.1984.
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Objectives: To study the different changes occurring at cellular level in firearm injuries from near to distant shots. StudyDesign: A prospective Study. Place and Duration of Study: Khyber Teaching Hospital Peshawar and B.V Hospital Bahawalpur. Material &Methods: Bodies presenting for autopsy within 12 hours after firearm injury were included. Wounds expressing maximum details were selectedfor study. Tissue samples were taken from wounds and preserved in 10% formalin. Sections were taken and slides were stained with HarrisHaemotoxylin. Olympus P-6 was used for photography and Nikon ( FE-2 body) for gross and microscopic photography. Results: Themorphology at cellular level was variable according to the distance of fire. Marked distortion and streaming of nuclei was more pronounced andevident in close contact wounds. However changes were less pronounced with the increasing distance. Section of exit lesion reveled splittingbetween dermis and epithelium. Further in this study rifle fire fatalities were maximum (53.33%) and distant shot fatalities were predominant(73.33%.). Conclusion: Microscopy can also be used as an additional tool to differentiate between entry and exit wounds and for estimatingrange of fire.
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Jha, Shilpa, Wasim S. Khan, and Nashat A. Siddiqui. "Mammalian Bite Injuries to the Hand and Their Management." Open Orthopaedics Journal 8, no. 1 (June 27, 2014): 194–98. http://dx.doi.org/10.2174/1874325001408010194.
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Bite wounds are a common form of hand injury with the potential to lead to severe local and systemic sequelae and permanent functional impairment. Mammalian bite wounds may be caused by a variety of animal class and species; injuries resulting from dogs, cats and humans are the most widely discussed and reported in the literature. Bite wounds may be contaminated with aggressive pathogens and the anatomical vulnerability of structures within the hand means that without early recognition and treatment with irrigation and antibiotics, alongside a low index of suspicion for deep structural involvement requiring formal surgical exploration and washout, the consequences of such injuries can be disastrous. We review the literature and discuss the epidemiology, pathophysiology and microbiology relating to these injuries, as well as clinical aspects including signs, symptoms, and management.
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Trukhan, A. P., D. V. Alkhovik, I. G. Kosinsky, V. A. Koryachkin, V. A. Porkhanov, and I. Yu Zherkal. "REPUBLICAN CENTER FOR TREATMENT OF GUNSHOT WOUNDS AND MINE-EXPLOSIVE INJURIES: 3 YEARS OF EXPERIENCE AND TRENDS OF DEVELOPMENT." Novosti Khirurgii 29, no. 2 (April 21, 2021): 207–12. http://dx.doi.org/10.18484/2305-0047.2021.2.207.
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Objective. To evaluate the results of organizational measures for improving the efficiency of the Republican Center for the treatment of gunshot wounds and mine-explosive injuries. Methods. The study is based on an analysis of the work of the Republican Center for the treatment of gunshot wounds and mine-explosive injuries and includes patients (n=54) who were treated from November 1, 2016 to October 31, 2019. Gunshot wounds were detected in 42 patients (77.8%). Explosive trauma was detected in 12 patients (22.2%). The most common causes of injuries were personal carelessness (20 cases (37.0%)), carelessness of others (16 cases (29.6%)), suicidal attempts (9 cases (16.6%)). In accordance with the purpose of the survey, three equal time intervals (three periods) each being equal to one year were studied. The following indicators were analyzed: the number of patients, the time from the moment of injuring to hospitalization, the type of patient’s transportation, the quality of surgical care at the hospitalization stages. Results. Implementation of the proposed organizational measures allowed increasing the number of patients hospitalized into the Republican Center for the treatment of gunshot wounds and mine-explosive injuries during the third year of work by 66.7% and 78.6%, respectively, compared with the previous time intervals. The frequency of hospitalization of patients within 24 hours after receiving an injury increased from 66.7% to 72.7%, and among patients who are not military personnel - from 45.5% to 69.2%. The proportion of errors in the treatment of patients with gunshot wounds and explosive injuries decreased by 34.0%. Conclusion. The proposed organizational measures allowed increasing the efficiency of the Republican Center for the treatment of gunshot wounds and mine-explosive injuries. In the future, it is advisable to continue close cooperation with healthcare organizations and to improve the regulatory framework for the treatment of gunshot wounds of various localization. What this paper adds The paper presents the results of the analysis of three-year work of the RepublicanCenter for the treatment of gunshot wounds and mine-explosive injuries.Realization of the proposed organizational measures allowed increasing the number of hospitalized patients, shortening the period from injury to hospitalization, and reducing the number of errors in patient care.
