Common Type Of Injury Research Articles

Abstracts from The 39th Annual Symposium of the National Neurotrauma Society, including the AANS/CNS Joint Section on Neurotrauma and Critical Care

Abstracts from The 39^th Annual Symposium of the National Neurotrauma Society, including the AANS/CNS Joint Section on Neurotrauma and Critical Care

Return to sport and beyond following intramuscular tendon hamstring injury: A case report of an English Premier League football player

BackgroundHamstring strain injuries are the most common type of injury in elite football and are associated with a high risk of reinjury, particularly those involving the intramuscular tendon (IMT). Limited information is available regarding the rehabilitation and return to sport (RTS) processes following such injuries. This case study describes the clinical presentation of an elite football player following IMT hamstring injury, their on- and off-pitch rehabilitation alongside performance monitoring throughout RTS and beyond. Case scenarioAn elite football player suffered a grade 2c hamstring injury during an English Premier League (EPL) match. The player underwent early post-injury management, alongside progressive off-pitch physical preparation. The ‘control-chaos continuum’ was used as a framework for on-pitch rehabilitation to prepare the player for a return to full team training and competition. Objective and subjective markers of the player's response to progressive on- and off-pitch loading were monitored throughout RTS and beyond. OutcomesThe player returned to on-pitch rehabilitation after 11 days, to full team training having achieved weekly pre-injury chronic running load outputs after 35 days and played in the EPL 40 days post-injury. The player did not suffer reinjury for the rest of the EPL season. ConclusionAn understanding the unique structural and mechanical properties of the IMT, alongside expected RTS timeframes are important to inform rehabilitation and decision-making processes post-injury. Performance and frequent load-response monitoring throughout RTS and beyond, in conjunction with practitioner experience and effective communication are critical in facilitating effective RTS and reduce risk of reinjury following IMT injury.

Efficacy of Conservative and Surgical Techniques in the Management of Scaphoid Fractures: A Longitudinal Study

Aim: The goal of this study was to assess the efficacy of conservative versus surgical treatment for acute scaphoid fracture. Study design: A longitudinal study Place and Duration: This study was conducted at Fauji Foundation Hospital, Rawalpindi, MMC college Mirpurkhas, BMCH Quetta, PHQ hospital Gilgit Pakistan from June 2020 to June 2021. Methodology: A total of 60 acute scaphoid fractures (within three weeks) were included in this study, regardless of location. During the clinical examinations, diagnostic tests were done. Patients were urged to have wrist radiography check if any of these tests were positive. If radiography revealed no fracture, the wrist was immobilised with a below-elbow slab, and the patient was instructed to return in 15 days. After two weeks, the identical x-ray series was repeated Results: During the study period, 60 cases of acute scaphoid fracture (< 3 weeks) were seen. The average age of patients was 36.5 years. There were n=48 (80%) male patients and n=12 (20%) female patients. A right-side fracture was found in 38 (63 %) of patients, while a left-side fracture was found in 22 (36 %). The most common type of injury was traffic accidents, but sports injuries, industrial injuries, domestic injuries, and assault injuries were also common. A total of 11 patients had poor results who were managed conservatively. Poor results were reported in 1 patient of the operatively managed patients. Conclusion: As compared to conservative management, surgical technique had more favourable outcome. There were poor results in every fourth patient that was managed conservatively, while poor results were negligible in patients who were operatively managed. Keywords: Scaphoid fracture, conservative and surgical management, treatment options

Clinical spectrum and functional outcome of firearm pellet-related eye injuries: A prospective follow-up study

