Outcomes of severe lower limb injury with Mangled Extremity Severity Score ≥ 7

2021 ◽  
Vol 103-B (4) ◽  
pp. 769-774
Author(s):  
Lotje A. Hoogervorst ◽  
Melissa J. Hart ◽  
Pamela M. Simpson ◽  
Lara A. Kimmel ◽  
Andrew Oppy ◽  
...  
Keyword(s):  
Lower Limb ◽  
Severity Score ◽  
Motor Vehicle ◽  
Soft Tissue Injury ◽  
Post Injury ◽  
Lower Limb Injury ◽  
Limb Injury ◽  
Mangled Extremity ◽  
Patient Reported ◽  
The Mean

Aims Complex fractures of the femur and tibia with associated severe soft tissue injury are often devastating for the individual. The aim of this study was to describe the two-year patient-reported outcomes of patients in a civilian population who sustained a complex fracture of the femur or tibia with a Mangled Extremity Severity Score (MESS) of ≥ 7, whereby the score ranges from 2 (lowest severity) to 11 (highest severity). Methods Patients aged ≥ 16 years with a fractured femur or tibia and a MESS of ≥ 7 were extracted from the Victorian Orthopaedic Trauma Outcomes Registry (January 2007 to December 2018). Cases were grouped into surgical amputation or limb salvage. Descriptive analysis were used to examine return to work rates, three-level EuroQol five-dimension questionnaire (EQ-5D-3L), and Glasgow Outcome Scale-Extended (GOS-E) outcomes at 12 and 24 months post-injury. Results In all, 111 patients were included: 90 (81%) patients who underwent salvage and 21 (19%) patients with surgical amputation. The mean age of patients was 45.8 years (SD 15.8), 93 (84%) were male, 37 (33%) were involved in motor vehicle collisions, and the mean MESS score was 8.2 (SD 1.4). Two-year outcomes in the cohort were poor: six (7%) patients achieved a GOS-E good recovery, the mean EQ-5D-3L summary score was 0.52 (SD 0.27), and 17 (20%) patients had returned to work. Conclusion A small proportion of patients with severe lower limb injury (MESS ≥ 7) achieved a good level of function 24 months post-injury. Further follow-up is needed to better understand the long-term trajectory of these patients, including delayed amputation, hospital readmissions, and healthcare utilization. Cite this article: Bone Joint J 2021;103-B(4):769–774.

scholarly journals Feasibility of anterior pelvic ring fixation alone for treating lateral compression type 1 pelvic fractures with nondisplaced complete sacral fractures: a retrospective study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8743
Author(s):  
Kun Shang ◽  
Chao Ke ◽  
Ya-Hui Fu ◽  
Shuang Han ◽  
Peng-Fei Wang ◽  
...  
Keyword(s):  
Lower Limb ◽  
Pelvic Ring ◽  
Pelvic Fractures ◽  
Lateral Compression ◽  
Lower Limb Injury ◽  
Sacral Fractures ◽  
Limb Injury ◽  
The Mean ◽  
Compression Type

Purpose The aim of this study was to evaluate the feasibility of anterior pelvic ring fixation alone for treating lateral compression type 1 (LC-1) fractures with nondisplaced complete sacral fractures. Methods Patients with LC-1 type pelvic fractures with nondisplaced complete sacral fractures in the Xi’an Honghui Hospital were screened. Those who underwent surgical treatment for the anterior pelvic ring fractures and conservative treatment for the sacral factures were included in the analysis. The Majeed and Short Form-12 (SF-12) functional scores were used to evaluate these patients. Results Of the 123 patients enrolled, 108 (88%) responded to our enquiries regarding the outcome. The mean follow-up period was 18.37 months for the 108 patients who responded. The mean SF-12 functional score was 48.22 ± 9.68. The mean Majeed score was 83.47 ± 9.23, including 52 with excellent, 47 with good, seven with fair, two with poor outcomes. The SF-12 functional and Majeed scores were significantly higher in those aged <45 years or without lower limb injury than in those aged ≥45 years or with lower limb injury (P < 0.05). Conclusion Acceptable functional outcomes can be obtained for LC-1 pelvic fractures with nondisplaced complete sacral fractures by using anterior pelvic ring fixation alone.

