Proportion Of Injuries Research Articles

Pediatric Diaphyseal Forearm Fracture Management with Biodegradable Poly-L-Lactide-Co-Glycolide (PLGA) Intramedullary Implants: A Longitudinal Study.

Background: Pediatric forearm fractures represent a substantial proportion of childhood injuries, requiring effective and minimally invasive treatments. Our study investigated the mid-term outcomes of biodegradable poly-L-lactide-co-glycolide (PLGA) intramedullary implants in managing diaphyseal forearm fractures in children. Methods: A follow-up cohort study was conducted with 38 patients treated with PLGA implants. Control examinations were performed one year post-operation, assessing bone healing through radiographic evaluations and functional outcomes using injured and uninjured limb range of motion (ROM) comparisons. Scarring was evaluated employing the Vancouver Scar Scale (VSS), and satisfaction via a questionnaire. Results: Children were predominantly female (76.4%), with a mean age of 9.71 (SD: 2.69) years. Effective fracture stabilization and bone healing were found in all patients, with a minor reduction (mean difference of -1.5°, p = 0.282) in elbow flexion on the operated side (139.3°) compared to the intact (140.8°). Elbow extension presented negligible average changes (0.2°, p = 0.098). Forearm movements were slightly reduced on the operated side (mean pronation: 80.8° vs. 83.7°, p = 0.166; average supination: 83.5° vs. 85.7°, p = 0.141). Wrist palmar flexion and dorsiflexion showed no significant differences. VSS ratings indicated minimal scarring (mean guardian and doctor scores were 1.13 and 0.55, respectively, p = 0.020), and all patients reported satisfaction with the treatment outcomes. Conclusions: Biodegradable implants are effective for pediatric forearm fractures, providing stable bone healing while preserving functional ROM with minimal scarring and high patient satisfaction. PLGA proved to be a viable alternative to traditional metal implants, eliminating secondary removal surgeries.

Body Checking Injuries in National Collegiate Athletic Association Men's Ice Hockey: Findings From the NCAA Injury Surveillance Program 2009/10 to 2019/20.

To describe the epidemiology of body checking injuries in the National Collegiate Athletic Association (NCAA) Men's Ice Hockey. Secondary data analysis of historical cohort data. A convenience sample of injuries in NCAA Men's Ice Hockey during the 2009/10 to 2019/20 academic years. NCAA student-athletes. Event type, season, time loss, body part, diagnosis, player position, and mechanism. This study examined injuries that occurred during practice or competition, regardless of time loss, reported to the NCAA Injury Surveillance Program. Injury counts, rates, and proportions were used. The injury rate and proportion ratios with 95% confidence intervals were also constructed. Three independent logistic regression models were constructed to examine differential odds of time loss (≥1 day; TL) injury and the 2 most common injuries, between body checking injuries and all other injuries. Overall, 1290 body checking injuries (rate = 1.59/1000 athlete-exposures) were reported during the study period. Most were attributed to the upper extremity (42%) or head/neck (27%). The competition injury rate generally decreased after 2012/13. After adjusting for covariates, odds of (1) a TL injury was lower and (2) an acromioclavicular sprain was higher among body checking injuries as compared with injuries attributed to all other activities. Odds of concussion was not associated with body checking injuries. Body checking injuries were frequently attributed to the head/neck and upper extremities, and the rate of these injuries during competition appeared to be decreasing. Still, improvements in helmet and shoulder pad technology may further improve health and safety.

The proportion of obstetric anal sphincter injuries and associated factors among mothers who gave birth vaginally at Habru Woreda public health institutions, Amhara region, Northeast, Ethiopia, 2022

BackgroundPerineal tear is a common complication of vaginal delivery. This study aimed to assess the proportion of obstetric anal sphincter injuries and associated factors among mothers who gave birth vaginally at Habru Woreda public health institutions, Amhara region, Northeast Ethiopia. MethodsA facility-based cross-sectional study was conducted from August to September 2022, with 600 participants recruited through a multi-stage sampling technique. Data were collected through interviews, observations, clinical examinations, and patient chart reviews. Multivariable regression analysis was performed to identify statistically significant variables, with an adjusted odd ratio (AOR) and 95 % confidence interval (CI) used to declare significance at p < 0.05. FindingsThe proportion of obstetric anal sphincter injuries was 3.0 %(18/600), with (95 % CI: 1.7–4.3). Factors significantly associated with these injuries included antenatal care attendance (AOR: 0.13, 95 % CI: 0.03–0.47), fundal pressure (AOR: 4.71, 95 % CI: 1.29–17.10), perineal support (AOR: 0.12, 95 % CI: 0.03–0.43), head circumference ≥36 cm (AOR: 4.81, 95 % CI: 1.39–16.65), and age at marriage <18 years (AOR: 4.25, 95 % CI: 1.11–16.24). ConclusionsThe proportion of obstetric anal sphincter injuries was low, and the associated factors included fundal pressure, large fetal head circumference, and early marriage, while antenatal care attendance and perineal support were protective factors. Recommendations include reducing perineal tears by supporting the perineum, avoiding fundal pressure, detecting large fetal heads early, discouraging early marriage, and promoting regular antenatal care.

