Common Injuries Research Articles

Assessing Lower-Extremity Visuo-Motor Reaction Time in Young Male Soccer Players: Test-Retest Reliability and Minimum Detectable Change of the Brain Pro System.

A reliable, versatile means of assessing visuo-motor reaction time (V-MRT) is important to football (soccer) players for many reasons, including the fact that faster V-MRT is a critical sport skill that may even play a role in reducing common sports injuries to the lower muscle extremities that can be associated with lost time on the field. We aimed to determine the test-retest reliability and minimum detectable change (MDC) of the Brain Pro System for assessing lower-extremity V-MRT in young male football players. We had 68 participants (M age = 16.35, SD = 1.71years) perform two assessment sessions one-week apart. For test-retest reliability, we calculated a one-way intra-class correlation coefficient (ICC) at the 95% confidence interval and provided the standard error of measurement (SEM) and minimum detectable change (MDC) (MDC = SEM × 1.96 × √2) for V-MRTs. We obtained excellent V-MRT test-retest reliability for dominant lower-extremity, non-dominant lower-extremity, and dominant and non-dominant lower-extremities (ICC2,1 = .93, 95%CI = .89-.96; ICC2,1 = .94, 95%CI = .91-.96; ICC2,1 = .96, 95%CI = .94-.97; respectively). The calculated MDC for the dominant lower-extremity V-MRT, the non-dominant lower-extremity V-MRT, and dominant and non-dominant lower-extremities (random) V-MRT were 1.21seconds, 1.13seconds, and 1.21seconds, respectively. Brain Pro System had excellent reliability for assessing lower-extremity V-MRT in young male football players. The MDC values at the 95% confidence level (MDC95) we obtained were reliable for assessing clinically meaningful V-MRT changes.

Management and patient outcomes following admission with acute cholecystitis in Ireland: A national registry-based study

IntroductionAcute cholecystitis is a common general surgical emergency, accounting for 3–10 % of all patients attending with acute abdominal pain. International guidelines suggest that emergency cholecystectomy is the treatment of choice for uncomplicated acute cholecystitis where feasible. There is a paucity of published data on the uptake of emergency cholecystectomy in Ireland. AimThe aim of this study was to evaluate the management of acute cholecystitis in Ireland and to establish the rate of emergency cholecystectomy performed. MethodsAll patients with acute cholecystitis presenting to public hospitals in Ireland between January 2017 and July 2023 were identified using the National Quality Assurance and Improvement System (NQAIS). Data were collected on patient demographics, co-morbidities, length of stay, operative intervention, endoscopic intervention, critical care admissions, in-patient mortality, and readmissions. Propensity score matched analysis and logistic regression were performed to account for selection bias in comparing patients managed with cholecystectomy and those managed conservatively. Results20,886 admission episodes were identified involving 17,958 patients. 3585 (20 %) patients underwent emergency cholecystectomy in total. 3436 (96 %) of these were performed laparoscopically, with 140 (4 %) requiring conversion to an open procedure, and common bile duct injuries occurring in 4 (0.1 %) of patients. In comparison to patients treated conservatively, patients who underwent cholecystectomy were younger (median 50 v 60 years, p < 0.001) and more likely to be female (64 % v 55 % p < 0.001). Following propensity score matched analysis, those who had an emergency cholecystectomy had reduced length of stay (LOS) (median 5 days (IQR 3–8) v 6 days (interquartile range (IQR) 3–10), p < 0.001) and fewer readmissions to hospital (282 (8 %) v 492 (14 %), p < 0.001). On logistic regression, age >65 (OR 1.526), CCI >3 (OR 2.281) and non-operative management (OR 1.136) were significant risk factors for adverse outcome. ConclusionUptake of emergency cholecystectomy in Ireland remains low, and is carried out on a younger, fitter cohort of patients. In those patients, however, it is associated with improved outcomes for cholecystitis compared to conservative management, including shorter LOS and reduced readmission rates for matched cohorts.

Pediatric Pelvis.

