scholarly journals Evaluation of Experience with Lower Extremity Arterial Injuries at an Urban Trauma Center

2018 ◽  
Vol 27 (01) ◽  
pp. 029-034 ◽  
Author(s):  
Randall Franz ◽  
Joshua Hill ◽  
Michael Lieber ◽  
John Galante ◽  
Christopher Tanga
Keyword(s):  
Lower Extremity ◽  
Trauma Center ◽  
Injury Severity ◽  
Surgical Techniques ◽  
Blunt Injury ◽  
Chi Square ◽  
Lower Extremity Injuries ◽  
Arterial Injuries ◽  
Increased Risk ◽  
Extremity Injuries

AbstractLower extremity arterial injuries (LEAIs) can be complicated injuries resulting in limb loss and death. Patients with LEAI often have multiple injuries increasing the risk for morbidity and mortality. We sought to evaluate the incidence and management of LEAI and to define associations between injuries and outcomes. We performed a retrospective review of LEAI at an urban level-1 trauma center from April 2005 to April 2015. Chi-square tests were used to compare independent groups with respect to mortality and amputation. Means were compared between independent groups using two-sample t-tests. From April 2005 to April 2015, 208 arterial injuries occurred in 163 patients. The majority (80.4%) suffered concomitant lower extremity injuries with 35.6% suffering systemic injuries. Surgical intervention was required for 72.1% of injuries. Amputation rate was 14.7%. Mortality rate was 8.0%. Data from 2010 to 2015 were more specifically analyzed. Injury severity score (ISS) was higher with fatalities (37 ± 13.16 vs. 11.8 ± 8.51, p < 0.0001) and in patients requiring an amputation (25.4 ± 15.32 compared with 11.6 ± 9.05, p = 0.0015). Popliteal artery injury was most likely to require an amputation (odds ratio [OR] = 2.9, p = 0.04). Mortality was more likely when systemic injuries were present (OR = 18.1, p = 0.0005). The majority of patients with arterial injuries require surgical management, most often with open surgical techniques. Arterial injuries associated with systemic injuries, blunt injury mechanisms, and higher ISS are at a significantly increased risk of mortality.

scholarly journals Concussion in National Football League Athletes Is Not Associated With Increased Risk of Acute, Noncontact Lower Extremity Musculoskeletal Injury

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110034
Author(s):  
Toufic R. Jildeh ◽  
Fabien Meta ◽  
Jacob Young ◽  
Brendan Page ◽  
Kelechi R. Okoroha
Keyword(s):  
Lower Extremity ◽  
National Football League ◽  
Field Performance ◽  
Return To Play ◽  
Lower Extremity Injury ◽  
Extremity Injury ◽  
Lower Extremity Injuries ◽  
Increased Risk ◽  
Extremity Injuries ◽  
And Control

Background: Impaired neuromuscular function after concussion has recently been linked to increased risk of lower extremity injuries in athletes. Purpose: To determine if National Football League (NFL) athletes have an increased risk of sustaining an acute, noncontact lower extremity injury in the 90-day period after return to play (RTP) and whether on-field performance differs pre- and postconcussion. Study Design: Cohort study, Level of evidence, 3. Methods: NFL concussions in offensive players from the 2012-2013 to the 2016-2017 seasons were studied. Age, position, injury location/type, RTP, and athlete factors were noted. A 90-day RTP postconcussive period was analyzed for lower extremity injuries. Concussion and injury data were obtained from publicly available sources. Nonconcussed, offensive skill position NFL athletes from the same period were used as a control cohort, with the 2014 season as the reference season. Power rating performance metrics were calculated for ±1, ±2, and ±3 seasons pre- and postconcussion. Conditional logistic regression was used to determine associations between concussion and lower extremity injury as well as the relationship of concussions to on-field performance. Results: In total, 116 concussions were recorded in 108 NFL athletes during the study period. There was no statistically significant difference in the incidence of an acute, noncontact lower extremity injury between concussed and control athletes (8.5% vs 12.8%; P = .143), which correlates with an odds ratio of 0.573 (95% CI, 0.270-1.217). Days (66.4 ± 81.9 days vs 45.1 ± 69.2 days; P = .423) and games missed (3.67 ± 3.0 vs 2.9 ± 2.7 games; P = .470) were similar in concussed athletes and control athletes after a lower extremity injury. No significant changes in power ratings were noted in concussed athletes in the acute period (±1 season to injury) when comparing pre- and postconcussion. Conclusion: Concussed, NFL offensive athletes did not demonstrate increased odds of acute, noncontact, lower extremity injury in a 90-day RTP period when compared with nonconcussed controls. Immediate on-field performance of skill position players did not appear to be affected by concussion.

