[Burn injuries to military personnel during the Six Day War].

About 2500 soldiers were injured during the Six Day War (June 1967) of whom 115 suffered from burns. In 34 of them 15% or more of their body surface was involved and 11 died. Typical features of these burn cases were supplementary injuries, a high rate of infection, and long periods of hospitalization. Prophylactic antibiotics were not useful. The general condition of many deteriorated during the first week after injury, indicating the importance of treating severe burns in specialized facilities.

[Partial sensory palsy of median nerve due to neurilemmoma].

A neurilemmoma that developed in the median nerve caused partial sensory loss in a 54-year-old woman. All symptoms disappeared within 3 months of excision of the tumor. This presentation highlights the fact that symptoms of nerve compression can be caused by intraneural tumors.

Intramuscular haemangioma of the forearm.

Intramuscular haemangioma, though benign, may be a serious disorder, because its large size can cause functional impairment, pain and disfigurement, which may require surgical excision. These, as well as the baffling histopathological aspects, are exemplified by this report of an intramuscular haemangioma of the forearm in an adolescent girl. Clinical recognition of a cutaneous angioma overlying a deeply-situated soft tissue tumour may aid the diagnosis of an intramuscular haemangioma.

Sensory changes with prolonged double-cuff tourniquet time in hand surgery.

This study evaluates the sensory changes that occur in the operated hand after the use of the double-cuff tourniquet technique for up to 4 hours. Thirty patients whose hand operations lasted more than 2 hours were evaluated. Tourniquet time ranged between 2 hours and 4 hours, 17 minutes. Light touch, von Frey's aesthesiometry, vibratory sensation, and two-point discrimination were examined. Subjective overall sensation and postoperative edema were also assessed. Patients were evaluated the evening before operation, on the second postoperative day, and at every out-patient follow-up visit, until all examined parameters returned to normal. Of the patients 73% demonstrated clinically normal sensibility test results within 23 days after operation. In 80% of all patients, subjective sensibility of the operated hand was equal to the nonoperated hand within 1 week of operation. Ultimately, all patients (96%) but one, demonstrated normal sensibility test results and normal subjective sensibility. Postoperative edema developed in 53% of the patients; it subsided in less than 4 weeks. The double-cuff technique can prolong tourniquet time safely for up to 4 hours.

Synovial sarcoma of the hand--a literature study.

Ninety cases of synovial sarcoma of the hand, including eight case reports have been described during the last fifty years, (1934-1984). 8.5% of all synovial sarcomata involve the hand, and affect predominantly individuals under the age of thirty. The five-year survival of these cases was 18% and the ten-year survival 9%.

Human bites of the hand: a study of one hundred six patients.

One hundred six patients with human bites of the hand (HBH) were studied in detail. This study was characterized by a higher than expected incidence among women, by a large number of patients who presented for treatment more than 1 week after injury, and by a high complication rate and a low incidence of hospitalization. The overall morbidity rate of these patients was considerable. Early and delayed cases of HBH were typified by an absence of complications. Except for partial or complete traumatic amputations, their recovery time was short, and the final functional result was usually favorable. Late cases were characterized by a high rate of infection-related complications, a prolonged morbidity period, and a less favorable final functional result. One hundred of our patients were successfully treated as outpatients. This led us to believe that most HBH can be treated on an outpatient basis. Hospitalization should be mainly reserved for patients with infection-related complications and for extremely unreliable patients. The time interval between injury and the commencement of treatment appears to be the single most important factor governing the final result in HBH.

Will they fly again? The probability of wounded military aviators returning to flying duty: a study of 70 cases.

In this study, 70 Israeli Air Force aviators, most of them suffering from severe or moderately-severe injuries, were evaluated as to their potential to return to active flying duty. Of these, 59 (84%) were able to return to flying and 11 (16%) were permanently grounded. While 44 of 51 fighter aviators (86%) returned to flying, only 30 of them (59%) returned to fly fighters, and the rest were transferred to another type of aircraft. The roles of age and severity of injury were studied in detail and it was concluded that higher age and severe injuries prolong the convalescence period but do not prevent the aviator from returning to flying. Nine aviators were permanently grounded because of medical reasons. In each case a single injury could be demonstrated as the direct cause of their permanent grounding. All aviators were followed-up for 3 years after having returned to flying. It was concluded that an evaluation period of 2 years is sufficient to determine the long-term success of military aviators returning to flying.

Ewing's sarcoma of the hand following recurrent trauma; a case report.

A case of Ewing's Sarcoma of the thumb is described. Four years after a fracture of the first metacarpal, followed by a series of repeated traumata to the area, a tumour was discovered. According to Ewing's criteria of trauma induced malignancy, this case is highly suggestive to have been caused by trauma.

Aeromedical evacuation in Israel--a study of 884 cases.

We analyzed 884 moderately severe and severe casualties evacuated by the aeromedical evacuation unit of the Israel Air Force. Of these, 452 were evacuated during the "Yom Kippur" War in 1973, and 432 during 1974-76. The aeromedical teams performed 24 rescusitations and 13 emergency operations, and provided primary medical care for 37 cases; 95% of the casualties reached the next stage of evacuation without deterioration in their medical condition. These data support our concept that the participation of a flight surgeon in aeromedical evacuation is highly valuable. The advantages of small helicopters for aeromedical evacuation purposes are outlined. The suitability of the aeromedical evacuation system in Israel for wartime as well as for peacetime is pointed out.