Common Location Of Injury Research Articles

#ReadyToPlay: health problems in women’s football–a two-season prospective cohort study in the Norwegian premier league

ObjectivesTo describe the prevalence, incidence and burden of all health problems in the Norwegian women’s premier league.MethodsDuring the 2020 and 2021 seasons, players in the Norwegian women’s premier league reported...

Quantifying Pediatric Gun Violence by Location, Time of Day, and Day of Week

BackgroundFirearm injuries are the leading cause of pediatric deaths. The objective of this study was to describe the location and timing of pediatric firearm injuries and to determine the proportion of these injuries that occur within schools in the United States. MethodsIn this retrospective cohort study, we used national emergency medical services (EMS) data from 2019 to evaluate dispatches to firearm injuries involving school-aged children (age 5–18). We extracted incident location type, patient demographics, number of patients on scene, and injury intent. ResultsWe identified 4764 EMS dispatches for firearm injuries in school-aged children during 2019. Assault was the most common cause of injury (53.9 %), followed by unintentional shootings (12.1 %) and self-inflicted injuries (6.1 %). Most incidents involved a single patient (91.4 %). Private residence (51.5 %) was the most common location, followed by street/road (23.8 %). 81 firearm injuries (1.7 %) occurred in a school. Private residence was the most common location of injury across all injury intents. During school hours, most firearm injuries occurred in a private residence (51.6 %) or on a street/road (19.9 %). A total of 63 dispatches (1.3 %) were considered a mass casualty incident, of which 9 (14 %) occurred in a school. ConclusionsRegardless of injury intent or time of day, the most common location for pediatric firearm injuries was a private home. Firearm injuries within schools were far less frequent. In designing prevention strategies, our data calls for renewed focus on preventing children from accessing firearms in the home and instituting comprehensive, community-based after school programs. Type of StudyRetrospective cohort. Level of EvidenceIII.

Characteristics of Sports-Related Injuries Presenting to a Pediatric Emergency Department.

Pediatric injuries associated with participation in sports are common. Understanding the epidemiology and trends of sports-related injuries is an important component of injury prevention efforts and is the objective of this study. A retrospective review of sports injuries presenting during the course of 1 year (2019) to the emergency department (ED) of Benjamin Russell Hospital for Children, a large academic children's hospital, was performed. Inclusion criteria focused on patients 18 years old and younger whose ED visit resulted from active participation in a sport. Cases were identified using International Classification of Diseases, Tenth Revision codes. Demographic data were collected and included sex, age, race, injury specifics (sport, location, type, and mechanism). Descriptive statistics were performed and categorical variables were analyzed using the χ2 test. A total of 1333 injuries seen by the ED during 2019 were sports injuries. Most commonly, these injuries were associated with football (43%), basketball (36%), soccer (11%), or baseball (8%). Considering sports-related injuries, 428 (32%) patients were 12 years and younger and 905 (68%) were 12 years old and older. The median age was 13 years (interquartile range 4 years). Other demographic findings included male sex 1143/1333 (86%) and Black race 835/1333 (63%). School was the most common location for sports injuries (28%). When comparing injuries by age groups (younger than 12 vs 12 and older), football and baseball injuries were more common in those younger than 12 years (53% vs 38%, z = 5.2, P < 0.00001; and 14.0% vs. 5.6%, z = 4.9, P < 0.00001, respectively), whereas basketball and soccer injuries were more common in those 12 years and older (43% vs 22%, z = 7.4, P < 0.00001; and 11.4% vs 9.3%, z = 5.9, P < 0.00001, respectively). When comparing injuries by sex, football and baseball injuries were more common in males (49% vs 6%, z = 11.1, P < 0.00001; and 9.4% vs. 2.1%, z = 3.3, P < 0.00001, respectively), whereas basketball and soccer injuries were more common in females (59% vs 32%, z = 7.2, P < 0.00001; and 27% vs 8%, z = 7.8, P < 0.00001, respectively. Sports injuries that are commonly encountered in the ED differ in age and sex. Basketball and soccer injuries were more likely to be encountered in older females, whereas baseball and football injuries were more likely seen in younger males. This may reflect efforts that have been previously focused on the sports considered to be higher risk, especially for concussive injuries. This information can help guide future preventive efforts provided by primary physicians, schools, and coaches.

