Soft Tissue Injuries Research Articles

Analysis of the Hamstring Injuries among Soccer Athletes

Nowadays, as the injury rate of hamstring injuries increases, it is important to find the effective recovery method. This article is in order to explain the reasons of why soccer athletes get hamstring injuries based on the detailed analysis of the injured structure anatomy of people, and discuss the functions and mechanisms of the injury, which include stretch and sprinting. Then explain both the modifiable and non-modifiable risk factors and risk group of human such as older people who has muscle weakness and the athletes who already experience the same injuries. Finally, the article provides several rehabilitation methods which can help athletes to do the recovery step by step, from soft tissue injuries, to reducing the inflammation and pain, then doing physiotherapy which includes the muscle strength training and flexibility training. Besides, it also gives an evaluation of each rehabilitation program to find the most effective and useful one and it also compare the similar rehabilitation program of L-protocol groups and C-protocol groups in many aspects. The common results show that by doing effective recovery, can help athletes with hamstring injuries return to the sports quickly. After that, several prevention methods are given in the article, such as doing warm up program and stretching before doing the sports, which can help athletes avoiding getting those kinds of injury

Clinical application of visual minimally invasive acupotomy

Visual minimally invasive acupotomy is applicable for the diseases with the pathological characteristics of soft tissue injury, including disorders of spine, four limbs and joints, peripheral nerve compression and chronic soft tissues. The diseases with superior effect obtained are cervicogenic headache, lumbar disc herniation, carpal tunnel syndrome and flexor tendon stenosing tenosynovitis. Under the guidance with ultrasound, visual minimally invasive acupotomy is advantaged at preoperative diagnosis, intraoperative guidance and postoperative evaluation in clinical practice so that it is precise, safe and reliable in clinical treatment. Visual minimally invasive acupotomy is essentially a kind of "ultra-minimally invasive" technique in treatment, focusing on the self-rehabilitation of the body induced by external treatment measures. It is highly complementary to the repair and reconstruction of minimally invasive surgery of modern medicine in clinical application.

Internal fixation vs manual reduction in the treatment of ankle fracture healing and inflammation: A case-control study.

Ankle fractures are among the most common bone injuries, which are often accompanied by soft tissue injuries. Proper management of these fractures is crucial to promote healing and minimize complications. This study explores the effects of 2 treatment methods for ankle fractures: open reduction and internal fixation and manual reduction followed by plaster external fixation. A retrospective analysis was conducted on 124 patients with ankle fractures admitted between March 2020 and September 2022. Patients were divided into 2 groups: 62 received internal fixation and 62 received manual reduction with plaster external fixation. The study evaluated various clinical outcomes, including treatment effectiveness, recovery times, the incidence of nonunion, ankle joint function and inflammatory factors, and complication rates. The internal fixation group showed a significantly higher effective treatment rate (96.77%) compared to the non-internal fixation group (85.48%). After treatment, the internal fixation group had significantly lower medial malleolus space and talus tilt angles, indicating better fracture alignment. The internal fixation group also had shorter treatment, postoperative recovery, and functional recovery times. Furthermore, the incidence of nonunion and complications was lower in the internal fixation group. Inflammatory markers such as interleukin-6 (IL-6), C-reactive protein (CRP), and interleukin-8 (IL-8) decreased significantly in the internal fixation group compared to the non-internal fixation group. Internal fixation is more effective than manual reduction and plaster external fixation for treating ankle fractures. It leads to better fracture healing, shorter recovery times, and fewer complications, including nonunion. Manual reduction with external fixation remains a viable option but may be associated with a higher risk of nonunion and delayed healing. Early and effective management of soft tissue injuries is crucial for improving treatment outcomes in ankle fractures.

