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At least 973 records · Page 54Linked to original sources
PubMed2000

[Left atrium rupture after non-penetrating injury to the back].

Survival after cardiac rupture associated with blunt thoracic trauma is very uncommon. In these patients successful management demands a high index of suspicion of cardiac injury. A case of a 24-year-old woman who presented unconscious and shocked in the emergency room after motorcycle trauma strictly limited to her back is reported. Rib and sternal fractures were absent; the typical signs of cardiac tamponade were not found. Therefore the suspicion of cardiac chamber rupture was not immediate and the cardiologist was consulted after several diagnostic exams. Transthoracic echocardiography showed a pericardial effusion with clots and initial cardiac tamponade. The patient was transferred to the operating room and a large hemopericardium was disclosed. Two lacerations were noticed: the first pericardial, near the inferior vena cava, and the second one in the posterior wall of the left atrium. It is possible that the associated pericardial tear and pericardial clots could have contributed to survival. After surgical repair, carried out during cardiopulmonary bypass, the recovery was quick and complete. This case report confirms the possibility of heart chamber rupture after blunt chest trauma even in the absence of obvious thoracic lesion and it shows that the presentation could be very insidious without a "classic" clinical picture of cardiac tamponade. In front of an unexplained shock after nonpenetrating thoracic trauma, a rupture of the heart chambers should be suspected and echocardiography is mandatory. In the emergency room environment pericardiocentesis should be performed only with a quickly available cardiac surgery or in the presence of overwhelming hemodynamic failure.

Adult↗
PubMed2005

A comparison of self-perceived physical and psycho-social worker profiles of people with direct work injury, chronic low back pain, and cumulative trauma.

This study investigated the psycho-social factors among injured workers and the influence of their psycho-social profile on the readiness of return to work. Sixty-four subjects with injuries on the upper limbs or lower limbs, low back pain, or cumulative trauma disorder were recruited. The workers' profiles (self-perceived physical health, mental health, and work readiness) together with the impact and types of work injury on the workers' perceived wellness were measured. The regression model of work readiness was constructed to develop a theoretical background for predicting work readiness based on different factors. The results showed that injured workers with chronic injury such as low back pain or cumulative trauma had poorer self-perception of physical health and psycho-social/mental health compared to those with direct trauma. The regression analysis further affirmed that self-perceived pain and physical functioning were significant factors influencing the readiness for returning to work. Workers with low back pain were found to have lower motivation for returning to work. Other factors such as the non-verbal intelligence of the injured workers, their anxiety level, and the support they received from family members were found to have some indirect impact on their ability to return to work, but this was not statistically proven.

Adult↗
PubMed1994

Injury and proprioception in the lower back.

No known research has attempted to quantify proprioception of the lower back or to examine the relationship between injury and proprioception in this region. The primary purpose of this study was to explore relationships between low back injury and proprioception of the lower back. Subjects were 88 working male firefighters from public emergency medical service departments. Three types of lower back proprioception (passive motion threshold, directional motion perception, and repositioning accuracy) were tested. Each type of proprioception was examined in the three primary planes of motion using a device designed by the author. Some anthropometric and personal variables were statistically controlled. All variables underwent multiple correlation analysis. The primary findings were: 1) longevity factors [age (r = .30, p < .01) and years of experience (r = .35, p < .001)] were best correlated with proprioceptive deficits in the sagittal plane; 2) injuries were correlated (p < .05) with proprioceptive deficits in the coronal (r = .22) and sagittal planes (r = .17) and with deficits in multiple planes (r = .19); 3) proprioceptive asymmetries were associated with injuries; and 4) the factor most highly correlated with the history of low back injuries was the presence of a spinal disorder (r = .40, p < .001). Impaired proprioception resulting from injury may degrade lumbar motor function, increasing workers' risk of reinjury. Restoring proprioception of the lumbar spine after injury should be a goal of treatment.

Adult↗
PubMed2003

Injury in the Australian sport of calisthenics: a prospective study.

The aims of this study were to determine the rate, anatomical regions, onset, severity, and type of injury in the sport of calisthenics and compare injuries reported by elite and non-elite participants. Prospective reports of injuries were collected over a 12-month period from 550 elite and non-elite calisthenics participants. The participants recorded the number of training sessions, competition, and performances per week, hours of training, and information on any injuries sustained each week during the survey period. Five hundred and fifty participants reported 190 injuries during the survey period, 0.4 injuries per participant year or 0.3 injured participants per participant year. The odds ratio of injury in the elite to the non-elite group was 2.0 (95% CI 1.3 to 2.9). Injuries to the lower back (32.4% of all injuries), hip thigh and groin (25.4% of all injuries) were most common. Activities involving lumbar extension (29.8% of all injuries and 61.0% of lower back injuries) were perceived by participants to have led to injury. In general, injuries were minor and mainly involved soft tissue structures (95.6% of all injuries). Participants had difficulty in identifying why their injuries had occurred. Calisthenics participants did not report high injury rates, but activities that involve lumbar extension are implicated in low back injuries and warrant further attention

Adolescent↗
PubMed1999

Serial changes in trunk muscle performance after posterior lumbar surgery.

