Fracture Injury Research Articles

The Effect of Lag Time Between Injury and Treatment of Zygomatic Complex Fractures on the Neurosensory Disturbances of the Infraorbital Nerve

The Effect of Lag Time Between Injury and Treatment of Zygomatic Complex Fractures on the Neurosensory Disturbances of the Infraorbital Nerve

Multicenter epidemiological analysis of related factors in 10,808 hospitalized children with lower limb and pelvic fractures in China.

To analyze the causes, locations, associated injuries, and relevant factors of lower limb and pelvic fractures in hospitalized children in China to provide a theoretical basis for reducing the incidence of such fractures. A retrospective analysis of children with lower limb and pelvic fractures admitted to 27 tertiary children's hospitals affiliated with China's Futang Research Center of Pediatric Development between December 1, 2015, and December 31, 2019, was conducted. Inpatient cases were analyzed in the following age groups: Infants (< 2years), Preschool children (2-5years), School children (6-11years), and Adolescents (12-18years). This study included 10,808 pediatric patients (7152 males, 3656 females). The proportion of preschool children of lower limb and pelvic fractures was the highest. The 10,808 patients sustained a total of 14,398 fractures. The shafts of the femur, tibia, and fibula, the distal tibia, distal fibula, and the pelvis were the six most common locations. Of the 734 pelvic fractures in children and adolescents, the top three locations were the ilium, pubic bone, and the ischium. Of the total patients, 9599 underwent surgery, while 1209 received non-surgical treatment. The three most common causes of pediatric lower limb and pelvic fractures were falling over, traffic accidents, and falling from a height. Among the 1806 concomitant traumas, respiratory traumas was the most common, mainly pulmonary contusion. The most common concomitant traumas of nervous, digestive and urinary system were scalp hematoma, liver injury and kidney injury respectively. The analysis of the location, age, causes, and concomitant injuries of lower limb and pelvic fractures showed that the most common fracture requiring hospitalization was tibia fracture, which was most common in preschool children. The most common cause of injury in preschool children was traffic accident. In addition, children are susceptible to accidental injuries from multiple sources in life, which can cause serious consequences of multi-system injuries.

Hiking Backpack Design Development with Integrated Splint Feature for Fracture Injuries

The background of this design is the risk of fracture injury to climbers when mountaineering. According to the International Alpine Trauma Registry (IATR), there were 306 mountaineering accidents resulting in fractures in 2019. First aid for fractures requires standardized equipment and methods to assist the rescue process. The problem studied is the difficulty of climbers in utilizing climbing equipment as splints when treating fracture victims on the mountain. The purpose of this design is to develop climbing equipment so that it can be converted into a means of bandaging to perform first aid for fracture injuries. The design method used is Quality Function Deployment (QFD), to determine the priority aspects related to the specifications of the means of massaging that users want. The result of the design is a backpack product with an internal frame that applies a collapsible mechanism so that it can be quickly accessed in an emergency and can be adjusted according to the dimensions of the body part that has a fracture injury. The developed splint design successfully meets the criteria for dimensional customization to the user's body and can immobilize the fracture according to standard first aid procedures.

Frequency and mechanism of injury for unintentional paediatric femoral fractures associated with consumer products over a 10-year period in the USA.

Femoral shaft fractures tend to be rare among children; however, these injuries are the most common major paediatric injuries treated by orthopaedic surgeons. The purpose of this study is to characterise the demographics and mechanisms of femoral injury associated with consumer products in the age group treated with spica casting, children 6 months to 6 years, to identify areas for injury prevention. Data from 2012 to 2021 were obtained from the National Electronic Injury Surveillance System maintained by the Consumer Products Safety Commission, documenting emergency department visits for unintentional injuries associated with consumer products. Narrative descriptions were analysed to identify common factors in the injury events such as location, products and mechanisms of action. From 2012 to 2021, the estimated incidence of femur fractures was 23.5 cases per 100 000 children with no significant difference in yearly frequency. The most common mechanism of injury was a fall with the most frequent fracture sources being bed/bunk beds (16.1%), floor (slips/falls, 9.7%) and trampolines (9.7%). Most fractures occurred at the patient's home (58.4%). The incidence of injury outside of the home and frequency of fractures involving play structures/trampolines increased with age. The incidence and demographic characteristics of paediatric femur fractures associated with consumer products have remained consistent over the past 10 years. As home was the most common location of fracture, prevention of femur fractures should focus on caregiver education around high-risk sources of fracture (bed, stairs and trampolines) and manufacturers should consider design alternatives that discourage potential misuse.