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Grimell, Jan. "Veterans, the hidden wounds of war, and soul repair." Spiritual Care 7, no. 4 (October 8, 2018): 353–63. http://dx.doi.org/10.1515/spircare-2018-0008.
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AbstractTo better understand how deployment in war zones and/or combat may inflict emotional wounds upon veterans, researchers, clinicians, and caregivers it was recently started to focus on the concepts of moral and spiritual injuries. Such injuries may remain undiscovered during psychiatric screening for posttraumatic stress disorder. What is often missing, however, is a conceptualization of the part of the self which is implicitly related to emotional wounds caused by moral and spiritual injuries. This article utilizes a number of historical and contemporary conceptualizations of what is called the soul, and their implications for pastoral and spiritual care of emotionally wounded veterans. Moreover, it explores the use of biblical stories in pastoral and spiritual care among veterans suffering from moral and spiritual injuries.
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Rouse, D. A. "Patterns of Stab Wounds: A Six Year Study." Medicine, Science and the Law 34, no. 1 (January 1994): 67–71. http://dx.doi.org/10.1177/002580249403400110.
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A series of 156 consecutive deaths from stabbing were analysed for age and sex of victim, number and size of wounds, the incidence and pattern of defence wounds, the association with other injuries and the pattern of self-inflicted wounds.
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Newlands, Shawn D., Sreedhar Samudrala, and W. Kevin Katzenmeyer. "Surgical Treatment of Gunshot Injuries to the Mandible." Otolaryngology–Head and Neck Surgery 129, no. 3 (September 2003): 239–44. http://dx.doi.org/10.1016/s0194-5998(03)00481-9.
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OBJECTIVES: Our goal was to review and identify risk factors for complications from treatment of mandible fractures due to gunshot wounds. STUDY DESIGN AND SETTING: We conducted a retrospective review of treatment outcomes in 90 patients with gunshot wounds to the mandible treated over a 10-year period at 2 tertiary care centers. RESULTS: Our series of 90 patients with mandibular injuries due to gunshot wounds included 68 patients who underwent surgical procedures on the mandible. There were 14 complications in this group. Complications were more common in patients whose mandibles were rigidly fixated; however, these patients' injuries were more severe. Complications were significantly increased in patients who lost a segment of mandible in the injury. CONCLUSIONS: Complications were related to severity of injury and independent of treatment modality. SIGNIFICANCE: The complication rate for patients with gunshot injuries can be very high, particularly if bone is missing. Stabilization of remaining mandibular segments with potentially multiple subsequent reconstructive procedures is often required to restore mandibular continuity in these patients.
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Cicák, A., and I. Mihál. "Can artificial wounding of beech stems induce necroses?" Journal of Forest Science 51, No. 12 (January 10, 2012): 559–63. http://dx.doi.org/10.17221/4588-jfs.
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The paper presents data on the induction of necroses after small injuries to beech stems caused by electrodes during measuring cambium electric resistance. Altogether 121 beech stems of tree class 1–3 (according to Kraft) were evaluated. Among 2,904 mechanical injuries in 121 stems evaluated (24 per stem), 155 injuries induced necroses, hence each 19<sup>th</sup> injury induced necrosis. Most stems (33.06%) showed one necrosis, few stems (4.96%) showed even four necroses. 28.93% of stems did not show any necrosis. In order to prevent the infection of wounds and subsequent induction of necroses the authors recommend to treat any wounds with a suitable fungicide after using an equipment causing even negligible wounds of stems.
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Guo, Ying, and Faye Y. Chiou-Tan. "Radial Nerve Injuries from Gunshot Wounds and Other Trauma." American Journal of Physical Medicine & Rehabilitation 81, no. 3 (March 2002): 207–11. http://dx.doi.org/10.1097/00002060-200203000-00009.
