| Abstracts - Epidemiologia |
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Modificado em 23 Fevereiro 2012 64 abstracts
Non-avalanche-related snow immersion deaths: tree well and deep snow immersion asphyxiation.
Van Tilburg C, Wilderness & environmental Medicine, 2010, 21(3):257,- Mountain Medical Clinic, Providence Hood River Memorial Hospital, Hood River, OR, USA. Non-avalanche-related snow immersion death (NARSID), or snow immersion asphyxiation, is a significant winter mountain hazard for skiers and snowboarders. This phenomenon occurs predominately in western North America, where large tree wells and deep snowpacks develop. Although statistics are difficult to procure, snow immersion asphyxiation has resulted in more than 70 documented deaths in the past 2 decades. The primary purpose of this review is to examine the existing literature on NARSID to help prevent such dangerous accidents through educating wilderness medicine professionals and fostering public awareness. The exact duration of burial to time of death and the cause of death are not precisely known but can be postulated from accident reports, experimental snow burial studies, and avalanche literature. In most cases, death probably occurs within 15 to 30 minutes from the time of burial. However, survival after prolonged burial in a tree well and deep snow is possible. The cause of death is asphyxiation, probably due to one of the mechanisms that produce asphyxia in avalanche burial victims: positional asphyxia, airway obstruction, or carbon dioxide displacement asphyxia. Prevention of snow immersion asphyxiation begins with skiers and snowboarders staying within the limits of their skills, using the proper tools for deep powder, staying in control at all times, and employing a buddy system. A skier or snowboarder who falls near or into a tree well should tuck, roll, and try to land upright, grab the tree trunk or a branch, and yell or blow a whistle to alert partners. If buried upside down, the person should stay calm and create an air pocket, which is probably of paramount importance. Skiers and snowboarders should use avalanche safety equipment to lessen the risk of snow submersion asphyxiation.
Injury incidence and predictors on a multiday recreational bicycle tour: The Register's Annual Great Bike Ride Across Iowa, 2004 to 2008.Boeke PS, House HR, Graber MA, Wilderness & environmental Medicine, 2010 21(3):202-7. Department of Emergency Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA. OBJECTIVE: The "Register's Annual Great Bike Ride Across Iowa" (RAGBRAI) is a 7-day recreational bicycle ride with more than 10,000 participants covering 500 miles. The heat and humidity of late July in Iowa, the prevalence of amateur riders, and the consumption of alcohol can combine creating the potential for a significant number of injuries. The purpose of this study is to determine the type, quantity, and severity of injuries on RAGBRAI and gather data on the factors related to these incidents. METHODS: This retrospective chart review examined ambulance "run sheets" for patients requiring transport to the hospital from the bike route between 2004 and 2008. These run sheets included name, age, chief complaint, anatomic location of injuries, medications administered, procedures performed, and a full narrative describing the initial scene, patient's account of the incident, services provided, and ongoing condition of the patient while en route to the hospital. Chi-square tests, Pearson's correlation tests, and t tests were applied to determine significant statistical outcomes. RESULTS: From 2004 to 2008, Care Ambulance Inc provided on-route medical services for 419 RAGBRAI participants. Of these participants, 190 (45.3%) required transport to a local hospital by Care Ambulance Inc. Females were more likely to require transport, as they comprised 46.3% of transported patients while only representing 35% of all RAGBRAI participants (P = .001). For men, increasing age was a significant predictor of transport, particularly males between the ages of 60 and 69 years old (P = .01). Of the 148 run sheets where mechanism of incident was documented, 114 incidents were caused by rider factors (77.0%), 29 by road factors (19.6%), and 5 by bicycle factors (3.4%). Higher heat indexes were correlated with an increased number of dehydration cases (r = 0.979, P = .02). Of participants who reported with minor injuries to a mobile first aid station and did not require transport, 90.1% had not imbibed any alcohol. Bony injuries were more common above the waistline as 39/45 (86.7%) fractures occurred to the clavicle, shoulder/proximal humerus, hand, or head. The most common bony injury each year of RAGBRAI was a clavicle fracture, which represented 44.4% of all recorded fractures from 2004 to 2008. Lacerations and abrasions were also more common above the waist, as 63.5% (127/200) of soft tissue injuries requiring treatment were either to the head or upper extremities. No specific event day showed any correlation with increased injury (P >.05). CONCLUSIONS: This study suggests that females and older males are more likely to require transport for injuries sustained on RAGBRAI, the majority of injuries occur around the head and upper extremities, dehydration case load is correlated with heat index, and that incidents are usually caused by rider factors. This research could be used by multiday recreational bicycle tour organizers to continue educating riders on riding carelessness and etiquette and prepare medical services for certain quantities and types of injuries.
The development and application of an injury prediction model for noncontact, soft-tissue injuries in elite collision sport athletes.Gabbett TJ.: Journal of strength and conditioning research / National Strength & Conditioning Association, 2010, 24(10):2593-603, Brisbane Broncos Rugby League Club, Brisbane, Australia. Limited information exists on the training dose-response relationship in elite collision sport athletes. In addition, no study has developed an injury prediction model for collision sport athletes. The purpose of this study was to develop an injury prediction model for noncontact, soft-tissue injuries in elite collision sport athletes. Ninety-one professional rugby league players participated in this 4-year prospective study. This study was conducted in 2 phases. Firstly, training load and injury data were prospectively recorded over 2 competitive seasons in elite collision sport athletes. Training load and injury data were modeled using a logistic regression model with a binomial distribution (injury vs. no injury) and logit link function. Secondly, training load and injury data were prospectively recorded over a further 2 competitive seasons in the same cohort of elite collision sport athletes. An injury prediction model based on planned and actual training loads was developed and implemented to determine if noncontact, soft-tissue injuries could be predicted and therefore prevented in elite collision sport athletes. Players were 50-80% likely to sustain a preseason injury within the training load range of 3,000-5,000 units. These training load 'thresholds' were considerably reduced (1,700-3,000 units) in the late-competition phase of the season. A total of 159 noncontact, soft-tissue injuries were sustained over the latter 2 seasons. The percentage of true positive predictions was 62.3% (n = 121), whereas the total number of false positive and false negative predictions was 20 and 18, respectively. Players that exceeded the training load threshold were 70 times more likely to test positive for noncontact, soft-tissue injury, whereas players that did not exceed the training load threshold were injured 1/10 as often. These findings provide information on the training dose-response relationship and a scientific method of monitoring and regulating training load in elite collision sport athletes.
Injury risk factors in junior tennis players: a prospective 2-year study. Hjelm N, Werner S, Renstrom P
22(1):40-8, 2012 The aim was to investigate injury risk factors in junior tennis players. Fifty-five players, 35 boys and 20 girls, answered a questionnaire about training habits, time of exposure, previous injuries and equipment factors. A battery of clinical tests and functional performance tests were also carried out. All tennis-related injuries that occurred during a 2-year period were identified and recorded. An injury was defined as an injury if it was impossible to participate in regular tennis training or playing matches during at least one occasion, a time loss injury. Potential injury risk factors were tested in a forward stepwise logistic regression model for injury. Thirty-nine players sustained totally 100 new and recurrent injuries. Injuries to the lower extremity were the most common ones (51%) followed by the upper extremity (24%) and the trunk (24%). Injured players performed more singles per week (P<0.0001) and played more tennis hours per year (P=0.016) than the uninjured players. Playing tennis more than 6 h/week was found to be a risk factor for back pain. A previous injury regardless of location was identified as an injury risk factor, and a previous injury to the back was a risk factor for back pain.
