-
BMC Medicine Jul 2012Lower limb injuries in sport are increasingly prevalent and responsible for large economic as well as personal burdens. In this review we seek to determine which easily... (Review)
Review
The effectiveness of neuromuscular warm-up strategies, that require no additional equipment, for preventing lower limb injuries during sports participation: a systematic review.
BACKGROUND
Lower limb injuries in sport are increasingly prevalent and responsible for large economic as well as personal burdens. In this review we seek to determine which easily implemented functional neuromuscular warm-up strategies are effective in preventing lower limb injuries during sports participation and in which sporting groups they are effective.
METHODS
Seven electronic databases were searched from inception to January 2012 for studies investigating neuromuscular warm-up strategies and injury prevention. The quality of each included study was evaluated using a modified version of the van Tulder scale. Data were extracted from each study and used to calculate the risk of injury following application of each evaluated strategy.
RESULTS
Nine studies were identified including six randomized controlled trials (RCT) and three controlled clinical trials (CCT). Heterogeneity in study design and warm-up strategies prevented pooling of results. Two studies investigated male and female participants, while the remaining seven investigated women only. Risk Ratio (RR) statistics indicated 'The 11+' prevention strategy significantly reduces overall (RR 0.67, confidence interval (CI) 0.54 to 0.84) and overuse (RR 0.45, CI 0.28 to 0.71) lower limb injuries as well as knee (RR 0.48, CI 0.32 to 0.72) injuries among young amateur female footballers. The 'Knee Injury Prevention Program' (KIPP) significantly reduced the risk of noncontact lower limb (RR 0.5, CI 0.33 to 0.76) and overuse (RR 0.44, CI 0.22 to 0.86) injuries in young amateur female football and basketball players. The 'Prevent Injury and Enhance Performance' (PEP) strategy reduces the incidence of anterior cruciate ligament (ACL) injuries (RR 0.18, CI 0.08 to 0.42). The 'HarmoKnee' programme reduces the risk of knee injuries (RR 0.22, CI 0.06 to 0.76) in teenage female footballers. The 'Anterior Knee Pain Prevention Training Programme' (AKP PTP) significantly reduces the incidence of anterior knee pain (RR 0.27, CI 0.14 to 0.54) in military recruits.
CONCLUSIONS
Effective implementation of practical neuromuscular warm-up strategies can reduce lower extremity injury incidence in young, amateur, female athletes and male and female military recruits. This is typically a warm-up strategy that includes stretching, strengthening, balance exercises, sports-specific agility drills and landing techniques applied consistently for longer than three consecutive months. In order to optimize these strategies, the mechanisms for their effectiveness require further evaluation.
Topics: Athletes; Athletic Injuries; Equipment and Supplies; Exercise; Female; Humans; Incidence; Lower Extremity; Male; Military Personnel; Randomized Controlled Trials as Topic; Young Adult
PubMed: 22812375
DOI: 10.1186/1741-7015-10-75 -
Canadian Journal of Surgery. Journal... 2021Given the rising prevalence of subways in combination with an increasing incidence of subway-related injuries, understanding subway-related trauma is becoming ever more...
BACKGROUND
Given the rising prevalence of subways in combination with an increasing incidence of subway-related injuries, understanding subway-related trauma is becoming ever more relevant. The aim of this study was to characterize the potential causes, injury characteristics and outcomes of subway-related trauma at a level 1 adult trauma centre in Toronto, Ontario.
METHODS
We conducted a retrospective cohort study to identify patients who presented to the emergency department a level 1 adult trauma centre with a subway-related injury between Jan. 1, 2010, and Dec. 31, 2018. Patients were identified via E-codes (X81, Y02, V050, V051 and W17). We then further screened for descriptions of subway-related injuries. Patients whose injuries did not involve a moving subway train were excluded.
RESULTS
We identified 51 patients who presented to the emergency department after being hit by a moving subway train. The majority of incidents (39 [76%]) were due to self-harm, 10 (20%) were unintentional injuries, and 2 (4%) were due to assault. The presence of alcohol was detected in 8 patients (80%) with unintentional injuries and 3 (8%) of those with self-inflicted injuries. Thirteen patients (25%) had a systolic blood pressure less than 90 mm Hg. The median Injury Severity Score was 17 (interquartile range 9-29). Seventeen patients (33%) presented with severe injuries (Abbreviated Injury Scale score ≥ 3) in 1 body region, and 19 (37%) had severe injuries in 2 or more body regions. The most common isolated severe injury was in the lower extremity, and the most common combinations of severe injuries were in the head and lower extremity, and head and thorax. Ten patients (20%) were declared dead in the emergency department. Of the 41 patients who survived their initial presentation, 12 (29%) went directly to the operating room, and 17 (41%) were transferred to the intensive care unit. The overall mortality rate was 29%.
CONCLUSION
Patients with subway-related injuries experienced high mortality rates and severe injuries. Most incidents were due to self-harm or alcohol-related. Further research into early identification of those at risk and optimal prevention strategies is necessary to curb further incidents.
