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Lower leg, foot, and ankle injuries in young athletes.

Most injuries to the young athlete do have a benign natural course-complete resolution of the difficulty without sequelae. In order to develop a contemporary program of management of the more serious disorders in this active population, the practitioner must be certain to carefully analyze the injury and initiate a rapid course of action. A fracture of the tibia must be reduced, held aligned, and then rehabilitated. A compartment syndrome commonly demands early fasciotomy; the young athlete and his or her parents warrant a sensitive understanding from physicians to quell the anxiety that is paramount to all of these disorders.

Adolescent↗

Incidence of injury during moderate- and high-intensity walking training in the elderly.

To evaluate the effect of 26 weeks of moderate- and high-intensity walking training on injury rates in the elderly, 68 healthy volunteers (31 men, 37 women) were assigned to moderate intensity (MOD, n = 26) or high-intensity (HI, n = 24) training, or to a control (CONT, n = 18) group. To achieve prescribed training intensity, many subjects walked uphill on a treadmill. Seven of 50 subjects who trained (14%) suffered a training-related orthopedic injury; one subject was injured during treadmill testing. Four training injuries (lower leg and foot) occurred during weeks 1-13; three training injuries (leg and groin) occurred during weeks 14-26. Six of the injuries were to women. Because only one training injury occurred during uphill treadmill walking, injuries appeared related to fast walking and not exercise intensity. The higher incidence of injury in females is consistent with our earlier work, indicating the importance of further research to determine the underlying cause.

Aged↗

An algorithm to assess stiff-legged gait in traumatic brain injury.

Spastic paretic stiff-legged gait is a frequently encountered gait problem in patients with traumatic brain injury, as well as in many other patients with upper motor neuron disease. Formerly, spasticity of the quadriceps was considered to be the sole cause of stiff-legged gait. Quantitative gait analysis, however, may implicate hip flexor weakness or poor ankle mechanics as the cause of stiff-legged gait. We discuss the use of an algorithm to evaluate stiff-legged gait in traumatic brain injury using a quantitative gait analysis system such that the specific etiology of stiff-legged gait can be identified and can serve as the basis of a treatment plan.

Algorithms↗

Post-traumatic and post-surgical Absidia corymbifera infection in a young, healthy man.

Absidia corymbifera infection in a healthy individual is rare. Most of the infection occurs in immunocompromised patients or diabetic patients. Cutaneous and subcutaneous mucormycosis have been increasingly reported in the literature as a result of massive trauma with contaminated wounds. We present a case of cutaneous mucormycosis in a healthy, young patient after surgical amputation for a crush injury of the leg. We also highlight the importance of the high index of clinical suspicion in the diagnosis and treatment of this fungal infection in the hype of methicillin-resistant Staphylococcus aureus (MRSA) infection in hospital setting these days. Despite an initial life-saving amputation, it was inadequate to ensure the eradication of A. corymbifera infection. A second amputation was required with parenteral liposomal amphotericin B to achieve a satisfactory cure.

Absidia↗