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At least 505 records · Page 28Linked to original sources
PubMed1997

Injuries in Australian Army recruits. Part I: Decreased incidence and severity of injury seen with reduced running distance.

Three hundred fifty male recruits were randomly allocated to either the standard recruit training program (N = 180) or substituted a weighted march activity for all running periods in the physical training program (N = 170). There were no other differences in the formal training program. The incidence of injury was 37.6 and 46.6% in the walk and run groups, respectively. The rate of injury was 52.9/100 recruits in the walk group and 61.7/100 in the run group. The exposure incidence was 12.8/1,000 hours of physical training in the walk group and 14.9/1,000 hours in the run group. There was no statistically significantly difference in the total number of injured recruits in the two groups (64 vs. 85, chi(2) = 2.90, p = 0.09, relative risk [RR] = 1.24). There were, however, significantly more lower-limb (43 vs. 75, chi(2) = 9.77, p = 0.0018, RR = 1.65) and knee injuries (15 vs. 35, chi(2) = 6.54, p = 0.011, RR = 2.14) in the Run group. Lower-limb injuries constituted 79.8% of all Run injuries and 61.1% of all Walk injuries. Injuries in the Run group produced more morbidity, with nearly double the number of days of restriction, hospitalization, and not fit for duty. Standardized morbidity rates showed an average of 5.4 days of restriction per injury in the Run group and 3.96 days of restriction per injury in the Walk group. Reduction of running distance in the physical training program resulted in significant reductions in both the incidence of lower-limb injury and the overall severity of injury.

Adult↗
PubMed1997

Pediatric fracture without radiographic abnormality. Description and significance.

With an expanding application of magnetic resonance imaging in acute musculoskeletal injury, an increasing number of occult traumatic lesions of bone are being identified. The authors describe the entity of fracture without radiographic abnormality, which as the name suggests is a bony injury not apparent on plain radiographs. The clinical significance and potential sequelae have not been defined in the pediatric patient. Accordingly, the purpose of this study is to describe and classify the entity of the pediatric fracture without radiographic abnormality and delineate its importance and appropriate management. Twenty-five children were seen primarily or referred to The Children's Hospital of Philadelphia after having sustained an acute traumatic injury; all refused to bear weight or use their extremity, and all had initial plain radiographs that were interpreted as normal. Subsequent magnetic resonance images of all 25 children showed an occult fracture. These included Salter-Harris fracture Types II (two patients), III (one patient), and IV (three patients), intraosseous epiphyseal fractures (18 patients), and a metaphyseal diaphyseal fracture (one patient). Four patients with intraosseous epiphyseal fractures ultimately sloughed a portion of their articular cartilage, as observed at arthroscopy. The decision to proceed with magnetic resonance imaging in the evaluation of a child who refuses to use an extremity depends on many variables. However, magnetic resonance imaging has proven useful in revealing fractures without radiographic abnormality and in ruling out other pathosis.

Adolescent↗
PubMed1976

Energy expenditure during walking in patients recovering from fractures of the leg.

The oxygen consumption during walking has been studied in 13 patients recovering from fractures of the leg and in 8 control subjects. Oxygen consumption of normal subjects when walking at velocities of 0.5, 1.0 and 1.5 m sec-1 was 8.0, 9.8 and 13.6 ml kg-1 min-1 respectively. For subjects walking on crutches with the leg encased in a Plaster of Paris cast, the oxygen consumption at these velocities was 12.0, 17.5 and 25.3 ml kg-1 min-1 respectively. The energy cost of walking was reduced when the cast was removed, when the crutches were replaced by sticks and when all aides were discarded. When all aids had been discarded the energy expenditure was normal at 0.5 and 1.0 m sec-1 but was still significantly higher at faster velocities.

Adult↗
PubMed1998

Skiing injuries in children, adolescents, and adults.

We prospectively gathered data on skiing injuries that had been sustained at the Sugarbush North ski area since 1972 and at the Sugarbush South ski area since 1981. The purpose of the current study was to document the overall rates of injury in children, adolescents, and adults participating in alpine skiing. We also sought to determine the ten most common injuries in each age-group. Finally, we analyzed short-term and long-term trends to determine if changes in equipment had had an effect on the frequency or pattern of injury. From the 1981-1982 to the 1993-1994 season, there were 2.79 injuries per 1000 skier days: 4.27 injuries in children, 2.93 in adolescents, and 2.69 in adults. During the last eight years of the study, the most common injuries were a contusion of the knee in children, a sprain of the ulnar collateral ligament of the thumb in adolescents, and a grade-III sprain of the anterior cruciate ligament in adults. The short-term trends revealed that, in children, the frequency of tibial fractures decreased 10 per cent while that of fractures of the upper extremity increased 8 per cent. The long-term trends showed that, in adults, the rate of tibial fractures decreased 89 per cent while that of injuries of the anterior cruciate ligament increased 280 per cent. The overall rate of injury decreased 43 per cent from the beginning of the study in 1972 to the end of the study in 1994; the decrease was 58 per cent in children, 45 per cent in adolescents, and 42 per cent in adults. Data on the types of equipment and the binding-release values were collected prospectively from injured skiers and from 2083 non-injured skiers. Of the fifty-nine skiers who sustained a spiral fracture of the tibia, forty-two (71 per cent) had binding-release values that were higher than the average for the uninjured group. We believe that the use of properly functioning modern equipment will decrease the rate of injury, particularly in children.

