Leg Injuries Research Articles

Three-Dimensional Innate Mobility of the Human Foot on Coronally-Wedged Surfaces Using a Biplane X-Ray Fluoroscopy.

Improving our understanding on how the foot and ankle joints kinematically adapt to coronally wedged surfaces is important for clarifying the pathogenetic mechanism and possible interventions for the treatment and prevention of foot and lower leg injuries. It is also crucial to interpret the basic biomechanics and functions of the human foot that evolved as an adaptation to obligatory bipedal locomotion. Therefore, we investigated the three-dimensional (3D) bone kinematics of human cadaver feet on level (0°, LS), medially wedged (−10°, MWS), and laterally wedged (+10°, LWS) surfaces under axial loading using a biplanar X-ray fluoroscopy system. Five healthy cadaver feet were axially loaded up to 60 kg (588N) and biplanar fluoroscopic images of the foot and ankle were acquired during axial loading. For the 3D visualization and quantification of detailed foot bony movements, a model-based registration method was employed. The results indicated that the human foot was more largely deformed from the natural posture when the foot was placed on the MWS than on the LWS. During the process of human evolution, the human foot may have retained the ability to more flexibly invert as in African apes to better conform to MWS, possibly because this ability was more adaptive even for terrestrial locomotion on uneven terrains. Moreover, the talus and tibia were externally rotated when the foot was placed on the MWS due to the inversion of the calcaneus, and they were internally rotated when the foot was placed on the LWS due to the eversion of the calcaneus, owing to the structurally embedded mobility of the human talocalcaneal joint. Deformation of the foot during axial loading was relatively smaller on the MWS due to restricted eversion of the calcaneus. The present study provided new insights about kinematic adaptation of the human foot to coronally wedged surfaces that is inherently embedded and prescribed in its anatomical structure. Such detailed descriptions may increase our understanding of the pathogenetic mechanism and possible interventions for the treatment and prevention of foot and lower leg injuries, as well as the evolution of the human foot.

Use of Point-of-Care Ultrasound to Identify Occult Fractures of the Tibia in the Pediatric Emergency Department: A Case Series

BackgroundAlthough point-of-care ultrasound (POCUS) has been shown to be useful in the identification of both pediatric and adult long-bone fractures in the emergency setting, radiography remains the standard of care. Emergency physicians are often faced with the dilemma of how to evaluate and treat the child with lower leg injury and physical examination concerning for fracture but no readily identifiable fracture line on radiography. Case ReportsWe present four cases in which POCUS was used to diagnose a radiographically occult fracture of the proximal tibia in young children. This is the first case series of occult fracture of the tibia diagnosed with POCUS. Why Should an Emergency Physician Be Aware of This?POCUS can demonstrate evidence of fracture even after unremarkable radiography is obtained, and POCUS findings consistent with fracture might allow for more effective guidance on discharge.

Sports Injury and Illness Epidemiology: Thailand Team Surveillance During the 30th Southeast Asian Games

Background: Injury and illness surveillance in sports is the first step of the injury prevention model that generates effective injury prevention measures. Objectives: To identify the incidence, severity, and causes of injuries and illness in the Thailand national team during the 30th Southeast Asian (SEA) Games. Methods: All medical encounters were documented using the International Olympic Committee (IOC) injury and illness surveillance system for multi-sport events. We recorded the daily occurrence of injuries and illnesses reported by Thailand’s medical teams over the 12 days of the competition period. Results: Among 980 Thai athletes (568 male and 412 female), that participated in the 30th SEA Games, a total of 105 injuries and illnesses were reported. There were 84 injuries and 21 illnesses which equated to an incidence of 86 injuries and 21 illnesses per 1000 athletes. The most commonly injured body part was the lower leg (14% of all injuries), followed by the shoulder and clavicle. Ligament sprain or rupture and contusion (25% of all injuries) were reported as the most common type of injury. Of all injuries, 56 were classified as needing medical attention (only), 26 caused performance restriction, and two caused complete-time loss. The most common athlete illness was respiratory illness (48% of all illnesses) followed by gastrointestinal illness (19% of all illnesses). One-third (7 out of 21) of athlete illnesses restricted the athlete's performance, and the remaining 14 only required medical attention. Conclusions: Overall, 8% of athletes incurred at least one injury during the competition, and 2% suffered from an illness. Lower leg injury and respiratory illness were the most common, which is similar to other multi-sport events. Based on the research data, injury prevention, especially of ligamentous sprain and lower limb injuries, should be the focus in multi-sport events.

