Kind Of Injury Research Articles

Dorsal dislocation of the first metatarsophalangeal joint associated with fractured second metatarsal head

Traumatic dislocations of the first metatarsophalangeal joint were first described by Mouchet in 1931. The anatomical complexity of the first metatarsophalangeal joint makes this injury one of a kind. There have been a limited number of case reports of this injury. The ability to reduce the dislocation by nonoperative measures depends largely on the type of dislocation and involvement of the sesamoid complex. We report a case of a 35-year-old male with complete dorsal dislocation of the first metatarsophalangeal joint with second metatarsal head fracture. On review at 12 months he was pain free, fully mobile and pleased with the result. The papers principle message is that significant injuries to the metatarsophalangeal joint may be associated with fractures of adjacent bone segments, which may change diagnostic and therapeutic approaches. Also, the evolution of patients with this kind of injury after reduction is not well know today, at short, medium and long term. Thus could be considered to be a further development of Jahss's classification.

The injured snowman

Total anomalous pulmonary venous return (TAPVR) is a rare congenital cardiac defect that may present with cyanosis, cardiac failure and failure to thrive in infancy. TAPVR type 1 has a typical radiographic appearance of the heart termed the snowman. We present a case of an infant with TAPVR type 1 with injuries in keeping with non-accidental injury (NAI) to highlight that children with chronic diseases are at greater risk of this kind of injury and that radiographic evaluation of the chest in cardiac disease plays a role beyond demonstrating the heart and vasculature of the chest.

Epidemiological study of injuries in greek taekwondo athletes

IntroductionTaekwondo constitutes one of the most ancient Korean self-defensive martial art. The nature of Taekwondo is such that requires eruptive, fast and strong kicks. The first official participation of the...

Perforating brain injury from a speargun. A case report

A case of a perforating brain injury caused by a speargun in a suicide attempt is described. Although this kind of injuries has been previously reported, the present case is specially interesting because the patient showed no neurological deficit after surgery. Some advices about the medical and surgical management are proposed based on this case and our literature review. The use of antibiotics and antiepileptic drugs and the anterograde extraction of the harpoon aided by the performance of a craniotomy surrounding the exit point are recommended.

Episodes of Injuries and Frequent Usage of Traditional Chinese Medicine for Taiwanese Elite Wrestling Athletes

Wrestling normally places extreme demands on the body and thus may cause various kinds of injuries. An in-depth understanding of the episodes of injured sites, types, timings, and treatment modalities would help participants be aware of wrestling-related injury occurrences so as to develop effective preventive measures. Therefore, this study aims to investigate the gender-specific injuries among elite wrestling athletes. Subjects were selected from the 2009 Taiwanese National Wrestling Sport Championship. Participants were adolescent wrestling athletes, ages 16-18, who must have received at least one bronze medal at national level tournaments in 2008. A total of 118 respondents, 96 males and 22 females, completed and returned the questionnaire in which demographic data and information about the types, sites, and timings of injuries suffered and treatment modalities adopted were elicited. The data were analyzed with independent t-tests. The questionnaire results revealed a significantly higher injury rate for males than for females. The top three injured sites for males were waist (11.1%), ankle joint (10.1%) and finger (9.6%); while for females were ankle joint (13.6%), knee (12.5%) and waist (11.3%). Contusions were the most frequent type of injury: for males (73.5%) and for females (70.6%); followed by tendon inflammation for males (10.7%) and accumulated injuries for females (15.2%). During training and matching periods, the frequency of injuries for males (69.0%) is lower than that for females (81.8%). Traditional Chinese medicine (TCM) with acupuncture and moxibustion was the most common treatment modalities used for males (51.8%) and for females (68.0%); followed by orthopedics: for males (29.5%) and for females (18.0%). The present study contributed as the first effort to reveal the potency of using TCM with acupuncture and moxibustion in wrestling competitions. To prevent possible brain and body injuries in wrestling, safety education, skills and rules, and scoring systems may require further revision. Increased training of wrestling health professionals and advanced research and development of auxiliary training devices and protective equipment for wrestling athletes are also recommended.

Jewellery- and ornament-related injuries in children and adolescents.