It is not the best option to perform transurethral enucleation of the prostate immediately after biopsy in patients with histological inflammation.

This study seeks to investigate the impact of histopathological evidence of histological prostatic inflammation (PI) on the surgical outcomes of patients with benign prostatic hyperplasia (BPH) undergoing transurethral bipolar enucleation of the prostate (BiLEP) after biopsy. We conducted a prospective study in which data were collected from 112 patients with BPH who underwent BiLEP immediately after prostate biopsy at the Department of Urology in our hospital between October 2020 and October 2023. This cohort included 52 patients with histopathological prostatic inflammation (BPH + PI group) and 60 patients with simple BPH (BPH group). Baseline characteristics, surgical details, International Prostate Symptom Score (IPSS), quality of life (QoL), post-void residual volume (PVR), maximum flow rate (Qmax), International Index of Erectile Function-5 (IIEF-5), postoperative pathology results, and surgical complications were compared between the two groups. The study findings indicate that in patients with BPH who underwent BiLEP, various parameters in the BPH + PI group including operation time, intraoperative flushing volume, hemoglobin drop value, postoperative white blood cells, postoperative C-reactive protein, and average pain score at 3 days postoperatively were significantly higher compared to those in the BPH group (p < 0.01). In addition, the IPSS and IIEF-5 scores of the BPH + PI group were significantly worse before surgery and at 2 weeks postoperatively compared to the BPH group (p < 0.01); however, no significant differences were observed between the two groups at 1 and 3 months postoperatively (p > 0.05). At 2 weeks postoperatively, the BPH + PI group exhibited significantly worse outcomes in terms of QoL, PVR, and Qmax compared to the BPH group (p < 0.01). However, there were no statistically significant differences between the two groups at 1 and 3 months postoperatively (p > 0.05). The incidence rates of postoperative complications, such as fever, prostatic capsule perforation, urinary tract irritation, bladder spasm, acute epididymitis, urinary tract infection, and urethral stricture, were higher in the BPH + PI group compared to the BPH group (p < 0.05). Nevertheless, there was no significant difference in the overall complication rates between the two groups (p > 0.05). There were no statistically significant differences observed between the two groups in postoperative irrigation volume, extubation time, hospitalization time, proportion of secondary operations, proportion of bladder injury, and proportion of urinary incontinence (p > 0.05). However, the proportion of reported prostate cancer after surgery in the BPH + PI group was significantly higher than that in the BPH group (p < 0.05). Histopathological prostatic inflammation does not have a significant impact on the long-term efficacy of BiLEP surgery immediately after biopsy. However, it does prolong surgery time, increase surgery-related complications, and influence short-term surgical outcomes and patient treatment experience. Therefore, it may be advisable to administer a course of anti-inflammatory treatment before performing BiLEP in such patients. Nevertheless, further high-quality studies are necessary to validate this approach.

An analysis of potentially avoidable neurosurgical transfers to a tertiary-care level I trauma center.

Previous studies of neurosurgical transfers indicate that substantial numbers of patients may not need to be transferred, suggesting an opportunity to provide more patient-centered care by treating patients in their communities, while probably saving thousands of dollars in transport and duplicative workup. This study of neurosurgical transfers, the largest to date, aimed to better characterize how often transfers were potentially avoidable and which patient factors might affect whether transfer is needed. This was a retrospective cohort study of neurosurgical transfers to an urban, tertiary-care, level I trauma center between October 1, 2017, and October 1, 2022. Prior to data analysis, the authors devised criteria to differentiate necessary neurosurgical transfers from potentially avoidable ones. A transfer was considered necessary if 1) the patient went to the operating room within 12 hours of arrival at the emergency department (ED); 2) a neurological MRI study was conducted in the ED; 3) the patient was admitted to the ICU from the ED; or 4) the patient was admitted to either neurology or a surgical service (including neurosurgery). Transfers not meeting any of the above criteria were deemed potentially avoidable. Patient and clinical characteristics, including diagnostic groupings from Clinical Classification Software categories, were collected retrospectively via electronic health record data abstraction and stratified by whether the transfer was necessary or potentially avoidable. Statistical differences were assessed with a chi-square test. A total of 5113 neurosurgical transfers were included in the study, of which 1701 (33.3%) were classified as potentially avoidable. Four percent of all transferred patients went to the operating room within 12 hours of reaching the receiving ED, 23.4% were admitted to the ICU from the ED, 26.6% had a neurological MRI study performed in the ED, and 54.4% were admitted to a surgical service or to neurology. Potentially avoidable transfers had a higher proportion of traumatic brain injury, headache, and syncope (p < 0.0001), as well as of spondylopathies/spondyloarthropathies (p = 0.0402), whereas patients needing transfer had a higher proportion of acute hemorrhagic cerebrovascular disease and cerebral infarction (p < 0.0001). This study demonstrates that a large number of neurosurgical transfers can probably be treated in their home hospitals and highlights that the vast majority of patients transferred for neurosurgical conditions do not receive emergency neurosurgery. Further research is needed to better guide transferring and receiving facilities in reducing the burden of excessive transfers.