Роль детективного напарника в сюжетно-композиційній організації романів Роберта Ґалбрейта (АКА Дж. К. Роулинг)

The article analyzes the image of Robin Ellakot in the context of its correspondence to the image of a classical detective partner. We consider this study relevant because there are currently no serious attempts to analyze the heroes of Galbraith's novels, at least not with regard to the canon of the detective genre. The subject of detective partners has not been adequately researched, and works have focused mainly on the character of the detective. A similar approach can be observed in individual samples of the analysis of Galbraith's works. Therefore, the present work makes an attempt to elaborate those features which allow to classify the novel heroes more clearly - either as detective assistants or as detectives. All previous mechanical attempts to reduce the main pair of characters to the classical canon, including Holmes and Watson, faced either their complete inconsistency or a change in their affiliation. For instance Strike, often identified with Holmes, is unexpectedly associated with Watson because of his military past in Afghanistan and leg injury. Therefore, the presented work formulates grounds for the unequivocal statement that the image of Robin cannot be interpreted as a representative of the classic detective partner, and this thesis is supported by more arguments from novel to novel. The most telling features that classify Robin Ellakot as a detective rather than an assistant are the following: a professional approach to various activities, the ability to disguise and pretend to be other persons, the ability to get to places inaccessible for other characters, the ability to intuitively grasp the truth. The article explains in detail the importance of these skills for the development of the plot and how they relate to the positive "game aspect" of detective novels. It is also emphasized that the positive "game aspect" allows us to balance its negative equivalent, which is always present in the works of R. Galbraith. It plays a key role in the development of detective intrigue. Thus, the article proves that the image of Robin Ellakot does not only balance the detective story but also allows the reader to choose which kind of detective story to read: Cormoran Strike procedural investigation with elements of intuitive guessing or Robin Ellakot intuitive-game investigation with elements of procedural investigation.

Evaluation of Leg Injury to Rail Passenger Occupying Walkover Seat in a Train Accident

It is important to enhance the safety to passenger even in a train accident. In order to grasp secondary impact risk to walkover seat occupant, the sled tests that assumed a level crossing accident were carried out. The results of the test made it clear that the severity of the leg injury to the passenger was higher than any other parts of body since the passenger's legs collided with the edge of a seating face of the front seat. To reduce such type of injury risk, the seating face which supported both ends of the aluminum pipe with the urethane elastomer was developed based on the impact test results. The sled tests were carried out to identify the injury risk reduction effect of the seating face with buffer. It was found that the leg injury risk of the seating face with buffer reduced for the conventional seating face more than 60%.

Epidemiology of NCAA Track and Field Injuries From 2010 to 2014.