Degloving Injury of the Thigh: A Case Report

Background: Morel-Lavallee lesions (MLLs), also known as degloving injuries, are uncommon traumatic soft tissue injuries resulting from the separation of the superficial fascia from the deep fascia, typically due to high-energy trauma or shear forces. This separation leads to fluid accumulation and disruption of skin vascularity, placing the overlying skin at risk for necrosis and infection. MLLs can mimic other soft tissue injuries, such as hematomas, and are often associated with delayed diagnosis and treatment. Case Presentation: A 46-year-old man presented with left thigh swelling persisting for three weeks following a motorcycle crash. Initial imaging with X-rays revealed no fractures, and point-of-care ultrasound identified a large encapsulated fluid collection consistent with MLL. Subsequent computed tomography angiography ruled out vascular injury and confirmed a subcutaneous fluid collection measuring 10.6 cm × 32.0 cm. Conservative management, including compression bandaging and prophylactic antibiotics, was initially recommended; however, after surgical review, ultrasound-guided drainage was performed to mitigate the risk of skin necrosis. The patient recovered uneventfully and was discharged 48 hours after the procedure. Conclusion: This case highlights the importance of maintaining a high index of suspicion for MLLs in patients with post-traumatic swelling, even in the absence of fractures or significant injuries. Accurate diagnosis and timely intervention are essential to reduce the risk of complications. Point-of-care ultrasound and computed tomography are valuable diagnostic tools in emergency settings, particularly for patients with contraindications to contrast agents. Future guidelines should emphasize clinical vigilance and the role of advanced imaging in managing MLLs effectively.

CAR WEIGHT AS A FUNDAMENTAL CRITERION IN THE WORK OF A FORENSIC EXPERT. A PRACTICAL VIEW

Forensic medical examination of injuries in traffic accidents is very important, because these cases remain one of the main causes of mortality among the working-age population. Determining the mechanisms and circumstances of injury, especially in the absence of witnesses or video recording of the accident, requires the use of new methods of analysis. The mass of the vehicle, which directly affects the intensity and nature of the injuries received, is an important but insufficiently studied criterion, justifying the need to improve approaches to forensic medical research in this area. The aim of the study: to analyze injuries sustained by drivers and passengers as a result of frontal collisions with incomplete overlap in class B vehicles, and to assess the impact of vehicle mass on the spectrum and nature of injuries sustained. Material and methods. The object of the study was 179 “Acts of forensic medical examination of corpses” and “Expert conclusions” regarding traffic accidents accompanied by injury and death of people. The study used anthropometric, morphometric, photographic, criminalistic and statistical methods of analysis. The description of injuries was carried out in accordance with the Abbreviated Injury Scale standards, taking into account the anatomical areas of injury. Results. The analysis showed that with the right incomplete overlap, the number of injuries was slightly higher compared to the left. The total number of injuries among drivers was 194 cases, which is more than among passengers — 166 cases. The most common injuries were fractures of the lower extremities, chest, and soft tissue injuries. This confirms the dependence of the nature of injuries on the location of the victims in the car, the direction of the collision, and the mass of the car. Conclusions. The mass of the vehicle and its class have a significant impact on the spectrum and severity of injuries resulting from traffic accidents. Therefore, the introduction of vehicle mass analysis as a mandatory parameter in forensic medical examinations will contribute to increasing the accuracy of determining injury mechanisms.