scholarly journals EFFECTIVENESS OF PRE-SEASON PHYSICAL PERFORMANCE TESTS IN IDENTIFYING IN-SEASON LOWER EXTREMITY INJURIES IN ADOLESCENT GYMNASTS

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0014
Author(s):  
Danielle A Farzanegan ◽  
Emily Francione ◽  
Nicole Melfi
Keyword(s):  
Lower Extremity ◽  
Physical Performance ◽  
Performance Tests ◽  
Kinetic Chain ◽  
Chi Square ◽  
Balance Test ◽  
Lower Extremity Injuries ◽  
Common Location ◽  
Acute Injuries ◽  
Extremity Injuries

Background: Artistic competitive gymnastics results in a wide, unique spectrum of injuries. Due to the high number of injuries and the current lack of research related to pre-competitive testing in adolescent gymnasts, it is crucial to find a method to predict the likelihood of an athlete sustaining an in-season injury. Purpose: The purpose of this study was to 1) describe the frequency and type of pre-season and in-season injuries, 2) determine if there were differences in physical performance tests between those who had a lower extremity (LE) injury in-season and those who did not, and 3) determine if there were differences in age, level, sex, BMI, sport modifications, previous injury, and current injury between those who had a LE injury and those who didn’t. Methods: Thirty-seven adolescent gymnasts (average age: 12.81 years) were included with levels ranging from 5 (novice) to 10 (elite). Participants (15 males and 22 females) were surveyed for previous and current injury. The athletes completed a performance battery before the competition season including: Lower Quarter Y-Balance Test (LQYBT), Closed Kinetic Chain dorsiflexion (CKCDF), single hop (SH), triple hop (TH), and the Functional Movement Screen (FMS). Follow-up data was collected at the end of the competitive season for comparison. The data was analyzed using descriptive methods and comparative analyses including chi-square and independent t-tests with an alpha level set at .05. Results: Sixty-five percent reported an injury in the last year and seventy-eight percent reported pre-season injuries at testing day. The most common location for pre-season injury was the ankle/foot (24% and 31% respectively). There were no differences between injured and non-injured athletes when comparing asymmetries in CKCDF, LQYBT posteromedial or posterolateral reach, hop testing, or FMS. The LQYBT-anterior scores were significantly different at p=.049 between the injured versus uninjured groups, with 91% of the in-season injury group having a difference <4cm. Similarly, the LQYBT-composite score using a cut-off of 95% was significant at p=.043 with those >95% category being more likely to get injured. There were no significant differences in demographic information comparing injury occurrence. Conclusion: The tested physical performance battery may be useful in tracking gymnasts over time, but may not be beneficial in forecasting injuries in a sport with high percentages of acute injuries. The collected injury volume may not be reflective of a standard season as COVID-19 decreased the number of competitions. Additional research to identify athletes at risk for injury requires further investigation.

scholarly journals Early sports specialisation and the incidence of lower extremity injuries in youth athletes: current concepts

2021 ◽  
pp. jisakos-2019-000288
Author(s):  
Richard N Puzzitiello ◽  
Coleen F Rizzo ◽  
Kirsten D Garvey ◽  
Elizabeth G Matzkin ◽  
Matthew J Salzler
Keyword(s):  
Lower Extremity ◽  
Injury Risk ◽  
Lower Extremity Injury ◽  
Medical Community ◽  
Repetitive Movement ◽  
Lower Extremity Injuries ◽  
Increased Risk ◽  
Athletic Success ◽  
Youth Athlete ◽  
Extremity Injuries

Year-round intensive, single-sport training beginning at an young age is an increasingly common trend in the youth athlete population. Early sport specialisation may be ineffective for long-term athletic success and contribute to an increased risk of physical injury and burn-out. The medical community has noted that repetitive movement patterns may occur in non-diversified activity and this may contribute to overuse injury in young athletes. Studies have begun to identify an association between early sport specialisation and lower extremity injuries in the youth athlete population that is independent of training volume. Recent literature has suggested that sport diversification, not specialisation, is a better path for athletic success and minimised lower extremity injury risk.

Patterns and Implications of Lower Extremity Injuries in a Community Level I Trauma Center

2004 ◽  
Vol 53 (4) ◽  
pp. 373-377 ◽  
Author(s):  
Grant A. Fairbanks ◽  
Robert X. Murphy ◽  
Thomas E. Wasser ◽  
W Michael Morrissey
Keyword(s):  
Lower Extremity ◽  
Trauma Center ◽  
Community Level ◽  
Lower Extremity Injuries ◽  
Level I ◽  
Extremity Injuries

scholarly journals EFFECTS OF SPORTS SPECIALIZATION ON LOWER EXTREMITY SAGITTAL PLANE LOADING IN ADOLESCENT MALES AND FEMALES