Foot core strengthening: relevance in injury prevention and rehabilitation for runners

2016 ◽  
Vol 64 (1) ◽  
Keyword(s):  
Injury Prevention ◽  
Lower Limb ◽  
Neuromuscular Electrical Stimulation ◽  
Plantar Fascia ◽  
Core Stability ◽  
Tibialis Posterior ◽  
Lower Limb Injury ◽  
Limb Injury ◽  
Plantar Fasciopathy ◽  
Intrinsic Foot Muscles

The human foot is a flexible structure characterized by a pronounced medial longitudinal arch (MLA) that compresses and recoils during running. That process is actively driven by the intrinsic foot muscles and requires a proper stability of the MLA. This introduces the concept of foot core stability. Because the intrinsic foot muscles are often neglected by clinicians and researchers, the purpose of this article is to provide some guidelines for incorporating foot core training in prevention or rehabilitation programmes for runners. The intrinsic foot muscles play a key role in postural control and maintain balance during single leg stance by controlling the height of the MLA and the foot pronation. During running, these muscles lengthen eccentrically during the absorption phase and subsequently shorten as the arch recoils during the propulsive phase, functioning in parallel to the plantar fascia. As a consequence, the dysfunction or weakness of the MLA active support may lead to injuries (e.g. plantar fasciopathy, Achilles or Tibialis posterior tendinopathy, metatarsalgia or medial tibial stress syndrome), due to numerous biomechanical cascades and mechanisms. In order to counteract or prevent these impairments, there are two ways for enhancing the foot core stability. Firstly in terms of volitional control of the intrinsic foot muscles, the “short foot exercise” must be practiced. Secondly strengthening sessions using neuromuscular electrical stimulation of these muscles seem to be a promising strategy in order to support the MLA and control the pronation during running. Practically, the foot core strengthening protocol may beneficiate not only the runners affected by excessive pronation related injuries but also those who sustained a long term lower limb injury and may be affected by a detraining process. In addition we warmly recommend integrating this protocol in any lower limb injury prevention programme or strength and conditioning plan for runners.

scholarly journals Forensic Engineering Assessment Of Safety For Stand Up Forklifts

2008 ◽  
Vol 25 (1) ◽  
Author(s):  
Richard M. Ziernicki ◽  
Railsback Benjamin T.
Keyword(s):  
Lower Limb ◽  
Safety Engineering ◽  
Engineering Analysis ◽  
Lower Limb Injury ◽  
Jury Verdict ◽  
Limb Injury ◽  
Forensic Engineering

Forklifts Operated From A Stand Up Position Rather Than A Seated Position Offer A Significant Advantage To Increase Warehouse Capacity. Stand Up Lift Trucks Can Be Operated In Warehouse Aisles As Narrow As 8 Feet. In Contrast, Traditional Sit Down Lift Trucks Typically Require Aisles Approximately 11 Feet Wide. This Paper Will Detail The Hazards Of Horizontal Intrusion And Lower Limb Injury For The Operators Of Stand Up Lift Trucks, Review Standards Related To Operator Protection Against Horizontal Intrusion And Lower Limb Injury, Summarize A Safety Engineering Analysis Of The Stand Up Lift Truck Design Including Guarding To Mitigate The Hazards, And Present Three Cases Tried To Jury Verdict Regarding Injury Accidents On Stand Up Lift Trucks.

Posture of rugby league players and its relationship to non-contact lower limb injury: A prospective cohort study

2019 ◽  
Vol 40 ◽  
pp. 27-32
Author(s):  
Edward Langdon ◽  
Suzanne J. Snodgrass ◽  
Jodi L. Young ◽  
Andrew Miller ◽  
Robin Callister
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Lower Limb ◽  
Prospective Cohort ◽  
Rugby League ◽  
Lower Limb Injury ◽  
Limb Injury

A randomized trial of preexercise stretching for prevention of lower-limb injury

2000 ◽  
Vol 32 (2) ◽  
pp. 271 ◽  
Author(s):  
RODNEY PETER POPE ◽  
ROBERT DALE HERBERT ◽  
JOHN DENNIS KIRWAN ◽  
BRUCE JAMES GRAHAM
Keyword(s):  
Randomized Trial ◽  
Lower Limb ◽  
Lower Limb Injury ◽  
Limb Injury
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