Outcomes of Lisfranc Injuries in the National Football League

2016 ◽  
Vol 44 (7) ◽  
pp. 1810-1817 ◽  
Author(s):  
Kevin J. McHale ◽  
Joshua C. Rozell ◽  
Andrew H. Milby ◽  
James L. Carey ◽  
Brian J. Sennett
Keyword(s):  
Athletic Performance ◽  
National Football League ◽  
Statistical Significance ◽  
Control Groups ◽  
Level Of Evidence ◽  
Similar Time ◽  
Lisfranc Injury ◽  
Significant Difference ◽  
Lisfranc Injuries ◽  
Return To Competition

Background: Tarsometatarsal (Lisfranc) joint injuries commonly occur in National Football League (NFL) competition; however, the career effect of these injuries is unknown. Purpose: To define the time to return to competition for NFL players who sustained Lisfranc injuries and to quantify the effect on athletic performance. Study Design: Case-control study; Level of evidence, 3. Methods: Data on NFL players who sustained a Lisfranc injury between 2000 and 2010 were collected for analysis. Outcomes data included time to return to competition, total games played after season of injury, yearly total yards and touchdowns for offensive players, and yearly total tackles, sacks, and interceptions for defensive players. Offensive power ratings ( OPR = [ total yards/10] + [ total touchdowns × 6]) and defensive power ratings ( DPR = total tackles + [ total sacks × 2] + [ total interceptions × 2]) were calculated for the injury season and for 3 seasons before and after the injury season. Offensive and defensive control groups consisted of all players without an identified Lisfranc injury who competed in the 2005 season. Results: The study group was composed of 28 NFL athletes who sustained Lisfranc injuries during the study period, including 11 offensive and 17 defensive players. While 2 of 28 (7.1%) players never returned to the NFL, 26 (92.9%) athletes returned to competition at a median of 11.1 (interquartile range [IQR], 10.3-12.5) months from time of injury and missed a median of 8.5 (IQR, 6.3-13.0) regular-season games. Analysis of pre- and postinjury athletic performance revealed no statistically significant changes after return to sport after Lisfranc injury. The magnitude of change in median OPR and DPR observed in offensive and defensive Lisfranc-injured study groups, −34.8 (IQR, −64.4 to 1.4) and −13.5 (−30.9 to 4.3), respectively, was greater than that observed in offensive and defensive control groups, −18.8 (−52.9 to 31.5) and −5.0 (−22.0 to 14.0), respectively; however, these differences did not reach statistical significance ( P = .33 and .21, respectively). Evaluation of the durability of injured players after the season of injury revealed no statistically significant difference in career length compared with controls. Conclusion: More than 90% of NFL athletes who sustained Lisfranc injuries returned to play in the NFL at a median of 11.1 months from time of injury. Offensive and defensive players experienced a decrease in performance after return from injury that did not reach statistical significance compared with their respective control groups over a similar time period.

scholarly journals Jones Fractures Identified at the National Football League Scouting Combine: Assessment of Prognostic Factors, Computed Tomography Findings, and Initial Career Performance

2018 ◽  
Vol 6 (8) ◽  
pp. 232596711879074 ◽  
Author(s):  
Robert C. Spang ◽  
Daniel B. Haber ◽  
Brendin R. Beaulieu-Jones ◽  
Kristen L. Stupay ◽  
George Sanchez ◽  
...  
Keyword(s):  
Computed Tomography ◽  
National Football League ◽  
Treatment Method ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Specific Performance ◽  
Incomplete Healing ◽  
Bony Healing ◽  
The Mean ◽  
Career Performance

