Adult ; Follow-Up Studies ; Humans ; Leg ; physiopathology ; surgery ; Leg Injuries ; physiopathology ; surgery ; Male ; Recovery of Function ; Replantation ; methods

Adult ; Female ; Fibula ; injuries ; physiopathology ; Humans ; Joint Dislocations ; diagnosis ; therapy ; Leg ; Male ; Tendons ; Treatment Outcome

OBJECTIVE: To analyze and compare different methods for assessment of the limbs joints function and to discuss the rationality of the methods. METHODS: Eight hundred and six cases were collected from the Fujian Minzhong Forensic Appraisal Center from 2007 to 2010. These cases included injuries of large limbs joints with or without peripheral nerve injury. The loss of joint function was calculated according to the simple joint mobility method or the table method introduced in the book "Forensic Clinical Judicial Authentication Practice". The results of disability evaluation with different methods were analyzed and compared between different joints and injury patterns. RESULTS: In 642 cases of simple joint injuries without peripheral nerve injury, the results of disability evaluation based on simple joint mobility were the same as that based on the table. In 118 cases of joint injuries with peripheral nerve injury, all of them could be classified as disability, 33 cases (28.00%) had higher degree based on the table method than based on the simple joint mobility method. While 21 cases (17.80%) did not be evaluated as disabled based on the simple joint mobility method. CONCLUSION The evaluation for loss of limb function would be easier, more scientific and reasonable by the direct table method than the simple joint mobility method.
Accidents, Traffic ; Adult ; Arm Injuries/physiopathology* ; Disability Evaluation ; Extremities ; Female ; Forensic Medicine/methods* ; Humans ; Joints/physiopathology* ; Leg Injuries/physiopathology* ; Male ; Peripheral Nerve Injuries/physiopathology* ; Range of Motion, Articular/physiology* ; Trauma Severity Indices

OBJECTIVE: To investigate the characteristics of forensic clinical identification on common peroneal nerve injury in traffic accident. METHODS: Eight cases of common peroneal nerve injury in traffic accidents were analyzed, including general condition of the wounded, the way of injury, the imaging results, the EMG results, and the degree of injury, etc. RESULTS: In 8 cases, 2 cases of complete common peroneal nerve injury were determined to grade 9 (disability degree) and 6 cases of partial common peroneal nerve injury were determined to grade 10 (disability degree). CONCLUSION By comparison, the disability degree of complete common peroneal nerve injury is higher than that of partial common peroneal nerve injury. The forensic clinical identification of common peroneal nerve should be made with synthetical consideration of medical history, symptoms, and auxiliary examinations.
Accidents, Traffic ; Adult ; Age Distribution ; Disability Evaluation ; Expert Testimony ; Female ; Fibula/injuries* ; Fractures, Bone/physiopathology* ; Humans ; Leg Injuries/physiopathology* ; Male ; Middle Aged ; Peroneal Nerve/physiopathology* ; Peroneal Neuropathies/physiopathology* ; Radiography ; Trauma Severity Indices

OBJECTIVETo explore a treatment approach for severely injured lower extremities.

METHODSThe data of 42 patients with severely traumatic lower extremities from 1989 to 1999 were retrospectively reviewed. According to MESS (mangled extremity severity score) the mean score of all the limbs was 6.24+/-1.45, 34 cases had MESS score < 7 and 8 cases had MESS score > or = 7. Treatment approaches included microvascular anastomosis technique, compound tissue flap transplantation technique and compound bone tissue flap transplantation.

RESULTSTwo patients died after operation and one patient had delayed amputation of a lower limb. The rest 39 patients were followed up for 4-13 years. All the lower extremities of the 39 patients survived and had equal length. The 39 cases were evaluated by Chen's criterion, showing that 37 had good result (29, Chen I and 8, Chen II), 1 sufficient (Chen III) and 1 poor (Chen IV).

CONCLUSIONSSuccessful emergency treatment of severely injured lower extremities could be achieved by using microsurgery techniques and strict controlling of lower extremity salvagel indications.

Adolescent ; Adult ; Child ; Emergency Medicine ; methods ; Female ; Follow-Up Studies ; Fractures, Bone ; physiopathology ; therapy ; Humans ; Leg Injuries ; physiopathology ; therapy ; Male ; Middle Aged ; Multiple Trauma ; physiopathology ; therapy ; Muscle, Skeletal ; physiopathology ; Orthopedic Procedures ; methods ; Range of Motion, Articular ; Recovery of Function ; Retrospective Studies ; Survival Analysis ; Tissue Transplantation ; methods ; Treatment Outcome