An epidemiological study of martial arts injuries in patients presenting to US emergency rooms

IntroductionWith the advent of mixed martial arts (MMA) growing in popularity, there has been a described increase in its participation. The term MMA generally describes the hybridization of combat disciplines including but not limited to: karate, judo, jiu-jitsu, wrestling, taekwondo, boxing, kickboxing, and Muay Thai. With increased participation in MMA and martial arts, differing physical demands are placed on participants. Due to the physical nature of combat sports, there are injuries associated with participation. The purpose of this study is to report the incidence and characteristics of injuries seen from various martial art disciplines presenting to United States Emergency Rooms in order to educate participants and providers alike about risks assumed with participating in martial arts. MethodsThe National Electronic Injury Surveillance System (NEISS) database was queried for martial arts-related injuries from 2009 to 2019. Cases were examined and data including patient age and gender, injury type and location, hospital disposition, and type of martial arts practiced were extracted. ResultsA total of 8,400 injuries were recorded, leading to a national estimate of 310,143 martial-arts related injuries over the 11 year period of 2009–2019 (95 % CI 239,063–381,223). The most common types of injuries were strains/sprains (n = 2664, 31.7 %), fractures (n = 1,575, 18.8 %), and contusions/abrasions (n = 1,698, 20.2 %). There were 260 dislocations, with shoulder dislocations being most common (n = 96, 36.9 %). Lower extremities were affected more frequently than upper extremities (n = 3566, 42.5 % versus n = 3026, 36.0 %), with the knee being the single most common location of injury (n = 811, 9.7 %). Males more commonly sustained fractures (19.7 % versus 17.4 %, p = 0.03) and dislocations (3.5 % versus 2.4 %, p = 0.01) when compared to females. Ankle injuries were more common in females than males (10.4 % versus 6.0 %, p < 0.001). Only 2.2 % of patients required admission to the hospital. Risk factors for admission included patients >35 years of age and male sex. ConclusionMartial arts injuries are a significant source of musculoskeletal injuries among patients presenting to US emergency rooms. Lower extremity injuries are seen most frequently, with patients rarely requiring hospital admission. Using this information, both providers and participants may be better equipped to make educated decisions on injury prevention and treatment.

Prevalence of Individuals with Traumatic Spinal Cord Injury in Nairobi, Kenya

Objectives: To determine the prevalence of individuals with a traumatic spinal cord injury in Nairobi, Kenya. Methods: Retrospective quantitative data was extracted from records of 1st January 2010 to December 2014, at the NSIH. (N=320) participants met the inclusion criteria of all TSCI patients injured archived medical files, out these (n=217) were men, and (n=103) women, collected data was analyzed by SPSS version 23.0. Pearson chi-square was applied to test for association between variables, Student t-test was used to compare mean difference between groups, study Significance level was at p-value &lt;0.05. Results: Mean age of the participants was 37.59 (SD= 15.038), the highest percentage age was 30-39 years old at (27.8%) followed aged 18-29 years at (26.6%). Male to female ratio was 2.1:1, highest prevalence occurred in 2010 and 2014 (20.5%), main cause of a TSCI transportation (49.1%), fall at (33.4%), assault (17.5%) common injury location was at lumber (53.1%), followed thoracic at (27.5%) cervical and sacral at (19.1%) and (0.3%) respectively. There were significantly more persons with paraplegia (54.1%) who had complete injuries than those with tetraplegia (19.6%). Other (27.3%) accounted for the TSCI patients with incomplete paraplegia and tetraplegia and no neurological deficits Conclusions: TSCI is a devastating condition to individuals; it has a high impact on QOL and ADL in low-income countries where there is an increase in manual labor and poor infrastructure, which predispose individuals to TSCI. Further studies need to be done to understand and compare epidemiological results, to inform appropriate prevention strategies that will decrease the burden of TSCI globally. KEYWORDS: Traumatic Spinal Cord Injuries, Activities of Daily Living, Gun Short Wound, National Spinal Injury Hospital, American Spinal Injury Association impairment scale.

Incidence of injuries and associated risk factors in a sample of Italian recreational padel players.