Background: Jones fractures result in subsequent dysfunction and remain an issue for athletes. Purpose: To (1) describe the epidemiology, treatment, and impact of Jones fractures identified at the National Football League (NFL) Scouting Combine on players’ early careers and (2) establish the value of computed tomography (CT) to determine bony healing after a fracture in prospective players. Study Design: Cohort study; Level of evidence, 3. Methods: All players who attended the combine between 2009 and 2015 were retrospectively reviewed to identify their history of Jones fractures. The playing position, treatment method, and number of missed collegiate games were recorded. The mean overall draft pick number, number of games started and played, snap percentage, and position-specific performance scores (fantasy score) over the first 2 years in the NFL were compared between players with fractures and controls. An imaging classification system was applied based on grading of each quadrant of the fifth metatarsal (plantar, dorsal, medial, lateral), with a score of 0 for not healed or 1 for healed. Results: Overall, the number of Jones fractures identified was 72 in 2285 athletes (3.2%), with all treated via intramedullary screw fixation. The mean overall draft pick number for players with fractures was 111.2 ± 67.9 compared with 99.0 ± 65.9 for controls ( P = .12). Performance scores for players with fractures were lower than those for controls across all positions, with a significant difference in running backs (2.6 vs 4.0, respectively; P < .001) and defensive linemen (1.4 vs 2.3, respectively; P = .02). The mean CT score was 2.5 ± 1.3. Of the 32 athletes who underwent imaging, 16 Jones fractures (50.0%) were healed or nearly healed, 12 (37.5%) were partially healed, and 4 (12.5%) showed little or no healing. The plantar cortex demonstrated the least healing (18/32; 56.3%), followed by the lateral cortex (15/32; 46.9%). Players with a mean score <1 were found to have fewer games started (2.7 ± 2.5) than those with 1 to 3 cortices healed (17.4 ± 10.4) or all cortices healed (8.7 ± 11.2). Conclusion: Based on CT, 50% of all players with a previous Jones fracture demonstrated incomplete healing. Moreover, position-specific performance scores over the first 2 years of a player’s career were lower across all positions for those with fractures compared with controls. Players with CT scores <1 were found to start fewer games and were drafted later than controls.

scholarly journals Prepectoral Direct-to-Implant Breast Reconstruction: Early Outcomes and Analysis of Postoperative Pain

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Rafi Fredman ◽  
Cindy Wu ◽  
Mihaela Rapolti ◽  
Daniel Luckett ◽  
Jason Fine ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Breast Reconstruction ◽  
Statistical Significance ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Trade Offs ◽  
Technological Advances ◽  
Significant Difference ◽  
Aesthetic Results ◽  
Postmastectomy Radiation Therapy

Abstract Background Direct-to-implant (DTI) breast reconstruction provides high-quality aesthetic results in appropriate candidates. Most commonly, implants are placed in the subpectoral space which can lead to pain and breast animation. Surgical and technological advances have allowed for successful prepectoral implant placement which may eliminate these trade-offs. Objectives Here we present early outcomes from 153 reconstructions in 94 patients who underwent prepectoral DTI. We sought to determine whether these patients have less postoperative pain and narcotic use than subpectoral implant or expander placement. Methods A retrospective review was performed for all prepectoral DTI reconstructions at our institution from 2015 to 2016. Data were collected on postoperative pain and narcotic use while in hospital. Results The average follow-up time was 8.5 months (range, 3–17 months) and the overall complication rate was 27% (n = 41) with the most common complications being skin necrosis (9%, n = 13) and infection (7%, n = 11). No statistically significant difference in complications was found in patients who underwent postmastectomy radiation therapy. Patients who underwent prepectoral DTI reconstruction did not have a statistically significant difference in postoperative pain and narcotic use while in-hospital compared with other techniques. Conclusion Prepectoral DTI reconstruction provides good results with similar complication rates to subpectoral techniques. Prepectoral DTI eliminates the problem of breast animation. Although our series did not reach statistical significance in pain scores or requirement for postoperative narcotics, we believe that it is an important preliminary result and with larger numbers we anticipate a more definitive conclusion. Level of Evidence: 4

scholarly journals The Effectiveness and Safety of Acupuncture for Patients with Chronic Urticaria: A Systematic Review

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Qin Yao ◽  
Shanshan Li ◽  
Xiaoxu Liu ◽  
Zongshi Qin ◽  
Zhishun Liu
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Chronic Urticaria ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Symptom Improvement ◽  
Control Groups ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
Significant Difference

Background. Acupuncture might have effectiveness in relieving the symptoms of chronic urticaria. There are currently no systematic reviews of acupuncture for chronic urticaria published in English.Objective. We conducted a systematic review to assess the effectiveness and safety of acupuncture for chronic urticaria.Methods. A systematic review and meta-analysis of randomized, controlled trials were performed. The primary outcome was global symptom improvement.Results. We included 6 studies with 406 participants. Three trials showed significant difference between acupuncture and drugs in global symptom improvement (relative risk 1.37; 95% CI 1.11–1.70;P=0.003). As an adjuvant to medication, acupuncture was also beneficial for global symptom improvement (relative risk 1.77; 95% CI 1.41–2.22;P<0.01). There were no severe adverse events related to acupuncture.Limitations. Some methodological limitations were observed. The overall risk of bias in the 6 included trials was high and all included RCTs were conducted in China and published in Chinese. Besides, the lack of proper control groups and the use of different rating methods and cut-offs in the included trials also made the evidence of this review limited.Conclusions. Acupuncture might be effective and safe for chronic urticaria in relieving symptoms, based on a low level of evidence. To draw a reliable conclusion, more high quality trials are needed in the future. This trial is registered with PROSPEROCRD42015015702.