Unintentional injuries are the leading cause of mortality and morbidity in children and teenagers in Canada. Few publications have addressed injuries caused by jewellery and ornaments in children. To examine the mechanisms and the incidence of injuries caused by jewellery and ornaments in children and teenagers, to identify children at high risk for these type of injuries and to recommend specific injury prevention strategies. Data were analyzed from a Canadian database (Canadian Hospitals Injury Reporting and Prevention Program) of a tertiary paediatric centre. All patients between zero and 18 years of age who were diagnosed in the emergency department with jewellery- and ornament-related injuries during a 10-year period (1997 to 2006) were identified. Patients were categorized according to six age groups (younger than one year of age; one to two years of age; two to four years of age; five to nine years of age; 10 to 14 years of age, and 15 to 18 years of age). For each case, the context and the mechanism of injury were investigated. From a total of 150,771 reported injury cases, 380 (0.25%) were jewellery related. Unlike with most trauma, girls predominate in this kind of injury (n=288; 75.8% of cases). Over one-half of cases (58.1%) were reported for children four years of age or younger. Emergency physicians reported the presence of jewellery as a foreign body in a natural orifice (mouth, nose, ear or genitourinary tract) in 308 cases (81%). No case of intestinal obstruction, strangulation or death was reported. Eleven cases (2.9%) required emergency hospitalization, all for endoscopic evaluation of a foreign body in the airway or in the digestive tract. In the adolescent group, five cases of injuries secondary to piercing were reported. The present study demonstrates that, although jewellery-related injuries are relatively infrequent, some can cause severe injuries that could compromise patients' health. As a primary prevention strategy, doctors and health professionals working with children should make parents and caregivers aware of the possibility of trauma in children wearing or playing with jewellery, especially in the zero- to four-year-old group requiring closer supervision. Specific anticipatory guidance concerning piercing may be helpful to adolescents.

Annexin 1 mimetic peptide protects against renal ischemia/reperfusion injury in rats

Inflammation is currently recognized as a key mechanism in the pathogenesis of renal ischemia-reperfusion (I/R) injury. The importance of infiltrating neutrophil, lymphocytes, and macrophage in this kind of injury has been assessed with conflicting results. Annexin 1 is a protein with potent neutrophil anti-migratory activity. In order to evaluate the effects of annexin A1 on renal I/R injury, uninephrectomized rats received annexin A1 mimetic peptide Ac2-26 (100 μg) or vehicle before 30 min of renal artery clamping and were compared to sham surgery animals. Annexin A1 mimetic peptide granted a remarkable protection against I/R injury, preventing glomerular filtration rate and urinary osmolality decreases and acute tubular necrosis development. Annexin A1 infusion aborted neutrophil extravasation and attenuated macrophage infiltration but did not prevent tissue lymphocyte traffic. I/R increased annexin A1 expression (assessed by transmission electron microscopy) in renal epithelial cells, which was attenuated by exogenous annexin A1 infusion. Additionally, annexin A1 reduced I/R injury in isolated proximal tubules suspension. Annexin A1 protein afforded striking functional and structural protection against renal I/R. These results point to an important role of annexin A1 in the epithelial cells defense against I/R injury and indicate that neutrophils are key mediators for the development of tissue injury after renal I/R. If these results were confirmed in clinical studies, annexin A1 might emerge as an important tool to protect against I/R injury in renal transplantation and in vascular surgery.

Early predictors of injury mortality among Swedish conscripts: A 35-year cohort study

Injuries represent an important cause of mortality among young adults. We studied the associations between adolescents’ family, psychological, behavioural and drug-related risk factors in relation to unintentional injury death. A population-based cohort of 49,411 Swedish conscripts aged 18–20 years was followed for 35 years. The end-point of study was injury death up to 2004. The relationship between two family, four psychological and eight behavioural risk factors and injury death were analysed with Cox proportional hazards analyses and χ 2 tests. Among 485 unintentional injury deaths, 40% occurred in subjects aged 25 years or under. The incidence per 1000 person years was 0.29 (95% CI, 0.26–0.31) and the mean age of death was 33 years. Problem drinking at both adolescent and adulthood was more strongly associated with injury death (HR = 5.40) than illicit drug use (HR = 2.70) even after adjusted for behavioural risk factors: (HR = 3.43) and (HR = 1.75), respectively. Adolescent risk factors such as contact with police and juvenile authorities, low emotional control, conduct problems at school and low social maturity were significant predictors of injury death in multivariate analyses. Young adults with social, behavioural and psychological problems and especially alcohol and drug use at both adolescent and adulthood have a high mortality rate due to road traffic injuries and all kind of injuries. Early identification of vulnerable groups of adolescents with psychological and behavioural problems including alcohol and drug use at local levels could make a difference.