PurposeTo determine the prognostic significance of various clinical features and surgical techniques concerning anatomical and visual outcomes in shotgun pellet-inflicted ocular trauma. MethodsThis prospective follow-up study was done at a tertiary care institute in Kashmir, India. Six hundred sixty-four eyes of 643 patients with firearm pellet-related ocular trauma were followed up for 6 months. ResultsOcular injury involved one eye in 622 (96.7%) patients and both eyes in 21 (3.3%) patients. Open globe injury (OGI) occurred in 451 (67.9%) eyes with perforating injury being the commonest type (248 eyes, 54.9%). For perforating injuries, entry wounds in the cornea and limbus had the worst prognosis. Closed globe injury (CGI) occurred in 213 (32.1%) eyes.An anatomical success rate of 66.3% (n = 250) was achieved for 56.8% (377/664) eyes requiring an average of 2.8 (SD 0.5) surgeries per eye. OGI was associated with poor outcomes in 259 (57.4%) and CGI with good outcomes in 200 (93.9%) eyes. The visual outcome had a significant association with grade and zone of injury both in OGI and CGI, and with the type of injury in OGI (p < .0001 each). Ocular trauma score (OTS) had a significant association with the degree of vision impairment (p < .0001). WHO category 0 visual impairment was seen in 270 (40.7%) eyes, category 1 in 85 (12.8%), category 2 in 35 (5.3%), category 3 in 30 (4.5%), category 4 in 172 (25.9%), and category 5 in 72 (10.8%) eyes irrespective of type of injury at 6 months post-treatment. ConclusionsThe perforating injury was the commonest type of injury caused by shotgun pellets. The site of the entry wound in perforating injury had prognostic significance. The outcome was generally poor in OGI and good in CGI.

Falls from ladders: Injury patterns and outcomes.

Our contemporary understanding of the impact of falls from ladders remains limited. The purpose of this study was to examine the injury patterns and outcomes of falls from ladders. Our hypothesis was that age affects both injury type and outcomes. The National Trauma Data Bank was queried for all patients who fell from a ladder (January 2007 to December 2017). Participants were stratified into four groups according to age: 15 years or younger, 16 years to 50 years, 51 years to 65 years, and older than 65 years. Univariate and multivariate analyses were performed to compare the injury patterns and outcomes between the groups. A total of 168,227 patients were included for analysis. Median age was 56 years (interquartile range, 45-66 years), 86.1% were male, and median ISS was 9 (interquartile range, 4-13). Increasing age was associated with a higher risk of severe trauma (ISS > 15: 8.8% vs. 13.7% vs. 17.5% vs. 22.0%; p < 0.001). Head injuries followed a U-shaped distribution, with pediatric and elderly patients representing the most vulnerable groups. Overall, fractures were the most common type of injury, in the following order: lower extremity, 27.3%; spine, 24.9%; rib, 23.1%; upper extremity, 20.1%; and pelvis, 10.3%. The overall intensive care unit admission rate was 21.5%; however, it was significantly higher in the elderly (29.1%). In-hospital mortality was 1.8%. The risk of death progressively increased with age with a mortality rate of 0.3%, 0.9%, 1.5%, and 3.6%, respectively ( p < 0.001). Strong predictors of mortality were Glasgow Coma Scale score of 8 or lower on admission (odds ratio, 29.80; 95% confidence interval, 26.66-33.31; p < 0.001) and age >65 years (odds ratio 4.07; 95% confidence interval, 3.535-4.692; p < 0.001). Only 50.8% of the elderly patients were discharged home without health services, 16.5% were discharged to nursing homes, and 15.2% to rehabilitation centers. Falls from ladders are associated with considerable morbidity and mortality, especially in the elderly. Head injuries and fractures are common and often severe. An intensified approach to safe ladder use in the community is warranted. Therapeutic/care management; Level III.

Effectiveness of Video Education on Mothers' Knowledge of Hazard Factors and First Aid Administration in Choking Incidents

