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Thirty-four microvascular free flaps were used to treat defects in the lower extremities after injuries. Twenty patients (74%) had severe open fractures (Gustilo type III B & C). Latissimus dorsi (n = 16) and iliac osteocutaneous (n = 7) flaps were most commonly used for coverage, and the overall failure rate was 9% (3/34). At follow up 29 of the patients (94%) had a reduced range of movement of the ankle, nine (29%) had some swelling and oedema, and 13 (42%) had occasional pain in the leg. Sixteen (52%) of the patients were limping, but 26 (84%) could walk one kilometre or more with no problems. No legs were amputated. The unemployment rate increased from 1/34 (3%) to 6/31 (19%) at follow up. Twenty-seven (87%) of our patients were satisfied with the results, despite the considerable and persistent limitation of function, and the increase in the unemployment rate.

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Minor burns due to fireworks which are treated in the Casualty Department have remained constant during the past ten years. The injured patients are boys and young men between 7-19 years. Boys are injured ten times as frequently as girls. The commonest sites of injuries are the upper limbs, the head and neck. The number of patients admitted to hospital on account of serious burns has increased. These are most frequently caused by clothes catching fire from fireworks which have been hidden under outer clothes or in trouser pockets. In order to avoid the serious burns caused by burning clothes, it is recommended that fireworks should not be concealed under clothes but carried away from the body possibly in a container made of non-inflammable material.

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During recent years, an increasing number of skateboard accidents have been registered in Odense Hospital. Typically, boys aged 10-14 years are involved and these had fallen on outstretched arms. No injuries endangering life were registered but 36% had fractures and half of these were localized to the wrist. Approximately 8% of the injuries resulted in hospitalization. Despite prohibition in the traffic legislation, 65% of the injuries occurred in trafficated regions and only 15% occurred in specially made skateboard rinks. The real risk involved in board skating are unknown but, in this selected group of board skaters, no significant connection could be demonstrated between routine experience in board skating, employment of protective equipment and frequency of fractures. Employment of protective equipment was commonest among persons who were members of a club and among those injured on skateboard ramps. The frequency of fractures was significantly higher among persons injured on ramps than among the remainder. Possible prophylactic measures are discussed and simple rules are recommended.

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During recent years, the import of roller skates has increased markedly and, during the period 1.1.1980-30.9.1988, an increase has been observed in the number of roller skate accidents treated in the Casualty Department of Odense Hospital. These accidents are particularly frequent in early spring and involve children under the age of 15 years, in particular, with slight preponderance of girls. The typical mechanism of injury is a fall which the victim tries to mitigate with the hands and arms. Nearly 90% of all injuries were localized to the locomotor system and just under half of the patients sustained fractures, typically of the wrist. Over 8% of the injuries necessitated hospitalization. The great majority of accidents occurred in unorganized groups and not in clubs, in ordinary traffic and without the use of protective equipment. In a selected group of roller skaters, as in this investigation, no connection could be found between the type of roller skates, employment of protective equipment and the frequency of fractures. The actual risk in roller skating is not known but possible prophylactic measures are discussed and simple safety rules are recommended.

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Necrotizing fasciitis is a serious infectious disease characterized by a necrotizing cellulitis of the subcutaneous tissue. The mortality has not changed over the last 50 years, probably because the condition is not recognized early enough to permit effective treatment by debridement. We report 3 cases illustrating different clinical courses.

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A case of dislocation of the extensor tendons of the hand caused by focal myoclonic epilepsy is presented. This particular aetiology, which has not previously been reported, is discussed. The tendons were repositioned and there was no sign of recurrence one year later.

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