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Pediatric Emergency Care Feb 2022As trampoline use grows more popular in the United States, the frequency of injuries continues to climb. We hypothesized that toddlers would be at the highest risk for...
OBJECTIVE
As trampoline use grows more popular in the United States, the frequency of injuries continues to climb. We hypothesized that toddlers would be at the highest risk for trampoline injuries requiring hospitalization.
METHODS
The National Electronic Injury Surveillance System database was examined for trampoline injuries from 2009 to 2018. Patients were categorized into 3 main age groups: toddlers (<2 years), children (2-12 years), and adolescents (13-18 years). Regression models were used to identify patients at high risk for injury or hospitalization.
RESULTS
There was a total of 800,969 meeting inclusion criteria, with 433,827 (54.2%) occurring at their own homes and 86,372 (18.1%) at the sporting venue. Of the total, 36,789 (4.6%) were admitted to a hospital. Fractures (N = 270,884, 34%), strain/sprain injuries (N = 264,990, 33%), followed by skin contusions/abrasions (N = 115,708, 14%) were the most common diagnoses. The most frequent injury sites were lower and upper extremities accounting for 329,219 (41.1%) and 244,032 (30.5%), whereas 175,645 (21.9%) had head and neck injuries. Musculoskeletal injuries (74%) and concussions (2.6%) were more frequent in adolescents than children (67.6% and 1.6%) and toddlers (56.3% and 1.3%). Internal organ and soft tissue injuries were frequent in toddlers. There were no fatalities reported in the injured patients. Multivariate analysis showed adolescents, female sex, extremity injuries, and musculoskeletal injuries were associated with hospitalization. Injury at a sporting venue was not associated with hospitalization.
CONCLUSIONS
Adolescents and girls are at increased risk of trampoline injury, warranting hospitalization. Safety standards may help prevent extremity and musculoskeletal injuries in the pediatric population. Finally, use of trampolines at sporting venues does not appear to be particularly dangerous.
Topics: Adolescent; Athletic Injuries; Child; Female; Fractures, Bone; Hospitalization; Humans; Soft Tissue Injuries; Sprains and Strains; United States; Wounds and Injuries
PubMed: 34339161
DOI: 10.1097/PEC.0000000000002457 -
Systematic Reviews May 2018Exertional lower body musculoskeletal injuries (ELBI) cost billions of dollars and compromise the readiness and job performance of military service and public safety... (Meta-Analysis)
Meta-Analysis Review
Prevention of exertional lower body musculoskeletal injury in tactical populations: protocol for a systematic review and planned meta-analysis of prospective studies from 1955 to 2018.
BACKGROUND
Exertional lower body musculoskeletal injuries (ELBI) cost billions of dollars and compromise the readiness and job performance of military service and public safety workers (i.e., tactical populations). The prevalence and burden of such injuries underscores the importance of prevention efforts during activities necessary to sustain core occupational competencies. Attempts to synthesize prevention techniques specific to tactical populations have provided limited insight on the comparative efficacy of interventions that do not modify physical training practices. There is also a need to assess the influence of sex, exposure, injury classification scheme, and study design. Thus, the primary purpose of the systematic review and planned meta-analysis detailed in this protocol is to evaluate the comparative efficacy of ELBI prevention strategies in tactical populations.
METHODS
A systematic search strategy will be implemented in MEDLINE, EMBASE, Cochrane, and CINAHL. A multi-tiered process will be used to capture randomized controlled trials and prospective cohort studies that directly assess the prevention of ELBI in tactical population(s). Extracted data will be used to compare prevention strategies and assess the influence of heterogeneity related to occupation, sex, exposure, injury characteristics, and study quality. In addition, individual risk of bias, meta-bias, and the quality of the body of evidence will be rigorously tested.
