Epidemiology of work-related hand and wrist injuries in a referral center: A descriptive study

BACKGROUND Occupational hand and wrist injuries(OHWIs)account for 25%of work-related accidents in low-and middle-income countries.In Colombia,more than 500000 occupational accidents occurred in 2021,and although the rate declined to less than 5%in 2020 and 2021,at least one in four accidents involved a hand or wrist injury.AIM To describe the OHWIs in workers seen at the emergency room at a second-level hospital in Colombia.METHODS An observational study was performed using data from workers who experienced OHWIs and attended a second-level hospital,between June,2020 and May,2021.The overall frequency of OHWIs,as well as their distribution by sociodemo-graphic,clinical,and occupational variables,are described.Furthermore,association patterns between sex,anatomical area(fingers,hand,wrist),and type of job were analyzed by correspondence analysis(CA).RESULTS There were 2.101 workers treated for occupational accidents,423(20.3%)were cases of OHWIs,which mainly affected men(93.9%)with a median age of 31 years and who worked mainly in mining(75.9%).OHWIs were more common in the right upper extremity(55.3%)and comprised different types of injuries,such as contusion(42.1%),laceration(27.9%),fracture(18.7%),and crush injury(15.6%).They primarily affected the phalanges(95.2%),especially those of the first finger(25.7%).The CAs showed associations between the injured anatomical area and the worker’s job that differed in men and women(explained variance>90%).CONCLUSION One out of five workers who suffered occupational accidents in Cundinamarca,Columbia had an OHWI,affecting mainly males employed in mining.This occupational profile is likely to lead to prolonged rehabilitation,and permanent functional limitations.Our results might be useful for adjusting preventive measures in cluster risk groups.

Epidemiological characteristics of traumatic spinal cord injuries in the intensive care unit from 2018 to 2023:a retrospective hospital-based study

BACKGROUND:The objective of this retrospective hospital-based study was to describe the epidemiological features of traumatic spinal cord injury(TSCI)in the intensive care unit(ICU)and assess the incidence and possible risk factors for venous thromboembolism(VTE)following TSCI.METHODS:We retrospectively reviewed the medical records of 370 patients with TSCI who were admitted between January 2018 and March 2023.The following parameters were collected:age,sex,body mass index,occupation,underlying diseases,smoking history,education level,etiology of injury,injury segments,American Spinal Injury Association(ASIA)Impairment Scale score,severity of injury,injury severity score(ISS),VTE risk score(Caprini score),treatment,VTE prophylaxis,ICU length of stay,length of hospital stay,concomitant injuries,and complications.Descriptive statistics were used to summarize the demographic and clinical characteristics of the study participants.Logistic regression analysis was used to determine the risk factors for VTE.RESULTS:The mean age of patients with TSCI was 55.5±13.4 years,with a male-to-female ratio of 6.5:1.The leading cause of TSCI was falls from height(46.5%),followed by traffic accidents(36.5%).The cervical spinal cord was the most affected segment,followed by the thoracolumbar region.Among all the patients,362(97.8%)had concomitant injuries.Complications were observed in 255 patients(68.9%)during hospitalization.The incidence rate of VTE was 25.1%.Logistic regression analysis revealed that age(OR=1.721,95%CI:1.207-2.454,P=0.003),mechanical ventilation(OR=3.427,95%CI:1.873-6.271,P<0.001),and non-use of chemical prophylaxis(OR=2.986,95%CI:1.749-5.099,P<0.001)were risk factors for VTE.CONCLUSION:Falls from height and traffic accidents were the main causes of TSCIs in the ICU,especially for male patients with cervical spinal cord injuries.VTE is a frequent complication in patients with TSCI in the ICU.Age,mechanical ventilation,and non-use of chemical prophylaxis were found to be independent risk factors for VTE following TSCI.