Adolescent↗
PubMed1998

Pitfalls in the radiologic evaluation of extremity trauma: Part II. The lower extremity.

Fractures of the lower extremity are common reasons for visits to family physicians. Some lower extremity fractures are especially likely to be missed. Examples of lesions that commonly go unrecognized include sacral insufficiency or fatigue fracture, fracture of the femoral neck (especially if the fracture is nondisplaced and/or impacted), tibial plateau fracture, Segond fracture (vertical fracture of the lateral tibia), patellar fracture, calcaneal fracture of the foot, Lisfranc fracture/dislocation of the tarsometatarsal apparatus, and Jones fracture of the fifth metatarsal. Lower extremity fracture in children may suggest the possibility of child abuse, especially in the case of multiple or bilateral fractures.

Child↗
PubMed1998

Common sports injuries seen by the primary care physician. Part II: Lower extremity.

Sports medicine is the science of caring for the medical and surgical needs of athletes and their injuries. Injuries of the upper extremity were dealt with in Part I in a previous article. Part II deals with injuries of the lower extremity. Trochanteric bursitis and hamstring strains are treated with rest, rehabilitation, and correction of training errors. Patellofemoral pain syndromes require accurate diagnosis and usually a rehabilitative program. Injuries to the medial collateral ligament are very common, but can be associated with tears of the meniscus and cruciate ligaments. The latter two often require surgical intervention. Ankle sprains are graded by severity. The most severe can result in chronic pain or instability, but most respond well to functional bracing and progressive return to activity.

Ankle Injuries↗
PubMed1998

[Analysis of leg geometry].

Analysis of bony geometry of the lower limb comprises frontal, sagittal and longitudinal alignment, as well as length and torsion, including at first the whole leg and finally the femur and tibia separately. Clinical examination assesses the bony geometry, functional aspects, ligamentous and soft tissue conditions, etc. Frontal and sagittal radiographs indicate axial alignment and angles of the hip, knee and upper ankle joint. Apex and size of deformities are defined simultaneously. CT and ultrasound techniques allow the measurement of length and torsion of the whole leg, as well as of the femur and tibia separately, provided those techniques are standardized with proven reproducibility.

Bone Malalignment↗
PubMed1995

[Surgical treatment of vascular injuries of the legs].

This retrospective study was carried out on 24 patients admitted to the Surgical Thoracic Department of the United Hospitals in Foggia between 1984 and 1992. In most cases are patients with multiple traumas, victims of road accidents. Different types of surgical treatment have been used, from the ligation or suture of the perforating artery to the resection with anastomosis T-T or interposition of graft. When there were bony injuries too, the vascular repairing venous-arterial, was carried out after the orthopedic one. The nerves have been repaired after the vessels. The nervous injuries are the chief cause of permanent functional damage, because today the success of the surgical operation used in the vascular injuries of the limbs is increased to values about 90%. For the vascular sutures we have used material that is not absorbed, the monofilament. The present average rate of amputation of 10% can be more lowered if we put attention to complementary expedients and if there is a more active and quicker collaboration among the different specialized departments.

Adolescent↗
PubMed1981

Diaphyseal fractures of both bones of the lower leg with associated injury of the ankle mortise.

Fractures of both bones of the lower leg may be accompanied by a disruption of the mortise with a shortening of the fibula. This combination was observed in four cases reported in this paper. The incidence of this injury may be higher if proper physical and radiological examinations are performed. Therefore, a thorough clinical and radiographic examination of the ankle joint is imperative, before and after reduction of the tibial fracture. Any shortening of the fibula should be corrected surgically, preferable at the time of injury. Malunion should be treated by corrective osteotomy.

Adolescent↗
PubMed1992

Knee-ligament injuries associated with leg fractures. Prospective study.

It has been proved in 25-35% of the cases that knee-ligament injuries are associated with fracture of the femoral diaphysis. No such association has been confirmed between leg fractures and knee ligaments. In order to find out if this is a coincidence, a prospective study was conducted on 229 patients who had undergone operations for leg fractures at various locations and of variable intensity. It was established in 41 cases (17.34%) that the leg fracture was associated with knee-ligament injuries, resulting in joint instability. A significantly higher percentage of associated ligament lesions was found in open fractures as opposed to closed leg fractures. The examination was carried out with the patient under general or block anesthesia. On the basis of what was established it is recommended that the knee be examined clinically in all leg osteosynthesis cases.

Adolescent↗
PubMedDate not supplied

[Fasciocutaneous flaps in the treatment of soft tissue defects of the lower leg caused by explosive war injuries].

The use of fasciocutaneous flaps for the reconstruction of lower leg soft-tissue defects inflicted during the bombing of our country is presented in this case report. The experience with 9 patients with soft-tissue defects of the lower leg is presented with the aim of examining the possibilities of war-wound reconstruction. The results of the earlier use of fasciocutaneous flaps in the lower leg reconstruction as well as the those obtained during the reconstruction of the lower leg soft-tissue defects in war wounds was proven to be safe and reliable method of the reconstructions of severe lower leg injuries, particularly of its distal segment and the malleolus region.

Adolescent↗