scholarly journals The Effect of Goal Setting Difficulty on Serving Success in Table Tennis and the Mediating Mechanism of Self-regulation

2012 ◽  
Vol 33 (1) ◽  
pp. 173-185 ◽  
Author(s):  
Weina Liu ◽  
Chenglin Zhou ◽  
Liu Ji ◽  
Jack Watson
Keyword(s):  
Goal Setting ◽  
Athletic Performance ◽  
Self Regulation ◽  
Measurement Tool ◽  
Table Tennis ◽  
Control Groups ◽  
Small Triangle ◽  
Significant Difference ◽  
Before And After ◽  
And Control

The Effect of Goal Setting Difficulty on Serving Success in Table Tennis and the Mediating Mechanism of Self-regulationGoal setting difficulty has been shown to contribute to athletic performance (Burton et al., 2000). However, the potential mediating mechanism of goal difficulty on performance is unclear. Therefore, the purpose of this study was to verify the effect of goal setting difficulty on serving success in table tennis, and determine if self-regulation is the mediating variable. The current study used serving success within a one minute period as the task, and the "Athlete's Self-regulation in Motor Learning" as the measurement tool. The experiment was designed as a 3 (serving frequency: 20/min, 23/min, and 26/min) x 2 (serving placement: left "small triangle", and right "small triangle") model. Participants (N = 60) in the current study were students from a physical education school. These participants were randomly assigned into the experimental and control groups. After the intervention, differences in self-regulation (p < 0.001) and serving success (p < 0.05) between the experimental and control groups were significant. For the experimental groups, there was a significant difference in self-regulation (p < 0.001) and serving success (p < 0.05) before and after the experiment. Serving frequency had a main effect on self-regulation (F (5, 24) = 12.398, p < 0.01) and serving success (F (5, 24) = 37.601, p < 0.001). Moderately difficult goal setting contributed to athletic performance. Regression analysis using bootstrapping methods revealed that self-regulation partially mediated the relationship between the two.

scholarly journals THE EFFECT OF A PURIFIED SOURCE OF CELLULOSE ON THE GROWTH AND BODY COMPOSITION OF GROWING PIGS

1961 ◽  
Vol 41 (1) ◽  
pp. 120-125 ◽  
Author(s):  
H. M. Cunningham ◽  
D. W. Friend ◽  
J. W. G. Nicholson
Keyword(s):  
Body Composition ◽  
Iodine Number ◽  
Feed Efficiency ◽  
Nutritive Value ◽  
Statistical Significance ◽  
Growing Pigs ◽  
Control Groups ◽  
Significant Difference ◽  
Ad Libitum ◽  
Basal Ration

One hundred pigs were used in two experiments to determine the nutritive value of a purified source of cellulose (solka-floc) and its effect on body composition and iodine number of the loin fat. In each experiment one group of pigs received a basal ration ad libitum while levels of 10 and 40 per cent solka floe were added to the basal ration of two groups at 62 and 162 pounds liveweight, respectively. The pigs given solka-floc were fed ad libitum and the amounts of basal ration consumed were pair-fed to two respective control groups. There was a significant decrease (P <.01) in dressing percentage of pigs fed solka-floc. Feed efficiency, based on total feed (less solka-floc) per pound of gain, was better in the pair-fed controls reaching statistical significance (P <.05) in one experiment. There was no significant difference in the protein or fat content of the carcasses but the iodine number of the loin fat was significantly higher (P <.01) in pigs fed solka-floc. It was concluded that in growing pigs there is no net gain in energy from the consumption of cellulose.

scholarly journals The Impact of Limited Code Switching on the Achievement of the Jordanian English Language Learners

2016 ◽  
Vol 2 (6) ◽  
Author(s):  
Samer R. Hmeadat
Keyword(s):  
English Language Learners ◽  
English Language ◽  
Statistical Significance ◽  
Code Of Conduct ◽  
Code Switching ◽  
Male Students ◽  
Control Groups ◽  
Significant Difference ◽  
The Mean ◽  
The Impact