DISCUSSION
This systematic review and planned meta-analysis will comprehensively evaluate ELBI mitigation strategies in tactical populations, elucidate factors that influence responses to treatment, and assess the overall quality of the body of research. Results of this work will guide the prioritization of ELBI prevention strategies and direct future research efforts, with direct relevance to tactical, health and rehabilitation science, and human performance optimization stakeholders.
SYSTEMATIC REVIEW REGISTRATION
The systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 3 Jan 2018 (registration number CRD42018081799 ).
Topics: Emergency Responders; Exercise; Humans; Lower Extremity; Military Personnel; Musculoskeletal System; Occupational Injuries; Prevalence; Wounds and Injuries
PubMed: 29729666
DOI: 10.1186/s13643-018-0730-9 -
Injury Oct 2020Composite tissue injuries are the result of high energy impacts caused by motor vehicle accidents, gunshot wounds or blasts. These are highly traumatic injuries... (Review)
Review
Composite tissue injuries are the result of high energy impacts caused by motor vehicle accidents, gunshot wounds or blasts. These are highly traumatic injuries characterized by wide-spread, penetrating wounds affecting the entire musculoskeletal system, and are generally defined by frank volumetric muscle loss with concomitant segmental bone defects. At the tissue level, the breadth of damage to multiple tissue systems, and potential for infection from penetration, have been shown to lead to an exaggerated, often chronic inflammatory response with subsequent dysregulation of normal musculoskeletal healing mechanisms. Aside from the direct effects of inflammation on myogenesis and osteogenesis, frank muscle loss has been shown to directly impair fracture union and ultimately contribute to failed wound regeneration. Care for these injuries requires extensive surgical intervention and acute care strategies. However, often these interventions do not adequately mitigate inflammation or promote proper musculoskeletal injury repair and force amputation of the limb. Therefore, identification of factors that can promote tissue regeneration and mitigate inflammation could be key to restoring wound healing after composite tissue injury. One such factor that may directly affect both inflammation and tissue regeneration in response to these multi-tissue injuries may be Vitamin D. Beyond traditional roles, the pleiotropic and localized actions of Vitamin D are increasingly being recognized in most aspects of wound healing in complex tissue injuries - e.g., regulation of inflammation, myogenesis, fracture callus mineralization and remodeling. Conversely, pre-existing Vitamin D deficiency leads to musculoskeletal dysfunction, increased fracture risk or fracture non-unions, decreased strength/function and reduced capacity to heal wounds through increased inflammation. This Vitamin D deficient state requires acute supplementation in order to quickly restore circulating levels to an optimal level, thereby facilitating a robust wound healing response. Herein, the purpose of this review is to address the roles and critical functions of Vitamin D throughout the wound healing process. Findings from this review suggest that careful monitoring and/or supplementation of Vitamin D may be critical for wound regeneration in composite tissue injuries.
Topics: Bony Callus; Fractures, Bone; Humans; Vitamin D; Wound Healing; Wounds, Gunshot
PubMed: 32624209
DOI: 10.1016/j.injury.2020.06.023 -
Nature Communications Aug 2021Pain is a central feature of soft tissue trauma, which under certain contexts, results in aberrant osteochondral differentiation of tissue-specific stem cells. Here, the...
Pain is a central feature of soft tissue trauma, which under certain contexts, results in aberrant osteochondral differentiation of tissue-specific stem cells. Here, the role of sensory nerve fibers in this abnormal cell fate decision is investigated using a severe extremity injury model in mice. Soft tissue trauma results in NGF (Nerve growth factor) expression, particularly within perivascular cell types. Consequently, NGF-responsive axonal invasion occurs which precedes osteocartilaginous differentiation. Surgical denervation impedes axonal ingrowth, with significant delays in cartilage and bone formation. Likewise, either deletion of Ngf or two complementary methods to inhibit its receptor TrkA (Tropomyosin receptor kinase A) lead to similar delays in axonal invasion and osteochondral differentiation. Mechanistically, single-cell sequencing suggests a shift from TGFβ to FGF signaling activation among pre-chondrogenic cells after denervation. Finally, analysis of human pathologic specimens and databases confirms the relevance of NGF-TrkA signaling in human disease. In sum, NGF-mediated TrkA-expressing axonal ingrowth drives abnormal osteochondral differentiation after soft tissue trauma. NGF-TrkA signaling inhibition may have dual therapeutic use in soft tissue trauma, both as an analgesic and negative regulator of aberrant stem cell differentiation.