Injury in elite county-level hurling: a prospective study. Murphy JC, Gissane C, Blake C
46(2):138-42, 2012 Objective To determine the incidence, prevalence and nature of sports injuries in elite male hurling players. Design Prospective study of county-grade hurling teams. Incidence, prevalence and descriptions of injuries were collated. Setting Four county teams during the 2007 season; January to September inclusive. Participants A total of 127 male players were followed over 34 weeks. Data were collected on a median (IQR) of 31 (30-32) players per team per week. The mean age was 23.3±2.5 years. Results There were 204 injuries to 104 players (82%, 95% CI (74 to 88)). Injury incidence rate during match-play (102.5 (84.4 to 123.2)) was 19 times higher than for training (5.3 (4.2 to 6.5)) (RR=19.5 (14.8 to 25.6)). The mean weekly prevalence of injury was 13.9% (12.5 to 14.8). Most injuries were new (n=170, 83.3%, (77.6 to 87.8)) and acute (n=165, 80.9% (74.9 to 85.7)). Muscle strain (n=86) accounted for 42.2% (35.6 to 49) of the total. 71% of injuries were to the lower limb (n=143, (63.5 to 76.0)) with hamstring strain (n=33, 16.5% (11.8 to 21.8)) predominating. Fractures constituted 7.4% injuries (n=15, 95% CI (4.5 to 11.8)), 12 of which were to the upper limb. There were three (1.5% (0.5 to 4.2)) eye injuries and one concussion injury (0.5% (0.1 to 2.7)). Conclusions These results provide data on hurling injuries using definitions that reflect international consensus statements. Injury incidence from match-play in particular is high compared with other sports. These findings have relevance for clinicians and coaches.
Injuries among World Cup ski and snowboard athletes. Flørenes TW, Nordsletten L, Heir S, Bahr R
22(1):58-66, 2012 There is little information available on injuries to World Cup skiers and snowboarders. The aim of this study was to describe and compare the injury risk to World Cup athletes in alpine skiing, freestyle skiing, snowboarding, ski jumping, Nordic combined and cross country skiing. We performed retrospective interviews with the International Ski Federation (FIS) World Cup athletes from selected nations during the 2006-2007 and 2007-2008 winter seasons and recorded all acute injuries occurring during the seasons. We interviewed 2121 athletes and recorded 705 injuries. There were 520 (72%) time-loss injuries and 196 (28%) severe injuries (absence >28 days). In freestyle skiing, alpine skiing and snowboarding, there were 27.6, 29.8 and 37.8 time-loss and 14.4, 11.3 and 13.8 severe injuries per 100 athletes per season, respectively. In Nordic combined, ski jumping and cross country skiing, there were 15.8, 13.6 and 6.3 time-loss and 3.3, 5.6 and 0.7 severe injuries per 100 athletes per season, respectively. In conclusion about 1/3 of the World Cup alpine, freestyle and snowboard athletes sustain a time-loss injury each season, while the risk is low in the Nordic disciplines. A particular concern was the high proportion of severe injuries observed among alpine, freestyle and snowboard athletes, which is in contrast to most other sports.
The practice of physical activity of the Portuguese adults and fulfilment of physical activity recommendations. Carvalho JP, André J, Raia L, Martins J, Marques A, Carreiro da Costa F British journal of sports medicine 45(15):A18, 2011 Dez The aim of the study was to analyse (by sex and age) the practice of physical activity (PA) in Portuguese adults according to the recommendation for PA. The sample consisted of 2657 adults (1130 male, 1527 female) age 20 to 60 y (43±7 y). PA was assessed by a questionnaire about leisure time activities and PA participation. The number of PA sessions per week and their intensity were taken into account to determine the meeting of the recommendations (moderate-intensity aerobic PA for a minimum of 30 min. 5 days/week, or vigorous PA for a minimum of 20 min 3 days/week). The data were analysed separating age, by brackets of 10 years, and sex. Statistical analyses were performed using qui-square and t-test. For the entire sample, only 32% (men 32%, women 31%) met the guidelines of PA. While the percentage of male that met the recommendation was higher among youngsters (43%), among women the oldest were the most active (33%). In general, there was no significant differences between sexes and the meeting of the recommendations (p=0.636). Within adults, both male and female, age-groups were not different (p=0.860, p=0.932). Analysing each age-group, the percentage of males that meet the recommendation was higher than female at age of 20-30 (43% vs 30%) and 41-50 (33 vs 315). On the other hand, the opposite was observed at age of 31-40 (30% vs 32%) and 51-60 (32% vs 33%). Although the percentage of men and women that meet the recommendation were different in all age-groups, it was observed that the meeting of the PA guidelines were independent of the sex - 20-30 (p=0.181), 31-40 (p=0.513), 41-50 (p=0.398) and 51-60 (p=0.912). Most of the participants did not practise enough PA to meet the recommendations. Both sexes have similar results in each age-group, demonstrating that both sex and age have no relationship with the meeting of PA guidelines.
The epidemiology of cross country skiing injuries. Howes J, Droog SJ, Evans J, Wood IM, Wood AM British journal of sports medicine 45(15):A20, 2011 Dez There is little literature about the epidemiology of injuries sustained while conducting cross country skiing due to the disparate nature of these athletes. The Royal Marines regularly deploys to Norway to conduct cross country ski-training and cold weather warfare training which presents a unique opportunity to analyse injuries sustained while conducting this sport. A total of 1200 personnel deployed to Norway in 2010 over a 14 week period. Patients who sustained injuries who were unable to continue training were returned to the UK. All data on personnel returned to the UK due to injury or illness was prospectively collected and basic epidemiology recorded. 53 patients (incidence 44/1000 personnel) were returned to the UK 20/53 (38%) of all cases were musculoskeletal injuries (incidence 17/1000 personnel). 15/20 musculoskeletal injuries were sustained while conducting cross country ski training (incidence 13/1000). Injuries sustained while skiing: 5/15 sustained anterior shoulders dislocation, 5/15 Grade 1-3 MCL/LCL tears, 2/15 sustained ACJ injuries, 1/15 crush fracture T11/T12, 1/15 tibial plateau fracture and 1/15 significant ankle sprain. The most common injury regardless of cause was anterior shoulder dislocation 6/20 (incidence 5/1000). Our results suggest that cross country ski training has a high injury rate requiring evacuation back to the UK. In our study group the high injury rate is possibly due to the rapid transition from non-skier to skiing with a bergen and weapon. Doctors covering Royal Marine training should have appropriate sports and exercise medical training, and rehabilitation units supporting the Royal Marines should expect sudden increases in referrals when large-scale cross country ski training is being conducted.
Injury surveillance during the 2010 IRB Women's Rugby World Cup. Taylor AE, Fuller CW, Molloy MG British journal of sports medicine 45(15):1243-5, 2011 Dez Centre for Sports Medicine, University of Nottingham, Queen's Medical Centre, C Floor, West Block, Nottingham NG7 2UH, UK. Este endereço de e-mail está protegido de spam bots, pelo que necessita do Javascript activado para o visualizar . Objective To assess and evaluate injuries sustained during the 2010 Women's Rugby World Cup. Design Prospective, cohort. Participants 285 women rugby players. Results Incidence of match injury was 35.5/1000 player-hours; mean severity was 55.0 days and median severity 9 days. Only one training injury was reported. Knee-ligament injuries were the most common (15%) and resulted in most days lost (43%). The tackle was the cause of most injuries. Conclusions The risk of injury in international rugby is significantly lower for women than for men. Further research is required to assess knee-ligament injuries in women's rugby.