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0028
Author(s):  
Shiho Goto ◽  
Joseph P. Hannon ◽  
Angellyn N. Grondin ◽  
James M. Bothwell ◽  
J. Craig Garrison
Keyword(s):  
Lower Extremity ◽  
Knee Flexion ◽  
Sagittal Plane ◽  
Adolescent Athletes ◽  
Lower Extremity Injuries ◽  
Male Adolescents ◽  
Increased Risk ◽  
Males And Females ◽  
Extremity Injuries ◽  
Dominant Side

Background: Sport specialization has been associated with increased risk of both acute and chronic lower extremity musculoskeletal injuries in adolescent athletes. Repetitive movement through sport specialization has been hypothesized to increase the stress through the lower extremity, leading to injury. However, the underlying mechanism is unclear. Purpose: The purpose of this study was to examine the differences in sagittal plane lower extremity loading between adolescent athletes who participate in a single sport (SS) verse those who participate multiple sports (MS). Methods: A cross sectional study design was used. A total 252 adolescent athletes participated in the study (Males: SS=26, Age=14.62±1.72, Ht=173.06±12.41 cm, Mass =62.47±14.72 Kg; MS=27, Age=13.52±1.72, Ht=171.61±11.20 cm, Mass =61.32±14.21 Kg Females: SS=127, Age=14.28±1.77, Ht=164.72±10.73 cm, Mass =58.29±11.17 Kg, MS=84, Age=13.62±1.41, Ht=163.22±7.67 cm, Mass =57.63±11.44 Kg). Participants were included if they were between the ages of 10 and 17, involved in high-risk sports for equal or greater than 50 hours per year, and reported no injuries in the 3 months prior to participation in the study. Joint moments of the hip, knee, and ankle were assessed at initial contact (IC) during a jump-landing (JL) task in both the dominant and non-dominant limbs. All values were normalized to the product of height and weight and averaged across three trials. Participants were grouped into SS or MS groups, then sub-grouped by gender. Separate independent t-tests were performed on each dependent variable for the dominant and non-dominant limbs in males and females to examine the differences between the groups (SS vs MS) (α = 0.05). Results: In the female cohort, the SS group demonstrated lesser knee flexion moments compared to the MS group on dominant side (SS=0.022 HtWt-1, MS=0.026 HtWt-1; p=0.012). The female SS group also demonstrated lesser hip extension moments (SS=0.031HtWt-1, MS=0.042 HtWt-1; p=0.022) and knee flexion moments on non-dominant side compared to that of the MS group (SS=0.023HtWt-1, MS=0.027 HtWt-1; p=0.013). There were no significant differences observed in any of the variables in male adolescents. Conclusion: Altered sagittal plane biomechanics were observed in female adolescents, but not in male adolescents during a JL task. The MS group had greater loading at the hip and knee joints than the SS group. Since MS has been suggested to increase the risk of lower extremity injuries, this biomechanical pattern at IC of a JL may be a profile for higher risk of lower extremity injuries. (394/400) [Table: see text]

scholarly journals Lower Extremity Musculoskeletal Injury Is Associated with Increased Risk of Concussion in High School Athletes

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0039
Author(s):  
Adam Lutz ◽  
Charles Thigpen ◽  
R. Gil Gilliland ◽  
John Thorpe ◽  
Michael Kissenberth ◽  
...  
Keyword(s):  
High School ◽  
Lower Extremity ◽  
Female Athletes ◽  
High School Athletes ◽  
Time Loss ◽  
Male Athletes ◽  
Lower Extremity Injuries ◽  
Increased Risk ◽  
Extremity Injuries ◽  
Combined Injuries

Objectives: Previous research indicates that concussion increases the risk of lower extremity injuries (LE) after return to sport. However, no study has examined the risk of precedent lower extremity injuries and their relationship to the development of a sport related concussion (SRC). To determine if the risk of combined injuries (LE injury-SRC) is elevated in high school athletes accounting for athlete sport and gender. Methods: 33,386 high school athletes were monitored over 4 seasons. 4223 LE injuries and 1132 concussions were reported. Injured athletes were identified by their school athletic trainer (AT) time-loss injury during a team-sponsored practice or game. ATs documented the date, mechanism, and sport of injury. Injured athletes were referred to a board-certified sports medicine physician for diagnoses and follow up care. Cumulative injury rates were calculated with 95% confidence intervals. Rate ratios were used to compare frequency of SRC after RTS following a LE injury. Comparisons were made overall cohort between those participating athletes with and without isolated and combined injuries as well as by gender. (α=0.05). Results: A cumulative incidence for athletes sustaining an isolated SRC was 2.3/100 athletes (95% CI= 2.1-2.5) and for isolated LE injury was 11.5/100 (95% CI=11.2-11.9) athletes. Athletes presenting with a LE injury had an increased risk (RR= 4.7; 95% CI = 4.2-5.2) of sustaining a subsequent SRC within 1 year when compared to athletes that did not suffer precedent LE injuries. Male athletes presenting with a LE injury had an increased risk (RR= 4.9; 95% CI = 4.2-5.7) of sustaining a subsequent SRC within 1 year when compared to male athletes that did not suffer precedent LE injuries. Female athletes presenting with a LE injury had an increased risk (RR= 4.4; 95% CI = 3.6-5.2) of sustaining a subsequent SRC within 1 year when compared to female athletes that did not suffer precedent LE injuries. In football, presenting with a LE injury had an increased risk (RR= 5.8; 95% CI = 4.5-7.4) of sustaining a subsequent SRC within 1 year when compared to football athletes that did not suffer precedent LE injuries. Conclusion: Our results are the first to show that high school athletes who suffer a time-loss LE injury are at 4.4-5.8 times increased risk to suffer a sports related concussion within the next year. Additional studies are warranted to confirm these findings.

