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PubMedDate not supplied

The perception of lexical tone in Mambila.

The issue of the perception of lexical tone has been addressed mainly through studies of Southeast Asian languages which feature phonological contour tones as well as level tones. Little attention has been paid to African languages which have, almost exclusively, only level tones. This paper examines tone perception in Mambila, a Benue-Congo language with four level lexical tones. A categorization experiment was run to determine some of the salient aspects of the perceptual nature of these tones. Since the four tones are well defined with respect to production, we sought to determine whether this characteristic carried over into perception, the expectation being that experimental stimuli, on the basis of pitch height alone, would fall into four reasonably well defined categories. Results showed interesting differences across the four tones, with indications that the two Mid tones, T2 and T3, are perceptually different than the High (T1) and Low (T4) tones. The experiment was run a second time, using a group of native English listeners, to assess to what extent results for the Mambila listeners were determined by the perceptual structure of the Mambila tone system. A Signal Detection analysis was used, which revealed important differences between the two groups of listeners. Results are discussed in light of what is known about universal tendencies of tone systems and the historical development of the Mambila system.

Adult↗

PubMed2002

Pattern of fatal head injuries in Ibadan--a 10 year review.

Head injury is an important cause of mortality worldwide. The objective of the present study was to analyse the pattern of fatal head injury among patients seen in University College Hospital, Ibadan. The study was based on retrospective investigation of cases of fatal head injury referred by the coroner to the Department of Pathology, University College Hospital, between 1991 and 2000. Pertinent clinical and postmortem findings were extracted from available coroner's autopsy records. There were 529 cases (402 males and 127 females). Their ages ranged from <1 year to 90 years (mean=33 years), the average age of females (27.8) being less than that of males (34.6) (p=0.00003). 83.8% were road traffic accidents, 8.9% falls from a height, 3.8% assault, and 3% gunshot injuries. 79.1% had a GCS of 8 or less at presentation. The mean survival period of children aged less than 15 years was 2 days while that of adolescents and adults aged 15 years and above was 5.6 days (p=0.02). Subdural (62.4%), subarachnoid (24.6%), epidural (10.2%), and intracerebral (10%) haemorrhages were the major causes of death. Skull fractures occurred in 38.2%, while cerebral contusions occurred in 22.1%. Intracranial infection was relatively uncommon in these patients. The present study has shown that young adults, predominantly males in their most productive years of life, are especially prone to fatal head injury.

Adolescent↗

PubMed1998

Treatment of traumatic dental displacement in dogs: six cases of lateral luxation.

In dogs and cats, the most common causes of dental injury are fights with other animals, car accidents, falls from a height, and chewing on hard materials such as bones or rocks. The trauma more often causes fracture of the teeth, but sometimes avulsion or luxation can occur. Avulsion is the complete displacement of the tooth out of the alveolar socket and luxation is the partial displacement of the tooth. Tooth luxation and avulsion represent dental emergencies. Time is an important factor for successful treatment; the prognosis becomes poorer the longer the tooth is out of the socket. This paper describes the guidelines for treatment of dental displacement in cats and dogs and presents six cases of dental lateral luxation in dogs seen at the Veterinary Hospital of the University of Pennsylvania (VHUP) in the period from May 1996 to September 1997.

Animals↗

PubMed2000

Sinus tarsi approach with trans-articular fixation for displaced intra-articular fractures of the calcaneus.

The charts and radiographs of 99 patients with 106 intraarticular fractures of the calcaneus were retrospectively reviewed. There were 75 men and 24 women. The average age was forty-two (range, 17 to 81). Fifty-seven of the fractures were left and 49 were right. The mechanism of injury was a fall from a height in 69 patients and motor vehicle accident in 30 patients. According to Sanders classification, seventy-one cases (67%) had type II fractures, 25 cases (23.6%) had type III, and ten cases (9.4%) had type IV. All the patients had operative management through a limited sinus tarsi approach with minimal fixation of the fracture with one or several pins. One of the pins was usually applied from the talus to the calcaneus through the fracture after reduction of the posterior facet. Nine cases (8.5%) developed postoperative infection, four cases (3.8%) had superficial wound infection, four cases (3.8%) had pin tract infection and one case (0.9%) had osteomylitis. Our follow-up at an average of 29 months (range, 12 to 84 months) showed that the American Orthopedic Foot and Ankle Society, Ankle-Hindfoot Score for the all group was 77.6 (range, 31-91). Forty-one fractures (38.8%) were graded excellent, 39 fractures (36.7%) good, 14 fractures (13.2%) fair, and 12 fractures (11.3%) were failures. Although radiological degenerative changes in the subtalar joint were seen in 41 cases (38.7%), only six cases (5.6%) required subsequent subtalar fusion. The authors conclude that the operative method used in the current study which followed the principle of minimal soft tissue damage and minimal internal fixation may be a good option for management of calcaneus fractures.