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Mitchell, S. Weir, George R. Morehouse, and William W. Keen. "THE CLASSIC: Gunshot Wounds and Other Injuries of Nerves." Clinical Orthopaedics and Related Research 458 (May 2007): 35–39. http://dx.doi.org/10.1097/blo.0b013e31803df02c.
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Waters, Robert L., and Ien H. Sie. "Spinal Cord Injuries From Gunshot Wounds to the Spine." Clinical Orthopaedics and Related Research 408 (March 2003): 120–25. http://dx.doi.org/10.1097/00003086-200303000-00014.
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Kendrick, Richard W. "Management of Gunshot Wounds and Other Urban War Injuries." Oral and Maxillofacial Surgery Clinics of North America 2, no. 1 (February 1990): 55–68. http://dx.doi.org/10.1016/s1042-3699(20)30414-3.
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Williams, David T., Danny L. Chang, and Matthieu P. DeClerck. "Penetrating spinal cord injuries with retained canal fragments." CJEM 11, no. 02 (March 2009): 172–73. http://dx.doi.org/10.1017/s1481803500011155.
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Case 1: A previously healthy 15-year-old boy was brought by paramedics to the emergency department (ED) after suffering multiple penetrating gunshot wounds (GSWs) to the lower extremities and a single entry to the left suprascapular region. Vital signs were within normal limits upon presentation. Case 2: A previously healthy 19-year-old man was brought by paramedics to the ED after suffering multiple stab wounds to the back. The patient was hypoxic and in severe respiratory distress upon arrival. A left thoracostomy tube was placed. Clinically the patient improved and vital signs returned to normal.
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Singh, Deepak Kumar, Vishnu Gupta, Sanjeev Chopra, Pankaj Gupta, and H. Bagaria. "Teeth in the brain: An unusual presentation of penetrating head injury." Indian Journal of Neurotrauma 05, no. 02 (December 2008): 117–18. http://dx.doi.org/10.1016/s0973-0508(08)80013-5.
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AbstractPenetrating injuries other than gunshot wounds or low-velocity wounds to the head are extremely rare. We report the case of a 19 year old male who sustained a penetrating craniocerebral trauma following a road traffic accident. Mechanism of injury seems to share characteristics of low velocity projectiles. We discuss the management of this unusual case reviewing the current literature on craniocerebral injuries caused by similar objects.
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Singh, Niten, Eric Bluman, Benjamin Starnes, and Charles Andersen. "Dynamic Wound Closure for Decompressive Leg Fasciotomy Wounds." American Surgeon 74, no. 3 (March 2008): 217–20. http://dx.doi.org/10.1177/000313480807400307.
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Decompressive fasciotomy for preservation of lower extremity function and salvage is an essential technique in trauma. The wounds that result from the standard two incision four-compartment leg fasciotomy are often accompanied by a wide soft tissue opening that in the face of true compartment syndrome are often impossible to close in a delayed primary fashion. We describe a technique using a device that allows for dissipation of the workload across the wound margin allowing for successful delayed primary closure. Consecutive patients who presented to the 28th Combat Support Hospital in Baghdad, Iraq with a diagnosis of compartment syndrome of the leg, impending compartment syndrome of the leg, or compartment syndrome of the leg recently treated with fasciotomies were followed. All patients underwent placement of the Canica dynamic wound closure device (Canica, Almonte, ON, Canada). Eleven consecutive patients treated at a combat support hospital in support of Operation Iraqi Freedom underwent four-compartment fasciotomies for penetrating injuries. There were five patients that underwent a vascular repair [three superficial femoral artery (SFA) injuries and two below knee popliteal artery injuries] and six patients that had orthopedic injuries (three comminuted tibial fractures, two fibula fractures, and one closed pilon fracture). Patients returned to the operating room within 24 hours for washout and wound inspection. Mean initial wound size was 8.1 cm; mean postplacement size was 2.7 cm; average time to closure was 2.6 days. All patients were able to undergo primary wound closure of the medial incision and placement of the Canica device over the lateral incision. Ten of the 11 patients (91%) could be closed in delayed primary fashion after application of the device. In our series of patients with penetrating wartime injuries and compartment syndrome of the leg we have found the use of this dynamic wound closure device to be extremely successful and expedient.
