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American Journal of Industrial Medicine Aug 1997Occupational injuries continue to exact a great toll on American workers and their employers--the physical and financial costs are enormous. However, in the current... (Review)
Review
Occupational injuries continue to exact a great toll on American workers and their employers--the physical and financial costs are enormous. However, in the current political climate, few employers or regulatory agencies will implement injury prevention interventions without specific evidence of their effectiveness. This paper reviews the literature on the design, conduct, and evaluation of occupational injury interventions. Our review suggests that randomized controlled trials are rare and also notes that the quasi-experimental studies in the literature often use the weakest designs. We recommend a hierarchical approach to evaluating occupational injury interventions--beginning with qualitative studies, following up with simple quasi-experimental designs using historical controls, continuing with more elaborate quasi-experimental designs comparing different firms' experience, and, when necessary, implementing randomized controlled trials.
Topics: Accidents, Occupational; Cost-Benefit Analysis; Health Promotion; Humans; Musculoskeletal Diseases; Occupational Diseases; Occupational Health; Outcome Assessment, Health Care; Program Evaluation; Randomized Controlled Trials as Topic; Research Design; Wounds and Injuries
PubMed: 9215438
DOI: 10.1002/(sici)1097-0274(199708)32:2<164::aid-ajim7>3.0.co;2-z -
Disaster Medicine and Public Health... Jun 2018On April 20, 2013, a 7.0-magnitude earthquake hit Lushan County, Ya'an City, Sichuan Province in southwest China. West China Hospital of Sichuan University, the largest...
On April 20, 2013, a 7.0-magnitude earthquake hit Lushan County, Ya'an City, Sichuan Province in southwest China. West China Hospital of Sichuan University, the largest and best hospital in Sichuan Province, is located in the city of Chengdu-about 100 km from the epicenter-and provided medical treatment to a total of 400 seismic patients. In this article, we retrospectively investigated 199 patients with musculoskeletal injuries who were treated in the Department of Orthopedics. Based on the seismic intensity distribution map, injury-occurring locations were divided into 5 grade-related areas: IX, VIII, VII, VI, and ≤V grade-area. The characteristics of seismic injuries were analyzed according to the geographic distribution of victims. We found that the constituent ratio of injury causes significantly differed in different earthquake areas according to the seismic intensity. (Disaster Med Public Health Preparedness. 2018; 12: 408-410).
Topics: Adolescent; Adult; Aged; China; Earthquakes; Female; Humans; Male; Middle Aged; Musculoskeletal Diseases; Retrospective Studies; Wounds and Injuries
PubMed: 30084339
DOI: 10.1017/dmp.2016.78 -
The Journal of Bone and Joint Surgery.... Jun 2012The prevalence of obesity among children and adults is increasing worldwide. There are substantial health risks and financial costs associated with the obesity epidemic... (Comparative Study)
Comparative Study Review
The prevalence of obesity among children and adults is increasing worldwide. There are substantial health risks and financial costs associated with the obesity epidemic that impact the practice of orthopaedic surgery. Patients with increased body mass index are more prone to sustaining distal extremity injuries than are those with a normal body mass index. Obese individuals are more likely than nonobese individuals to seek treatment for osteoarthritis of the knee.