Recovery after neurologic injury in operative acetabular and pelvic fractures: Defining the natural history of foot drop

IntroductionDorsiflexion weakness, or footdrop, is a well-described sequela of high-energy acetabular and pelvic trauma, but little data exists describing the factors related to neurologic recovery and the timeline therein. An improved understanding of these factors would facilitate prognostication, patient education, and treatment decision-making. The aim of this study was to compare neurologic recovery between acetabular and pelvic fractures, delineate factors associated with recovery, and determine the expected timeline of recovery. MethodsA retrospective chart review was conducted at a level 1 tertiary referral center from 2000 to 2021 using CPT codes and keyword search functions to identify adult patients with neurologic injury in the setting of operative acetabular and/or pelvic ring trauma. Patients were included if they had documented, graded weakness not clearly explained by a concomitant injury (extremity or spine) following a pelvic/acetabular injury. Patients were followed to a minimum of 6 months follow-up or to neurologic recovery. Primary outcomes were the presence of motor recovery and time to initial and maximum recovery. The contributions of injury type and initial neurologic status were analyzed using logistic regression for impact on neurologic recovery. ResultsWe identified 121 patients with neurologic injury and resultant footdrop in the setting of an operative pelvic ring or acetabular fracture. From this cohort, 58 patients (47.9 %) demonstrated some degree of neurologic recovery in follow-up. There was no difference in recovery when comparing injury type (pelvis vs. acetabulum). Any motor function (including flicker) at time of initial evaluation was predictive of recovery (OR 6.18, [2.00 – 19.14]; p = 0.002). Initial neurologic function also correlated with more rapid recovery in comparison to patients with initial absent neurologic function both in time to initial recovery (56 days vs 107 days; p = 0.016) and time to maximum recovery (153 days vs 241 days; p = 0.027). ConclusionsThese results highlight the relatively poor prognosis for neurologic recovery in operative pelvic and acetabular injuries. Any initial neurologic function is predictive of likelihood of neurologic recovery and correlates with a more expedient neurologic recovery. Ultimately, this enables providers to better educate patients and facilitates decisions regarding further intervention.