Padel is a racket sport similar to tennis, which since the COVID-19 pandemic has been gaining popularity among recreational players. Despite its popularity, epidemiological studies are still lacking. This study aimed to identify the prevalence of injuries among Italian recreational padel players and associated risk factors. A questionnaire was administered to 127 recreational padel players between January 2022 to March 2022. The questionnaire consisted of questions to collect information regarding intrinsic and extrinsic factors related to padel practice, injury location, and injury typology. Frequencies and proportions were calculated for variable description. Binomial logistic regression was adopted to identify potential risk factors. Of the 127 participants, 100 (78.8%) reported having had an injury during the previous year. Such injury in most cases (37%) resulted in an absence from padel from 8 to 28 days. The most common injury locations were lower leg/Achilles tendon (17.1%) and elbow (13.8%), while the most common injury typologies were tendinopathies (33.6%) and contusions (14.9%). Among the identified risk factors the amount of time played padel (3.5-5 hours/week), racket type (round), and racket weight (either not knowing or 356-375 g) resulted in an increase in the probability of occurring an injury. Recreational padel results in a high percentage of injuries. These frequently result in tendinopathies of the Achilles tendon and elbow. Inadequate racket characteristics and the amount of time played could contribute to an increase in injury incidence.

Incidence and characteristics of vascular trauma at a level 2 trauma center

ObjectiveDespite the significant number of trauma patients treated at level 2 trauma centers (L2TCs) in the United States, most of the literature describing vascular trauma is from level 1 trauma centers (L1TCs). Currently, trauma center designation criteria do not require vascular surgery as a necessary component service. MethodsA retrospective chart review was performed for all trauma patients with a vascular surgery consultation seen at our L2TC between 2013 and 2018. Patient demographics, injury characteristics, and outcomes were collected and analyzed with descriptive statistics. ResultsOf the 3062 trauma patients evaluated at our L2TC, 110 (3.6%) had a vascular surgery consultation. Operative intervention was performed in 35.2% of consults, and 1.0% of all trauma patients had a vascular intervention. Average age was 57 years, and the majority were male (n = 75; 68.2%). Mean Injury Severity Score was 12.0 ± 9.6, and blunt injury (n = 77; 87.5%) was more common than penetrating (n = 11; 12.5%). The most common location of injury was the lower extremity (n = 23; 74.2%), followed by upper extremity (n = 3; 9.7%), chest (n = 2; 6.5%), neck (n = 2; 6.5%), and pelvis (n = 1; 3.2%). Endovascular interventions were performed by the vascular surgery service in 67.7% (n = 21) of all injuries. There was one amputation (3.2%) and one postoperative mortality (3.2%). ConclusionsAt our L2TC, postoperative morbidity and mortality rates at 30 days were substantially lower compared with previously reported data. However, mean injury severity score and the incidence of penetrating and polytrauma were also lower at our institution. Most patients were managed nonoperatively, but when they did require an operation, endovascular therapies were more commonly implemented. Vascular surgery should be considered an integral service in trauma level designation, and there is a need for further investigation of these outcomes in L2TCs.

Traumatic Spinal Cord Injury in Children: Clinical Profile and Management Outcome in a Developing Country's Rural Neurosurgery Practice.

There is paucity of data-driven study on pediatric traumatic spinal cord injury (SCI) in the developing countries. This study aims to define the clinical profile of pediatric traumatic SCI in a rural tertiary hospital in a sub-Saharan African country. This was a prospective observational study of all children with spinal cord injury managed at our center over a 42-month period. There were 20 patients, comprising 13 males and 7 females with a mean age of 11.5 years. Road traffic crash was the cause in 70% of the cases (motorcycle accident = 45%), and fall from height in 25%. Pedestrians were the victims of the road traffic crash in 42.9% (6/14) of the cases, while 21.4% (3/14) and 28.6% (4/14) were passengers on motorcycles and in motor vehicles, respectively. The cervical spine was the most common location of injury, occurring in 90% of the cases (18/20). Seventy-five percent of the patients (15/20) had transient deficits, but were grossly normal neurologically on examination (American Spinal Cord Injury Association [ASIA] grade E); 2 patients had ASIA D, while 1 patient each had ASIA C, B, and A injuries. All patients were managed nonoperatively. The patients with incomplete deficits improved, while those with complete injury did not make any motor or sensory gain. Road traffic accident, mostly motorcycle crash, was the most common etiology of pediatric SCI in this series, and most of the injuries were located in the cervical spine. Disabling injury constituted a small proportion of pediatric SCI in our practice.

