[The most common errors in rehabilitation after leg injuries or leg surgery].
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A deep case study on 118 pedestrians struck to fronts of vehicles or vehicle derivatives was carried out. In this paper we investigated a leg injury which occurs the most frequently in a vehicle-pedestrian collision. The data obtained from the case study were compared with those of autopsied cases. Influence of impact speed and point, and of an accident pattern were considered. The leg injury showed higher AIS (Abbreviated Injury Scale) than that of the arm injury caused by direct impact against the front exterior of vehicles. The impact speed and ISS (Injury Severity Score) showed strong correlation, but the former and AIS did not show significant correlation. The higher impact speed and the run-over are likely to cause a bilateral leg fracture.
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Leg injuries due to motorcycle accidents are becoming increasingly common, and a relatively high proportion of these injuries are severe, requiring intensive and prolonged treatment with an often disappointing final result. A total of 309 injured motorcyclists consented to take part in a study investigating the possibility that crash bars fitted to motorcycles might protect the motorcyclist's legs from injury. In the group as a whole, it seemed possible that crash bars would afford some protection, but the figures were not statistically significant. In the group of 150 motorcyclists injured by side impact, 8 of the 25 with crash bars escaped injuries of the legs compared with only 17 out of 125 who did not have crash bars. These results suggest that crash bars provide a measure of protection to motorcyclist's legs, especially when the impact is from the side.
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The following possible risk factors for leg injuries in female soccer players were studied: age, anatomical alignment, generalized joint laxity, thigh muscle torque, muscle flexibility, ligamentous laxity of the knee and ankle joints, recent injuries, and duration of soccer exposure. A total of 146 players from 13 teams in the second and third Swedish divisions underwent clinical examination, isokinetic measurements of quadriceps and hamstring torques, and testing of postural sway of the legs. All soccer-related leg injuries resulting in absence from at least one scheduled practice session or game were recorded during one outdoor season (April-October). In 50 players there were 61 traumatic injuries, and 17 players sustained 19 overuse injuries. The overall injury incidence rate (traumatic and overuse) was 5.49/1000 h of soccer. Variables significantly increasing the risk of traumatic leg injuries included generalized joint laxity, low postural sway of the legs, hyperextension of the knee joint, and a low hamstring-to-quadriceps ratio during concentric action. Multivariate logistic regression showed hyperextension of the knee joint, a low postural sway, reduced H/Q ratio during concentric action, and a higher exposure to soccer to significantly increase the risk of traumatic leg injury. All five players who suffered an anterior cruciate ligament injury during the study period had a lower hamstring-to-quadriceps ratio during concentric action on the injured side than on their noninjured side.
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In order to reduce straw input, soft lying mats are used increasingly instead of straw bedding in cubicle systems for dairy cows. This study aimed at comparing different types of soft lying mats with straw bedding regarding cow behaviour and leg injuries. Data were collected on five farms with straw bedding and on 13 farms using four types of soft lying mats consisting of different materials. On each farm, lying behaviour of 10 cows was recorded automatically during 3 days by means of a pneumatically operated resting sensor fitted in a belt. In addition, standing up and lying down behaviour of cows was quantified by direct observations, and all cows on a given farm were checked once for leg injuries.There were no significant differences between cows kept in cubicle systems with soft lying mats and straw bedding regarding the total time spent lying per day and the number of lying bouts per day. Standing up and lying down behaviour also did not differ between cows with access to soft lying mats and straw bedding. Leg injuries were most frequent in the tarsal and carpal joints. Cows kept in cubicle systems with soft lying mats had a significantly higher incidence of both hairless patches more than 2 cm in diameter (P<0.001) and scabs or wounds less than 2 cm in diameter (P<0.001) located in the tarsal joints than cows in cubicle systems with straw bedding. With the carpal joints, on the other hand, the incidence of leg injuries did not differ significantly between these two housing conditions. In conclusion, the results of this study indicate that soft lying mats are equivalent to straw bedding in terms of cow behaviour but less favourable with respect to leg injuries located in the tarsal joints.
In this study, we first present a comparison between pelvis/upper leg injuries observed in real-world accidents as recorded in the database of the Medical University of Hanover, and the EEVC test results of corresponding cars as published by EuroNCAP. The fact that modern cars with rounded hood edges cause very few pelvis/upper leg injuries is discussed against the findings of the EEVC tests, where these cars do not perform significantly better than their older counterparts with sharper hood leading edges. This discrepancy could be due to the fact that the radius of the hood edge is not accounted for in the current version of the test protocol. In a second step, various impacts against several different simplified hood shapes were simulated using a detailed finite element model of a 50(th) percentile male pedestrian. The finite element model (THUMS) has been extensively validated against PMHS experiments in previous studies. The validated model affords detailed insight into pelvic and femoral deformations and loading patterns, and reveals, as expected, that the shape of the hood leading edge plays a critical role in the resulting biomechanical loading patterns. Based upon the results of this study, recommendations are offered for a more appropriate characterization of the hood shape with regard to pelvis/upper leg injury risk.
Injuries in the leg span a broad spectrum of patient age and athletic level. Overuse injuries, such as medial tibial stress syndromes and stress fractures, tend to occur in the young athlete, whereas tennis leg usually occurs in the older population. With a few exceptions, most of these injuries can be successfully treated nonoperatively. Particularly with the young athlete, it is important to stress the necessity to rest and avoid activities that would compound the injury.