Eyelid Wounds: Epidemiological, Clinical and Etiological Aspects

Purpose: The aim is to show epidemiological, clinical and etiological characteristics of palpebral wounds. Methodology: This was a retrospective study focusing on patients with an eyelid wound, over a 10-year period from 2012 to 2021. We collected and analyzed the data using Excel. Results: The frequency of eyelid wounds was 0.1%. The average age of our patients was 19.38 years with a range of 1 and 62 years. The sex ratio was 3.7. Eighty-one percent of patients lived in Dakar. Fifty-seven percent (57%) of patients consulted less than 24 hours after the trauma and 7% of patients on D1. The circumstances were brawls (11%), domestic accidents (9%), road accidents (6%), and work accidents (6%). We noted 1 case of dog bite. Thirteen patients presented with post-traumatic decreased visual acuity. Involvement of the isolated upper eyelid was noted in 40% of cases and both eyelids in 15% of cases. Involvement of the lacrimal ducts was noted in 17% of cases, and that of the free edge in 21% of cases. Eyelid wounds were associated with eyeball damage in 21% of cases. Various associated lesions were observed. Ninety-one percent of patients received surgical treatment. Three cases of superinfections, 1 case of conjunctival granuloma and 1 case of phthysis of the eyeball with postoperative retinal detachment were noted. Conclusion: Eyelid sores are relatively common in our context. They require rapid surgical treatment in order to preserve the functional and aesthetic prognosis. .

Epidemiology of civilian blast injuries inflicted by terrorist bombings from 1970-2016

An upsurge of terrorist activity has occurred in the past two decades. As part of this, explosive devices continue to be extensively deployed against civilians in wide-ranging environments. Bombings remain the leading worldwide cause of civilian fatalities due to terrorism. This demands an understanding of modern terrorist bombing trends to inform mitigation strategy. The objective of this study was to identify the occurrence and severity of bombings against civilian targets in diverse attack settings, and to establish corresponding blast injury profiles. Data was obtained from analysis of the Global Terrorism Database(GTD) and a meta-analysis of blast injury data derived from the PubMed database. Closed environment explosions were associated with significantly greater(p<0.05) mortality than in open spaces. The injury profiles were found to be influenced by attack setting, with higher rates of primary injury on trains and buses, and secondary injury in open space.

Epidemiology of animal bite injuries in North of Fars province in Iran

Objective:To investigate the epidemiological situation of animal bites in Rostam city of Fars province.Methods:This is a cross-sectional study.Cases of animal bites registered in health centers of Rostam city of Fars province from the beginning of 2014 to 2020 were analyzed using the census method.The tool for collecting information was the portal of the Ministry of Health and the registration offices of people who were referred to the rabies center.Results:A total of 628 cases of animal bites registered in health centers of Rostam city of Fars province from the beginning of 2014 to 2020.The mean age of the injured was(31.3±20.2)years.Of the total injured cases,414(65.9%)were male,and 491(78.2%)lived in villages.Most of the cases were bitten by dogs(n=420,66.8%)and the upper limb was involved in 280(55.2%)cases.In addition,an increasing trend was observed in the incidence of animal bites from 2015 to 2020.Conclusions:The incidence of animal bites in Rostam City is high,and most of the cases occur in rural areas.Considering the injuries caused by animal bites,the risk of rabies transmission,and the high costs of vaccination and serum therapy,it is necessary to hold control,educational,and vaccination programs.

Epidemiology of School-Related Injuries in Belgium. A Better Knowledge for a Better Prevention

The landmark Convention on the Rights of the Child states that children around the World have right to safe environment. In Belgium, as in many countries, children spend, on average, 4.5 weekdays at school, during nearly 8 hours per day. Studies have shown that, the risk of school-related injury exceeds the risk during leisure time. Literature reports that school accidents account for 10 to 30% of all accidents among pupils. Despite that, few papers treat of the school-related injuries. Consequently, based on 1540 accidents forms from an insurance company, injury places, mechanisms involved, body parts injured and nature of injuries were described. Head injuries, upper and lower limbs injuries were investigated in more details. Pearson’s chi-square test was used to assess the relationships between the variables and multivariate logistic regression models were used to study the three specific types of injuries cited above. Gender ratio (M/F) was equal to 1.6 with 25.9% of children under 6 years, 29.4% of 6 - 9 years, 26.9% of 10 - 12 years and 17.8% from 13 years or more. The major places of injuries were the playground (56.9%) and the physical education (19.7%). Falls were observed in 52.1% of cases and contacts were reported in 24.3%. The head injuries account for 40.6%, the upper limbs for 32.0% and the lower limbs injuries for 20.2%. The bruises and the scratches were observed in 23.8% and the wounds in 21.5%. Fractures were reported in 16.1%. In conclusion, having a routine access to the data from the insurance companies could be an important source of information for an injury surveillance system in which the school injuries will be included. Taking into account this data will require an awareness of all the concerned persons about the relevance of such a system and a harmonization of the accidental forms.

