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PubMed1982

University of Manchester sports injury clinic.

This paper reviews the work of the sports injury clinic based at the Student Health Centre, University of Manchester during its first eighteen months. A total of 852 patients including 46 Centre of Excellence athletes were treated. The results indicate that the establishment of such a specialised clinic is worthwhile, that the injured sportsmen should be treated by individuals trained and interested in the treatment of injured patients in general and that the commonest injuries are soft tissue injuries to the knee of ankle joint. A record card, designed for future computer analysis, is illustrated. It includes details of the sport, training, mechanism of injury, pathology and treatment.

Athletic Injuries↗
PubMed2005

Injuries in martial arts: a comparison of five styles.

OBJECTIVE: To compare five martial arts with respect to injury outcomes. METHODS: A one year retrospective cohort was studied using an injury survey. Data on 263 martial arts participants (Shotokan karate, n = 114; aikido, n = 47; tae kwon do, n = 49; kung fu, n = 39; tai chi, n = 14) were analysed. Predictor variables included age, sex, training frequency ( 3 h/week), experience (<3 years v >or=3 years), and martial art style. Outcome measures were injuries requiring time off from training, major injuries (>or=7 days off), multiple injuries (>or=3), body region, and type of injury. Logistic regression was used to determine odds ratios (OR) and confidence intervals (CI). Fisher's exact test was used for comparisons between styles, with a Bonferroni correction for multiple comparisons. RESULTS: The rate of injuries, expressed as percentage of participants sustaining an injury that required time off training a year, varied according to style: 59% tae kwon do, 51% aikido, 38% kung fu, 30% karate, and 14% tai chi. There was a threefold increased risk of injury and multiple injury in tae kwon do than karate (p<0.001). Subjects >or=18 years of age were at greater risk of injury than younger ones (p<0.05; OR 3.95; CI 1.48 to 9.52). Martial artists with at least three years experience were twice as likely to sustain injury than less experienced students (p<0.005; OR 2.46; CI 1.51 to 4.02). Training >3 h/week was also a significant predictor of injury (p<0.05; OR 1.85; CI 1.13 to 3.05). Compared with karate, the risks of head/neck injury, upper extremity injury, and soft tissue injury were all higher in aikido (p<0.005), and the risks of head/neck, groin, and upper and lower extremity injuries were higher in tae kwon do (p<0.001). No sex differences were found for any of the outcomes studied. CONCLUSIONS: There is a higher rate of injury in tae kwon do than Shotokan karate. Different martial arts have significantly different types and distribution of injuries. Martial arts appear to be safe for young athletes, particularly those at beginner or intermediate levels.

Adolescent↗
PubMed1990

Injuries to dancers. Prevalence, treatment and prevention.

Studies from the USA and UK indicate that the back, neck and shoulder and the lower limb (particularly the hip, knee, ankle and foot) are the most frequent sites of injury among dancers. Most injuries are soft tissue injuries. Most dancers experience injuries at some time and about half have chronic injuries. Shoulder injuries appear to be caused by frequent or unaccustomed lifting, and are treated by rest and oral anti-inflammatory medication. Back injuries include sprains, prolapsed or herniated intervertebral discs, and spondylolytic stress fractures. Several risk factors, especially training error, have been identified for overuse injuries. Hip injuries include degenerative changes and osteoarthritis, stress fractures, bursitis and damage to the sciatic nerve. The most common foot injury is an anterior lateral ligament sprain, which may lead to permanent instability in the ankle. More soundly based research into the prevalence, diagnosis and treatment of injuries is needed.

Dancing↗
PubMed1997

Fat necrosis after trauma: a benign cause of palpable lumps in children.

OBJECTIVE: Our objective is to describe the clinical entity and MR imaging appearance of fat necrosis after trauma, a benign cause of palpable soft-tissue lesions in children. A related objective is to establish MR imaging criteria that can be used reliably to differentiate this entity from other more serious causes of soft-tissue masses. CONCLUSION: Fat necrosis after trauma is a common cause of palpable lumps in children and has a benign course on long-term follow-up. When characteristic MR imaging findings are seen, conservative therapy is appropriate.

Child↗
PubMedDate not supplied

Facial bone fractures in Nigerian children.

A ten year review of ninety-three patients aged 16 years or less treated for facial bone fractures at the University College Hospital, Ibadan was studied. Of the total number of 1203 patients of all ages treated for facial fractures, 93 (7.7%) were within the age range of the study. The male to female ratio was 2.6:1 and majority of the patients (50, 53.8%) were within age group C (11-16 years). The mandible (106, 83.5%) was more involved than the middle third of the facial skeleton (21, 16.5%). Road traffic accidents (51.6%) were the most common cause of facial fractures while the most common concomitant injuries were soft tissue injuries (74.5%).

Adolescent↗
PubMed1951

Knuckle pads.

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Disease↗
PubMed1951

[Knuckle pads].

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Disease↗
PubMed1951

[Knuckle pads].

