Kind Of Injury Research Articles

Symptom. Toxic story

Symptom. Toxic story

Forensic Analysis of 133 Cases of Knee Injuries

Objective To discuss the types, characteristics, and the evaluation of disability of knee injuries. Methods The data of 133 cases of knee injury from 2017 to 2019 were collected and statistically analyzed according to the region of injury, the degree of disability, etc. Results One hundred and twenty-five cases of injury were compound, and 8 cases were simple. The incidences of ligament injury, meniscus injury and fracture were 88.72%, 75.19% and 57.89%, respectively. Of the cruciate ligament injuries, 12 cases were posterior cruciate ligament injury while 51 cases were anterior cruciate ligament injury, and the differences between the two kinds of injury had statistical significance （P<0.05）; 32 cases were secondary traumatic arthritis. The rates of disability of knee injuries were 38.35% （Grade Ⅸ and Ⅹ）. Conclusion Compound knee injuries are common, and traumatic arthritis has a relatively high rate. Multiple injuries can affect the stability and weight-bearing of the knee joint. It is suggested that in addition to evaluating the range of motion of knee joint, multiple factors should be considered to assess disability.

The different impact of trauma and relational stress on physiology, posture, and movement: Implications for treatment

This paper examines two intertwining but different general categories of adversity: trauma and relational stress, including inadequate early attachment, and, later, the adversity that occurs in other important relationships and with society at large. Without conscious intent, children adapt automatically to traumatic events to assure survival, and to the inadequacies and misattunements of significant others, both individuals and groups, to maximize the resources available or at least minimize the stress. These adaptations leave scars in the form of symptoms and patterns of thinking, feeling and acting that correlate with each kind of injury. Understanding the differences in the etiology and effects of trauma and non-traumatic relational stress can help guide both general clinical approaches and specific technique (Ogden, 2009). The physical legacy of each category of adversity is different and can be seen in patterns of gesture, posture, and physiology that can obstruct the development of a rich and rewarding movement vocabulary. As well, irrational thought patterns, or cognitive distortions, arise that correspond to each category. Adaptive emotional responses in current time are superseded by both the dysregulated emotions associated with trauma and the unresolved emotions associated with misattunements of significant others that are ongoing or have not been sufficiently repaired. These physical, cognitive and emotional patterns tend to persist long after the events that elicited them are over. The repercussions of trauma combine with the stress that occurs in relationships between individuals and groups of people. Although these injuries cannot be fully separated, clinical intervention appropriate for addressing the effects of each as they emerge in the therapy hour are markedly different. Distinguishing between these categories of adversity helps clinicians prioritize appropriate clinical strategy and technique to maximize therapeutic efficacy. These clinical choices become imperative in a relationally focused, trauma informed, culturally sensitive integrative therapeutic approach.

Leg length inequality and its relationship with injuries incidence of young basketball players: an observational study.

Introduction: The leg length inequality (LLI) creates postural changes collaborating with the emergence of functional limitations and musculoskeletal disorders. In a sport like basketball inequality of the lower limbs may be added to the demands of the sport and generate an increase in the incidence of injuries. Objective: The aim of this study was to identify young basketball players from with structural or functional LLI and its influence in injury incidence in a period of 6 months. Methods: 18 players were followed with an average age of 14.50 ± 1.86 of a basketball team from the city of Sorocaba for a period of 6 months. At the beginning and end of that period were applied tests from the Morbidity Survey Report modified for basketball to obtain data such as physical characteristics, training time, incidence of injuries, quantitative and qualitative measurement of the length of the lower limbs. Results: 72.2% of players had LLI and 50% had some kind of injury during this period, among the most common, sprains and muscle strains. Conclusions: There was a high rate of players with LLI and a positive relationship between this inequality with the incidence of injury.

Functional Electrical Stimulation Therapy for Retraining Reaching and Grasping After Spinal Cord Injury and Stroke.