Epidemiology of Fingertip Injuries at South Central Hospital Petróleos Mexicanos “Pemex” with a Review of the Literature

Background: The hand is an essential component for performing our daily tasks;as a result, injuries to the fingertip are frequently seen. Accurate evaluation and treatment of fingertip injuries are essential to avoiding long-term disability, job loss and psychological issues. No matter the injury classification system, maintaining finger length, regaining sensation, and improving appearance are the three main objectives of treatment. The objective of this research was to outline the epidemiology of fingertip injuries treated between 2021 and 2022 at a highly specialized referral hospital in Mexico City. Methodology: This investigation is cross-sectional, retrospective, and observational. From January 2021 to December 2022, 60 patients with a diagnosis of fingertip injury from the South Central Hospital “Pemex” were included. The descriptive statistical analysis was performed using SPSS29. Results: 60 patients were included, 27 (45%) were women and 33 (55%) were men. Allen’s classification was able to classify only 19 patients, of which 18 (94.7%) had a type 1 classification and one (5.26%) had a type 2 classification. 10% of patients experienced complications, which included 2 patients with surgical site infections (3.3%), 3 patients with persistent pain (5%), and 1 patient (1.6%) with graft rejection. Conclusions: There are currently insufficient epidemiological data on hand and wrist injuries and its effects on labor in Mexico. Fingertip injuries require particular care in order to prevent complications and long-term damage. The creation of national registries could help with the creation of reference manuals for the care of hand and wrist injuries in our nation.

Epidemiological and clinical features of paediatric open globe injuries in southwestern Turkey

AIM:To evaluate the epidemiologic,anatomic,and clinical features of open globe injuries in children.METHODS:The medical files of patients under the age of 16 who had been operated for an open globe injury at Akdeniz University Hospital’s Department of Ophthalmology were retrospectively evaluated.RESULTS:A total of 90 patients were evaluated in this study.Among these patients,26(28.9%)were female and64(71.1%)were male.The mean age of the patients was7.7±4.2 years.The male/female ratio was observed to increase with increasing age(P=0.006,P=7.48).Injuries were most likely to occur in spring and autumn(P=0.028).The time interval between the injury and the surgical repair was 9.36±27.4h.Forty(44.4%)of the injuries occurred in the home,27(30%)occurred in the yard,and 21(23.3%)happened while playing in the street.The most common causes of injury were sharp metal objects(P【0.001).Injury to the cornea occurred in47(52.2%)of the patients(P【0.001).The most common complication to occur was cataract formation.Additional operations were necessary for 37(41.1%)of the patients.The final visual acuity was correlated with both the initial visual acuity of the wounded eye prior to surgery and the length of the wound(P【0.001,r=0.502 and P【0.001,r=-0.442,respectively).CONCLUSION:Open globe injuries that are suffered in childhood generally occur either at home,in the yard,or on the street,with sharp metal objects being the most common cause of injury.The initial visual acuity and the length of the wound are the most important determinants of the final visual acuity.

The Role of Age as a Risk Factor for Pickleball-Related Injuries

Pickleball is a popular sport that includes players from many different demographics. The popularity has resulted in not only increases in participation but also in activity related injuries. The purpose of this study was to identify risk factors along with potential mechanisms for injuries related to pickleball and identify effective countermeasures. Methods included the identification of pickleball related injuries from a US National Emergency Room database (NEISS). A narrative section of the database was used to identify and categorize potential mechanisms of injury. Results indicated that the types and mechanisms of injury relate to three specific age groups: younger, middle age, and older players. Injuries to younger players under the age of 26 are likely the result of misuse of sport equipment. Middle aged players from 26 to 50 sustained injuries more related activity overuse. However, there were more concerns with players over 50 years of age with a great percentage resulting in cardia arrest or symptoms leading to more severe cardiovascular conditions. While pickleball activity should be encouraged as it is a beneficial form of physical activity, there should be specific age-group interventions to reduce injury. It should be highly recommended that doctors approve the activity for individual at risk for heart conditions and supervision for adults in that age group.

Epidemiological investigation of military training injuries for sea trainingand parachuting training

Objective: To study epidemiological characteristics of the military training injuries (MTI) during parachuting training of the air force and sea training of the navy. Methods:The subjects of this study were 1382, including 971 navy soldiers (300 recruits and 671 soldiers) and 411 for force recruits. Navy: Each of injured soldiers was investigated by the trained battalion surgeon; Air force: When the parachuting training finished , two doctors in specific field screened and investigated them one by one. Results: The incidence of injury in for force recruits was 16.3% and in navy recruits was 18. 7%. The incidence of navy soldiers was 5.5%, which was significantly lower than that of navy recruits. There was a peak of incidence in the 2nd training month of navy recruits. The peak of incidence of navy soldiers was in 1st training month. The incidence of air force maintained at a high level except 2nd training month. The incidences of lower legs and ankles were higher than those of other sites in navy with percentage of 42.9% and 17.9% respectively. The incidences of ankles and lumbar region were higher than those of other sites in air force with percentage of 26.9% and 23.9% respectively. Incidence of acute traumatic injuries was highest during special course. Conclusion: The result showed the incidence of injury in sea and parachuting training varied. Different preventive measures should be adopted during special training.