    The study sought to investigate the impact of limited and regulated code switching on the achievement of the Jordanian EFL learners. To achieve the aim of study, the use of code-switching was intended to be integrated within the code of conduct which made up the backbone of the class management.  The study sample consisted of (105) students from the eighth and ninth grades in Berein Secondary School, The Second Directorate of Education in Zarqa District. The subjects were divided into four groups; two experimental groups consisted of (51) male students who were taught through using code-switching. The other two control groups consisted of (52) male students who were taught the same content through the conventional strategy. Questionnaires were distributed into (100) male and female English teachers in different public and private schools to know their attitudes toward using code-switching in their daily lessons in EFL classrooms.  To achieve the goals of this study, the researcher chose both the quantitative design (achievement test) and the qualitative design (interviews and questionnaire) to conduct his study. Analysis of One-Way ANOVA was performed to test the statistical significance of the differences among groups. The results revealed that there was a statistical significant difference at the level (α =0.05) in the mean scores between the experimental groups and the control groups in favor of the experimental groups. The result showed that there were statistically significant differences between the mean scores of the subjects of the experimental groups who were taught through the code of conduct and using the code-switching.  

scholarly journals Lisfranc injuries: fix or fuse?

2021 ◽  
Vol 2 (10) ◽  
pp. 842-849
Author(s):  
Noortje Anna Clasina van den Boom ◽  
Guido A. N. L. Stollenwerck ◽  
Laureanne Lodewijks ◽  
Jeroen Bransen ◽  
Silvia M. A. A. Evers ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Risk Of Bias ◽  
Level Of Evidence ◽  
Assessment Development ◽  
Significant Difference ◽  
Patient Reported ◽  
Mean Differences ◽  
Lisfranc Injuries

Aims This systematic review and meta-analysis was conducted to compare open reduction and internal fixation (ORIF) with primary arthrodesis (PA) in the treatment of Lisfranc injuries, regarding patient-reported outcome measures (PROMs), and risk of secondary surgery. The aim was to conclusively determine the best available treatment based on the most complete and recent evidence available. Methods A systematic search was conducted in PubMed, Cochrane Controlled Register of Trials (CENTRAL), EMBASE, CINAHL, PEDro, and SPORTDiscus. Additionally, ongoing trial registers and reference lists of included articles were screened. Risk of bias (RoB) and level of evidence were assessed using the Cochrane risk of bias tools and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. The random and fixed-effect models were used for the statistical analysis. Results A total of 20 studies were selected for this review, of which 12 were comparative studies fit for meta-analysis, including three randomized controlled trials (RCTs). This resulted in a total analyzed population of 392 patients treated with ORIF and 249 patients treated with PA. The mean differences between the two groups in American Orthopedic Foot and Ankle Society (AOFAS), VAS, and SF-36 scores were -7.41 (95% confidence interval (CI) -13.31 to -1.51), 0.77 (95% CI -0.85 to 2.39), and -1.20 (95% CI -3.86 to 1.46), respectively. Conclusion This is the first study to find a statistically significant difference in PROMs, as measured by the AOFAS score, in favour of PA for the treatment of Lisfranc injuries. However, this difference may not be clinically relevant, and therefore drawing a definitive conclusion requires confirmation by a large prospective high-quality RCT. Such a study should also assess cost-effectiveness, as cost considerations might be decisive in decision-making. Level of Evidence: I Cite this article: Bone Jt Open 2021;2(10):842–849.

Clinical Outcomes of Patients With Anterior Shoulder Instability and Glenolabral Articular Disruption Lesions: A Retrospective Comparative Study

2020 ◽  
Vol 48 (14) ◽  
pp. 3472-3477
Author(s):  
Martin S. Davey ◽  
Eoghan T. Hurley ◽  
Christopher A. Colasanti ◽  
John P. Scanlon ◽  
Mohamed Gaafar ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Shoulder Instability ◽  
Return To Sport ◽  
Return To Play ◽  
Anterior Shoulder Instability ◽  
Control Group ◽  
Control Groups ◽  
Level Of Evidence ◽  
Significant Difference ◽  
And Control

