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PubMed2003

Treatment of isolated type I open fractures: is emergent operative debridement necessary?

A retrospective review was done of treatment of isolated Type I open fractures. Ninety-one patients with isolated Type I open fractures were included in the study. Patients with multiple injuries, gunshot wounds, hand injuries, compartment syndromes, intraarticular fractures, or higher type open fractures were excluded. All patients received antibiotics and were followed up until fracture union. The patients' charts were reviewed for the type of fracture, mechanism of injury, type of treatment, length of hospital stay, and complications encountered, especially infections. There was a 0% incidence of infection in all patients. Only one patient received operative debridement within 12 hours. A prospective randomized study of the treatment of Type I open fractures is needed to determine whether immediate operative debridement is necessary to prevent infection. Immediate operative debridement may not be necessary in the isolated, low-energy Type I open fracture with stable fracture patterns.

Adult↗
PubMed2002

Injuries in Australian cricket at first class level 1995/1996 to 2000/2001.

OBJECTIVE: To describe and analyse injuries and illness occurring in Australian cricket at first class level. METHODS: Injuries occurring to the state and national teams were surveyed prospectively between the seasons 1998/1999 and 2000/2001, and the three preceding seasons were surveyed retrospectively. The definition of an injury was detailed and generally required the player to miss playing time in a major match. RESULTS: Average injury match incidence in the seasons studied prospectively varied from a low of 19.0 injuries per 10 000 player hours in first class domestic matches to a high of 38.5 injuries per 10 000 player hours in one day internationals. The average seasonal incidence was 19.2 injuries per squad (25 players) per season (20 matches). Injury prevalence (the percentage of players missing through injury at any given time) was 14% for pace bowlers, 4% for spin bowlers, 4% for batsmen, and 2% for wicket keepers. The most common injuries were hamstring strains, side strains, groin injuries, wrist and hand injuries, and lumbar soft tissue injuries. Bowlers who had bowled more than 20 match overs in the week leading up to a match had an increased risk of sustaining a bowling injury (risk ratio 1.91, 95% confidence interval (CI) 1.28 to 2.85). A further risk for bowling injury is bowling second in a match-that is, batting first (risk ratio 1.62, 95% CI 1.04 to 2.50). A risk factor for injury in fielding is colliding with the boundary fence. CONCLUSIONS: Further study is required to determine ways to minimise the risk of injury in fast bowlers. Cricket grounds should mark a boundary line on the playing field to prevent players colliding with fences in the field.

Athletic Injuries↗
PubMed2001

Epidemiology of amputations and severe injuries of the hand.

In a prospective population-based study, all open hand, wrist, and forearm injuries that were treated during a 10-year period, at hospitals and emergency wards in three Norwegian cities with 225,000 inhabitants, were registered. Injury severity was graded using the abbreviated injury scale (AIS). For moderate injuries (AIS 2) overall incidence (95% CI) was 59 (56-62), incidence among males 92 (86-98), and among females 28 (25-31) per 100,000 person-years. For severe injuries (AIS > or = 3), overall incidence (95% CI) was 7.5 (6.3-8.6), incidence among males 11.1 (9.1-13.1), and among females 4.0 (2.8-5.2) per 100,000 person-years. In a second study, all upper extremity amputation and devascularization injuries were referred during a 9-year period to the only replantation center in a southern Swedish region where 1.6 million inhabitants were analyzed. The incidence rate (95% CI) for upper extremity amputation or devascularization injuries potentially requiring replantation or revascularization was 1.9 (1.7-2.1), incidence among males 3.3 (2.9-3.7), and among females 0.5 (0.4-0.7) per 100,000 person-years.

Abbreviated Injury Scale↗