Document Detail


A fractured peace: a changing pattern of violence.
MedLine Citation:
PMID:  9326144     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Since the paramilitary cease-fire in Northern Ireland in August 1994 we have seen a change in the pattern of so called 'punishment attacks'. Shootings with low velocity handguns have been replaced by severe beatings to the extremities from multiple assailants using iron bars or similar weapons. In the 18 months prior to the cease-fire there were 177 punishment shootings, which were usually relatively minor and did not require any plastic surgical expertise. Between August 1994 and November 1996, however, there were 461 punishment beatings. These beatings result in much greater morbidity and require considerable orthopaedic and plastic surgical input. In the Northern Ireland Plastic and Maxillofacial Unit we have treated 18 patients with a mean age of 22.9 years (range 16-32 years) who have been the victims of punishment beatings. These patients sustained multiple injuries, all with severe soft tissue involvement; 70% had compound fractures. The majority of patients had multiple wounds. Four patients with compartment syndrome as a result of their injuries required fasciotomies. Soft tissue reconstruction included split skin grafting (4 patients), fasciocutaneous flaps (4 patients), adipofascial flaps (2 patients), local muscle flaps (2 patients) and free muscle transfers (2 patients). Six patients required more than one procedure for soft tissue reconstruction because of multiple injuries. Each patient had a cumulative mean time in theatre of 6.7 hours. The mean hospital stay was 22.2 days (range 2-52 days). This change in the pattern of injury has led to an increased use of plastic surgical resources. Patient morbidity is significantly greater than when guns are used, and permanent disability is often the result.
Authors:
M H Eames; B Kneafsey; D Gordon
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  British journal of plastic surgery     Volume:  50     ISSN:  0007-1226     ISO Abbreviation:  Br J Plast Surg     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1997-10-16     Completed Date:  1997-10-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  2984714R     Medline TA:  Br J Plast Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  416-20     Citation Subset:  IM    
Affiliation:
Northern Ireland Plastic and Maxillofacial Service, Ulster Hospital Dundonald, Belfast, Northern Ireland.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Fractures, Open / surgery
Humans
Leg Injuries / surgery
Length of Stay
Male
Multiple Trauma / etiology,  surgery*
Northern Ireland
Soft Tissue Injuries / surgery
Surgery, Plastic / methods*
Violence / trends*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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