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Injury Dec 2019
Topics: Cost of Illness; Global Health; Humans; Infections; Musculoskeletal Diseases; Outcome and Process Assessment, Health Care; Patient Care Management; Quality Improvement; Wounds and Injuries
PubMed: 31727403
DOI: 10.1016/j.injury.2019.11.001 -
Seminars in Musculoskeletal Radiology Oct 2023"Whiplash," a term describing the severe acceleration and deceleration forces applied to the head, craniocervical junction (CCJ), and cervical spine during trauma, is...
"Whiplash," a term describing the severe acceleration and deceleration forces applied to the head, craniocervical junction (CCJ), and cervical spine during trauma, is one of the most frequent mechanisms of injury to the CCJ. The CCJ is a complex region at the transition of the cranium and the cervical spine, essential for maintaining craniocervical stability. In whiplash injuries, the CCJ may be compromised due to underlying ligamentous or, less frequently, osseous, intravertebral disk and/or muscular lesions. Imaging is crucial in detecting acute lesions but may also play a role in the follow-up of chronic pathology because soft tissue lesions and progressive disk pathology could contribute to a whiplash-associated disorder.
Topics: Humans; Whiplash Injuries; Diagnostic Imaging; Ligaments; Cervical Vertebrae; Musculoskeletal Diseases
PubMed: 37816359
DOI: 10.1055/s-0043-1772170 -
Injury Dec 2023With the advent of mixed martial arts (MMA) growing in popularity, there has been a described increase in its participation. The term MMA generally describes the...
INTRODUCTION
With the advent of mixed martial arts (MMA) growing in popularity, there has been a described increase in its participation. The term MMA generally describes the hybridization of combat disciplines including but not limited to: karate, judo, jiu-jitsu, wrestling, taekwondo, boxing, kickboxing, and Muay Thai. With increased participation in MMA and martial arts, differing physical demands are placed on participants. Due to the physical nature of combat sports, there are injuries associated with participation. The purpose of this study is to report the incidence and characteristics of injuries seen from various martial art disciplines presenting to United States Emergency Rooms in order to educate participants and providers alike about risks assumed with participating in martial arts.
METHODS
The National Electronic Injury Surveillance System (NEISS) database was queried for martial arts-related injuries from 2009 to 2019. Cases were examined and data including patient age and gender, injury type and location, hospital disposition, and type of martial arts practiced were extracted.
RESULTS
A total of 8,400 injuries were recorded, leading to a national estimate of 310,143 martial-arts related injuries over the 11 year period of 2009-2019 (95 % CI 239,063-381,223). The most common types of injuries were strains/sprains (n = 2664, 31.7 %), fractures (n = 1,575, 18.8 %), and contusions/abrasions (n = 1,698, 20.2 %). There were 260 dislocations, with shoulder dislocations being most common (n = 96, 36.9 %). Lower extremities were affected more frequently than upper extremities (n = 3566, 42.5 % versus n = 3026, 36.0 %), with the knee being the single most common location of injury (n = 811, 9.7 %). Males more commonly sustained fractures (19.7 % versus 17.4 %, p = 0.03) and dislocations (3.5 % versus 2.4 %, p = 0.01) when compared to females. Ankle injuries were more common in females than males (10.4 % versus 6.0 %, p < 0.001). Only 2.2 % of patients required admission to the hospital. Risk factors for admission included patients >35 years of age and male sex.
CONCLUSION
Martial arts injuries are a significant source of musculoskeletal injuries among patients presenting to US emergency rooms. Lower extremity injuries are seen most frequently, with patients rarely requiring hospital admission. Using this information, both providers and participants may be better equipped to make educated decisions on injury prevention and treatment.
Topics: Female; Humans; Male; Martial Arts; Wrestling; Joint Dislocations; Upper Extremity; Fractures, Bone; Emergency Service, Hospital; Athletic Injuries
PubMed: 37867023
DOI: 10.1016/j.injury.2023.111089 -
Journal of Back and Musculoskeletal... 2022
Topics: Athletic Injuries; Humans; Musculoskeletal System
PubMed: 35662105
DOI: 10.3233/BMR-225002 -
British Journal of Sports Medicine May 2024To determine the prevalence and incidence of musculoskeletal injury in amateur and professional golfers, and to identify common injury sites and factors associated with... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To determine the prevalence and incidence of musculoskeletal injury in amateur and professional golfers, and to identify common injury sites and factors associated with increased injury frequency.
DESIGN
Systematic epidemiological review and meta-analysis.
DATA SOURCES
PubMed (Medline), Embase, the Cochrane Library and SPORTDiscus were searched in September 2023.
ELIGIBILITY CRITERIA
Studies published in the English language reporting the incidence or prevalence of musculoskeletal injuries in golfers at all anatomical sites.
