Common Peroneal Neuropathy Secondary to Repetitive Direct Blow Contusion Injuries in a Cheerleader: A Case Report

A 13-year-old female cheerleader presented with common peroneal neuropathy secondary to repetitive direct blow contusion injuries to the lateral leg, sustained during her role as a flyer in cheerleading. Symptoms resolved when removed from cheerleading activities. Nerve conduction velocity and needle electromyography electrodiagnostic test studies performed at presentation and during treatment confirmed improvement of the neuropathy. The use of a protective knee brace that provided cushion near the fibular head prevented recurrence after returning to cheerleading. An association between common peroneal neuropathy and cheerleading has not been documented in previous literature. Awareness of this association will help with diagnosis and prevention of injuries.

Descriptive Epidemiology of Adolescent Clavicle Fractures: Results From the FACTS (Function after Adolescent Clavicle Trauma and Surgery) Prospective, Multicenter Cohort Study

Background: The majority of previous investigations on operative fixation of clavicle fractures have been related to the adult population, with occasional assessments of the younger, more commonly affected adolescent population. Despite limited prospective data for adolescents, the incidence of operative fixation of adolescent diaphyseal clavicle fractures has increased. Purpose: To detail the demographic features and descriptive epidemiology of a large pooled cohort of adolescent patients with diaphyseal clavicle fractures presenting to pediatric tertiary care centers in the United States through an observational, prospective, multicenter cohort study (Function after Adolescent Clavicle Trauma and Surgery [FACTS]). Study Design: Cross-sectional study; Level of evidence, 4. Methods: Patients aged 10 to 18 years who were treated for a diaphyseal clavicle fracture between August 2013 and February 2016 at 1 of 8 geographically diverse, high-volume, tertiary care pediatric centers were screened. Treatment was rendered by any of the pediatric orthopaedic providers at each of the 8 institutions, which totaled more than 50 different providers. Age, sex, race, ethnicity, fracture laterality, hand dominance, mechanism of injury, injury activity, athletic participation, fracture characteristics, and treatment decisions were prospectively recorded in those who were eligible and consented to enroll. Results: A total of 545 patients were included in the cohort. The mean age of the study population was 14.1 ± 2.1 years, and 79% were male. Fractures occurred on the nondominant side (56%) more frequently than the dominant side (44%). Sport was the predominant activity during which the injury occurred (66%), followed by horseplay (12%) and biking (6%). The primary mechanism of injury was a direct blow/hit to the shoulder (60%). Overall, 54% were completely displaced fractures, defined as fractures with no anatomic cortical contact between fragments. Mean shortening within the completely displaced group was 21.9 mm when measuring the distance between fragment ends (end to end) and 12.4 mm when measuring the distance between the fragment end to the corresponding cortical defect (cortex to corresponding cortex) on the other fragment (ie, true shortening). Comminution was present in 18% of all fractures. While 83% of all clavicle fractures were treated nonoperatively, 32% of completely displaced fractures underwent open reduction and internal fixation. Conclusion: Adolescent clavicle fractures occurred more commonly in male patients during sports, secondary to a direct blow to the shoulder, and on the nondominant side. Slightly more than half of these fractures were completely displaced, and approximately one-fifth were comminuted. Within this large cohort, approximately one-third of patients with completely displaced fractures underwent surgery, allowing for future prospective comparative analyses of radiographic, clinical, and functional outcomes.

Under Fire from All Sides

With the Wells Fargo case reaffirming the Consumer Financial Protection Bureau’s mission, its future seemed assured. But a few weeks later in October 2016, Judge (soon-to-be Justice) Kavanaugh wrote an opinion that leveled a direct blow to the bureau’s independence. His ruling for the court of appeals held that the Constitution requires the president to have the power to replace the bureau’s director anytime, for any reason. In November, Donald Trump was elected president. Inauguration Day was only two and a half months away, and the bureau would be under fire from all three branches of the government. With renewed calls from the financial industry for Cordray to be fired, the bureau was at a crossroads. This chapter chronicles the steps that the bureau and Cordray himself took to stave off and, if necessary, contest his firing.

Middle third clavicle fractures are the most common fractures in head injuries: a biomechanical and epidemiological study in 1000 patients

<p class="abstract">A consecutive series of 1000 cases of head injury, out of which 385 patients presented with fractures. In the 385 patients with fractures, 179 patients presented with clavicle fractures, among that, 127 are middle third fractures. Out of the 189 patients who had clavicle fractures, 90% of them had direct blow to shoulders and 10% had fallen on the outstretched hand. This variation with the mechanism of injury was further investigated by biomechanical analysis of the forces involved in clavicular fractures.</p><p class="abstract"> </p>

Emergency urethroplasty for penile urethral injury in a case of blunt trauma of the penis: challenges and dilemmas during management

Penile urethral injury may be associated with cavernosal rupture due to distractive force during coitus. Non-coital penile injury due to direct blow to the penis causing penile urethral and cavernosal rupture is rare. Definite management of urethral injury in such cases can be deferred as extent of devitalised tissue can be deceptive in acute conditions.

Traumatic Closed Proximal Muscle Rupture of the Biceps Brachii in Military Paratrooper

Traumatic closed proximal muscle rupture of the biceps brachii has been infrequently cited in the medical bibliography. Early reports of this injury derived from US military during parachute jumps, and it may compromise >4% of injuries at altitude. The mechanism is a direct blow to the upper extremity by static lines. We report a case of traumatic closed proximal rupture of the biceps brachii in a healthy 25 years of age military paratrooper. He was managed with primary surgical repair, and after three years of follow-up, the patient has excellent functional results.

Que nada se sabe

Avid critic of the knowledge dependent of the old masters, Francisco Sanches strikes a direct blow at the heart of Aristotelic philosophy with the aim of demystifying the author par excellence of Scholasticism. Francisco Sanches, in this context, attempts to show that the human mind, for as sharp as it may be, is always fallible. In fact, shadows of truth show themselves if we search carefully. The whole history of philosophy proves this assertion, or had it not been more than a history of what was humanly capable of investigating. Some authors, possibly the most distinguishable, transcended the humanly capable of other authors, being therefore, unfortunately, treated as masters of knowing. Unfortunately indeed, as this dogmatic acceptance stagnates knowledge. Francisco Sanches visits exactly the classic masters of knowledge, and humbly shows the fallibility of the sapient assertions of Aristoteles.

Rational Designing Two-Stage Anvil Block of Impact Mechanisms

In the article the solution of the problem of heightening of efficiency of impact systems for the score of selection of rational shapes anvil blocks is reduced. Shape execution of anvil block in the form of two steps is offered - impact and cylindrical piston, which length steal up by "golden section" rule. Results of a finding of shapes of the impact impulses generated at direct blow on rods two-stage anvil blocks are reduced and analyzed.