Neurological conditions like hemiplegia following stroke or tetraplegia following spinal cord injury, result in a massive compromise in motor function. Each of the two conditions can leave individuals dependent on caregivers for the rest of their lives. Once medically stable, rehabilitation is the main stay of treatment. This article will address rehabilitation of upper extremity function. It is long known that moving the affected limb is crucial to recovery following any kind of injury. Overtime, it has also been established that just moving the affected extremities does not suffice, and that the movements have to involve patient’s participation, be as close to physiologic movements as possible, and should ideally stimulate the entire neuromuscular circuitry involved in producing the desired movement. For over four decades now, functional electrical stimulation (FES) is being used to either replace or retrain function. The FES therapy discussed in this article has been used to retrain upper extremity function for over 15 years. Published data of pilot studies and randomized control trials show that FES therapy produces significant changes in arm and hand function. There are specific principles of the FES therapy as applied in our studies: (i) stimulation is applied using surface stimulation electrodes, (ii) there is minimum to virtually no pain during application, (iii) each session lasts no more than 45–60 min, (iv) the technology is quite robust and can make up for specificity to a certain extent, and (v) fine motor function like two finger precision grip can be trained (i.e., thumb and index finger tip to tip pinch). The FES therapy protocols can be successfully applied to individuals with paralysis resulting from stroke or spinal cord injury.

Clinical Outcomes in Ring Avulsion Fingers and Systematic Review of the Literature.

Ring avulsions continue to be a challenge in reconstructive surgery. We conducted a retrospective study and reviewed all Urbaniak-Kay type IV degloving injuries replanted at our institution between 2011 and 2018. A systematic review of the literature was also conducted to assess the survival rates, functional, and sensibility outcomes. The results of our systematic review outline a survival rate of 79.50% (101/127). With 1 artery being repaired, 79% of the fingers survived, a value that increased to 87.50% when 2 arteries were anastomosed (P = 0.484). Statistically significant differences (P < 0.001) were found when comparing the survival rates of the fingers with 2 or more veins repaired (87%) with those with only 1 vein anastomosed (51.90%). In terms of nerve reconstruction, there was a significant difference (P < 0.001) with the 2-point discrimination test in favor of the reconstructed group when nerve reparation was done (10.80 mm ± 2.95 mm) versus when digital nerves were not repaired (15.25 mm ± 0.50 mm). Fingers after secondary procedures did not obtain better mobility. The mean total active motion in nonreoperated fingers was 221 degrees (195-270 degrees), whereas the total active motion in the cases who received secondary surgeries was 152 degrees (110-195 degrees), with statistically significant differences (P = 0.02). Therefore, we recommend attempting replantation of degloved fingers. All efforts must be done to carry out 2 vein anastomoses, and our results strongly recommend attempting at least some kind of nerve reconstruction. Secondary surgeries should be reserved for selected cases only, because of the extensive scarring in this kind of injuries. Early mobilization protocols must be encouraged to achieve a good functional result.

Exosomes released from educated mesenchymal stem cells accelerate cutaneous wound healing via promoting angiogenesis.

ObjectivesSkin serves as the major interface between the external environment and body which is liable to many kinds of injuries. Mesenchymal stem cell (MSC) therapy has been widely used and became a promising strategy. Pre‐treatment with chemical agents, hypoxia or gene modifications can partially protect MSCs against injury, and the pre‐treated MSCs show the improved differentiation, homing capacity, survival and paracrine effects regard to attenuating injury. The aim of this study was to investigate whether the exosomes from the educated MSCs contribute to accelerate wound healing process.Materials and methodsWe extracted the exosomes from the two educated MSCs and utilized them in the cutaneous wound healing model. The pro‐angiogenetic effect of exosomes on endothelial cells was also investigated.ResultsWe firstly found that MSCs pre‐treated by exosomes from neonatal serum significantly improved their biological functions and the effect of therapy. Moreover, we extracted the exosomes from the educated MSCs and utilized them to treat the cutaneous wound model directly. We found that the released exosomes from MSCs which educated by neonatal serum before had the more outstanding performance in therapeutic effect. Mechanistically, we revealed that the recipient endothelial cells (ECs) were targeted and the exosomes promoted their functions to enhance angiogenesis via regulating AKT/eNOS pathway.ConclusionsOur findings unravelled the positive effect of the upgraded exosomes from the educated MSCs as a promising cell‐free therapeutic strategy for cutaneous wound healing.