The development of the pelvis follows a predictable pattern of ossification that involves the maturation of bone, synchondroses, and apophyses. These growth centers appear and close at distinct times during skeletal maturity and give rise to structural changes in the pelvis that can be distinctively appreciated on various imaging modalities. Accurate interpretation of radiologic images requires knowledge of skeletal development because the varying appearance of the maturing pediatric pelvis may be mistaken for pathology. In addition, many normal features within the pelvis can be erroneously perceived as injury. This article incorporates a multimodality review of normal pelvic maturation, a discussion of developmental variants, and a description of common injuries unique to the pediatric pelvis.

Acromioclavicular dislocation: A common injury affecting a healthy population.

Acromioclavicular dislocation: A common injury affecting a healthy population.

Forensic medical evaluation of penetrating abdominal injuries.

This study aims to discuss the characteristics, origins, degree of injury, results, reporting, and forensic medical aspects of penetrating abdominal injuries. In this study, 28,619 cases who applied to the emergency department of Kutahya Health Sciences University Evliya Celebi Training and Research Hospital between January 1, 2016 and December 31, 2020 were reviewed. The forensic reports and medical documents of 85 cases with penetrating abdominal injuries were evaluated retrospectively, with the approval of the ethics committee. Among the patients included in the study, 87.1% were male and 12.9% were female. The mean age was found to be 31±13 years. When the origins of the cases were analyzed, 87.1% were found to have developed as a result of intentional injury. The incidents predominantly occurred between 20: 00 and 04: 00 hours. As a result of the examinations performed at the hospital after the incident, alcohol was detected in 36.5% of the cases, while 30.6% of the individuals did not consume alcohol. It was observed that 32.9% of the cases were not tested for alcohol. The most common injuries identified were sharp injuries, accounting for 69.4% of cases, and firearm injuries, comprising 27.1%. Organ damage was noted in 68.2% of the cases, with the small intestine being the most frequently damaged organ. The average number of wounds present was 3.6. Intra-abdominal hemorrhage was detected in 61.2% of the cases, and intra-abdominal artery injuries were found in 8.2%. The mortality rate for penetrating abdominal injuries was 8.2%. In forensic traumatology, penetrating abdominal injuries commonly lead to life-threatening conditions and loss of organ function, which represent the most severe category in trauma severity assessment. Penetrating abdominal injuries most often result from violent incidents, as observed in our study and in the literature.

A systematic review on the most common injuries in handball

A systematic review on the most common injuries in handball

Early surgical treatment using regional clinical pathways to reduce the length of postoperative hospital stay in hip fracture patients: A retrospective analysis using the Japanese Diagnosis Procedure Combination database.

Hip fracture is a common injury in older adults; however, the optimal timing of surgical treatment remains undetermined in Japan. Therefore, this retrospective study aimed to ascertain the rate of early surgery among hip fracture patients and investigate its effectiveness, along with "regional clinical pathways" (patient plan of care devised by Japanese clinicians), in reducing the length of hospital stay (LOS) postoperatively. We hypothesized that performing early surgery along with a regional clinical pathway is effective to reduce the postoperative LOS and complications among hip fracture patients. We examined the data of patients diagnosed with femoral neck and peritrochanteric fractures retrieved from the Japanese Diagnosis Procedure Combination database between April 2016 and March 2018. Patients were divided into the early (43,928, 34%; surgery within 2 days of admission) and delayed (84,237, 66%; surgery after 2 days of admission) surgery groups. The difference in postoperative LOS between the two groups was 3 days (early vs. delayed: 29 days vs. 32 days). The early surgery group had more cases of intertrochanteric fractures (57% vs. 43%) and internal fixation (74% vs. 55%) than did the delayed surgery group. In contrast, the delayed surgery group had more cases of femoral neck fractures (43% vs. 57%) and bipolar hip arthroplasty (25% vs. 42%) or total hip arthroplasty (1.2% vs. 3.0%). Moreover, the early surgery group showed a lower incidence of complications, except anemia (12% vs. 8.8%). Logistic regression analysis using the adjusted model revealed that early surgery and implementation of regional clinical pathways reduced LOS by 2.58 and 8.06 days, respectively (p<0.001). Early surgery and implementation of regional clinical pathways for hip fracture patients are effective in reducing postoperative LOS, allowing regional clinical pathways to have a greater impact. These findings will help acute care providers when treating hip fracture patients.