RESULTS
20 studies (9221 golfers, 71.9% male, 28.1% female) were included, with mean age 46.8 years. Lifetime injury prevalence was significantly greater in professional golfers (73.5% (95% CI: 47.3% to 93.0%)) than amateur golfers (56.6% (95% CI: 47.4% to 65.5%); relative risk (RR)=1.50, p<0.001). Professional golfers had a significantly greater lifetime prevalence of hand and wrist (RR=3.33, p<0.001) and lower back injury (RR=3.05, p<0.001). Soft tissue injuries were most common, and diagnoses were typically non-specific. Injury frequency was not associated with age or sex. Two studies reported a greater injury risk in amateur golfers playing more than three and four rounds per week.
CONCLUSION
Over half of golfers are at risk of sustaining a musculoskeletal injury during their lifetime. Risks and patterns of injury differ between professional and amateur golfers, with professionals significantly more likely to develop lower back, and hand and wrist injuries. A recent international consensus statement on the reporting of injury and illness in golf should aid consistency in future research assessing the epidemiology of specific diagnoses, informing golf injury prevention and management strategies.
PROSPERO REGISTRATION NUMBER
CRD42023408738.
Topics: Humans; Athletic Injuries; Back Injuries; Golf; Hand Injuries; Incidence; Musculoskeletal System; Prevalence; Risk Factors; Soft Tissue Injuries; Wrist Injuries; Male; Female; Middle Aged
PubMed: 38508702
DOI: 10.1136/bjsports-2023-107324 -
World Journal of Surgery Apr 2020Though declining in the recent decades, high-energy musculoskeletal trauma remains a major contributor to the burden of disease in high-income countries (HICs). However,... (Review)
Review
INTRODUCTION TO THE PROBLEM
Though declining in the recent decades, high-energy musculoskeletal trauma remains a major contributor to the burden of disease in high-income countries (HICs). However, due to limitations in the available body of the literature, evaluation of this burden is challenging. The purpose of this review is to assess: (1) the current epidemiologic data on the surgical burden of high-energy musculoskeletal trauma in HICs; (2) the current data on the economic impact of high-energy musculoskeletal trauma; and (3) potential strategies for addressing gaps in musculoskeletal trauma care for the future.
REVIEW OF LITERATURE
In 2016, mortality from road traffic injuries (RTIs) between the ages of 15-49 was reported to be 9.5% (9.0-9.9) in high-income countries, accounting for approximately 255 million DALYs. While RTIs do not fully capture the extent of high-energy musculoskeletal trauma, as the most common mechanism, they serve as a useful indicator of the impact on the surgical and economic burden. In 2009, the global losses related to RTIs were estimated to be 518 billion USD, costing governments between 1 and 3% of their gross domestic product (GDP). In the last decade, both the total direct per-person healthcare cost and the incremental direct per-person costs for those with a musculoskeletal injury in the USA rose 75 and 58%, respectively.
FUTURE DIRECTIONS
ADDRESSING THE GAPS: While its impact is large, research on musculoskeletal conditions, including high-energy trauma, is underfunded compared to other fields of medicine. An increased awareness among policy makers and healthcare professionals of the importance of care for the high-energy musculoskeletal trauma patient is critical. Full implementation of trauma systems is imperative, and metrics such as the ICD-DALY have the potential to allow for real-time evaluation of prevention and treatment programs aimed to reduce injury-related morbidity and mortality. The dearth in knowledge in optimal and cost-effective post-acute care for high-energy musculoskeletal trauma is a reason for concern, especially since almost half of the costs are attributed to this phase of care. Multidisciplinary rehabilitation teams as part of a musculoskeletal trauma system may be of interest to decrease further the long-term negative effects and the economic burden of high-energy musculoskeletal trauma.
Topics: Accidental Falls; Accidents, Traffic; Adolescent; Adult; Aged; Developed Countries; Female; Gross Domestic Product; Health Care Costs; Humans; Income; Male; Middle Aged; Musculoskeletal System; Quality-Adjusted Life Years; Wounds and Injuries; Young Adult
PubMed: 30043200
DOI: 10.1007/s00268-018-4742-3 -
Injury Feb 2023Early patient assessment is relevant for surgical decision making in severely injured patients and early definitive surgery is known to be beneficial in stable patients.... (Review)
Review
INTRODUCTION
Early patient assessment is relevant for surgical decision making in severely injured patients and early definitive surgery is known to be beneficial in stable patients. The aim of this systematic review is to extract parameters indicative of risk factors for adverse outcome. Moreover, we aim to improve decision making and separate patients who would benefit from early versus staged definitive surgical fixation.
METHODS
Following the PRISMA guidelines, a systematic review of peer-reviewed articles in English or German language published between (2000 and 2022) was performed. The primary outcome was the pathophysiological response to polytrauma including coagulopathy, shock/haemorrhage, hypothermia and soft tissue injury (trauma, brain injury, thoracic and abdominal trauma, and musculoskeletal injury) to determine the treatment strategy associated with the least amount of complications. Articles that had used quantitative parameters to distinguish between stable and unstable patients were summarized. Two authors screened articles and discrepancies were resolved by consensus. Quantitative values for relevant parameters indicative of an unstable polytrauma patient were obtained.