Surgical management of pelvic ring injuries: a study of twelve cases

&lt;p&gt;The bony pelvic ring is constituted of the sacrum and bilateral innominate bones and stabilized by the sacroiliac, sacrospinous and sacro tuberous ligaments. Secondary stabilization is provided by the iliolumbar ligaments. Injury to the posterior ring structures brings more severe clinical instabilities. Assessment of mechanisms and mode of injuries is necessary for management of pelvic injury. Twelve patients were involved in this study of different kinds of injuries by classification and methods of treatment four patients were treated by anterior fixation. Three by posterior and three by anterior as well as posterior. One was by conservative means. Anterior includes symphysis plating, posterior includes intrapelvic plates as well as sacroiliac percutaneous screw fixation. Combined includes posterior plating and sacroiliac screw and external fixator anteriorly. All patients showed good results in terms of stability, union of fracture, relief of pain and movements. Two patients had some residual neurological deficit as foot drop. Pelvic ring injuries need a specialized approach for management and outcomes. Application of appropriate classification for management plays a significant role in outcomes.&lt;/p&gt;

Different Surgical Reconstructions for Femoral Nerve Injury: A Clinical Study on 9 Cases.

Femoral nerve palsy can cause loss in quadriceps function and knee extension disability, which may lead to severe lower extremity impairment. The obturator nerve trunk transfer in the pelvic, the obturator nerve mortal branches transfer out of the pelvic, along with nerve graft, was introduced years ago to restore femoral nerve function. However, the outcomes of these procedures have never been compared. The aims of this study were to give our experiences in surgical reconstruction for femoral nerve injury and to compare the outcomes of different approaches. Nine patients with complete femoral nerve injury have been enrolled in this study between March 2012 and July 2016. All patients were followed up for at least 2 years after surgical intervention for sural nerve graft (n = 3), obturator trunk transfer in the pelvic (n = 2), or obturator nerve mortal branches transfer out of the pelvic (n = 4). All patients gained satisfactory quadriceps Medical Research Council grade (M3-M4+) after more than 2 years of follow-up. The sural nerve graft led to the earliest recovery on average, followed by obturator nerve mortal branches transfer in the thigh level and then obturator nerve trunk transfer in the pelvic. The functional outcomes, demonstrated by Lower Extremity Functional Scale and Femoral Nerve Motor Function Scale scores, also showed that the sural nerve graft was the best on average, followed by obturator nerve trunk transfer in the pelvic and then obturator nerve mortal branches transfer in the thigh level. Our results indicate that all these 3 procedures are safe and reliable ways to reconstruct femoral nerve function and can be applied to patients with different kinds of injuries. The sural nerve graft should be considered in the first place and the obturator nerve transfer at different level (trunk transfer in the pelvic or mortal branches transfer out of the pelvic) can be performed as the alternative.

The Incidence of Complications of Dental Trauma and Associated Factors: A Retrospective Study.

Objective The aim of this work was to study the incidence of complications of dental traumatisms and look for associations between factors related to trauma and the occurrence of complications. Materials and Methods. It is a longitudinal retrospective study on a sample of 125 traumatized teeth. The sample is taken from patients consulting the dentistry service at the hospital Sahloul Sousse between 2014 and 2017. Criteria for including a patient were presence of a permanent incisor affected by a subluxation, intrusion, lateral luxation, extrusion, or avulsion injuries associated or not with concomitant dentoalveolar injuries. Data were collected using a questionnaire. The information about etiology of trauma, delay of consultation, orientation of the patient, kind of injury, and emergency treatment and complications were obtained from the patients' records. Results The incidence of complications was 8%: external root resorption was present in 70% of cases, surface resorption was observed in 10% of cases, and replacement resorption in 10%, ankylosis in 10%. About pulpal complications, pulp necrosis was found after 4 weeks of follow-up, as well as the internal root resorption after one year. The most common cause of the trauma was the fall (40%). The majority of patients came for emergency consultation within “1 to 3 days,” and the coronary fracture without pulp exposure was the first diagnosis (20.60%). Statistical analysis showed no significant relationship between the cause of the trauma and the complication (P=0.577) and between the delay of consultation and complication (P=0.577) and between the delay of consultation and complication (P=0.577) and between the delay of consultation and complication (Conclusion Treatment of dental injuries is usually delayed and not given as much attention as general medical treatment that can explain the occurrence of pulpal and periodontal complications. Immediate consultation and treatment could improve long-term prognosis of the injured tooth.