PECULIARITIES OF PROVIDING MEDICAL ASSISTANCE TO CIVILIAN VICTIMS OF EXPLOSIVE INJURIES

Introduction. On February 24, 2022, Ukraine faced a stark new reality as war reshaped the lives of its people, including the medical community. In today's world, where wars and conflicts have become an unfortunate part of reality, the management of injuries sustained during combat operations has gained critical importance. Civilians, often unintended victims of conflict, lack the protective measures afforded to military personnel. Treating wounded civilians presents unique challenges, as they frequently suffer from comorbidities that complicate both medical care and rehabilitation. These factors necessitate tailored approaches to diagnosis, treatment, and recovery. The aim of this study was to analyze the injuries caused by blast trauma among the civilian population and to develop an algorithm for the diagnosis and treatment of patients affected by such trauma. Materials and methods. Medical records of 94 inpatients with explosive injuries treated in the surgical departments of the Communal Non-Commercial Institution of the Kharkiv Regional Council “Regional Clinical Hospital” and the Communal Non-Commercial Institution of the Kharkiv City Council “City Clinical Multidisciplinary Hospital No. 25” between 2022 and 2024 were analyzed. Among the patients, 36 (38.3%) were women aged 21 to 87 years, and 58 (61.7%) were men aged 23 to 86 years. Results and Discussion. Soft tissue injuries were observed in all 94 patients admitted to the hospital. Of these, 45 patients (47.9%) sustained soft tissue damage to one or more anatomical regions without involvement of thoracic, abdominal, or pelvic organs. All patients underwent surgical treatment of wound, which included hemorrhage control, removal of visible foreign bodies, and wound debridement. For patients with traumatic limb amputations, surgical treatment included the formation of limb stumps. Patients with bone injuries underwent immobilization of the affected areas. Subsequently, dynamic monitoring of the wounds was conducted to assess healing and detect complications. Internal organ damage was identified in 49 victims (52.1%). All patients with intrapleural complications underwent Bülau drainage of the pleural cavities as the initial intervention. The second stage of care for victims with combined trauma involved laparotomy, during which the extent of the surgical procedure was determined intraoperatively. The third stage focused on wound management. During the primary operation, interventions were limited to wound debridement, hemostasis, and tamponade of wound channels. Subsequent procedures included repeated wound treatments, the primary delayed closure, or the use of vacuum-assisted closure (VAC) systems in cases of extensive soft tissue damage. For such cases, the final step involved autodermoplasty. Conclusions. The experience of managing these victims highlights the importance of a stepwise approach to treating blast injuries, integrating modern surgical and resuscitation techniques. This structured approach has demonstrated its potential to yield favorable outcomes. Despite the severity of injuries and the presence of comorbidities, all patients were discharged in satisfactory condition, underscoring the high efficacy of the proposed treatment strategy.

Evaluating Meniscus, Ligament and Soft Tissue Injury Using MRI in Tibial Plateau Fractures: A Tscherne Classification Approach.

Background and Objectives: This study investigated associated meniscus and ligament injuries in tibial plateau fractures using magnetic resonance imaging (MRI) and assessed soft tissue injuries in relation to the Schatzker classification and Tscherne classification. Materials and Methods: The data of 185 patients who sustained tibial plateau fractures from January 2010 to April 2021 were retrospectively reviewed. Fractures were classified according to the Schatzker classification system. Soft-tissue injuries were assessed using the Tscherne classification. Menisci and ligaments were evaluated using preoperative MRI. Nerve injuries, compartment syndrome and wound problems were also assessed. The incidence of soft tissue injuries, as well as the relationship between the Schatzker and Tscherne classification systems, were analyzed. Results: Evidence of derangement of meniscus and ligament around the knee was found in 183 (98.9%) patients. The most common injury was a medial collateral ligament injury. The incidence of lateral collateral ligament injury, nerve injury, compartment syndrome and wound problem was higher in high-energy tibial plateau fractures. A tendency was observed between the Schatzker and the Tscherne classifications (p value < 0.001). Higher Tscherne grade was also associated with the incidence of posterior cruciate ligament injury, nerve injury and compartment syndrome. Conclusions: In tibial plateau fractures, soft tissue injuries were highly prevalent. High-energy fractures tended to exhibit higher Tscherne classification grades and showed an increased incidence of meniscus and ligament injuries. The Tscherne classification appears to be a helpful system for predicting soft tissue injuries in tibial plateau fractures. And preoperative MRI can be a helpful tool.