Poster 373: Lower Extremity Injury Rates on Turf Versus Natural Grass Surfaces - An Analysis of Professional Football Athletes in the 2021 and 2022 Seasons

Objectives: As the emphasis on player safety in the national football league (NFL) has increased in recent years, numerous risk factors for injury have been closely scrutinized for their roles in placing players at increased risk. One such factor, the use of artificial turf football fields, has become a controversial topic, with many current and former players stating that turf fields place players at higher risk for injury while alternative sources have suggested there is no significant injury rate between artificial and natural grass surfaces. The purpose of this study was to quantify the rate of lower extremity injuries occurring in NFL players on artificial turf compared to natural grass surfaces and to characterize the degree of time missed with injury and the proportion of injuries requiring surgery. We hypothesized that major lower extremity injuries requiring surgical intervention occurred on artificial turf surfaces at a higher rate than on natural grass. Methods: Lower extremity Injury data for the 2021 and 2022 NFL seasons were obtained using publicly available records from the internet. All reported lower extremity injuries during the regular and playoff seasons were analyzed. Upper extremity, head, and back injuries were excluded. Preseason data was also excluded. Data collected included player position and age, playing surface of the field on which, the injury occurred, injury type, weeks missed with injury, and whether the patient underwent season-ending or minor surgery. Statistical analysis was performed using R Software (Rlabs). Descriptive statistics were used to summarize data, including percentages and counts for categorical and ordinal data and means with interquartile ranges for continuous data. Incidences of injury on both grass and turf fields were calculated for the 2021 and 2022 seasons by taking a ratio of the number of injuries that occurred and the number of games played on respective fields. Additionally, injuries were stratified by subsequent number of games missed: 0 games missed, 1-2 games missed, &gt;6 games missed. Multivariable logistic regression was performed to determine the influence of field type on the risk of major surgery. A p-value less than 0.05 was statistically significant. Results: In total there were 327 (44.12%) lower extremity injuries in 2021 and 391 (54.45%) lower extremity injuries in 2022, resulting in a total of 718 lower extremity injuries. A demographic summary of these injuries by position, age, field, and history of previous injury is displaced in Table 1. Combining the 2021/2022 seasons, the incidence rate of lower extremity injury on natural grass surfaces was 1.22 injuries/game while for turf surfaces, the incidence rate was 1.42 injuries/game (Table 2). Injury severity was stratified by weeks missed. Odds of a season-ending surgery were found to be significantly higher on turf surfaces compared to natural grass surfaces (OR 1.60, 95% CI 1.28-1.99, p&lt;0.05), while additional variables, including weather, age, position, and week of injury occurrence and history of prior injury were not found to influence the odds of season-ending surgery. In total, there were 50 players injured on the grass who required lower extremity surgery and 83 players injured on turf who required lower extremity surgeries. The most common surgeries after a lower extremity on grass were ACL repair (17), Achilles repair (9), and ankle or syndesmosis ORIF (7). The most common surgeries after a lower extremity on turf were ACL repair (30), Achilles repair (12), patella ORIF, or patellar tendon repair (8) (Table 3). Conclusions: The debate about playing on artificial turf versus natural grass has persisted for several years; however, there is a discrepancy in data reported on these overall injury rates. Our study showed that NFL athletes were more likely to get injured on artificial surfaces and that turf dramatically increased the likelihood of suffering a serious injury requiring surgery. These findings support earlier research, highlighting the necessity of putting player safety first and reducing dangers on pitches with artificial turf. For players, coaches, and teams to make wise decisions about playing surfaces, the study offers useful information regarding playing safety. Overall, it indicates that there is a higher risk of lower extremity injuries on artificial grass in the NFL, confirming the continuing discussion about field safety.