Can a Red-Breasted toucan thrive in the wild with a fractured beak?

Beak fractures in Toucans can be common for different causes and usually treated with prostheses while the bird is kept in captivity up to total beak regrowth. There is no information of Toucans thriving in the wild with this kind of injury. Here, I report a free-living Red-breasted Toucan (Ramphastos dicolorus) recorded on video with an avulsion of half of its upper jaw showing an adapted behavior for feeding. The bird was observed twice in the same area. The apparent absence of caseous content and debris in the injury through the analysis of the frames suggests an old lesion in recovery. Based on the literature on beak injuries, I discuss some potential threats the lesion could pose to the specimen in the wild and suggest further researches that can be done with animals already in captivity recovering from the same injury.

Triple longitudinal fracture of distal phalanges; a report of a rare case and review of the literature

Phalanx fractures are frequent. They account for 10% of all fractures. Distal phalanges are the most fractured bones of the hand. They are usually caused by a compressive force, such as in crush injuries. This kind of injuries are common in all age groups. they can damage important structures such as bones, muscles, tendons, blood vessels, nerves, skin and nail bed, which should be repaired in order to retrieve not only good functional outcome, but also a good cosmetic appearance. We report the case of an atypical simultaneous fracture of the distal phalanx of three fingers, and discuss it in the light of the literature.

Management of traumatically intruded permanent maxillary central incisors

The management of intrusive luxation varies depending on the patient's age, stage of root development, and severity of the trauma. These kinds of injuries are associated mostly with severe damage to the pulpal tissue, periodontium, and the tooth. The aim of this case report is to present multidisciplinary management of complete intrusion of maxillary central incisors in a 9-year-old healthy girl with external root resorption. The root canals were cleaned and medicated with calcium hydroxide then the teeth were extruded by an orthodontist. After two months, a 4 mm apical plug with mineral trioxide aggregate was placed in the apical third of the canals and the remaining of the canal was obturated with thermoplasticized gutta-percha. Cervical root resorption was noticed during the follow-up evaluation and was surgically managed.

Lock Stock and Barrel of Wound Healing.

Any kind of injury may lead to wound formation. As per World Health Organization Report, "more than 5 million people die each year due to injuries. This accounts for 9% of the world's population death, nearly 1.7 times the number of fatalities that result from HIV/AIDS, tuberculosis and malaria combined. In addition, ten million people suffer from non-fatal injuries which require treatment". This scenario leads to increased health and economic burden worldwide. Rapid wound healing is exigent subject-field in the health care system. It is imperative to be updated on wound care strategies as impaired wound healing may lead to chronic, non-healing wounds and thus further contributes to the national burden. This article is a comprehensive review of wound care strategies. The first and second part of this review article focuses on the understanding of wound, its types and human body's healing mechanism. Wound healing is natural, highly coordinated process that starts on its own, immediately after the injury. However, individual health condition influences the healing process. Discussion of factors affecting wound healing has also been included. Next part includes the detailed review of diverse wound healing strategies that have already been developed for different types of wound. A detailed description of various polymers that may be used has been discussed. Amongst drug delivery systems, oligomers, dendrimers, films, gels, different nano-formulations, like nanocomposites, nanofibers, nanoemulsions and nanoparticles are discussed. Emphasis on bandages has been made in this article.