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Bajec, Djordje, Dejan Radenkovic, Pavle Gregoric, Vasilije Jeremic, Vladimir Djukic, Nenad Ivancevic, Borivoje Karadzic, et al. "Hirursko lecenje povreda jetre - petogodisnje iskustvo." Acta chirurgica Iugoslavica 57, no. 4 (2010): 9–14. http://dx.doi.org/10.2298/aci1004009b.
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Due to improved methods of treatment and management of hemorrhage, the mortality from liver injuries has decreased significantly over the past few decades. In spite of that, liver injuries still represent diagnostic and therapeutic challenge. This retrospective study included 197 patients surgically treated because of trauma of the liver at The Clinic for Emergency Surgery, during the period 2004-2009. The results showed significant difference in mortality rates in cases of penetrating wounds compared to blunt trauma and gunshot wounds. The severity of injury evaluated by Organ Injury Scale was significantly higher in gunshot wounds compared to blunt and penetrating trauma. The correlation of severity of injuries and mortality rates showed that the mortality is significantly lower in patients with grade 1, 2, and 3 injuries compared to grades 4 and 5 (p=0.016). Specific complication rate was 28.4%, while mortality rate was 21.8%. The results reflect diagnostic and treatment problems, as well as the importance of multidisciplinary approach to the patients with liver trauma.
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Vasil’ev, A. Yu, and I. S. Obelchak. "Multidetector computed tomography in the diagnosis of lesions of the main vessels for gunshot injury of the chest." Regional blood circulation and microcirculation 18, no. 1 (May 3, 2019): 31–38. http://dx.doi.org/10.24884/1682-6655-2019-18-1-31-38.
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Purpose – examine the possibilities of multislice computed tomangiography (MSCTA) in case of suspected damage to the great vessels in a chest gunshot fghting injury.Material and methods. A radiation survey of 130 wounded with gunshot injuries of the chest to assess the nature, diagnosis of gunshot injuries of the vascular bed.Results. Of the 130 wounded with gunshot wounds to the chest, 41 (31.5 %) of the injured had gunshot wounds to the chest were nonpenetrating, and 89 (68.5 %) had penetrating injuries. In 76 (58.4 %) patients with gunshot chest injuries, the nature of the wound was fragmentation, in 54 (41.6 %), wounds were bullet wounds. In the algorithm of radiation examination of patients with gunshot wounds of the chest to identify the nature of damage to the organs of the mediastinum and vascular structures, the main method of visualization was MSCT with contrast enhancement. Damage to the bone skeleton of the chest (ribs, collarbone, sternum, scapula) by MSCT was observed in 23 (17.6 %) patients. Almost half – 66 (50.1 %) of the wounded with gunshot injuries during MSCT examination, traumatic injury (pulmonitis) of the lung was observed. In 2 (1.5 %) cases, damage to the heart was detected that was not recognized at the stage of skilled surgical care. False posttraumatic aneurysm of the thoracic aorta was diagnosed in two wounded. Accuracy, sensitivity, specifcity of MSCT angiography in imaging of the vascular bed and diagnosis of damage to the great vessels of the chest cavity was 98, 97 and 97 %, respectively.Conclusions. MSCT made it possible to reliably assess the nature of the gunshot injuries of the chest, identify timely damage to the great vessels of the mediastinum, determine the localization of the foreign injuring bodies near the vascular structures, and determine the surgical tactics.
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Volk, Angela S., Tom Shokri, Mofiyinfolu Sokoya, Yadranko Ducic, and Larry H. Hollier. "Facial Gunshot Wounds." Facial Plastic Surgery 35, no. 06 (November 29, 2019): 578–83. http://dx.doi.org/10.1055/s-0039-1700879.
