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Medical coverage for track and field events.

Providing medical coverage at a track and field event is similar to other spectator events, but there are some important differences. With simultaneous events occurring over a large area, reliable communication with quick access to all event sites is mandatory. Preparation needs to include a prearranged emergency response plan for each event. Because field events involve throwing heavy and sometimes sharp objects (discus, hammer, shot put, and javelin) or landing in a cushioned pit (high jump, pole vault), sites need well-demarcated, constantly monitored boundaries with properly installed, well-maintained safety equipment. All personnel involved in monitoring these events should be educated on proper procedure in managing potential head or neck injuries. Event officials must also remained focused on their tasks, avoiding the distractions that simultaneous events can cause. Because most events are outdoors, appropriate protection and recovery sites for heat, cold, and sun exposure should be arranged.

Arm Injuries↗

Renal lysozyme levels in animals developing Proteus mirabilis-induced pyelonephritis.

In animals developing experimentally induced unilateral pyelonephritis, both the infected kidney (IK) and the contralateral noninfected kidney (NIK) showed an immediate increase in renal lysozyme activity of about 5 days' duration after the unilateral injection of viable Proteus mirabilis into the renal cortex. Lysozyme activities of the NIK were consistently higher than those of the IK. This initial increase was followed by a second increase which lasted throughout the period of observation (17 days), and enzyme activities of the NIK were consistently higher than those of the IK. In saline punctured kidneys of control animals, both the saline punctured kidney (SP) and the non-saline punctured kidney (NSP) showed only the immediate increase in renal lysozyme activity, which persisted until the SP was completely healed. These enzyme activities were less than those observed in the infected animals, but the response of the NSP was greater than that of the SP. Trauma not directed to the kidney does not produce a similar response of renal lysozyme. The elevated renal lysozyme of the NIK could not be shown to protect it from bacterial infection.

Animals↗

Complete avulsion of the hamstring tendons from the ischial tuberosity. A report of two cases sustained in judo.

Rupture of the hamstring tendon is a rare injury. Two cases of complete rupture of the hamstring tendons sustained while playing judo are reported. The diagnosis of a rupture of the hamstring tendons was difficult from physical examination because of severe pain on knee or hip joint movement. Magnetic resonance imaging was non-invasive and showed the lesion clearly. In one of these two cases the less satisfactory results of non-operative treatment were clearly shown in both isokinetic muscle force evaluation and sports activities.

Adult↗

Risk factors for lower extremity injury: a review of the literature.

Prospective studies on risk factors for lower extremity injury are reviewed. Many intrinsic and extrinsic risk factors have been implicated; however, there is little agreement with respect to the findings. Future prospective studies are needed using sufficient sample sizes of males and females, including collection of exposure data, and using established methods for identifying and classifying injury severity to conclusively determine additional risk factors for lower extremity injury.

Age Factors↗

Risk factors for sports injuries--a methodological approach.

The methodology for studies designed to investigate potential risk factors for sports injury is reviewed, using the case of hamstring strains as an example. Injuries result from a complex interaction of multiple risk factors and events. Therefore, a multivariate statistical approach should be used. In addition, the sample size of the study needs to be considered carefully. Sample size mainly depends on the expected effect of the risk factor on injury risk, and to detect moderate to strong associations 20-50 injury cases are needed, whereas small to moderate associations would need about 200 injured subjects. Studies published to date on the risk factors for hamstring strains have methodological limitations, and are too small to detect small to moderate associations.

Athletic Injuries↗

Report on injuries sustained by patients treated at the Birmingham General Hospital following the recent bomb explosions.

As a result of recent bomb explosions a total of 82 patients were treated at the Birmingham General Hospital, 61 with minor injuries. Bomb injuries may be divided into three main groups due to the blast effect (such as blast lung and ruptured tympanic membranes), the flash (such as burns to the exposed part of the body), and shrapnel (which may cause a wide variety of injuries). The amount of warning of such explosions is usually minimal, and so the prepared accident schemes of most hospitals are inappropriate. If the disaster occurs outside normal working hours much responsibility initially falls on the resident staff. This report gives some idea of the type of injuries they are likely to see.

Adolescent↗

Non-fatal injuries sustained by seatbelt wearers: a comparative study.