The Foot and Ankle in Ultramarathon Runners: Results of the Ultrarunners Longitudinal TRAcking (ULTRA) Study.

The foot and ankle play a critical role in ultramarathon running. Because foot and ankle injuries are the most common location of injury in this group, proper care is essential for prevention. In this sport, small issues can become big problems over such long distances, and understanding the preventative measures taken by ultramarathon runners may provide insight for other athletes looking to avoid similar problems. The purpose of this study was to examine the routine and preventative care of the foot and ankle, as well as injury rates, in this group of high-risk athletes. The Ultrarunners Longitudinal TRAcking (ULTRA) Study is the largest known prospective longitudinal study of ultramarathon runners. In this portion of the study, participants reported general health status, running behavior and performance, as well as foot and ankle care, injuries, stretching frequency, and shoewear. A total of 734 ultramarathon runners participated in the study. This group ran a median of 40.2 km per week. Overall, 71.2% of active ultramarathon runners reported a foot or ankle injury in the previous 12 months. The most common injuries reported were plantar fasciitis (36.3%), Achilles tendinitis (24.0%), nonspecific foot pain (14.0%), and stress fractures (13.4%). Sit and reach flexibility test showed that 63.7% of runners could not reach past their toes. There were no significant correlations for sit and reach flexibility or stretching frequency with injury rate. The high prevalence of foot and ankle injuries in ultramarathon runners does not appear to be influenced by arch type, foot strike pattern, orthotic usage, stretching behavior, or actual flexibility. A high percentage of the study runners used comfort as a shoe selection method, independent of alignment or foot strike pattern. These findings guide the clinician in shared decision making with runners about routine care, including injury prevention and shoe selection. Level II, prospective study.

Poster 392: Analysis of Musculoskeletal Injuries Among Collegiate Varsity Esports Athletes

Objectives: Electronic sports (esports) have grown tremendously in the past decade with an estimated market value of $493 million in 2017 and an expected growth to $2.3 billion dollars by the end of 2022. Additionally, colleges are embracing this growing culture with over 200 varsity esports programs as of May 2022, up from 7 varsity programs just two years earlier. Despite its growing success, little has been studied on the injuries of these athletes. Prior studies have noted that injuries to professional esports players have forced them to miss significant time and in some instances, into an early retirement. Due to poor posture, a sedentary lifestyle, and repetitive hand motions, the most common injuries to esports athletes include injuries to the hand, wrist, back and neck. The purpose of this study is to investigate the prevalence of injuries sustained through collegiate esports players and explore the injuries’ impacts on their careers. The authors hypothesized that athletes who spend more time practicing and playing competitively in esports will report an increased history of musculoskeletal injury. Methods: A list of collegiate esports athletes was collected from publicly available sources. Athletes with available contact information were sent a self-reporting questionnaire. The questionnaire examined variables including length of time playing esports, hours/day playing esports, esports-related injury history, surgeries needed, and missed competition time. Demographic and workload data were then compared between injured and uninjured athletes. Results: Overall, 153 collegiate esports athletes (88% male, aged 18-42 years) were included, with 41 (26.8%) having experienced at least one injury from esports. As demonstrated in Table 1, of the 41 injured athletes, 3 (7.3%) required surgery, 17 (41.5%) had multiple injuries, and 7 (17.1%) missed competition time for an average of 3.0 ± 2.3 weeks. Athletes who have been on their respective college team longer (1.7 ± 0.9 vs. 2.0 ± 1.0 years, p=0.026) and who spent more hours per day practicing had a higher injury incidence (p=0.012). There was no difference in current age, sex, age at which athletes began competing in esports, and scholarship status between groups (all p&gt;0.05). When analyzing the 41 athletes who experienced an injury, the most common injury was to the wrist with 25 total injuries. There were 11 neck, 10 back, 9 finger, 8 hand, 6 elbow, and 4 thumb injuries. Conclusions: Collegiate esports players who trained for more hours per day and played competitive collegiate esports for more years were more likely to have experienced an esports-related injury. Interestingly, while hours per day was a significant risk factor for injury, the number of days per week had was not a significant risk factor for injury, possibly indicating that injuries are sustained through continuous and excessive playing rather than intermittent playing over a longer period. The three most common injury locations were to the wrist, back, and neck, while shoulder and thumb injuries were the least common. Fortunately, only a small portion of athletes who experienced an injury were forced to miss competition time, and even fewer required surgery. With this being the largest investigation into collegiate esports-related injuries, future medical research can help collegiate and professional programs place a greater emphasis on the management and prevention of esports-related injuries. [Table: see text]

Winter Sports Injuries in Elite Female Athletes: A Narrative Review.