Identification of Injuries in Amateur Boxing Athletes in Gorontalo City: Study for Developing Prevention and Treatment Strategies

Injuries in boxing athletes often occur in the upper extremities of the body, especially the head and face, which can result in concussions, cuts and bruises. This research aims to identify the types of injuries experienced by boxing athletes in Gorontalo City and explore their causes. The method applied is a survey using questionnaires as the main data collection technique. The population of this study consisted of 50 active female boxing athletes from Gorontalo City. The results showed that the most common injuries occurring in boxing were injuries to the head and face (44%), followed by injuries to the wrist (29%), shoulders (29%), knuckles (22%), knees (16%), and ankle (16%). The main factors causing injury include conditions during training or competition (36%) and the time of injury (32%). Based on the results of this research, it can be concluded that the parts of the body most frequently injured are the head and face with a percentage of 44%. These findings emphasize the importance of developing injury prevention and treatment strategies, especially to the head and face, to improve the safety and health of amateur boxing athletes in Gorontalo.

Fracture distribution in electric scooter accidents: a nationwide observational cohort study of 1,874 fractures from the Swedish fracture register

Background and purposeElectric scooters (e-scooters) have become increasingly popular as a mode of transportation in recent years. The impact of e-scooter accidents on the healthcare system and resulting orthopaedic injuries remains largely unknown. This study describes the distribution of fractures caused by e-scooter accidents.MethodsAll patients who had one or more fractures from e-scooter accidents registered in the Swedish Fracture Register (SFR) between 7 April 2019 and 30 December 2022 were included. Fractures were classified using the AO Foundation/Orthopaedic Trauma Association (AO/OTA) fracture classification system. We analysed the distribution of fractures, the proportion that required surgical management and seasonal variation of injuries.ResultsDuring the study period, 1,874 fractures in 1,716 patients were registered in the SFR. The mean age of patients was 29 (SD 14) years and 70% of fractures occurred in males. High-energy accidents accounted for 299 fractures (16%). The most common fractures were of the hand (n = 363, 19%), wrist (n = 352, 19%) and proximal forearm (n = 356, 19%). Wrist fractures were the most common injury in children (n = 183), accounting for 44% of paediatric fractures. Surgical treatment was performed on 556 (30%) fractures, with wrist fractures being the most commonly treated in both adults (n = 78, 17%) and children (n = 36, 36%).InterpretationFractures caused by e-scooter accidents predominantly occur in the upper extremity. E-scooter accidents comprise a new source of injury requiring attention and surgical resources from an already strained healthcare system.

Functional Outcomes of Bipolar Hemiarthroplasty in Unstable Intertrochanteric Femur Fractures in the Elderly: A Prospective Study.

Background Intertrochanteric femur fractures are relatively common injuries among elderly individuals. Treatment options include fixation of intertrochanteric fractures using proximal femoral nails (PFNs), dynamic hip screws (DHSs), and unipolar and bipolar hemiarthroplasty. Unstable types of intertrochanteric fractures (Arbeitsgemeinschaft für Osteosynthesefragen (AO) types 31-A2 and A3) are more common in elderly osteoporotic people. Intertrochanteric femur fractures having a subtrochanteric extension, comminution at the posteromedial cortex, and reverse obliquity are considered to be unstable. The purpose of the study is to evaluate the functional outcomes of an unstable intertrochanteric femur fracture treated with bipolar hemiarthroplasty as the primary treatment option. Aims and objectives This study aims to assess the functional outcomes of bipolar hemiarthroplasty in unstable intertrochanteric fractures in the elderly using the Harris Hip Score (HHS) and the Merle d'Aubigné and Postel Criteria. The time point of assessment was from August 2016 to August 2018. Material and methods Fifteen elderly patients with unstable intertrochanteric fractures of the femur were treated with cemented bipolar hemiarthroplasty. Patients with unstable femur fractures or with osteoporosis and age above 65 years were included in the study. Harris Hip Score and the Merle d'Aubigné and Postel Criteria were used to measure functional outcomes. Patients were followed up at the first, third, and sixth months and subsequently at the end of one year. Results The mean age of the patients was 78.73 years. The majority (11) of the patients were female (73%). The average operative time was 119 minutes, the average blood loss was 380 ml, the mean postoperative hospital stay was 12 days, and the average time taken for mobilization was four days. An average of 15 elderly patients with unstable intertrochanteric fractures of the femur were treated with cemented bipolar hemiarthroplasty. The HHS on the first follow-up was 42.44 (SD of 6.52), followed by a score of 64.43 (SD of 8.11) on the second follow-up, 82.32 (SD of 2.81) on the third follow-up, and 84.23 (SD of 3.15) on the fourth follow-up. Eleven patients had good results, and two had fair results at the one-year follow-up, according to the HHS. According to the Merle d'Aubigné and Postel Criteria, 11 patients had very good results, and two had moderate results at the one-year follow-up. The average Merle d'Aubigné score was 14.6 on the final follow-up after one year. Conclusion Bipolar hemiarthroplasty in an unstable intertrochanteric femur fracture in the elderly results in better functional outcomes, as it helps in early full weight-bearing mobilization, which significantly decreases complications of prolonged immobilization and can be safely considered in the treatment of unstable intertrochanteric fractures in elderly patients.