Background:Track and field (T&F) athletes compete in a variety of events that require different skills and training characteristics. Descriptive epidemiology studies often fail to describe event-specific injury patterns.Purpose:To describe the epidemiology of injuries in National Collegiate Athletic Association (NCAA) T&F by sex, setting (practice vs competition), and time of season (indoor vs outdoor) and to compare injury patterns by events within the sport.Study Design:Descriptive epidemiology study.Methods:Data were obtained from the NCAA Injury Surveillance Program for all indoor and outdoor T&F injuries during the academic years 2009-2010 to 2013-2014. Injury rates, injury rate ratios, and injury proportion ratios (IPRs) were reported and compared by sex, injury setting, season, and event. Analysis included time-loss as well as no-time loss injuries.Results:Over the 5 seasons, the overall injury rate was 3.99 injuries per 1000 athletic-exposures (95% CI, 3.79-4.20). After controlling for injury diagnoses, women’s T&F athletes experienced an 18% higher risk of injury (95% CI, 7% to 31%) and missed 41% more time after an injury (95% CI, 4% to 93%) when compared with men. Among all athletes, the injury risk during competition was 71% higher (95% CI, 50% to 95%) compared with practice and required 59% more time loss (95% CI, 7% to 135%). Distance running accounted for a significantly higher proportion of overuse injuries (IPR, 1.70; 95% CI, 1.40-2.05; P < .05) and required 168% more time loss (95% CI, 78% to 304%) than other events. The hip and thigh were the body regions most commonly injured; injury type, however, varied by T&F event. Sprinting accounted for the greatest proportion of hip and thigh injuries, distance running had the greatest proportion of lower leg injuries, and throwing reported the greatest proportion of spine and upper extremity injuries.Conclusion:Injury risk in NCAA T&F varied by sex, season, and setting. Higher injury rates were found in women versus men, indoor versus outdoor seasons, and competitions versus practices. The hip and thigh were the body regions most commonly injured; however, injury types varied by event. These findings may provide insight to programs aiming to reduce the risk of injury and associated time loss in collegiate T&F.

Epidemiology of Lower Leg Soft Tissue Injuries in High School Athletes.

BackgroundAnnually there are an estimated 4.5 million sports- and recreation-related injuries among children and young adults in the United States. The most common sports-related injuries are to the lower extremities, with two-thirds occurring among children and young adults (age range 5-24 years). The objective is to describe the epidemiology of lower leg injuries across 27 high school (HS) sports over a 3-year period.MethodsThe Datalys Center for Sports Injury Research and Prevention provided lower leg injury data for 27 sports in 147 high schools for 2011-2012 through 2013-2014 academic years from National Athletic Treatment, Injury and Outcomes Network (NATION) HS Surveillance Program.ResultsThe overall rate of lower leg injuries over this 3-year period was 1.70 per 10 000 acute events (AEs) (95% CI, 1.59-1.82). In men, the highest number of lower leg injuries was in football (n=181), but indoor track had the highest rate of injury at 2.80 per 10 000 AEs (95% CI, 2.14-3.58). In women, the highest number of lower leg injuries and the highest rate of injury were in cross-country (n=76) at 3.85 per 10 000 AEs (95% CI, 3.03-4.81). The practice injury rate was 0.91 times the competition injury rate (95% CI, 0.78-1.07).ConclusionAn improved understanding of the most common sports in which lower leg injuries are seen may help direct appropriate resource utilization. Our data would suggest efforts toward prevention of these overuse injuries, especially in football, track, and cross-country may have the greatest impact on the health of student athletes.Level of Evidence:Level IV, case series.

Foot and Ankle Injury Surveillance of Collegiate Student-Athletes Utilizing the Pac-12 Health Analytics Program