There is a lack of reviews covering the topic of the parallel high prevalence of injuries in female winter sport elite athletes. We aimed to review the data on incidence and patterns of injuries in female athletes participating in official competitions of winter sports. We conducted a comprehensive literature search on epidemiological data and etiological information on alpine skiing, snowboarding, ski jumping and cross-country skiing. The most common location of injury was the knee among skiers and ski jumpers and the incidence of severe ACL events was 7.6 per 100 ski racers per season (95% CI 6.6 to 8.9) in female alpine skiers. Snowboarders and cross-country skiers were more affected in the ankle and the foot. The most common cause was contact trauma with stagnant objects. The injury risk factors include training volume, knee pre-injuries, the period of the season and the technical equipment. Females are at greater risk of suffering from overuse injuries during the competitive season, as opposed to male athletes who are more likely to suffer from traumatic injuries. Our findings can be used to inform coaches and athletes and to guide future injury prevention plans.

Musculoskeletal injuries in trauma patients: a Swedish nationwide register study including 37,266 patients

Trauma causes over 4 million annual deaths globally and accounts for over 10% of the global burden of disease. Trauma patients often sustain multiple injuries in multiple organ systems. We aimed to investigate the proportion and distribution of musculoskeletal injuries in adult trauma patients. This is a register-based study using data from the national Swedish trauma register (SweTrau) collected in 2015-2019. By categorizing Abbreviated Injury Scale (AIS) codes into different injury types, we provide a detailed description of the types of musculoskeletal injuries that occurred in trauma patients. 51,335 cases were identified in the register. After exclusion of 7,696 cases that did not have any trauma diagnosis (AIS codes) registered from the trauma and 6,373 patients aged < 18, a total of 37,266 patients were included in the study. 15,246 (41%) had sustained musculoskeletal injury. Of the patients with musculoskeletal injuries, 7,733 (51%) had more than 1 such injury. Spine injuries were the most common injury location (n = 7,083 patients, 19%) followed by lower extremity injuries (n = 5,943 patients, 16%) and upper extremity injuries (n = 6,273 patients, 17%). Fractures were the dominating injury type with 30,755 (87%) of injuries being a fracture. 41% of the trauma patients had at least 1 musculoskeletal injury. A spine injury was the most common injury location. Fractures was the dominating injury type constituting 87% of all injuries. We also found that half the patients (51%) with spine or extremity injuries had ≥ 2 such injuries.

Surfing injuries: A US epidemiological study from 2009–2020

BackgroundThe sport of surfing has grown exponentially. Early studies of surfing injuries are outdated as newer and more accessible surf technology has become available. This study's goal was to describe surfing injury patterns, incidence, and disposition of pediatric and adult surfers. Study designA retrospective review of surfing injuries from 2009 to 2020 of adult (>18 years of age) and pediatric (<18 years of age) patients was performed using the National Electronic Injury Surveillance System (NEISS) database. The consumer product code 1261 (Surfing) was used to identify injury patterns. Chi-squared test was performed on all categorical variables. Logistic regression was used on significant variables from the frequency tables. All analysis was performed with R-statistical programming software. ResultsThere was an overall decreasing trend of surfing injuries over time. Injuries for both adult and pediatric patients tended to occur most within the summer season (p<0.001). The odds of an adult surfing injury victim being male is 2.89 (95% CI 1.87–4.44). The head/neck/face were the most injured body part in both groups. The pediatric group had a significantly higher rate of concussions at 6.5% compared to the adult group at 3.2%. Overall, the most common injury type was to the skin (p<0.001). Disposition between groups were similar with most patients being discharged home. Mortality was rare with three reported fatalities in the adult group and none in the pediatric group. ConclusionThe incidence of surfing injuries is continuing to decline despite more people surfing, revealing the improved safety of the sport over the last decade. Head/neck/face injuries are common injury locations, and pediatric surfers are particularly at increased risk of concussions. Continued education, usage of safety equipment such as protective headgear, and awareness of injury patterns, could further lessen potential injuries.