Adolescent↗

PubMed2004

The nutcracker fracture of the cuboid in children: a case report.

The fracture of the cuboid in children is rarely diagnosed and has probably been underreported for nondisplaced fractures. The diagnosis is often missed, and overlooked cuboid fracture can lead to severe alterations in foot mechanics and function. This case report involves a displaced compression fracture of the left cuboid in a 9-year-old girl after a fall from a height, which was treated by open reduction, bone graft, internal fixation with pins, and plaster splint immobilization. Follow-up examination 2 years after the injury revealed good bone union and a very good functional result.

Child↗

PubMed1980

Fractures of the neck of the talus in children.

A review of children with talar injuries treated at the Winnipeg Children's Hospital yielded 12 patients that had been treated for fractures of the neck of the talus between 1960 and 1978, inclusive. Three developed avascular necrosis of the body of the talus; two of these had their fractures recognized only after avascular necrosis had become radiologically evident. The children ranged in age from 1 year 7 months to 13 years 11 months at the time of the injury. Fracture of the neck of the talus does occur in children and may be associated with avascular necrosis of the body. This injury should be considered and the talus should be examined in all children sustaining trauma secondary to falls from a height or motor vehicle trauma.

Adolescent↗

PubMed1989

The heel of achilles: calcaneal avulsion fracture from a gunshot wound.

Greek mythology relates that the legendary warrior Achilles was made invincible by his mother Thetis, who dipped him in the River Styx while holding him by his heel. Because his heel was never immersed, it remained his one area of vulnerability. After the fall of Troy, Achilles met his demise when he was shot in the heel by Paris, whose arrow was guided by the Greek god Apollo. This is the derivation of the term "Achilles tendon." Avulsion fractures of the tuberosity of the calcaneus are rare injuries. Schonbauer reviewed a series of 870,000 accident cases treated at the Vienna Trauma Hospital and found only four such cases in addition to 151 cases of subcutaneous Achilles tendon rupture. In Bohler's series of 182 calcaneal fractures, avulsion of the calcaneal tuberosity accounted for less than 1% of these injuries. Rowe reported four Achilles avulsion fractures in his series of 154 calcaneal fractures. Three basic mechanisms of injury have been described: (1) dorsiflexion violence against the maximally plantarflexed foot, typically occurring in a fall from a height; (2) powerful contraction of the triceps surae muscle with simultaneous extension of the knee such as when a person is about to sprint in a race; (3) a direct blunt blow to the hindfoot. We are describing a case of avulsion of the calcaneal tuberosity due to direct penetrating trauma from a gunshot wound, a mechanism not previously reported.

Adult↗

PubMed2003

The epidemiology of multifocal upper limb fractures.

AIM: The aim of this study is to identify the epidemiology of multifocal upper limb fractures and define any commonly occurring patterns. PATIENTS: Patients included were those over the age of 13 years who presented to one orthopaedic trauma unit, in an eight-year period, and who sustained a multifocal upper limb fracture. RESULTS: There were 83 patients with 171 multifocal upper limb fractures. Mean age 60 years; range 13 to 92 years. 78 patients had bifocal fractures and 5 had trifocal. The most common pairing of fourteen different combinations was distal radius and proximal humerus. All but nine patients had involvement of the proximal humerus or distal radius. The most common injuries were the two-part proximal humerus fracture, the simple intra-articular olecranon fracture and the extra-articular fracture of the distal radius with metaphyseal comminution. CONCLUSION: This study has shown that multifocal fractures of the upper limb are most likely to occur in the middle aged to elderly women who have had a fall from standing height. As previously demonstrated osteopenic fractures are increasing in incidence in developed countries, where the population is ageing, which implies that the incidence of multifocal fractures of the upper limb is likely to increase.

Adolescent↗

PubMed2003

Electrocution in South Delhi: a retrospective study.