Category:Ankle; Sports; OtherIntroduction/Purpose:In order to monitor student-athlete health, identify risk factors associated with sports injuries, and develop and evaluate injury prevention programs at the collegiate level, it is necessary to implement and utilize high quality sports injury surveillance systems. The Pac-12 Health Analytics Program (HAP) addresses this need by standardizing electronic medical record entries and common data elements across all Pac-12 institutions. The literature suggests that collegiate student-athletes are at higher risk for certain injuries that have chronic effects on their health-related quality of life. Previous investigations utilizing the HAP database found ankle injuries to be the second most prevalent lower extremity injury in this population. This study aims to build upon these previous findings and further characterize below-knee injuries using the HAP database.Methods:We retrospectively reviewed archival data from Pac-12 student-athletes followed in the HAP database, a deidentified Pac-12 conference-wide sports injury surveillance system used to study the epidemiological characteristics of varsity student- athletes from 2017-2020. Data collection is part of the standard of care provided by varsity athletic trainers and entered into the Presagia Sports electronic medical record. This data is then deidentified and automatically sent to the Pac-12 for inclusion in the HAP. Individual authorization forms were obtained from student-athlete participants prior to deidentification and inclusion in the HAP database. Student-athletes who sustained a lower extremity (LE) injury below the knee were included. Data on demographics and injury characteristics were analyzed.Results:Foot and ankle injuries account for 20.3% (6,776/33,432) of all database injuries, representing 23.4% (2,214/9,444) of all student-athletes. Female-athletes (26.8%) had a higher injury rate than male-athletes (20.9%) (p<0.00001). Lower leg injuries were categorized as ankle (43.1%), foot (25.3%), lower leg (18.4%), and ankle/heel (13.2%). Ligament sprain was the most common injury type (38.1%) followed by tendinopathy (14.4%) and inflammation (7.9%). Males were more likely to sustain an acute injury (81.8%) than females (63.7%). Injuries most commonly occurred on synthetic (46.0%). Common mechanisms of injury (MOI) included running (21.6%), contact with another player (18.4%), and contact with a hard object (14.8%). Injuries most commonly occurred during in-season (48.9%) compared to off-season (25.5%) and pre-season (20.9%) segments of the competitive year. Half of injuries (50.0%) resulted in lost time from sport, however only 6.7% of injuries were season ending and only 2 injuries (<0.01%) resulted in medical retirement.Conclusion:Most ankle injuries occurred on synthetic surfaces, suggesting an opportunity for enhanced monitoring and prehabililitation programs for sports that utilize these types of surfaces. Further investigations accounting for covariates and risk factors may inform injury prevention strategies and improve student-athlete wellness. While the Pac-12 HAP database is early in development, this report demonstrates the potential value that injury surveillance systems can provide for student-athlete health. The Pac-12 HAP is a collaborative and effective injury database, setting the standard for other regional conferences.

In-depth understanding of single bicycle crashes in Sweden - Crash characteristics, injury types and health outcomes differentiated by gender and age-groups

IntroductionTo study in-depth characteristics of single bicycle crashes and type of injuries considering gender and age differences. MethodsHospital reported bicycle crashes identified in the Swedish national database STRADA were combined with self-reported detailed information regarding crash circumstances and injury outcomes. Gender and age-group differences were investigated using univariate statistics and Pearson Chi- Square test. ResultsA total of 616 cyclists injured in single bicycle crashes between 2013 and 2017 were included. Participants (49% women) had a mean age of 58 years (ranged 15–89 years), most rode a comfort bike (54%) and cycled several times a week (81%). The most common crash type was skidding on ice or snow (26%). This crash type was significantly more common among women than men (30% versus 21%). Women more than twice as often lost balance at low or no speed (13% versus 5%). While men's injuries were located more than twice as often at shoulder and upper arm (28% versus 11%), women injured more than four times as often the lower leg and ankle (30% versus 7%). Differences regarding age-groups could be observed as an exponential increase of hip and upper leg injuries with increased age (9, 19 and 38%). Older cyclists were more often injured while losing balance at no or low speed and while getting on or off the bicycle. ConclusionsConcrete countermeasures to prevent injuries in single bicycle crashes can be suggested and directed to different target groups, i.e. women or men or younger or elderly.

Safety Levels and Occupant Injury Risk for Light Commercial Vehicles in the ASEAN Region: Results of Crashworthiness Data