Football injuries on synthetic turf fields. Akkaya S, Serinken M, Akkaya N, Türkçüer I, Uyanık E Eklem hastaliklari ve cerrahisi = Joint diseases & related surgery 22(3):155-9, 2011 dezDepartment of Orthopedics and Traumatology, Medical Faculty of Pamukkale University, 20070 Kinikli, Denizli, Turkey. Este endereço de e-mail está protegido de spam bots, pelo que necessita do Javascript activado para o visualizar . OBJECTIVES: Football injuries that occur during football matches played on synthetic fields and the features of these injuries were investigated and the data was pursued for the prevention and reduction of these injuries. PATIENTS AND METHODS: All adolescent and adult trauma cases who admitted to the Emergency Department with football injuries on synthetic fields were retrospectively investigated. Nine hundred and eighty-five male cases were detected with a mean age of 30.1±4.2 years (range 15-57 years). Age, gender, times of admittance to the Emergency Department, site of injury, type of injury, and clinical result data of the cases were examined. RESULTS: 19:00 to 24:00 hours (n=852, 86.5%) and weekdays were the most frequent admittance times. It was detected that lower-extremities (n=583, 59.2%) were the most commonly affected body parts and the upper-extremity injuries (n=281, 28.6%) and the head and neck injuries (n=75, 7.6%) were the second and third most commonly seen injuries, respectively.The most frequently observed injury types were contusions, abrasions and hematomas in all cases (n=364, 37.0%). Sprains/strains were the second most common types of injuries (n=343, 34.8%). When the final diagnoses of all cases were examined, it was determined that the anterior talofibular ligament injuries were the second most frequent after soft-tissue injuries (n=217, 22%). CONCLUSION: Football matches on synthetic fields can lead to serious orthopedic injuries. Investigation of the mechanisms of these injuries, which cause workday and economic losses, will be a guide for the future studies on the prevention of these injuries.
Br J Sports Med
Issue: 15, A20, 2011Howes J et, al.
Occurrence of injuries and illnesses during the 2009 IAAF World Athletics Championships (Dez 2010)
Rugby league injuries in New Zealand: a review of 8 years of Accident Compensation Corporation injury entitlement claims and costsKing DA, Hume PA, Milburn P, Gianotti S.: British Journal of Sports Medicine, 2009, 43(8):595-602. Emergency Department, Hutt Valley District Health Board, Lower Hutt, New Zealand. AIM: This paper provides an overview of the epidemiology of rugby league injuries and associated costs in New Zealand requiring medical treatment. METHOD: New Zealand national Accident Compensation Corporation injury data for the period 1999 to 2007 were searched for rugby league injury cases. Data were analysed by demographics, body region, nature/severity of injury, and medical procedure and costs. RESULTS: A total of 5941 injury entitlement claims were recorded over the study period with a significant decrease observed in the injury rate between the 1999-2000 and 2002-2003 reporting years. The total cost of the injuries for the study period was $42,822,048 (equivalent to pound15,916,072). The mean (SD) number of injury entitlement claims per year was 743 (271) and yearly cost was $5,352,760 (pound1,989,880) ($2,485,535 (pound923,994)). The knee was the most commonly reported injury site (225 per 1000 entitlement claims; $8,750,147 (pound3,252,020)) and soft tissue injuries were the most common injury types (474 per 1000 entitlement claims; $17,324,214 (pound6,438,599)). Accounting for only 1.8% of total injury entitlement claims, concussion/brain injuries accounted for 6.3% of injury entitlement costs and had the highest mean cost per claim ($25 347 (pound9420)). The upper and lower arm recorded the highest mean injury site claim cost of $43,096 (pound16,016) per claim. The 25-29 age group recorded 27.7% of total injury entitlement claims and 29.6% of total injury entitlement costs, which was slightly more than the 20-24 age group (27.3% claims; 24.7% costs). Nearly 15% of total moderate to serious injury entitlement claims and 20% of total costs were recorded from participants 35 years or older. DISCUSSION: This study identified that the knee was the most common injury site and soft tissue injuries were the most common injury type requiring medical treatment, which is consistent with other international studies on rugby league epidemiology. This study also highlights that the rate of injury and the average age of injured rugby league players increased over time. The high cost of concussion/brain injuries is a cause for concern as it reflects the severity of the injuries. CONCLUSION: Injury prevention programmes for rugby league should focus on reducing the risk of concussion/brain injury and knee and soft tissue injury, and should target participants in the 20-30 years old age range. More longitudinal epidemiological studies with specific details on injury mechanisms and participation data are warranted to further identify the injury circumstances surrounding participation in rugby league activities.
Acute hamstring injuries in Danish elite football: a 12-month prospective registration study among 374 playersPetersen J, Thorborg K, Nielsen MB, Hölmich P.: Scandinavian Journal of Medicine & Science in Sports, 2010, 20(4):588-92. Department of Orthopaedic Surgery, Amager Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. The purpose of the present study was to examine the incidence rates of acute hamstring injuries in Danish elite football sustained during training or match play. Furthermore, it was our intention to document details about the recurrence, severity and the injury seasonal distribution. Hamstring injuries among 374 elite football players were registered prospectively during a 12-month period. A total of 46 first-time and eight recurrent hamstring injuries were registered. The incidence rates for incurring a first-time hamstring injury showed a significantly (P28 days from injury to injury free). Each team sustained a mean of 3.4 hamstring injuries per season, with a mean of 21.5 days missed per injury (range 3-136; median 16 days per injury). The seasonal distribution showed an accumulation of injuries in the first 2 months after a 3.5-month mid-season winter break.
Thumb injuries in intercollegiate men's lacrosse.Bowers AL, Horneff JG, Baldwin KD, Huffman GR, Sennett BJ.: The American Journal of Sports Medicinem, 201003 38(3):527-31. Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA. Background: Men's intercollegiate lacrosse is played at a fast pace and with significant force. Glove protection is required. However, the thumb is at risk because of contact with opponents' sticks, the ball, other players, and the ground or artificial surface. Purpose: To characterize patterns of hand injuries in men's intercollegiate lacrosse and to compare them with those in similar intercollegiate stick-handling sports that require gloves. Study design: Descriptive epidemiology study. Methods: The National Collegiate Athletic Association (NCAA) Injury Surveillance System was utilized to evaluate thumb injuries in intercollegiate stick-handling sports (men's lacrosse, women's lacrosse, and men's ice hockey) during 16 intercollegiate seasons. Injuries were defined as events requiring an athlete to seek medical treatment and miss competition. Data were collected for injuries to the thumb, phalanges, and hand. Descriptive statistics were performed to calculate rates of injury per 1000 athlete-exposures and the relative exposure of the thumb with respect to total hand injuries. chi(2) testing with the Yates correction for continuity was performed to determine differences in proportions of injury among the 3 sports studied. Results: During 16 intercollegiate seasons, there were 692 thumb, finger, and hand injuries in 3 038 255 athlete-exposures. Total thumb injuries were significantly higher in men's lacrosse, accounting for 59.4% of total hand injuries, when compared with women's lacrosse (42%) and men's ice hockey (35.8%) (P <.001). Thumb fractures and contusions were each also found to be significantly more prevalent (P <.001) when compared with women's lacrosse and men's ice hockey. Conclusion: Men's intercollegiate lacrosse requires the use of gloves; nonetheless, injury rates of the thumb are significantly elevated in this sport compared with other gloved, stick-handling sports. Recommendations include the development of gloves with improved thumb protection.
