432 CURRENT LITERATURE

surgery. After dissection of one of the skin flaps, half the excess skin was excised with the argon gas surgical unit and half with a conventional electrosurgical unit. The excised skin was then sent for histologic analysis to assess the depth of tissue damage caused by each technique. The statistically significant difference in mean distance from the cut margin to the end of cautery artifact at the level of epidermis was 0.27 mm for the argon gas surgical unit and 0.67 mm for the conventional electrosurgical unit. The standard deviation in the argon gas group was also much smaller, implying that the results were more consistent and predictable. With conventional electrocautery, there must be direct contact be- tween the electrode tip and the tissue. In contrast, argon- enhanced coagulation is based on a concept that uses ionized gas to act as an electrical bridge to conduct current between the electrode and the tissues. This creates a noncontact form of coagulation. Argon, an inert gas, is relatively safe and will not ignite materials such as linen, gauze, gloved hands, drapes, or fatty tissue, as a laser or conventional electrosurgi- cal unit might. The investigators also noted a clinically sig- nificant decrease in postoperative swelling, hematoma, ser- oma, and drain output. The reduction in bleeding has contributed to reducing the operative time. Uses now also include blepharoplasty, breast reduction, and abdomi- noplasty.-P.S. LAM

Reprint request to Dr Man: Aesthetic Ambulatory Surgical Unit, 851 Meadows Rd, Suite 222, Boca Raton, FL 33486

Baseball Injuries: A Little League Survey. Pasternack JS, Veenema KR, Callahan CM. Pediatrics 98:445, 1996

Injuries in organized youth baseball occur at a small but significant rate and have been the subject of inquiry by a number of groups. Studies indicate between 2% and 8% of players are injured per season in organized youth baseball. Forty-six percent of these injuries are head or facial injuries. Numerous medical and dental organizations have made safety recommendations over the years but some of these recommendations were not accepted in organized youth baseball. Some of these have included face protection for the batters and use of a reduced impact baseball. In this article, the investigators present data from a survey of 2,861 Little League players, ages 7 to 18. Although the programs were co-ed, no girls over the age of 12 were participating. In one league, players were required to wear a batting helmet equipped with a wire mesh face guard whereas all other players wore a standard batting helmet without a faceguard. Managers were asked to report all injuries during the season that satisfied the provided criteria. At the end of the season, the managers of the two teams were interviewed. Injuries were classified as acute (catastrophic, severe, or minor), by player hours, and the involved activities at the time of injury. Results indicated the players participated for a total of 140,932 player hours. There were no catastrophic injuries in the 66 acute injuries, but 11 were classified as severe (8 hardball, 3 softball). Injuries included torn knee ligaments, injuries to permanent teeth, and fractures. Minor injuries included contusions, sprains, fractures, lacerations, dental injuries (3), closed head injuries, abrasions, and muscle strain. Over the course of the season, 2.3% of the players sustained an acute injury, which occurred at a rate of .057 injuries per 100 player-hours, There were 4 ball-related facial injuries (all on defense) in the group wearing the batting helmet with face mask, and 3 ball-related injuries (2 on defense, 1 on offense) in the group wearing the helmet with- out the face mask. The investigators concluded that most

injuries occur on defense and would not be prevented by wearing a face mask on the batting helmet. Facial injuries would have been prevented by the batting helmet with face mask, but not by a helmet with only eye guards. The investi- gators conclude that overall, 14% of the injuries could have been prevented, but not facial injuries. Because 62% of all injuries are caused by impact with the baseball, a reduced impact baseball would seem logical, but studies have shown that these balls have not seemed to lower the incidence of catastrophic or serious injuries. Further data are needed.- ROGER ALEXANDER

Reprint requests to Dr Pasternack: Department of Emergency Medi- cine, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642.

Unusual Presentations of Injuries Associated with the Mandibular Condyle in Children. McGrath CJR, Egbert MA, Tong DC, et al. Br J Oral Max Surg 34:311, 1996

Fractures of the condyle are the most common mandibular fractures seen in children, accounting for up to 67% of all mandibular injuries. In this report, the investigators review several case reports showing interesting clinical presenta- tions secondary to condylar fractures. The investigators re- view the anatomy of the condylar area, misleading signs and symptoms, and indications for surgical fracture intervention. The investigators conclude that supplemental imaging of the condyle, particularly coronal computed tomography scans, are extremely helpful in the diagnosis and management of condylar fractures.-C.E. PEOPLES III

Reprint requests to Dr McGrath: University of Wsahington Depart- ment of Oral and Maxillofacial Surgery, SB-24, Seattle, Washington 98195.

Healing of Osseous Submucous Cleft Palates with Guided Bone Regeneration. Matzen M, Kostopoulos L, Karring T. Scan J Plast Reconstr Hand Surg 30:161, 1996

The purpose of this study was to show the use of polytetra- fluoroethylene membranes for bone regeneration on experi- mentally induced submucous cleft palates in rats. An osseous submucous palatal defect was created in 58 male albino Wister rats. The animals were then randomly divided into a test and control group. The test group received two pieces of polytetrafluoroethylene membranes, one between the nasal mucosa and the defect and one between the palatal mucosa and the defect. The control group received no membranes. The animals were then sacrificed at 7 and 12 weeks. The test group showed complete regeneration of bone in the defect whereas the control group showed some bone regeneration at the periphery but there was always a residual defect. Guided tissue regeneration may provide a new alternative to cleft palate treatment, but further studies are necessary regarding the way this bone will respond to normal growth and development. - W. CARVAJAL

Reprint requests to Dr Matzen: Department of Plastic Surgery, Odense University Hospital, DK-5000, Odense C, Denmark.

Alcoholism in Women. North CS. Postgrad Med 100:221, 1996

Alcohol use disorders are present in up to 10% of female patients in U.S. medical practices, and the incidence is in- creasing. This increase has paralleled women’s successful competition with men for equality in the marketplace. Never-