Trunk Injuries Research Articles

Comparative Temporal Infrared Thermography of Arboricultural Materials for Sun‐Induced Trunk Injury Prevention in Broad‐Leaved Woody Plants

ABSTRACTUsing an infrared (IR) thermal camera, we evaluated the efficacy of six arboricultural materials for preventing sunscald and frost crack. The trunks of adult Yoshino cherry (Prunus × yedoensis) and Japanese zelkova (Zelkova serrata) were treated with (i–iii) three paint types (white water paint [P–W], white latex paint [P–L], and quicklime [P–Q]), (iv and v) two band wrap types [brown tree wrap (B–B) and white tree wrap (B–W)], and (vi) a wound paste: thiophanate‐methyl paste (TP) in the shape of a band 10 cm thick. Outdoor IR thermographs were captured four times a day at 3 h intervals (09:00 a.m., 12:00 p.m., 03:00 p.m. and 06:00 p.m.) over four consecutive days in late October 2019. Bark temperatures recorded for P–W, P–L, P–Q and B–W treatments were consistently lower than those for untreated trunks. The mean temperature difference between B–W and untreated bark (up to 4.57°C) remained pronounced between 09:00 a.m. and 06:00 p.m. for both tree species each day. Conversely, no significant differences in bark temperatures were observed under B–B and TP treatments compared with untreated bark (p = 0.01). Elevated bark temperature was observed on the south side compared with the other three cardinal directions; however, temperatures were similar in all directions at 06:00 p.m. These findings suggest that white tree wrapping may provide a viable approach to prevent sun‐induced trunk injuries, leveraging the light reflectivity of the white colour and thermal insulation properties of the wrapping material.

Surgical management of severe noncompressible torso and organ hemorrhages

Noncompressible torso hemorrhages (NCTH) are now recognized as the leading cause of preventable death in the context of severe military and civilian injuries. Approximately 20% of all trauma patients still die from uncontrolled bleeding associated with rapidly evolving disorders of blood coagulation function. Summary of recent advances in the field of nonsurgical and surgical management, presentation of current treatment concepts and future research directions. Selective literature review and analysis. The concepts for the early treatment of NCTH have considerably evolved over the last decade. The updated definition of NCTH includes acombination of high-grade anatomic body trunk injury, hemodynamic instability, urgent need for hemorrhage control, and aggressive hemostatic treatment. The treatment concepts consider the following 3 aspects: controlling the source of bleeding (close the tap), maintaining organ perfusion and restoring hemostasis (fill the tank) and increasing the body's resistance to ischemia (upgrade the armor). New tools, well-established damage control concepts and early and aggressive therapeutic intervention for hemostatic failure have significantly improved the outcomes. Future research needs to refine and validate the current concepts for further clinical application.

EXPERT-EPIDEMIOLOGICAL FEATURES OF NON-LETHAL MOTORCYCLE-RELATED TRAUMA

The forensic examination of victims of motorcycle trauma is a current issue in forensic practice. However, the forensic characteristics of contemporary nonfatal motorcycle injuries have not been adequately investigated. Aim of the work. To investigate the epidemiology of nonfatal motorcycle injuries and to determine the forensic characteristics of injuries typical of victims of motorcycle traffic accidents. Materials and methods. The study material consisted of 40 forensic medical reports on individuals affected by motorcycle injuries, performed at the Ternopil Regional Forensic Medical Bureau between 2016 and 2023. The data extraction was performed in a formalised card for each case, containing details about the injured person, circumstances, location and conditions of the injury. The types of injuries, their location and distribution by body part (head, trunk, limbs) were meticulously recorded. The data obtained were processed using variational statistical methods. Results. Research shows that the majority of nonfatal injuries to motorcyclists occur on the roads during the summer and early autumn, with peaks in June and September, typically as a result of collisions with other vehicles (usually cars). The victims are predominantly male (35 (87.5%)), young (19 (47.5%)) and mature (13 (32.5%)). Of these, 31 (77.5%) were motorcyclists, 6 (15.0%) were passengers and only 3 (7.5%) were pedestrians (p≤0.01). Different lower limb injuries were identified in 35 victims (87.5%, p≤0.01), upper limb injuries in 22 (55%) of the injured and head injuries in 20 (50%). Combined injuries involving two or more different anatomical parts of the body (head, torso and limbs) were found in 35 (87.5%) victims. Head injuries presented as abrasions, bruises or contusions, mainly to the face, often to several facial areas at the same time, typically accompanied by concussion or cerebral contusion. All victims with torso trauma were diagnosed with various soft tissue injuries, of which 18 (90%) were located on the anterior surface of the chest, in the pelvic or abdominal area (often in combination), with spinal injuries occurring in only 2 (10%) victims. Upper limb trauma was associated with various soft tissue injuries, as well as fractures and ligamentous damage in more than half of the victims with upper limb injuries. Victims with lower limb trauma had both superficial soft tissue injuries (abrasions, bruises, haematomas, contusions) and deeper injuries (lacerations or crush injuries), together with open or closed fractures of the femur, tibia and fibula, or multiple fractures. Isolated injuries involving only the trunk or upper extremities, or only the head and trunk, or only the trunk and lower extremities in nonfatal motorcycle trauma were found only in isolated cases. Conclusions. Non-fatal motorcycle trauma usually occurs on the road, in warm weather conditions, as a result of the motorcycle colliding with another vehicle. The majority of victims are motorcyclists, young and middle-aged males. Characteristic features of non-lethal motorcycle trauma are: a significant number of superficial soft tissue injuries and their predominance over fractures or internal organ injuries; the combination of head, trunk and limb injuries with a predominance of lower limb injuries; the predominant location of injuries on the frontal surface of the victims' bodies.