Large bowel injuries during gynecological laparoscopy

Laparoscopy is one of the most frequently preferred surgical options in gynecological surgery and has advantages over laparotomy, including smaller surgical scars, faster recovery, less pain and earlier return of bowel functions. Generally, it is also accepted as safe and effective and patients tolerate it well. However, it is still an intra-abdominal procedure and has the similar potential risks of laparotomy, including injury of a vital structure, bleeding and infection. Besides the wellknown risks of open surgery, laparoscopy also has its own unique risks related to abdominal access methods,pneumoperitoneum created to provide adequate operative space and the energy modalities used during the procedures. Bowel, bladder or major blood vessel injuries and passage of gas into the intravascular space may result from laparoscopic surgical technique. In addition, the risks of aspiration, respiratory dysfunction and cardiovascular dysfunction increase during laparoscopy. Large bowel injuries during laparoscopy are serious complications because 50% of bowel injuries and60% of visceral injuries are undiagnosed at the time of primary surgery. A missed or delayed diagnosis increases the risk of bowel perforation and consequently sepsis and even death. In this paper, we aim to focus on large bowel injuries that happen during gynecological laparoscopy and review their diagnostic and management options.

A systematic review of running-related musculoskeletal injuries in runners

Objective:Running-related musculoskeletal injuries(RRMIs),especially stemming from overuse,frequently occur in runners.This study aimed to systematically review the literature and determine the incidence and prevalence proportion of RRMIs by anatomic location and specific pathology.Methods:An electronic database search with no date beginning restrictions was performed in SPORTDiscus,PubMed,and MEDLINE up to June 2020.Prospective studies were used to find the anatomic location and the incidence proportion of each RRMI,whereas retrospective or cross-sectional studies were used to find the prevalence proportion of each RRMI.A separate analysis for ultramarathon runners was performed.Results:The overall injury incidence and prevalence were 40.2%±18.8%and 44.6%±18.4%(mean±SD),respectively.The knee,ankle,and lower leg accounted for the highest proportion of injury incidence,whereas the knee,lower leg,and foot/toes had the highest proportion of injury prevalence.Achilles tendinopathy(10.3%),medial tibial stress syndrome(9.4%),patellofemoral pain syndrome(6.3%),plantar fasciitis(6.1%),and ankle sprains(5.8%)accounted for the highest proportion of injury incidence,whereas patellofemoral pain syndrome(16.7%),medial tibial stress syndrome(9.1%),plantar fasciitis(7.9%),iliotibial band syndrome(7.9%),and Achilles tendinopathy(6.6%)had the highest proportion of injury prevalence.The ankle(34.5%),knee(28.1%),and lower leg(12.9%)were the 3 most frequently injured sites among ultramarathoners.Conclusion:The injury incidence proportions by anatomic location between ultramarathoners and non-ultramarathoners were not significantly different(p=0.798).The pathologies with the highest incidence proportion of injuries were anterior compartment tendinopathy(19.4%),patellofemoral pain syndrome(15.8%),and Achilles tendinopathy(13.7%).The interpretation of epidemiological data in RRMIs is limited due to several methodological issues encountered.

Prevalence of musculoskeletal injuries and a proposal for neuromuscular training to prevent lower limb injuries in Brazilian Army soldiers:an observational study