Background: Choking is one of the most common types of unintentional injury that results in the death of children aged under 14 years. Objectives: This study aimed to assess the effect of providing mothers with video education on their awareness of choking hazards as well as methods of administering first aid to children aged between 6 months to 8 years. Methods: In this quasi-experimental study conducted from October to April 2021 in Dezful city of Iran, 110 mothers were divided into intervention and control groups by adopting convenience sampling method. The education program was run by offering two video presentations. Participants in both groups were asked to complete two questionnaires in order to evaluate their knowledge about first aid for choking children before and 30 days after the intervention. Data were analyzed based on frequency and Wilcoxon test using SPSS 16 software. Results: Mothers were found to have a very limited knowledge about the issues, including the right age for beginning chewing and smashing solid food in children, the most common food resulting in choking, and the best way to assess the risk of an object leading to choking of a child under the age of four. Furthermore, 10.9% of the mothers in the intervention group, as well as 12.7% of them in the control group were discovered to adopt Heimlich maneuver when facing the choking accident. The given percentages reached 67.3% and 16.4% in the intervention and control groups, respectively, after providing the mothers with proper training. Only 16.4% of mothers in the intervention group and 18.2% of them in the control group demonstrated the required knowledge of opening the airway in infants before the intervention. After offering the video education, however, this knowledge was increased by 68.5% and 20% in the intervention group and control group, respectively. Their knowledge of the risk factors for choking in control group (P = 0.000) and intervention group (P = 0.001) was significant before and after offering the video education; regarding the methods of administering first aid for choking children, however, the result was significant only in the intervention group (P = 0.000). Conclusions: Educating mothers may have improved their knowledge about the risk factors as well as the methods of dealing with choking children.

The clinical pattern of intentional injuries at a primary Saudi Arabian trauma center.

The term "intentional injuries" refers to a spectrum of injuries resulting from self-inflicted injuries, interpersonal violence, and group acts of violence. Intentional injuries are underreported in Saudi Arabia. This study aimed to analyze and evaluate the characteristics of intentional injuries in patients who presented to the emergency department of a primary trauma center in Medina, Saudi Arabia in 2013. A prospective cohort database analysis of the clinical patterns and treatment outcomes of 252 patients who had intentional injuries between January and December 2013 was done. The proportion of trauma patients with intentional injuries was 1.3%. The mean age was 34.2±9.4 years, 141 patients (56.0%) were male, and 111 (44.1%) were female (male to female ratio, 1.27:1). The majority (n=159, 63.1%) of injuries occurred at night. Most occurred outside the home (n=180, 71.0%). Financial problems (n=62, 24.6%) and social disputes (n=61, 24.2%) were the most common reasons. Sharp objects (n=93, 36.9%) were the most common weapons used. The head and neck were the most commonly injured areas (n=63, 54.4%). Superficial cuts (n=87, 34.5%), were the most common type of injury. Suturing of wounds (n=54, 21.4%) and surgical debridement (n=47, 18.7%) were the most commonly performed modalities of management. We conclude that intentional injuries in Saudi Arabia are a health care hazard that is, unfortunately, underreported. The clinical pattern is similar in most aspects to international reports but differs in certain features due to the specific religious and conservative characteristics of the community. Nationwide clinical studies are strongly recommended.

Clinical characteristics, hospital course, and disposition of patients with nontraumatic spinal cord injury in a large private health care system in the United States

Objectives: To evaluate the clinical characteristics, hospital courses, outcomes after hospitalization, and factors associated with outcomes in patients with nontraumatic spinal cord injuries (NTSCI). Design: Retrospective analysis. Setting: A large for-profit United States health care system. Participants: 2807 inpatients with NTSCI between 2014 and 2020 were identified using International Classification of Disease codes. Main Outcome Measure: Demographic, clinical characteristics, hospital course, and disposition data collected from electronic health record. Results: The mean age was 57.91 ± 16.41 years with 69.83% being male. Incomplete cervical level injury was the most common injury type, spinal stenosis was the most common diagnostic etiology and central cord syndrome was the most common clinical syndrome. The average length of stay was 9.52 ± 15.8 days, with the subgroup of 1308 (46.6%) patients who were discharged home demonstrating a shorter length of stay (6.42 ± 10.24 days). Falls were the most common hospital-acquired complication (n = 424, 15.11%) and 83 patients deceased. There were increased odds of non-home discharge among patients with the following characteristics: older age, Medicare insurance, non-black racial minority, increased Charlson Comorbidity Index (CCI), intensive care unit (ICU) stay, use of steroid or anticoagulant medications, and hospital-acquired pulmonary complications. Increased in-hospital mortality was observed in those with Medicaid insurance, ICU stay, increased CCI, diagnosis of degenerative spine disease, other unspecified level of injury, and hospital-acquired pulmonary complications. Conclusions: NTSCI in this sample were predominantly incomplete cervical central SCIs. Increased CCI, ICU stay, and hospital-acquired pulmonary complications were associated with poorer outcomes after acute care hospitalization among patients with NTSCI.