scholarly journals SPORT SPECIALIZATION IS A RISK FACTOR FOR OVERUSE, BUT NOT ACUTE, LOWER EXTREMITY INJURIES: A PROSPECTIVE STUDY

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0011
Author(s):  
David Bell ◽  
Kevin M. Biese ◽  
Eric G. Post ◽  
Dan Schaefer ◽  
Timothy A. McGuine ◽  
...  
Keyword(s):  
Middle School ◽  
Risk Factor ◽  
Lower Extremity ◽  
Overuse Injury ◽  
Sport Participation ◽  
Baseline Survey ◽  
Lower Extremity Injuries ◽  
Previous Injury ◽  
Increased Risk ◽  
Extremity Injuries

BACKGROUND: Sport specialization is often associated with intense, high volume training, which may result in injury – especially overuse injuries. However, there is limited prospective research investigating these relationships. Additionally, previous research has focused on adolescents older than 12 years of age with no data available in younger cohorts, who may be more susceptible to repetitive stress. Therefore, the purpose of this study is to determine if sport specialization is associated with increased risk of overuse and acute lower extremity injuries in middle school aged athletes. METHODS: A total of 281 children (113 females (40%), age=12.1±1.2years; range 10-14 years of age) completed an online survey with their parents for 39 weeks. The study was conducted during the 2017-2018 academic year with a baseline survey conducted the first week of September. Weekly surveys were sent to respondents via Qualtrics with the final weekly survey in June of 2018. The baseline survey consisted of 1) demographic information, 2) injury history in the previous 12 months, 3) a sport specialization scale which classified individuals in low, moderate, and high levels of specialization, and 4) sport participation volume (months per year in primary sport). The weekly surveys asked participants to report and musculoskeletal injury they sustained during sport participation. Participants were included in the analysis if they completed at least 80% of the total surveys. Multivariable logistic regression analyses were utilized to examine associations between specialization category (reference category: low) and prospective injury categories, while adjusting for differences in age, sex, and previous injury history. RESULTS: Respondents reported 57 acute and 32 overuse lower extremity injuries during the observation period. Highly specialized athletes had significantly greater odds of reporting a prospective lower extremity overuse injury than subjects in the low specialization group (OR: 3.78, 1.02-12.90, p=0.03), even after adjusting for sex, age, and previous injury history. However, specialization was not a risk factor for acute lower extremity injuries (OR: 2.20, 0.72-6.77, p=0.17). CONCLUSION: Highly specialized middle school athletes are nearly 4 times greater risk of developing an overuse injury compared to low specialization athletes. Younger athletes may be more susceptible to injuries at younger ages. Thus, adolescent athletes should avoid specialization when possible.

Balance and Proprioceptive Training for Rehabilitation of the Lower Extremity

1994 ◽  
Vol 3 (1) ◽  
pp. 68-83 ◽  
Author(s):  
James J. Irrgang ◽  
Susan L. Whitney ◽  
Emily D. Cox
Keyword(s):  
Motor Control ◽  
Lower Extremity ◽  
Lower Extremity Injuries ◽  
Somatosensory Information ◽  
Recurrent Injury ◽  
Increased Risk ◽  
Proprioceptive Training ◽  
Extremity Injuries ◽  
Scientific Rationale

Recently there has been emphasis on including balance and proprioceptive training in the rehabilitation of sports-related lower extremity injuries. It is believed that injury to joint and musculotendinous structures results in altered somatosensory information that adversely affects motor control. This may result in increased risk for recurrent injury, decreased performance, or both. Balance and proprioceptive training have been advocated to restore motor control to the lower extremity. This paper will review the current scientific rationale for use of balance and proprioceptive training in the rehabilitation of sports-related lower extremity injuries. Additionally, guidelines for training to improve balance and proprioception will be discussed.

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