The logistics industry in Malaysia has greatly evolved in recent years. With regard to the freight industry, business operations depend on transportation service using commercial vehicles to deliver products in a timely manner. Technically categorised as N1 vehicle, the Light Commercial Vehicle (LCV) or light duty truck is designed to carry goods with maximum load not exceeding 3.5 tons. To maximize cargo size, the occupant cabin space has been pushed forward, hence, becoming a ‘flat head type’ vehicle. Nevertheless, the flat head vehicle fared poorly in terms of its crashworthiness performance during a frontal collision. In the ASEAN region, the automotive market for LCVs or the ‘People Mover’ trails behind passenger cars (M1 category) from the safety aspect where most small lorries or panel vans are sold with the lowest safety standards due to undemanding requirements and regulations imposed on this vehicle category. To examine the current issue surrounding this vehicles category in ASEAN, this paper shall discuss 1) the results of crashworthiness data for LCVs based on the assessment conducted by ASEAN NCAP and Japan NCAP and 2) review the leg injury analysis involving five LCVs tested by ASEAN NCAP. The vehicles with the worst performance for both NCAPs were compared, namely the TATA Super Ace (ASEAN NCAP) which came with no safety features, and the Daihatsu Hijet Cargo DX (Japan NCAP) which was equipped with ABS, airbag for both driver and front passenger, seatbelt pretensioner for driver and front passenger, as well as seatbelt load limiter for the driver and front passenger. The results showed that the driver and front passenger of the TATA Super Ace sustained very serious lower extremity, chest, and head injuries compared to Japan NCAP’s low performing LCV. In addition, five LCV models (TATA Super Ace, Chana Era Star II, DFSK V25L, Suzuki Carry, and Cherry Transcab) were tested by ASEAN NCAP without the fitment of any protection to the driver and front passenger during frontal crashes. As a result, the occupants, especially the driver, faced a very high risk of sustaining serious lower extremity, chest, and head injuries. The crash test results led to all five LCV models tested being awarded zero-star safety rating. The injury analysis also proved that the driver fatality was greatly affected by severe injuries, or AIS 3+ in the head, lower extremity and chest. It can be concluded that the safety of LCVs in ASEAN is a cause for serious concern where improvements are urgently needed to ensure that this vehicle category is equipped with sufficient safety features.

Lower Leg Injury Mechanism Investigation During an IED Blast Under a Vehicle Using an Anatomic Leg Model.

Attacks with improvised explosive device (IED) constituted the main threat to, for example, Polish soldiers in Iraq and Afghanistan. Improving safety during transport in an armored vehicle has become an important issue. The main purpose of the presented research is to investigate the mechanism of lower leg injuries during explosion under an armored vehicle. Using a numerical anatomic model of the lower leg, the analysis of the leg position was carried out. In all presented positions, the stress limit of 160 (MPa) was reached, which indicates bone damage. There is a difference in stress distribution in anatomic elements pointing to different injury mechanisms.

Do Rubber Floor Mats Prevent Lameness in Gestating Sows Housed in Large Groups? A Field Experiment on Three Commercial Farms in France.

Simple SummaryIn the European Union, gestating sows are housed in groups in pens that often have slatted floors. Slatted floor can cause injuries to the animals’ legs and hooves, leading to potentially painful lameness. The purpose of our study was to verify if the installation of rubber mats on their floors could limit the occurrence of injuries and lameness in gestating sows. Mats were installed on three commercial farms for use over two consecutive sow pregnancies. The mats limited the occurrence of inflammations around the sows’ leg joints but had no impact on the occurrence of lameness or leg and hoof injuries. The benefit of mats would be greater if they were available throughout the sows’ lives and not just during the gestation period. However, the mat design tested was unsatisfactory because manure did not drain well off the mat and sows were dirtied quickly.Lameness and foot disorders are major health and welfare issues in intensive swine production systems. They are exacerbated when sows are housed in large groups on slatted concrete floors during gestation. Our study aimed to assess the effect of rubber mats in the lying area of the gestation pen on lameness and leg health in gestating sows housed in large pens in commercial conditions. The study was conducted on three commercial farms over two successive gestations. A total of 582 Large White × Landrace sows, housed in 10 static groups, were enrolled: 5 groups in pens with rubber mats and 5 groups on slatted concrete floors. Lameness, bursitis, leg injuries, claw growth defects and claw lesions were measured at the beginning, middle and end of each gestation period. The rubber mats decreased the risk of suffering from bursitis, but had no effect on the risk of lameness, leg injuries, claw growth defects or claw lesions. Sows housed on rubber mats were heavily soiled compared with those on slatted concrete floors because the mats were not perforated for slurry evacuation. Locomotion disorders and foot lesions remained prevalent despite the rubber mats in the lying area of the gestation pens, but adding rubber mats in service rooms and farrowing crates may produce better results.