Rugby and cervical spine injuries - has anything changed? A 5-year review in the Western Cape.Dunn RN, van der Spuy D.: South African Medical Journal = Suid-Afrikaanse tydskrif vir geneeskunde, 2010, 100(4):235-8. Division of Orthopaedic Surgery, Univeristy of Cape Town, South Africa. OBJECTIVES: To review the incidence of all rugby-associated cervical spine injuries in the Western Cape and identify risk factors. METHODS: We reviewed case notes and X-rays of 27 male patients with rugby-related cervical spine injuries treated in the acute spinal injury (ASCI) unit at Groote Schuur Hospital from April 2003 to June 2008, and followed up with telephone interviews. Patient profile, rugby profile, subsequent injury management from the field to definitive surgery and neurological status on admission, discharge and follow-up using the American Spinal Injury Association (ASIA) classification were assessed. RESULTS: Average patient age was 25.3 years; 19% of them were scholars. The highest level of education among the adults was primary school in 70% of cases. Forwards and backs had the same injury rate. Most injuries occurred outside the metropole; more occurred in the tackling phase; 39% occurred during foul play; a third of players were not stabilised with a collar on the field; and 65% were taken to an inappropriate primary contact centre. A median of 10 hours elapsed before admission to the ASCI unit. Facet dislocations occurred in 59%; 8 presented neurologically complete and remained so; and 3 presented with residual sensation, with 2 improving to normal. Three presented as ASIA C improving to D, and all Ds improved to Es. Despite their injuries, 60% said they would advise their sons to play rugby. Only 22% regretted playing. CONCLUSIONS: Despite a reduction in cervical spine injuries in rugby in the Western Cape, the latter mostly occur outside the metropole, where levels of education are lower, foul play is more often associated with the injury, and rapid access to medical care is generally unavailable.
Spinal cord injuries in South African Rugby Union (1980 - 2007).Hermanus FJ, Draper CE, Noakes TD.: South African Medical Journal = Suid-Afrikaanse tydskrif vir geneeskunde, 2010, 100(4):230-4. School of Public Health and Family Medicine, University of Cape Town, South Africa. OBJECTIVES AND DESIGN: To address an apparent increase in the number of rugby-related spinal cord injuries (SCIs) in South Africa, a retrospective case-series study was conducted on injuries that occurred between 1980 and 2007. We aimed to identify preventable causes to reduce the overall rate of SCIs in South African rugby. METHODS: We identified 264 rugby-related SCIs. A structured questionnaire was used, and it was possible to obtain information on a total of 183 players, including 30 who had died. RESULTS: SCIs increased in number in the 1980s and in 2006. Forwards sustained 76% of all SCIs, and club players 60%. Players aged 17 had the highest number of SCIs. In only 50% of cases were medical personnel present at the time of injury, and 49% of injured players waited longer than 6 hours for acute management. Of players with an SCI, 61% had a catastrophic outcome after 12 months, including 8% who died during that time; 65% received no financial compensation; and only 29% of players had medical aid or health insurance. CONCLUSION: A register of all rugby-related SCIs in South Africa is essential to monitor the magnitude of the problem, identify potential risk factors, and formulate appropriate preventive interventions. The lack of reliable denominator data limits calculation of incident rates. Players from previously disadvantaged communities in particular suffered the consequences of limited public health care resources and no financial compensation.
Bicycle injury events among older adults in Northern Sweden: a 10-year population based study.Scheiman S, Moghaddas HS, Björnstig U, Bylund PO, Saveman BI.: Accident; Analysis and Prevention, 2010, 42(2):758-63. Department of Surgery and Perioperative Sciences, Section of Surgery, Umeå University, SE-901 85 Umeå, Sweden. Bicycles are a common mode of transportation and injured bicyclists cause a substantial burden on the medical sector. In Sweden, about half of fatally injured bicyclists are 65 years or older. This study analyzes the injury mechanisms, injuries, and consequences among bicyclists 65 years or older and compare with younger bicyclists (< or =64) and older adults as passenger car drivers, to give a basis for an injury preventive discussion for this age group. Umeå University Hospital's primary catchments area had 142,000 inhabitants in 2006. Nearly all injured road users in the well-defined geographic area are treated at this hospital and a 10-year data set (N=456) of injured bicyclists aged 65+ from the hospital's continuous injury registration (1997-2006) was analyzed. The results show that the annual injury incidence was 2.4 and 2.2 per 1000 men and women, respectively, aged 65 or older. For men the incidence rate was constant in the three age groups 65-74, 75-84 and 85+, while it decreased strongly for women. The incidence rate for old adults as passenger car drivers and younger bicyclists was 1.0 and 4.6, respectively. Most frequent injury mechanisms were falls when getting on or off a bicycle (20%) and by potholes or irregularities on the ground, edge of a sidewalk, or similar (13%). Only 6% were hit by cars, trucks, or buses. Half of the injured suffered fractures or dislocations, and 10% suffered concussion or more serious intracranial injuries. Getting on or off the bicycle caused most fractures (especially a high fraction of the hip and femur fractures) and resulted in 27% of all inpatient days in hospital. Three individuals died. One-third of the injured were treated as inpatients for a total of 1413 days (on average 9 days), with 69% of the days being caused by fractures. The cost for out- and inpatient acute treatment was approximately USD 4700 (SEK 33,000) per injured. The results merit an interest for this target group; bicycle injuries among older adults are costly both for the individual and the medical sector. Injury mitigation strategies focused on the needs of this group are probably as well motivated as those focused on older car drivers.
Upper extremity sports injury: risk factors in comparison to lower extremity injury in more than 25 000 casesClinical Journal of Sport Medicine : official journal of the Canadian Academy of Sport Medicine, 2010, 20(4):256-63. Centre for Rehabilitation, University Medical Centre Groningen, Groningen, the Netherlands. OBJECTIVE: To analyze differences in sports injury characteristics of the upper and lower extremity and to identify factors that contribute to the risk of sustaining an upper extremity injury compared with the risk of sustaining a lower extremity injury. DESIGN: Retrospective cohort study. SETTING: An emergency department of a large European level I trauma center. PATIENTS: A total of 25 120 patients with a simple sports injury, attending during 1990-2005. ASSESSMENT OF RISK FACTORS: Independent variables used to assess risk factors were extracted from a local database. These include age, sex, type of injury, site and side of the injury, type of sport, injury mechanism, and data on admission. MAIN OUTCOME MEASURES: Main outcome measure was the relation of various risk factors to the occurrence of either upper or lower extremity injury. Logistic regression analysis was used to identify predictors for upper extremity injury. RESULTS: Thirty-five percent upper and 53% lower extremity injuries were recorded. Most injuries were sustained when playing soccer (36%). Fractures were more frequently diagnosed in the upper than in the lower extremities (44% and 14%, respectively), especially in children. Falling was the main cause of upper extremity injury. Further risk factors were young age and playing individual sports, no-contact sports, or no-ball sports. Women were at risk in speed skating, inline skating, and basketball, whereas men mostly got injured during skiing and snowboarding. CONCLUSIONS: A high percentage of sports injuries are sustained to the upper extremity. Different risk factors were identified for both sexes. These risk factors should be taken into account when designing preventive measures.