Peripheral nerve block (Tetra block) - an effective alternative anesthesia for patients undergoing fractured femur neck surgery with recent myocardial infarction and low ejection fraction: a case report

The fractured neck of the femur (NOF) is a common injury among the elderly population1 . Ischemic heart disease (IHD)is a common comorbid condition in these patients, and recent myocardial infarction (MI)adds a unique challenge for the anesthesiologist1 . The best timing for the surgery is known to be the day of admission or the day after admission. However, this poses a challenge due to patients possibly being on antiplatelet or anticoagulant therapy, which means central neuraxial blockade is not an option1 . General anesthesia (GA) for these patients can lead to cardiovascular and respiratory instability due to associated low ejection fraction (EF)2 . Hemodynamic fluctuations related to anesthesia can be harmful. In this case study, a patient with a NOF fracture and a recent MI with a low EF underwent hemiarthroplasty. The procedure used a peripheral nerve block (PNB) alongside sedation as the sole anesthetic technique. The patient remained stable throughout the surgery and in the postoperative period. Keywords: Neck of femur fracture, Myocardial Infarction, Peripheral Nerve Block, Tetra block, Locoregional, Ejection Fraction.

Painfully ignorant? Impact of gender and aim of training on injuries in climbing

IntroductionClimbing has evolved from an obscure outdoor sport to a predominantly indoor sport with the rise of mainstream climbing on artificial walls. Reported climbing-related injuries were predominantly chronic and may...

Audit of Genito-Anal Injuries in male and female sexual abuse cases - A retrospective study.

Background: Sexual assault is a global issue wherein timely examination of sexual assault victims by medico-legal officers and an understanding of the characteristics and factors influencing their injuries have a crucial impact on medico-legal evidence collection and its use in the court. Genital injury findings improve the level of justice for victims, but the lack of injury does not negate the possibility of sexual violence incurred on the victim. The following study describes in great detail the different factors associated with injury characteristics and the medico-legal importance of all these factors. Methodology: It was a retrospective descriptive study conducted at the Forensic Medicine Department of King Edward Medical University, Lahore, Pakistan. All the cases included that fulfill the predefined inclusion criteria were included. A record chart was designed, and six years’ data was recorded in it from the medical records of the medico-legal clinic. It was entered and edited manually. Methods used to prevent data entry errors included double entry and validation following data entry Difference of proportions between variables, where appropriate, has been calculated by Pearson Chi-Square test and Fischer Exact test at 95% confidence interval. Data were analyzed using SPSS v23. All procedures performed in this study involving human participants were following the ethical standards of the institutional and/or national research committee and the Helsinki declaration. Results: Genito anal injury was present in 28.2% cases and was absent in 71.8% cases. Most of the victims were aged 11 to 15 years. The most common injury in the victims was a tear. In females, the most common injury site was the vagina, while the perianal area was the most injured site in males. There was a significant relation (p&lt;0.05) between type and site of injury, gender, site of injury, and prior sexual intercourse experience and prevalence rate of injury. Conclusion: This study concludes that the presence of injuries in the Genito anal area is suggestive of sexual assault and provides useful court evidence.