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.

Pattern of admission, outcome and predictors of trauma patients visiting the surgical emergency department in comprehensive specialized hospital: a retrospective follow up study

Background: Traumatic injuries represent huge burden in the developing world, and significant proportion has found in low- and middle-income countries. However, the pattern, outcome and factors of injury varies from setup to setup and is less studied public health problems. Objective: To assess pattern of admission, outcome and its predictors among trauma patients visiting the surgical emergency department in comprehensive specialized hospital. Methods: A retrospective follow up study was conducted and data was taken from the medical records of patients from 2019 to 2021. Simple random sampling technique was used to get a sample size of 386 from injured patient charts. Data were entered into Epi-Data version 4.6 software and exported to STATA version 14.1 for analysis. The dependent variable was injured patient’s outcome that could be died or not died. The independent variables with P-value less than 0.25 in the bi-variable regression analysis were considered for the multivariable regression. Adjusted Odds Ratio with the 95% Confidence Interval were used to declare statistical significance. Result: About 13.99% of injured patients with (95% CI: 10, 17) had died during the study period. The leading cause of injury was assault (62.44%) followed by road traffic accident (26.17%). Severe Glasgow coma scale (AOR 6.6; 95% CI: 2.6-16.4), Length of hospital stay≥7days (AOR=2.8; 95% CI: 1.2-6.2), time of arrival in between 1-24 hours (AOR=0.15; 95% CI: (0.06-0.37), and upper trunk injury (AOR=6.3; 95% CI: 1.3-28.5) were significantly associated with mortality. Conclusion and Recommendation: Mortality after traumatic injury was considerably high. Severe Glasgow coma scale, Length of hospital stay≥7days, time of arrival in between 1-24 hours, and upper trunk injury were the associated factors for mortality. Priority should be given for injured patients with decreased level of consciousness and upper trunk injury. Establishment of organized pre-hospital emergency services and provision of timely arrival is recommended. We recommend prospective follow up study.

Socioeconomic factors and outcome after repair and reconstruction of digital and major nerve trunk injuries in the upper limb

Peripheral nerve injuries in the upper limb can lead to substantial disability and pain. We aimed to assess how socioeconomic factors affect outcomes after repaired or reconstructed digital or major nerve trunk injuries in the upper limb. We identified 670 individuals, who underwent surgical nerve repair or reconstruction using sensory nerve autografts, in the Swedish National Quality Registry for Hand Surgery 2010–2018. Socioeconomic factors, including education, cohabitation, type of work, sick leave, immigrant status and income, were gathered from the Swedish statistical agency (www.scb.se) and National Diabetes Register (NDR). We calculated prevalence ratios (PR) to assess the relationship between socioeconomic factors and surgical outcomes for the nerve injuries. Individuals with a major nerve trunk injury had higher QuickDASH scores and lower income compared to those with digital nerve injury. Individuals with immigration background (adjusted PR = 2.0, 95% CI 1.2–3.2), history of > 4 weeks of sick leave the year before surgery (adjusted PR = 1.8, 95% CI 1.1–3.1), or education level below tertiary (adjusted PR = 2.8, 95% CI 1.7–4.7) had significantly higher QuickDASH scores. Recognizing impact of non-biological factors, including immigration, prior sick leave, and education level, on outcome after nerve surgery is crucial for improving prognosis in socioeconomically deprived individuals.