7474 Demographic Patterns In Early Vertebral Fracture Diagnoses Among Women After Initiation Of Bisphosphonate Therapy

Abstract Disclosure: J.C. Lo: None. G.H. Tabada: None. M. Chandra: None. L.D. Carbone: None. T.C. Tan: None. J. Yang: None. E. Garcia: None. Introduction: Vertebral fractures (VFX) are a major osteoporotic fracture that identify women at high risk for subsequent fracture. However, less is known about demographic patterns in VFX diagnoses among women initiating osteoporosis therapy, including prior and subsequent VFX diagnoses. In this study, we examined racial and ethnic variation in VFX diagnoses among older women who initiated oral BP therapy in a large healthcare system. Methods: The study cohort included women aged 65-85y who initiated oral bisphosphonate (BP) therapy in 2008-2017, excluding those with selective bone disorders, metastatic cancer, multiple myeloma, kidney dialysis or transplant. Prior VFX diagnosis was based on ICD-9/10-CM diagnosis codes in the 5 years prior to or at BP initiation, excluding fracture codes related to open fracture or spinal cord injury. In the 2 years after BP initiation, new or initial encounter diagnoses of VFX were examined among those without prior VFX diagnoses. Findings were compared by race and ethnicity, overall and within age strata (65-74y, 75-85y). New VFX diagnoses after BP initiation were examined using Cox proportional hazard analyses, reporting hazard ratios (HR) with 95% confidence intervals (CI). Results: Among 50,870 women aged 65-85y (56.5% age &amp;lt;75y) who initiated BP (66.9% White, 16.7% Asian/PI, 11.9% Hispanic, 3.2% Black), 2819 (5.5%) had prior VFX diagnosis. By race and ethnicity, 4.5% of White, 2.3% of Asian/PI, 3.5% of Hispanic, and 4.1% of Black women aged 65-74y had prior VFX diagnosis, increasing to 7.9% of White, 6.6% of Asian/PI, 7.9% of Hispanic, and 6.3% of Black women aged 75-85y. During 2 years follow-up after BP initiation and stratified by age, the incidence of new VFX diagnosis (per 1000 person-years) was 8.9 (7.9-9.9) for White, 3.2 (2.3-4.5) for Asian/PI, 7.1 (5.3-9.5) for Hispanic, and 6.8 (3.8-12.3) for Black women aged 65-74y, and 17.4 (15.9-19.0) for White, 13.0 (10.2-16.6) for Asian/PI, 14.2 (11.2-18.1) for Hispanic, and 6.1 (3.1-12.2) for Black women aged 75-85y. Adjusting for age, prior clinical fracture, and BP initiation year, the risk of new VFX diagnosis among women aged 65-74y (White as reference) was much lower for Asian/PI women (HR 0.40, CI 0.28-0.57) but not Black (HR 0.70, CI 0.38-1.29) and Hispanic (HR 0.80, CI 0.59-1.10) women. For older women aged 75-85y, the risk was much lower for Black women (0.36 (CI 0.18-0.72) but not Asian/PI (0.78, CI 0.60-1.02) and Hispanic (0.83, CI 0.64-1.07) women. Conclusion: Compared to White women, much lower VFX diagnosis among younger but not older Asian/PI women and among older but not younger Black women were seen in the 2 years after BP initiation. While new VFX diagnoses may represent prevalent or incident VFX and underlying fracture risk and continuation of BP may differ by group, these pilot findings support the need for more studies examining ethnic variation in VFX among older women, including differences by age. Presentation: 6/3/2024

Rising rates of traumatic fractures among mountain bikers: A national review of emergency department visits

Hypothesis/PurposeMountain biking (MTB) is a quickly growing sport, with fractures being the most common injury among MTB athletes. Currently, there is a lack of analysis of MTB fractures based on emergency department (ED) data obtained on a national scale. It was hypothesized that the total number of fractures presenting to United States (US) EDs increased significantly over the last decade, and adult male riders experienced higher rates of fracture and fracture-related hospitalization than other demographics. MethodsAll data was extracted from the National Electronic Injury Surveillance System (NEISS), a public database representing approximately 100 US EDs. NEISS was queried for all MTB-related fractures from January 1st, 2013-December 31, 2022. ResultsNEISS returned a national estimate (NE) of 35,260 MTB fractures visiting EDs between 2013 and 2022. Fracture injuries increased significantly over the study period, including a 247 % increase from 2019 to 2020. The mechanism of injury most likely resulting in fracture was being thrown from the bike (39.6 %, NE:5,436). The upper extremity was the most commonly fractured body region (32.8 %, NE:11,574), and trunk fractures had the highest rate of hospitalization (44.2 %, NE:3705). Males accounted for the majority of fractures (87.9 %, NE:30,996), and were more likely to be hospitalized than females (22.2 %>17.4 %). Adults (age≥40) were more likely to sustain a fracture (48.8 %) and be hospitalized because of it (25.8 %) than other age groups. Adults were also most likely to fracture their trunk (33.9 %). ConclusionMTB fractures increased significantly from 2013 to 2022, possibly due to the gaining popularity of MTB since COVID-19. The upper extremity was the most frequently fractured body region, and being thrown from the bike was the mechanism most likely to result in a fracture. Adult male riders are at a high risk for trunk fractures, demonstrating the importance of protective equipment such as chest and torso protectors for these athletes. Level of EvidenceIII

