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Introduction Little consensus exists over the management of high-grade renal injuries, with continued debate over observation versus invasive surgery. Blunt renal artery injury (BRAI) is a high-grade injury that may result in renal dysfunction, hypertension, or failure. Materials and methods Management of BRAI at a level I trauma centre during a decade was retrospectively reviewed to determine incidence, assess management strategy, and evaluate hospital outcomes. Data collected included demographics, injury details, standardised scoring, renal injury grade, haemodynamic stability, diagnostic modalities, medical interventions, mortality, and hospitalisation length. Results Thirty-eight BRAI patients (21 Grade IV and 17 Grade V injuries) were admitted, representing 0.16% of trauma admissions, and consisting primarily of young males. Ultrasonography and CT was performed in 92.1% and 76.3% of patients, respectively. Primary management included exploratory laparotomy in 42.9%, angiography and embolisation in 34.3%, and observation in 22.9%. Six nephrectomies and one revascularisation were performed. The incidence of BRAI and use of angiography are higher than those reported in previous studies. Conclusion Over the past decade, increased use of CT as a diagnostic tool for confirming renal injury in haemodynamically stable patients at our institution may have contributed to the increase in BRAI detection. Higher utilisation of angiography has enabled a more conservative approach. In this series, angiography had a success rate of 94.4%. Angiography and embolisation or observation with careful monitoring are viable management options in haemodynamically stable patients with isolated BRAI.

Eighty midshaft fractures of the forearm bones in children are reviewed. These fractures occur predominantly in boys and are more frequent in the left forearm. The fractures can occur at any age, but the majority are seen between 6 and 8 years of age. They are divided into two groups: greenstick (Type 1) and displaced fractures (Type 2). Greenstick fractures (Type 1, 82.5 per cent) need only correction of the deformity without breaking the intact cortex, followed by supervized splintage for 6 weeks. Type 2(a) (3.8 per cent) fractures, where only one bone is displaced, were treated conservatively, but the displaced bone tends to heal with lateral angulation causing limited rotation unless adequately aligned surgically. Type 2(b) (13.7 per cent) fractures, where both bones are displaced, occur in young teenagers. The majority of these should be treated by internal fixation if adequate alignment cannot be achieved or maintained by conservative means.

Three murine anti-human beta-interferon (IFN-beta) monoclonal antibodies have been isolated following adoptive transfer of immune spleen cells. Adoptive transfer was used to increase the specific efficiency of the fusion. These antibodies have been used to define two epitopes on IFN-beta; the antiviral, antiproliferative, and immunomodulatory effects of IFN-beta are associated with one of these epitopes.