Immediate self‐replantation of an avulsed permanent mandibular incisor – a case report

Approximately 50% of children under the age of 15 years are subjected to various kinds of injuries in the orofacial region. In the permanent dentition, the most severe dental injury affects the surrounding alveolar bone structure and leads to loss of the tooth. The current literature emphasizes that the awareness of appropriate triage procedures following dental trauma is unsatisfactory and that delay in treatment is the single most influential factor affecting prognosis. This case report presents the immediate self-replantation of a right lateral mandibular incisor of a 12-year-old male patient following a traumatic avulsion. The same patient had earlier, aged 10 years, experienced a trauma leading to the loss of all four maxillary incisors. The missing incisors were replaced by a removable acrylic denture. Having the requisite experience from the earlier accident, the child performed on himself an immediate replantation of the tooth at the site of the accident. After avulsion, the tooth was not splinted timely nor was an endodontic procedure carried out and no antibiotics were prescribed. The first dental examination after the trauma was performed 6 months later and since then, radiographic follow-up has been introduced. One year after the trauma, following the late endodontic treatment performed 6 months after reimplantation, the tooth is asymptomatic and stable. Immediate self-replantation of an avulsed tooth is the best treatment choice, even without any other proceeding treatment. However, the healing process should be followed up to allow for the treatment of the early signs of pulpal necrosis and/or root resorption.

Do modern conflicts create different medical needs?

Purposes This study involved analysis of ( a) type of injuries and medical services used by military casualties in 3 conflicts and ( b) medical needs of military and civilian casualties from the 2006 conflict. Basic Procedures Military casualties from 3 conflicts and military and civilian casualties from the 2006 conflict were analyzed. Casualties were compared in relation to type of injury, length of stay (LOS), and operating room use (ORU). Main Findings Hospital LOS of soldiers in many departments decreased while increasing in intensive care unit (ICU). Type of injuries sustained by civilians and military casualties differed significantly. More civilian casualties required admission to ICU. Civilian ORU was higher for orthopedic and otolaryngological procedures. Principal Conclusions Civilians are less well protected during military conflicts, therefore, more susceptible to certain kind of injuries. Civilian and military casualties during conflicts have different medical needs. Civilians have higher morbidity than soldiers, which result in an increased need for treatment in ICU.

Hypothalamic and pituitary affection after traumatic brain injury in childhood

Introduction: During the past few years evidence suggests that there is an affection of the hypothalamic-pituitary system even after a moderate traumatic brain injury (TBI). Until recently little has been known about how often and after what kind of injury they result. Furthermore nothing is known about the clinical relevance. Possible causes could be primary as well as secondary traumatic lesions in the region of the hypothalamic-pituitary system.

What kinds of injuries do OSHA inspections prevent?

Objective OSHA's enforcement program is one of the major public efforts to protect American workers. We examine both the scope of injury prevention that inspections can contribute and the types of standards that contribute the most. Methods We linked Pennsylvania Department of Labor and Industry files for lost-time injuries and employment to calculate injury rates for 1998-2005 for all single-establishment manufacturing firms. We linked these to OSHA inspection records. Results Inspections with penalties did affect injury types unrelated to standards as well as those related. We also found again that citations for violations of the standard requiring personal protective equipment had the largest impact on preventing injuries. Impact on Industry Programs requiring protective equipment use deserve added attention from consultants and inspectors. In addition, some inspections spur managers to undertake safety measures that go beyond compliance with standards.

Parameter Design for the Counter-Blanking Process Using the Finite Element Method and the Taguchi Approach

There is an increasing demand for high quality metal stamped parts. In general, burr formation is the main defect found subsequent to the blanking process. This defect must be strictly removed specifically for consumer products in order to prevent any kind of injury to the operators. Such a removal process results in an increase of the production cost. The unique merit of the counter-blanking process focuses on fabricating the burr-free blanked parts. However, it is difficult to control the numerous process parameters involved in this process in order to achieve the burr-free blanked parts. Thus, this study aims at investigating the process parameter design for the counter-blanking process by means of combining the finite element method (FEM) and statistical analysis techniques, including the Taguchi method and the analysis of variance (ANOVA) techniques. The results indicate that the process parameter of blanking clearance has a major influence on the die-roll formation features of the burr-free blanked part, respectively followed by the punch penetration depth and the same level of influence of the two process parameters of punch and die diameters in the second step. To conclude, this technique could be applied as a tool to achieve good quality of the burr-free blanked parts by optimizing the value of the process parameters and their favorable combinations.