Youth marathon runners and race day medical risk over 26 yearsRoberts, William O, Nicholson, William G.: Clinical Journal of Sport Medicine : official journal of the Canadian Academy of Sport Medicine, 2010, 20(4):318-21. Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA. OBJECTIVE: To report the number of marathon finishers younger than 18 years and race day medical encounters at the same site and to compare them with adult finishers. DESIGN: Retrospective cohort study. SETTING: Urban 42-km road race. PARTICIPANTS: Twin Cities Marathon finishers. ASSESSMENT OF RISK FACTORS: The race records from 1982 to 2007 were assessed for finishers younger than 18 years to determine the number of finishers and medical encounters, incidence of race-related medical encounters, and type and severity of medical problems. MAIN OUTCOME MEASURES: Age group marathon finishers and medical encounters. RESULTS: Three hundred ten marathon (225 boys and 85 girls) aged 7 to 17 years finished the race with times ranging from 2:53:22 to 6:10:00. There were 4 medical encounters (minor in nature and required no intervention beyond a short period of rest) for an incidence of 12.9 per 1000 finishers. The odds ratio for youth compared with adult finish line medical encounters was 0.52 (P = 0.2658; 95% confidence interval, 0.19-1.39). CONCLUSIONS: Three hundred ten youth marathon successfully finished Twin Cities Marathon over 26 years with only 4 requiring post-race medical evaluations. The relative risk of requiring acute race day medical attention was less than, but not statistically different from, adult finishers.
The ultimate frisbee injury study: the 2007 Ultimate Players Association College Championships.Yen LE, Gregory A, Kuhn JE, Markle R.: Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 2010, 20(4):300-5 Minor and James Medical, Seattle, Washington 98104, USA. Leslianne. OBJECTIVE: To quantify and characterize the injuries incurred by ultimate players during the 2007 Ultimate Players Association College Championships. DESIGN: Cross-sectional study. SETTING: The Ultimate Players Association College Championships in Columbus, Ohio, in May 2007. PARTICIPANTS: Athletes who left the field of play due to injury time-outs (ITOs). There were 107 recorded ITOs. INTERVENTIONS: During the 3 days of the 2007 College Championships, 86 games were observed by the research staff. Athletes calling an ITO were interviewed. Sex, activity at time of injury, type of injury, and associated contact, if any, were recorded. MAIN OUTCOME MEASURES: Return to play, injury type, and injured body part. RESULTS: One injury prevented return to play in each of the 2 sex divisions, equivalent to 1.66 per 1000 athlete-exposures in championships bracket games. The majority of ITOs were related to contact, 53% in the men's division and 68% in the women's division. The lower extremities were injured in 53% and 51% of cases in the men's and women's divisions, respectively. Laying out was one of the most common activities at time of ITO (29% and 22% in men's and women's divisions, respectively) and accounted for all of the men's closed head injuries and 2 of the 3 women's closed head injuries. CONCLUSIONS: There was a low rate of play-ending injuries. There were no statistically significant associations. Physical contact and laying out were frequently linked with ITO.
Trail-walking exercise and fall risk factors in community-dwelling older adults: preliminary results of a randomized controlled trial.Yamada M, Tanaka B, Nagai K, Aoyama T, Ichihashi N.: Journal of the American Geriatrics Society, 2010, 58(10):1946-51. Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan. OBJECTIVES: To evaluate the effects of a trail-walking exercise (TWE) program on the rate of falls in community-dwelling older adults. DESIGN: Pilot randomized controlled trial (RCT). SETTING: This trial was conducted in Japan and involved community-dwelling older adults as participants. PARTICIPANTS: Sixty participants randomized into a TWE group (n=30) and a walking (W) group (n=30). INTERVENTION: Exercise class combined with multicomponent trail walking program, versus exercise class combined with simple indoor walking program. MEASUREMENT: Measurement was based on the difference in fall rates between the TWE and W groups. RESULTS: Six months after the intervention, the incidence rate ratio (IRR) of falls for the TWE group compared with the W group was 0.20 (95% confidence interval (CI)=0.04-0.91); 12 months after the intervention, the IRR of falls for the TWE group compared with the W group was 0.45 (95% CI=0.16-1.77). CONCLUSION: The results of this pilot RCT suggest that the TWE program was more effective in improving locomotion and cognitive performance under trail-walking task conditions than walking. In addition, participants who took part in the TWE demonstrated a decrease in the incidence rate of falls 6 months after trial completion. Further confirmation is needed, but this preliminary result may promote a new understanding of accidental falls in older adults.
Epidemiology of US high school sports-related fractures, 2005-2009.Swenson DM, Yard EE, Collins CL, Fields SK, Comstock RD.: Clinical Journal of Sport Medicine, 2010, 20(4):293-9. Ohio State University, College of Medicine, Columbus, Ohio, USA. OBJECTIVE: To describe the epidemiology of fractures among US high school athletes participating in 9 popular sports. DESIGN: Descriptive epidemiologic study. SETTING: Sports injury data for the 2005-2009 academic years were collected using an Internet-based injury surveillance system, Reporting Information Online (RIO). PARTICIPANTS: A nationally representative sample of 100 US high schools. ASSESSMENT OF RISK FACTORS: Injuries sustained as a function of sport and sex. MAIN OUTCOME MEASURES: Fracture injury rates, body site, outcome, surgery, and mechanism. RESULTS: Fractures (n = 568 177 nationally) accounted for 10.1% of all injuries sustained by US high school athletes. The highest rate of fractures was in football (4.61 per 10 000 athlete exposures) and the lowest in volleyball (0.52). Boys were more likely than girls to sustain a fracture in basketball (rate ratio, 1.35,; 95% confidence interval, 1.06-1.72) and soccer (rate ratio, 1.34; 95% confidence interval, 1.05-1.71). Overall, the most frequently fractured body sites were the hand/finger (28.3%), wrist (10.4%), and lower leg (9.3%). Fractures were the most common injury to the nose (76.9%), forearm (56.4%), hand/finger (41.7%), and wrist (41.6%). Most fractures resulted in >3 weeks' time lost (34.3%) or a medical disqualification from participation (24.2%) and were more likely to result in >3 weeks' time lost and medical disqualification than all other injuries combined. Fractures frequently required expensive medical diagnostic imaging examinations such as x-ray, computed tomographic scan, and magnetic resonance imaging. Additionally, 16.1% of fractures required surgical treatment, accounting for 26.9% of all injuries requiring surgery. Illegal activity was noted in 9.3% of all fractures with the highest proportion of fractures related to illegal activity in girls' soccer (27.9%). CONCLUSIONS: Fractures are a major concern for US high school athletes. They can severely affect the athlete's ability to continue sports participation and can impose substantial medical costs on the injured athletes' families. Targeted, evidence-based, effective fracture prevention programs are needed.