Age-specific Patterns of Intimate Partner Violence Related Injuries in US Emergency Departments

PurposeTo identify intimate partner violence (IPV)-related injury patterns of U.S. patients of three age groups: <18 years (adolescents), 18–25 years (emerging adults), and >25 years (adults). MethodsWe performed a nationally representative retrospective review of all patients presenting to U.S. Emergency Department for IPV-related injuries from 2005 through 2020. Demographics and injury patterns were calculated using statistical methods accounting for the weighted stratified data. Main outcomes were injury morphology, mechanism, severity, location, and temporal associations of IPV-related injuries among the three age groups. ResultsThere was a higher proportion of female victims, sexual assault cases, and lower trunk injuries among adolescents compared to emerging adults and adults. There was increasing injury severity, fractures, and hospital admissions with increasing age. Adolescents experienced a greater prevalence of fractures of the head, neck, hands, fingers, and distal lower extremity, while trunk fractures increased with age. The peak prevalence of violence-related Emergency Department visits among adolescents was in June and September, with the peak day as Tuesday. DiscussionInjurious forms of IPV are prevalent across all age groups, with sexual assault cases demonstrably higher among adolescents and increasing severity of injuries as victims age. Identification of age-specific injury patterns will aid health-care professionals and policymakers in developing targeted interventions for adolescents who experience IPV.

Chest Compression-Associated Internal Thoracic Artery Injury During Cardiopulmonary Resuscitation: Incidence, Injury Patterns and Efficacy of Transcatheter Arterial Embolization.

To investigate the incidence and patterns of chest compression-associated internal thoracic artery injury (CAI) during cardiopulmonary resuscitation and identify the embolization techniques used to treat hemorrhage. A retrospective study was conducted in the patients who underwent transcatheter arterial embolization (TAE) for life-threatening hemorrhage caused by CAI at two tertiary care centers between May 2013 and December 2019. Data on background characteristics, imaging findings, embolization and outcomes were collected from the medical records. Among 385 patients in whom circulation returned after resuscitation, there were 9 patients (2.3%) who required TAE for CAI. Eight of 9 patients had acute myocardial infarction, and all had been started on extracorporeal membrane oxygenation before TAE. Seven patients had unilateral, and two had bilateral internal thoracic artery injuries. Main trunk injury of internal thoracic artery was seen in 27%, while branch injury in 73%. Six patients (67%) had multiple injuries in the internal thoracic artery territory, and five (56%) had injuries to other vessels. In all cases, we embolized the main trunk of the internal thoracic artery using n-butyl 2-cyanoacrylate and coils (n = 8), a gelatin sponge only (n = 2), or coils and a gelatin sponge (n = 1). TAE was technically successful in all, without any complication. The 30-day mortality rate was 44%. CAI needing hemostatic intervention occurred in 2.3% of patients after successful cardiopulmonary resuscitation. Branch injury was more common than main trunk injury, and multiple vessel injuries were common. TAE appears to be safe and effective for controlling life-threatening hemorrhage.

Defective Assistive Device Involvement in Older Adult Emergency Department Visits.

Many older adults adopt equipment to address physical limitations and reduce dependence on others to complete basic activities of daily living. Although a few prior studies have considered injuries associated with assistive devices for older adults, those studies focused on older adults' health and functional risks for injury. There is limited analysis of older adult injuries involving defective or malfunctioning assistive devices. Data from this study are from the National Electronic Surveillance System All Injury Program which collected data on consumer product-related injuries from a probability sample of 66 hospital Emergency Departments across the United States. Data from 30776 older adult Emergency Department (ED) injury narratives from 2016 to 2020 were coded according to the assistive device involved and whether malfunctioning led to the injury. The study team manually examined all narratives in which the assistive device was coded to have malfunctioned. A total of 10974 older adult ED cases were treated for 12488 injuries involving a defective device. Injuries included 4212 head and neck injuries (eg, concussion), 4317 trunk injuries (eg, hip fractures), and 3959 arm or leg injuries (eg, leg fracture). Of these patients, 4586 were admitted to a hospital ward for further evaluation and treatment. Seventy percent of these patients were injured while using a walker; in contrast, wheelchairs were implicated in only 4% of the above cases. Design flaws were identified in 8158 cases and part breakage/decoupling incidents in 2816 cases. Our findings provide evidence that assistive devices are actively involved in older adult injuries. Further research is needed to reduce injuries associated with assistive devices by educating patients and their careproviders about device use and assembly and developing effective methods for informing manufacturers about malfunctioning devices.