Topics: Animals; Axons; Cartilage; Cell Differentiation; Mice; Mice, Inbred C57BL; Nerve Growth Factor; Osteogenesis; Receptor, trkA; Signal Transduction; Stem Cells; Wounds and Injuries
PubMed: 34400627
DOI: 10.1038/s41467-021-25143-z -
Journal of Orthopaedic Research :... Apr 2020In this review, we highlight themes from a recent workshop focused on "Plasticity of Cell Fate in Musculoskeletal Tissues" held at the Orthopaedic Research Society's... (Review)
Review
In this review, we highlight themes from a recent workshop focused on "Plasticity of Cell Fate in Musculoskeletal Tissues" held at the Orthopaedic Research Society's 2019 annual meeting. Experts in the field provided examples of mesenchymal cell plasticity during normal musculoskeletal development, regeneration, and disease. A thorough understanding of the biology underpinning mesenchymal cell plasticity may offer a roadmap for promoting regeneration while attenuating pathologic differentiation. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:708-718, 2020.
Topics: Animals; Cell Differentiation; Cell Plasticity; Disease; Humans; Musculoskeletal Development; Myositis Ossificans; Ossification, Heterotopic; Regeneration; Wounds and Injuries
PubMed: 31721278
DOI: 10.1002/jor.24523 -
European Journal of Trauma and... Apr 2016The widespread availability of ultrasound (US) technology has increased its use for point of care applications in many health care settings. Focused (point of care) US... (Review)
Review
The widespread availability of ultrasound (US) technology has increased its use for point of care applications in many health care settings. Focused (point of care) US is defined as the act of bringing US evaluation to the bedside for real-time performance. These images are collected immediately by the practitioner, allowing for direct integration into the physician's medical decision-making process. The real-time bedside diagnostic ability of US becomes a key tool for the management of patients. The purpose of this review is to (1) provide a general description of the use of focused US for bedside procedures; (2) specify the indications and common techniques used in bedside US procedures; and (3) describe the techniques used for each bedside intervention.
Topics: Clinical Decision-Making; Early Medical Intervention; Humans; Musculoskeletal Diseases; Point-of-Care Systems; Ultrasonics; Ultrasonography; Wounds and Injuries
PubMed: 26059560
DOI: 10.1007/s00068-015-0539-3 -
Pediatric Emergency Medicine Practice Sep 2017Upper and lower extremity injuries are common in children, with an overall risk of fracture estimated at just under 1 in 5 children. Pediatric bone anatomy and... (Review)
Review
Upper and lower extremity injuries are common in children, with an overall risk of fracture estimated at just under 1 in 5 children. Pediatric bone anatomy and physiology produce age specific injury patterns and conditions that are unique to children, which can make accurate diagnosis difficult for emergency clinicians. This issue reviews the etiology and pathophysiology of child-specific fractures, as well as common injuries of the upper and lower extremities. Evidence-based recommendations for management of pediatric fractures, including appropriate diagnostic studies and treatment, are also discussed.