A Study into the Pawprints of Urban Dogs

The aim of the article is to present a comprehensive study on specific paw parameters and features, movement peculiarities, leg injuries, hairiness, etc. of dogs that lived in the city of Vilnius and its surroundings and left their marks on clay ware made by local craftsmen. The study was based on 238 clay objects found in Vilnius and dating from the late thirteenth to the eighteenth century. Dogs were found to leave the highest number of pawprints on bricks (90.8%), with significantly lower numbers on floor tiles (8%) and roof tiles (1.2%). The apparent increase in the number of traces is recorded from approximately the fifteenth century due to the steady increase in the quantity of clay products and the accessibility of the production environment to domestic animals. More than 450 dog pawprints in clay were examined using a trasology technique. Most frequently, one, two, or three traces were found on an artefact, while four, five, or six traces on one object were much less frequent. The analysis of trace features showed that 179 of the traces were those of the forepaws and 112 of the hind paws. The assessment of the deformation of the clay articles during firing and the comparison of the data obtained with the parameters of the paws of current breeds of dogs suggest that about 2% of the pawprints were left by small or young dogs. Mediumsized dogs left 70.5% of the traces, 25.7% belonged to dogs resembling current breeds of Doberman or Labrador retriever, 4.7% dogs similar to Borzoi or German shepherd, and 0.9% to Akita or Bobtail. An additional comparison of the pawprints with those of the present-day Lithuanian hounds showed that this type of dog could have left about 22% of the total number of the paw prints studied. It can be concluded that the results of the tracing studies revealed a significantly broader picture than the zooarchaeological material. Pawprint studies show that 25% of the dogs in the city of Vilnius during the period in question were long-haired and 75% were short-haired. The recorded paw pathologies provided information on various nail and toe injuries, tendon pathologies, and one possible case of patella dislocation. Meanwhile, the analysis of the dogs’ speed of movement suggests that at least some of the dogs in Vilnius between the late thirteenth and the eighteenth century were not tied and moved freely in the environment of the craftsmen who manufactured clay ware. In summary, the preliminary results of the pawprint analysis make a significant contribution to the broader knowledge of the history of dogs and provide unique data on urban dogs, which are scarcely recorded in written and zooarchaeological sources.

Training to Improve the Landing of an Uninjured Leg in Crutch Walk Using AR Technology to Present an Obstacle

A patient who unexpectedly sustains a lower leg injury often uses crutches for walking, to both assist the patient and prevent further injury until a full recovery is made. In this study, a novel crutch walk training system was developed; a head-mounted display (HMD) was introduced to present a virtual obstacle for trainees using crutches. Through repetitions of the training, it was expected that the trainees would improve their overall body stability. Healthy subjects participated in experimental training exercises using the developed training system. As a result, the participants acquired the skill of walking well with crutches without losing their body balance significantly, even in the event of facing a virtual obstacle, during the five training sessions.

Creep behavior of human knee joint determined with high-speed biplanar video-radiography and finite element simulation