Lethal injuries in single stabs to the trunk – A study on homicides and suicides in Sweden

IntroductionHomicides using knives or other sharp objects are the most common type of homicide in Europe, and the second most common type of homicide worldwide. In contrast, suicides using sharp objects are rarer, constituting only a few per cent of all suicides in western countries. We investigated single stab injuries to the trunk in both homicides and suicides to assess differences in extent of injuries and in medical care, which could be of value for trauma management, public health and forensic assessment. MethodsWe identified all cases in Sweden between 2010 and 2021 that died of a single stab to the trunk, in either a homicide (n = 94) or a suicide (n = 45), and that were the subject of a forensic autopsy. We obtained data on demographics, hospital care and injured structures. To assess the severity of injuries, we applied AIS (Abbreviated Injury Score) and NISS (New Injury Severity Score). The inter-rater reliability of NISS between two raters was evaluated with intra-class correlation (ICC), with 95 % confidence intervals (CI). The data was analysed using Fisher's exact test, Mann-Whitney U test and logistic regression models. ResultsThe inter-rater reliability between the two NISS raters showed an ICC of 0.87 (95 % CI 0.68−0.95). We observed a larger variation of injuries in suicides, with a higher proportion of both unsurvivable (NISS 75) and minor injuries (NISS ≤ 8) (66.7 % and 8.9 % respectively) compared to in homicides (46.8 % and 0 % respectively). We observed a larger proportion of injuries to the heart in suicides (68.9% vs. 46.8 %, p = 0.018). In homicides, injuries involving vessels (52.1% vs. 13.3 %, p < 0.001) and hospital care (56.4 % vs. 8.9 %, p < 0.001) were significantly more common compared to suicides. Discussion and conclusionCausation (self-inflicted or assaults) seems to be associated with characteristics of injury and the likelihood of receiving hospital care. These findings could potentially be valuable for trauma management and forensic assessment of manner of death, however, determining the mortality of the injuries would require a comparison group comprising injured survivors.

International variation in injury burden and comparative outcomes: How injury looks like in different parts of the world

Injury is reported as one of the leading causes of morbidity and mortality globally. However, its burden stays under-reported in low- and middle-income countries, which prevents understanding of the true distribution and impact of injury worldwide. This dearth of data not only includes the burden of trauma-associated mortality but also involves the identification of long-term patient-reported outcomes after injury. High-income countries have shown that the development of trauma registries can achieve proper data collection, the findings from which can ultimately decrease trauma-associated morbidity and mortality. Expanding such an initiative to low-resource settings with high injury proportions can aid in understanding the long-term outcomes of post-trauma patients, identifying the factors that continue to contribute to its injury burden, and developing strategies catered to reducing it.Here, we discuss the variation in the global injury burden and go a step beyond mortality to highlight the importance of capturing long-term patient-reported outcomes post-trauma. We describe the process of developing trauma registries in high-income countries and extrapolate the findings from this experience to set up similar registries in resource-limited settings. Lastly, we demonstrate the feasibility and initial impact of using its data on identifying predictors of in-hospital mortality and determining long-term patient-reported outcomes in the context of low-resource settings. Through these findings, we share the outlook of an evolved trauma care system in both high- and low-income regions with reduced morbidity and mortality globally.

Epidemiology of Hamstring Tears in National Collegiate Athletic Association Athletes: Findings From the National Collegiate Athletic Association Injury Surveillance Program Between 2014/2015 and 2018/2019.

To describe the epidemiology of hamstring tears in National Collegiate Athletic Association (NCAA) sports. Descriptive epidemiology study. Athletic trainers from NCAA schools reported injuries to the NCAA Injury Surveillance Program. A convenience sample of NCAA hamstring tear injuries during the 2014/2015 through 2018/2019 academic years. NCAA student-athletes. Sport, sex, event type, season segment, injury history, and activity at the time of injury. Injury counts, rates, and proportions were used. Two thousand ninety-six hamstring tears from 8 474 400 athlete-exposures (AEs) were reported (2.47 per 10 000 AEs). Rates were highest in Men's Soccer (5.97 per 10 000 AEs) and Women's Soccer (3.13 per 10 000 AEs), among all Men's and Women's sports, respectively. Competition-related rates in Men's and Women's sports were highest in 2015 to 2016 then followed a decreasing pattern across the remainder of the study period. Among sex-comparable sports, rates were higher in men's (compared with women's) Baseball/Softball, Soccer, and Track and Field. The prevalence of recurrent injuries was comparable among men's (14.8%) and women's (11.5%) sports. Time loss hamstring tears were more prevalent in Men's sports than Women's sports [injury proportion ratio = 1.33; 95% confidence interval, (1.21, 1.47)]. Overall, hamstring tear rates were higher across all Men's sports compared with Women's sports. Rates across event type were comparable in several sports; and so, adjustments to practice are needed considering that practice environments are more modifiable than competitions. Indeed, improving hamstring tear prevention programs to reduce the burden of this injury in NCAA athletes remains critical.