One hundred and fifty three unselected autopsy cases of electrocution received from South Delhi were studied during the period 1996-2001. Data for the study was gathered from autopsy reports and hospital records. The cases represented approximately 1.98% of all autopsy cases received from South Delhi at the All India Institute of Medical Sciences, New Delhi (India). Data was analysed with regard to the age and sex of the victim, season of the year, site of the body, time of day, place of occurrence and presence of entry and exit wounds on the body. Death occurred at the scene of the fatal event in 150 cases and three cases died in hospital. Three cases showed no electric burn marks on the body; the cause of death in one of these cases was polytrauma due to a fall from a height and one case had committed suicide.

Adolescent↗

PubMed2006

Minimally-invasive treatment of intra-articular fractures of the calcaneum.

We describe the results of 287 intra-articular fractures of the calcaneum in 247 patients treated by minimally-invasive reduction and K-wire fixation between 1994 and 2003. There were 210 men (85%) and 37 women (15%). The most common cause of injury was a fall from a height in 237 patients (96%). Fracture classification was based on the method described by Sanders and Essex-Lopresti. All patients were operated on within 21 days of injury and 89% (220) within 48 hours. The reduction was graded as nearly anatomical (less than 2 mm residual articular displacement and satisfactory overall alignment) in 212 (73.9%) fractures. There were 20 cases (7%) of superficial pin-track infection and five (1.7%) of deep infection. All healed at a mean of 6 weeks (3 to 19). Loss of reduction was observed in 13 fractures (4.5%) and a musculocutaneous flap was needed in three (1%). The results were evaluated in 176 patients (205 fractures) with a mean age of 44.3 years (13 to 67), available for follow-up at a mean of 43.4 months (25 to 87) using the Creighton-Nebraska Health Foundation Assessment score. The mean score was 83.9 points (63 to 100). There were 29 (16.5%) excellent, 98 (55.7%) good, 26 (14.8%) fair and 23 (13%) poor results. A total of 130 patients (73.9%) were able to return to their original occupation at a mean of 5.6 months (3.2 to 12.5) after the injury. Semi-open reduction and percutaneous fixation is an effective treatment for displaced intra-articular fractures of the calcaneum.

Adolescent↗

PubMed2000

Cause and clinical characteristics of rib fractures in infants.

OBJECTIVE: Rib fractures are uncommon in infancy and, when diagnosed, often raise the suspicion of child abuse. However, the prevalence of other causes of rib fractures has not been well defined. The purpose of this study was to determine the causes and clinical presentations of rib fractures in infants <12 months old. METHODS: Retrospectively, we identified all infants with rib fractures under 12 months old over a 3-year period using computerized databases at the Children's Hospital Medical Center in Cincinnati, Ohio and at the Children's Hospital, Winnipeg, Manitoba, Canada. Data extracted from the individual patient charts included: age, sex, chief complaint, number and location of rib fractures, associated injuries, birth history, history of cardiopulmonary resuscitation, and any evidence of bone dysplasia. After the chart review and a review of the radiographs by a pediatric radiologist, all fractures were determined to be attributable to one of the following causes: child abuse, birth injury, bone fragility, or accidental trauma. A determination of abuse was made when there were other injuries indicative of abuse, there was no clinical or radiographic evidence of bone fragility, there was a confession of abuse, when no reasonable history of trauma was provided, or when the history was not plausible to explain the rib fractures. Standard practice at these hospitals involves obtaining skeletal surveys on all children <2 years old when abuse is suspected. The child abuse team, which consists of physicians, nurses, and social workers, conducts these investigations and works closely with police in evaluating these children. RESULTS: Thirty-nine infants with rib fractures were identified. Thirty-two (82%) were caused by child abuse. Three (7. 7%) were attributable to accidental injuries, 1 (2.6%) was secondary to birth trauma, and 3 (7.7%) were attributable to bone fragility. All 3 infants with fractures from accidental injury had sustained notable trauma (a motor vehicle collision, a forceful direct blow, and a fall from a height). Of the 3 infants with fractures secondary to bone fragility, 1 infant had osteogenesis imperfecta, 1 infant had rickets, and 1 infant, who was born at 23 weeks' gestation, had fragile bones attributable to prematurity. CONCLUSIONS: Most rib fractures in infants are caused by child abuse. Although much less common, rib fractures can also occur after serious accidental injuries, birth trauma, or secondary to bone fragility. A thorough clinical and imaging evaluation is mandatory.

Birth Injuries↗

PubMed1997

Treatment of segmental defects of the radius with use of the vascularized osteoseptocutaneous fibular autogenous graft.