Soccer players have a high risk of soft-tissue injuries to their legs. Fractures of the tibia and fibula represent a serious potential injury; despite this, the incidence of these fractures in soccer players is unknown. Shin guards have become the only protective devices that are required by international and collegiate soccer associations. Nonetheless, the protective ability of shin guards has only been studied to a limited extent. Shin guards are assumed to be most effective at reducing leg abrasions and contusions. The role of shin guards in protecting against fractures has yet to be determined. Further analysis of the clinical effectiveness and biomechanical properties of shin guards is necessary to reduce the rate of leg fractures.
Acute ischaemia in the tibial compartments is a recognized complication of fractures, vascular injury, vascular surgery, crush injuries and burns. The tissue pressure was measured in the first week after injury and the effect of diuretics has been evaluated in a double-blind randomized manner. The pressure in the anterior tibial compartment was measured in the first week after injury in a double-blind randomized manner in 40 patients who had sustained either accidental or surgical injury of the leg. The pressure in the group treated with placebos increased by 20 per cent in the first 24 hours, whereas the pressure fell by 25 per cent in those treated with diuretics. Diuretic treatment is recommended for patients with injury of the lower limbs.
1. The glycogen-depletion patterns were studies as a measure of muscle-fibre recruitment in patients after leg injuries (fractures, ligament injuries). Intermittent isometric and dynamic isokinetic knee extension were performed with 30 and 50% of the maximal isometric torque of the injured leg. In a third group isokinetic and dynamic exercise with weights were compared by using maximal effort procedures. 2. The 30% maximal voluntary contraction programme, which corresponded to 16% of maximal voluntary contraction of the non-injured leg, resulted in glycogen depletion of type I fibres, which was significant only in the isometric exercise. In the 50% maximal voluntary contraction programme (41% of maximal voluntary contraction of the non-injured leg) depletion of type II fibres dominated and was significant with isometric exercises. In the maximal effort programmes there was a significant depletion of type II fibres. 3. Subjects with a relatively large reduction in strength or a small number of type I fibres demonstrated more depletion of these fibres than other subjects. 4. In patients with moderately reduced muscle strength and muscle fibre atrophy static or dynamic exercises using at least 50% of the actual maximal voluntary contraction can thus be used to recruit and train type II fibres.
BACKGROUND: Deep-vein thrombosis is a well-recognized complication after trauma to the legs and subsequent immobilization, but there are no generally accepted approaches to preventing this complication. METHODS: We performed a prospective, double-blind, placebo-controlled trial to evaluate the efficacy and safety of subcutaneous reviparin (1750 anti-Xa units given once daily) in 440 patients who required immobilization in a plaster cast or brace for at least five weeks after a leg fracture or rupture of the Achilles tendon. The study drug was given throughout the period of immobilization. Venography of the injured leg was performed within one week after removal of the plaster cast or brace, or earlier if there were symptoms suggesting deep-vein thrombosis. RESULTS: Data on efficacy and end points were available for 371 patients. Deep-vein thrombosis was diagnosed in 17 of the 183 patients randomly assigned to receive reviparin (9 percent) and in 35 of the 188 patients randomly assigned to receive placebo (19 percent) (odds ratio, 0.45; 95 percent confidence interval, 0.24 to 0.82). Most of the thromboses were distal (14 in the reviparin group and 25 in the placebo group). There were two cases of pulmonary embolism, both in patients in the placebo group who also had proximal deep-vein thrombosis. There were no differences between the two groups with respect to bleeding or other adverse events. CONCLUSIONS: Deep-vein thrombosis is common in persons with leg injury requiring prolonged immobilization. Reviparin given once daily appears to be effective and safe in reducing the risk of this complication.
The aim of this study was to assess the effect of grazing (G) vs. zero-grazing (ZG), level of milk production, and quality and type of housing system [free stalls (FS) and straw yards (SY)] on the prevalence of lameness and leg injuries in dairy cows. Observations were made on 37 commercial dairy farms across Great Britain. A single visit of 5 d duration was made to each farm. During this visit, lameness scores and the incidence of swellings, rubs, and injuries to hocks and knees were recorded on all the peak- or mid-lactation cows. Aspects of the quality of housing and management that were likely to affect foot and leg health were recorded. There were more lame cows on ZG farms (39 +/- 0.02%) than on grazing (G) farms (15 +/- 0.01%), and lameness scores were higher on FS farms compared with SY farms (0.25 +/- 0.01 vs. 0.05 +/- 0.01). Cows on SY farms had fewer hock and knee injuries compared with FS farms. The frequency of knee swellings was higher on ZG farms (0.31 +/- 0.02) than on G farms (0.15 +/- 0.01). Aspects of the free-stall design affected foot and leg health. The number of hock swellings increased with increasing stall gradient (0.16 +/- 0.01 with no slope vs. 0.39 +/- 0.02 at a 0 to 1.5% slope). There was an interaction between the length of the free-stall lunging space and the hip width of the cow, indicating that the incidence of lameness is generally highest on farms with small free stalls and heavy cows. High levels of milk production did not affect lameness or leg injury. The results indicate that housing cows throughout the year potentially has a detrimental effect on foot and leg health. However, good free-stall design may reduce lameness and leg lesions.
Serum IgG profiles for calves up to 50 days varied markedly depending on the level of passively acquired immunity. A relationship between serum IgG at 5 days of age and prevalence of leg injuries (skin lesions) was found, whereas no associations were seen regarding IgG and diarrhoea or liveweight gain.