Introduction: Isolated musculocutaneous nerve injuries occur rarely due to their anatomical location. We present our patient with a musculocutaneous nerve injury in a motorcyclist. Case: The patient was initially treated for a motorcycle accident. Further examination of the patient revealed impaired elbow flexion and numbness of the lateral forearm. Electromyography confirmed impaired function of the musculocutaneous nerve. After 3 months, the patient‘s condition did not show any improvement, neither electromyography confirmed recovery of the nerve activity, so surgical treatment was planned. In the surgical revision, neuroma-in-continuity was discovered and resected. The resulting nerve defect was 6 cm long. We provided nerve grafting using sural nerve from the right lower limb. After surgery, the patient began physical therapy and electrical stimulation. Two years later, the patient reached complete recovery of muscle strength. Conclusion: Due to the lack of improvement after a 3-month period, we proceeded with a surgical revision, which demonstrated a complete lesion of the nerve that could not heal spontaneously. Therefore, we opted for the nerve graft method and the patient regained full function of elbow flexors.

• MeSH
• dopravní nehody MeSH
• dospělí MeSH
• lidé MeSH
• motocykly MeSH
• nervový přenos MeSH
• nervus musculocutaneus * chirurgie   zranění   MeSH
• nervus suralis transplantace   MeSH
• poranění periferního nervu * chirurgie   etiologie   klasifikace   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Cieľom predkladanej prípadovej štúdie je analýza úmrtia športovca, ktorý absolvoval preteky v horskej cyklistike, ktorému krátko po pretekoch bolo nevoľno s deklarovanými bolesťami na hrudníku, čo neskôr viedlo k poruche vedomia a k resuscitačnej príhode. Rozšírenou kardiopulmonálnou resuscitáciu sa životné funkcie nepodarilo obnoviť, čo viedlo k smrti. Nakoľko došlo k náhlemu úmrtiu z plného zdravia bolo nariadené prehliadajúcim lekárom vykonanie pitvy. Pitvou a histopatologickým vyšetrením bol zistený akútny infarkt prednej steny na podklade stenózy prednej medzikomorovej vetvy ľavej koronárnej artérie s histopatologickým nálezom eozinofilnej koronárnej periarteritídy. Náhle úmrtie pri športových aktivitách je komplexným problémom, pred ktorým stoja lekári vykonávajúci pitvu. Pre exaktné posúdenie prípadu nestačí len vykonať vonkajšiu a vnútornú prehliadku tela pri pitve, je tiež dôležité, aby súdny lekár mal dostatok znalostí z danej problematiky a mal k dispozícii dostatok informácii o okolnostiach úmrtia, anamnestické údaje ev. kompletnú zdravotnú dokumentáciu. Zistená eozinofilná koronárna periarteritída sa vyskytuje zriedkavo s dominantným výskytom v mužskej populácii, pričom etiológia doposiaľ nie je známa.

Presented case study deals with the sudden death of a 47 years old male, shortly after a mountain bike race after reported nausea and chest pain followed by loss of consciousness and resuscitation. Cardiopulmonary resuscitation was unsuccessful. An autopsy was enacted due to the sudden death in a seemingly healthy person. An acute infarction of the anterior cardiac wall on the basis of stenosis of the anterior interventricular branch of the left coronary artery with histopathological findings of eosinophilic coronary periarteritis was assessed. Sudden death during sport activities represents a complex problem which forensic physicians have to face. An external and internal examination of the body is not always sufficient. It is crucial for the forensic physician to have sufficient knowledge and enough information about the circumstances of the death and anamnestic records. Eosinophilic coronary periarteritis occurs rarely, predominantly in males and with uncertain etiology.

• Klíčová slova
• eosinofilní koronární periarteritida,
• MeSH
• arteritida komplikace   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• motocykly MeSH
• náhlá smrt etiologie   patologie   MeSH
• náhlá srdeční smrt * patologie   MeSH
• sporty * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