AIP1 suppresses neovascularization by inhibiting the NOX4-induced NLRP3/NLRP6 imbalance in a murine corneal alkali burn model.

BackgroundApoptosis signal-regulating kinase 1-interacting protein 1 (AIP1) participates in inflammatory neovascularization induction. NADPH oxidase 4 (NOX4) produces reactive oxygen species (ROS), leading to an imbalance in nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3) and NLR family pyrin domain containing 6 (NLRP6) expression. The mechanisms of AIP1, NOX4, ROS and inflammasomes in corneal neovascularization were studied herein.MethodsC57BL/6 and AIP1-knockout mice were used in this study. The alkali burn procedure was performed on the right eye. Adenovirus encoding AIP1 plus green fluorescence protein (GFP) (Ad-AIP1-GFP) or GFP alone was injected into the right anterior chamber, GLX351322 was applied as a NOX4 inhibitor, and then corneal neovascularization was scored. The expression of related genes was measured by quantitative real-time polymerase chain reaction, western blotting and immunofluorescence staining. 2′,7′-Dichlorofluorescin diacetate staining was used to determine the ROS levels.ResultsThe expression of AIP1 was decreased, while that of cleaved interleukin-1β (clv-IL-1β) and vascular endothelial growth factor A (VEGFa) was increased after alkali burn injury. NOX4 expression was increased, the imbalance in NLRP3/NLRP6 was exacerbated, and corneal neovascularization was increased significantly in AIP1-knockout mice compared with those in C57BL/6 mice after alkali burns. These effects were reversed by AIP1 overexpression. NLRP3/NLRP6 expression was imbalanced after alkali burns. GLX351322 reversed the imbalance in NLRP3/NLRP6 by reducing the ROS levels. This treatment also reduced the expression of clv-IL-1β and VEGFa, suppressing neovascularization.ConclusionsAIP1 and NOX4 can regulate corneal inflammation and neovascularization after alkali burn injury. Based on the pathogenesis of corneal neovascularization, these findings are expected to provide new therapeutic strategies for patients.Plain English summaryCorneal alkali burn injury is a common type of ocular injury that is difficult to treat in the clinic. The cornea is a clear and avascular tissue. Corneal neovascularization after alkali burn injury is a serious complication; it not only seriously affects the patient’s vision but also is the main reason for failed corneal transplantation. Corneal neovascularization affects approximately 1.4 million patients a year. We show for the first time that AIP1 and NOX4 can regulate corneal inflammation and neovascularization after alkali burns. The expression of AIP1 was decreased, while that of clv-IL-1β and VEGFa was increased after alkali burns. We tried to elucidate the specific molecular mechanisms by which AIP1 regulates corneal neovascularization. NOX4 activation was due to decreased AIP1 expression in murine corneas with alkali burns. NOX4 expression was increased, the imbalance in NLRP3/NLRP6 was exacerbated, and corneal neovascularization was increased significantly in AIP1-knockout mice compared with those in C57BL/6 mice after alkali burns. These effects were reversed by AIP1 overexpression. Additionally, NLRP3/NLRP6 expression was unbalanced, with NLRP3 activation and NLRP6 suppression in the corneal alkali burn murine model. Eye drops containing GLX351322, a NOX4 inhibitor, reversed the imbalance in NLRP3/NLRP6 by reducing ROS expression. This treatment also reduced the expression of clv-IL-1β and VEGFa, reducing neovascularization. Therefore, we provide new gene therapeutic strategies for patients. With the development of neovascularization therapy, we believe that in addition to corneal transplantation, new drug or gene therapies can achieve better results. Video Supplementary InformationThe online version contains supplementary material available at 10.1186/s12964-022-00877-5.

Is Kinesio Taping Effective for Sport Performance and Ankle Function of Athletes with Chronic Ankle Instability (CAI)? A Systematic Review and Meta-Analysis.