Cricket injury in New Zealand: a study of injury insurance claims from 2008 to 2018

This study aimed to quantify injury claims in organised community cricket in New Zealand over a 10-year period, 1 July, 2008 to June 30, 2018. Retrospective analysis of administrative insurance claims data from the Accident Compensation Corporation (ACC), New Zealand. Injury claims relating to cricket in males and females in New Zealand were identified from coded data and relevant text searches of routinely collected claims data. Summary statistics for key variables (age, body part, injury type, and injury factors) are presented together with annual injury claim incidence rates (ICR) calculated using population-based denominators. There were 62,776 claims for cricket injury occurring at a place of recreation/sports. Most claims were in males (91.4%) and those aged 15-19 year old age group. There was an increase in the total number of injury claims over the 10-year period (1.5%, p = 0.04), but the ICR was consistent (males: varying between 258.8-304.8, and females: 22.6-28.3 claims annually per 100,000 population). Soft tissue injury claims were the most common injury type. Lumbosacral claims were most common for bowlers (78%). Lower limb injury claims were the predominant claim from batting (36%) and fielding (42%), with knee injury claims (34%) being the most common lower-limb injury location. Lumbosacral, shoulder and knee injuries were common amongst all playing positions and worthy of preventative attention. Strategies targeting prevention of these injuries may reduce the ICR within the ACC.

MANAGEMENT OF BILE DUCT INJURY IN A REFERRAL CENTER, 10 YEARS OF EXPERIENCE

Abstract Introduction Bile duct injury represents major morbidity and mortality, and in the last two decades in which laparoscopy cholecystectomy has been universally available several factors associated with bile duct injury have been described: one of them being the surgeon's training and experience in laparoscopic cholecystectomy. Some authors have reported that the training curve stabilizes the risk of bile duct injury from 1.7 to 0.17% by procedure number 50. Given that most surgical residency programs don't have enough experience in laparoscopy, this likely contributes to the development of bile duct injury. Therefore, it is important to elucidate the risk factors for bile duct injury in our country. Methods In a referral center we collected the data from 10 years of experience in bile duct repair for bile duct injury. The clinical records for 83 patients were obtained and analyzed. Results High-quality hepaticojejunostomy was performed in all 117 cases, 89.8% open, 8.5% laparoscopic and 1.7% was converted from laparoscopic to open. In 41% of patients, partial resection of the IV segment was necessary. the main post-operatory complication was surgical site infection in 19.6%, overall mortality was 3.4%. according to McDonald Classification for Group A 56.4%, Group B 28.2%, Group C 10.2%, Group D 5.2%, in long-term follow-up. Conclusions Surprisingly, the open cholecystectomy was the most common procedure associated with bile duct injury in our population. Postoperative injury detection was the most frequent, and the most common injury location was near the confluence. We obtained good long-term results even the type of injuries. The disproportion between training centers and hospitals all around the country may impact these results due to the lack of experience of the young surgeons that have only had training in laparoscopic surgery and the lack of universal laparoscopic availability for emergencies. The patients that suffer from this complication are of middle age, and there is a significant disproportion between males and females, with females being the most affected group. It has an impact on their quality of life. High-quality hepaticojejunostomy with Hepp-couinaud technique provides good long-term results, with no difference between the 1–5 year and the 6–10 year groups. The segment IV hepatectomy represents a good option to access the hilar plate. It is important to continue to expose surgeons during their residencies to open cholecystectomy. Prevention is the cheapest and safest way to decrease the incidence of bile duct injury. The implementation of high-volume centers such as ours is important to bring early and high-quality solutions to problems like these.

Incidence of acute injuries in Swedish gymnastics with a special focus on cruciate ligament injuries.

