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Layman's guide to common complaints. 4. Sprains, strains and cuts.
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Sprain, strain, and contusion.
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Sprains, strains and bruises.
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A controlled study of diflunisal in sprains and strains.
A preliminary double-blind, randomized trial was carried out in general practice to compare the efficacy of treatment with diflunisal (500 mg) twice daily and a combination of dextropropoxyphene (65 mg) plus paracetemol (650 mg) 3-times daily for 3 days in relieving pain associated with strains and sprains. Analysis of the results from 51 patients showed that both treatments were equally effective in releiving spontaneous pain and pain on movement after 1 and 3 days, and there were no differences between the two groups in patients' overall evaluation of treatment or physicians' assessment of therapeutic response. Both treatments were well tolerated during the short-term period of the trial.
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.
Orthopedics in the emergency room: sprains and strains.
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The use of magnetic resonance imaging in diagnosing Wilms' tumor mimicking a lumbosacral strain and sprain.
Wilms' tumor is the most common tumor of the kidney in childhood. This article discusses the case of a young adult with a Wilms' tumor whose initial presentation appeared similar to a lumbosacral strain. The use of magnetic resonance imaging in diagnosing Wilms' tumor is discussed, along with the common clinical picture of the disease.
Orthopedic problems in family practice: incidence, distribution, and curricular implications.
The spectrum of orthopedic problems encountered by family physicians in everyday practice has received little study in the past. This paper presents and analyzes the incidence and distribution of orthopedic problems in general/family practice based on four sources of secondary data. These sources include the National Ambulatory Medical Care Survey, a Family Practice Service in a large military teaching hospital, a state wide study in Virginia, and two community-based family practice settings in Washington State. Orthopedic problems constitute about ten percent of all office visits in family practice. Over one half of these involve chronic, nontraumatic musculoskeletal problems. Major differences are noted in the distribution of sprains, strains, and fractures in adults and children. Fractures of the hand, foot, forearm, lower leg, and clavicle comprise between 50 and 80 percent of fractures seen in the settings under study. This kind of information should be helpful in better defining goals and methods for graduate training of family practice residents in orthopedics.
Injuries in the 14th and 15th years of life.
From a sample of 849 adolescents studied at age 15, 429 had been involved in 657 separate incidents, which resulted in 705 acute injuries requiring medical attention during their 14th and 15th years of life. The most common injuries were sprains, strains, fractures and lacerations, and the most common body site was the finger. The majority of injuries were of minor severity. Striking against an object or person was the most common incident resulting in injury, followed by being struck by an object or person, and overexertion or strenuous movement. Approximately half of the injuries were incurred during sport or a similar physical activity. Sporting injuries are examined in detail and preventive measures discussed.
Intrinsic risk factors and athletic injuries.
The benefits of physical activity are widely known. However, the risk of a musculoskeletal injury is an unfavourable consequence in physical training. Age, gender, injury history, body size, local anatomy and biomechanics, aerobic fitness, muscle strength, imbalance and tightness, ligamentous laxity, central motor control, psychological and psychosocial factors as well as general mental ability are factors in the predisposition to injury. Junior (15 to 16 years) and senior athletes seem to be at a higher risk of injury in many types of sport. However, the relationship between age and injuries apparently depends on both the type and intensity of activity practiced. The majority of injured athletes in many studies have been males. Men are, however, more likely to participate in vigorous exercise and sport and it is not known if men are at a generally higher risk of injury when the exposure is taken into account. Certain lesions, such as sprains, strains and dislocations, tend to recur. Previous injuries may necessarily not cause a repetition of injury if treated adequately, but certain individuals may be at a higher risk of injury due to injury-prone biological characteristics. Excessive height and weight have been shown to predispose to stress injuries in physical training. Idiopathic or acquired abnormalities in the anatomy or biomechanics in any joint may lead to a local injury. However, physical requirements vary widely between different types of activity and predisposition to injury due to anatomical or biomechanical factors seems to be characteristic for each type of exercise. Lack of fitness, muscle weakness, joint looseness and poor general flexibility have been suggested as factors in the outcome of athletic injuries but no definite conclusions can be made on the basis of the existing literature. Long simple reaction times to visual stimuli and long choice reaction times to visual stimuli have recently been related to musculoskeletal injuries. No exceptional personality dimension in injury proneness as a whole has been found and the results from specific groups cannot be extrapolated generally. Accumulation of life stress apparently predisposes to an athletic injury. Musculoskeletal injuries seem to be more common in subjects with lower scores in intelligence tests but no causation has been shown yet. Altogether, a complex network of risk factors for athletic injuries has been found. However, no prospective study including all the recognised injury risk factors has been presented in the literature.(ABSTRACT TRUNCATED AT 400 WORDS)
Analyses of battle casualties by weapon type aboard U.S. Navy warships.