Navigated and minimally invasive screw osteosynthesis of atalus fracture

The aim of this surgery is to safeguard the multifragmentary and nondisplaced talus fracture (body and neck) against secondary dislocation in anavigated and minimally invasive manner using screw osteosynthesis. Due to the young age of the patient in the presented case and the risk of apossible secondary dislocation, the decision was made in favor of surgical treatment. Soft tissue swelling, wound infections and allergies to the osteosynthesis material. The video is available online (in English) and shows the individual surgical steps in detail. Preoperative computed tomography (CT) imaging and screw planning. Attachment of the reference array. 1) Cone beam CT (CBCT) scan, image fusion and fusion control. Planning of the minimally invasive skin incisions. Skin incision, navigated drilling and insertion of the K‑wires. 2) CBCT scan and position check of the K‑wires, fine adjustment if necessary. Insertion of the screws. 3) CBCT scan with subsequent position check of the screws, retightening of the screws if necessary. Performed in the Robotic Suite (Brainlab, Munich, Germany) using the following elements: navigation unit curve navigation system, movable robotic 3D CBCT, "Loop-X" and wall monitor "BUZZ". Postoperative X‑ray and CT to control the position of the implants. Partial weight-bearing of the foot with 10 kg sole contact for 6weeks. Physiotherapy with active and passive joint mobilization. Thrombosis prophylaxis with enoxaparin sodium. Optional implant removal after approximately 1year. Navigated operations are routine, so far mainly in the area of the spine. This article shows that navigated extremity surgery can be successfully performed in hybrid operating theaters.

Review on Pharmacological Evaluation of Anti-Inflammatory Agents

Anti - inflammatory diseases and pain are among the main problems that significantly influence the lifestyle of millions of people and existing therapies are not always effective and can cause several adverse effects. In this context, the molecular modifications or synthesis of compounds continue being the best strategies for the identification of new compounds for the treatment of pain and inflammation. The aim of this study was to evaluate the anti-inflammatory activities The clinical phase further validated the drug's efficacy in reducing symptoms of inflammatory disorders, including arthritis and soft tissue injuries. Its tolerability and multi-target action position it as a promising alternative to existing therapies. This evaluation supports the potential of the drug for clinical use, offering a new avenue for managing inflammation with reduced side effects. Future studies will focus on long-term safety and broader therapeutic applications.Safety assessments indicated minimal adverse effects at therapeutic doses, with a superior gastrointestinal and cardiovascular safety profile compared to traditional NSAIDs.Compare the efficacy and safety of the agent with standard anti-inflammatory drugs (e.g., NSAIDs, corticosteroids, or biologics). Test the drug in models of acute and chronic inflammation to assess its versatility. Investigate its therapeutic efficacy in specific inflammatory conditions, such as arthritis, colitis, or other autoimmune disorders.Anti-inflammatory drugs, including non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, are widely used for managing pain, inflammation, and chronic conditions such as arthritis. While effective, their use is associated with significant adverse effects, such as gastrointestinal, cardiovascular, renal, and hepatic toxicities, as well as allergic reactions. Pharmacovigilance, the science and activities involved in detecting, assessing, understanding, and preventing adverse drug reactions (ADRs), plays a critical role in ensuring the safe use of these medications

A prospective study to compare the outcome of patellar fractures treated with tension band wiring versus cannulated cancellous screws fixation

The largest sesamoid bone in the body, the patella, is essential to the stability and functionality of the knee. It functions as a fulcrum to adhere to the patellar ligament and quadriceps tendon, increasing the quadriceps' effectiveness. Both static elements (ligaments and the joint capsule) and dynamic elements (muscles such as the hamstrings and quadriceps) are necessary for patella-femoral stability. Both direct trauma and indirect causes, such as falling when your quadriceps are clenched, can result in fractures. While direct blows might result in comminution and soft tissue injury, indirect injuries usually cause damage to the tendons or bones.There are different ways to treat fractures. For fractures with less than 2 mm displacement, non-operative treatments can be used. Surgical alternatives include screw fixation, tension band wiring and partial or complete patellectomy. It is a comparative randomized control trial.The purpose of this study is to evaluate the cannulated cancellous screws techniques in terms of safety and outcome when compare to tension band wiring for treatment of displaced transverse patellar fractures. A longitudinal observational study was carried out in the department of orthopaedics for a time period of 20 months from November 2020 to June 2022. Patients were divided into two groups one treated with cannulated cancellous screws and another treated with tension band wiring then followed up at intervals of 1st, 3rd and 6 month Results were evaluated with regard to union rate, ROM, pain score, functional outcome, complications and hardware removal rates. The mean radiological union was 9.2 weeks in cannulated cancellous screws group and 9.73 weeks in tension band wiring group, The mean knee ROM was 135° in cannulated cancellous screws Group and 129° in tension band wiring group andfunctional score in cannulated cancellous screws group was 66.7% excellent, 26.6% good and 6.7% poor outcomes. In tension band wiring group functional score was 46.6% excellent, 40% good and 13.4% poor outcomes as per WEST’S Criteria. Complications encountered in tension band wiring group were more with respect to hardware prominence, soft tissue irritation and hardware removal rates than cannulated cancellous screws group.Cannulated cancellous screws for treatment of displaced transverse patella fracture are safe and biomechanically stable implant with lesser degree of soft tissue irritation when compared to tension band wiring.

