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[EXPOSED FRACTURE].

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Fractures, Bone↗

Tennis leg.

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Athletic Injuries↗

Injuries in Rugby Union football.

In a prospective study of 185 players attached to 10 British rugby clubs, 151 injuries were recorded among 98 of them (53%) during a single season. Forwards sustained significantly more injuries than backs. The standard of rugby, players' body weights, degree of fitness, and presence of joint hypermobility did not affect the risk of injury. The leg was the most common site of injury. Head and neck injuries were significantly more common when play was static and on wet pitches. Scrummaging accounted for no neck injuries. Almost half the injuries occurred during the last quarter of games. Foul play might have caused as many as 47 (31%) of all reported injuries. Complete eradication of deliberately dangerous play would considerably reduce the high incidence of injuries in this sport.

Adult↗

Soft tissue injuries to USA paralympians at the 1996 summer games.

OBJECTIVE: To report the soft tissue injuries sustained by the members of four disabled sports organizations (DSOs) who competed as the USA Team at the 1996 Paralympic Games. SETTING: 1996 Paralympic Games, Atlanta, Georgia. METHODS: Soft tissue (strain, sprain, tendonitis, bursitis, or contusion) injury frequencies sustained by Disabled Sports USA (DSUSA, n = 66), the United States Association for Blind Athletes (USABA, n = 53), the United States Cerebral Palsy Athletic Association (USCPAA, n = 56), and Wheelchair Sports USA (WSUSA, n = 129) athletes were compared by body region with chi-square tests (p<.05) and standardized residual assessment. RESULTS: A total of 254 soft tissue injuries (67% acute onset, 170/254) were sustained by the participant DSO members. Statistical design limitations and poor USCPAA athlete homogeneity prompted their exclusion from group comparisons (descriptive results are reported). The most common injury regions for specific DSOs were shoulder (26%), hip-thigh (14%), and ankle (12%) for DSUSA; hip-thigh (21%), cervicothoracic region (19%), and shoulder (17%) for USABA; lumbar region (14%), foot-toe (13%), and ankle (9%) for USCPAA; and shoulder (18%), arm-elbow (12%), forearm-wrist (12%), and lumbar region (9%) for USUSA. Chi-square residual analysis showed that the USABA athletes contributed more to cervicothoracic and lower leg region injury frequencies than DSUSA or WSUSA athletes. The WSUSA athletes contributed more to elbow-arm and forearm-wrist region injury frequencies than DSUSA or USABA athletes. The DSUSA athletes contributed more to ankle region injury frequencies than USABA or WSUSA athletes. CONCLUSIONS: Differences in soft tissue injury frequency among athletes of differing DSOs suggest that the competitive use of adaptive or assistive devices, in combination with sport-specific stressors and the athletes' disabilities, is related to the development of predictable soft tissue injury patterns. The decreased incidence of shoulder injury among WSUSA athletes suggests that the injury prevention advice provided by previous studies is being implemented among athletes at this competitive level. The increased incidence of ankle injuries among DSUSA athletes suggests lower extremity load imbalances (prosthetic vs. uninvolved) during running. The increased incidence of lower leg injuries among USABA athletes suggests "overuse" injury patterns typical of nondisabled runners, or inadvertent contacts (contused shins), whereas the increased incidence of cervicothoracic injuries suggests injuries related to falls, "near falls," or sudden directional changes prompted by guidance aids.

Athletic Injuries↗

[Snow-boarding injuries can be prevented].

The last four winter seasons have witnessed a dramatic increase in the popularity of snowboarding. A series of snowboarding injuries treated at University Hospital, Umeå, predominantly consisted of those sustained by teenage boys, often when jumping or losing balance for other reasons. The upper extremities were the most common sites of injury, 2/3 of these injuries being fractures. The commonest type of lower extremity injury was sprain, and 2/3 of lower extremity injuries affected the foremost leg. To prevent injuries, it is recommended that snowboard bindings should be modified by the introduction of some sort of release mechanism, and enthusiasts should be urged to attend a training course, to use soft-shell footwear and to wear gloves with reinforcement protecting the hand and wrist.

Adolescent↗

[Post-traumatic osteitis following severe soft tissue and skeletal injuries of the distal lower leg and foot].

Complications after severe soft tissue- and skeletal injuries of the distal lower leg and foot are frequent. The incidence of infection is outlined on the basis of the AO-Documentation-Center in Berne. In case of infection, necrotic tissue must be eliminated and stability of the fracture has to be maintained. Cancellous bone grafts as well as microvascular plastics should only be considered in the presence of a well vascularized fracture-bed. The benefit of antibiotics and disinfectants and the interrelation between infection and allergy to implants are discussed.

Anti-Bacterial Agents↗

Increased vascular resistance in paralyzed legs after spinal cord injury is reversible by training.

The purpose of the present study was to determine the effect of a spinal cord injury (SCI) on resting vascular resistance in paralyzed legs in humans. To accomplish this goal, we measured blood pressure and resting flow above and below the lesion (by using venous occlusion plethysmography) in 11 patients with SCI and in 10 healthy controls (C). Relative vascular resistance was calculated as mean arterial pressure in millimeters of mercury divided by the arterial blood flow in milliliters per minute per 100 milliliters of tissue. Arterial blood flow in the sympathetically deprived and paralyzed legs of SCI was significantly lower than leg blood flow in C. Because mean arterial pressure showed no differences between both groups, leg vascular resistance in SCI was significantly higher than in C. Within the SCI group, arterial blood flow was significantly higher and vascular resistance significantly lower in the arms than in the legs. To distinguish between the effect of loss of central neural control vs. deconditioning, a group of nine SCI patients was trained for 6 wk and showed a 30% increase in leg blood flow with unchanged blood pressure levels, indicating a marked reduction in vascular resistance. In conclusion, vascular resistance is increased in the paralyzed legs of individuals with SCI and is reversible by training.

Adult↗