Analysis of Swedish and Dutch accident data on cyclist injuries in cyclist-car collisions

Objective: To reduce the number of severe injuries sustained by cyclists in crashes with vehicles, it is important to understand which kinds of injuries are occurring to identify what should be assessed by means of virtual testing.Method: A detailed analysis of injuries was made based on Swedish and Dutch accident data. The most frequently injured body regions and the most frequent single injuries of these body regions were analysed.Results: Cyclists most frequently injured their heads, upper and lower extremities, and bone fractures as well as brain injuries were identified as one of the most important injuries.Conclusions: For the virtual assessment of cyclist protection, injury predictors for long bone, skull and pelvic fractures as well as brain injuries are required in Human Body Models.

Chronological Age and Training Age as Determinants of Soccer Specific Speeds

The main purpose of this study was to unveil how chronological and training age or maturity of soccer players relate or affect linear sprinting speed, repeated sprinting ability (RSA), and change-of direction speed (CODS) performance. Competitive soccer players at the Ethiopian national soccer league level participated in the study. A total of 88 volunteered soccer players (age, 22.25±2.27 years old; training age; 9.38±2.78 years) who were free from any kind of injury at the time of data collection completed the study protocol. While age was calculated using a player’s birth certificate, fitness performance was measured using specific test protocols for each fitness element. For credibility, fitness test was conducted on a weekly basis for about five consecutive weeks and the average was taken. Bivariate correlation, partial correlation and GLM analyses were used. The bivariate correlation showed that sprinting speed (r (88) = - .254, p=.017), CODS (r (88) = -216, p.043) and RSA best (r (88) = 0.235, p=.028) significantly correlated with age (p&lt;.05). However, RSA total time, RSA average and RSA worst did not correlate with age. With training age, only CODS showed small, but significant negative correlation (r (88) = -.230, p=.031). While sprinting speed significantly correlated with maturity, other qualities that rely on the ability to produce the best performance repeatedly did not relate with age or training age. These findings suggest that speed and speed related performances depend on maturity and genetic make-up and these are less trainable qualities that may not significantly improve over time.

Epigenetic understanding of pain mechanisms and modern treatment perspectives

Human and animal research showed that environmental factors and lifestyle change ‘activate and deactivate’ gene expression due to epigenetic processes, which influences the perception of pain. Chronic and acute pain induce cellular memory of pain. It means that tissue lesion may cause epigenetic changes depending on the scale and kind of injury and conditions related to it. Cellular memory about pain may be transmitted to the cells of offspring through transgenerational transmission, thus inducing in further generations anxiety to neutral stimuli, related to the pain of their ancestors. In the same way, the consequences of excess opioid use may be transmitted to future generations, which is particularly dangerous, as the phenomenon of opioid abuse is becoming a serious threat to public health. It was proved that epigenetic changes in chronic pain occur in concrete genes in various diseases and conditions. Epigenetic changes also occur in genes influencing pain sensitivity. Changes in DNA methylation, histone modifications and non-coding RNA in regions related to pain, cause neuropathic, inflammatory and visceral pains. Epigenetic regulation of gene expression has recently been one of the most important objects in research on pain pathogenesis. The consequences are therapy trials with the use of DNA demethylation or reacetylation of histone lysine residues. In animal and human research, it was proved that the use of histone deacetylase inhibitors and DNA methyltransferase inhibitors decreases pain sensation. The research in the creation of new analgesics is promising. However, current epigenetic medications are highly nonspecific inhibitors that may have unknown side effects. Currently available knowledge does not allow yet to state whether they can be used in a long-term treatment of chronic pain.