BACKGROUND: There have been major improvements in the trauma system and injury prevention in Al-Ain City. We aimed to study the impact of these changes on the incidence, pattern, injury severity, and outcome of hospitalized motorcycle-related injured patients in Al-Ain City, United Arab Emirates. METHODS: This is a retrospective analysis of two separate periods of prospectively collected data which were retrieved from Al-Ain Hospital Trauma Registry (March 2003 to March 2006 compared with January 2014 to December 2017). All motorcycle-injured patients who were admitted to Al-Ain Hospital for more than 24 h or died in the Emergency Department or after hospitalization were studied. RESULTS: The incidence of motorcycle injuries dropped by 37.1% over the studied period. The location of injury was significantly different between the two periods (p = 0.02, Fisher's exact test), with fewer injuries occurring at streets/highways in the second period (69.1% compared with 85.3%). The anatomical injury severity of the head significantly increased over time (p = 0.03), while GCS on arrival significantly improved (p < 0.0001), indicating improvements in both prehospital and in-hospital trauma care. The mortality of the patients significantly decreased (0% compared with 6%, p = 0.002, Fisher's exact test). CONCLUSIONS: The incidence of motorcycle injuries in our city dropped by almost 40% over the last 15 years. There was a significant reduction in the mortality of hospitalized motorcycle-injured patients despite increased anatomical severity of the head injuries. This is attributed to improvements in the trauma care system, including injury prevention, and both prehospital and in-hospital trauma care.

• MeSH
• dopravní nehody MeSH
• kraniocerebrální traumata * MeSH
• lidé MeSH
• motocykly * MeSH
• retrospektivní studie MeSH
• rozvojové země MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Traumatická dislokace varlat je vzácným typem poranění mužského genitálu, které vzniká zejména při dopravních nehodách. Typicky vzniká především při nehodách na motocyklu, kde dochází k tupému nárazu genitálu na nádrž motocyklu, bývá proto v literatuře označováno termínem "fuel tank injury" (poranění palivovou nádrží). Včasná diagnostika pomocí sonografie a CT vyšetření a bezodkladná léčba má stěžejní význam pro zachování funkce dislokovaného varlete. Prezentujeme kazuistiku bilaterální traumatické dislokace varlat u 34letého pacienta po motocyklové nehodě, diagnostikované sonograficky a CT a následně řešené uzavřenou repozicí v celkové anestezii.

Traumatic dislocation of testes is a rare type of genital injury, which occurs mostly following motor vehicle accidents, particularly motorcycle accidents due to a blunt impact of the scrotum and perineum on the fuel tank of the motorcycle. This injury is often referred to as "fuel tank injury" in the literature. An early diagnosis using ultrasonography and CT scan and immediate surgical management are of key importance for preserving of the function of the dislocated testis. We present a case of bilateral traumatic testicular dislocation in a 34-year-old patient following a motorcycle accident, diagnosed using ultrasonography and CT and managed with manual reduction under general anesthesia.

• Klíčová slova
• manuální repozice,
• MeSH
• dopravní nehody MeSH
• dospělí MeSH
• lidé MeSH
• motocykly MeSH
• testis * diagnostické zobrazování   patologie   zranění   MeSH
• tupá poranění * etiologie   terapie   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 87-97%), lacerations accounted for 3% (95% CI: 1-6%), and gunshot wounds (GSWs) for 3% (95% CI: 0-7%). The prevalence of male patients was 93% (95% CI: 90-96%) and female cases 7% (95% CI: 4-10%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 49-82%) prevalence followed by car crashes with 14% (95% CI: 8-20%). Other causes were rare. Ninety percent (95% CI: 78-98%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 2-22%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 47-58%) followed by upper plexus lesion with 39% (95% CI: 31-48%) and lower plexus injury with 6% (95% CI: 1-12%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare.

• MeSH
• dopravní nehody MeSH
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• motocykly MeSH
• neurochirurgické výkony metody   MeSH
• plexus brachialis zranění   chirurgie   MeSH
• poranění periferního nervu epidemiologie   chirurgie   MeSH
• střelné rány MeSH
• zákroky plastické chirurgie metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

OBJECTIVES: Crashes due to motorcyclists colliding with an open car door can cause devastating injuries. In Taiwan, such crashes typically occur when the motorcyclist is travelling alongside a row of parallel-parked cars, and a driver suddenly opens the door in front of or next to the motorcycle without determining whether it is safe to do so. Injuries resulting from motorcycle door crashes tend to be severe. This study examined the factors that contribute to motorcycle door crashes. METHODS: By using linked data from the National Traffic Crash Dataset and Emergency Medical Service for Taipei City for the years 2010-2015, this study estimated a mixed multinomial logit model to predict the likelihood of three types of door crashes: driver-door crashes, left passenger-door crashes, and right passenger-door crashes. RESULTS: Data on 8237 motorcycle door crashes were extracted from the two datasets and matched. The results from the mixed multinomial logit model revealed that illegal parking, older car occupants, teenage car occupants, intoxicated car occupants and motorcyclists, and motorcycle speeding contribute to driver-door crashes; and female passengers and taxis as the type of vehicle involved in crash are associated with left passenger-door crashes. CONCLUSIONS: Our study suggested that controlling motorcycle speed, and prosecuting illegal parking and drink driving/riding may constitute effective countermeasures. The "Dutch Reach" intervention measure, which is commonly adopted in Europe for bicycle door crashes, should be applied in Taiwan to curb motorcycle door crashes, especially for elderly car occupants.