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Disease↗
PubMed1991

[Recent trends in the treatment of lower leg fractures].

Indications of appropriate treatment of tibial shaft fractures are one of the priority problems present-day traumatology has to address. In choosing the optimal mode of treatment of tibial shaft fractures not only the configuration of the fracture but also injury of soft tissues has been assigned increasing importance. At the Department of Traumatology of the Postgraduate Institute of Medicine in Bratislava, 962 tibial shaft fractures were treated over the period of 12 years from 1977-1988. Conservative treatment was applied in 600 fractures and 362 fractures were treated surgically. The therapeutic results obtained by using the newly introduced methods of treating tibial shaft fractures, i.e. functional plating and osteosynthesis by flexible Ender nailing, were analyzed in a retrospective and prospective study. The results of these approaches were compared with those achieved by classical methods of the AO school, rigid intramedullary nailing and external fixation. The favorable outcome of union and the good functional effect obtained in the studied and compared series of patients indicate that conservative functional treatment is the method of choice in tibial shaft fractures. Of the surgical therapeutic methods, flexible as well as stable intramedullary osteosynthesis by Ender nailing proved to be both the most sparing and the most physiological approach. The paper proposes an indication scheme of tibial shaft fracture treatment designed for clinical use considering the categorization of fractures according to up-to-date classification. For each type of tibial shaft fracture and soft tissue injury the optimal mode of treatment is suggested. Besides the main indication, possibilities of alternative treatment are also being pointed out.

Fracture Fixation↗
PubMed1995

The versatility of the gastrocnemius muscle flap.

The gastrocnemius muscle rotation flap is a utilitarian procedure for management of soft-tissue defects about the knee. Ten patients underwent medial gastrocnemius muscle rotation flaps at our institution during a 24-month period. Four of the 10 patients underwent primary muscle rotation-plasty for reconstruction following tumor resection; 3 patients had soft-tissue defects following trauma; 2 patients had skin ischemia following total knee arthroplasty; and 1 patient had a soft-tissue defect from scar formation. All procedures were performed by an orthopaedic surgeon. At follow-up of 6 to 24 months, the soft-tissue coverage was maintained in all patients. All of the muscle rotation flaps survived. The gastrocnemius rotation flap provides reliable anterior knee soft-tissue coverage and can be performed by most orthopaedic surgeons.

Adolescent↗
PubMed1994

[3D-ultrasound of soft tissues and joints].

Sonography has become a reliable diagnostic method in musculo-skeletal diseases. It allows a simple and noninvasive examination of joints and soft tissues. Especially in rheumatic diseases meaningful findings can be obtained. In the present study first results of three-dimensional (3D) sonography of the musculo-skeletal system are reported. The method was first validated by examining healthy test persons and criteria for regular findings were defined. In the second part of the study an unselected group of patients with inflammatory and noninflammatory joint and soft tissue diseases were examined and the obtained results were compared with the findings of the conventional real-time sonography. Comparison of the 2D and 3D procedure showed a superiority of the 3D method with regard to the assessment of large (hip), middle-sized (elbow) and small joints (finger, toe). Additional information about the synovial space, the surface of the cartilage, and the thickness of the synovial membrane was provided by 3D sonography. Volumetry of joint effusions and Baker cysts was easier to perform and more reliable than with the conventional method. Soft tissue alterations could be delineated reliably, depending on their size. Our results demonstrate that 3D sonography can improve the diagnostics of musculo-skeletal diseases. In the future, 3D sonography should play an important part in the diagnosis of joint and soft tissue diseases.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Peculiar indications for the pedicled or free rectus abdominis flap in reconstructive surgery. A review of our experience.

Among all known flaps, the rectus abdominis muscle flap possesses an unique diversity in flap designs due to the special vascular supply of the abdominal wall. The axial vascularization of the rectus abdominis muscle gives ofF several musculocutaneous perforators, which are mainly located in the periumbilical region. Abdominal wall skin perfusion is guaranteed by spoke-wheel like vessels arising from these perforators. Subsequently several designs (muscle, myocutaneous and myosubcutaneous) are possible, by varying the included tissue and the position of the skin island. We described 7 cases where the rectus abdominis muscle was used as a muscle or myocutaneous flap for reconstruction of large defects. In most cases a pedicled transfer was necessary, possible and sufficient to reconstruct the difficult defects in various body regions. Great amounts of well perfused tissue can be transferred with still possible primary closure of the donor site. Due to its rich perfusion and constancy of vascular pattern, it represents an excellent and safe pedicled reconstructive procedure for large defects of the thorax, the abdomen, the forearm or the hip and pelvis where free tissue transfers are impossible or contraindicated. No other local transposition would have achieved this goal, due to the lack of volume and mobility. Moreover the flap is ideal for reconstruction of contour deficiencies due to the abundance of fat, as for example in breast or buttock reconstruction. However the flap is not the first choice for traumatic and infected wounds where fat tissue is not desired.

Abdominal Muscles↗