In a chart review 31 TRAUMATIC knee dislocations were identified in 30 patients during an eight year period (1992-2000). Fifteen dislocations (48.4%) were posterior, seven anterior, eight occult and one medial. Out of the five cases of VASCULAR INJURIES three happened with posterior dislocations and in four patients associated ipsilateral limb INJURIES were present. The general incidence of simultaneous limb injury was 54.8% (17 cases). Two knees with VASCULAR injury required amputation. All VASCULAR compromised limbs had impaired distal pulsation.

Introduction: Subclavian artery injury is an uncommon VASCULAR trauma with potential morbidity and mortality. Management of subclavian artery trauma requires open and endoVASCULAR techniques and timely and efficacious decision is mandatory. We retrospectively reviewed TRAUMATIC subclavian artery INJURIES in a high-volume VASCULAR surgery center in Iran. Methods: In a retrospective study, we assessed subclavian artery INJURIES during 6 years in Shohada-Tajrish Medical Center. Background characteristics, type of incision, type of operation and outcome of patients were evaluated. Results: A total of 14 patients had subclavian artery injury (mean age 29. 9 ± 13. 4 years, 92. 9% male). Trauma was in left and right sides in eight (57. 1%) and six patients (42. 9%) respectively. Arteriorrhaphy, interposition and ligation of injured artery was done in 7 (50. 0%), 3 (21. 4%) and 4 (28. 6%) patients respectively. Associated nerve injury was present in six patients (42. 9%). EndoVASCULAR proximal control was obtained in six patients (42. 9%) prior to VASCULAR exposure. Time of patient referral did not have significant association with shock or type of operation (P > 0. 05). Conclusion: Although TRAUMATIC subclavian artery INJURIES are rare, its VASCULAR exposures and reconstructions are of potential clinical concern. EndoVASCULAR interventions can facilitate proximal control. In addition, endoVASCULAR repair by covered stent is an alternative to open surgery.

Drowning is one of the most serious and neglected public health problems. It causes the loss of more than 200, 000 lives annually. More than 90% of this mortality rate occurs in low-and middle-income countries. In 2019, INJURIES accounted for almost 8% of total global mortality. Drowning is the 3rd leading cause of unintentional injury deaths worldwide and children are the main at-risk group. Data on TRAUMATIC INJURIES in drowning is scarce in most developing countries due to lack of appropriate mortality reporting system. Moreover, most of the studies are limited to only a few countries. For every child who dies in a drowning accident, 5 others will receive hospital care. Out of these near-drowning cases, 15 percent will die, and 20 percent will be left with severe neurological INJURIES. Based on the current limited studies, the prevalence of drowning INJURIES varies from 0. 5% to 11% because of the differences in the study populations and the levels of hospitals. All INJURIES occurred in a swimming pool. The most prevalent site of INJURIES due to drowning was cervical spine, INJURIES to the C5 through C6 levels were the most common. Anoxic brain injury secondary to submersion was the most cause of death in hospital. Also, studies mention isolated case repo rts of retinal hemorrhages. The physical INJURIES described included bruising and fractures. Old age and a history of diving were the most risk factors for getting INJURIES. It has been recommended that physicians and emergency health workers who care for drowning/neardrowning patients be aware of possible trauma, especially cervical spine INJURIES. Those patients with a history of a TRAUMATIC mechanism such as diving should undergo evaluation by specialized trauma teams.