Topics: Adolescent; Adult; Age Distribution; Body Mass Index; Child; Female; Humans; Injury Severity Score; Male; Middle Aged; Musculoskeletal Diseases; Obesity; Orthopedic Procedures; Osteoarthritis, Hip; Osteoarthritis, Knee; Postoperative Complications; Prognosis; Reference Values; Risk Assessment; Sex Distribution; United States; Wounds and Injuries
PubMed: 22637211
DOI: 10.2106/JBJS.K.00330 -
Sports Medicine (Auckland, N.Z.) Jan 2010Over the last decade, the sport of mountain biking has experienced extensive growth in youth participation. Due to the unpredictable nature of outdoor sport, a lack of... (Review)
Review
Over the last decade, the sport of mountain biking has experienced extensive growth in youth participation. Due to the unpredictable nature of outdoor sport, a lack of rider awareness and increased participation, the number of injuries has unnecessarily increased. Many believe that the actual incidence of trauma in this sport is underestimated and is just the 'tip of the iceberg'. The most common mechanism of injury is usually attributed to downhill riding and forward falling. Although rare, this type of fall can result in serious cranial and thoraco-abdominal trauma. Head and neck trauma continue to be documented, often resulting in concussions and the possibility of permanent neurological sequelae. Upper limb injuries range from minor dermal abrasions, contusions and muscular strains to complex particular fracture dislocations. These are caused by attempting to arrest the face with an outstretched hand, leading to additional direct injury. Common overuse injuries include repeated compression from the handlebars and vibration leading to neurovascular complications in the hands. Along with reports of blunt abdominal trauma and lumbar muscle strains, lower extremity injuries may include various hip/pelvic/groin contusions, patellofemoral inflammation, and various muscle strains. The primary causes of mountain biking injuries in children and adolescents include overuse, excessive fatigue, age, level of experience, and inappropriate or improperly adjusted equipment. Additional factors contributing to trauma among this age group involve musculoskeletal immaturity, collisions and falls, excessive speed, environmental conditions, conditioning and fitness status of the rider, nonconservative behavioural patterns, and inadequate medical care. The limited available data restrict the identification and understanding of specific paediatric mountain biking injuries and injury mechanisms. Education about unnecessary risk of injury, use of protective equipment, suitable bikes and proper riding technique, coupled with attentive and proper behaviour, are encouraged to reduce unnecessary injury. This article provides information on the causation and risk factors associated with injury among young mountain bikers, and recommendations to minimize trauma and enhance optimal performance and long-term enjoyment in this outdoor sport.
Topics: Adolescent; Athletic Injuries; Bicycling; Child; Female; Humans; Incidence; Male; United States; Wounds and Injuries
PubMed: 20020788
DOI: 10.2165/11319640-000000000-00000 -
Bone Apr 2018In the mature adult skeleton, new bone formation is normally restricted to regeneration of osseous tissue at sites of fracture. However, heterotopic ossification, or the...
In the mature adult skeleton, new bone formation is normally restricted to regeneration of osseous tissue at sites of fracture. However, heterotopic ossification, or the formation of bone outside the normal skeleton, can occur within muscle, adipose, or fibrous connective tissue. Periarticular non-hereditary heterotopic ossification (NHHO) may occur after musculoskeletal trauma, following CNS injury, with certain arthropathies, or following injury or surgery that is often sustained in the context of age-related pathology. The histological mechanism of bone development in these forms of heterotopic ossification has thus far been uncharacterized. We performed a histological analysis of 90 bone specimens from 18 patients with NHHO secondary to defined precipitating conditions, including traumatic brain injury, spinal cord injury, cerebrovascular accident, trauma without neurologic injury, and total hip or knee arthroplasty. All bone specimens revealed normal endochondral osteogenesis at heterotopic sites. We defined the order of sequence progression in NHHO lesion formation as occurring through six distinct histological stages: (1) perivascular lymphocytic infiltration, (2) lymphocytic migration into soft tissue, (3) reactive fibroproliferation, (4) neovascularity, (5) cartilage formation, and (6) endochondral bone formation. This study provides the first systematic evaluation of the predominant histopathological findings associated with multiple forms of NHHO and shows that they share a common mechanism of lesion formation.
Topics: Adult; Aged; Brain Injuries, Traumatic; Cell Movement; Female; Humans; Immunohistochemistry; Male; Middle Aged; Ossification, Heterotopic; Osteogenesis; Spinal Cord Injuries; Stroke; Wounds and Injuries; Young Adult
PubMed: 29225159
DOI: 10.1016/j.bone.2017.12.006 -
Veterinary Journal (London, England :... Mar 2011Musculoskeletal injury is the most common cause of lost training days in the young Thoroughbred horse in flat race training. To date, there has been little investigation...