RESULTS
The initial systematic search using MeSH criteria yielded 1550 publications deemed relevant to the following topics (coagulopathy (n = 37), haemorrhage/shock (n = 7), hypothermia (n = 11), soft tissue injury (n = 24)). Thresholds for stable, borderline, unstable and in extremis conditions were defined according to the existing literature as follows: Coagulopathy; International Normalized Ratio (INR) and viscoelastic methods (VEM)/Blood/shock; lactate, systolic blood pressure and haemoglobin, hypothermia; thresholds in degrees Celsius/Soft tissue trauma: traumatic brain injury, thoracic and abdominal trauma and musculoskeletal trauma.
CONCLUSION
In this systematic literature review, we summarize publications by focusing on different pathways that stimulate pathophysiological cascades and remote organ damage. We propose that these parameters can be used for clinical decision making within the concept of safe definitive surgery (SDS) in the treatment of severely injured patients.
Topics: Humans; Hypothermia; Fracture Fixation; Fractures, Bone; Multiple Trauma; Soft Tissue Injuries; Abdominal Injuries
PubMed: 36404162
DOI: 10.1016/j.injury.2022.11.008 -
Skeletal Radiology Dec 2022Professional tennis tournaments have onsite sports medicine physicians who oversee the athletes' overall health during competition, including musculoskeletal injury and...
Professional tennis tournaments have onsite sports medicine physicians who oversee the athletes' overall health during competition, including musculoskeletal injury and general illnesses. The medical team is composed of orthopedic and non-operative sports medicine physicians. Frequently, the tournament doctors require imaging to localize and grade musculoskeletal injuries and to make decisions regarding treatment, safe training, and return to match play. The most versatile and readily available imaging modality to evaluate for acute musculoskeletal injury is point-of-care ultrasonography. In 2015, a dedicated radiology service was created at the US Open by bringing in a musculoskeletal radiologist who would perform ultrasounds in a formal and consistent manner. In addition, the radiologist was tasked with onsite radiography as well as review of all MRI examinations done at the imaging center. This article describes how this radiology service was implemented, what types of studies were performed and the advantages of having an onsite musculoskeletal radiologist at the tournament. This service allowed the medical team to provide the comprehensive and efficient medical care required in a major professional tennis event. It also showed the value of having the in-person expertise of the musculoskeletal radiologist in the sports medicine team. This same model could be applied to other professional sporting events.
Topics: Athletes; Athletic Injuries; Humans; Musculoskeletal Diseases; Point-of-Care Systems; Radiology; Sports; Tennis
PubMed: 35876863
DOI: 10.1007/s00256-022-04128-z -
AJR. American Journal of Roentgenology Dec 2019Blunt pelvic trauma is associated with injuries to the musculoskeletal, lower genitourinary, and vascular systems, leading to significant morbidity and mortality. This... (Review)
Review
Blunt pelvic trauma is associated with injuries to the musculoskeletal, lower genitourinary, and vascular systems, leading to significant morbidity and mortality. This article provides a comprehensive review of these injuries, reviews classification systems that are helpful in predicting prognosis, describes the most appropriate imaging tests for injury detection, and emphasizes the role that interventional radiology plays in the setting of pelvic trauma. Blunt pelvic injuries can involve the musculoskeletal, genitourinary, and vascular systems, often concomitantly, making it imperative for radiologists to recognize injury patterns and understand implications for management. Injury classifications can be helpful in determining management and predicting prognosis. Contrast-enhanced CT is the imaging modality test of choice in evaluating pelvic trauma, and protocols should be optimized for best detection of injuries. Transcatheter arterial embolization plays a critical role in stopping acute hemorrhage and improving clinical outcomes.
Topics: Fractures, Bone; Humans; Pelvic Bones; Urogenital System; Vascular System Injuries; Wounds, Nonpenetrating
PubMed: 31613662
DOI: 10.2214/AJR.18.21050 -
Clinics in Sports Medicine Oct 2019Athletic trainers, physical therapists, and team physicians have differing roles when providing care, yet often need to collaborate. Athletic trainers and physical... (Review)
Review
Athletic trainers, physical therapists, and team physicians have differing roles when providing care, yet often need to collaborate. Athletic trainers and physical therapists use a variety of therapeutic modalities and manual therapy techniques in conjunction with rehabilitation exercises to improve outcomes. Clinicians must be knowledgeable of the scientific rationale for each modality to choose the most effective treatment for the specific condition and stage of recovery. The team physician should be familiar with the use of common procedures in an athletic training room. Here, we review the most current evidence and the basic methods encountered in athletic training room settings.
Topics: Athletic Injuries; Compression Bandages; Cryotherapy; Cupping Therapy; Ear Diseases; Electric Stimulation Therapy; Exercise Therapy; Hematoma; Humans; Hyperthermia, Induced; Lacerations; Massage; Nails; Physical Therapy Modalities; Suture Techniques; Ultrasonic Therapy
PubMed: 31472770
DOI: 10.1016/j.csm.2019.06.006