Exploring Relationships Between Size and Function of Trunk Muscles, Injuries and Concussion in a Professional Rugby League Team

Abstract Purpose Examine for injury risk factors and establish clinical cut-off values related to size and function of trunk muscles. Methods A prospective study of 28 professional Rugby League players was conducted. Cross-sectional areas (CSAs) of the multifidus (MF), quadratus lumborum (QL) and ability to contract the abdominal and MF muscles were measured from pre-season ultrasound images. Playing season injuries resulting in games missed were recorded by club personnel. Logistic regression models were used to determine the adjusted odds ratios for trunk muscle measures as risk factors for playing season injuries. Results The adjusted odds ratio (OR) values indicated that if a player had a small MF muscle (&lt; 9.98 cm2 at L5; P = 0.032) or a small QL (&lt; 10.8 cm2; P = 0.045), their odds of more games missed due to season injuries was increased (OR MF = 9.4; 95% CI = 1.21–72.9; OR QL = 7.3; 95% CI = 1.1–51.6). For players with increased contraction of the MF (contraction &gt; 7.2%; P = 0.028) and abdominal muscles (&gt; 49.9%; P = 0.08), the odds of sustaining a concussion were increased (OR MF 14.5; 95% CI 1.3–159; OR transversus abdominis 6.2; 95% CI = 0.8–48.6). Conclusion As size and ability to contract trunk muscles are modifiable factors, further intervention studies targeting motor control of these muscles may be warranted.

Individual factors determine landing impacts in rested and fatigued cheerleaders.

High vertical ground reaction forces (VGRF) during landings following acrobatic elements in artistic gymnastics is associated with trunk and lower extremity injury risk. As similar data regarding injury risk factors in cheerleading are scarce, the purpose of this study was to assess VGRF in pop-off dismounts of rested and fatigued flyers in cheerleaders. Fifteen German cheerleaders were recruited for this study, including seven female flyers and eight male bases. It was expected that performance would change in fatiguing athletes, potentially increasing the risk for injuries. However, neither the mean VGRF (rested: BW, fatigued: BW, overall range: 2.1-14.9 BW) nor the individual VGRF-time courses of the flyers changed significantly after the workout. Instead, we show that the flyers' ability to land - but not the bases' ability to catch - significantly influences the maximum and time-resolved impacts.

Prevalence of dance-related injuries and associated risk factors among children and young Chinese dance practitioners.

While Chinese dance is a popular dance genre among Chinese teenagers and adults, little is known regarding the prevalence of dance-related injuries or factors associated with such injuries among Chinese dance practitioners. The current cross-sectional study aimed to determine the prevalence of dance-related injuries and their associated risk factors among young Chinese dance practitioners in Hong Kong. Online surveys were distributed to dancers through local dance associations, while paper-based surveys were distributed to young Chinese dance performers during the 54th School Dance Festival in Hong Kong. Self-reported hours of dancing, injuries in the last 12 months, injury sites, and related factors were collected. The injury rate, 12-month prevalence of dance-related injuries were determined. Risk factors for common dance injuries were analyzed using separate multivariate regression models. A total of 175 children (aged 10-14 years) and 118 young (aged 15-24 years) Chinese dance practitioners provided their dance injury information. Young dancers had a significantly higher injury rate (6.5 injuries vs 4.6 injuries/1000 dance hours) and 12-month prevalence (52.5% vs 19.4%) than their child counterparts. The most commonly injured sites were the knee (children:7.4%; young:15.3%), lower back (children: 4.6%; young: 9.5%), and ankles (children: 5.1%; young: 16.9%). Age was a significant independent risk factor for dance-related injuries to the upper back, lower back, and pelvis/buttock (odds ratios ranging from 1.2 to 1.3/additional years). Additionally, height was a significant independent risk factor for lower limb injury (odds ratios ranging from 1.0-1.1/additional centimeter). Collectively, young Chinese dance practitioners are more vulnerable to dance-related injuries than are child dancers. Older age increases the risk of trunk injuries, whereas taller dancers are more likely to sustain lower-limb injuries. Future research should determine the mechanisms underlying dance-related injuries among these dancers.