Fibular nails versus hindfoot nails in the management of ankle fractures with soft tissue injury in the elderly – a preliminary study

Fibular nails versus hindfoot nails in the management of ankle fractures with soft tissue injury in the elderly – a preliminary study

Management of internal bleeding : Guidelines of the American Association for the Surgery of Trauma (AAST) and World Society of Emergency Surgery (WSES)

Internal bleeding is a common and serious complication in trauma patients. The American Association for the Surgery of Trauma (AAST) and the World Society of Emergency Surgery (WSES) have developed comprehensive guidelines to standardize and optimize the care of these patients. In Germany, abdominal injuries are involved in around 20% of all polytraumas, often caused by falls or road traffic accidents. The liver and spleen are most frequently affected. Correct diagnosis and timely management are crucial for patient survival. Computed tomography (CT) is gold standard to assess organ injuries, while ultrasound (fokussiertes Assessment mit Sonographie für Trauma, FAST) provides a readily available, non-invasive diagnostic tool. Magnetic resonance imaging (MRI) is used for detailed soft tissue injuries. The AAST has developed a scoring system (Organ Injury Scale, OIS) to classify the severity of organ injuries. The WSES classifies the hemodynamic condition of the patient. Spleen: Treatment decisions are based on hemodynamic stability. Unstable patients often require emergency surgery, while stable patients can be treated conservatively. In the presence of active bleeding, embolization is a treatment option. Liver: Stable patients with a positive blush (leakage of contrast medium) are treated angiographically. Unstable patients should undergo surgery with perihepatic packing and Pringle maneuver. Kidney: Conservative treatment for stable patients. Embolization is used for active bleeding. Unstable patients require surgical treatment. Gastrointestinal tract: Duodenal hematomas can be treated conservatively. Pancreatic injuries require conservative or surgical intervention depending on the severity and stability of the patient. These guidelines aim to improve the survival and outcome of trauma patients with internal bleeding.

Bilateral Gastrocnemius Flap For Harlequin Defects Around The Knee

Background : Tibial plateau fractures (especially bicondylar Schatzker type 5 and type 6) are a result of high energy trauma. Along with bony component, soft tissue injury is a major determinant in the treatment and final outcome. Bicondylar fractures needs bicolumnar fixation and as such require separate approaches: postero-medial and lateral incisions. The soft tissue of the proximal tibia swells significantly after the injury, coupled with extensive soft tissue dissection during fixation this can lead to subsequent wound breakdown and infection along either side of the proximal tibia which resembles “harlequin eyes”. This study describes outcome of management of post operative soft tissue complications following bicolumnar fixation of proximal tibia with medial and lateral gastrocnemius flap. Method : Three patients who had bilateral soft tissue necrosis at surgical incision sites treated with debridement and bilateral gastrocnemius flaps between January 2016 and December 2017 were included in this study. The mean age was 38 years (range 18–50 years) and the mean duration of follow-up was 10 months. Outcome assessments included the condition of the flap and fracture healing time. Result : All fractures united after surgery. There were no soft tissue complications and all flaps healed well. The mean bony union time was 6 months. Conclusion: Our technique of covering soft tissue loss at surgical site on medial and lateral side of proximal tibia with bilateral gastrocnemius flap in the same setting is a reliable and safe surgical method for these conditions.