Creep and relaxation of knee cartilage and meniscus have been extensively studied at the tissue level with constitutive laws well established. At the joint level, however, both experimental and model studies have been focused on either elastic or kinematic responses of the knee, where the time-dependent response is typically neglected for simplicity. The objectives of this study were to quantify the in-vivo creep behavior of human knee joints produced by the cartilaginous tissues and to use the relevant data to validate a previously proposed poromechanical model.Two participants with no history of leg injury volunteered for 3T magnetic resonance imaging (MRI) of their unloaded right knees and for biplanar video-radiography (BVR) of the same knees during standing on an instrumented treadmill for 10 min. Approximately 550 temporal data points were obtained for the in-vivo displacement of the right femur relative to the tibia of the knee. Models of the bones and soft tissues were derived from the MRI. The bone models were used to reconstruct the 3D bone kinematics measured using BVR. Ground reaction forces were simultaneously recorded for the right leg, which were used as input for the subject-specific finite element knee models. Cartilaginous tissues were modeled as fluid-saturated fibril-reinforced materials.In-vivo creep of the knee was experimentally observed for both participants, i.e., the joint displacement increased with time while the reaction forces at the foot were approximately constant. The creep displacements obtained from the finite element models compared well with the experimental data when the tissue properties were calibrated (Pearson correlation coefficient = 0.99).The results showed the capacity of the poromechanical knee model to capture the creep response of the joint. The combined experimental and model study may be used to understand the fluid-pressure load support and contact mechanics of the joint using material properties calibrated from the displacement data, which enhance the fidelity of model results.

Application of localized cryotherapy (-160 °C) on tennis leg injury: tissue remodeling and recovery in an elite Italian soccer player

article: Application of localized cryotherapy (-160 °C) on tennis leg injury: tissue remodeling and recovery in an elite Italian soccer player - Medicina dello Sport 2021 September;74(3):537-46 - Minerva Medica - Journals

Most Frequently Affected Body parts in Road Traffic Accidents Reporting to the Accident and Emergency Department of the Largest Tertiary Care hospital of Karachi in 2019

Introduction Injuries sustained during Road Traffic Accidents (RTAs) amounts to a serious public health crisis. The aim of the study was to determine the body parts most likely affected in an RTA in patients brought to Accident and Emergency (A&amp;E) department of Jinnah Postgraduate Medical Centre (JPMC), the largest tertiary care hospital of Karachi. Method A descriptive cross-sectional study was done in January-March 2019 among 371 respondents aged 15-65 years. Study participants were recruited through non-probability convenience sampling. A structured questionnaire was used to collect data on sociodemographic variables and type, severity and nature of injury. Chi Square test was used to determine the significant difference between using safety precautions with body parts affected. All analysis was performed on SPSS version 20. Results Out of 371 study participants, 64.4% (n=239) were between 15-35 years with 91.9% (n=338) males. In 77.1% (n=286) cases, emergency medical services responded in less than one hour and first aid was provided by doctor to 95.7% (n=355) at hospital. In 82.5% (n=306) cases, private vehicles were involved, with 46.1% (n=171) motorcycles. In 79.8% (n=296) cases, bone injury was prevalent, with 57.1% (n=212) leg injuries, which was the most frequently affected body part. Majority, 56.2% of the study participants who did not wear seat belts had chest area affected (p=0.006). Conclusion It is concluded that males of 15-35 years who were motorcyclists were more prone to RTAs with lower limbs more frequently being affected. Safety precautions like wearing seatbelts provide protection against RTAs.

Arthroscopic findings and treatment of maisonneuve fracture complex

BackgroundThe Maisonneuve fracture complex (MFC) is a well-known lower leg injury. However, the optimal treatment is still not clear and there is limited data on concomitant injuries of cartilage. Therefore, the aim of our study was to report the incidence of incidental cartilage injuries and their management in arthroscopic treatment of MFC.Patients and methodsBetween February 2018 and February 2021 all patients presenting with MFC in our department were treated with diagnostic ankle arthroscopy and percutaneous syndesmotic screw or suture-endobutton fixation. In case of instable cartilage, it was debrided and according to the International Consensus Meeting on Cartilage Repair of the Ankle, in grade IV lesions < 10 mm or < 100 mm2 area the subchondral bone was microfractured.ResultsEighteen patients, 16 male and two female, with a mean age of 48.1 years, were included. In all cases, instability of the distal tibiofibular articulation was confirmed arthroscopically. Injuries of the cartilage were found in 56% of the cases and in 31% of the patients surgical intervention was required. In three talar and one tibial lesion additional arthroscopic bone marrow stimulation with microfracture of the subchondral bone was performed.ConclusionsAnkle arthroscopy is a helpful method to guide fibular reduction and to detect and address associated cartilage injuries. Due to the high rate of chondral lesions, addressing these arthroscopically may contribute to better postoperative results.Level of evidenceIV

Analysis of Foot-Ankle-Leg Injuries in Various Under-Foot Impact Loading Environments With a Human Active Lower Limb Model.