Musculoskeletal injury is the most common cause of lost training days in the young Thoroughbred horse in flat race training. To date, there has been little investigation of the regional patterns of injury frequently observed by clinicians in racehorse practice. The present study was conducted to determine incidence of musculoskeletal injuries in Thoroughbreds in training in Newmarket, United Kingdom. Veterinary records for all horses resident in three large (>100 horse) training yards were assessed for occurrence of significant musculoskeletal injury. A total of 248 injuries were recorded in 217 individual horses, from a total population of 616 individual horses; fractures of the tibia (20.7%) and proximal phalanx (14.5%) were the most common. Overall injury rates were similar between yards (23-26%/year), with seasonal patterns noted for some injury types. Incidence of certain injuries (P1, metacarpal/metatarsal condylar, pelvic fractures, and superficial digital flexor tendonitis) varied between yards. The majority of carpal, P1 fracture and SDF tendonitis cases were right-sided.
Topics: Animals; Female; Fractures, Bone; Horse Diseases; Horses; Incidence; Lameness, Animal; Male; Musculoskeletal Diseases; Musculoskeletal System; Pedigree; Physical Conditioning, Animal; Seasons; United Kingdom; Wounds and Injuries
PubMed: 20089426
DOI: 10.1016/j.tvjl.2009.12.019 -
Journal of Orthopaedic Surgery (Hong... Apr 2011To report injury patterns and management of musculoskeletal injuries after an earthquake. (Comparative Study)
Comparative Study
PURPOSE
To report injury patterns and management of musculoskeletal injuries after an earthquake.
METHODS
94 male and 161 female patients aged 17 to 90 (mean, 53) years underwent surgery for musculoskeletal injuries. Their injury patterns, anaesthesia administered, surgeries undertaken, and development of postoperative complications were reviewed.
RESULTS
Of the 255 patients, 155 sustained superficial lacerations with minor soft-tissue contusion, whereas 100 sustained injuries that necessitated surgery under anaesthesia. The injuries involved the tibia/ankle (n=90), the hand (n=48), the pelvis/femur (n=41), the radius/ulnar (n=36), the foot (n=20), the humerus (n=10), and the spine (n=10). 30 (12%) of the patients had multiple injuries. The most common procedure performed was debridement (n=58), followed by open reduction and internal fixation with plates and screws for closed fractures (n=20), Kirschner wiring (n=11), external fixation (n=8), and general surgery and others (n=6). Repeated debridements were performed for 19 open fractures; 10 involved the distal tibia. 63 procedures were carried out under anaesthesia or sedation. General anaesthesia involved 2 patients; one had a right hemi-colectomy for an ischaemic bowel and another had an appendicectomy. Regional anaesthesia included sub-arachnoid block for lowerlimb surgeries (n=21), axillary brachial plexus block for upper-limb surgeries (n=11), and femoral and sciatic nerve blocks for a lower-limb surgery (n=1). The remaining 28 procedures involved conscious sedation. The mean number of debridements for open fractures was 2.8 (range, 2-5). The mean followup duration was 10.4 (range, 7-14) days. Only one patient developed a postoperative wound infection.
CONCLUSION
Our team was effective in managing orthopaedic injuries after an earthquake. The postoperative complication rate was low. Regional and spinal anaesthesia are relatively safe alternatives to general anaesthesia when carried out under such austere circumstances. The success of the mission depended on collaboration with the local health care workers and external agencies.
Topics: Adolescent; Adult; Aged; Anesthesia; Disasters; Earthquakes; Female; Follow-Up Studies; Humans; Indonesia; Male; Middle Aged; Multiple Trauma; Musculoskeletal Diseases; Musculoskeletal System; Orthopedic Procedures; Prevalence; Retrospective Studies; Survival Rate; Trauma Severity Indices; Treatment Outcome; Wounds and Injuries; Young Adult
PubMed: 21519067
DOI: 10.1177/230949901101900102 -
The Journal of the American Academy of... Jan 2020We sought to characterize the prevalence of methamphetamine (MA) abuse and associated orthopaedic injury patterns at our level 1 trauma center. (Observational Study)
Observational Study
INTRODUCTION
We sought to characterize the prevalence of methamphetamine (MA) abuse and associated orthopaedic injury patterns at our level 1 trauma center.
METHODS
We conducted a retrospective review of all orthopaedic consults for the year 2016. Patients were classified as MA users based on urine toxicology results and social history.