The number of casualties was determined for 513 incidents involving U.S. Navy warships sunk or damaged during World War II. Ship type and weapon were significant factors in determining the numbers of wounded and killed. Multiple weapon attacks and kamikazes yielded more wounded in action than other weapon types. Multiple weapons and torpedos resulted in a higher incidence of killed in action than other weapons. Penetrating wounds and burns were the most prominent injury types. Kamikaze attacks yielded significantly more burns than incidents involving bombs, gunfire, torpedos, mines, and multiple weapons. Mine explosions were responsible for more strains, sprains, and dislocations than the other weapon types.
A five-year study of mortality in a busy ski population.
A 5-year study of a busy ski population in Utah revealed a total at-risk period of approximately 3.5 million skier-days. While the morbidity (fractures, strains, sprains, and occasionally more severe injuries) associated with skiing is well recognized and considered by most physicians concerned to be distributed somewhat unevenly within the various skills of skiing, the authors have identified an exceedingly low mortality among the same population. Six individuals died as a result of injuries directly attributable to skiing. Three of these were considered to be advanced skiers and three were of intermediate skill. In three instances the environment was considered to play a role in the accident. Two of these victims were skiing out of control, one as a result of ice-covered snow and one as a result of speed in combination with a small jump. The third victim was crushed in an avalanche. One accident was completely unexplained, the skier having skied without apparent attempt at checking or change of course into a nonrecreational area. The two remaining skiers of intermediate skill both suffered injuries incident to falling forward with considerable force onto a relatively flat, hard snow surface. Notwithstanding the intense and sometimes prolonged exertion at relatively high altitudes (9,400 to 11,000 ft or 2.9 to 3.3 km), only one skier with a previous history of atherosclerotic heart disease died while skiing. One additional middle-aged skier with similar history died at the conclusion of the day.(ABSTRACT TRUNCATED AT 250 WORDS)
[The influence of sports injuries on sport participation and work].
The incidence and complications of sport injuries in athletics, basketball, gymnastics, hockey, netball, cricket, tennis and soccer were analysed from questionnaire responses of 239 sport participants in Pretoria. Lower limb injuries were most common (73%). Torn tendomuscular organs represented 29,3% of the total number of injuries; sprains, strains and dislocations 35,9%; and fractures 20,5%. Medical treatment was sought by 62,8% of the patients. A total of 60,7% of the subjects was advised to suspend further participation in sport, but 30,6% failed to do so and more than half of these again sustained injuries. Those who were booked off from work totalled 18,0%, but a further 4,5% stayed away from work voluntarily.
Safety of a preadolescent basketball program.
A preadolescent youth basketball program was prospectively studied to determine injury rates and the kinds of injuries sustained. The overall injury rate was 7.6% (39 injuries among the 510 children aged 5 to 12 years). Girls had a higher injury rate than boys (P less than .02). Only 12 children (2.4%) suffered significant injuries as defined by the inability to play for at least one session. Most injuries were contusions (35.9%), followed by strains or sprains (28.2%), epistaxis (12.8%), lacerations (5.1%), and one finger fracture (2.6%), the most significant injury. Games were more likely to produce injuries than practice sessions; most injuries occurred in the second half of game play. This study documents a low injury rate in an organized preadolescent basketball program.
Interdependence of polymorphonuclear neutrophils and macrophages stained for N-acetyl-beta-glucosaminidase in lavage effluents from toluene diisocyanate-exposed rat lungs.
Male Sprague-Dawley rats were exposed to toluene diisocyanate (TDI) concentrations between 0.082 and 1.087 ppm for 4 h, and pulmonary lavage was carried out 24 h after initiation of the exposure. Cells recovered from the lavage effluents of TDI-exposed rat lungs were identified and counted, then pulmonary macrophages (PMs) resulting from cytocentrifuged preparations were examined for N-acetyl-beta-glucosaminidase (NAG) cytochemical staining. Exposure to TDI led to a parallel and concentration-dependent increase in the number of polymorphonuclear neutrophils (PMNs) and the proportion of PMs stained for NAG, suggesting that the same primary event initiates the two cell responses.