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AbstractCraniomaxillofacial gunshot injuries, resulting from assault, suicide attempts, and accidental trauma, represent a major public health dilemma in the United States. Due to the extent of injury and resulting osseous and soft tissue loss, facial gunshot wounds pose a unique challenge to the reconstructive surgeon. Initial management should use advanced trauma life support principles with the goal of patient stabilization. Acute operative management should center around wound decontamination, debridement, and temporary closure. Historically, definitive surgical management focused on delayed reconstruction secondary to high rates of wound infections, necrosis, and ischemia. With improvements in imaging modalities, the advent of virtual surgical planning, and the popularization of microvascular free flaps, contemporary methods have shifted toward earlier more definitive reconstruction. Autologous free tissue transfer has resulted in a decrease in hospital stay and the number of overall surgeries. Importantly, due to the variability in injury pattern and complexity in reconstruction, a systematic approach toward intervention is needed to mitigate complications and optimize overall functional and aesthetic outcomes.
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Chierice, João, Geraldo Figueiredo, Moyses Lima-Filho, Igo Lago, Rodrigo Costa, and José Marin-Neto. "Hybrid interventional and surgical treatment of complex traumatic cardiac dagger wounds." Journal of Transcatheter Interventions 29 (July 1, 2021): 1–5. http://dx.doi.org/10.31160/jotci202129a20210008.
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Penetrating injuries to the heart are usually devastating and few patients survive the initial trauma. The most frequent penetrating injuries are caused by projectile injuries and less commonly by melee weapons. Most of these injuries involve chamber free walls and a small percentage can affect the interventricular septum. We report a case in which an emergency surgical procedure was successful in controlling cardiac tamponade, and repairing a right ventricular laceration caused by multiple stab wounds. Subsequently, a successful interventional occlusion of a large interventricular septal defect, associated with significantly augmented pulmonary flow was performed.
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Low, Garren M. I., Kenji Inaba, Konstantinos Chouliaras, Bernardino Branco, Lydia Lam, Elizabeth Benjamin, Jay Menaker, and Demetrios Demetriades. "The Use of the Anatomic ‘Zones’ of the Neck in the Assessment of Penetrating Neck Injury." American Surgeon 80, no. 10 (October 2014): 970–74. http://dx.doi.org/10.1177/000313481408001013.
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The traditional classification of neck injuries uses an anatomic description of Zones I through III. The objective of this article was to characterize the association between external wounds and the corresponding internal injuries after penetrating neck trauma to identify the clinical use of the anatomic zones of the neck. Patients who sustained penetrating neck trauma from December 2008 to March 2011 were analyzed. All patients underwent structured clinical examination documenting the external zone where the wound(s) were located. All internal injuries were then correlated with the external wounds. An internal injury was defined as “unexpected” if it was located outside the borders of the neck zone corresponding to the external wound. In total, 146 patients sustaining a penetrating neck injury were analyzed; 126 (86%) male. The mechanism of injury was stab wounds in 74 (51%) and gunshot wounds in 69 (47%). Mean age was 31 years (range, nine to 62 years). Thirty-seven (25%) patients sustained had a total of 50 internal injuries. There was a high incidence of noncorrelation between the location of the external injury and the internal structures that were damaged in patients with hard signs of vascular or aerodigestive injury. The use of the anatomic zones and their role in the workup of penetrating neck injury are questionable.
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ANGERMANN, P., and M. LOHMANN. "Injuries to the Hand and Wrist. A Study of 50,272 Injuries." Journal of Hand Surgery 18, no. 5 (October 1993): 642–44. http://dx.doi.org/10.1016/0266-7681(93)90024-a.
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This study reports the causes, characteristics and treatment of injuries to the hand and wrist presented to five accident and emergency departments in a 2-year survey of 13% of the Danish population. The rate of injury to the hand or wrist was 28.6% of all injuries, or 3.7 per 100,000 inhabitants per year. 34% of the accidents were domestic, 35% were leisure accidents, 26% were occupational and 5% were traffic accidents. Only 2% of the patients were admitted to hospital for further treatment or observation and 13% were referred to a hospital as outpatients. The most frequent causes for admission were fractures (42%), tendon lesions (29%) and wounds (12%).
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Donison, Christopher. "Hand Size vs the Standard Piano Keyboard." Medical Problems of Performing Artists 15, no. 3 (September 1, 2000): 111–14. http://dx.doi.org/10.21091/mppa.2000.3022.