Background: The activities carried out by soldiers in the army involve great physical demands and require intense trainings to perform combat-specific tasks. Musculoskeletal injury is a potential threat to the health and physical integrity of the soldier. This study aimed to evaluate the prevalence of lower limb musculoskeletal injuries among soldiers and to propose a training protocol to prevent the most frequent injuries.Methods: This observational(cross-sectional) study recruited a sample of 103 soldiers who required medical attention,from a total 202 new battalion soldiers. The medical records(paper and online) had a form of running text. All data collected were recorded by the registered physicians of the battalion medical post. The records were analyzed by the following variables: medical diagnosis, injury site, mechanism, type of treatment, time loss, existence of previous injury,and recurring injury.Results: A total of 112 musculoskeletal injuries were diagnosed in 71 soldiers, and other types of diseases/injuries were diagnosed in the other soldiers. Joint pain accounted for 55.4% of the diagnoses. The knee was the most affected site, while trauma and overload were the most common mechanisms of injury. Drug treatment was used most frequently, accounting for 58% of the cases. The majority of the sample obtained a temporary leave of absence for1 to 6 days or not at all. Previous injuries and recurrence were not presented as risk factors for injury. With the data received, a protocol for the prevention of injuries to the lower limbs was proposed.Conclusions: This study indicated that the most frequent site of injury is the knee, and joint pain is the most common diagnosis. These results may support the necessity to develop a neuromuscular training protocol to prevent lower limb injuries, which we suggest to be applied in future studies.

Benefits of multidisciplinary collaborative care team-based nursing services in treating pressure injury wounds in cerebral infarction patients

BACKGROUND Cerebral infarction patients need to be bedridden for long periods of time often resulting in pressure injuries,which may represent a serious threat to patients'life and health.An effective nursing program should be adopted for timely intervention in patients with pressure wounds.AIM To explore the value of nursing services based on a multidisciplinary collaborative treatment team in patients with pressure injury wounds following cerebral infarction.METHODS Patients with cerebral infarction pressure injury wounds in our hospital from December 2016 to January 2021 were selected and divided into one study group and one control group based on the simple random number table method.The control group was treated with conventional nursing care(CNC),and the study group was treated with care services based on multidisciplinary collaborative care(MDCC).The Pressure Ulcer Scale for Healing(PUSH),healing effect,Self-Perceived Burden Score(SPBS),and satisfaction with the intervention were calculated before and after 2 and 4 wk of intervention in both groups.RESULTS Sixty-two patients were enrolled,and 31 patients were assigned to each group.The results of the interventions were as follows:(1)There was no significant difference between the PUSH scores of the MDCC group(11.19±2.46)and CNC group(12.01±2.79)before the intervention(P>0.05),and the PUSH scores were lower after 2 and 4 wk of intervention in the MDCC group(6.63±1.97 and 3.11±1.04)than in the CNC group(8.78±2.13 and 4.96±1.35 points)(P<0.05);(2)The rate of wound healing in the MDCC group(96.77%)was higher than that in the CNC group(80.65%)(P<0.05);(3)There was no significant difference between the SPBS scores of emotional factors(21.15±3.11),economic factors(9.88±2.15),and physical factors(8.19±2.23)in the two groups before the intervention.The scores of emotional factors(13.51±1.88),economic factors(6.38±1.44),and physical factors(5.37±1.08)were lower in the MDCC group than in the CNC group(16.89±2.05,7.99±1.68 and 7.06±1.19)after 4 wk of intervention(P<0.05);and(4)Satisfaction with the intervention was higher in the MDCC group(93.55%)than in the CNC group(74.19%)(P<0.05).CONCLUSION Interventions for patients with cerebral infarction pressure wounds based on an MDCC treatment team can effectively reduce patients'self-perceived burden,improve pressure wound conditions,facilitate wound healing,and increase patient satisfaction with the intervention.

Epidemiology and risk factors for sports-and recreation-related eye injury:a multicenter prospective observational study

AIM:To identify the epidemiologic characteristics of sportsand recreation-related eye injuries in a large metropolitan city and investigate risk factors associated with visual impairment.METHODS:We performed a multicenter prospective observational study on patients using the regional eye injury registry data.This study included patients with sportsand recreation-related eye injury in four tertiary teaching hospitals in Daegu,Republic of Korea,from August 2016 to July 2018.The primary outcome was visual impairment at the first hospital visit.Distributions of sex,age,place,and causative materials were analyzed according to causative activities.To examine the association between causative activities and visual impairment,a Logistic regression analysis was used.RESULTS:Of the 349 sports-and recreation-related eye injuries,soccer was the most common causative activity,with 21.8%(n=76).Sports-and recreation-related eye injuries occurred mainly in teenagers,individuals in their 20 s,and men.Badminton and soccer were significantly associated with visual impairment at the first hospital visit compared with combat sports[(adjusted odds ratio(AOR),5.18;95%confidence interval(CI),1.67-16.09 for badminton and AOR,3.87;95%CI,1.36-10.99 for soccer].CONCLUSION:Intervention efforts such as deployment of protective eyewear in sports facilities and schools and promotion of wearing protective eyewear during these activities in teenagers and individuals in their 20 s are mandatory.