Gymnastics is a sport with unique technical and physical demands. Elements of high rotational landing impacts may lead to severe injuries. In order to understand the risks of the sport and design injury prevention programs the magnitude of acute injuries must be understood. The aim was to investigate acute injuries, medical invalidity and injury costs in gymnastics using national insurance data. Insurance data covering acute injuries in Swedish gymnastics from October 2015 to October 2020 were analyzed. All Swedish gymnasts with either a training or competition license were included (N.=333,932 licenses, 249,823 females; 84,109 males). A total of 1733 acute injuries were reported, and the injury incidence was 5.2 per 1000 gymnast years, with no differences between upper and lower body. The arm followed by the foot and the knee were body locations with highest injury incidence. Skeletal injuries were most common in the arm and foot, and ligament injuries in the foot and knee. The proportion of cruciate ligament injuries was 37% of all knee injuries and 5% of all acute injuries. No significant difference between male and female gymnasts was observed. The highest proportion of medical invalidity was found in the knee (33%), the foot (22%), and the arm (20%). Sixteen percent of all cruciate ligament injuries led to medical invalidity and was the injury causing highest costs to the insurance company. The knee was the third most common injury location and the injury causing the highest medical invalidity.

Follow-up household assessment for child unintentional injuries two years after the intervention: A community-based study from Karachi, Pakistan

BackgroundUnintentional childhood injuries are a growing public health concern, and the home is the most common location for non-fatal injuries in children less than 5 years of age. This study describes the long-term effects of two injury prevention educational interventions for caregivers—an educational pamphlet and an in-home tutorial guide—by comparing the change in the prevalence of home injury hazards before and after the interventions. MethodsThis was a pre- (June and July 2010) and post-study with short-term follow-up (November-December 2010) and long-term follow-up (November 2012- January 2013). Neighborhood one included households that received only educational pamphlets after completing a baseline assessment; neighborhood two included households that received an in-home tutorial guide after completing the baseline assessment and receiving the educational pamphlet. The main outcome of this study was the reduction in home injury hazards for children under 5 years of age. ResultsA total of 312 households participated in the long-term phase to compare the effect of the interventions. Between the short-term to long-term follow-up, injury hazards significantly reduced in neighborhood two compared to neighborhood one. These included fall hazards (walker use) (IRR 0.24 [95% CI 0.08-0.71]), drowning hazards (open bucket of water in the courtyard and uncovered water pool) (IRR 0.45 [95% CI 0.85-0.98] and IRR 0.46 [95% CI 0.76-0.94]), burn hazards (iron, water heater within reach of child) (IRR 0.56 [95% CI 0.33-0.78] and IRR 0.58 [95% CI 0.32-0.91]), poisoning hazards (shampoo/soap and medicine within reach of child) (IRR 0.53 [95% CI 0.44-0.77] and IRR 0.7 [95% CI 0.44-0.98]) and breakable objects within reach of child (IRR 0.62 [95% CI: 0.39-0.99]). ConclusionAn injury prevention tutorial to caretakers of children supplemented with pamphlets could significantly decrease the incidence of falls, drowning, burns, poisoning, and cut injury hazards for children under 5 years of age in their homes in a low-resource setting. This intervention has the potential to be integrated in existing public health programs, such as Lady Health Visitors (LHVs), to disseminate injury prevention information in routine home health visits.

Trends in Work-Related Fatal Farm Injuries, Saskatchewan, Canada: 2005–2019

ABSTRACT Objectives This study was conducted to estimate farm fatality rates and to describe patterns of fatal agricultural injuries on Saskatchewan farms from 2005 to 2019. Methods Data on work-related farm fatalities was collected from January 2005 to December 2019 in the Province of Saskatchewan as a part of the injury and mortality surveillance for the Canadian Agricultural Injury Reporting (CAIR) program. Data were abstracted from records made available by the Provincial Coroner’s Office. Results There were 166 farm work-related fatalities recorded between 2005 and 2019 in Saskatchewan. The majority (93.4%) of work-related fatalities were in males. The overall work-related fatality rate was 10.5 (95% CI: 8.9–12.1) per 100,000 farm population. The overall age-adjusted work-related fatality rate was 18.1 (95% CI: 15.2–20.9) per 100,000 farm population among males and 1.4 (95% CI: 0.6–2.3) per 100,000 farm population among females. Age-adjusted rate decreased from 91.2 (95% CI: 69.4–117.66) per 100,000 farm population in 2005–2009 to 89.7 (95% CI: 64.9–120.2) per 100,000 farm population in 2015–2019 in males. Trend analysis of the work-related fatality rate in all cases showed a non-significant average annual decline of 2.6% (p = 0.156). Rollover injuries contributed to a high proportion of fatalities in children (30.0%) and the elderly population (14.9%). The most common causative agent was a tractor, and the most common location of injury was the farmyard or field. Conclusion The burden of mortality in this industry is still substantial. There was a non-significant decreasing trend in the injury rate over the 15-year period. Elderly farmers continue to be at high risk for fatality, while the rates for children have declined. Application of prevention approaches could reduce the risk of fatal injury, and in particular the high proportion of rollover injuries in children and the elderly population.