The “Extreme Atasoy” flap

Distal finger injuries are very common in Hand Surgery. The purpose of this paper is to describe our “Extreme Atasoy flap” technique in the reconstruction of apical lesions of the fingers. Twenty patients were treated with the “Extreme Atasoy flap” technique. The following variables were evaluated: age, sex, comorbidity, cause of amputation, Visual Analogue Scale for pain assessment to time 0 (VAS T0), VAS to time 30 days (VAS T30), hospitalization time (HT), time to heal (TH), major complications (MC), minor complications (mC), advancement flap (AF), and static 2-point discrimination test to assess sensitivity. In our case series, no major complications were present. The average healing time was 2.4 days, and the 2-point discrimination test regarding sensitivity was satisfactory. The patients reported good aesthetic and functional outcomes. Treatment of fingertip injuries is an important topic in Hand Surgery. Local flaps are common forms of treatment in these kinds of injuries. The surgical technique is similar to that described by Atasoy, but with some important differences: the preoperative design is different, the donor site is not closed with stitches but heals by secondary intention, and the vascular pedicles are extremely skeletonized. This technique has proven to be safe and simple to carry out and provides good coverage of the distal portions of the fingers. Level of Evidence: Level V, therapeutic study

Return to sports and re-rupture rate following anterior cruciate ligament reconstruction in amateur sportsman: long-term outcomes.

The aim of this study was to retrospectively evaluate patient satisfaction, the return-to-sport rate and activity level at a long-term follow-up in a large cohort of amateur sportsmen who underwent primary anterior cruciate ligament (ACL) reconstruction. A total of 218 patients who underwent primary ACL reconstruction between 2004 and 2011, were successfully recontacted and retrospectively reviewed at an average follow-up of 10.5 years (range, 7 to 14 years). All surgeries were performed by one single surgeon. All of them underwent primary ACL reconstruction with autogenous hamstring tendon grafts. Assessment included Knee Osteoarthritis Outcome Score (KOOS) score, International Knee Documentation Committee (IKDC) Subjective Knee Form, Tegner activity level. Patients were also asked what kind of injury they sustained (either direct or indirect trauma), what kind of sport they were performing when they got injured, at what time they did return to sports and which sport they practised before and after surgery. Fourteen patients underwent re-rupture. In 11 cases, this was due to a new trauma occurring at an average time of 22.9 (SD 23.8) months following primary surgery. In 3 cases rupture occurred during rehabilitation period. Mean postoperative KOOS score was 88.5 (SD 8.5), while mean IKDC subjective score was 87.5 (SD 10.9). At the time of follow-up, most patients (214 subjects, 98%) were participating in sport. 156 subjects returned to pre-injury level (71.6%). The study reported long-term favourable subjective outcomes in amateur sportsman following ACL reconstruction, with a low re-rupture rate and a high percentage of subjects (93.6%) returning to sports participation 12 months after surgery. Most patients (71.6%) were able to return to their preprimary level of activity and sport. Younger age at the time of ACL reconstruction positively affected return to sports; however, younger patients were significantly more likely than older patients to undergo re-rupture.

Erythropoietin signal protected human umbilical vein endothelial cells from high glucose‐induced injury

High glucose (HG) induces endothelial injury in vasculature, leading to tissue injury in diabetic condition. Therefore, diabetes is one of the major cause of end-stage kidney disease as well as cardiovascular diseases. Chronic inflammation is involved in the progression of HG-induced cell injury. Recently, it has been reported that erythropoietin (EPO) protects the tissues from some kind of injury, such as hypoxia and mechanical stress. However, the contribution of EPO to HG-induced tissue injury remains to be explored. Therefore, we hypothesized that EPO protects endothelial cells from HG-induced injury via the regulation of inflammatory and anti-inflammatory balance. We performed genome-wide transcriptome profiling in human umbilical vein endothelial cells (HUVEC), which were stimulated by HG with/without EPO treatment and detected the expression of inflammation associated genes. The expression pattern of mRNA expression in HG stimulated HUVEC with/without EPO were different in hieralchial clustering analysis. While inflammatory cytokines/chemokines mRNA expression were increased by the HG stimulation in HUVEC, Th2-related cytokine receptors and intracellular signaling molecules showed the reduced mRNA expression levels. EPO treatment reduced inflammatory cytokines/chemokines mRNA expression and increased Th2-related cytokine mRNA expression levels. Moreover, EPO stimulation increased mRNA expression of EPO receptor and β-common receptor. EPO signaling protects HG-induced cell injury by the regulation of immune balance.