Effect of data censoring on thoracic injury risk curves

Objective The first objective was to evaluate the effect of using less censored (i.e., exact and interval-censored) data on thoracic injury risk curves and the resulting injury probabilities. The second objective was to generate new injury risk curves to predict Abbreviated Injury Scale (AIS) 3+ rib fractures based on chest deflection. Methods Two data sets consisting of postmortem human surrogate (PMHS) tests with multipoint chest deflection measurements were compiled: A less censored data set consisting of exact and interval-censored data and a doubly censored data set consisting of left- and right-censored data. Chest deflection data from both data sets were processed in a consistent manner to calculate the maximum deflections at different locations across the chest. Survival analysis methods were used to generate nonparametric and parametric injury risk curves for serious skeletal injury. The total sample sizes and proportions of less censored data used to generate the risk curves were varied for each curve to evaluate the effects of sample size and less censored data on risk curve shape and predicted injury thresholds. Results Increasing the proportion of less censored data resulted in steeper injury risk curves and a higher predicted risk for a given amount of deflection. Differences in injury risk were more pronounced in the upper half of the injury risk curves. Introducing less censored data also produced narrower confidence intervals. At a total sample size of 79, increasing the percentage of less censored data from 0 to 30 had minimal effect on the shape of the risk curve. Conclusions Doubly censored chest deflection data have historically been used to generate thoracic injury risk curves for frontal motor vehicle crash events. This study found that incorporating less censored data into thoracic injury risk curves meaningfully affected the shape of the injury risk curves and their resulting injury risk predictions. All of the injury risk curves generated in the study predicted a lower threshold for serious rib fracture injury compared to previously developed injury risks curves that are currently in use in the field. Based on the results of this study, adding less censored data to injury risk curves should be strongly considered to improve thoracic injury risk curve prediction and confidence, especially for smaller sample sizes.

Wrist &amp; Hand

The October 2024 Wrist &amp; Hand Roundup360 looks at: Circumferential casting versus plaster splinting in preventing redisplacement of distal radial fractures; Comparable outcomes for operative versus nonoperative treatment of scapholunate ligament injuries in distal radius fractures; Perceived pain during the reduction of Colles fracture without anaesthesia; Diagnostic delays and physician training are key to reducing scaphoid fracture nonunion; Necrotizing fasciitis originating in the hand: a systematic review and meta-analysis; Study design influences outcomes in distal radial fracture research; Long-term results of index finger pollicization for congenital thumb anomalies: a systematic review; Enhancing nerve injury diagnosis: the evolving role of imaging and electrodiagnostic tools.

Sagittal Fragment Rotation and Ogden Type-I Classification Are Hallmarks of Combined Tibial Tubercle Fracture and Patellar Tendon Injury.

Tibial tubercle fractures (TTFs) are uncommon injuries, comprising <3% of all proximal tibial fractures. These fractures occasionally occur in conjunction with a patellar tendon injury (PTI). We aimed to identify risk factors associated with combined TTF and PTI. A retrospective review was performed of patients presenting to a single, tertiary children's hospital with TTF between 2012 and 2023. Demographic data, operative details, radiographs, and injury patterns were analyzed. Radiographs were assessed for the epiphyseal union stage (EUS), Ogden classification, and fracture patterns. Multiple logistic regression models were used to assess the impact of body mass index, comminution, fracture fragment rotation, EUS, bilateral injury, and Ogden classification on injury type. We identified 262 fractures in 252 patients (mean age, 13.9 ± 1.31 years). Of the patients, 6% were female and 48% were Black. Of the 262 fractures, 228 (87%) were isolated TTFs and 34 (13%) were TTFs with PTI. Multivariable analysis demonstrated fragment rotation on lateral radiographs (p < 0.0001) and Ogden Type-I classification (p < 0.0001) to be the most predictive risk factors for a combined injury. Rotation was associated with a substantial increase in the odds of a combined injury, with an odds ratio of 22.1 (95% confidence interval [CI], 6.1 to 80.1). Ogden Type-I fracture was another significant risk factor, with an odds ratio of 10.2 (95% CI, 3.4 to 30.4). The Ogden classification and fragment rotation are the most useful features for distinguishing between isolated TTF and combined TTF with PTI. This is the first study to identify risk factors for TTF combined with PTI. Surgeons may use this information to aid in preoperative planning. Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Comparative risk of ulnar nerve injury in pediatric supracondylar humeral fractures: a multicenter evaluation of Kirschner wire fixation techniques.