Basketball-related injuries in school-aged children and adolescents in 1997-2007.Charles Randazzo, Nicolas G. Nelson, Lara B. McKenzie, MA.: Pediatrics, 2010, 126(4):727-33. Center for Injury Research and Policy, Research Institute at Nationwide Children's Hospital, and Department of Pediatrics, College of Medicine, Ohio State University, 700 Children's Dr, Columbus, OH 43205, USA. OBJECTIVE: The objective was to determine national patterns of basketball-related injuries treated in emergency departments in the United States among children and adolescents <20 years of age. METHODS: A retrospective analysis was conducted with data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission, from 1997 to 2007. Sample weights provided by the Consumer Product Safety Commission were used to calculate national estimates of basketball-related injuries. Trend significance of the numbers and rates of basketball-related injuries over time was analyzed by using linear regression. RESULTS: An estimated 4 128 852 pediatric basketball-related injuries were treated in emergency departments. Although the total number of injuries decreased during the study period, the number of traumatic brain injuries (TBIs) increased by 70%. The most common injury was a strain or sprain to the lower extremities (30.3%), especially the ankle (23.8%). Boys were more likely to sustain lacerations and fractures or dislocations. Girls were more likely to sustain TBIs and to injure the knee. Older children (15-19 years of age) were 3 times more likely to injure the lower extremities. Younger children (5-10 years of age) were more likely to injure the upper extremities and to sustain TBIs and fractures or dislocations. CONCLUSIONS: Although the total number of basketball-related injuries decreased during the 11-year study period, the large number of injuries in this popular sport is cause for concern.
Skateboard-related injuries: not to be taken lightly. A National Trauma Databank Analysis.Lustenberger T, Talving P, Barmparas G, Schnüriger B, Lam L, Inaba K, Demetriades D.: The Journal of Trauma, 2010, 69(4):924-7. Division of Acute Care Surgery (Trauma, Emergency Surgery, and Surgical Critical Care), Keck School of Medicine, University of Southern California, Los Angeles, California, USA. BACKGROUND: With the increasing popularity of skateboarding, trauma centers are experiencing increased number of skateboard injuries. The incidence and type of injuries and the effect of age on these variables are poorly described in the literature. METHODS: Data from National Trauma Databank during a 5-year period was used for this study. Injury Severity Score (ISS), injured body area, specific injuries, and outcomes were calculated according to age groups (younger than 10 years, 10-16 years, and older than 16 years). RESULTS: During the study period, there were 2,270 admissions due to skateboard-related injuries (0.1% of all trauma admissions). There were 187 patients (8%) younger than 10 years, 1,314 patients (58%) 10 years to 16 years, and 769 patients (34%) older than 16 years. The overall mortality was 1.1% and ranged from 0% in the age group younger than 10 years to 0.3% in the group 10 years to 16 years and 2.6% in the group older than 16 years (p < 0.001). The incidence of severe trauma (Injury Severity Score = 16) in the three age groups was 5.4%, 13.5%, and 23.7%, respectively (p < 0.001). The incidence of traumatic brain injury in the three age groups was 24.1%, 32.6%, and 45.5%, respectively (p < 0.001). The younger age group (younger than 10 years) was significantly more likely to suffer femur fractures and less likely to suffer tibia fractures than the older age groups. Helmets and use of a skateboard park were significant factors protecting against head injury. CONCLUSION: Skateboard-related injuries are associated with a high incidence of traumatic brain injury and long bone fractures. Age plays an important role in the anatomic distribution of injuries, injury severity, and outcomes. Our findings demonstrate that helmet utilization and designated skateboard areas significantly reduce the incidence of serious head injuries.
Injuries in women's soccer: a 1-year all players prospective field study of the women's Bundesliga (German premier league).Clinical Journal of Sport Medicine: official journal of the Canadian Academy of Sport Medicine, 2010, 20(4):264-71. Orthopedic Clinic Munich-Schwabing, Munich, Germany. OBJECTIVE: To obtain precise information on injury patterns in the women's premier soccer league in Germany. DESIGN: One-year, prospective, epidemiologic cohort study. SETTING: Institutional level German Football Association. PARTICIPANTS: All 254 players from all 12 women's premier league teams were included. INTERVENTIONS: Base information by standardized personal interviews. Evaluation of all injury-associated medical data transmitted by standardized documentation forms. ASSESSMENT OF RISK FACTORS: Injuries incidence rates (average, 95% confidence intervals) based on the exposure in matches and at practice. MAIN OUTCOME MEASURES: All time loss diagnoses, number and context of injuries related to their anatomical localization, severity, and rehabilitation period were recorded. RESULTS: All 254 players finished the study [average age, 22.8 years (16-35 years)]. Two hundred forty-six injuries amounted to an injury rate of 3.3 per 1000 hours (games, 18.5 per 1000 hours; practice, 1.4 per 1000 hours). Injury distribution: knee, 31.0%; ankle, 22.1%; thigh, 12.9%; and head, 7.1%. The seasonal peak was at the beginning of the competitive season. Injury rates doubled after the 60th minute. Twenty-nine percent of the injuries were severe, and 37% were moderate. CONCLUSIONS: Female players suffer a high amount of head injuries and severe knee and ankle injuries. The most common single injury is a sprained ankle. Torn ligaments in the ankle and knee are the most common injuries that require a long recovery period. Most of the severe injuries (>30 days) are due to noncontact intrinsic mechanisms. Almost one-quarter of all injuries consist of exertion syndromes not yet correlated with certain seasonal periods.
Training injuries in professional rugby leagueGabbett TJ, Godbolt RJ.: Journal of Strength and Conditioning Research / National Strength & Conditioning Association, 2010, 24(7):1948-53. Brisbane Broncos Rugby League Football Club, Queensland, Australia. This study investigated the incidence of training injuries in professional rugby league players and identified the training activities that were associated with the highest rates of injury in these athletes. The incidence of training injuries was prospectively studied in 35 professional rugby league players (mean +/- SD age 23.7 +/- 3.8 years) over an entire season. Injury data were collected from 216 training sessions, which included all strength, conditioning, and game-based training sessions. During the season, a total of 126 training injuries were recorded, giving an overall incidence of injury of 20.7 per 1,000 training hours. The thigh was the most common site of injury, with twice as many posterior thigh injuries (19.8%) as anterior thigh injuries (9.5%). Hematomas (31.8%) and muscular strains (22.2%) were the most common types of injury. The majority of injuries (35.7%) were sustained in traditional conditioning activities that involved no skill component (i.e., running without the ball). In contrast, the incidence of injuries sustained while participating in strength (7.1%) and game-based training activities (14.3%) was low. Of the injuries that resulted in lost training time, one-third were sustained in traditional conditioning activities. Given the low incidence of injury in game-based activities, and the added skill and physical benefits associated with this form of training, strength and conditioning coaches should consider using appropriately designed game-based training activities as a physical conditioning tool in professional rugby league players.
Prospective study on injuries of the German national ice hockey teams in more than 1000 gamesGröger A, Kuropkat C, Mang A, Gradinger R.: Sportverletzung Sportschaden : Organ der Gesellschaft für Orthopädisch-Traumatologische Sportmedizin, 2010, 24(2):91-7. City Med. München. Due to the fast and physical nature of the game, prevention of injuries is an important issue in ice hockey. The injuries of the German male senior and junior (U16, U17, U18, U19, U20) national ice hockey teams were documented and analyzed in 1006 games between 1986 and 2006. This unique long observation period over 20 years, as well as the standardized protocol of documentation provides reliable data concerning injury pattern in German international ice hockey. Overall 277 injuries were recorded. Comparing the first and the last ten years of observation, the number did not decline over the time, despite various national and international efforts of injury prevention. The majority of the injuries, almost 60%, were caused by body contact with increasing tendency. Remarkably, the injuries with no body or puck/stick contact more than doubled in the last ten years compared to the first ten years of observation. Most injuries happened to the extremities with decreasing tendency to lower body and increasing tendency to upper body injuries. The number of head injuries did not change significantly. More injuries occurred in the second and third period compared to the first period of the game. The data of this study indicate that many injuries might be due to insufficient physical condition with consecutive lack of concentration and coordination. Players do not seem to meet the increasing technical and athletic requirements of international ice-hockey. The increasing speed and physical energy in international ice-hockey make the game unique and fascinating. Therefore, the aim must be to decrease the number and above all the severity of injuries by further development and adjustment of the player's equipment. Also, a better cooperation of players, coaches, sports medicine and referees seems to be necessary for injury prevention in the future.