Injuries in Students of Three Different Dance Techniques

As with any athlete, the dancer has a high risk for injury. Most studies carried out relate to classical and modern dance; however, there is a lack of reports on injuries involving other dance techniques. This study is an attempt to determine the differences in the incidence, the exposure-related rates, and the kind of injuries in three different dance techniques. A prospective study about dance injuries was carried out between 2004 and 2007 on students of modern, Mexican folkloric, and Spanish dance at the Escuela Nacional de Danza. A total of 1,168 injuries were registered in 444 students; the injury rate was 4 injuries/student for modern dance and 2 injuries/student for Mexican folkloric and Spanish dance. The rate per training hours was 4 for modern, 1.8 for Mexican folkloric, and 1.5 injuries/1,000 hr of training for Spanish dance. The lower extremity is the most frequent structure injured (70.47%), and overuse injuries comprised 29% of the total. The most frequent injuries were strain, sprain, back pain, and patellofemoral pain. This study has a consistent medical diagnosis of the injuries and is the first attempt in Mexico to compare the incidence of injuries in different dance techniques. To decrease the frequency of student injury, it is important to incorporate prevention programs into dance program curricula. More studies are necessary to define causes and mechanisms of injury, as well as an analysis of training methodology, to decrease the incidence of the muscle imbalances resulting in injury.

The Polymethylmethacrylate Effects on Auricle Conchal Cartilage: Report of 21 Cases

Both surgical and nonsurgical techniques, including soft tissue augmentation, are available to restore a youthful appearance to the face. Soft tissue augmentation with nonabsorbable fillers is increasingly important, as a growing number of patients are seeking aesthetic improvement without the downtime and cost of major surgical procedures. Polymethylmethacrylate (PMMA), an injectable implant composed of a suspension of microspheres in different media, is one such soft tissue filler. Because the application of PMMA into the pericartilage of the ear is becoming a more common practice among plastic surgeons, the authors offer a systematic analysis of its effects. They believe this information to be of paramount importance to prevent injuries and deformities. Twenty-one patients who presented to the lead author's clinic with prominent ears during a period of 16 months between 2007 and 2008 were retrospectively reviewed. The authors analyzed PMMA's effects on each patient's ear shell cartilage, which was extracted during correction without causing any kind of injury or deformity to the participants in this study. The histopathologic study from the excised skin and cartilage samples showed a granulomatous inflammation in all patients. There was no association between the incidence of tissue alterations and the mean length of PMMA on the conchal cartilage. The potential consequences of PMMA injection in close proximity to cartilage cannot be predicted and the possibility of myxomatous cartilage degeneration is a serious potential adverse event because it can cause permanent deformities of the cartilaginous skeleton.

Traumatic bilateral hip dislocation with bilateral sciatic nerve palsy

Abstract Bilateral hip dislocation rarely occurs. In this paper, a case of bilateral hip dislocation associated with bilateral sciatic nerve palsy resulted from a road traffic accident is reported. Both hips were emergently reduced under general anaesthesia. Acetabular reconstruction was done bilaterally due to the unstable hips. The patient subsequently developed heterotopic ossification and avascular necrosis on the left hip and underwent total hip arthroplasty. The sciatic nerve on the right side achieved complete recovery but that on the left side only partly recovered and was augmented by tendon transfer. Such injuries are serious and one should be aware of the complications because they can resurface and so patients should be followed up for a long time. To the best of our knowledge, this kind of injury has not been reported in the English language literature.

An analysis of children’s traumatism in the Republic of Uzbekistan

The article analyses children’s traumatism in Uzbekistan within 2000-2009. The authors characterize the organization of prophylaxis, particularly primary and secondary ones, and describe the structure of children’s traumatism by kinds of injuries. A reduction of traumatism in children and an improvement of the aid rendering service during the above period are shown.