RESULTS
The prevalence of MA use was 10.0%. MA users were more likely to present with hand lacerations and other infections (P < 0.05 for all). Regarding the mechanism of injury, MA users were more likely to be involved in automobile versus pedestrian, automobile versus bicycle, ballistic, knife, closed fist, other assault/altercation, and animal bite injuries (P < 0.05 for all).
DISCUSSION
MA use is prevalent at our level 1 trauma center. The prevalence and injury patterns of MA abuse warrant deeper study into the effects of this drug on orthopaedic outcomes.
LEVEL OF EVIDENCE
Level III.
Topics: Adult; Amphetamine-Related Disorders; Female; Humans; Male; Methamphetamine; Middle Aged; Musculoskeletal System; Retrospective Studies; Trauma Centers; Wounds and Injuries
PubMed: 30985479
DOI: 10.5435/JAAOS-D-18-00618 -
The Journal of Surgical Research May 2020Management of orthopedic injuries is a critical component of comprehensive trauma care. As patterns of injury incidence and recovery change in the face of emerging...
BACKGROUND
Management of orthopedic injuries is a critical component of comprehensive trauma care. As patterns of injury incidence and recovery change in the face of emerging injury prevention efforts and technologies and an aging US population, assessment of the burden of orthopedic injury is essential to optimize trauma system planning. We sought to estimate the incidence of orthopedic injury requiring emergency orthopedic surgery in the United States.
METHODS
Using nationally representative samples from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project, we estimated the incidence of orthopedic injury, polytrauma with orthopedic injury, and emergency operative orthopedic procedures performed for the management of traumatic injury. We used multivariable logistic regression to identify patient, injury, and hospital characteristics associated with odds of emergency orthopedic surgery.
RESULTS
A total of 7,214,915 patients were diagnosed with orthopedic injury in 2013-2014, resulting in 1,167,656 emergency orthopedic surgical procedures. Fall-related injuries accounted for 51% of health care encounters and 61% of emergency orthopedic surgical procedures. Odds of emergency orthopedic surgery were 2.04 times greater for patients with polytrauma, compared with isolated orthopedic injury (P < 0.001).
CONCLUSIONS
The total burden or orthopedic injury in the United States is substantial, and there is considerable heterogeneity in demand for care and practice patterns in the orthopedic trauma community. Population-based trauma system planning and tailored care delivery models would likely optimize initial treatment, recovery, and health outcomes for orthopedic trauma patients.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Cross-Sectional Studies; Emergency Service, Hospital; Female; Health Planning; Humans; Injury Severity Score; Male; Middle Aged; Musculoskeletal System; Orthopedic Procedures; Retrospective Studies; Trauma Centers; United States; Wounds and Injuries; Young Adult
PubMed: 31991329
DOI: 10.1016/j.jss.2019.12.023 -
Journal of Occupational Medicine. :... Jun 1993Injuries are a common occurrence in young, active civilian and military populations. This study examined injury incidence and the association of musculoskeletal injuries...
Injuries are a common occurrence in young, active civilian and military populations. This study examined injury incidence and the association of musculoskeletal injuries with age and physical fitness in soldiers. Subjects were a cohort of 298 male soldiers assigned to an infantry battalion in Alaska. The soldiers' ages were obtained from the battalion records and their physical fitness was assessed from 2-mile run times, sit-ups, and push-ups. Injuries were documented from a retrospective review of the soldiers' medical records for a 6-month period (October to March) before the fitness testing. Fifty-one percent of the soldiers suffered one or more injuries. The most common injury diagnosis was musculoskeletal pain, followed by strains, sprains, and cold-related injuries. Soldiers experienced a total of 212 separate injuries, which resulted in 1764 days of limited duty. The crude annualized injury rate was 142 injuries per 100 soldiers (one soldier could experience more than one type of injury). The proportion of soldiers injured decreased as age increased. Slower 2-mile run times and fewer sit-ups were associated with a higher incidence of musculoskeletal injuries. This study documents the injury incidence in infantry soldiers and identifies younger age and low physical fitness as potential risk factors for these injuries.
Topics: Accidents, Occupational; Adolescent; Adult; Alaska; Cross-Sectional Studies; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Military Personnel; Physical Fitness; Risk Factors; Wounds and Injuries
PubMed: 8331441
DOI: 10.1097/00043764-199306000-00017