A comparative video analysis of hamstring injuries mechanism and situational pattern in men's and women's football (soccer).

To describe the injury mechanism and situational patterns of severe (absence >28 days) hamstring muscle injuries in professional male and female football (soccer) players. The data for males were sourced from Serie A clubs participating in both national and international competitions from 2018 to 2021. For the female cohort, hamstring injuries were identified during matches of the top national/international competitions from 2017 to 2023. Video footage was obtained, and three raters categorised injury mechanisms and situational patterns. Injuries were also examined according to the month, minuteand location. A total of 129 severe hamstring injuries were identified, with 64 occurring in females and 65 in males. Video analysis was possible for 29 (45%) female cases and 61 (94%) male cases. Female injuries had longer lay-off times (97.8 ± 77.1 days) than males (39.6 ± 20.9 days). Females had a higher proportion of indirect contact injuries (34%) than males (13%) and a lower proportion of non-contact injuries (66% vs. 87%). Four situational patterns were identified: running was the most common for both sexes, representing 59% of female injuries and 41% of male injuries. Over-stretching injuries were split across open and CKC scenarios but collectively explained nearly half (48%) of male injuries but only one in five (21%) female injuries. Kicking injuries had a higher proportion in females (17%) than males (10%). Injuries were more common in the second half for females and the first half for males. Females had a higher proportion of indirect contact, runningand kicking injuries and a lower proportion of non-contact and stretch-type injuries than males. Understanding injury patterns can inform tailored prevention programs, considering sex-specific differences. Level IV.

An Analysis of Tube Thoracostomy in Combat Implications for Improved Prehospital Recognition and Treatment.

Thoracic trauma occurs frequently in combat and is associated with high mortality. Tube thoracostomy (chest tube) is the treatment for pneumothorax resulting from thoracic trauma, but little data exist to characterize combat casualties undergoing this intervention. We sought to describe the incidence of these injuries and procedures to inform training and materiel development priorities. This is a secondary analysis of a Department of Defense Trauma Registry (DoDTR) data set from 2007 to 2020 describing prehospital care within all theaters in the registry. We described all casualties who received a tube thoracostomy within 24 hours of admission to a military treatment facility. Variables described included casualty demographics; abbreviated injury scale (AIS) score by body region, presented as binary serious (=3) or not serious (<3); and prehospital interventions. The database identified 25,897 casualties, 2,178 (8.4%) of whom received a tube thoracostomy within 24 hours of admission. Of those casualties, the body regions with the highest proportions of common serious injury (AIS >3) were thorax 62% (1,351), extremities 29% (629), abdomen 22% (473), and head/neck 22% (473). Of those casualties, 13% (276) had prehospital needle thoracostomies performed, and 19% (416) had limb tourniquets placed. Most of the patients were male (97%), partner forces members or humanitarian casualties (70%), and survived to discharge (87%). Combat casualties with chest trauma often have multiple injuries complicating prehospital and hospital care. Explosions and gunshot wounds are common mechanisms of injury associated with the need for tube thoracostomy, and these interventions are often performed by enlisted medical personnel. Future efforts should be made to provide a correlation between chest interventions and pneumothorax management in prehospital thoracic trauma.

The changing epidemiology of traumatic spine injuries: a trends analysis of 26 years of patients at a major level 1 trauma center in the United States