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Last year at the Performing Arts Medicine Association annual symposium in Aspen, one of the topics focused on was piano performance-related injury. I was invited to attend the symposium and give a talk on the issue of hand size and keyboard size as they may relate to injury. Although my mission to bring about the adoption of a second smaller standard size for the piano keyboard has been primarily motivated by the idea that there is great loss of potential achievement and enjoyment at the instrument for the smaller-handed pianists of the world, the idea that injury may be a greater risk for smaller hands seemed like one more reason to promote the concept. In recollecting my experience as a full-time student in a piano performance program, instances of tendinitis and other repetitive strain injuries were practically exclusively the problem of smaller-handed pianists (mostly female, of course), and it seemed to be generally accepted by students and teachers alike that this was a greater risk for these players. Yet this information is completely anecdotal, and to my knowledge, no conclusive experimental study had proved this to be true. It just seemed obvious to everybody and nobody required proof.
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Jalili, Reza, Myriam Maude Verly, Breshell Russ, Ruhangiz T. Kilani, and Aziz Ghahary. "645 Topical Application of a Novel Powdered Scaffold for Rapid Treatment of Skin Injuries." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S168—S169. http://dx.doi.org/10.1093/jbcr/iraa024.265.
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Abstract Introduction In large skin injuries, lack of matrix deposition impedes timely healing process. The longer a wound remains open, the greater is the risk of infection, non-healing, and other complications. It is therefore crucial to find effective means to promote rapid closure of skin defects. Our group has previously developed a liquid in situ-forming nutritional scaffold, known as MeshFill (MF). MF has been previously proven to be very effective in accelerating the wound repair process, notably that of complex wounds. However, MF is limited in its application to deep and tunnelling wounds, and requires reconstitution with a solvent as well as maintenance at cold temperature until application. To address these limitations, our group has developed a powdered form of MF for rapid topical application on superficial skin injuries such as dehisced surgical wounds and burn injuries. Methods Our goal was to investigate whether a powdered form of MF could be directly applied onto the wounds to accelerate healing. Ideally, powdered MF would absorb the moisture within the wound environment and reconstitute into the gel form in situ. We examined the efficacy of powder MF (PMF) compared to reconstituted gel MF (GMF) and to a standard dressing protocol. To do so, splinted full thickness wounds were generated on the back of mice and treated with either PMF or GMF or were bandaged with no treatment (NT). The healing process was monitored until wounds were fully closed. Clinical wound measurements and histological assessments were performed to compare different treatment regimens. Results Application of both PMF and GMF accelerated wound epithelialization at days 7 and 14, compared to NT, and had faster wound closure times. On average, the PMF treatments healed 17% faster than the NT control, and the GMF treatments healed 21% faster than the NT control. No significant difference between PMF and GMF was found for any outcomes. Additionally, our results suggest that epidermis formation was more effective in P and MF conditions compared to NT. Conclusions These findings suggest that topical application of a powdered form of MeshFill is as effective as standard reconstituted MeshFill gel in accelerating the healing process of skin injuries. Applicability of Research to Practice Topical application of a powdered scaffold may be a very convenient and practical method for rapid treatment of large superficial wounds such as dehisced surgical wounds, burn injuries, and filling gaps in meshed skin grafts.
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de Wind, Christina M. "Severe Infections following Fish Bone and Spine Injuries." Tropical Doctor 26, no. 4 (October 1996): 168–69. http://dx.doi.org/10.1177/004947559602600410.
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Injuries by fish bones and spines can cause severe infections and tissue necrosis, more extensive than one would expect in such small wounds. This paper describes the injuries and the treatment of 25 patients.
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SHEFFY, N., Y. MINTZ, A. RIVKIND, and S. SHAPIRA. "Terror-Related Injuries: A Comparison of Gunshot Wounds Versus Secondary-Fragments—Induced Injuries from Explosives." Journal of the American College of Surgeons 203, no. 3 (September 2006): 297–303. http://dx.doi.org/10.1016/j.jamcollsurg.2006.05.010.
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