Prevalence of spondylolisthesis in a population of gymnasts.Toueg CW, Mac-Thiong JM, Grimard G, Parent S, Poitras B, Labelle H.: Studies in health technology and Informatics, 2010, 158:132-7. Dept of Orthopaedic Surgery, Sainte-Justine University Hospital, Montreal, Canada. Spondylolysis occurs in 6 % of the general population. Of these, approximately 75% will develop spondylolisthesis. According to multiple studies, an increased prevalence of spondylolysis and spondylolisthesis exists in groups of athletes practicing certain Sports such as gymnastics. In the literature, prevalence of spondylolisthesis in gymnasts can reach up to 40 to 50 %. However, the specific risk factors associated with the development of spondylolisthesis in gymnasts are not known. The main purpose of this study was to evaluate the prevalence of spondylolysis and spondylolisthesis in a population of gymnasts, as well as the associated epidemiological characteristics. In order to achieve this goal, we presented our project to the two most renowned gymnastics centers in the city of Montreal, which allowed us to recruit a total of 93 gymnasts (19 males and 74 females). A radiological evaluation, with the low emission radiographic system, EOS, allowed us to identify the subjects that were affected by spondylolysis and spondylolisthesis. Additionally, standardized questionnaires allowed us to evaluate and compare different epidemiologic parameters such as age, height, weight, number of years of practice, number of hours of training per week. Of the 93 gymnasts evaluated clinically and radiographically, we identified 6 (1 male, 5 females) gymnasts presenting a spondylolysis and/or spondylolisthesis. This 6.5% prevalence found in our population is similar to the one reported in the general population. Gender did not seem to be a determinant factor. Also, gymnasts with and without spondylolysis and/or spondylolisthesis seemed to be similar in terms of height. However, gymnasts with spondylolysis and/or spondylolisthesis seemed to be heavier than gymnasts without one of these two affections, older and training with greater intensity. These Results suggest that the real prevalence rate of spondylolysis and spondylolisthesis in gymnasts may have been overestimated in previous studies. A selection bias, due to the high competitive level in the two gymnastics centers where our recruitment took place, could be involved. Our findings could also be the result of new or different training methods compared to those used in past studies. This might suggest that with intense training schedules, heavier individuals could potentially be prone to increased loads at the lumbosacral junction, thus favoring the development of spondylolysis and spondylolisthesis. These hypotheses should be explored in further details in the near future, especially with investigation of radiological parameters of the spine and pelvis.
Injury profile in junior tennis players: a prospective two year study.Hjelm N, Werner S, Renstrom P.: Knee surgery, Sports Traumatology, Arthroscopy, 2010, 18(6):845-50, Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institute, Stockholm, Sweden. The aim of this study was to prospectively make a survey of injuries in junior players from a Swedish local tennis club during a 2-year period in relation to gender, anatomic location, month of the year when injured, injury type and injury severity. All 12-18 years old members in a tennis club playing more than twice weekly were asked to participate. Fifty-five junior tennis players, 35 boys and 20 girls accepted to participate. All tennis-related injuries were prospectively registered and evaluated. Time of exposure for playing tennis was recorded. Thirty-nine players sustained 100 injuries, 73 in boys and 27 in girls. Injury incidence for boys was 1.7 injuries/1000 h of tennis playing time and for girls 0.6 injuries/1000 h. Ankle sprains, low back pain and knee injuries were the most common ones. Sixty-five percent were new injuries, and the majority of these injuries were located at the knee joint followed by the ankle joint, while most of the recurrent injuries were found in the lumbar spine. Boys suffered mainly from low back pain and ankle injuries and girls from low back pain and knee injuries. Forty-three percent of the injuries caused absence from tennis for more than 4 weeks and 31% more than 1 week.
Epidemiology of ankle sprain at the United States Military Academy.Waterman BR, Belmont PJ,.William Beaumont Army Medical Center, El Paso, TX, USA. BACKGROUND: Ankle sprain is a common injury in athletic populations that results in significant time lost to injury. HYPOTHESIS: The incidence rates (IRs) of ankle ligament sprains are influenced by gender, height, weight, body mass index (BMI), physical conditioning, level of competition, type of sport, and athlete exposure to sport. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A longitudinal cohort study was performed to determine the effect of risk factors for ankle sprain at the United States Military Academy between 2005 and 2007. RESULTS: A total 614 cadets sustained new ankle sprains during 10 511 person-years at risk, resulting in an overall IR of 58.4 per 1000 person-years. Women (96.4), compared with men (52.7), had a significantly increased rate ratio (IRR) for ankle sprain of 1.83 (95% confidence interval [CI], 1.52-2.20). Men with ankle sprains had higher mean height, weight, and BMI than uninjured men (P <.001). Men with ankle sprains had higher average scores in push-ups, sit-ups, and run time than uninjured men (P <.001). Ankle sprain occurred most commonly during athletics (64.1%). Ankle sprain IR did not significantly differ between intercollegiate and intramural athletic competition after controlling for athlete-exposure (IRR, 1.05; 95% CI, 0.81-1.37). The ankle sprain IRR of female compared with male intercollegiate athletes was 0.93 (95% CI, 0.67-1.32) per 1000 person-years and 1.04 (95% CI, 0.74-1.47) per 1000 athlete-exposures. The intercollegiate sports of men's rugby, women's cheerleading, and men's/women's basketball, soccer, and lacrosse had the highest ankle sprain IR. CONCLUSION: Higher mean height and weight in men, increased BMI in men, greater physical conditioning in men, and athlete exposure to selected sports were all risk factors for ankle sprain.
Acrobatic gymnastics injury: occurrence, site and training risk factors.Purnell M, Shirley D, Nicholson L, Adams R.: Physical Therapy in Sport, 2010-05 11(2):40-6. Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe NSW 1825, Australia. OBJECTIVE: To determine the incidence and risk factors for injury associated with the performance of acrobatic gymnastics. DESIGN: Retrospective injury and training survey. SETTING: New South Wales acrobatic gymnastics clubs. PARTICIPANTS: Surveys were completed by 73 acrobatic gymnasts (69 female) aged 8-26 years. MAIN OUTCOME MEASUREMENTS: Data on injury incidence and frequency for injury site were collected. Multiple-regression and ROC curve analysis were used to evaluate training-associated injury risk factors. RESULTS: Half (50.7%) of the participants had sustained an injury associated with acrobatic gymnastics in the past 12 months, with 28.8% of participants affected by chronic injury at the time of the study. Age of onset for acute and chronic acrobatics-related injury averaged 13.9 (SD +/- 3.03) and 14.7 (SD +/- 3.85) years, respectively. Injury sites were predominately the knee, ankle and wrist. Risk factors for injury were having an age of >or=13 years and training for >or=8 h per week at age 11 years. CONCLUSIONS: The results suggest that the 11-15 years age period is critical for the occurrence of injury in acrobatic gymnasts. This is possibly due to the adolescent growth spurt which may create an increased vulnerability to injury if training volume during this time is above a certain threshold.