Nine patients who had a complex, combined skeletal and soft-tissue defect involving the radius were managed with operative reconstruction with use of a vascularized osteoseptocutaneous fibular autogenous graft. All of the patients were male, and the average age was thirty-two years (range, twenty-one to forty-two years). Three patients sustained the injury as the result of a gunshot wound and two each, as the result of a motor-vehicle accident, a fall from a height, or a machinery-related accident. Five patients had a concomitant fracture of the ulna. The average length of the radial defect was seven centimeters. Six patients had a deep osseous infection. The average length of the fibular autogenous graft was 7.9 centimeters, and the average size of the associated fasciocutaneous component was 11.8 by 5.9 centimeters. Two patients had a concomitant arthrodesis of the wrist. A split-thickness skin graft was used to close the donor site in six patients. Two patients had postoperative vascular complications that necessitated revision with an autogenous vein graft. One patient had a second operation six months postoperatively to correct an angular deformity that had developed secondary to a non-union at the graft-host bone junction. After an average duration of follow-up of twenty-four months, all but one of the patients had radiographic evidence of osseous union at both the proximal and the distal graft-host bone junction. No patient had evidence of resorption of the graft or symptoms referable to the donor leg at the time of the most recent examination. Six patients had returned to their preinjury occupation.

Adult↗

PubMed2001

"Early" apoplexy due to traumatic intracranial aneurysm--case report.

A 76-year-old man presented with a traumatic aneurysm of the left internal carotid artery which caused repeated subarachnoid hemorrhages within 20 hours of a fall from a height. Early computed tomography (CT) detected no brain abnormalities, but repeat CT found subarachnoid hemorrhage. Internal carotid angiography detected a pseudoaneurysm, which was not treated because of his poor clinical condition. He died of multiple organ failure. Early detection of a traumatic intracranial aneurysm is important for the prevention of aneurysmal rupture, or "delayed" apoplexy. Review of 171 cases with traumatic aneurysms from the literature found that false negative angiography occurred only in three cases on post-trauma day 7 and thereafter. Early diagnostic angiography within a week of the initial trauma is indicated if traumatic aneurysm is suspected to detect early signs of irregularity, spasm, and narrowing of the arterial wall. Repeat angiography is indicated if aneurysmal formation is still highly suspected in spite of negative initial angiography.

Acute Disease↗

PubMed1981

Pediatric Lisfranc injury: "bunk bed" fracture.

A common pediatric fracture is often overlooked due to the subtle deformity of the proximal first metatarsal. The injury is produced during a fall from a height, resulting in a flexion force that wedges the oblique first cuneiform-first metatarsal epiphysis into the first metatarsal-second metatarsal interspace. The injury is more severe than indicated by the bone injury, in that ligaments are involved in subluxation. Anatomic features of the first metatarsal-first cuneiform area present a suitable site for the described injury to occur. The pathogenesis of adult Lisfranc tarsometatarsal dislocation is the model for the pediatric equivalent. The clinical, physical, and radiologic findings of 16 patients are reviewed.

Child↗

PubMed1995

Complete dislocation of the knee: spectrum of associated soft-tissue injuries depicted by MR imaging.

OBJECTIVE: Complete knee dislocation is a rare injury. The purpose of this study was to evaluate the spectrum of injuries that are depicted by MR imaging in patients with a dislocation of the knee and to determine if there is any predictive factor that might indicate those patients who may be at risk for popliteal nerve injury. MATERIALS AND METHODS: A retrospective search for patients sustaining traumatic knee dislocations who had radiographs and an MR imaging examination of the knee as part of their initial evaluation was done at three level I trauma centers for the period between 1989 and 1993. Each MR examination was independently reviewed by three osteoradiologists for ligamentous, tendinous, meniscal, and osseous injuries. Equivocal diagnoses were decided by consensus. Only patients who underwent surgery were selected. MR imaging findings were confirmed at the time of surgery. Seventeen patients (15 men, two women; age range, 14-62 years; mean age, 29 years) were studied. Motor vehicle accident, fall from a height, a vehicle striking a pedestrian, and football injury were common mechanisms of injury. Posterior dislocation (seven patients) and anterior dislocation (five patients) were the most common injuries. RESULTS: At the time of surgery, all patients had complete tears of the anterior cruciate ligament, 15 had complete tears of the posterior cruciate ligament, nine had complete tears of the medial collateral ligament, and 12 had tears of the fibular collateral ligament (nine tore both the fibular collateral ligament and the biceps femoris tendon). Popliteal tendon tears occurred in eight patients (six complete, two partial). Of the six patients with complete tears of the popliteal tendon, five occurred at the musculotendinous junction; all were the result of either posterior or posterolateral dislocations. Four patients had injuries to the peroneal nerve; three of the four also had tears of the popliteal tendon. On MR imaging, the integrity of the anterior cruciate and lateral collateral ligaments was correctly depicted in all 17 patients; evaluation of the posterior cruciate ligament resulted in one false-positive and one false-negative diagnosis of a tear; evaluation of the medial collateral ligament resulted in one false-positive diagnosis of a tear; and one false-positive diagnosis of a tear occurred with evaluation of the popliteal tendon. CONCLUSION: Knee dislocations cause extensive disruption of the ligaments that stabilize the knee and the surrounding soft-tissue structures, including the popliteal artery. Nearly all will result in disruption of the cruciate ligments and, often, injury of the collateral ligaments. An injury to the popliteal tendon denotes a more severe injury. The mechanism of injury that results in a popliteal tendon tear may also increase the possibility of a peroneal nerve injury. Recognition of this pattern of injuries on MR imaging enables precautionary observation for ischemic changes of the foot to be instituted in patients that otherwise may not be considered at risk for acute vascular compromise.