Topics: Arm Injuries; Child; Child, Preschool; Diagnosis, Differential; Emergency Service, Hospital; Evidence-Based Medicine; Fracture Fixation; Fractures, Bone; Humans; Infant; Infant, Newborn; Leg Injuries; Musculoskeletal System
PubMed: 28825959
DOI: No ID Found -
Journal of Dance Medicine & Science :... Dec 2015The objective of this study was to provide an epidemiological review of the literature concerning ballet injuries affecting pre-professional ballet dancers. The... (Review)
Review
The objective of this study was to provide an epidemiological review of the literature concerning ballet injuries affecting pre-professional ballet dancers. The literature search was limited to published peer-reviewed reports and involved an extensive examination of Scopus, SPORTDiscus, and CINAHL. The following search terms were used in various combinations: ballet, injury, epidemiology, risk factor, pre-professional, and intervention. Additional citations were located using the ancestry approach. Unlike some other athletic activities that have been the focus of recent intervention research, there is a paucity of intervention and translational research in pre-professional ballet, and sample sizes have often been small and have not accounted for the multivariate nature of ballet injury. Exposure-based injury rates in this population appear similar to those reported for professional ballet dancers and female gymnasts. A preponderance of injuries affect the lower extremity of these dancers, with sprains and strains being the most frequent type of injury reported. The majority of injuries appear to be overuse in nature. Injury risk factors have been tested in multiple studies and indicate a variety of potential injury predictors that may provide useful guidance for future research.
Topics: Age Factors; Ankle Injuries; Athletic Injuries; Cumulative Trauma Disorders; Dancing; Female; Humans; Knee Injuries; Low Back Pain; Male; Musculoskeletal Diseases; Primary Prevention; Risk Factors
PubMed: 26641701
DOI: 10.12678/1089-313X.19.4.140 -
World Journal of Surgery Apr 2020The burden of musculoskeletal conditions is growing worldwide. In low- and middle-income countries (LMIC), the burden cannot be fully estimated, due to paucity of... (Review)
Review
BACKGROUND
The burden of musculoskeletal conditions is growing worldwide. In low- and middle-income countries (LMIC), the burden cannot be fully estimated, due to paucity of credible data. Further, no attempt has been made so far to estimate surgical burden of musculoskeletal conditions. This is a difficult task and accurate estimation of what would constitute surgical burden out of the total musculoskeletal burden in LMIC is not possible, due to number of constraints.
METHODS
This review looks at current understanding of the musculoskeletal conditions, that can be measured in LMIC and the limitations based on previous studies and past global burden of diseases estimates.
RESULTS
An attempt has been made to identify major conditions where a range of surgical burden can be predicted.
CONCLUSION
We conclude that there is huge scope for improvement in the current surveillance mechanism of surgical procedures undertaken for musculoskeletal conditions in LMIC so that the surgical burden can be more accurately predicted. Unless this burden can be highlighted, the attention to these conditions in LMIC will be limited.
Topics: Developing Countries; Global Health; Humans; Income; Musculoskeletal Diseases; Musculoskeletal System; Orthopedic Procedures; Wounds and Injuries
PubMed: 30238386
DOI: 10.1007/s00268-018-4790-8 -
The Journal of Surgical Research Jan 2017Platelets are small anucleate cytoplasmic cell bodies released by megakaryocytes in response to various physiologic triggers. Traditionally thought to be solely involved... (Review)
Review
Platelets are small anucleate cytoplasmic cell bodies released by megakaryocytes in response to various physiologic triggers. Traditionally thought to be solely involved in the mechanisms of hemostasis, platelets have gained much attention due to their involvement wound healing, immunomodulation, and antiseptic properties. As the field of surgery continues to evolve so does the need for therapies to aid in treating the increasingly complex patients seen. With over 14 million obstetric, musculoskeletal, and urological and gastrointestinal surgeries performed annually, the healing of surgical wounds continues to be of upmost importance to the surgeon and patient. Platelet-rich plasma, or platelet concentrate, has emerged as a possible adjuvant therapy to aid in the healing of surgical wounds and injuries. In this review, we will discuss the wound healing properties of platelet-rich plasma and various surgical applications.
Topics: Biomimetics; Blood Component Transfusion; Blood Platelets; Blood Transfusion, Autologous; Humans; Platelet-Rich Plasma; Surgical Wound; Wound Healing
PubMed: 27979486
DOI: 10.1016/j.jss.2016.08.063