Background: Anterior shoulder instability is a common clinical condition that often requires surgical stabilization. Glenoid labral tears are often associated with instability, with glenolabral articular disruption (GLAD) lesions occasionally being identified arthroscopically during repair, particularly in collision athletes. Purpose: To evaluate the clinical outcomes and recurrence rates in patients who had GLAD lesions and underwent arthroscopic Bankart repair (ABR) and compare them with a control group without GLAD lesions. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of patients who underwent ABR with GLAD lesions, by a single surgeon between July 2012 and March 2017, was performed. Additionally, these were pair matched in a 2:1 ratio for age, sex, sport, and level of play with a control group who underwent ABR without GLAD lesions. Return to sport, the level of return, and the timing of return were assessed. The visual analog scale (VAS) for pain score, Rowe score, Shoulder Instability–Return to Sport after Injury (SIRSI) score, and Subjective Shoulder Value (SSV) were evaluated. Results: The study included a total of 66 patients (22 and 44 patients for the GLAD and control groups, respectively), with a mean age of 25.8 years and a mean follow-up of 66 months. Overall, there was no significant difference in any of the clinical outcome scores (VAS, Rowe, SIRSI, and SSV) utilized for the GLAD and control groups ( P > .05 for all). Similarly, there was no significant difference in the total rate of return to play (90.9% vs 88.6%; P > .99) or return at the same/higher level (68.2% vs 72.7%; P = .78). There was no significant difference in timing of return to play (6.3 ± 6.6 months vs 6.4 ± 2.5 months; P = .98). There were 3 cases (13.6%) requiring further surgery (1 revision stabilization, 1 arthroscopic release, and 1 rotator cuff repair) in the GLAD group and 2 cases (4.5%) requiring further surgery (both revision stabilization) in the control group; the difference was not statistically significant ( P = .32). Conclusion: After arthroscopic repair, patients with GLAD lesions had similar midterm outcomes when compared with a control group without GLAD lesions.

scholarly journals PHYSICAL ACTIVITY IN THE TREATMENT OF DEPRESSION IN COLLEGE STUDENTS

2022 ◽  
Vol 28 (1) ◽  
pp. 68-71
Author(s):  
Xiaowei He
Keyword(s):  
Mental Health ◽  
College Students ◽  
Physical Exercise ◽  
Control Group ◽  
Observation Group ◽  
Control Groups ◽  
Level Of Evidence ◽  
Treatment Of Depression ◽  
Significant Difference ◽  
And Control

ABSTRACT Introduction: The mental health of college students is getting more and more attention from society. Physical exercise as a means of psychotherapy and mental health has become common at home and abroad. Objective: We explore the effect of prescribing physical exercise in the treatment of depression in college students. Methods: College students who had been diagnosed with depression were randomly divided into an observation group and a control group, each with 18 patients. The control group received drug treatment. The observation group received sports therapy in addition to drug therapy. Results: There was a statistically significant difference in HAMD scores between the observation and control groups in the first week (P<0.01). Conclusions: Exercise can play a role in treating depression patients rapidly, safely, and efficiently. Level of evidence II; Therapeutic studies - investigation of treatment results.

scholarly journals WHAT IS THE BEST DISTAL LEVEL OF ARTHRODESIS IN LUMBAR FUSION IN PATIENTS WITH ADOLESCENT IDIOPATHIC SCOLIOSIS: L3 OR L4?

2019 ◽  
Vol 18 (3) ◽  
pp. 200-204
Author(s):  
MURILO TAVARES DAHER ◽  
NILO CARRIJO MELO ◽  
VINÍCIO NUNES NASCIMENTO ◽  
PEDRO FELISBINO JR ◽  
BRENDA CRISTINA RIBEIRO ARAÚJO ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Fusion ◽  
Statistical Significance ◽  
Lumbar Curve ◽  
Coronal Alignment ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Idiopathic Adolescent Scoliosis ◽  
Group A ◽  
Group Fusion

ABSTRACT Objective To evaluate coronal alignment in patients with idiopathic adolescent scoliosis with structured lumbar curves submitted to surgical treatment by comparing coronal alignment in the group fusion up to L3 and the group fusion up to L4. Methods Retrospective cohort study. We evaluated patients submitted to surgical treatment with arthrodesis of the lumbar curve with high density of screws with at least 6 months of follow-up. Radiographically, coronal alignment, shoulder height and functional outcome were analyzed through SRS30 questionnaire. Results A total of 25 patients were analyzed, of which 23 were female and 2 were male, with a mean age of 15.2 years (12 to 29 years) at the time of surgery. The patients were divided into two groups. Group A, n = 15: Distal level of fusion in L3 and Group B, n = 10: distal level of fusion in L4. There was no statistically significant difference between Groups A and B when compared to coronal alignment (balanced vs. unbalanced). However, when compared with the coronal alignment (CA) values, lower values of CA were observed in Group A, with statistical significance. No difference was observed between Groups A and B with respect to the SRS30 questionnaire. Conclusions Patients with idiopathic adolescent scoliosis submitted to arthrodesis of the lumbar curve have a better coronal alignment when the distal fusion level is L3. Level of evidence III; Comparative Retrospective Study (based on prospectively collected data).

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