Injuries in Spanish female soccer players

Background: Epidemiologic research to learn the incidence, type, location, and severity of female soccer injuries and the risk factors for sustaining a sport injury is the first step in developing preventive policies. The aim of this study was to analyze the incidence of injuries in the population of female soccer players in Spain.Methods: The injuries incurred by 25,397 female soccer players were registered by the medical staff of the Spanish Football Federation during 1 season. A standardized medical questionnaire was used to classify the injury according to type, severity, location, and injury mechanism. A total of 2108 injuries was reported with an incidence of 0.083 injuries per player per season. Most injuries were in the lower limbs(74.0%), mainly affecting knee(30.4%) and ankle joints(17.9%).Results: The proportion of injuries derived from contact with another player was higher during matches(33.7%) than during training(11.4%;p < 0.001). Noncontact injuries were classified as severe more frequently than were contact injuries(51.0% vs. 42.6%; p < 0.001). A higher incidence of injury was found in adult soccer players(≥18 years) vs. their counterparts younger than 18 years(0.094 vs. 0.072 injuries per player per year, respectively; p < 0.001). There were no differences between age groups in any other injury variable(e.g., type, mechanism, location, or severity; p > 0.05).Conclusion: Most female soccer injuries were located at the knee and ankle; the injury mechanism determined the playing time lost; and the player's age did not affect injury characteristics.

Marine biological injuries and their medical management:A narrative review

The marine environment can be extremely dangerous,and the harm caused by marine organisms when they contact the human body can be especially harmful,even deadly.Contact includes stings,bites,wounds,and consumption as food.In this article,the characteristics of the common marine biological injuries are summarized,the major marine organisms causing damage in China’s marine waters are described,and injury prevention and treatment methods are discussed.

Epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China:a hospital-based retrospective study

Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been rare.To the best of our knowledge,no national-level study of treatment status and economic burden has been performed.This retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national level.We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China.Patient epidemiological and clinical features,treatment status,and total and daily costs were recorded.Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program.The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent surgery.Only 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 hours.The total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 hours,which is associated with improved sensorimotor recovery,increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.

A clinical study of penetrating craniocerebral injuries caused by firearms

Penetrating craniocerebral firearm injuries remains one of the most lethal of all head traumas and are common in both war and peace time. Data were reviewed for 6487 moderately, severely head injuring patients (Glasgow Coma Scale (GCS) scores 3 to 12) tre

Epidemiology of open fractures in sport: One centre's 15-year retrospective study

AIM To describe the epidemiology of sport-related open fractures from one centre's adult patient population over a 15-year period. METHODS A retrospective review of a prospectively-collected database was performed: The database contained information all sport-related open fractures, sustained from 1995 to 2009 in the Edinburgh, Mid and East Lothian Populations.RESULTS Over the 15-year period, there were 85 fractures recorded in 84 patients. The annual incidence of open sport-related fractures was 0.01 per 1000 population. The mean age at injury was 29.2 years(range 15-67). There were 70(83%) males and 14 females(17%).The 6 most common sports were soccer(n = 19, 22%), rugby(n = 9, 11%), cycling(n = 8, 9%), hockey(n = 8, 9%); horse riding(n = 6, 7%) and skiing(n = 6, 7%). The five most common anatomical locations were finger phalanges(n = 30, 35%); tibial diaphysis(n = 19, 23%); forearm(n = 12, 14%); ankle(n = 7, 8%) and metacarpals(n = 5, 6%). The mean injury severity score was 7.02. According to the Gustilo-Anderson classification system, 45(53%) fractures were grade 1; 28(33%) fractures were grade 2; 8(9%) fractures were grade 3a; and 4(5%) fractures were grade 3b. Out of the total number of fractures, 7(8%) required plastic surgical intervention as part of management. The types of flaps used were split skin graft(n = 4), fasciocutaneous flaps(n = 2); and adipofascial flap(n = 1). CONCLUSION We analysed the epidemiology of open fractures secondary to sport in one centre over a 15-year period. Soccer and rugby were the most common causative sports while fractures of the finger phalanx and of the tibial diaphysis were the most common sites. Open fractures are uncommon in sport; however, when they are sustained they usually occur on muddy sport fields or forest tracks and therefore must be treated appropriately. It is important that clinicians and sports therapists have knowledge of these injuries, in order to ensure they are managed optimally.