High-pressure injection injuries to the hand.

High-pressure injection injury hides the true extent of the lesions behind an apparent small and harmless puncture of the finger or the hand. Through clinical description, we wish to point out the need for prompt treatment to avoid mutilating and function-threatening complications. We wish to outline the role of the emergency physician who must be aware of the incidence of high-pressure injection injury and become accustomed to early referral to a surgeon, experienced in extensive surgical exploration, removal of foreign bodies, and rehabilitation.

[Antero-superior impingement of the shoulder. Indications for and options in surgical treatment].

Many therapeutic questions and controversies surround the impingement syndrome of the shoulder, however it appears that the major procedure is rotator cuff decompression. This is achieved by antero-inferior acromioplasty and section of the coracoacromial ligament, during open or arthroscopic surgery. Which patients will be helped by this procedure? When does the surgical decision have to be taken? Is the suture of the rotator cuff tear and the removal of intratendinous calcifications needed in addition to the acromioplasty? Many major questions remain unanswered.

Is early bone scintigraphy a reliable method to assess the viability of vascularized bone transplants?

This clinical study reveals radiomarker uptake in corticocancellous non-vascularized bone grafts as early as 3 days postoperatively. It therefore calls into question whether seventh-postoperative-day bone scintigraphy is a reliable method for determining the viability of vascularized bone grafts.

Comminuted fractures of the base of the first metacarpal treated by distraction-external fixation.

A new technique is presented for the treatment of comminuted intraarticular fractures of the base of the thumb metacarpal. A triangular Hoffmann external radius and first- and second-metacarpal fixator is used. The reduction is maintained by prolonged distraction and abduction of the first metacarpal bone.

[Surgery of acute cholecystitis in patients 80 years of age or older].

In 17 Belgian surgical centers, 324 operations have been performed for acute cholecystitis in patients 80 years of age or older. In this group of patients: 1. The incidence of acute cholecystitis is hardly higher in women than in men.