Prevalência e fatores associados a quedas em idosos em um município do Rio de Janeiro

INTRODUÇÃO: Estima-se que 50% das quedas em idosos resultem em algum tipo de lesão. O objetivo deste estudo é estimar a prevalência e identificar fatores associados a quedas em idosos em um município no Rio de Janeiro. METODOLOGIA: Um inquérito foi conduzido em residentes com mais de 60 anos capazes de prestar informações por si, através de um questionário de avaliação multidimensional, aplicado por agentes comunitários treinados. As análises incluíram cálculos de proporções e respectivos intervalos de confiança de 95%. RESULTADOS: Foram entrevistados 1.064 idosos, em sua maioria mulheres (57%), com idade média de 71,4 anos. No ano anterior à entrevista, 322 participantes (30,3% - IC95% 27,6-33,2) caíram, dos quais 148 (13,9% - IC95% 11,9-16,2) o fizeram pelo menos duas vezes. Algumas associações se evidenciaram: sexo feminino, idade avançada, ser divorciado, morar só, assim como as variáveis indicadoras de más condições de saúde, capacidade funcional e satisfação com a vida. CONCLUSÃO: Este estudo ratifica fatores associados a quedas em idosos já conhecidos. O grande desafio deste conhecimento é a proposição de intervenções nos fatores modificáveis e a identificação ativa dos idosos sob risco, objetivando a reabilitação preventiva.

Resultados y eficiencia del tratamiento rehabilitador del hemipléjico. Estudio evolutivo

Introduction The analysis of the efficiency of a stroke rehabilitation program has special importance. It requires prolonged treatments and the results depend on the kind of injury and the type and intensity of the rehabilitation treatment. Objective Analyze the results and the efficiency of the cerebral vascular rehabilitation program in patients during these periods 2002–2007 (P02-07) and 1994–2001 (P94-01). Patients and method Is a study with a group of patients who suffered a cerebral vascular accident between the 01-01-2002 and the 31-12-2007 and they had admitted in the Physical Medicine and Rehabilitation service for a treatment. We used the Functional Independence Measure (FIM) before and after the rehabilitation program. The efficiency was considered like the quotient between gain and stay. It is constructed the pattern of results and the matrix of efficiency of Stineman. We compared the efficiency, the pattern of results and the matrix of efficiency of this period (2002–2007) with the one from 1994 to 2001. Results The patients of the P02-07 (129 patients) have a smaller age than those of the P94-01 (247 patients) (63,5 versus 69.1; IC95% 3,2 to 8,1), they have a similar FIM (76,9 and 76.8), but the gain (27,3 versus 33.7; IC95% 2,1 to 10,5) and the stay (29,3 versus 36.7; IC95% 0,7 to 13) are inferiors, and the efficiency is similar (1,5 and 1.4) in both periods. There are no differences between the patterns of results, although the percentile 75 is inferior in the P02-07 (96 versus 103). The matrix of efficiency are different in the group V (low efficiency) that falls in P02-07 (19, 5% versus 30, 4%; p=0.03). Conclusions There is a reduction in the stay and the gain in the FIM, but the efficiency is similar. The group of low efficiency improves but, in the results, percentile 75 of the FIM at discharge has lower values.

Clinical practice

Approximately 50% of children under the age of 15 are victims of various kinds of injuries in the orofacial region. Post-traumatic complications may occur, including crown discolouration, cervical root fracture, ankylosis, root resorption and tooth loss. The most severe complication after dental injury in primary dentition can affect the developing permanent tooth germ, and various consequences may be seen several years later when the permanent tooth erupts. In the permanent dentition, the most severe dental injury affects the surrounding alveolar bone structure and will lead to loss of the tooth. Current literature emphasises that awareness of appropriate triage procedures following dental trauma is unsatisfactory and that delay in treatment is the single most influential factor affecting prognosis. What should a paediatrician know, and more importantly, how should he/she advise parents and caretakers? In an emergency situation such as tooth avulsion, reimplantation within 30 min is the best treatment option at the site of the accident. If reimplantation of the tooth is impossible, milk, saline or even saliva are the preferred transport media. The prognosis for an avulsed tooth depends upon prompt care, which is a determinant factor for successful treatment of the traumatised tooth. In all other dental trauma cases, it is important to refer the child to a paediatric dentist, to follow up the healing process and reduce late post-traumatic complications. With timely interventions and appropriate treatment, the prognosis for healing following most dental injuries is good. In conclusion, it is important that paediatricians are able to inform parents and caretakers about all possible and long-lasting consequences of different dental injuries.