STUDY DESIGN: Serial changes in trunk muscle performance were prospectively studied in 20 patients who underwent posterior lumbar surgery. OBJECTIVE: To evaluate the influence of back muscle injury on postoperative trunk muscle performance and low back pain, to clarify the significance of minimization of back muscle injury during surgery. SUMMARY OF BACKGROUND DATA: The current investigators have reported examination of iatrogenic back muscle injury in an animal model and in humans. However, definite impairment caused by such back muscle injury has not been clarified. METHODS: The patients were divided into a short-retraction-time group (< 80 minutes; n = 12) and a long-retraction-time group (> or = 80 minutes; n = 8). Before surgery and 3 and 6 months after surgery, the degree of back muscle injury was estimated by magnetic resonance imaging, and trunk muscle strength was measured. In addition, the incidence and severity of low back pain were serially analyzed. RESULTS: Back muscle injury was directly related to the muscle retraction time during surgery. The damage to the multifidus muscle was more severe, and the recovery of extensor muscle strength was delayed in the long-retraction-time group. In addition, the incidence of postoperative low back pain was significantly higher in the long-retraction-time group. CONCLUSIONS: Postoperative trunk muscle performance is dependent on the muscle retraction time. Thus, it is beneficial to shorten the retraction time to minimize back muscle injury and subsequent postoperative low back pain.

Adolescent↗
PubMed1995

The effect of regional trauma care systems on costs.

OBJECTIVE: To assess cost savings from regional trauma care systems. DESIGN: Multivariate regression analysis is used to isolate the effects of regional trauma care systems on medical costs while controlling for personal and injury characteristics and other factors likely to influence medical costs. Percentage reductions in costs are translated into dollar cost savings with corrections for excluded costs and losses from premature death. SETTING: Injuries to workers filing workers' compensation lost workday claims. PARTICIPANTS: Randomly sampled workers' compensation claims from 17 states filed between 1979 and 1988 (N = 217,000). MAIN OUTCOME MEASURE: Medical payments per episode of four injury groups: lower-extremity fractures and dislocations, upper-extremity fractures and dislocations, other upper-extremity injuries, and back strains and sprains. We distinguish hospitalized from nonhospitalized claims. RESULTS: Statistical analyses reveal that states with trauma care systems have 15.5% lower costs per hospitalized injury episode. Savings average $1025 per case in 1988 dollars. Costs per episode for disabling nonhospitalized injury are 10% lower in states with trauma care systems, with savings averaging $75 per case. The largest savings are for back injuries. CONCLUSIONS: Extending trauma care systems nationwide could lower annual medical care payments by $3.2 billion. Including productivity losses due to premature death, the savings could total $10.3 billion, 5.9% of national injury costs.

Arm Injuries↗
PubMed1992

Personal and job characteristics of musculoskeletal injuries in an industrial population.

A cross-sectional study was conducted of 10,350 full-time regular employees who worked at Shell Oil Company's manufacturing facilities between 1987 and 1989. Two hundred seventy-five employees with low-back and 456 with nonlow-back musculoskeletal injuries were compared with 8295 employees who did not have musculoskeletal injuries during this period. Based on morbidity data collected from a prospective health surveillance system, this study shows that estimated relative risks (RRs) for low-back injuries are significantly higher among smokers (RR = 1.54, P less than .01) and overweight persons (RR = 1.42, P less than .01). This observation is also true for nonlow-back musculoskeletal injury (RR = 1.23, P = .05 for smokers and RR = 1.53, P less than .01 for overweight persons). In addition, persons in potentially more physically demanding jobs (primarily maintenance job titles) had an increased RR for both low-back and nonlow-back musculoskeletal injuries (RR = 1.57, P less than .01 and RR = 1.35, P = .02, respectively). The findings of this study suggest that it may be possible to reduce the impact of musculoskeletal injury through implementation of an integrated injury prevention program. Such programs would include not only the traditional elements of job factors evaluation and modifications, employee education and training, and an overall increased attention to ergonomics but also medical counseling and support for personal fitness programs, workplace smoking cessation programs, and weight-reduction programs.

Accidents, Occupational↗
PubMed1983

Low back pain in the athlete. From spondylogenic injury during recreation or competition.

Low back pain is a common complaint of athletes, and accurate diagnosis is essential, since many causes of back problems can lead to disability. If the obvious mechanical causes, such as muscle strain, "kissing spines," and leg-length inequality, have been ruled out, the more serious sources of low back pain, such as disk herniation, Scheuermann's disease (swimmer's back), compression fractures of the vertebral body, and stress fractures of the posterior elements, should be considered. Treatment goals for all these disorders include pain relief and prevention of further injury.

Adolescent↗