In-hospital complications of work-related musculoskeletal injuries

Background, ObjectivesWork-related musculoskeletal (MSK) injuries are a major contributor to morbidity worldwide and frequently result in hospitalisation. Hospital complications are common, costly, and largely preventable, but relevant data is required to address this. This study aimed to identify the incidence and factors associated with in-hospital complications of work-related MSK injuries. MethodsThis study is based on work-related MSK hospital admission data from Victorian Admitted Episodes Database, 2016–2022. Complications were identified based on ICD-10-AM coding using CHADx (Classification of Hospital Acquired Diagnoses). Negative binomial and logistic regression analyses were performed to identify factors related to in-hospital complications. ResultsIn-hospital complications occurred in 6.3 % of work-related MSK injury admissions. In the adjusted models, ages ≥45 years, female sex, and area-level disadvantage were associated with in-hospital complications. Stay at public (vs private) hospitals, comorbidity, emergency admissions, and general anaesthesia were also associated. Complication rates were higher in hospitalised workers with direct head, neck, and trunk injuries and cumulative MSK disorders than those with direct extremities injuries and acute MSK conditions. The most common complications were cardiovascular, gastrointestinal complications and adverse drug events. ConclusionThis study identified patient, injury and hospital-related characteristics associated with in-hospital complications of work-related MSK injuries for informing prevention strategies and risk estimation by hospital staff and workers' compensation schemes. The results demonstrate a sizable rate of complications given the relatively young and healthy study population.

Training for shorter ultra-trail races results in a higher injury rate, a more diverse injury profile, and more severe injuries: 2022 Mac ultra races

ObjectivesDetermine and compare the epidemiology, clinical characteristics, and injury severity among race entrants training towards different ultra-trail race distances. DesignRetrospective cross-sectional study. SettingThe six months training period before the 2022 Mac Ultra races (46 km, 80 km, 161 km and 322 km). ParticipantsOf the 245 race entrants, 162 (66% of Mac ultra-trail runners) consented to analyse their data. Outcome measuresInjury rate (injuries per 1000 h of running), point prevalence (% of currently injured participants), injury severity (time loss), and the frequency (n, %) of injuries reported during pre-race medical screening in the six months before the race. Using inferential statistics, we compared the injury rates between the different race distance categories (46 km, 80 km, 161 km, 322 km). All tests were performed at a 5% level of significance. ResultsWe reported a statistically significantly higher injury rate among 46 km study participants (3.09 injuries per 1000 h) compared to the injury rates reported among 80 km (0.68 injuries per 1000 h; p = 0.001) and 161 km (1.09 injuries per 1000 h; p = 0.028) participants. The lower limb (89%) was the most injured anatomical region, with only 46 km study participants reporting upper limb, trunk, and head injuries (11%). Muscle/tendon was the most reported injured tissue type (56%), with muscle injuries (31%) the most reported pathology type. Shorter distance ultra-trail runners reported the highest injury severity. ConclusionUltra-trail runners training towards shorter ultra-trail distance races presented with a higher injury rate, more diverse injury profile, and a higher injury severity.

Energy device injury. Common basilar arterial trunk injury with harmonic scalpel.

Energy device injury. Common basilar arterial trunk injury with harmonic scalpel.

Consistently High Frequency of Scooter Injuries in Children-Retrospective Data Analysis in a Level I Trauma Centre.

The aim of this retrospective study was to present an epidemiological overview of paediatric nonelectric-scooter-related injuries, focusing on changes in injury mechanism and frequency. A retrospective, descriptive data analysis at a Level I trauma centre, including patients aged from 0 to 18 years injured by riding nonelectric scooters, was performed. The observation period ranged from January 2015 to December 2022. The total study population consisted of 983 (mean age: 7.9 ± 4.0 years) children and adolescents, with most patients being male (800/983; 81.4%). The frequency of nonelectric scooter injuries was relatively consistent over the observation period. Patients sustained mostly minor injuries (lacerations, bone contusions, sprains) (527/983; 53.6%), followed by head injuries (238/983; 24.5%), limb fractures (166/983; 16.9%) and trunk injuries (52/983; 5.3%). However, a few patients sustained severe injuries, including skull fractures (7/238; 2.9%), intracranial haematoma (4/238; 1.7%) or lacerations of abdominal organs (4/52; 7.7%). This study presented a consistently high frequency of scooter injuries in children. Children under 15 years were the most affected by scooter-related injuries. Although most injuries were minor, serious injuries occurred that should not be underestimated. Hence, we emphasise the use of protection gear and recommend raising awareness among parents and children.

Chitin Conduits with Different Inner Diameters at Both Ends Combined with Dual Growth Factor Hydrogels Promote Nerve Transposition Repair in Rats.

Severe peripheral nerve injuries, such as deficits over long distances or proximal nerve trunk injuries, pose complex reconstruction challenges that often result in unfavorable outcomes. Innovative techniques, such as nerve transposition repair with conduit suturing, can be employed to successfully treat severe peripheral nerve damage. However, cylindrical nerve guides are typically unsuitable for nerve transposition repair. Furthermore, angiogenic and neurotrophic factors are necessary to stimulate the emergence of axonal lateral sprouts, proximal growth, and the rehabilitation of neuron structures and functions. In the current study, we used chitosan to make chitin conduits with different inner diameters at both ends, combined with gelatin methacrylate hydrogels that can continuously release dual growth factors, namely, the vascular endothelial growth factor (VEGF) and the nerve growth factor (NGF), and evaluated its impact on nerve transposition repair in rats. At 16 weeks after the operation, our findings showed that the conduit combined with the dual growth factor hydrogel significantly improved the restoration of both motor and conduction functions of the nerve. In addition, histological analysis showed significant recovery of nerve fibers, target muscles, and neurons. In conclusion, the combination of chitin conduits with different inner diameters and dual growth factor hydrogels can significantly improve the effect of nerve transposition repair, which has important potential clinical value.

Surgical treatment of isolated soft tissue gunshot shrapnel injuries by combining primary delayed sutures with platelet-rich autoplasma injections into mine-explosive wounds

Aim: to assess the treatment effectiveness in patients with soft tissue gunshot shrapnel injuries by applying primary delayed sutures in combination with platelet-rich autoplasma injections into wounds. Materials and methods. The study included 60 (100.0 %) patients with soft tissue gunshot shrapnel wounds. All wounded were divided into two groups. The comparison group consisted of 30 (50.0 %) patients admitted to a hospital with primary delayed sutures (6–7 days). The main group included 30 (50.0 %) patients whose local treatment modification consisted in a combination of primary delayed suturing with platelet-rich autoplasma injection into a wound. A wound channel was observed on the 8th, 11th –14th days from the moment of injury using visual inspection, linear measurements and diagnostic ultrasound system (Mindray M6, 220A). Results. 60 (100.0 %) patients were urgently hospitalized to the third stage of medical evacuation and treated according to standard treatment protocols for this pathology at the third stage of evacuation. According to a wound defect localization, the wounded of the comparison groups, 30 (50.00 %), were distributed as follows: a lower limb wound – 22 (73.33 %) patients, an upper limb wound – 6 (20.00 %), and a trunk wound – 2 (6.67 %). The main group also included 30 (50.00 %) wounded, whose treatment at the third stage of medical evacuation was modified by using a combination of primary delayed sutures and platelet-rich autoplasma injection. On the 8th day after an injury, a visual inspection of the wounds detected no hyperemia or suppuration in both groups. The visual inspection of wounds in the comparison group at 11.0 ± 3.9 days post-injury revealed 24 (80.00 %) patients with complications such as seromas in 17 (56.67 %) cases, hematomas with wound suppuration – in 7 (23.33 %). In the main group, 2 (6.67 %) cases of wound suppuration were detected (U = 120.00, p = 0.000001). The basic parameters of wound linear measurements according to the diagnostic ultrasound system data at the 11th–14th day post-injury after primary and delayed suturing in the studied groups: in the comparison group, upper limb wounds – S (mm2) 43.3 ± 12.6, V (mm3) 53.3 ± 13.9; lower limb wounds – S (mm2) 194.7 ± 50.7, V (mm3) 706.3 ± 190.4; trunk wounds – S (mm2) 20.5 ± 7.2, V (mm3) 22.5 ± 5.4. In the main group, upper limb wounds – S (mm2) 28.2 ± 8.5, V (mm3) 23.2 ± 7.1; lower limb wounds – S (mm2) 56.4 ± 19.6, V (mm3) 102.4 ± 21.1; trunk wounds – S (mm2) 12.3 ± 3.2, V (mm3) 10.4 ± 2.9. The total duration of inpatient treatment at the 3rd stage of medical evacuation in the comparison group wounded was 30.0 ± 2.3 days, and in the main group it was 12.0 ± 3.1 days (U = 290.00, p = 0.0354). Conclusions. In the structure of gunshot shrapnel wounds in both groups, there were 43 (71.67 %) lower limb traumatic injuries, 11 (18.33 %) upper limb, and 6 (10.00 %) trunk injuries. The use of platelet-rich autoplasma in combination with primary delayed suturing stimulated wound healing and accelerated wound-healing process as evidenced by a significant decrease in the wound defect area and volume on the 11th–14th day post-injury in the main group compared to the comparison group. The method for treatment of gunshot shrapnel wounds developed by us reduced the frequency of postoperative complications since 24 (80.00 %) patients were diagnosed with complications in the comparison group, while only 2 (6.67 %) patients in the main group (U = 120.00, p = 0.00001). The use of platelet-rich autoplasma made it possible to reduce the length of hospital stay for patients at the third stage of medical evacuation: in the comparison group, this period was 30.0 ± 2.3 days, and in the main group, 12.0 ± 3.1 days (U = 290.00, p = 0.0354).

The Relationship Between Kinematical Parameters of Trunk and Knee Injuries in Male Judo Players

Background and Aims The knee joint injury in judokas mostly occurs in the standing position. This study aims to investigate the relationship between kinematic variables of trunk and the occurrence of knee injuries in male judokas. Methods In this study, 15 male judokas aged 20-30 years (7 with a history of knee joint injury and 8 controls) were selected based on the inclusion and exclusion criteria. Then, after installing markers on their body, they were asked to stand on a 30-cm box and, after a jump upwards, land on the ground on one foot (the support foot). Cameras were used to measure the angles of the knee and trunk joints during the jump landing task. Shapiro-Wilk test was used to examine the normality of data distribution. ANCOVA was used to compare the groups. The ssignificance level was set at 0.05. Results Healthy judokas had lower knee flexion angle and higher knee valgus angle. Moreover, they had lower trunk flexion angle, higher internal knee rotation, and higher relative rotation speed between femur and tibia compared to the injured group (P&lt;0.05). Conclusion Male Judo players with a history of knee injury have lower knee flexion and greater knee valgus, lower trunk flexion, higher internal knee rotation, and higher relative rotation between femur and tibia compared to their healthy peers. Professionals and coaches need to design injury prevention exercises for this group of athletes.

Anatomical relationship between the brachiocephalic trunk and the trachea and the clinical implications

To observe the anatomical features and relative position of the brachiocephalic trunk and the trachea to provide an anatomical basis for diagnosis and treatment of mechanical airway obstruction and for facilitating the performance of tracheotomy. A total of 91 formalin- fixed adult cadavers (70 male and 21 female) were used in this study. The whole length of the larynx and the trachea were separated and exposed from the neck to the chest, followed by separation of the aortic arch and its 3 branches to observe the anatomical position of the brachiocephalic trunk and the trachea. The brachiocephalic trunk and the trachea did not intersect in 3.30%, partially intersected in 71.43%, and completely intersected in 25.27% of the 91 cadaveric specimens. The male specimens all showed greater outer diameter of the aortic arch, the brachiocephalic trunk and the trachea with a greater length of the trachea than the female specimens (P < 0.05), while the distances from the aortic arch to the brachiocephalic trunk or the cricoid cartilage did not differ significantly between them (P > 0.05). The number of the tracheal cartilage rings above the brachiocephalic trunk ranged from 3 to 10, and the mean number did not differ significantly between the male and female specimens (P > 0.05). The brachiocephalic trunk has complex anatomical relationship with the trachea, and caution should be taken to avoid injuries of the brachiocephalic trunk and the aortic arch in the diagnosis and treatment of mechanical respiratory obstruction and during tracheotomy.