Biomedical subjects
Publications and source records attributed to I G Kendall.
This is the first reported case of sesamoid bone interposition in the interphalangeal joint of the hallux as a complication of closed reduction of a dislocated interphalangeal joint of the hallux. The case also highlights the importance of post-reduction radiographs.
A study of 206 injured rear seat passengers was undertaken over two 4-month periods before and after the introduction of legislation enforcing use of rear seat-belts on 1 July 1991. The proportion of both adults and children using rear seat-belts increased after the law. Those wearing belts were less likely to suffer serious injury. The majority of passengers comply with the law but many rear seat passengers remain unrestrained because cars are not fitted with belts.
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A review of 179 autopsies was undertaken over a 1-year period to determine if clinically useful information was obtainable from coroners post mortems performed on patients referred from the A&E department. Fifty-six patients had undergone unsuccessful resuscitation. The leading causes of death were heart disease and trauma. Discrepancies between the diagnosis made during resuscitation and the cause of death found at autopsy were revealed especially in those dying from noncardiac causes. Iatrogenic trauma from resuscitation attempts occurred in a significant number of cases. It is suggested that review of selected Coroners post mortems should be part of departmental audit, with a view to improving clinical skills.
A summary of injuries sustained by 340 sportsmen over 9 successive weekends from 16 November 1991 to 12 January 1992 attending an accident and emergency (A&E) department is presented. Most injuries occurred in young males usually as a result of soccer or rugby. Sixty-seven per cent of patients were discharged with no further followed up in hospital. Seventy-two per cent of patients were X-rayed, 33% of X-rays showed a fracture or dislocation. A total of 193 attendees received minimal treatment, (defined as discharge with advice only, simple analgesia or strapping only with no hospital follow-up) and of these 152 were X-rayed. A total of 100 patients who received minimal treatment were selected randomly by computer to receive a follow-up letter asking about certain issues relating to their care in the A&E department. Most patients felt that the A&E Department was the most appropriate source of treatment for their sports injury, and over half attended specifically for an X-ray examination. Despite the doctors view that many of these minor injuries could have been self-treated, few patients felt able to treat future similar minor injuries themselves. They were, however, more likely to go elsewhere for treatment on subsequent occasions.
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A previously healthy young man presented to A&E with severe dyspnoea. The cause of his distress was bilateral spontaneous pneumothoraces. Prompt insertion of chest drains relieved his distress. This rare clinical entity should be considered in an individual with severe respiratory distress. Diagnosis is difficult on clinical examination alone.
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