Background and Objectives: Ankle injuries are the most common type of injury in healthy active individuals. If not treated properly, recurrent sprains can lead to a condition of chronic ankle instability (CAI). The aim of the present review is to evaluate the effects of Kinesio Taping (or KT) on sports performances and ankle functions in athletes with CAI. Materials and Methods: This systematic review with meta-analysis was carried out following the criteria of the Prisma Statement system (registered on Open Science Framework, number: 10.17605/OSF.IO/D8QN5). For the selection of the studies, PubMed, Scopus and Web of Science were used as databases in which the following string was used: (“kinesiology tape” OR “tape” OR “taping” OR “elastic taping” OR “kinesio taping” OR “neuro taping”) AND (unstable OR instability) AND (ankle OR (ankle OR “ankle sprain” OR “injured ankle” OR “ankle injury”)). The Downs and Black Scale was used for the quality analysis. The outcomes considered were gait functions, ROM, muscle activation, postural sway, dynamic balance, lateral landing from a monopodalic drop and agility. Effect sizes (ESs) were synthesised as standardized mean differences between the control and intervention groups. Calculation of the 95% confidence interval (CI) for each ES was conducted according to Hedges and Olkin. Results: In total, 1448 articles were identified and 8 studies were included, with a total of 270 athletes. The application of the tape had a significant effect size on gait functions, ROM, muscle activation and postural sway. Conclusions: The meta-analysis showed a significant improvement in gait functions (step velocity, step and stride length and reduction in the base of support in dynamics), reduction in the joint ROM in inversion and eversion, decrease in the muscle activation of the long peroneus and decrease in the postural sway in movement in the mid-lateral direction. It is possible to conclude that KT provides a moderate stabilising effect on the ankles of the athletes of most popular contact sports with CAI.

Frequency and Pattern of Injuries in Victims of Violence at District Sanghar

Background: The main objective of the study was to determine the types and frequency of bodily medical and legal injuries that occur in a rural setting. Study Design: Retrospective study Place and Duration of Study: Civil Hospital Sanghar from 1st January 2020 to 31st December 2020 Methodology: One hundred cases were enrolled. Results: 90% of the cases were males and 10% were females. The frequency with which males were injured was higher than that of females. There were 45 cases of Shajjah, with 48 males and 9 females among the overall number. Conclusion: According to the findings of our study, the most common types of injuries were Shajjah and Jur-ghyr-e-jaiffa, which were followed by a variety of other types of injuries in the participants. Females were shown to be less susceptible to such injuries than males. Keywords: Hurt, Medico-legal injuries, Shajjah

Head Injury during Childbirth.

Head injuries are the most common type of birth injuries. Among them, most of the injuries is limited to the scalp. and the prognosis is good enough to be unnoticed in some cases. Intracranial injuries caused by excessive forces during delivery are rare. However, since some of them can be fatal, it is necessary to suspect it at an early stage and evaluate thoroughly if there are abnormal findings in the patient.

Knowledge and Practices Related to Burn First Aid among General Population in Saudi Arabia

Background: Burn injuries represent a common type of traumatic injuries. They may cause morbidity, mortality, or psychological and cosmetic problems. About 265 000 individuals die secondary to burns according to the WHO results. Simple first aids following a burn injury have been shown to improve the outcome.&#x0D; Objectives: Evaluation of first aid knowledge about the management of burns among the general population in Saudi Arabia.&#x0D; Subjects and Methods: This is a cross-sectional study that assesses awareness regarding burn injury first aids among the general population in Saudi Arabia. Data was collected using a questionnaire formed of 18 questions about demographic data, burn first aid knowledge and practice. Burn first aid knowledge and practice parts of the survey assessed participants' knowledge regarding basics of burn first aid and when to seek medical assistance.&#x0D; Results: 70.6% of the sample study has previous knowledge of applying first aid for burns. 62.8% of the sample study think it's wrong to put raw eggs or herbs on the wound. 51.04% of the sample study use honey while 30.73% of them use toothpaste to treat burns. 76.3% of the sample study think that jewelry and clothing should be removed from the affected area of burn.&#x0D; Conclusion: 70.6% of Saudi population had basic knowledge regarding the first aid of burn, however, there are wrong beliefs about the benefit of using honey, toothpaste, and raw egg in case of burns. Raising awareness of community members about the benefits of first aids for burns is recommended.

