Development of mine-blast trauma severity score for lower extremities in men

This study presented the results of the analysis of existing approaches to the assessment of the severity of lower extremity injuries protected with explosion-proof shoes in case of mine-explosive ammunition explosion. An increasing number of mine explosives are used in modern local wars and armed conflicts. At present, more than 110 million mines are planted and activated. Every year, nearly 10 thousand individuals are killed by explosive demolitions, and more than 20 thousand civilians sustain injuries. The necessity to clear minefields and to destroy located ammunition increases the risks of mine clearance specialists to mine-blast trauma of the lower extremities. To reduce the likelihood of severe trauma in this population, developing effective blast protective equipment, such as anti-mine boots, is necessary. The effectiveness evaluation of protective boots requires special methodology that should comprise relevant methods of mine-blast trauma severity estimation. Mine-blast trauma is a special type of surgical pathology where the injured individual has extremity avulsion or multiple injuries to extremity tissues accompanied by severe impairment of body functions. Almost all available domestic classifications of mine-explosive wounds have a pronounced clinical orientation, and foreign ones have terminologies that are not accepted in Russia and cannot be fully used for assessment purposes. The modified working classification, in the form of a rating scale, showed not only the characteristics of a given blast trauma but also the criteria of trauma severity estimation and feasibility of exposure to blast trauma. The results of the study demonstrated the potential for its use to estimate the protective features of mine clearance specialist boots when exposed to charge explosion, as well as recommendations to include this classification in documenting the science and technology that deal with the general specifications of protective equipment for specialists at the project stage.

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TELEREHABILITATION OF THE KNEE JOINTS OF PATIENTS WITH POLYTRAUMA

Wiadomości Lekarskie ◽

10.36740/wlek202101109 ◽

2021 ◽

Vol 74 (1) ◽

pp. 48-51

Author(s):

Andriy I. Tsvyakh ◽

Andriy Y. Hospodarskyy ◽

Nataliia O. Marchenkova ◽

Ihor R. Kopytchak ◽

Volodymyr P. Kostjuk ◽

...

Keyword(s):

Remote Monitoring ◽

Learning Algorithm ◽

Lower Extremities ◽

Knee Joints ◽

Control Group ◽

Injured Limb ◽

Lower Extremity Injuries ◽

Orthopedic Rehabilitation ◽

Sensor Temperature ◽

Extremity Injuries

The aim: The overarching theme of this paper is to discuss implementation of the telemedicine technology for rehabilitation of patients with injuries of the lower extremities. Materials and methods: Consecutive patients were recruited over a four-year period. A total of 48 polytrauma patients with lower extremity injuries were enrolled in the study after the resolution of the surgical sequelae. 16 patients from the control group underwent traditional rehabilitation procedures for a 3-week period after injury. A total of 32 subjects were enrolled in the telerehabilitation group for a 3-week study period after injury and were trained with a set of exercises for home use. Home remote monitoring for the 96 test subjects included use of a Portable device with Axis-sensor, temperature and volume sensors, that were fixed to the injured limb. Software permits the monitoring of exercise time, local temperature, the biomechanics of active movements of the injured limb. Results: The orthopedic surgeon during telerehabilitation took significantly less time to consult patients (1.9 minutes) than the traditional rehabilitation (15.2 minutes). Patient satisfaction was higher for the telerehabilitation with machine learning algorithm (78.3%) than for the orthopedic surgeon’s traditional rehabilitation (36.7%). Conclusions: Subjects reported a higher satisfaction with telerehabilitation than with the traditional orthopedic rehabilitation due to the fact that they spent less time at the hospital and had more time for exercises at home under orthopedic remote monitoring. The telerehabilitation system can be used in complex rehabilitation of patients with injuries of the lower extremities.

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Judgment and Approach for Management of Severe Lower Extremity Injuries

Clinics in Plastic Surgery ◽

10.1016/s0094-1298(20)30851-8 ◽

1991 ◽

Vol 18 (3) ◽

pp. 525-543 ◽

Cited By ~ 2

Author(s):

Robert L. Walton ◽

Douglas M. Rothkopf

Keyword(s):

Lower Extremity ◽

Lower Extremity Injuries ◽

Extremity Injuries

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

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211003491 ◽

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.

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

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00141 ◽

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.

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Association Between Ball-Handling Versus Defending Actions and Acute Noncontact Lower Extremity Injuries in High School Basketball and Soccer

The American Journal of Sports Medicine ◽

10.1177/0363546514564541 ◽

2015 ◽

Vol 43 (4) ◽

pp. 802-807 ◽

Cited By ~ 9

Author(s):

Scott M. Monfort ◽

R. Dawn Comstock ◽

Christy L. Collins ◽

James A. Onate ◽

Thomas M. Best ◽

...

Keyword(s):

High School ◽

Lower Extremity ◽

Lower Extremity Injuries ◽

Extremity Injuries

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ORTHOPEDIC INJURIES IN ADOLESCENT GYMNASTS: A SYSTEMATIC REVIEW

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00117 ◽

2021 ◽

Vol 9 (7_suppl3) ◽

pp. 2325967121S0011

Author(s):

Katie Kim ◽

Michael Saper

Keyword(s):

Lower Extremity ◽

Upper Extremity ◽

Weight Bearing ◽

The Body ◽

Adolescent And Young Adult ◽

Body Region ◽

Lower Extremity Injuries ◽

Common Location ◽

Orthopedic Injuries ◽

Extremity Injuries

Background: Gymnastics exposes the body to many different types of stressors ranging from repetitive motion, high impact loading, extreme weight bearing, and hyperextension. These stressors predispose the spine and upper and lower extremities to injury. In fact, among female sports, gymnastics has the highest rate of injury each year. Purpose: The purpose of this study was to systematically review the literature on location and types of orthopedic injuries in adolescent (≤20 years) gymnasts. Methods: The Pubmed, Medline, EMBASE, EBSCO (CINAHL) and Web of Science databases were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify all studies reporting orthopedic injuries in adolescent and young adult gymnasts. All aspects of injuries were extracted and analyzed including location, type and rates of orthopedic injuries. Results: Screening yielded 22 eligible studies with a total of 427,225 patients. Twenty of 22 studies reported upper extremity injuries of which four specifically focused on wrist injuries. Eight studies reported lower extremity injuries. Nine studies reported back/spinal injuries. Seven studies investigated each body location of injury; one study reported the upper extremity as the most common location for injury and six studies reported the lower extremity as the most common location for injury. Of those seven studies, five (23%) reported sprains and strains as the most common injury. One study reported fractures as the most common injury. Conclusion: There is considerable variation in reported injury location. Some studies focused specifically on the spine/back or wrist. The type of gymnastics each patient participated in was also different, contributing to which area of the body was more heavily stressed, or lacking. Current literature lacks data to fully provide evidence regarding which body region is more frequently injured and the type of injury sustained.

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