• MeSH
• automobily statistika a číselné údaje   MeSH
• datové soubory jako téma MeSH
• dopravní nehody mortalita   prevence a kontrola   statistika a číselné údaje   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• logistické modely MeSH
• mladiství MeSH
• mladý dospělý MeSH
• motocykly statistika a číselné údaje   MeSH
• prostředky k ochraně hlavy statistika a číselné údaje   MeSH
• řízení pod vlivem návykové látky statistika a číselné údaje   MeSH
• senioři MeSH
• věkové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Taiwan MeSH

• MeSH
• automobily MeSH
• licence MeSH
• lidé MeSH
• motocykly MeSH
• posuzování zdravotní způsobilosti * MeSH
• řízení motorových vozidel * normy   MeSH
• sporty MeSH
• zdravotní stav MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• směrnice pro lékařskou praxi MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• lidé MeSH
• motocykly MeSH
• poskytování zdravotní péče zákonodárství a právo   MeSH
• urgentní zdravotnické služby * organizace a řízení   zákonodárství a právo   MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Slovenská republika MeSH

BACKGROUND: Brachial plexus injury occurs in up to 5% of polytrauma cases involving motorcycle crashes and in approximately 4% of severe winter sports injuries. One of the conditions for the success of operative therapy is early detection, ideally within three months of injury. The aim of this study was to evaluate associated injuries in patients with severe brachial plexus injury and determine whether there is a characteristic concomitant injury (or injuries), the presence of which, in the polytrauma, could act as a marker for nerve structures involvement and whether there are differences in severity of polytrauma accompanying specific types of brachial plexus injury. METHODS: We evaluated retrospectively 84 surgical patients from our department, from 2008 to 2011, that had undergone brachial plexus reconstruction. For all, an injury severity scale (ISS) score and all major associated injuries were determined. RESULTS: 72% of patients had an upper, 26% had a complete and only 2% had a lower brachial plexus palsy. The main cause was motorcycle crashes (60%) followed by car crashes (15%). The average ISS was 35.2 (SD=23.3), although, values were significantly higher in cases involving a coma (59.3, SD=11.0). The lower and complete plexus injuries were significantly associated with coma and fractures of the shoulder girdle and injuries of lower limbs, thoracic organs and head. Upper plexus injuries were associated with somewhat less severe injuries of the upper and lower extremities and less severe injuries of the spine. CONCLUSION: Serious brachial plexus injury is usually accompanied by other severe injuries. It occurs in high-energy trauma and it can be stated that patients involved in motorcycle and car crashes with multiple fractures of the shoulder girdle are at high risk of nerve trauma. This is especially true for patients in a primary coma. Lower and complete brachial plexus injuries are associated with higher injury severity scale.

• MeSH
• časná diagnóza MeSH
• dislokace kloubu MeSH
• dopravní nehody statistika a číselné údaje   MeSH
• dospělí MeSH
• fraktury kostí terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• motocykly MeSH
• neuropatie brachiálního plexu chirurgie   MeSH
• plexus brachialis zranění   patofyziologie   chirurgie   MeSH
• polytrauma komplikace   patofyziologie   chirurgie   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• skóre závažnosti úrazu MeSH
• zákroky plastické chirurgie * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• disekce aorty etiologie   patologie   MeSH
• dopravní nehody MeSH
• fatální výsledek MeSH
• koronární aneurysma etiologie   patologie   MeSH
• koronární cévy zranění   patologie   MeSH
• lidé MeSH
• mladý dospělý MeSH
• motocykly MeSH
• pitva MeSH
• poranění srdce etiologie   patologie   MeSH
• příčina smrti MeSH
• tupá poranění etiologie   patologie   MeSH
• Check Tag
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH