Common Injuries Research Articles

Meniscal Lesions in Multi-Ligament Knee Injuries.

Multi-ligament knee injuries (MLKIs) are rare and complex knee lesions and are potentially associated with intra-articular injuries, especially meniscal tears. Understanding the meniscal tear patterns involved in MLKI can help the orthopedic surgeon treat these complex injuries. The purpose of this study was to describe the incidence, classification, and treatment of meniscal injuries in a cohort of patients with MLKIs and carry out an updated review of the evidence available. Descriptive retrospective study. Patients with a history of reconstructive surgery for MLKI performed between 2013 and 2023 were included. Informed consent was obtained from all patients included in the study. Patient demographics, magnetic resonance imaging (MRI) study, and operative reports were reviewed. Groups were then formed based on ligament injury patterns. Meniscal tears were identified by MRI and through diagnostic arthroscopy for each patient. The association between meniscal lesions and injury patterns was calculated through Fisher's exact test. Agreement between the presence of meniscal tear on MRI and in diagnostic arthroscopy was measured using the kappa test. The sensitivity and specificity of MRI were calculated. We inferred the presence of a meniscal tear by injury pattern using the Agresti-Coull confidence interval. For the statistical analysis, a significance of 5% and a confidence interval of 95% were considered. Seventy patients with MLKIs were included, with a mean age of 30.69years (SD 10.65). Forty-seven patients had meniscal lesions (67.1%). Of them, 6 had only medial meniscus tears, 31 had only lateral meniscus tears, and 10 had lesions of both menisci, comprising 57 meniscal lesions in total. An anterior cruciate ligament (ACL) + medial collateral ligament/posteromedial corner (MCL/PMC) was the most common injury pattern (52.86% of all patients). Of these 37 patients, 78.38% had meniscal injuries, and most of them (68.97%) were only lateral meniscus injuries. The odds ratio (OR) of having a meniscal tear when having an ACL + medial-side injury was 4.83 (95% CI; 0.89-26.17). Patients with ACL + lateral-side injury pattern had meniscal tears in 42.86%. The lateral meniscus was involved in 100% of these patients. 62.5% of medial meniscus injuries were treated by meniscal repair, and 37.5% by partial meniscectomy. 58.54% of lateral meniscus injuries were treated by meniscal repair, and 39.02% by partial meniscectomy. Agreement calculated using the kappa test between MRI and diagnostic arthroscopy for medial meniscal lesions was 78.57%, and for lateral meniscal lesions was 84.29%. The ligament injury pattern and the side of the injured collateral ligament influenced the incidence and laterality of meniscal damage. ACL + medial-side injuries were shown to have significantly greater meniscal damage compared to other injury patterns.It is crucial to have a high index of suspicion, obtain a high-quality MRI, and arthroscopically evaluate any possible meniscal lesions in MLKIs.

Changes in injury and illness incidence and burden in elite junior male Australian footballers over a 6–year period

ObjectivesThe study aimed to determine a contemporary multi-year junior Australian football (AF) injury and illness profile and secondly, explore changes in incidence and burden over the six-year period. DesignProspective cohort study. MethodsThis study involved an elite male junior Under-18 competition and included six seasons of injury data between 2015 and 2021. A total of 1559 eligible players were included in the analysis. An injury was defined as ‘any physical or medical condition that resulted in a player missing one or more regular competition season matches.’ A Poisson regression model determined injury and illness incidence and burden across the league over a 6-year period and explored changes in injury incidence and burden over time. ResultsThe frequency of injuries was 1023 over the six seasons. The most frequently reported injuries were ankle sprain or joint injuries (26.5 injuries/season), hamstring strains (15.8 injuries/season), and concussion (15.1 injuries/season). The most burdensome injuries were ankle sprain or joint injuries with 82.5 missed matches/season, followed by anterior cruciate ligament injuries with 53.7 missed matches/season and hamstring strains with 46.9 missed matches/season. Injury incidence did not change for the most common injury types over time (all p > 0.05). Injury burden significantly increased for concussions, ACL injuries, MCL injuries, and ankle sprain or joint injuries (all p < 0.05). ConclusionsThe multi-year injury surveillance methodology identified injuries with the highest consistent incidence and those that caused the most burden to elite male junior AF players. The results can be used to reliably guide future injury prevention methodologies to reduce the impact on players and clubs.

MASS-12: Evidence-based Martial Arts Striking Sports Injury Prevention Programme

Despite a focus on contact injuries in martial arts, many injuries are non-contact, from ligament tears to ankle sprains, and could be prevented with appropriate prehabilitation. With an emphasis on tradition, recreational martial arts clubs have not yet widely adopted modern prehabilitation exercises. We reviewed the literature to identify injury prevalence and mechanism in martial arts striking sports (MASS). Given the lack of data on female martial artists, we also reviewed common injuries in female athletes. We then identified sport-specific evidence-based interventions using a combination of literature review and Physiotec and filtered this through the constraints of recreational MASS environments to develop a cohesive, useable prehabilitation programme. We propose a programme of 12 exercises for injury prevention (MASS-12). We emphasise the importance of biomechanical retraining to prevent common injuries in martial arts. Hip-knee-ankle alignment is key to injury prevention in MASS, while improved injury surveillance is needed for future intervention.

Curcumin-activated Wnt5a pathway mediates Ca2+ channel opening to affect myoblast differentiation and skeletal muscle regeneration.

Skeletal muscle injury is one of the most common sports injuries; if not properly treated or not effective rehabilitation treatment after injury, it can be transformed into chronic cumulative injury. Curcumin, an herbal ingredient, has been found to promote skeletal muscle injury repair and regeneration. The Wnt5a pathway is related to the expression of myogenic regulatory factors, and Ca2+ promotes the differentiation and fusion process of myoblasts. This study explored the effect and mechanism of curcumin on myoblast differentiation during the repair and regeneration of injured skeletal muscle and its relationship with the Wnt5a pathway and Ca2+ channel. Myogenic differentiation of C2C12 cells was induced with 2% horse serum, and a mouse (male, 10weeks old) model of acute skeletal muscle injury was established using cardiotoxin (20μL). In addition, we constructed a Wnt5a knockdown C2C12 cell model and a Wnt5a knockout mouse model. Besides, curcumin was added to the cell culture solution (80mg/L) and fed to the mice (50mg/kg). Fluorescence microscopy was used to determine the concentration of Ca2+. Western blot and RT-qPCR were used to detect the protein and mRNA levels of Wnt5a, CaN, NFAT2, MyoD, Myf5, Pax7, and Myogenin. The expression levels of MyoD, Myf5, Myogenin, MHC, Desmin, and NFAT2 were detected using immunofluorescence techniques. In addition, MyoD expression was observed using immunohistochemistry, and morphological changes in mouse muscle tissue were observed using HE staining. During myoblast differentiation and muscle regeneration, Wnt5a expression was upregulated (P<0.001) and the Wnt5a signalling pathway was activated. Wnt5a overexpression promoted the expression of MyoD, Myf5, Myogenin, MHC, and Desmin (P<0.05), and conversely, knockdown of Wnt5a inhibited their expression (P<0.001). The Wnt5a pathway mediated the opening of Ca2+ channels, regulated the expression levels of CaN, NFAT2, MyoD, Myf5, Myogenin, MHC, and Desmin (P<0.01) and promoted the differentiation of C2C12 myoblasts and the repair and regeneration of injured skeletal muscle. The expression of Wnt5a, CaN, NFAT2, MyoD, Myogenin, Myf5, and MHC in C2C12 myoblast was significantly increased after curcumin intervention (P<0.05); however, their expression decreased significantly after knocking down Wnt5a on the basis of curcumin intervention (P<0.05). Similarly, in Wnt5a knockout mice, the promotion of muscle regeneration by curcumin was significantly attenuated. Curcumin can activate the Wnt5a signalling pathway and mediate the opening of Ca2+ channels to accelerate the myogenic differentiation of C2C12 cells and the repair and regeneration of injured skeletal muscle.

Body Checking Injuries in National Collegiate Athletic Association Men's Ice Hockey: Findings From the NCAA Injury Surveillance Program 2009/10 to 2019/20.

To describe the epidemiology of body checking injuries in the National Collegiate Athletic Association (NCAA) Men's Ice Hockey. Secondary data analysis of historical cohort data. A convenience sample of injuries in NCAA Men's Ice Hockey during the 2009/10 to 2019/20 academic years. NCAA student-athletes. Event type, season, time loss, body part, diagnosis, player position, and mechanism. This study examined injuries that occurred during practice or competition, regardless of time loss, reported to the NCAA Injury Surveillance Program. Injury counts, rates, and proportions were used. The injury rate and proportion ratios with 95% confidence intervals were also constructed. Three independent logistic regression models were constructed to examine differential odds of time loss (≥1 day; TL) injury and the 2 most common injuries, between body checking injuries and all other injuries. Overall, 1290 body checking injuries (rate = 1.59/1000 athlete-exposures) were reported during the study period. Most were attributed to the upper extremity (42%) or head/neck (27%). The competition injury rate generally decreased after 2012/13. After adjusting for covariates, odds of (1) a TL injury was lower and (2) an acromioclavicular sprain was higher among body checking injuries as compared with injuries attributed to all other activities. Odds of concussion was not associated with body checking injuries. Body checking injuries were frequently attributed to the head/neck and upper extremities, and the rate of these injuries during competition appeared to be decreasing. Still, improvements in helmet and shoulder pad technology may further improve health and safety.

The impact of decreased tibial torsion angle on ankle sprain in football

Objective: Ankle sprains are one of the most common sports-related injuries. Among them, lateral ankle sprains (LAS) predominantly occur as inversion-type injuries. As a result of LAS, athletes are required to stay away from training/competitions for a certain period, which leads to a decline in their athletic performance. While the injury mechanisms for inversion-type injuries have been elucidated, it is imperative to investigate anatomical risk factors associated with these injuries. Material and Methods: This study aimed to examine the influence of tibial torsion angle (TTA) in lateral ankle sprains. In the study, the TTA of 67 male football players was recorded during pre-season evaluations. Among these players, 23 experienced LAS, while 44 did not. Results: A statistically significant difference in TTA was observed between players who suffered LAS during the season and those who did not (p&lt;0.05). The findings indicate that individuals with lower TTA are more likely to experience LAS. In addition, a cutoff value analysis revealed that football players with right TTA&lt;11° and left TTA&lt;10° are at an increased risk of injury. Conclusion: In conclusion, the tibial torsion angle should be included as a risk factor in pre-season assessments for lateral ankle sprains, and athletes with low TTA should be integrated into injury prevention programs targeting LAS.

Design and performance analysis of the 4UPS-RRR parallel ankle rehabilitation mechanism

Abstract. Ankle sprains are among the most common musculoskeletal injuries. Patients often require systematic rehabilitation training to expedite tissue healing and facilitate joint recovery. However, such training places high demands on medical staff, involves a lengthy process, requires considerable labor, and suffers from a shortage of skilled rehabilitation personnel. To address the need for effective ankle joint dysfunction rehabilitation training, this study analyzes the bone structure and movement mechanism of the ankle. Drawing on the parallel mechanism configuration, we propose a 4UPS-RRR parallel ankle rehabilitation mechanism. The rotation center of the rehabilitation mechanism can be highly coincident with the rotation center of the human ankle joint. The structure and degrees of freedom of the mechanism were designed and analyzed using screw theory. Additionally, a kinematic model of the mechanism was established. The mechanism's workspace was mapped by constraining the linear actuator length and spherical joint rotation angle. Furthermore, the mechanism's dexterity was assessed through the establishment of its Jacobian matrix, with the correctness of the kinematic model verified through simulation. Finally, an experimental platform was utilized to test the maximum range of robot motion, confirming the practicality of the ankle rehabilitation mechanism.

Characterizing Physical Intimate Partner Violence-Associated Injuries Among Adults in Low- and Middle-Income Countries: A Systematic Review.

Forty-two percent of women who experienced intimate partner violence (IPV) reported that their experience of IPV resulted in an injury. This review aims to review the existing literature from low- and middle-income countries (LMICs) on IPV-related injuries as well as identify IPV-related injury patterns and locations. A systematic electronic database search was conducted between August and September 2021 (Prospero ID: CRD42021281519). Five databases yielded 408 articles; 328 remained for title and abstract screening after duplicates were removed. Of the 59 eligible for full-text review, 19 articles were eligible for extraction. After quality assessment, 18 articles were included in the study. Most (56%) studies were observational studies. Studies represented 15 different countries. The majority of the studies (89%) had authors whose institutional affiliation was located in the country where the study took place. Soft tissue injuries were the most commonly reported injury type followed by fractures and burns. The most common injury locations were the head, neck, and face followed by both upper and lower limbs. The most commonly cited injury mechanism was bodily force. The findings of this study echo what has been written in the literature regarding IPV-related injury patterns from high-income countries (HICs). One limitation of this study is that the search only included literature published in English. The injury patterns identified in this article confirm the need for awareness and action on the part of both medical and surgical providers in order to best address IPV in LMICs.

Platelet-Rich Plasma for Patellar Tendinopathy: A randomized controlled trial correlating clinical outcomes and quantitative imaging

Abstract Background Patellar tendinopathy (PT) is a common overuse injury in active individuals, often with incomplete recovery. Recently, platelet-rich plasma (PRP) treatment has shown promising results. Traditional qualitative markers are not reliable indicators of treatment response. Advanced quantitative imaging, such as Ultrashort-TE (UTE) MRI and ultrasound (US) shear-wave elastography (SWE) may be valuable adjuncts. Purpose To investigate the clinical outcomes and quantitative imaging changes in adults with symptomatic patellar tendinopathy treated with PRP, needle tenotomy (NT) or sham injection (SH). Materials and Methods Single-blinded prospective randomized controlled trial from April 2017 until July 2022 with three parallel interventions in athletes with symptomatic PT: PRP, NT and SH. VAS pain, VISA-P function, conventional US, shear wave speed (SWS), UTE T2* relaxation time (T2*single) and T2* fraction of fast-relaxing macromolecular-bound water (FF) were acquired at 0, 16 and 52-weeks. Longitudinal analyses were used to compare intra- and inter-group differences over time. Correlations were assessed by Pearson’s correlation coefficient. Results 29 subjects (mean age, 26.1±5.3 years; 82.8% men) were randomized. At 52-weeks all groups demonstrated a significant improvement in pain, though most pronounced within the PRP group (ΔVAS=-5.9, 95% confidence interval (CI) [-7.8, -3.9], p&amp;lt;.001). SWS increased significantly only in the PRP group (Δ+2.3, [0.8, 3.9], p=.003). Change in SWS was moderately correlated with change in pain across all groups (r=-.52, [-.76, -.15], p=.009). FF significantly increased in all groups (Δ=0.10-0.11, p=.024-0.046); a significant decrease in T2*single was only seen in the PRP group (Δ=-8.07, [-14.6, -1.55], p=.014). Conclusion Clinical improvement was evident irrespective of treatment but was greatest with PRP. SWS correlated with improvement in pain and may represent an adjunctive measure to assess healing in patellar tendinopathy. Correlative changes in T2* UTE quantitative markers suggest their potential for response assessment, but further research is needed to clarify their clinical applicability.

3D-printed Mg-incorporated PCL-based scaffolds improves rotator cuff tendon-bone healing through regulating macrophage polarization.

Introduction: Rotator cuff tear (RCT) is a common shoulder injury impacting mobility and quality of life, while traditional surgeries often result in poor healing. Tissue engineering offers a promising solution, with poly (ε-caprolactone) (PCL) being favored due to its slow degradation, biocompatibility, and non-toxicity. However, PCL lacks sufficient compression resistance. Incorporating Mg, which promotes bone growth and has antibacterial effects, could enhance RCT repair. Methods: The Mg-incorporated PCL-based scaffolds were fabricated using a 3D printing technique. The scaffolds were incorporated with different percentages of Mg (0%, 5%, 10%, 15%, and 20%). The osteogenic activities and anti-inflammatory properties of the scaffolds were evaluated in vitro using human osteoblasts and macrophages. The tissue ingrowth and biocompatibility of the scaffolds were assessed in vivo using a rat model of RCT repair. The ability of the scaffolds to enhance macrophage polarization towards the M2 subtype and inhibit inflammation signaling activation was also investigated. Results: It was found that when incorporated with 10% Mg, PCL-based scaffolds exhibited the optimal bone repairing ability in vitro and in vivo. The in vitro experiments indicated that the successfully constructed 10Mg/PCL scaffolds enhance osteogenic activities and anti-inflammatory properties. Besides, the in vivo studies demonstrated that 10Mg/PCL scaffolds promoted tissue ingrowth and enhanced biocompatibility compared to the control PCL scaffolds. Furthermore, the 10Mg/PCL scaffolds enhanced the macrophages' ability to polarize towards the M2 subtype and inhibited inflammation signaling activation. Discussion: These findings suggest that 3D-printed Mg-incorporated PCL scaffolds have the potential to improve RCT by enhancing osteogenesis, reducing inflammation, and promoting macrophage polarization. The incorporation of 10% Mg into PCL-based scaffolds provided the optimal combination of properties for RCT repair augmentation. This study highlights the potential of tissue engineering approaches in improving the outcomes of RCT repair and provides a foundation for future clinical applications.

A - 40 The Impact of Early Access on Sports-Related Concussions in Youth Hockey Players

Abstract Purpose Sports-related concussions are the most common setting for adolescents to sustain a concussion. Delayed access to care is a risk factor for recovery and youth athletes have limited access to early intervention often due to lack of athletic trainer coverage. The purpose of this study was to evaluate the effect of early access on sports-related concussions in youth hockey players. Method Participants (n = 67) included youth athletes from hockey organizations who partnered with a local specialty concussion clinic. Athletes presented to clinic for care (median = 2 days) after sustaining a concussion. We examined whether the number of days since injury to initial exam (DSI) significantly predicted recovery time while controlling for common injury modifiers, such as symptom severity, anxiety sensitivity, and age. Recovery was measured in number of days since injury to the date of medical clearance. Results Multivariate general linear analyses indicated that DSI (M = 4.96, SD = 8.90), significantly predicted the number of recovery days (M = 12.85, SD = 9.47), with each day earlier to initial exam predicting almost one day faster recovery (B = 0.92; p &amp;lt; 0.001; ηp2 = 0.813). Variables of age (M = 13.78, SD = 2.59), anxiety sensitivity (M = 8.91, SD = 9.69), and concussion severity (M = 19.22, SD = 8.90), were not predictive recovery. Conclusions Early access resulted in faster medical clearance. This sample of youth hockey players do not have access to an athletic trainer to provide early intervention. Our results suggest that the ability to have early intervention through a specialty concussion clinic partnership resulted in faster recovery, highlighting the importance of continuing to explore and cultivate these relationships with youth sports.

Violence against Women within Italian and European Context: Italian “Pink Code”—Major Injuries and Forensic Expertise of a Socio-Cultural Problem: A Narrative Review

Background: Violence against women or other vulnerable individuals is a serious violation of human rights and a global public health issue representing a significant “problem of enormous global health proportions”. Violence against women is an endemic phenomenon; the numbers are very high, highlighting the severity and urgency of the problem. Methods: We conducted this research by examining the field of violence against women. Our analysis involved reviewing papers published between 2018 and December 2023, which were identified through electronic database searches. Out of a total of 136 papers initially identified, we considered 71 documents. Results: This research highlights the global nature of violence against women, including psychological assessments of harm, as a socio-cultural problem and underlines the more common injuries. Conclusions: We examined how the presence of forensic experts can be beneficial in identifying and evaluating injuries, as well as reconstructing the dynamics of the events, particularly for judicial purposes.

163 Laparoscopic Surgery: Good for the Patient, Bad for the Surgeon. A Systematic Narrative Review

Abstract Background Musculoskeletal (MSK) injuries are very common among laparoscopic surgeons. These injuries can result in physician burnout, early retirement, and medical/surgical treatment. The aims of this study are to identify the causes of MSK injuries in laparoscopic surgeons, the most common injuries, and strategies to prevent them. Method Following the PRISMA guidelines, Medline, Embase and PubMed databases were systematically searched for relevant articles using the predefined inclusion/exclusion criteria. Data was extracted by two independent reviewers. Results A total of 321 papers were found, after screening 41 papers were selected for inclusion. Many study designs involved the use of biomechanical methods, surveys, and quality of life questionnaires. Studies varied drastically in their sample sizes. Results show that long periods of static postures held in non-ergonomic positions are a significant contributing factor to MSK injuries. This is more likely in laparoscopic surgery, as surgeons hold more fixed positions with more physical demand when compared with open surgery. Studies show that the most common sites for injury are the neck, back and shoulder. Conclusions MSK injuries are an ongoing problem which is often underestimated and poorly reported. There was clear evidence in the literature that microbreaks and strength training is beneficial, and that ergonomic training should be a standard element of surgical training.

Management of Distal Tibial Deformity Secondary to Traumatic Physeal Arrest: Systematic Review and Meta-Analysis

Abstract Background Injuries of the ankle growth plate are the second most common physeal injury of the childhood and comprises 6% of all fractures of the tibia. These injuries are typically observed among children 10 to 12 years of age, usually as Salter-Harris (SH) Type 1 and Type 2 fractures followed by Type 3 and Type 4 fractures. Objective To review modalities of treatment for distal tibia deformity secondary to physeal arrest post traumatic and to perform a systematic review and meta- analysis of the outcome for different methods of treatment. Methodology The included studies published between 2000 and 2021. Regarding the type of included studies, 8 studies (out of 10 studies) were retrospective; while 2 studies were prospective. Results Meta-analysis study was done on 6 studies which described Epiphysiodesis technique for distal tibial deformities secondary to post-traumatic physeal arrest; with overall number of patients (N = 215). We calculated efficacy for each technique through (Bone union ―success rate‖) and (Excellent functional outcome). We calculated safety for each technique through (Revision rate) and (Complication’s rate). Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2022. Conclusion Ilizarov technique for corrections of post-traumatic physeal arrest ankle deformities showed better efficacy and safety profiles, compared to Epiphysiodesis. Which also, showed relatively good efficacy and safety especially in children with post-traumatic physeal arrest ankle deformities.

Minimizing the Risk of Surgical Site Infection Following Hip Fracture Operation.

Introduction: Hip fractures are the most common serious injury in the elderly, associated with disability, morbidity, and mortality. Surgical site infection (SSI) is a serious post-operative complication. This prospective cohort study outlines how our center made cumulative improvements in SSI incidence rates, reaching a 12-month average of 0.5%. Methods: All patients undergoing hip fracture operation between 2016 and 2021 were included. The primary outcome measure was confirmed SSI, according to the Public Health England definition. Results were compared with the baseline recordings by an independent SSI team in 2013. Demographic data were compared with National Hip Fracture Database records. Peri-operative infection control and wound management tactics introduced between 2014 and 2021 were collated to gain an overview care bundle. Results: Baseline recordings identified a 9.0% SSI rate in a three-month observation period. In our study, 3,138 hip fracture operative cases were completed between October 2016 and December 2021. There were 9 superficial and 32 deep infections identified, yielding an overall infection rate of 1.3%. However, when analyzing the 12-month average, there was consistent decline in SSI from the baseline 9.0% in 2013 to 0.5% in 2021 (p < 0.05). A peri-operative care bundle included pre-operative bleeding risk assessment. Intra-operatively, double preparation and draping is used for arthroplasty. Broad-spectrum antibiotic agents and tranexamic acid are administered. Meticulous hemostasis and watertight wound closure are observed. Anti-coagulated patients received negative pressure dressings. Post-operatively, a dedicated senior lead team provided daily inpatient review of patients, with urgent consultant review of all wound healing concerns. Conclusion: Patients with a hip fracture have numerous risk factors for SSI. A dedicated multi-focal tactic, adopted by a multi-disciplinary department, can yield substantial risk reduction. Each intervention is evidence based and contributes to cumulative improvement. By prioritizing infection prevention, we have minimized the need for complex infection management interventions and achieved an annual saving of £860,000 for our trust.

Complications of Bipolar Hemiarthoplasty: An Observational Study

Background: The femoral neck fracture remains an uncovered fracture, and therapy guidelines are constantly improving. Hip fractures are a common injury in emergency rooms, particularly among the elderly. It is also seen in young patients who participate in athletics or suffer from high-energy injuries. To avoid problems, immediate diagnosis and treatment are necessary. Aim of the Study: The goal of this study was to investigate the complications of bipolar hemiarthoplasty for femoral neck fractures in the elderly. Methods: This study was conducted in 250 Bedded General Hospital, Pabna, Bangladesh, from January 2023 to January 2024. The study included patients who were admitted and underwent bipolar hemiarthroplasty. All collected data was entered into a Microsoft Excel Work Sheet and analyzed descriptively using SPSS 11.5. Results: The patients' ages varied from 60 to 85 years, with a mean of 66.5 years. Out of 100 patients, 55 (55%) were females and 45 (45%) were males. Of the 100 patients, 32 (32%) had fractures on the left side and 68 (68%) had fractures on the right side. In our study, 75 patients (75%) received injuries from falls on the ground, 19 patients (19%) from road traffic accidents, and 6 patients (6%) from assault. Out of 100 patients, 44 (44%) underwent surgery within &lt;10 days of injury, 22 (22%) within 10-30 days, 7 (7%) within 30-50 days, 16 (16%) within 50-70 days, and 11 (11%) within &gt;70 days. Out of 100 patients, 4 (4%) had a prosthesis with a 39 mm head size, 12 (12%) had a prosthesis with a 41 mm head size, 18 (18%) had a prosthesis with a 43 mm head size, 27 (27%) had a prosthesis with a 45 mm head size, 17 (17%) had a prosthesis with a 47 mm head size, and 18 (18%) had a prosthesis with a 49 mm head size. Conclusion: According to the study, even if the incidence of other complications was comparable to that reported in the literature, hemiarthroplasty was not a good procedure for patients with a longer life expectancy.

Effectiveness of behavior change in rehabilitation interventions to improve functional recovery after lower limb fracture: a systematic review.

Ankle fractures are common injuries that can significantly impact mobility and quality of life. Rehabilitation following ankle fracture treatment is crucial for recovery, yet adherence to regimens remains a challenge. Behaviour Change Techniques (BCTs) have been suggested to improve adherence, but their effectiveness in ankle fracture rehabilitation is not well established. This review aimed to evaluate the effectiveness of BCTs in the rehabilitation of ankle fracture patients.We conducted a comprehensive search across multiple databases, including MEDLINE and EMBASE, focusing on Randomised Controlled Trials (RCTs) that incorporated BCTs into rehabilitation interventions. The effectiveness of BCTs on patient-reported outcomes (PROMs), quality of life, and adverse events was analysed.Nine RCTs met the inclusion criteria, encompassing a range of interventions that employed BCTs, most commonly including goal setting and instruction on how to perform behaviours, specifically physiotherapy exercises. The review found limited evidence supporting their effectiveness in improving PROMs. Only one study showed a significant positive effect, but it was deemed at high risk of bias. The lack of integration of behavioural theory in the design of rehabilitation interventions and the varied nature of the BCTs employed across studies may contribute to these findings.The use of BCTs in ankle fracture rehabilitation is prevalent, but this review highlights a significant gap their role of enhancing patient outcomes. Future research should incorporate a theory-based approach to intervention design, utilising a broader range of BCTs, to fully evaluate their potential in improving rehabilitation adherence and outcomes following ankle fracture .

Volar Plate Draping (VPD) for Severely Comminuted Proximal Phalanx Head Fractures

AbstractWhile proximal phalangeal joint injuries with comminution of the base of the middle phalanx are common injuries, proximal interphalangeal (PIP) joint fracture dislocations with an intact base of middle phalanx and a comminuted head of proximal phalanx are rare. Volar plate arthroplasty and other described techniques prevail for the former injury, while the latter does not have any supportive literature on the exact method of management. We herein present a 20-year-old male with a severely comminuted head of proximal phalanx fracture with dislocation of the PIP joint, which was not reconstructable but was managed successfully with a novel technique of volar plate draping that resurfaced the raw phalangeal head. A 3-year follow-up of the patient, whose finger has full, painless, and complete functional range of movement, gives us the belief that this procedure can provide a fully functional finger where other methods fail to do so.

Anterior cruciate ligament tear detection using gated recurrent unit and flexible fitness dependent optimizer

Anterior Cruciate Ligament (ACL) tear is a common knee injury that can be diagnosed using Magnetic Resonance Imaging (MRI). In this study, a novel approach has been proposed for improving the accuracy of ACL tear detection using an optimized Gated Recurrent Unit (GRU) model. The GRU model is a type of Recurrent Neural Network (RNN) that can capture the temporal features of MRI images. The optimization of the GRU model is based on a modified metaheuristic technique, called the Flexible Fitness Dependent Optimizer (FFDO). The FFDO is a flexible and problem-dependent algorithm that can find the best solutions to optimize problems by generating and evaluating a set of candidate solutions based on a fitness function. The proposed approach is applied to the MRNet dataset, and the results are compared with 17 state-of-the-art methods. The results show that the proposed approach can achieve a high accuracy of97.95%for ACL tear detection, which is higher than the existing deep learning and machine learning methods. The proposed approach can also achieve high values for other performance metrics, such as specificity, sensitivity, precision, MCC, F1-score, and AUC. The proposed approach can effectively extract the essential features of knee MRI images that are indicative of ACL tears with high diagnostic accuracy.

Poster 353: Impact of Meniscus and Cartilage Treatment on Return to Sport Following Anterior Cruciate Ligament (ACL) Reconstruction

Background: Anterior cruciate ligament (ACL) tears are a common injury in athletes. ACL tears often occur with other injuries, including cartilaginous injuries. There is a lack of research regarding cartilage treatment on return to sport (RTS) following ACL reconstruction. Purpose: To evaluate the impact of meniscus and/or cartilage (meniscus-cartilage) treatment on return to sport (RTS) rates and time to return to sport following ACL reconstruction with hamstring tendon (HT), patellar tendon (BPTB), and quadriceps tendon (QT) grafts. Methods: Competitive and recreational athletes between the ages of 13-24 who had an ACL reconstruction between 2010-2022 were included. Activity level, sport, graft type, cartilage treatment, RTS testing result data, and time to RTS were collected. Chi-square statistics and Wilcoxon rank sum tests were used, and statistical significance was set to p&lt;0.05. Results: There were 855 total patients with 354 HT, 361 BPTB, and 140 QT grafts of which 275 did not have meniscus-cartilage treatment and 580 received meniscus-cartilage treatment. Females comprised 52% of ACL reconstructions without meniscus-cartilage treatment and 42% of ACL reconstructions with meniscus-cartilage treatment. The median age was 18 and 17 for those receiving meniscus-cartilage treatment and those without treatment, respectively. Median time to RTS was 27.86 weeks for 151 patients without meniscus-cartilage treatment and 30.49 weeks for 299 patients receiving meniscus cartilage-treatment (p=0.0253). The median 6-meter timed hop ratio was 1.01 for 21 athletes with meniscus-cartilage treatment and 0.965 for 12 athletes without meniscus-cartilage treatment (p=0.0492). Median isokinetic quadriceps testing at 300 degrees per second was 85% of the contralateral leg for 170 athletes with meniscus-cartilage treatment and 85% for 67 athletes without meniscus-cartilage treatment (p=0.7181). Return to previous level of play occurred in 91/104 (87.5%) of those without meniscus-cartilage treatment and 196/220 (89%) of those with meniscus-cartilage treatment (p=0.6742). ACL and non-ACL reinjuries occurred in 18% (49/272) of those without and 20% (118/577) of those with meniscus-cartilage treatment (p=0.4047). Conclusions: Time to clearance to return to sport occurred more quickly in those without meniscus-cartilage treatment. Six-meter timed hop testing results were superior in those receiving meniscus-cartilage treatment. This study will aid orthopaedic surgeons and their athletes while addressing common concomitant injuries during ACL reconstruction.