The injuries sustained by 969 drivers and front-seat passengers in road-traffic accidents were studied. Altogether 196 (20-2%) of the drivers and passengers were wearing seat belts and 773 (79-8%) were not. The injuries among the two groups differed greatly in both severity and distribution. A total of 54 (27-6%) of the seatbelt wearers sustained one or more fractures compared with 300 (38-8%) of the non-wearers, and 18 (9-2%) of the seatbelt wearers were severely injured compared with 300 (38-8%) of the non-wearers. Soft-tissue injuries to the face were sustained by only 29 (14-8%) of the seatbelt wearers compared with 425 (55%) of the non-wearers. Since wearing seatbelts may become compulsory, the type and pattern of injuries to be expected in wearers should be appreciated.

Abdominal Injuries↗

Nail gun injuries in residential carpentry: lessons from active injury surveillance.

OBJECTIVE: To describe circumstances surrounding injuries involving nail guns among carpenters, calculate injury rates, identify high risk groups and preventive measures. METHODS: and setting: Active injury surveillance was used to identify causes of injury among a large cohort of union residential and drywall carpenters. Injured carpenters were interviewed by experienced journeymen; enumeration of workers and hourworked were provided by the union. The combined data allowed definition of a cohort of carpenters, their hours worked, detailed information on the circumstances surrounding injuries, and identification of preventive measures from the perspectives of the injured worker and an experienced investigator. RESULTS: Nail guns were involved in 14% of injuries investigated. Ninety percent of these injuries were the result of the carpenter being struck, most commonly by a nail puncturing a hand or fingers. The injury rate among apprentices was 3.7 per 200 000 hours worked (95% confidence interval (CI) 2.7 to 4.9) compared with a rate of 1.2 among journeymen (95% CI 0.80 to 1.7). While not always the sole contributing factor, a sequential trigger would have likely prevented 65% of the injuries from tools with contact trip triggers. CONCLUSIONS: Training, engineering, and policy changes in the workplace and manufacturing arena are all appropriate targets for prevention of these injuries. Use of sequential triggers would likely decrease acute injury rates markedly. Over 70% of injuries among residential carpenters were associated with through nailing tasks (such as nailing studs or blocks, trusses or joists) or toe nailing (angled, corner nailing) as opposed to flat nailing used for sheathing activities; this provides some indication that contact trip tools could be used solely for flat nailing.

Accidents, Occupational↗

Digital subtraction angiography in extremity trauma.

Digital subtraction angiography (DSA) may have considerable impact on the work-up of patients who have suffered blunt or penetrating trauma. The angiographic evaluation of vascular injuries (e.g., arteriovenous fistulae, pseudoaneurysms, hemorrhage) can be accomplished rapidly and with minimal catheter use and manipulation, which is particularly important for those critically ill patients who have significant immobility because of multiple fractures. We retrospectively reviewed the digital subtraction angiograms in 50 consecutive cases of extremity trauma. The quality of the images in 44 of these permitted a confident diagnosis, the accuracy of which was confirmed by surgical or clinical follow-up. One false-positive and three false-negative examinations for small muscle bleeders were discovered, but none of these was considered clinically significant. DSA reduces the time required to perform the procedure, the amount of contrast material injected, patient discomfort, and film cost. Its major disadvantage is the limited field size of the image intensifier.

Angiography↗

MR imaging in the prognostication of hamstring injury. Work in progress.

PURPOSE: To correlate morphologic and magnetic resonance (MR) imaging findings in hamstring injury with short-term prognosis and convalescence interval (CI). MATERIALS AND METHODS: A retrospective study of 14 professional athletes with hamstring injury was performed. The injuries were categorized according to muscle group involved, percentage of cross-sectional area affected, location, and signal intensity on T1- and T2-weighted spin-echo images. RESULTS: Longer CIs (> 6 weeks) were seen in injuries with complete transection, greater than 50% cross-sectional muscle involvement, ganglionlike fluid collections (long T1 and T2), hemorrhagelike signal intensity (short T1 and T2), distal myotendinous junction tears, and deep muscular tears. Shorter CIs (< 5 weeks) were seen in superficial muscle injuries and muscle belly injuries that involved small cross-sectional areas of the muscle. CONCLUSION: Prediction of CI for high-performance athletes with complete hamstring injury may be accomplished with use of MR imaging and poor prognostic factors.

Adult↗