BACKGROUND CONTEXTTraumatic spinal injuries (TSI) are associated with high morbidity, mortality, and resource utilization. The epidemiology of TSI varies greatly across different countries and regions and is impacted by national income levels, infrastructure, and cultural factors. Further, there may be changes over time. It is essential to investigate TSI to gain useful epidemiologic information. However, there have been no recent studies on trends for TSI in the US, despite the changing population demographics, healthcare policy, and technology. As a result, reexamination is warranted to reflect how the modern era has affected the epidemiology of US spine trauma patients and their management. PURPOSETo determine epidemiologic trends in traumatic spine injuries over time. STUDY DESIGN/SETTINGRetrospective analysis; level 1 trauma center in the United States. PATIENT SAMPLEA total of 21,811 patients, between the years of 1996 and 2022, who presented with traumatic spine injury. OUTCOME MEASURESAge, sex, race, Injury Severity Score, mechanism of injury, injury diagnosis, injury level, rate of operative intervention, hospital length of stay, intensive care unit length of stay, discharge disposition, in-hospital mortality. METHODSData was collected from our institutional trauma registry over a 26-year period. Inclusion criteria involved at least one diagnosis of vertebral fracture, spinal cord injury, spinal subluxation, or intervertebral disc injury. Exclusion criteria consisted of patients with no diagnosed spine injury or a diagnosis of strain only. A total of 21,811 patients were included in the analysis. Descriptive statistics were tabulated and ordinary least squares linear regression was conducted for trends analysis. RESULTSRegression analysis showed a significant upward trend in patient age (+13.83 years, β=+0.65/year, p<.001), female sex (+2.7%, β=+0.18%/year, p=.004), falls (+10.5%, β=+0.82%/year, p<.001), subluxations (+12.8%, β=+0.35%/year, p<.001), thoracic injuries (+1.5%, β=+0.28%/year, p<.001), and discharges to subacute rehab (+15.9%, β=+0.68%/year, p<.001). There was a significant downward trend in motor vehicle crashes (-7.8%, β=-0.47%/year, p=.016), firearms injuries (-3.4%, β=-0.19%/year, p<.001), sports/recreation injuries (-2.9%, β=-0.18%/year, p<.001), spinal cord injuries (-11.25%, β=-0.37%, p<.001), complete spinal cord injuries (-7.6%, β=-0.24%/year, p<.001), and discharges to home (+4.5%, β=-0.27%/year, p=.011). CONCLUSIONSAt our institution, the average spine trauma patient has trended toward older females. Falls represent an increasing proportion of the mechanism of injury, on a trajectory to become the most common cause. With time, there have been fewer spinal cord injuries and a lower proportion of complete injuries. At discharge, there has been a surge in the utilization of subacute rehabilitation facilities. Overall, there has been no significant change in injury severity, rate of operative intervention, length of stay, or mortality.

Fracture related infection and sepsis in orthopedic trauma: A review

Trauma is a leading cause of death in the United States for people under 45. Amongst trauma-related injuries, orthopedic injuries represent a significant component of trauma-related morbidity. In addition to the potential morbidity and mortality secondary to the specific traumatic injury or injuries sustained, sepsis is a significant cause of morbidity and mortality in trauma patients as well, and infection related to orthopedic trauma can be especially devastating. Therefore, infection prevention and early recognition of infections is crucial to lowering morbidity and mortality in trauma. Risk factors for fracture-related infection include obesity, tobacco use, open fracture, and need for flap coverage, as well as fracture of the tibia and the degree of contamination. Timely administration of prophylactic antibiotics for patients presenting with open fractures has been shown to decrease the risk of fracture-related infection, and in patients that do experience sepsis from an orthopedic injury, prompt source control is critical, which may include the removal of implanted hardware in infections that occur more than 6 weeks from operative fixation. Given that orthopedic injury constitutes a significant proportion of traumatic injuries, and will likely continue to increase in number in the future, surgeons caring for patients with orthopedic trauma must be able to promptly recognize and manage sepsis secondary to orthopedic injury.

Epidemiology of injuries in U.S. high school track and field throwing events from 2008 to 2019.

Injury characteristics of high school track and field throwing athletes in the United States are not well studied. Understanding epidemiology of injuries is important to identify treatment and prevention strategies. To describe injury rates and patterns in U.S. high school track and field throwing events from a longitudinal national sports injury surveillance system. Descriptive epidemiology study. Data were provided by the National High School Sports Related Injury Surveillance System, High School RIO (Reporting Information Online). Athletic trainers reported injury and exposure data through the High School RIO website on a weekly basis. An athlete exposure (AE) was defined as one athlete participating in one school-sanctioned practice or competition. Throwing events of discus, shot put, and javelin were analyzed in this study. Injury rate, rate ratios (RR), injury proportion ratios (IPR). U.S. high school athletes. A total of 267 track and field throwing injuries occurred during 5,486,279 AEs. Overall, the rate of injuries in competition was higher than in practice (RR 1.35, 95% confidence interval [CI] 1.01-1.80). In practice, the rate of injuries was higher for girls than boys (RR 1.53, 95% CI 1.12-2.08). The most frequently injured body part was the shoulder (21.7%), followed by the ankle (16.5%) and knee (12.0%). The most common types of injury were muscle strains (26.14%) and ligament sprains (25%). Recurrent injuries accounted for a higher proportion of chronic injuries compared to new injuries (IPR 1.85, 95% CI 1.16-2.97). This study described injury characteristics of high school track and field throwing athletes from 2008 to 2019. Based on our results, injury prevention may be particularly important for female throwers with prior injury.

Factors associated with road traffic injury in a high-risk zone of Bangladesh: a mixed-method study

IntroductionRoad traffic injuries are a significant public health issue in low-income and middle-income countries. This study was designed to explore the pattern and factors associated with road traffic injury in...