Epidemiology and Risk Factors of Table-Tennis-Related Injuries: Findings from a Scoping Review of the Literature.

Background and Objectives: Table tennis represents one of the fastest ball games in the world and, as such, is characterized by unique physiological demands. Despite its popularity, there is a dearth of data related to table-tennis-related risk factors and injuries. Therefore, the present review was conducted to fill in this gap of knowledge. Material and Methods: The present review was designed as a scoping review. Eleven online databases were searched with no language/date limitations. Results: Forty-two investigations were retained in the present review. These studies indicated that tenosynovitis, benign muscle injuries, strains, and sprains were the most common injury types. In order, the most commonly affected anatomical regions were the lower limb, shoulder, spine, knee, upper limb, and trunk. When comparing the injury occurrence between training and competition, the results were contradictory. National/international athletes had higher indices of injury than regional players, even though other investigations failed to replicate such findings. According to some scholars, there was a difference between female and male athletes: in females, more injuries involved the upper limbs when compared to men who had more injuries to the lower limbs, while other studies did not find differences in terms of gender. Conclusions: Table tennis is generally considered at lower risk for injuries than other sports. However, the present scoping review showed that injuries can occur and affect a variety of anatomic regions. Sports scientists/physicians could utilize the information contained in the current review for devising ad hoc programs to adopt an effective/appropriate prevention strategy and to monitor table tennis players’ training load and to achieve maximal fitness, as these will reduce the risk of injuries. However, most of the studies included in our scoping review are methodologically weak or of low-to-moderate evidence, being anecdotal or clinical case reports/case series, warranting caution when interpreting our findings and, above all, further high-quality research in the field is urgently needed.

A 12-year experience in the management of traumatic bladder rupture at an Australian level 1 trauma centre

Objective: To review the contemporary bladder trauma epidemiology, diagnosis and management over a 12-year period at a level 1 trauma centre in Australia. Patients and Methods: From July 2001 through June 2013, 97 multi-trauma patients at a level 1 trauma centre in Australia were identified to have sustained bladder rupture. Data on demographics, clinical presentation, diagnosis, management and complications were extracted from the TraumaNET database, medical records and health-coding database. Results: Of the 97 patients, 98% of bladder ruptures resulted from blunt trauma mostly from road accidents. There was a male preponderance of 64%. Intra-peritoneal bladder rupture (51%) was the most common type of injury followed by extra-peritoneal bladder ruptures (42%) and combined intra- and extra-peritoneal bladder ruptures (7%). Concomitant pelvic fractures occurred in 78% of patients and concurrent intra-abdominal injuries in 68%. Initial imaging missed 28% of bladder ruptures, with computed tomography with intravenous contrast missing 65% of bladder ruptures. The majority of intra-peritoneal bladder ruptures and 56% of extra-peritoneal bladder ruptures were repaired surgically, with 83% of repairs performed in conjunction with another surgical procedure. The in-hospital mortality rate was 9%, and all deaths were due to concomitant injuries. Conclusion: Traumatic bladder rupture is associated with a 9% mortality rate due to the frequently associated significant concurrent injuries. Computed tomography cystogram or plain cystogram is the imaging modality of choice in diagnosing bladder rupture. Intra-peritoneal bladder ruptures should be repaired surgically, while extra-peritoneal bladder ruptures can be treated conservatively in selected patients. The timing of surgical repair should be coordinated with other specialties. Level of evidence: 4

Sledding Accidents at a Level 1 Pediatric Trauma Center Between 2006 and 2016.