Adolescent↗

PubMedDate not supplied

Effects of pentazocine in experimental head injury.

In previous studies we demonstrated the adverse effects of ethyl alcohol in murine head injury. Using this model in this study, effects of prior administration of pentazocine (Talwin) on the survival of mice are reported. Swiss Webster mice were randomly divided into one of three groups. Group I (n = 20) received pentazocine and Group II (n = 20, controls) received saline. Groups I and II were then injured under ether anaesthesia by allowing a weight to fall from a height of 15 cm on the cranium. Ten animals received pentazocine and were anaesthetized but had no head trauma (Group III). In Group II, 85% survived 24 h, and in Group I, 35% survived; all mice in Group III survived 24 h (significance: chi 2, p less than 0.005; Group I versus Groups II and III). Pentazocine increases the lethality of murine head injury.

Animals↗

PubMed1984

Pediatric neck injuries. A clinical study.

This review of pediatric neck injuries includes patients admitted to Children's Hospital of Columbus, Ohio, during the period 1969 to 1979. The 122 patients with neck injuries constituted 1.4% of the total neurosurgical admissions during this time. Forty-eight patients had cervical strains; 74 had involvement of the spinal column; and 27 had neurological deficits. The injuries reached their peak incidence during the summer months, with motor-vehicle accidents accounting for 31%, diving injuries and falls from a height 20% each, football injuries 8%, other sports 11%, and miscellaneous 10%. There is a clear division of patients into a group aged 8 years or less with exclusively upper cervical injuries, and an older group with pancervical injuries. In the younger children, the injuries involved soft tissue (subluxation was seen more frequently than fracture), and tended to occur through subchondral growth plates, with a more reliable union than similar bone injuries. In the older children, the pattern and etiology of injury are the same as in adults. The entire cervical axis is at risk, and there is a tendency to fracture bone rather than cartilaginous structures.

Adolescent↗

PubMed1996

Acute Pelvic Fractures: I. Causation and Classification.

Acute pelvic fractures are potentially lethal, even with modern techniques of poly-trauma care. The appropriate treatment of such fractures is dependent on a thorough understanding of the anatomic features of the pelvic region and the biomechanical basis of the various types of lesions. Although the anterior structures, the symphysis pubis and the pubic rami, contribute approximately 40% to the stiffness of the pelvis, clinical and biomechanical studies have shown that the posterior sacroiliac complex is more important to pelvic-ring stability. Therefore, the classification of pelvic fractures is based on the stability of the posterior lesion. In type A fractures, the pelvic ring is stable. The partially stable type B lesions, such as "open-book" and "bucket-handle" fractures, are caused by external- and internal-rotation forces, respectively. In type C injuries, there is complete disruption of the posterior sacroiliac complex. These unstable fractures are almost always caused by high-energy severe trauma associated with motor vehicle accidents, falls from a height, or crushing injuries. Type A and type B fractures make up 70% to 80% of all pelvic injuries. Because of the complexity of injuries that most often result in acute pelvic fractures, they should be considered in the context of polytrauma management, rather than in isolation. Any classification system must therefore be seen only as a general guide to treatment. The management of each patient requires careful, individualized decision making.

Journal Article↗