Topics: Accidents; Adolescent; Adult; Aged; Alcohol Drinking; Blood Pressure; Craniocerebral Trauma; Critical Care; Emergency Service, Hospital; Female; Glasgow Coma Scale; Humans; Injury Severity Score; Lower Extremity; Male; Middle Aged; Ontario; Physical Abuse; Railroads; Retrospective Studies; Self-Injurious Behavior; Surgical Procedures, Operative; Trauma Centers; Trauma Severity Indices; Wounds and Injuries; Young Adult
PubMed: 34728524
DOI: 10.1503/cjs.020219 -
British Journal of Hospital Medicine... Mar 2022An arterial injury is a time-critical emergency and, when associated with a fracture or dislocation, its management requires joint specialist input from orthopaedic and... (Review)
Review
An arterial injury is a time-critical emergency and, when associated with a fracture or dislocation, its management requires joint specialist input from orthopaedic and vascular or plastic surgeons. Initial management involves haemorrhage control and stabilisation of the patient, reduction and splinting of the limb and careful reassessment. With ongoing vascular compromise, urgent surgery is indicated to restore arterial flow and stabilise the skeleton, and this should be performed at a centre with appropriate expertise. This article provides an evidence-based review of the British Orthopaedic Association Standards for Trauma for the diagnosis and management of arterial injuries associated with extremity fractures and dislocations.
Topics: Angiography; Extremities; Fractures, Bone; Humans; Joint Dislocations; Vascular System Injuries
PubMed: 35377208
DOI: 10.12968/hmed.2021.0454 -
Orthopaedics & Traumatology, Surgery &... Feb 2018"Urgent, complete, definitive" treatment still today seems to be an appropriate attitude in many trauma cases. There are, however, several situations in which emergency... (Review)
Review
"Urgent, complete, definitive" treatment still today seems to be an appropriate attitude in many trauma cases. There are, however, several situations in which emergency definitive fixation is not the optimal strategy for all cases of fracture. Temporary fixation has a role to play in the orthopedic "trauma damage control" design comprising successive steps, as applied in multiple trauma, multiple fracture, severe multi-tissue limb lesions and soft-tissue lesions of unpredictable progression. The aim of this study is to define the strategies, indications, principles and limitations of temporary fixation in limb and pelvis fracture.
Topics: Extremities; Fracture Fixation; Fractures, Multiple; Humans; Multiple Trauma; Patient Selection; Pelvic Bones; Soft Tissue Injuries
PubMed: 29197635
DOI: 10.1016/j.otsr.2017.03.032 -
Bulletin of the Hospital For Joint... 2013Golf is a global sport enjoyed by an estimated 60 million people around the world. Despite the common misconception that the risk of injury during the play of golf is... (Review)
Review
Golf is a global sport enjoyed by an estimated 60 million people around the world. Despite the common misconception that the risk of injury during the play of golf is minimal, golfers are subject to a myriad of potential pathologies. While the majority of injuries in golf are attributable to overuse, acute traumatic injuries can also occur. As the body's direct link to the golf club, the upper extremities are especially prone to injury. A thorough appreciation of the risk factors and patterns of injury will afford accurate diagnosis, treatment, and prevention of further injury.
Topics: Athletic Injuries; Biomechanical Phenomena; Golf; Humans; Orthopedic Procedures; Recovery of Function; Risk Factors; Treatment Outcome; Upper Extremity
PubMed: 24032581
DOI: No ID Found -
The Surgical Clinics of North America Oct 2017Musculoskeletal injuries cause a significant burden to society and can have a considerable impact on patient morbidity and mortality. It was initially thought that these... (Review)
Review
Musculoskeletal injuries cause a significant burden to society and can have a considerable impact on patient morbidity and mortality. It was initially thought that these patients were too sick to undergo surgery and later believed that they were too sick not to undergo surgery. The pendulum has subsequently swung back and forth between damage control orthopedics and early total care for polytrauma patients with extremity injuries and has settled on providing early appropriate care (EAC). The decision-making process in providing EAC is reviewed in an effort to optimize patient outcomes following severe extremity trauma.
Topics: Advanced Trauma Life Support Care; Fractures, Bone; Health Care Costs; Humans; Joint Dislocations; Musculoskeletal System; Orthopedic Procedures; Vascular System Injuries; Wounds and Injuries
PubMed: 28958361
DOI: 10.1016/j.suc.2017.06.005 -
African Health Sciences Jun 2018We aimed to review the biomechanics of lower limb injuries caused by frontal-impact road traffic collisions. (Review)
Review
AIM
We aimed to review the biomechanics of lower limb injuries caused by frontal-impact road traffic collisions.
METHODS
In this narrative review, we identified articles through pubmed, Scopus and Science Direct search engines for the period of 1990-2014. Search terms included: "biomechanics", "lower limb injury", "hip injury", "knee injury", "foot and ankle injury" and "frontal impact collision". We studied factors affecting the anatomical site, frequency and severity of the injuries.