Sledding is not a risk-free winter sport. According to the US Consumer Product Safety Commission, there were an estimated 13,954 sledding accidents requiring medical care in 2010. However, specific information concerning pediatric injuries related to sledding is not well defined. This study aimed to identify the most common types of injuries associated with sledding accidents and demographic factors related to risk of injury in pediatric patients, and to compare injuries associated with 2 different age groups and sexes. This is a retrospective descriptive study of pediatric patients (<18 years of age) presenting to a regional level I pediatric trauma center secondary to a sledding injury between 2006 and 2016. Demographic information including sex, age, mechanism of injury, and injury severity score was captured and analyzed using descriptive statistics. There were 209 patients identified for 10 years. There were no mortalities. There were 85 patients with primary head injury, of which 82 (96.5%) were hospitalized and 33 (38.8%) required an intensive care unit (ICU) stay. Seventy-five patients primarily suffered from extremity injuries, of which 56 (74.6%) had lower extremity fractures requiring operative intervention. There was no difference in ICU or length of stay between younger children (0-11 years) and adolescents (12-18 years) or between male and female patients. Childhood sledding can result in a variety of significant injuries requiring surgical intervention and hospitalization. Children pulled on sleds behind motorized vehicles are at higher risk for more severe injuries resulting in a higher rate of ICU admission.

The epidemiology of surfing injuries in a major Australian Centre – A ten year clinical audit

IntroductionAustralia is one of the largest surfing nations with over 10% of the population participating; yet there is a paucity of literature analysing the injuries from surfing participation, particularly injuries requiring orthopaedic care. This study retrospectively analyses surfing injuries presenting to a tertiary hospital Emergency Department over a ten-year period with aims of quantifying surfing injuries and investigating injury characteristics requiring orthopaedic input. MethodsA retrospective clinical audit of presentations to Gold Coast Public Hospital Emergency Departments over a ten-year period was conducted using electronic hospital databases. Broad search teams were used to identify presentations, followed by exclusion based on relevance. Subsequent analysis of data was performed to investigate patient demographics and injury characteristics. ResultsA total of 2680 surfing related injury presentations were analysed. The median age was 30 years (range 2–77), with 455 females (17%) and 2225 males (83%). Lacerations were the most common injury type (37.9%), followed by ligament injury (21.3%), fractures (12.2%), and contusions (11.4%). The most common areas for lacerations were head/face (59.2%), lower limb (30%), and upper limb (26.5%). Dislocation rate was 4.9%, with shoulder dislocation (76.5%), and patella dislocation (12.1%) being the most common types. 1512 presentations (56.4%) required orthopaedic management. 93.5% did not require admission and were discharged. ConclusionOver half (56.4%) of surfing injuries were orthopaedic in nature; requiring orthopaedic advice or management. Lacerations, ligament injury, fractures and dislocations were the most commonly managed injuries. This emphasises the importance of understanding the prevalence and characteristics of surfing injuries for an orthopaedic service.

Relationships Among Shoulder Rotational Strength, Range of Motion, Pitching Kinetics, and Pitch Velocity in Collegiate Baseball Pitchers.

Cross, JA, Higgins, AW, Dziuk, CC, Harris, GF, and Raasch, WG. Relationships among shoulder rotational strength, range of motion, pitching kinetics, and pitch velocity in collegiate baseball pitchers. J Strength Cond Res 37(1): 129-135, 2023-Throwing shoulder injuries are the most common type of injury experienced by baseball pitchers. Weakness in the shoulder musculature and insufficient throwing arm range of motion are both risk factors for developing a shoulder injury. The goal of this study was to determine correlations among shoulder rotational strength, range of motion, pitching kinetics, and pitch velocity in collegiate pitchers. Thirteen uninjured male college pitchers were evaluated. Clinical measures included shoulder internal and external rotation range of motion, peak isokinetic internal and external rotator strength, and peak isometric internal and external rotator strength. Three-dimensional biomechanics were assessed as subjects threw from an indoor pitching mound to a strike zone net at regulation distance. Pearson's correlations were used to assess the associations among the clinical measures and throwing metrics. Five significant correlations were found between peak shoulder compressive force and strength, and 4 significant correlations were found between pitching velocity and strength ( p < 0.05). No significant correlations were found between range of motion and pitching kinetics or velocity. Our results suggest that as shoulder rotational strength increases, the peak shoulder compressive force and pitch velocity both increase. Knowledge of relationships between strength metrics and pitching biomechanics may allow for improved strength training routines with the goal of increasing velocity without increasing injury risk.