This multicenter, retrospective cohort study aimed to compare the risk of ulnar nerve injury in pediatric supracondylar humeral fractures treated with percutaneous lateral-pins, blinded-crossed-pins, and crossed-pins with a mini-incision. Data were collected from 1705 children treated between January 2010 and December 2023 at four orthopedic centers in Colombia. The incidence of postoperative ulnar nerve injury was compared among three fixation techniques: lateral-pin, blinded-crossed-pin, and crossed-pin with a mini-incision. A statistically significant difference in nerve injury rates was observed between the lateral-pin and both blinded-crossed-pin and mini-incision crossed-pin techniques (p < 0.001), with the lateral-pin technique demonstrating a significantly lower risk of injury. No significant difference was found between the blinded-crossed-pin and mini-incision crossed-pin techniques (p = 0.67). Crossed-pin fixation was associated with a higher incidence of ulnar nerve injury, regardless of the use of a mini-incision. The lateral-pin technique remains the safest option for minimizing iatrogenic nerve injury. There is insufficient evidence to support the mini-incision as a safer alternative to traditional crossed-pin fixation.

Successful management of a combined penile and urethral fracture.

This case highlights a rare occurrence of combined penile fracture and urethral injury in a 35-year-old male, emphasizing the critical need for accurate diagnosis and precise surgical intervention in such cases. After a mishap during sexual intercourse, the patient faced intense penile pain, swelling, and urethrorrhagia. Advanced diagnostic methods, particularly MRI, confirmed a disruption in the tunica albuginea within the left corpora cavernosa. The patient underwent emergent surgical repair, addressing both urethral and corpora cavernosa injuries, leading to a successful postoperative course. This case report underscores the paramount importance of comprehending and effectively managing complex urological traumas. Timely and appropriate surgical intervention is crucial for ensuring optimal patient recovery and well-being in instances of combined penile and urethral injuries.

Early experience using vacuum-assisted closure for managing soft tissue injuries in open type IIIB tibial fractures, a non-randomised controlled trial from a North African level one trauma centre

Purpose: The primary objective was to investigate our early results of using vacuum-assisted closure (VAC) for wound management in patients with open IIIB tibial fractures and compare the results with a group subjected to conventional daily dressing. Methods: A prospective non-randomised clinical trial (NRCT) with a parallel design and allocation ratio of 1:1 was conducted after obtaining ethical committee approval. Forty skeletally mature patients with unilateral type IIIB open tibia fractures were included over two years, starting from April 2019. In group A, patients were treated with VAC, which was changed every four days if needed, and in group B, patients had daily conventional dressings. Results: Both groups had no differences in the basic demographic, comorbidities, injury mechanism, and associated injuries. The need for secondary debridement surgeries was significantly lower in Group A than in Group B, 1 ± 0.50 versus 2.50 ± 0.85, respectively ( P &lt; 0.001). The time till definitive coverage was significantly lower in Group A than in Group B, 12.22 ± 2.90 versus 23.56 ± 8.68 (days); P &lt; 0.001. All coverage procedures succeeded in Group A, while four (20%) failed in Group B, P = 0.04. Infection was higher in Group B, with six (30%) patients compared to one (5%) in Group A, P = 0.01. Conclusion: Reports on VAC's role in managing severe open fracture wounds are rare in our area, and the initial results we obtained are encouraging, with lower infection rates and less cumbersome reconstruction procedures; however, further evaluation of the procedure's cost-effectiveness is mandatory.

Pediatric Off-Road Vehicle Injuries: Side-by-Sides Worse for the Upper Extremity.

