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Sabine Maguire Bruce Hunter Lindsay Hunter Jo Richard Sibert Mala Mann Alison Mary Kemp 《Archives of disease in childhood》2007,92(12):1113-1117
INTRODUCTION: A torn labial frenum is widely regarded as pathognomonic of abuse. METHODS: We systematically reviewed the evidence for this, and to define other intra-oral injuries found in physical abuse. Nine studies documented abusive torn labial frena in 27 children and 24 [corrected] were fatally abused: 22 were less than 5 years old. Only a direct blow to the face was substantiated as a mechanism of injury. RESULTS: Two studies noted accidentally torn labial frena, both from intubation. Abusive intra-oral injuries were widely distributed to the lips, gums, tongue and palate and included fractures, intrusion and extraction of the dentition, bites and contusions. CONCLUSIONS: Current literature does not support the diagnosis of abuse based on a torn labial frenum in isolation. The intra-oral hard and soft tissue should be examined in all suspected abuse cases, and a dental opinion sought where abnormalities are found. 相似文献
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V Bhattacharya G R Reddy Sunish Goyal Umesh Kumar 《Journal of plastic, reconstructive & aesthetic surgery》2007,60(8):892-897
Defects involving the distal leg and foot are frequently encountered following various aetiological factors. Paucity of local tissue causes surgeons to resort to the retrograde peninsular flap, the cross leg flap or the free flap. With specific knowledge of perforators, the fasciocutaneous flap from the calf area can be transferred to the defect in a single stage based on skeletonised distal perforators. The surgical anatomy, flap planning and procedure have been detailed. Nineteen patients were treated during the period 1995 to 2005. The perforators were identified preoperatively by audio Doppler. The flaps were marked and dissected proximal to the defect skeletonising the distal perforators under loupe magnification and transferred to the defect in a single stage. The donor site was skin grafted. Out of 19 cases, 16 flaps healed uneventfully, one flap necrosed completely and in two cases there was marginal necrosis. The cases were followed up for 2-10 years with an average of 6 years. With detailed knowledge of perforators one can safely reconstruct distal moderate-size defects of the lower limb in a single stage, thus having the benefits of free tissue transfer without resorting to microsurgery. This technique has proved to be an advancement in the reconstructive repertoire allowing flaps of non conventional dimensions to be perfused by skeletonised perforators. 相似文献
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Suresh Kumar Masilamani Annamalai Rachel Buckingham John Cashman 《Journal of children's orthopaedics》2007,1(2):107-113
The treatment of Legg-Calvé-Perthes disease remains controversial. The aim of this survey was to ascertain the current management
strategies of this condition amongst UK paediatric orthopaedic surgeons, with particular regard to containment procedures
in the fragmentation phase. Questionnaires were distributed at the January 2006 meeting of the British Society for Children’s
Orthopaedic Surgery (BSCOS) and was posted to all absent members. The results showed a great deal of variability not only
in the treatment of Perthes disease, but also in the decision-making processes. Consideration must now be given to a carefully
constructed national multi-centre prospective randomised controlled study into the optimum management of this disease 相似文献
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Prasanna Kumar Reddy R Venkata Subramanian S Yuvaraja 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2005,9(3):356-357
Transposition of the gallbladder to the left side without situs inversus viscerum is rare. These gallbladders are situated under the left lobe of the liver between Segment III and IV or on Segment III to the left of the falciform ligament. Because routine preoperative studies may not detect the anomaly, it may provide the surgeons with an unusual surprise during laparoscopy. Awareness of the unpredictable confluence of the cystic duct into the common bile duct and selective use of intraoperative cholangiography aid in the safe laparoscopic management of this unusual problem. 相似文献
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