IEDs are a common cause of stable and unstable spinal injuries in the Afghanistan conflict. Spinal immobilization is an underutilized intervention in the battlefield care of casualties in the conflict in Afghanistan. This may be a result of tactical limitations; however, current protocols should continue to emphasize the judicious use of immobilization in these patients.

Background Kyphosis in myelomeningocele is a rare and difficult problem. Many strategies have been used with no single procedure universally agreed on. Techniques involving anterior and posterior fixation may provide better fusion. Questions/purposes We describe a novel procedure for anteroposterior kyphectomy in patients with myelomeningocele. Apical posterior kyphectomy is followed by the insertion of two rods distally into the vertebral bodies and sacrum. Sublaminar wires are placed superiorly and the kyphosis is reduced by sequential tightening. We determined kyphosis correction and intraoperative blood loss for this new procedure Methods We retrospectively reviewed 22 patients (average age, 7.6 years [range, 2-17 years]) who underwent apical kyphectomy from 1982 to 2008. Charts were examined and radiographs measured preoperatively, immediately postoperatively, and at final followup. Followup averaged 6.4 years (range, 0-14 years) with 19 patients having at least 2 years of followup. Results Kyphosis decreased from a mean of 123°(range, 79°-163°) preoperatively to 40°(range, 13°-92°) immediately postoperatively and was a mean of 60°(range, 14°-126°) at final followup. Operating time was 248 minutes (range, 180-345 minutes), estimated blood loss was 765 mL (range, 140-2100 mL), and length of stay was 14 days (range, 1-57 days

Acute compartment syndrome is a limb-threatening condition in which early diagnosis and surgical consultation for fasciotomy are required to preserve functional outcome. The diagnosis is typically considered in patients with traumatic mechanisms of injury such as a direct blow and crush to the compartment, particularly when there is a fracture in the same compartment. We report the case of a patient with acute compartment syndrome of the dorsal forearm that occurred as a result of an atypical noncontact traumatic mechanism. Establishing the diagnosis of compartment syndrome was complicated in this patient, as some of the signs and symptoms of acute compartment syndrome could have been attributed to the presence of a coexisting rupture of the extensor digitorum muscle. This report serves to remind emergency physicians that, although rare, acute compartment syndrome can result from exertional and noncontact traumatic mechanisms.

Hospital admissions for trampoline-related injuries are a metric of injury severity. The literature shows hospital admissions are more likely to occur from trampoline park injuries rather than home trampoline injuries. The purpose of this study was to investigate the demographics, injury characteristics, patient experiences, and economic impact of home versus trampoline park injuries requiring admission to hospital before and after two indoor trampoline parks opened in the catchment area of a Level II trauma centre. A case series research design was used. All patients who were admitted to hospital following a trampoline injury were contacted. For those who consented, clinical data was recorded from patients' charts and electronic health records. A subset of participants consented to a telephone interview wherein patient narratives were collected on the mechanism of injury, recovery process, and impact of the injury. During the study period, 15 patients required 17 hospital admissions. Twelve consented to participate in the study. Nine of the 12 required an operative intervention. Eight of the 12 were trampoline park injuries. Anatomical location of the injuries, injury type and severity scores, hospital stay, and median age were similar. The economic impact of home trampoline and trampoline park injuries varied. Overall, there were more hospital admissions and more operative interventions for trampoline park injuries during the four-year study period. Seven participants who consented to be interviewed provided additional insights into the injury experience and long-term outcomes. This study contributes to the literature on trampoline-related injuries, focusing on hospital admissions, economic impact, and adds the important perspective of patients in evaluating the effect of these injuries.