This is a retrospective study on the records of patients with TRAUMATIC VASCULAR INJURIES of lower limbs admitted in Shohada -ye-Tajrish hospital (69-72) and Sina hospital (71-77).57 patients were studied as acute VASCULAR trauma and 6 patients as complications of VASCULAR trauma. Almost half of the patients with acute VASCULAR trauma were 15-29 years old and men have been at risk of trauma ten times more than women.63% of the patients had blunt trauma and motorcycle & car accidents were the most Common events Causing trauma (47.5%) .26% of the patients were at hemorrhagic shock at admission.72% of the patients had long ischemia and 55% relative ischemia.56% of the patients with TRAUMATIC arterial INJURIES also had venous INJURIES.33% of the patients had injury to nerve, 53% injury to bone, 63% injury to muscle and 76% injury to skin.One third of the patients had compartment syndrome. In overall, prophylactic or Curative fasciotomy had been done for 44% of the patients.The most common treatment being done in arterial INJURIES was interposition graft (37%) and in venous INJURIES ligation and interposition graft (each one 33%).Out come of the patients has significantly been related to ischemic severity, shock, compartment syndrome and injury to nerve or bone but not related to muscular or cutaneous INJURIES. .Finally: 58.5% of all patients had complete recovery, 13% had neurologic or orthopedic or muscular sequelae, 19% underwent primary or secondary amputation and 9.5% died

Introduction: TRAUMATIC spondyloptosis is a rare condition. It is a neurogenic complication due to high energy trauma and unstable spine which almost always needs surgical treatment. A 30 years old man with L4 spondyloptosis and L5 fracture, neurologic deficit in both lower limbs, urinary incontinence and visceral perforation referred to Shafa Yahyaeian Hospital He underwent nonsurgical treatment because he was a poor surgical candidate (Poor medical condition, visceral perforation and buttock bed sore) Results: At the last follow up three years after trauma, he was in good general condition with full recovery of his neurologic problem and ambulated without assistance.Conclusion: Although TRAUMATIC spondyloptosis needs surgical treatment, in special situations for very high risk patients, nonsurgical treatment can be a good alternative.

Introduction & Objective: The main purpose of this review is to discuss the latest recommendations and strategies for treatment of pediatric patients with TRAUMATIC brain injury (TBI).Materials & Methods: Through this review, 45 eligible and relevant studies were chosen and the level of evidence was evaluated. The statements which are discussed as “recommendations” refer to class II level of evidence, while the ones which are brought as “options” refer to class III.Results: In pediatric patients with TBI, CPP should be kept above 40mmHg. Bolus infusion of mannitol (0.25- 1g/kg) or continuous infusion of hypertonic (3%) saline (0.1-1 ml/kg) are useful methods to reduce ICP. It is recommended to use minimum doses to decrease ICP to 20mmHg. Administration of steroids suppress endogen cortisol secretion and increase complications like infection. Long-term prophylactic hyperventilation, even mild, should be avoided.Conclusions: Undoubtedly, nothing is more effective than proper prophylaxis. The main duty of a physician in confronting TBI is to reduce secondary INJURIES caused by hypoxia, hypotension, elevated ICP, reduced CPP, cerebral ischemia, etc.

Background & Aims: Penetrating or blunt TRAUMATIC INJURIES of the vertebral arteries is not common. The clinical presentation and outcome of vertebral artery trauma are primarily related to associated INJURIES rather than to specific arterial lesion itself. The mechanism of TRAUMATIC injury is critical in determining the appropriate diagnostic and treatment regimens. The aim of this study is to evaluate the mechanisms and angiographic findings in vertebral artery traumas.Materials & Methods: Eleven patients with vertebral artery INJURIES were studied by angiography in Imam Khomeini Hospital, Tabriz.Results: 82% of our patients were male and 18% were female. The average age was 37.20±12.41 years old. The most common cause of the injury was blunt trauma and the most common site was the origin of vertebral arteries. The most common type of VASCULAR INJURIES was complete arterial occlusions.Conclusion: Penetrating trauma was thought to account for more than 95% of all cerebroVASCULAR INJURIES in the past but it appears that blunt injury may account for one third of the cases. In developed countries, blunt vertebral artery INJURIES occur principally with spinal INJURIES and in our country occur with upper thoracic rib fractures. Therefore, in our country many cases of blunt vertebral artery INJURIES, specially associated with cervical spine traumas' are missing so aggressive diagnostic screening is necessary for accurate diagnosis.