Immediate care of crush injuries and compartment syndromes with the split-thickness skin excision.

Prospective evaluation of the one-stage procedure in 32 patients who suffered from 37 severe friction-avulsion injuries was carried out. Most injuries (81%) were in the lower extremity. Split-thickness skin excision was used for immediate diagnosis of flap vascularity and wound coverage.

Prosthetic rehabilitation of elderly bilateral amputees.

A retrospective evaluation of vascular amputees, all over 55 years of age, found that 18 underwent bilateral lower limb amputation. The ages of patients ranged from 55 to 83 years, mean age at the time of second amputation was 65.9 years, 13 men and 5 women.

Simultaneous bilateral fractures of the femoral necks and the proximal humeral heads during convulsion.

Simultaneous bilateral fractures of either the femoral necks or the humeral heads are rare injuries. Four simultaneous fractures of both femoral necks and humeral heads have not been previously described. The case reported occurred after an epileptic convulsion in a woman with multiple metastases from breast cancer.

The effect of non-inflamed synovial fluid on neutrophil function in vitro.

In neutrophils preincubated with non-inflamed synovial fluid, opsonized zymosan-induced O2- production was increased by 232.7 +/- 19.1% and degranulation induced by zymosan or phorbol myristate acetate was increased by 152.

Percutaneous phenol blocks to motor points of spastic forearm muscles in head-injured adults.

The motor points of spastic wrist and finger flexors were identified using a nerve stimulator. These motor points were injected percutaneously with either a 3% or 5% aqueous solution of phenol in 11 patients with brain injury. The effectiveness of the blocks was assessed by recording the resting angle of the wrist, active extension of the wrist, and passive extension of the wrist--first with the fingers flexed and then with the fingers extended.

Neonatal heart rate reactivity following variable decelerations during labor.

The instantaneous heart rate of 65 healthy neonates was continuously monitored during labor and the first 30 minutes of neonatal life. It was found that infants who had moderate or severe variable decelerations in utero had a significantly delayed neonatal heart rate (NHR) reactivity without any evidence of perinatal asphyxia. The NHR pattern of infants with and without variable decelerations is described and possible mechanisms which could explain the delayed NHR reactivity are discussed.

An undeliverable fetus with an ominous fetal heart pattern: an obstetric dilemma.

An unusual fetal heart rate (FHR) pattern was detected in a patient with sickle cell crisis in early labor. Despite the potentially ominous significance of this pattern, immediate delivery by cesarean section had to be deferred because of maternal contraindications. Institution of treatment directed at possible etiologic factors failed to correct the heart rate abnormalities.

The mechanism of dorsal fracture dislocation of the fifth carpometacarpal joint.

Fracture dislocation at the base of the fifth metacarpal is a rare injury. Fewer than 25 cases have been published in the English-language literature. A force acting along the longitudinal axis of the fifth metacarpal causes a fracture dislocation at the base of the bone in a dorsal-ulnar direction, because of the anatomy of the joint and the mechanical properties of the bone and the intermetacarpal ligament.

Induction of labor with intravenous prostaglandin.

The present study utilizing an open label design evaluates the efficacy of prostaglandin F2alpha in the induction of labor in normal and complicated primigravid and multigravid pregnancies and in particular in patients with an unripe cervix. The results reveal that labor was successfully induced in 33 of 38 (86.8 per cent) normal patients in the 0 to 5 Bishop group and in 17 of 18 (94.