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Lancet (London, England) Oct 2014Improvements in the control of haemorrhage after trauma have resulted in the survival of many people who would otherwise have died from the initial loss of blood.... (Review)
Review
Improvements in the control of haemorrhage after trauma have resulted in the survival of many people who would otherwise have died from the initial loss of blood. However, the danger is not over once bleeding has been arrested and blood pressure restored. Two-thirds of patients who die following major trauma now do so as a result of causes other than exsanguination. Trauma evokes a systemic reaction that includes an acute, non-specific, immune response associated, paradoxically, with reduced resistance to infection. The result is damage to multiple organs caused by the initial cascade of inflammation aggravated by subsequent sepsis to which the body has become susceptible. This Series examines the biological mechanisms and clinical implications of the cascade of events caused by large-scale trauma that leads to multiorgan failure and death, despite the stemming of blood loss. Furthermore, the stark and robust epidemiological finding--namely, that age has a profound influence on the chances of surviving trauma irrespective of the nature and severity of the injury--will be explored. Advances in our understanding of the inflammatory response to trauma, the impact of ageing on this response, and how this information has led to new and emerging treatments aimed at combating immune dysregulation and reduced immunity after injury will also be discussed.
Topics: Age Factors; Endocrine System; Hemostasis; Humans; Immunity, Innate; Neutrophils; Sex Factors; Systemic Inflammatory Response Syndrome; Wounds and Injuries
PubMed: 25390327
DOI: 10.1016/S0140-6736(14)60687-5 -
British Journal of Sports Medicine Dec 2018The fascial system builds a three-dimensional continuum of soft, collagen-containing, loose and dense fibrous connective tissue that permeates the body and enables all...
The fascial system builds a three-dimensional continuum of soft, collagen-containing, loose and dense fibrous connective tissue that permeates the body and enables all body systems to operate in an integrated manner. Injuries to the fascial system cause a significant loss of performance in recreational exercise as well as high-performance sports, and could have a potential role in the development and perpetuation of musculoskeletal disorders, including lower back pain. Fascial tissues deserve more detailed attention in the field of sports medicine. A better understanding of their adaptation dynamics to mechanical loading as well as to biochemical conditions promises valuable improvements in terms of injury prevention, athletic performance and sports-related rehabilitation. This consensus statement reflects the state of knowledge regarding the role of fascial tissues in the discipline of sports medicine. It aims to (1) provide an overview of the contemporary state of knowledge regarding the fascial system from the (molecular and cellular responses) to the (mechanical properties), (2) summarise the responses of the fascial system to altered loading (physical exercise), to injury and other physiological challenges including ageing, (3) outline the methods available to study the fascial system, and (4) highlight the contemporary view of interventions that target fascial tissue in sport and exercise medicine. Advancing this field will require a coordinated effort of researchers and clinicians combining mechanobiology, exercise physiology and improved assessment technologies.
Topics: Adaptation, Physiological; Aging; Athletic Injuries; Athletic Performance; Biomedical Research; Consensus; Exercise; Fascia; Humans; Musculoskeletal Diseases; Sports; Sports Medicine
PubMed: 30072398
DOI: 10.1136/bjsports-2018-099308 -
Seminars in Musculoskeletal Radiology Feb 2022Snowboarding and skiing remain the two most popular winter sports worldwide. Musculoskeletal (MSK) injuries are common in snowboarding, and the number has increased... (Review)
Review
Snowboarding and skiing remain the two most popular winter sports worldwide. Musculoskeletal (MSK) injuries are common in snowboarding, and the number has increased significantly since the advent of snow parks. The number of injuries is the highest for novice snowboarders; more experienced boarders generally sustain more severe injuries. Snowboarders can experience a wide array of MSK injuries, but some injury types are more frequently encountered because of the specific injury mechanism unique to snowboarding. This article reviews the most common snowboarding injuries with a focus on the current understanding of the injury mechanism and provides an approach to imaging.