Side-by-side (SXS) and all-terrain vehicles (ATVs) are different off-road vehicles (ORVs) but often categorized together in the literature. We hypothesized pediatric upper extremity (UE) fracture patterns and injury severity scores (ISS) differ between ORV types. The authors' home-state trauma repository identified 157 pediatric patients aged 0 to 17 years with UE fractures after ORV accidents during 2011-2021. ORV injuries, fracture type, and procedures were identified using International Classification of Diseases, 9th Revision and 10th Revision coding followed by manual chart review or phone calls. We identified specific ORV type, driver/passenger status, and restraint use to compare differences between fracture characteristics, number of surgeries, and ISS. Groups were compared for differences at P < 0.05 significance. Among 157 ORV injuries, 75 resulted from ATVs (48%), 50 SXSs (32%), and 32 from all other vehicles (20%). Average age was 12 years, and 49% (n = 77) required surgery. SXS injuries had significantly higher open fracture rates (42%, n = 21) compared with ATVs (7%, n = 5) and all other ORV types (16%, n = 5; P < 0.0001). Seventy percent of fractures (n = 35) sustained after SXS accidents required surgery compared with 41% (n = 31) for ATVs and 34% (n = 11) for all other ORV types (P < 0.001). SXS drivers had 71% left-sided injuries, whereas 85% passengers had right-sided injuries (P < 0.0001). Patients younger than 13 years (n = 73) had significantly higher surgery rates (59%) compared with 40% for those 13 years and older (n = 84; P = 0.02). There were no significant differences in mean ± SD ISS between ATV (8 ± 6), SXS (8 ± 6), and other vehicles (7 ± 4; P = 0.34). UE fractures caused by SXS were more likely to be open and require surgery compared with ATVs and other ORVs. SXS drivers were more likely to sustain left-sided injuries, whereas passengers had significantly higher right-sided injuries. Patients younger than 13 years were more likely to require surgery compared with teenagers.

Understanding the mechanism of injury and fracture pattern of paediatric triplane ankle fractures versus adult trimalleolar fractures.

Paediatric triplane fractures and adult trimalleolar ankle fractures both arise from a supination external rotation injury. By relating the experience of adult to paediatric fractures, clarification has been sought on the sequence of injury, ligament involvement, and fracture pattern of triplane fractures. This study explores the similarities between triplane and trimalleolar fractures for each stage of the Lauge-Hansen classification, with the aim of aiding reduction and fixation techniques. Imaging data of 83 paediatric patients with triplane fractures and 100 adult patients with trimalleolar fractures were collected, and their fracture morphology was compared using fracture maps. Visual fracture maps were assessed, classified, and compared with each other, to establish the progression of injury according to the Lauge-Hansen classification. Four stages of injury in triplane fractures, resembling the adult supination external rotation Lauge-Hansen stages, were observed. Stage I consists of rupture of the anterior syndesmosis or small avulsion of the anterolateral tibia in trimalleolar fractures, and the avulsion of a larger Tillaux fragment in triplanes. Stage II is defined as oblique fracturing of the fibula at the level of the syndesmosis, present in all trimalleolar fractures and in 30% (25/83) of triplane fractures. Stage III is the fracturing of the posterior malleolus. In trimalleolar fractures, the different Haraguchi types can be discerned. In triplane fractures, the delineation of the posterior fragment has a wave-like shape, which is part of the characteristic Y-pattern of triplane fractures, originating from the Tillaux fragment. Stage IV represents a fracture of the medial malleolus, which is highly variable in both the trimalleolar and triplane fractures. The paediatric triplane and adult trimalleolar fractures share common features according to the Lauge-Hansen classification. This highlights that the adolescent injury arises from a combination of ligament traction and a growth plate in the process of closing. With this knowledge, a specific sequence of reduction and optimal screw positions are recommended.

Radial nerve injuries in humeral fractures: case series and medico-legal implications.

Radial nerve injury following humeral fracture is the most common peripheral nerve injury associated with long bone fractures. The purpose of this study is to analyse our treatment protocols and long-term outcomes of humeral fractures associated with radial nerve injury which were surgically treated at the I.R.C.C.S. Orthopaedic Institute Galeazzi (Milan, Italy). The study was designed to evaluate retrospectively 30 patients, 15 men and 15 women, affected by humeral fracture associated with radial nerve palsy, treated at Orthopaedic Institute Galeazzi (Milan, Italy) from 1st January 2012 to 31st December 2022. Radial nerve injury was diagnosed based on the clinical evaluations of the neurological deficit. The cases were analyzed for any documented sensory impairment, wrist extensor weakness and/or finger weakness, with or without a "drop-hand" posture described in the patient's medical record at admission or throughout the hospital stay. Patients with pathological humeral shaft fractures were excluded. All patients, accounted for the study, were operated under general anaesthesia, and no peripheral nerve block was performed. The treatment of this clinical condition represents a challenge for orthopaedic surgeons. Most patients (86.7%, 26 patients) experienced total recovery of the radial nerve function during the follow-up period, whereas only 4 patients achieved a partial nerve function recovery, with lingering weakness when extending the fingers. The chronic outcomes arising from surgical treatment of the humeral fracture with related radial nerve injury can lead to impairment sequelae of greater clinical-functional significance, with possible medico-legal implications. Radial nerve injury constitutes one of the most common complications arising from humeral fracture. The course of the nerve and its close relationship with the humerus are likely to entail a high risk of injury with shaft fractures. A treatment algorithm should be recommended for the management of radial nerve injury associated with humeral shaft fracture.

