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OBJECTIVE: The current study was designed to study hip spica casted and uncasted child dummies in front- and side-impact tests using a variety of restraints. METHODS: Casted one- and three-year-old ATDs were restrained by a traditional child seat, a special hip spica child seat, and the vehicle seat belts. All tests positioned the child upright in either the rear-facing (one-year-old) or forward-facing (three-year-old) direction. One exception was vehicle seat belt tests for the one-year-old, which required the child to be positioned supine due to the position of the child's body imposed by the cast. The ATDs were tested in frontal impacts per FMVSS 213 (delta V of 30 mph) and in side impact using the pulse proposed for 213 (delta V of 20 mph). Corresponding control tests were performed with the uncasted ATDs. The FMVSS 213 mandated injury metrics (HIC36, 3 ms chest gs) and nonmandated due care metrics (HIC15, Nij) were evaluated. RESULTS: For the one-year-old casted tests, 50 percent of the responses increased when compared to the uncasted control. A similar comparison for the three-year-old revealed an 80 percent increase when the dummy was fit with a body cast. HIC36 and chest gs were below the limits established in FMVSS 213 for all casted and uncasted tests. Frontal peak Nij values were in the tension-extension in nine out of ten cases and ranged from 0.8 to 0.83 (uncasted) and 1.02 to 1.92 (casted). Side-impact Nij was approximately 50 percent of the corresponding frontal tests. CONCLUSIONS: The addition of a body cast increases head, neck, and chest responses in front- and side-impact tests. The increases are greatest for the three-year-old who was forward facing.

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This study correlated the frequency of bone bruises with soft tissue injuries in the knee and examined bruise frequency as a function of time postinjury. Magnetic resonance imaging of 1546 patients revealed bone bruises in 19% of patients without an associated meniscal or ligamentous injury. For those patients presenting with at least one meniscoligamentous injury, the frequency of bruising was 60% at 0 to 4 weeks, 42% at 4 to 10 weeks, and 31% at 10 to 26 weeks postinjury. The frequency of bruising varied with the presence of concomitant injuries, with the greatest frequency of bruises (78%) observed in patients with anterior cruciate ligament injuries.

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Significant blood loss during total hip arthroplasty is usually unavoidable. Blood loss is even more of a problem during revision total hip arthroplasty. Using the Cell-Saver for retrieval of red blood cells to be used for autotransfusion during surgery is a safe and useful way of sparing donor blood transfusion. This is a retrospective analysis of primary and revision total hip arthroplasty cases and comparison between cases in which Cell-Saver was used versus those in which Cell-Saver was not used. Generally accepted standards to determine the need for blood transfusion, including measured serum hemoglobin and patient symptoms and vital signs, were used as guidelines in treating patients. Using multiple regression models and taking into account certain variables between cases, it was determined that a significant amount of donor blood transfusion can be saved when the Cell-Saver is used. The Cell-Saver is an important aid in intraoperative treatment for both primary and revision total hip arthroplasty cases.

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Joint infection secondary to sporotrichosis is quite rare. Recently there have been two reports of sporotrichosis arthritis in the literature. An early report of synovitis of the knee secondary to sporotrichosis without cutaneous or multifocal involvement appeared in 1957. Sporotrichosis is a fungal disease that commonly causes bone and joint infection in its extracutaneous form. This report discusses sporotrichosis of the knee joint in a 28-year-old patient.

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Three methods for testing the comparative strength of orthopedic casts have been considered. Two of the tests, three-point-beam-bending and diametral compression, were expected to yield information about "material" strength, and a third simulated an actual cast yielding information about "structural" strength. In one study using these three methods, differences in strength were detected in the material tests, but not in the structural test. Thus, the authors believe that tests of material strength alone are insufficient to establish clinically relevant differences between the strength of orthopedic casts. Adequate testing must include structural tests like the cast-cylinder test described in this article if meaningful and clinically relevant conclusions are to be drawn regarding the comparative strength of the actual cast. Since both the three-point-beam-bending and diametral compression tests produced essentially the same results, both tests are probably not necessary. However, each of these two tests does serve to substantiate the results of the other.

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The strength of five commercially available synthetic orthopedic casting products are discussed. Using three testing designs, significant differences could be consistently determined. These testing methods provide a means of comparing the various casting products on the market. The authors point out that this study was a comparison of ultimate strength only, and did not compare the other characteristics of the products. It also was noted that all these synthetic casting materials were stronger than plaster-of-Paris casting material.

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The effect of hydration water temperature (dip water) on the strength of orthopedic casts is discussed. Three methods of testing are used in an attempt to detect any differences and also to assess their clinical relevance. It was found that warmer water produced stronger casts, however, the differences were not found to be clinically relevant. It is suggested that water temperature be chosen on the basis of considerations other than strength.

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