Topics: Athletic Injuries; Humans; Skiing
PubMed: 35139559
DOI: 10.1055/s-0041-1731702 -
Current Sports Medicine Reports 2015Research regarding musculoskeletal injury risk has focused primarily on anatomical, neuromuscular, hormonal, and environmental risk factors; however, subsequent injury... (Review)
Review
Research regarding musculoskeletal injury risk has focused primarily on anatomical, neuromuscular, hormonal, and environmental risk factors; however, subsequent injury risk screening and intervention programs have been largely limited to neuromuscular factors and have faced challenges in both implementation and efficacy. Recent studies indicate that poor neurocognitive performance, either at baseline or in the aftermath of a concussion, is associated with elevated risk of musculoskeletal injury. Despite the relatively limited current understanding regarding the nature of the relationship between different aspects of neurocognitive performance and musculoskeletal injury risk, this is a promising area of research that may yield significant advances in musculoskeletal injury risk stratification, rehabilitation, and prevention.
Topics: Athletic Injuries; Brain Concussion; Cognition Disorders; Humans; Musculoskeletal Diseases; Musculoskeletal System; Risk Factors; Stress, Psychological
PubMed: 25968852
DOI: 10.1249/JSR.0000000000000157 -
The Journal of Bone and Joint Surgery.... May 2007Crescent fracture dislocations are a well-recognised subset of pelvic ring injuries which result from a lateral compression force. They are characterised by disruption...
Crescent fracture dislocations are a well-recognised subset of pelvic ring injuries which result from a lateral compression force. They are characterised by disruption of the sacroiliac joint and extend proximally as a fracture of the posterior iliac wing. We describe a classification with three distinct types. Type I is characterised by a large crescent fragment and the dislocation comprises no more than one-third of the sacroiliac joint, which is typically inferior. Type II fractures are associated with an intermediate-size crescent fragment and the dislocation comprises between one- and two-thirds of the joint. Type III fractures are associated with a small crescent fragment where the dislocation comprises most, but not all of the joint. The principal goals of surgical intervention are the accurate and stable reduction of the sacroiliac joint. This classification proves useful in the selection of both the surgical approach and the reduction technique. A total of 16 patients were managed according to this classification and achieved good functional results approximately two years from the time of the index injury. Confounding factors compromise the summary short-form-36 and musculoskeletal functional assessment instrument scores, which is a well-recognised phenomenon when reporting the outcome of high-energy trauma.
Topics: Adolescent; Adult; Female; Fracture Fixation, Internal; Fractures, Bone; Humans; Joint Dislocations; Male; Middle Aged; Recovery of Function; Sacroiliac Joint; Tomography, X-Ray Computed; Trauma Severity Indices; Treatment Outcome
PubMed: 17540753
DOI: 10.1302/0301-620X.89B5.18129 -
American Family Physician May 2001Bicycle riding is a popular form of recreation among persons of all ages, and related injuries cause significant morbidity and mortality. Most injuries occur in males... (Review)
Review
Bicycle riding is a popular form of recreation among persons of all ages, and related injuries cause significant morbidity and mortality. Most injuries occur in males and are associated with riding at high speed; most serious injuries and fatalities result from collisions with motor vehicles. Although superficial soft tissue injuries and musculoskeletal trauma are the most common injuries, head injuries are responsible for most fatalities and long-term disabilities. Overuse injuries may contribute to a variety of musculoskeletal complaints, compression neuropathies, perineal and genital complaints. Physicians treating such patients should consider medical factors, as well as suggest adjusting various components of the bicycle, such as the seat height and handlebars. Encouraging bicycle riders to wear helmets is key to preventing injuries; protective clothing and equipment, and general safety advice also may offer some protection.
Topics: Acute Disease; Adolescent; Age Distribution; Bicycling; Child; Chronic Disease; Ergonomics; Family Practice; Female; Head Protective Devices; Health Education; Humans; Incidence; Information Services; Male; Primary Prevention; Risk Factors; Sex Distribution; United States; Wounds and Injuries
PubMed: 11388717
DOI: No ID Found -
Medicine and Sport Science 2005The purpose of this chapter is to review critically the existing studies on the epidemiology of pediatric rugby injuries and discuss suggestions for injury prevention... (Review)
Review
OBJECTIVES
The purpose of this chapter is to review critically the existing studies on the epidemiology of pediatric rugby injuries and discuss suggestions for injury prevention and further research.
DATA SOURCES
Data were sourced from the sports medicine and science literature mainly since 1990, and from a prospective injury surveillance project in rugby undertaken by the University of New South Wales (UNSW) in Sydney during 2002. Literature searches were performed using Medline and SportsDiscus.
