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Current concepts in the role of steroids in the treatment of sprains and strains.

With the development of nonsteroidal anti-inflammatory drugs, the use of corticosteroids in the treatment of sprains and strains has greatly diminished. They are used occasionally in the treatment of tendinitis in various areas of the body, but they are not used for ligamentous sprains and muscle strains. Injection of corticosteroids into ligaments, tendons and joints is often quite controversial and most clinicians have abandoned their use in the treatment of common athletic injuries.

Adrenal Cortex Hormones↗

Fluproquazone in the management of strains and sprains.

A double-blind randomized trial was carried out in 59 patient suffering from moderately severe to severe strains and sprains to compare the efficacy of 4-(p-fluorophenyl)-1-isopropyl-7-methyl-2(1H)-quinazolinone (fluproquazone) in the relief of pain. Patients received either 50 mg or 100 mg fluproquazone up to 6 times daily for 3 days. The results of subjective assessments showed that after 2 days pain had either completely resolved or markedly improved in all patients. Both treatments were equally effective in relieving both spontaneous pain and pain on movement after 1 and 2 days. No differences were found between the two groups in the patients' overall evaluation of treatment or physicians' assessment of therapeutic response. Both dosage were well tolerated during the short-term trial.

Adult↗

Sulindac versus ibuprofen in sprains and strains.

In a double-blind parallel group randomised study 191 patients with acute sprains and strains of ankle, hip, shoulder or knees were treated with either 400 mg sulindac or 1200 mg ibuprofen per day for 4 days; of these, 176 completed the trial. Spontaneous pain (day and night), pain on active movement, swelling and tenderness were assessed before and after the treatment period along with a physician's and patient's assessment of therapy at the end of the study. The vast majority of patients had a successful outcome whichever treatment they were taking. No patients reported any adverse effect during the study.

Adolescent↗

Neck strains and sprains among motor vehicle occupants-United States, 2000.

CONTEXT: Motor vehicle (MV)-related injury is a leading cause of death and emergency department visits in the US. Information has been limited regarding the magnitude and types of injuries suffered by the survivors of MV crashes. OBJECTIVE: To estimate the incidence and patterns of neck strain/sprain injury among MV occupants treated in US hospital emergency departments. DESIGN AND PARTICIPANTS: Descriptive epidemiologic analysis of persons treated at a stratified, probability sample of US hospital emergency departments from 1 July to 31 December 2000. SETTING: US. MAIN OUTCOME MEASURES: Annualized national estimates of number and rate of neck strain/sprain injury among MV occupants overall and by patient's age and sex. Rates were calculated per 100,000 population as well as per billion person miles traveled. RESULTS: In 2000, an estimated 901,442 (95% CI 699,283-1,103,601) persons with neck strain/sprain injury were treated in US hospital emergency departments. For MV occupants, neck strain/sprain was the most frequent type of injury, comprising 27.8% of all injuries to MV occupants treated in emergency departments that year. The incidence (per 100,000 population) of neck strain/sprain was significantly lower in younger children and peaked in the 20-24-year age group. The incidence (per billion person miles traveled) peaked in the 15-19-year age group. Females tended to have a higher incidence of emergency department-treated neck strain/sprain than males. CONCLUSIONS: Neck strain/sprain is the most common type of injury to MV occupants treated in US hospital emergency departments. Based on emergency department visits, these estimates suggest that the problem of neck injury may be larger than has been previously demonstrated using other surveillance tools. Further research is needed to determine contributory factors and prevention measures to reduce the risk of neck injury among MV occupants especially among those at higher risk such as females, older teenagers and young adults.

Accidents, Traffic↗

Strains and sprains.

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Ankle Injuries↗

Addressing occupational strains and sprains: musculoskeletal injuries in hospitals.

Recognition related to the need for ergonomic design improvements among health care workers, management and administration, and equipment manufacturers is growing. The future should bring new concepts and innovations which can provide many benefits. Beyond the potential reduction in caregiver injuries, many possibilities exist to improve patient outcomes through better equipment design. As an additional benefit, applying the principles of ergonomics may enhance and increase caregiver productivity through a reduction of patient transfers required, and by minimizing staff required to ambulate patients. Another added value to applying ergonomics to equipment design is the development of convertible furnishing which could create a reduction in operating and capital expenses by reducing the need for some furnishings. Equipment such as cardiac chairs, sling scales, patient chairs, special rental surfaces, and other features might be incorporated into bed design. Ergonomic programs make sense and provide opportunities to create win-win situations throughout the health care industry. Current and future innovations will provide improvements resulting in outcomes from which everyone will benefit. These benefits include a higher quality of work life for health care workers and an improved quality of care for patients.

Accidents, Occupational↗

Study on the effect of etofenamate 10% cream in comparison with an oral NSAID in strains and sprains due to sports injuries.

In this 60 patient study of sports traumatology due to football injuries, etofenamate gel proved equally effective as oral naproxen on the overall pain scores (65% none to mild pain for etofenamate versus 86% for naproxen; p greater than 0.05). The global clinical impression results have been rated as good or excellent in 44% in the naproxen group versus 50% in the etofenamate group. The incidence of side effects in the etofenamate group (3%) was lower than in the naproxen group (20%). This study demonstrates that etofenamate gel has equal efficacy as oral NSAIDS but a better side effect profile in sport injuries in football players.

Administration, Topical↗

Double-blind comparison of ketoprofen and placebo in the treatment of sprains and strains.

Sixty patients (42 men and 18 women between the ages of 18 and 37 years) with grade 2 or grade 3 sprains or elongations participated in a seven-day double-blind study. By random determination, they were treated with either 100 mg of ketoprofen or placebo TID. Pain evaluation, vital signs, concomitant medication, and side effects were determined on days 1,3, and 7. Compared with placebo, ketoprofen produced statistically significant reductions (P less than 0.05) in investigator-rated pain at rest (day 3), on palpation (days 1, 3, and 7), on motion (days 1 and 3), and on the subject-rated analog scale (days 1 and 3). It also achieved a greater relief of pain (days 1 and 3) and greater overall efficacy, as expressed by the statistically significant improvements in the total pain scores on motion and on palpation, on the total pain relief score, on the total pain analog score, and on the sum of pain intensity differences for pain at rest, on palpation, and on motion. Tolerance to the seven-day ketoprofen treatment was excellent. Results from the study indicate that ketoprofen is efficacious in relieving pain following sprains and strains.

Acetaminophen↗