Principles and Surgical Techniques in the Management of Intraoperative Retroperitoneal Vascular Injury

Objective: To assess the surgical techniques and ideas in the treatment of the intraoperative retroperitoneal vascular injury. Methods: Between Oct 2017 and Dec 2019, 85 retroperitoneal tumor patients with retroperitoneal vascular injury intraoperatively in Changhai Hospital, Naval Medical University were analyzed retrospectively. Among them, the arterial injury occurred in 52 patients, the venous injury occurred in 49 patients, and 16 patients had both arterial and venous injuries. Main disease diagnosis, common types of vascular injury, different management methods, and results of vascular injury were analyzed. Results: The most common type of diagnosis is a retroperitoneal primary malignant tumor, followed by metastatic malignant tumor and retroperitoneal benign tumor. The most frequent injury arteries were the aorta (12 patients) and common iliac artery (12 patients), followed by the external iliac artery (6 patients) and superior mesenteric artery (6 patients). The most frequent injury vein was inferior vena cava (10 patients), followed by internal iliac vein (7 patients), external iliac vein (6 patients), inferior mesenteric vein (6 patients), and common iliac vein (4 patients). A total of 19 patients received artificial vessels replacements, including aortic replacement (4 patients), renal artery replacement (1 patient), superior mesenteric artery (2 patients), common iliac artery (5 patients), external iliac artery (3 patients), inferior vena cava (1 patient), Right renal vein (1 patient), common iliac vein (1 patient) and external iliac vein (1 patient). The remaining patients underwent ligation and sutures to achieve hemostasis. All patients attained hemostasis in the operating room and were admitted to medical wards or the medical ICU. After artificial vessels replacements, one patient died of DIC postoperatively, other patients had an uneventful perioperative course, no anastomotic bleeding was reported. Conclusion: In the management of intraoperative retroperitoneal vascular injury, it is important to assess the extent of injury, select reasonable remediation methods, and adopt artificial vessels replacements when necessary.

Emergent Surgical Airway Skills: Time to Re-evaluate the Competencies.

IntroductionOne of the most challenging scenarios an anesthesia provider can face is treating a can't intubate can't ventilate (CICV) patient. The incidence of CICV is estimated to be around one in 10,000 cases. According to the American Society of Anesthesiology Closed Claims Study, adverse respiratory events are the most common type of injury, with difficult intubation and ventilation contributing to the majority of these cases. The objective of this non-interventional quality improvement project was to evaluate the prior training, exposure, and self-reported confidence in handling the CICV scenario among anesthesia providers at Henry Ford Hospital in Detroit, MI.MethodsAn online questionnaire was distributed via email to all residents, certified registered nurse anesthetists (CRNAs), and attending anesthesiologists in March 2021. The email contained a link to an online questionnaire via Microsoft Forms (Microsoft Corporation, Redmond, WA). Univariate group comparisons were carried out between the respondents’ role (attending, CRNA, or resident), as well as between the number of years that the respondents were in practice (< 5 years, 5-10 years, > 10 years).ResultsOut of the total 170 anesthesia providers, 119 participated in the study where 54 (45%) were attendings, 44 (37%) were residents, and 21 (18%) were CRNAs. The majority (75%) did not know the surgical airway kit location, and 87% had not performed the surgical airway procedure before. The vast majority (96.7%) recommended simulation training compared to online training or lecture series, and just over 50% recommended annual training frequency. When looking at the differences in responses based on years of experience as an anesthesia provider, the majority of those with > 10 years in practice knew how to perform the surgical airway technique while respondents with < 5 years did not know how to perform the technique, and 50% of those with five to 10 years experience knew how to perform the surgical airway procedure for a CICV scenario.ConclusionAlthough there were many significant differences observed between the various provider roles and years in practice, surprisingly, the responses revealed both a lack of experience and confidence in performing the surgical airway procedure in all provider roles. These findings highlight a need for better emergency airway teaching and training. These findings will be used to guide the design and implementation of improved surgical airway training for residents, CRNAs, and attending anesthesiologists with the goal of better preparedness for handling a CICV scenario.