Placental transcriptional signatures associated with cerebral white matter damage in the neonate.

Cerebral white matter is the most common anatomic location of neonatal brain injury in preterm newborns. Factors that predispose preterm newborns to white matter damage are understudied. In relation to studies of the placenta-brain-axis, dysregulated placental gene expression may play a role in preterm brain damage given its implication in programming early life origins of disease, including neurological disorders. There is a critical need to investigate the relationships between the placental transcriptome and white matter damage in the neonate. In a cohort of extremely low gestational age newborns (ELGANs), we aimed to investigate the relationship between the placental transcriptome and white matter damage as assessed by neonatal cranial ultrasound studies (echolucency and/or ventriculomegaly). We hypothesized that genes involved in inflammatory processes would be more highly expressed in placentas of ELGANs who developed ultrasound-defined indicators of white matter damage. Relative to either form of white matter damage, 659 placental genes displayed altered transcriptional profiles. Of these white matter damage-associated genes, largely distinct patterns of gene expression were observed in the study (n = 415/659 genes). Specifically, 381 genes were unique to echolucency and 34 genes were unique to ventriculomegaly. Pathways involved in hormone disruption and metabolism were identified among the unique echolucency or ventriculomegaly genes. Interestingly, a common set of 244 genes or 37% of all genes was similarly dysregulated in the placenta relative to both echolucency and ventriculomegaly. For this common set of white matter damage-related genes, pathways involved in inflammation, immune response and apoptosis, were enriched. Among the white matter damage-associated genes are genes known to be involved in Autism Spectrum Disorder (ASD) and endocrine system disorders. These data highlight differential mRNA expression patterning in the placenta and provide insight into potential etiologic factors that may predispose preterm newborns to white matter damage. Future studies will build upon this work to include functional measures of neurodevelopment as well as measures of brain volume later in life.

Differences in characteristics between patients ≥ 65 and < 65 years of age with orthopaedic injuries after severe trauma

AimMany trauma patients have associated orthopaedic injuries at admission. The existing literature regarding orthopaedic trauma often focuses on single injuries, but there is a paucity of information that gives an overview of this group of patients. Our aim was to describe the differences in characteristics between polytrauma patients ≥ 65 and < 65 years of age suffering orthopaedic injuries.MethodsPatients registered in the Norwegian Trauma Registry (NTR) with an injury severity score (ISS) > 15 and orthopaedic injuries, who were admitted to Haukeland University Hospital in 2016–2018, were included. Data retrieved from the patients’ hospital records and NTR were analysed. The patients were divided into two groups based on age.ResultsThe study comprised 175 patients, of which 128 (73%) and 47 (27%) were aged < 65 (Group 1) and ≥ 65 years (Group 2), respectively. The ISS and the new injury severity score (NISS) were similar in both groups. The dominating injury mechanism was traffic-related and thoracic injury was the most common location of main injury in both groups. The groups suffered a similar number of orthopaedic injuries. A significantly higher proportion of Group 1 underwent operative treatment for their orthopaedic injuries than in Group 2 (74% vs. 53%). The mortality in Group 2 was significantly higher than that in Group 1 (15% vs. 3%). In Group 2 most deaths were related to traffic injuries (71%). High energy falls and traffic-related incidents caused the same number of deaths in Group 1. In Group 1 abdominal injuries resulted in most deaths, while head injuries was the primary reason for deaths in Group 2.ConclusionsAlthough the ISS and NISS were similar, mortality was significantly higher among patients aged ≥ 65 years compared to patients < 65 years of age. The younger age group underwent more frequently surgery for orthopaedic injuries than the elderly. There may be multiple reasons for this difference, but our study does not have sufficient data to draw any conclusions. Future studies may provide a deeper understanding of what causes treatment variation between age groups, which would hopefully help to further develop strategies to improve outcome for the elderly polytrauma patient.