Injuries from electronic cigarettes, and cigarette/cigar-related paraphernalia, NEISS, 2012-2022.

There is a need to determine the role of smoking/vaping related products in Emergency Department (ED) product-related injuries by age and sex to determine if interventions are warranted. These products include the combustible tobacco products' paraphernalia to light them (CTPP), electronic nicotine delivery systems (ENDS), and electronic non-nicotine delivery system (ENNDS). Data from the National Electronic Injury Surveillance System (NEISS), years 2012-2022, were examined for injury data associated with CTPP and ENDS/ENNDS. Bivariate comparisons were conducted. There were an estimated 3,142 (95%CI: 2,384-3,975) ED-treated ENDS/ENNDS product-related injuries and 46,116 (95%CI: 38,712-53,520) CTPP product-related injuries. Males were more likely to have an ED-treated ENDS/ENNDS product-related injury than females (proportion 0.93 [95%CI: 0.82, 0.98] versus 0.70 [95%CI: 0.02, 0.19]) as well as a CTPP product-related injury than females (proportion, 0.60 [95%CI: 0.56, 0.64] versus 0.40 [95%CI: 0.37, 0.44]). There were more ED-treated ENDS/ENNDS product-related injuries among persons ≥18 years than <18 years (proportion, 0.89 [95%CI: 0.75, 0.96] versus 0.11 [95% CI: 0.4, 0.35]). There were also more ED-treated CTPP product injuries among persons ≥ 18 years than <18 years (proportion, 0.73 [95%CI: 0.68, 0.78] versus 0.27 [95%CI: 0.22, 0.32]). No change in the proportion of injuries in our sample associated with END/ENNDS over time were observed. There is a need to consider injuries related to ENDS/ENNDS and CTPP product-related injuries in the discussion of the risks associated with smoking/vaping. Although ENDS/ENNDS have had fewer ED-treated injuries, the number of such injuries has remained stable, rather than declined over the previous decade. Injury prevention is a public health imperative and targeted interventions by healthcare providers during routine care, and the use of public service announcements could specifically target adults ≥18 years. Providing peer-to-peer educational programs, and initiating similar programs targeted at males who use CTP and ENDS/ENNDS have the potential to decrease injury risk.

Ocular injuries among patients with major trauma in England and Wales from 2004 to 2021

BackgroundOcular trauma is a significant cause of blindness and is often missed in polytrauma. No contemporary studies report eye injuries in the setting of severe trauma in the UK. We investigated ocular injury epidemiology and trends among patients suffering major trauma in England and Wales from 2004 to 2021.MethodsWe conducted a retrospective study utilising the Trauma Audit and Research Network (TARN) registry. Major trauma cases with concomitant eye injuries were included. Major trauma was defined as Injury Severity Score >15. Ocular injuries included globe, cranial nerve II, III, IV, and VI, and tear duct injuries. Orbital fractures and adnexal and lid injuries were not included. Demographics, injury profiles, and outcomes were extracted. We report descriptive statistics and 3-yearly trends.ResultsOf 287 267 major trauma cases, 2368 (0.82%) had ocular injuries: prevalence decreased from 1.87% to 0.66% over the 2004–2021 period (P < 0.0001). Males comprised 72.2% of ocular injury cases, median age was 34.5 years. The proportion of ocular injuries from road traffic collisions fell from 43.1% to 25.3% while fall-related injuries increased and predominated (37.6% in 2019/21). Concomitant head injury occurred in 86.6%. The most common site of ocular injury was the conjunctiva (29.3%). Compared to previous TARN data (1989–2004), retinal injuries were threefold more prevalent (5.9% vs 18.5%), while corneal injuries were less (31.0% vs 6.6%).ConclusionsWhilst identifying eye injuries in major trauma is challenging, it appears ocular injury epidemiology in this setting has shifted, though overall prevalence is low. These findings may inform prevention strategies, guideline development and resource allocation.

Epidemiological characteristics and factors affecting healing in unintentional pediatric wounds