Comparison of Traditional Dressing Change Techniques and Vacuum Sealing Drainage Techniques in the Treatment of Skin and Soft Tissue Injuries

Objective: To analyze the therapeutic effects of traditional dressing change techniques and vacuum sealing drainage (VSD) techniques on skin and soft tissue injuries. Methods: 60 patients with skin and soft tissue injuries admitted to the hospital from October 2021 to October 2023 were selected. They were randomly divided into an observation group (30 cases) receiving VSD treatment and a control group (30 cases) receiving the traditional dressing change technique. The total effective rate, treatment indicators, inflammatory factors, and complication rate were compared between the two groups. Results: The total effective rate of the observation group was higher than that of the control group, and the treatment indicators were better than those of the control group (P &lt; 0.05). Before treatment, the levels of inflammatory factors were similar between the two groups (P &gt; 0.05). After four weeks of treatment, the levels of inflammatory factors in the observation group were lower than those in the control group (P &lt; 0.05). The complication rate of the observation group was lower than that of the control group (P &lt; 0.05). Conclusion: In the treatment of skin and soft tissue injuries, VSD can improve the total effective rate, shorten the treatment cycle, alleviate the degree of inflammatory reaction, and reduce the risk of complications.

Pediatric Lateral Condyle Fractures With Elbow Dislocation: Revisiting the Song Classification of the Most Severe Injuries.

Lateral condyle fractures are the second most common pediatric elbow fracture and are at risk for malunion, nonunion or avascular necrosis. The Song or Jakob classification guides management and risk of complications. However, many lateral condyle fractures have accompanying bony or soft tissue injuries, including elbow dislocations, which are not represented in the current Song or Jakob classification systems. Little is known about the incidence and outcomes of these more complex injuries. The purpose of this study was to describe the largest known case series of these injuries and characterize the incidence and outcomes. Injury, presentation, treatment, and outcome data were retrospectively gathered on pediatric elbow fractures at a single center from November 2007 to October 2017. Of 4607 pediatric elbow fractures, 492 were lateral condyle fractures, with 30 cases (6.1%) presenting with concomitant elbow dislocation. Predominantly affecting males (76.7%) with a median age of 6.9 years, these injuries often resulted from intermediate energy mechanisms. High rates of coincident neurovascular deficits (23%), skin tenting (13.3%), and polytrauma (13.3%) were observed. All cases were treated surgically, primarily within 24 hours, with no instances of AVN, nonunion, or fixation failure reported. Across the cohort, there were 2 (6.7%) pin tract infections, 2 cases required return to the operating room, and 12 (40.0)% patients requiring outpatient physical therapy for elbow stiffness. Lateral condyle fractures with concomitant ulnohumeral dislocation are distinct and unstable injuries requiring prompt inpatient treatment. Current classification systems do not adequately address this fracture-dislocation combination, risking underdiagnosis and potentially delayed reduction of a dislocated elbow. We propose adding a "Song 6" or "Jakob 4" category to existing classifications to ensure these injuries are properly identified and managed. This amendment will improve clinical awareness, facilitate timely intervention, and optimize outcomes for pediatric patients with these complex fractures. IV.

Time-Sensitive Injuries for the Sports Medicine Surgeon - "Sports Medicine Trauma", Part 2: Lower Extremity.

Skeletal fractures are traumatic injuries that are widely accepted as requiring acute treatment to avoid long-term disability and dysfunction. There are a number of soft-tissue injuries or non-traditional fractures, frequently treated by sports medicine surgeons, which additionally require treatment in an expedited fashion in order to optimize healing and function. Sports medicine injuries of the lower extremity requiring acute treatment include, but are not limited to, multiligamentous knee injuries, proximal hamstring ruptures, quadriceps tendon ruptures, patellar sleeve avulsions, patellar tendon ruptures, tibial spine avulsions, posterior cruciate ligament avulsions, bucket handle meniscus tears, and achilles tendon ruptures. The purpose of this manuscript is to review the sports medicine injuries of the lower extremity which require acute/urgent management to facilitate optimal treatment.