Fracture Injuries in Adult Korean Taekwondo Sparring Athletes

PURPOSE: Fractures are common among Taekwondo-sparring athletes, yet little research has been conducted on these injuries in adult athletes. This study aimed to examine fracture injuries and post-fracture management practices in Taekwondo sparring athletes, with an emphasis on comparing lightweight and heavyweight classes.METHODS: Data were collected through interviews with 182 adult taekwondo sparring athletes in Korea (95 males and 85 females). The athletes were divided into lightweight and heavyweight groups based on the weight class in which they competed.RESULTS: Approximately 58.3% of the participants experienced taekwondo-related fractures, with heavyweight players having a significantly higher rate than lightweight players (χ²=3.987, p=.036). Overall, Taekwondo-related fractures occurred most frequently in the hand region during defensive maneuvers, and were caused by contact mechanisms. Fractures were more common among heavyweight athletes during competition and among lightweight athletes during training (χ²=6.395, p=.011). Heavyweight players were more likely to undergo surgery after fractures, whereas lightweights were more likely to receive conservative treatment (χ²=4.270, p=.039). Approximately half of the players (51.4%) returned to play after their fractures without a confirmed diagnosis of bone union, and the most common post-fracture psychological distress was fear of reinjury (57.2%).CONCLUSIONS: The current findings suggest that the fracture injury characteristics among elite Taekwondo-sparring athletes vary according to weight class, emphasizing the importance of injury prevention and management programs tailored to each specific weight class.

Identification of specific injury-related SNPs in high-level athletes of Arab origin: A pilot study

Valuable insights for preventing sports injuries in athletes have been achieved through advancements in genetics. This study aimed to determine the allelic frequency of distinct single nucleotide polymorphisms (SNPs) in a group of high-level athletes of Arab origin and to explore whether any significant relationship exists between specific genotypes in the selected SNPs with the prevalence and severity of non-contact soft tissue injuries (NCSTIs) and stress fracture injuries (SFIs). A cohort of 30 Arab male adult athletes trained at the same Sports excellence Centre from various individual sports was recruited and genotyped for collagen type 5 alpha 1 (COL5A1) rs12722 and vitamin D receptor (VDR) rs10735810 variants. The injury data of participant athletes were collected over two training seasons and categorized according to the site and type (muscle, tendon, ligament, or stress fracture) and severity (mild, moderate, or severe). For the COL5A1 rs12722, the examined genotypes were not related to the NCSTIs occurrence, while for VDR rs10735810, the CT and TT genotypes showed a prevalence for increased stress fracture injuries (RR = 7.72; 95 % CI: 1.66–35.87; p = 0.011 and RR = 9.93; 95 % CI: 2.83–34.89; p < 0.001, respectively), and increased odds for severe stress fractures (OR = 10.91, 95 % CI: 1.34–126.92, p = 0.033). This pilot study indicates a possible association between specific genotypes in the examined polymorphisms and the prevalence and severity of NCSTIs and SFIs. Given the constraints of the small sample size in the current study, additional research is required to gain a comprehensive understanding of this specific population.

CNS and Thorax Injury and Associated Risks Factors in Equestrian Sports.