Acromioclavicular joint dislocation with loop double endobutton fixation assisted by orthopaedic surgery robot positioning system

ObjectiveAcute acromioclavicular (AC) joint dislocation is a common orthopedic injury that can significantly impair shoulder function and reduce quality of life. Effective treatment methods are essential to restore function and alleviate pain. To investigate the short-term clinical efficacy of the minimally invasive closed-loop double endobutton fixation assisted by orthopaedic surgery robot positioning system (TiRobot) in the treatment of AC joint dislocation, and to evaluate its feasibility and safety.MethodsThe clinical data of 19 patients with AC joint dislocation who underwent treatment with closed-loop double Endobutton fixation assisted by TiRobot between May 2020 and December 2022 were retrospectively analyzed. Visual Analog Scale (VAS) pain scores, the Constant Murley Score (CMS), and shoulder abduction range of motion were assessed and compared preoperatively and at the last follow-up. Computed tomography (CT) parameters of the acromioclavicular joint, including acromioclavicular distance (ACD), the distance between the upper and lower Endobutton (DED), the horizontal distance between the anterior edge of the distal clavicle and the anterior edge of the acromion (DACC), the diameter of the clavicular tunnel (DCT), and coracoid tunnel diameter (DC), were compared at 2 days, and 1 month after surgery, as well as at the last follow-up, along with the evaluation of intraoperative and postoperative complications.ResultsThe postoperative VAS, CMS, and shoulder-abduction range of motion were significantly improved compared with the preoperative (all, P<0.05). The statistical analysis showed no significant difference in the CT image parameters of the acromioclavicular joint at 2 days and 1 month after surgery(all, P>0.05). Comparisons of DCT and DC revealed statistically significant differences between the last follow-up and 1 month after surgery (P<0.05), and no statistically significant difference was found in ACD, DED, and DACC(all, P>0.05). There were no complications such as infection or vascular or neurological damage, no cases of rostral or clavicle fractures, loss of reduction, heterotopic ossification, shoulder stiffness, and no loosening or breaking of internal fixations.ConclusionClosed-loop double endobutton internal fixation assisted by TiRobot is an ideal method for the treatment of acute acromioclavicular (AC) joint dislocation. This method has the advantages of relatively simple operation, more accurate localization of bone tunnel during operation, less surgical trauma, and good recovery of shoulder function.

Risk factors for intensive-care-unit-acquired weakness.

Wang et al reported 1063 cases from the initial 14 d of intensive care unit (ICU) stay, and analyzed relevant data such as age, comorbidities, recent dosages, vapor pressure dosages, duration of mechanical ventilation, length of ICU stay, and rehabilitation therapy, which are closely related to ICU-acquired weakness (ICU-AW). It is suggested that the length of ICU stay and the duration of mechanical ventilation are the main factors. ICU-AW is the most common neuromuscular injury in the ICU, which affects clinical progression and outcomes of patients. This manuscript helps to improve the early recognition of ICU-AW, thereby reducing mortality and improving prognosis.

Pickleball: A Standard Review of Injury Prevalence and Prevention in a Rapidly Growing Sport.

Pickleball is the fastest growing sport in the United States. People of all ages participate in the sport, with the most being aged 35 years or older. Pickleball is a paddle and racket sport with a smaller court size, lighter racket, and similar rules as tennis. From 2019 to 2021, the number of pickleball players increased from 3.3 to 4.8 million. Historically, as a sport grows in popularity, there tends to be a linear increase in injuries. This review compiles data from retrospective studies containing emergency department data and case reports of specific injuries sustained playing pickleball. One factor that could be perceived as favorable concerning injury risk is the smaller court size compared with tennis, although no correlation has been found between court size and rate of injury. The most common injuries presenting to the emergency department among pickleball players were muscle strains, joint sprains, and fractures. Men were three times more likely to sustain muscle strains and joint sprains while women were three times more likely to sustain fractures. As the sport continues to grow, the tracking of injury types and mechanisms of injury will become important in informing injury prevention strategies and improved safety for players.