Lower limb injuries caused by under-foot impacts often appear in sport landing, automobile collision, and antivehicular landmine blasts. The purpose of this study was to evaluate a foot-ankle-leg model of the human active lower limb (HALL) model, and used it to investigate lower leg injury responses in different under-foot loading environments to provide a theoretical basis for the design of physical dummies adapted to multiple loading conditions. The model was first validated in allowable rotation loading conditions, like dorsiflexion, inversion/eversion, and external rotation. Then, its sensitivity to loading rates and initial postures was further verified through experimental data concerning both biomechanical stiffness and injury locations. Finally, the model was used to investigate the biomechanical responses of the foot-ankle-leg region in different under-foot loading conditions covering the loading rate from sport landing to blast impact. The results showed that from -rovide a theoreticaln to 30 deg dorsiflexion, the neutral posture always showed the largest tolerance, and more than 1.5 times tolerance gap was achieved between neutral posture and dorsiflexion 30 deg. Under-foot impacts from 2 m/s to 14 m/s, the peak tibia force increased at least 1.9 times in all postures. Thus, we consider that it is necessary to include initial posture and loading rate factors in the definition of the foot-ankle-leg injury tolerance for under-foot impact loading.

Cost Analysis in Work Accidents and Occupational Diseases in Private Sector Employees: The Case of Duzce Province

İşyerinde gerek çalışan gerekse de işveren tarafından iş sağlığı ve güvenliği önlemlerinin alınamaması nedeniyle iş kazaları meydana gelmektedir. Mesleki risklere maruziyet sonucu ortaya çıkan hastalıkların sonucu olarak da meslek hastalığı tanımı yapılmaktadır. Bu çalışma ile iş kazası ve meslek hastalığı nedeniyle Düzce ili Sosyal Güvenlik Kurumu (SGK) hastanelerinden yararlanan özel sektör çalışanlarının çalışanlara, işverenlere, kamu hastanelerine ve topluma maliyetleri hesaplanmıştır. Yapılan değerlendirmeler sonucunda Düzce kamu hastaneler birliği hastanelerine iş kazası ve meslek hastalığı nedeniyle müracaat edenlerin sayısının yıllar itibarıyla artış gösterdiği belirlenmiştir. İş kazası nedeniyle ağırlıklı olarak 21-25 yaş grubundan, meslek hastalığı nedeniyle de ağırlıklı olarak 36 yaş ve üzeri çalışanların olduğu belirlenmiştir. İş kazası nedeniyle hastanelere müracaat eden hastaların ortalama 8 dakika 14 saniyede muayene oldukları hesaplanmıştır. Yapılan hesaplamalar sonucunda hastaların ortalama 29 dakika 50 saniye poliklinikte tedavi gördükleri ve ortalama 38 dakika 2 saniye de hastanede kaldıkları belirlenmiştir. 2010-2014 yılları arasında Düzce kamu hastaneler birliğine iş kazası ile müracaat eden hastaların büyük çoğunluğunun el ya da kol yaralanmalarından ve ayak ya da bacak yaralanmalarından kaynaklı şikâyetle müracaat ettikleri belirlenmiştir. Yapılan değerlendirmeler sonucunda iş kazası nedeniyle hastalara ortalama 4 gün rapor düzenlendiği belirlenmiştir. 2010-2014 yılları arasında iş kazasından kaynaklı olarak yıllara bağlı ortalama toplam maliyetler minimum 339,10 TL, maksimum da 447,72 TL olarak hesaplanmıştır.