Epidemiological study of injuries in international Rugby Sevens.Fuller CW, Taylor A, Molloy MG.: Clinical Journal of Sport Medicine, 2010, 20(3):179-84. Centre for Sports Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom. Objective: To assess incidence, nature, and causes of injuries sustained in international Rugby Sevens. Design: Prospective cohort: definitions and procedures were compliant with the consensus statement for epidemiological studies in rugby union. Setting: 2008/2009 International Rugby Board Sevens World Series (8 tournaments) and Rugby World Cup Sevens 2009. Participants: Two hundred ninety players, representing 12 countries. Assessment of risk factors: Injuries sustained as function of playing position and nature, cause, and time of onset. Main Outcome Measures: Number, location, diagnosis, severity, and cause of injuries: incidence (injuries/1000 player-hours) and severity (days absence from training/competition) of injuries. Results: One hundred four injuries were recorded during 578 team games (979.1 player-match hours), which equates to 0.18 injuries per team match, 0.96 injuries per team per tournament, or 106.2 injuries per 1000 player-hours (95% confidence interval, 87.8-128.9). These injuries had a mean severity of 45 days and a median severity of 24 days. The lower limb (70%) and joint (non-bone)/ligament (52%) were the most common site and type of injury. Most match injuries were acute (93%) and resulted from contact (78%) events; being tackled (34%) and running (22%) were the most common causes of injury. Conclusions: Results indicated that the risk of injury from international Rugby Sevens was higher than that reported for international 15-a-side rugby; in particular, the severity of injury was significantly higher. A need for further research into the reasons for the high average severity of injury and the development of injury prevention strategies for ankle and knee ligament injuries in Rugby Sevens were indicated.
Shoulder injuries in overhead SportsWörtler K.: Der Radiologe, 2010, 50(5):453-9. Institut für Röntgendiagnostik, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str.22, 81675, München. Overhead sport places great demands on the shoulder joint. Shoulder pain in overhead athletes and throwers can in the majority of cases be attributed to lesions resulting from chronic overuse of tendons and capsuloligamentous structures or to sequels of microinstability and secondary impingement. Due to its great impact on therapeutic decisions, imaging in athletes with unclear shoulder pain is a challenge. In this connection, magnetic resonance (MR) arthrography represents the cross-sectional imaging modality of first choice, as it allows depiction and exclusion of pathologic alterations of all relevant joint structures with sufficient confidence.This article reviews the biomechanical and clinical aspects and MR arthrographic features of the most common shoulder pathologies in overhead athletes, including biceps tendinopathy, superior labral anterior-posterior (SLAP) lesions, rotator cuff lesions, as well as extrinsic and intrinsic impingement syndromes.
Injuries of the cervical spine in motorcycling and bicycling traffic accidentsJecmenica DS, Alempijevic DjM, Aleksandric BV, Pavlekic SB, Baralic I, Antic BZ.: Acta Chirurgica Iugoslavica, 2010, 57(1):135-40. Institut za sudsku medicinu "Milovan Milovanovic", Medicinski fakultet Univerziteta u Beogradu. Due to the vehicle characteristics neck injuries are common in motorcycle and moped users involved in traffic accidents. We are reporting on neck injuries amongst 502 fatalities of drivers and passengers of motorcycles and mopeds, and cyclists. Cervical spine injuries were found in 124 cases (24.7%). Cervical spine injury was statistically significantly more frequently in passengers (61.9%) compared to the drivers (20.7%) of motorcycle and moped (chi2 = 13.384; p < 0.01), the lesions are usually localized in the upper cervical spine (52.4%), the most frequently at atlantoocciptal region (F = 25.835; p); these injuries were most frequently caused by frontal (31.45%) or rear (50.81%) axial collisions. Almost all cases of cervical spine injuries were present without apparent external injuries; they were associated with lesions of neck muscles, blood vessels and/or neck organs, and in 79 cases (63.7%) there was a lesion of the cervical spinal cord. The research Results indicate a large incidence of neck injuries in traffic accidents especially in motorcycle, moped and bicycle axial collision with the possible absence of external injuries, which may represent a clinical and forensic problem.
Risk of injury associated with rugby union played on artificial turfFuller CW, Clarke L, Molloy MG.: Journal of Sports Sciences, 2010, 28(5):563-70 . Centre for Sports Medicine, University of Nottingham, Nottingham, UK. The aim of this study was to compare the incidence, nature, and cause of injuries sustained in rugby union played on artificial turf and grass. The study comprised a two-season investigation of match injuries sustained by six teams competing in Hong Kong's Division 1 and training injuries sustained by two teams in the English Premiership. Injury definitions and recording procedures were compliant with the international consensus statement on epidemiological studies of injuries in rugby union. There were no significant differences in the overall incidence (rate ratio = 1.42; P = 0.134) or severity (P = 0.620) of match injuries sustained on the two surfaces. The lower limb and joint (non-bone)/ligament injuries were the most common location and type of match injury on both surfaces; the incidence of anterior cruciate ligament injuries was nearly four times higher on artificial turf than grass but the difference was not statistically significant (rate ratio = 3.82; P = 0.222). There were no significant differences in the overall incidence (rate ratio = 1.36; P = 0.204) or severity (P = 0.302) of training injuries sustained on artificial turf and grass. The lower limb and muscle/tendon injuries were the most common location and type of training injury on both surfaces. The Results indicate that the overall risks of injury on artificial turf are not significantly different from those experienced on grass; however, the difference in the incidence of anterior cruciate ligament injuries on the two surfaces is worthy of further study.
Injuries sustained at a temporary ice-skating rink: prospective study of the Winchester experience 2007-2008Kelsall NK, Bowyer GW.: Injury, 2009, 40(12):1276-8. Department of Trauma & Orthopaedics, Royal Hampshire County Hospital, Romsey Road, Winchester, Hampshire, SO22 5DG, United Kingdom. Anecdotal reports when a temporary ice-rink opened in Winchester, suggested a burden on the Emergency Department (ED) and Trauma & Orthopaedic (T&O) services. This study was undertaken to assess, prospectively, the workload created as a consequence of ice-rink injuries, when the facility was reopened over Christmas 2007. All patients attending from the ice-rink were included and their injuries reviewed. Costs of care were calculated based on ED attendance, out-patient appointments (OPA's), radiography, plaster immobilisation and government tariffs for surgical procedures. The ice-rink was open for 39 days welcoming 43,000 skaters. Sixty-two accidents were recorded in the accident book, 43 attended the ED. Radiographic investigation was necessary for 31 patients. Nineteen had diagnoses of soft tissue injury, 3 of head/facial injuries. T&O received 23 referrals; all fractures were in the upper limb, 6 requiring admission and surgery. Fifty-eight ED, fracture clinic and physiotherapy OPA's were required. Additional costs to The Royal Hampshire County Hospital (RHCH) were calculated as 33,718.50 pounds. This temporary facility created a smaller than predicted burden for the ED and T&O service, however, sufficient consideration of OPA requirements should be made when planning service provision whilst temporary recreational facilities, such as this, are open.
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