ObjectiveTo analyze the epidemiological characteristics and wound healing conditions of common unintentional skin lacerations in children.MethodsA retrospective analysis was conducted on data from 1,107 children, aged 0–12 years, with skin lacerations who received emergency treatment at Qilu Hospital of Shandong University from January 1, 2019, to December 30, 2022. Data on age, injury site, time from injury to suturing, and wound healing conditions were statistically analyzed.ResultsAmong the 1,107 cases, 714 (64.5%) were male and 393 (35.5%) were female, with a male-to-female ratio of 1.8:1; median age was 5 years (IQR, 3–7). Infants and toddlers (0–3 years old) constituted the highest proportion, accounting for 36.3% (402 cases). The number of children aged over 3 years gradually decreased with increasing age. In younger children, the most common injuries were to the forehead, scalp, and lower jaw; in school-aged children, the proportion of limb and trunk injuries significantly increased. Age (OR, 1.34; 95% CI, 1.23–1.46), outdoor injuries (OR, 2.21; 95% CI, 1.18–4.16), lower limb injuries (OR, 5.35; 95% CI, 2.86–10.00), and wound length greater than 3 cm (OR, 10.65; 95% CI, 5.02–22.60) were significant risk factors for poor wound healing. The risk of poor wound healing increased by 34% for each additional year of age.ConclusionIn children, the common sites of unintentional skin lacerations show distinct age and gender distribution characteristics. Older age, outdoor injuries, longer wound lengths, and lower limb injuries are independent risk factors for poor wound healing.

Muscle Injuries in Elite Youth Football Academy: A Six-Year Longitudinal Study on the U15 Football Team

To develop specific preventive strategies, it is necessary to investigate in detail the occurrence of injuries in young football players. This study aimed to provide details about the type, location, severity, and contact nature of muscle injuries in elite U15 Croatian football players. A total number of 130 muscle injuries occurred during the six competitive seasons, of which 88 were DOMS injuries and 42 were rupture injuries. Specifically, 87% of all muscle injuries belonged to the four major groups, with only 15 injuries to the other muscle groups: hamstrings (43), quadriceps (41), adductors (25), calves (6). The muscle injury incidence was stable during the observed period as the injury incidence rate ratio (IRR) was 1.01 (95%CI: 0.99–1.03), with 3.13 (95%CI: 3.09–3.17) muscle injuries per 1000 h of exposure in the first season and 3.06 (95%CI: 3.02–3.1) in the sixth season. A significantly higher risk for muscle injuries was discovered in the competition as the incidence for the whole observed period was 7.38 (95%CI: 7.29–7.47) compared to 2.25 (95%CI: 2.24–2.26) in the training period. Despite the relatively stable number of sustained muscle injuries, the relative proportion of muscular injuries increased over the years due to a severe decrease in the total number of injuries. Regarding the proportion of players who had sustained a muscle injury, our results suggest that approximately two out of five players can expect a muscular injury over the one-season period. Relatively high injury expectancy rates, as well as reinjury rates, require specific preventive interventions that will reduce the number and severity of new and recurred injuries. Future studies should include a wide set of predictor variables in order to establish the most important injury risk factors.

Comparative Analysis of Occupational Injuries Dynamics in Russia and the Republic of Crimea in 2017–2021

Introduction. One of the health-saving resources for the working population is the improvement of the occupational safety system and prevention of occupational injuries (OI). Systematic scientific research in this field remains relevant as it helps to understand the interrelationships between the causes and consequences of OI in different sectors of economic activity. In recent years, there has been a lack of research on the structure and dynamics of OI in the Republic of Crimea (RC), and its indicators have not been compared. The aim of this study was to conduct a comparative analysis of Crimean and all-Russian dynamics of occupational injuries over a five-year period from 2017 to 2021 in order to identify trends and develop strategies for improving production safety.Materials and Methods. Methods of systematization of scientific literature on the issue of OI were employed. Statistical data on the state of OI in the Republic of Crimea and the Russian Federation were analyzed and compared. The results were graphically presented in the form of histograms. Additionally, the positions of the republic in the official ratings on compliance with labor legislation were taken into consideration.Results. The analysis of statistics has made it possible to compare the structure and dynamics of OI indicators in the Republic of Crimea with similar data on the national average. Regional differences in occupational injury rates have been identified. In 2017–2021, the number of fatal injuries per 1 000 workers increased in the country, and in Crimea the problem was more acute than in the average for Russia. According to the results for 2021, construction was the most hazardous type of activity in the Crimean region, while mining was the most dangerous one in the Russian Federation. The relative rates of occupational injuries (per 1 000 employees) in the region were lower than the national average. At the same time, the proportion of fatal injuries in Crimea was 1.5–2 times higher than the national average. The highest level of fatal injuries in Crimea was recorded in 2018–2019, likely due to increased construction activity. Injury rates were increasing, while the costs of occupational safety measures were also rising. At the same time, in 2021, the amount of funds allocated to labor protection in Crimea was approximately 1.7 times lower than the similar national average (per employee).Discussion and Conclusion. It is advisable to use data on occupational injuries in the Republic of Crimea to develop scientifically grounded recommendations for improving the regional occupational safety system. These results are partially influenced by the integration of Crimea and are presented in comparison with all-Russian indicators. Therefore, the findings of this scientific work can be applied more broadly when developing a strategy for labor protection in other regions of the Russian Federation.