RESULTS
The most common reported mechanisms of injury were: the impaction of the knee with the dashboard resulting in acetabular fracture or posterior hip dislocation; and toepan intrusion in combination with forceful application of the brake resulting in foot and ankle fractures. The probability of an occupant sustaining significant injury to the hip is increased in taller males, and being out of position during the collision. The probability of an occupant sustaining a fracture to the foot and ankle is increased in shorter female occupants with a large overlap impact or a near oblique collision.
CONCLUSION
Understanding the biomechanics of frontal-impact road traffic collisions is useful in alerting clinicians to the potential lower limb injuries sustained in these collisions.
Topics: Accidents, Traffic; Adult; Ankle Injuries; Biomechanical Phenomena; Female; Foot Injuries; Humans; Knee Injuries; Leg Injuries; Lower Extremity; Male; United Arab Emirates; Wounds and Injuries
PubMed: 30602959
DOI: 10.4314/ahs.v18i2.17 -
Annals of Plastic Surgery May 2020This study aimed to present the use of flow-through free anterolateral thigh (ALT) flap for the reconstruction of severe limb injury.
OBJECTIVE
This study aimed to present the use of flow-through free anterolateral thigh (ALT) flap for the reconstruction of severe limb injury.
PATIENTS AND METHODS
Four patients (2 male and 2 female subjects), with an average age of 26 (9-39) years, were included. These injuries referred to upper and lower limbs, including bone, soft tissue, nerve, and arterial segments. Two patients experienced large soft tissue defects in the lower limb and were repaired by double flow-through ALT flaps. The sizes of damaged soft tissues in the remaining 2 patients were 14 × 10 cm and 21 × 13 cm, respectively. Three patients had bone fractures, in which one of them experienced bone shortening during operation. The arterial injury was observed in 2 patients and the lengths of defects were 5 and 12 cm, respectively. Flow-through free ALT flap was applied for all 4 patients.
RESULTS
Patients were followed up for 18 months. All the flaps have survived successfully without any vascular crisis or infection. All incision wounds were under primary healing stage, without any severe complications. The flaps showed better appearance, color, texture, and satisfactory sensation. All patients had satisfactory functional recovery of their injured limbs.
CONCLUSIONS
The flow-through free ALT flap assists in overcoming complex traumatic injuries with severe soft tissue and arterial defects in the limbs. This flow-through ALT flap can be an effective alternative for reconstruction of severe limb injury.
Topics: Adult; Female; Free Tissue Flaps; Humans; Male; Plastic Surgery Procedures; Skin Transplantation; Soft Tissue Injuries; Thigh; Treatment Outcome
PubMed: 32282414
DOI: 10.1097/SAP.0000000000002372 -
Ugeskrift For Laeger Sep 2022
Topics: Bicycling; Humans; Lower Extremity; Thigh; Wounds, Penetrating
PubMed: 36065872
DOI: No ID Found -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Dec 2023Limb injuries caused by landmine explosions are tricky to treat and difficult to protect. It is necessary to establish an animal model for studying lower limb injury and...
BACKGROUND
Limb injuries caused by landmine explosions are tricky to treat and difficult to protect. It is necessary to establish an animal model for studying lower limb injury and to investigate the characteristics and mechanisms of lower limb injury induced by landmine blasts.
METHODS
Twenty-six mature white rabbits were randomly divided into sham group (n=10) and injury group (n=16). Landmine blast was simulated by electric detonators under the right lower limb in upright state by a special modified fixation frame. High-speed photography was used to observe the body movements. Vital signs, vascular injury (determining by digital subtraction angiography), pathological characteristics, and ATP concentration of the tibialis anterior muscle and triceps surae of shank were recorded for com-parison.
RESULTS
Generally, middle and lower segment of the injured legs of the rabbits was seriously damaged. The limb stump presents a distribution of three areas, tissue free zone, contusion hematoma, and edema contusion. Sneak wound track, myofascial destruction, and periosteum stripping were typical characteristics of landmine blast injury. ATP concentration and pathological analysis showed that the tibialis anterior muscle was the most seriously injured, followed by the gastrocnemius and soleus. ATP concentration of affected muscle of both the contusion and commotio area declined remarkably over time, but the muscle in the avulsion area stayed at a low activity level with no change over the time. Small vascular injury in the contusion area was evident. The site of the sciatic nerve lesion was higher than the muscle. Injured site of sciatic nerve injury was higher than serious contusion muscle. High-speed photography demonstrated that the joints of the injured limb extremely flexed followed by a rapid stretch under the blast shock wave.
CONCLUSION
The established experimental model presents typical effect of lower limbs wounded by the mine blast in war field. Landmine blast can cause typical damage on lower limbs including nerve lesion, knee injury, and microcirculation damage that is pro-gressive over time. The limb stump is divided into three zones based on gross pathology and micropathology, which can provide an important reference for clinical treatments and prognosis.
Topics: Animals; Rabbits; Adenosine Triphosphate; Blast Injuries; Contusions; Explosions; Leg Injuries; Lower Extremity; Vascular System Injuries
PubMed: 38073454
DOI: 10.14744/tjtes.2023.39560