Radiological characteristics and injury mechanism of Logsplitter injury: a descriptive and retrospective study

BackgroundLogsplitter Injury is a type of high-energy ankle fracture dislocation. The mechanism of injury has not been described in detail. A detailed understanding of the radiological features and pathological changes can further guide treatment.MethodsBetween April 2009 and December 2018, a retrospective analysis was conducted on 62 patients with Logsplitter injury. The study analysed the characteristics of fibular injury, tibial injury, syndesmosis injury, medial injury and lateral ligament injury on preoperative X-ray and CT scans. The incidence of the different injury types was summarised. The correlation between Logsplitter injuries and the mechanisms causing them were analysed using the Lauge-Hansen classification of ankle fractures.ResultsThe study provides data on the types of fractures observed. Of the total fractures, 98.4% were open fractures. The fibula injuries were classified as no fracture (1.6%), transverse or short oblique fractures (61.3%), butterfly fragments (25.8%), and comminuted fractures (11.3%). The tibial injuries included compression of lateral articular surfaces (38.7%) and posterior compressions (6.5%). Medial injuries, including medial malleolar fractures, accounted for 87.1%, and deltoid ligament rupture accounted for 12.9%. The study found that injuries to the syndesmosis consisted of simple ligament ruptures (11.3%), Tillaux fractures (8.1%), Volkmann fractures (43.5%), and Tillaux and Volkmann fractures (37.1%). In 12.9% of cases, there was a complete rupture of the lateral collateral ligament. Based on the Lauge-Hansen classification, 87.1% of injuries were pronation-abduction injuries, while 8.1% were pronation and external rotation injuries, and 1.6% were supination external rotation injuries. Furthermore, 3.2% of cases could not be classified.ConclusionThe pathoanatomic characteristics of Logsplitter injury are diverse, with some cases accompanied by collateral ligament injury. It is important to note that these evaluations are objective and based on current results. The most common injury mechanism is vertical violence combined with abduction, although in some cases, it may be a vertical combined external-rotation injury.Level of evidence(4) case series.Trial registrationThis study has been approved by the ethical research committee of the Honghui Hospital of Xi’an Jiaotong University, under the code: 202,003,002.

Wrestling injuries during the 2016 Rio and 2020 Tokyo Olympic Games

ObjectivesTo evaluate and compare the injuries of Olympic wrestlers during the 2016 Rio and 2020 Tokyo Olympic Games held in August 2021 due to the COVID-19 pandemic.MethodsIn this descriptive epidemiological...

Musculoskeletal system injuries in the Polish Territorial Defence Forces

BackgroundMusculoskeletal system injuries (MSIs) are the major health problem of soldiers. The aim of this study was to assess the types of MSIs that occurred most frequently among soldiers and...

Metacarpal Stress Fractures in Athletes: A Systematic Review.

Stress fractures in general are common injuries; however, there is limited literature on metacarpal stress fractures in athletes. Our objective is to contribute the first systematic review of metacarpal stress fractures in athletes, with a particular focus on epidemiology, presentation, and outcomes. A systematic review regarding metacarpal stress fractures in athletes was performed via PubMed, EMBASE, MedLine, Cochrane, and Web of Science. Inclusion criteria consisted of case reports and case series of metacarpal stress fractures in athletes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A total of 11 studies (29 cases) were included. The mean patient age was 17 years, with 12 men and 15 women. The most common sports were tennis and badminton. The most common presentation was pain in the dorsal aspect of the hand related to activity. All patients underwent successful nonoperative management, with mean return to play of 9 weeks. Metacarpal stress fractures can present with significant pain and impact performance in athletes who perform sports involving repetitive movements of the hand and wrist. Nonoperative treatment, consisting of abstinence from sport until the patient was pain free combined with gradual return to play, was successful for all patients. The addition of proper technique and training load can result in satisfactory return to play. For patients who present with hand pain related to exercise, particularly a young racquet sport player, metacarpal stress fractures are a "can't miss" diagnosis associated with significant functional impairment.