Equestrian sports continue to gain popularity in the United States and are associated with a high injury rate, especially involving the central nervous system and thorax. Due to this high rate of injury and the potential for long-term consequences associated with participation, an understanding of the unique risks of this sport is needed. To describe severe injury in equestrian sports and review the role that protective gear plays in injury mitigation. The PubMed Database was searched using the search terms "equestrian" and "horse" combined with "spinal cord injury," "head injury," "traumatic brain injury," "experience levels," and "demographics." A total of 53 papers were selected based on their relevance of epidemiology, risk factors, and management of injuries sustained during equestrian activities. Case studies, randomized controlled trials, prospective studies, and retrospective studies were all included for further review. Systematic review. Level 4. None. Injuries to the thorax, including fractures, pneumothoraces, internal organ contusions, and crush injuries, have been cited in multiple national and international trauma registries as the most prevalent injury location in equestrians; however, head and neck injuries, high cervical spine fractures, and closed head injuries are reported to be associated with the highest rates of mortality. Helmets provide protection against skull fracture and traumatic brain injury. Vests were not associated with diminished rates of spinal cord injuries; however, they may provide protection to the thorax. Riding experience also plays a role in reducing the prevalence of injury. Equestrian-related activities are associated with a high risk of injury despite protective measures. Protective gear can mitigate some injury risk but does not protect against spinal injury. Continued investigation into improving protective equipment, rider education, and preventative strategies to mitigate this risk is needed.

Comparative study of short-term effectiveness of three surgical methods for ulnar styloid base fracture complicated with triangular fibrocartilage complex injury

To compare the short-term effectiveness of arthroscopic suture of triangular fibrocartilage complex (TFCC), arthroscopic suture of TFCC combined with open reduction and internal fixation, and simple open reduction and internal fixation in the treatment of distal radius fractures combined with ulnar styloid base fractures and TFCC injury. A clinical data of 97 patients with distal radius fractures combined with ulnar styloid base fracture and TFCC injury, who were admitted between September 2019 and September 2022 and met the selective criteria, was retrospectively analyzed. After reduction and internal fixation of distal radius fractures, 37 cases underwent arthroscopic suture of TFCC (TFCC group), 31 cases underwent arthroscopic suture of TFCC combined with open reduction and internal fixation of ulnar styloid base fractures (combination group), and 29 cases underwent simple open reduction and internal fixation of ulnar styloid base fractures (internal fixation group). There was no significant difference in baseline data between groups ( P>0.05), such as gender, age, injury side, time from injury to operation, and preoperative radius height, palm inclination, ulnar deviation, grip strength, wrist range of motion (ROM) in rotation, ulnar-radial deviation, and flexion-extension. The differences (change value) in radius height, metacarpal inclination angle, ulnar deviation angle, grip strength, and wrist ROM in rotation, ulnar-radial deviation, and flexion-extension between preoperative and 12 months after operation in 3 groups were compared. The effectiveness was evaluated according to the modified Gartland-Werley score at 12 months after operation. All incisions healed by first intention. All patients were followed up 12-18 months (mean, 14 months). X-ray films showed that there were 4 patients with non-union of ulnar styloid base fracture in TFCC group, and the remaining patients had fracture healing at 3 months after operation. The radius height, palm inclination, and ulnar deviation of 3 groups at 12 months after operation were significantly better than those before operation ( P<0.05); however, the differences in the change values of the above indexes between groups was not significant ( P>0.05). At 12 months after operation, the change values of wrist ROM in rotation, ulnar-radial deviation, and flexion-extension in the TFCC group and the combination group were significantly greater than those in the internal fixation group ( P<0.05), and there was no significant difference between the TFCC group and the combination group ( P>0.05). The change values of grip strength was significantly greater in the combination group than in the internal fixation group ( P<0.05); there was no significant difference between the other groups ( P>0.05). The excellent and good rates according to the modified Gartland-Werley score were 91.89% (34/37), 93.54% (29/31), and 72.41% (21/29) in the TFCC group, the combination group, and the internal fixation group, respectively. The excellent and good rates of the TFCC group and the combination group were significantly higher than that of the internal fixation group ( P<0.05); there was no significant difference between the TFCC group and the combination group ( P>0.05). For ulnar styloid base fractures with TFCC injury, compared with simple open reduction and internal fixation, arthroscopic suture of TFCC or suture TFCC combined with internal fixation treatment are both beneficial for wrist function recovery, and their short-term effectiveness are similar. Therefore, arthroscopic suture of TFCC may be a better choice.