Time-sensitive injuries for the sports medicine surgeon - "Sports Medicine Trauma", Part 1: Upper Extremity.

Skeletal fractures are traumatic injuries that are widely accepted as requiring acute treatment to avoid long-term disability and dysfunction. There are a number of soft-tissue injuries or non-traditional fractures, frequently treated by sports medicine surgeons, which additionally require treatment in an expedited fashion in order to optimize healing and function. Sports medicine injuries of the lower extremity requiring acute treatment include, but are not limited to, irreducible shoulder dislocations, acute traumatic rotator cuff tears, posterior sternoclavicular joint dislocations, high grade acromioclavicular joint dislocations, pectoralis major tendon ruptures, distal biceps tendon ruptures, and triceps tendon ruptures. The purpose of this manuscript is to review the sports medicine injuries of the upper extremity which require acute/urgent management to facilitate optimal treatment.

Biomimetic Versatile Anisotropic, Electroactive Cellulose Hydrogel Scaffolds Tailored from Fern Stem Serving as Nerve Conduit and Cardiac Patch.

Peripheral nerve injury (PNI) and myocardial infarction (MI) are the two most clinically common soft excitable tissue injuries. Both nerve and cardiac tissues exhibit structural anisotropy and electrophysiological activity, providing a wide range of biophysical cues for cell and tissue repair. However, balancing microstructural anisotropy, electroactivity, and biocompatibility is challenging. To address this issue, Dicranopteris linearis (D. linearis) is proposed as a low-perceived value fern plant. Moreover, to enhance its usefulness, it can be designed into a tubular structure and a lamellar structure to bridge the damaged tissue. Therefore, a robust yet simple top-down approach is proposed to designing and fabricating the desired biomimetic versatile hydrogels orienting from the D. linearis to customize for different soft excitable tissue repair applications. These anisotropic electroactive hydrogels performed well as nerve guidance conduits (NGC) and engineered cardiac patches (ECP) in the repair of PNI and MI, respectively. Two birds, one stone. Accordingly, the biomimetic strategy of D. linearis to NGC and D. linearis to ECP is first proposed, opening a new horizon for constructing tissue engineering using natural sources.

Diagnostic Role of High resolution US and MRI in evaluation of Ulnar nerve Entrapment Neuropathy and soft tissue Injuries around the Elbow Joint

Diagnostic Role of High resolution US and MRI in evaluation of Ulnar nerve Entrapment Neuropathy and soft tissue Injuries around the Elbow Joint

Assault rifle injuries in civilians: ballistics of wound patterns, assessment and initial management.

Wounds from assault rifles and their commercial offspring have been encountered with increasing frequency in civilian practice. Our aim is to summarize wound ballistics related to the main injury patterns that can also affect management strategies. An online search of the PubMed was conducted for research and review articles published after 2000 in English, using the MeSH terms "gunshot wounds", "mass casualty incidents", "war-related injuries", "soft tissue injuries", "vascular system injuries", "colon injuries", "wound infection", "antibiotic prophylaxis", "debridement", "hemorrhage", "penetrating head injuries", "pneumothorax" and additional free-text terms. Other academic databases were also searched for relevant articles and book chapters. Consensus regarding recognition of high energy wounds from assault rifle projectiles is largely based on war experience. Studies of such wounds inflicted by expanding projectiles suggest that their wounding effects significantly increase tissue damage and adverse outcomes following injury, as a result of the temporary cavity and bullet fragmentation. The use of assault rifles in mass shootings has prompted utilization of tourniquet for control of life-threatening hemorrhage, also derived from military experience, while limited evidence indicates that tension pneumothorax rather than extremity wounds is the leading cause of potentially preventable death in these incidents. Wound ballistics provides a system for evaluation of injuries from assault rifles and risk analysis of shooting incidents. Lessons learned from armed conflicts can improve the management of victims, with due consideration given to characteristics of civilian injuries. Further research is required to define the impact on survival by key life-saving procedures in the prehospital setting, in order to prioritize these interventions.