MAIN RESULTS
Reported injury rates were between 7 and 18 injuries per 1,000 hours played, with the rate of injuries resulting in loss of playing or training time measured at 6.5-10.6 per 1,000 hours played. Injury rates increased with age and level of qualification. Head injury and concussion accounted for 10-40% of all injuries. In the UNSW study, concussion accounted for 25% of injuries resulting in loss of playing or training time in the under 13 year age group. Upper and lower extremity injuries were equally apportioned, with musculoskeletal injuries being the main type of injury. Fractures were observed in the upper extremity and ankle, and joint/ligament injuries affected the shoulder, knee and ankle. The tackle was associated with around 50% of all injuries. The scrum produced fewer injuries, but is historically associated with spinal cord injury.
CONCLUSIONS
Rugby is a contact sport with injury risks related to physical contact, primarily in the tackle. Most injuries affect the musculoskeletal system, with the exception of concussion. Spinal cord injury is rare, but catastrophic. Research is required to understand better injury risks and to reduce the incidence of shoulder, knee and ankle joint injuries, concussion and spinal injury.
Topics: Adolescent; Age Factors; Arm Injuries; Athletic Injuries; Brain Concussion; Child; Craniocerebral Trauma; Football; Fractures, Bone; Humans; Leg Injuries; Risk Factors; Spinal Cord Injuries
PubMed: 16247264
DOI: 10.1159/000085394 -
Journal of Sport Rehabilitation Feb 2020Clinical Scenario: Physical activity is vital for human health. Musculoskeletal injury may inhibit adults from participating in physical activity, and this amount may be... (Review)
Review
Clinical Scenario: Physical activity is vital for human health. Musculoskeletal injury may inhibit adults from participating in physical activity, and this amount may be less than adults without a history of musculoskeletal injury. Clinical Question: Do individuals with a history of ankle or knee musculoskeletal injury participate in less objectively measured physical activity compared with healthy controls? Summary of Key Findings: Four studies were included. Two studies concluded patients who have undergone an anterior cruciate ligament reconstruction (ACLR) spent less time in moderate to vigorous physical activity levels when compared with healthy controls, but still achieved the daily recommended amount of physical activity. One study determined that participants with CAI took fewer steps per day compared with the control group. The fourth study determined patients with patellofemoral pain were less physically active than healthy controls as they took fewer steps per day and spent less time participating in mild and high activity. Clinical Bottom Line: There is consistent, high quality evidence that demonstrates individuals with a history of ankle or knee musculoskeletal injury participate in less objectively measured physical activity compared with healthy individuals. Strength of Recommendation: Due to nature of study designs of the included articles in this critically appraised topic, we recommend a grade of 3B.
Topics: Ankle Injuries; Biomedical Research; Evidence-Based Medicine; Exercise; Healthy Lifestyle; Humans; Knee Injuries; Muscle, Skeletal; Patient Education as Topic
PubMed: 31094646
DOI: 10.1123/jsr.2018-0486 -
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 -
Reviews on Environmental Health Jun 2016Musculoskeletal injury exerts a significant burden on US industry. The purpose of this study was to investigate the frequency and characteristics of musculoskeletal...
INTRODUCTION
Musculoskeletal injury exerts a significant burden on US industry. The purpose of this study was to investigate the frequency and characteristics of musculoskeletal injuries in the California (CA) film and motion picture (FMP) industry which may result in unforeseen morbidity and mortality.
METHODS
We reviewed the workers' compensation (WC) claims database of the Workers' Compensation Insurance Rating Bureau of California (WCIRB) and employment statistics through the US Bureau of Labor Statistics (BLS). We analyzed the frequency, type, body part affected, and cause of musculoskeletal injuries.
RESULTS
From 2003 to 2009, there were 3505 WC claims of which 94.4% were musculoskeletal. In the CA FMP industry, the most common injuries were strains (38.4%), sprains (12.2%), and fractures (11.7%). The most common sites of isolated injury were the knee (18.9%), lower back (15.0%), and ankle (8.6%). Isolated musculoskeletal spine injuries represented 19.3% of all injuries. The most common causes of injury were work-directed activity (36.0%) and falls (25.5%).
CONCLUSION
We present the first report on the unique profile of musculoskeletal injury claims in the FMP industry. This data provides direction for improvement of workplace safety.
Topics: California; Databases, Factual; Humans; Industry; Motion Pictures; Musculoskeletal System; Occupational Injuries; Risk; Workers' Compensation
PubMed: 26812757
DOI: 10.1515/reveh-2015-0023