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1

Examination and Treatment of Hamstring Related Injuries  

PubMed Central

Context: There is a wide spectrum of hamstring-related injuries that can occur in the athlete. Accurate diagnosis is imperative to prevent delayed return to sport, injury recurrence, and accurate clinical decision making regarding the most efficacious treatment. Evidence Acquisition: This review highlights current evidence related to the diagnosis and treatment of hamstring-related injuries in athletes. Data sources were limited to peer-reviewed publications indexed in MEDLINE from 1988 through May 2011. Results: An accurate diagnostic process for athletes with posterior thigh–related complaints should include a detailed and discriminative history, followed by a thorough clinical examination. Diagnostic imaging should be utilized when considering hamstring avulsion or ischial apophyseal avulsion. Diagnostic imaging may also be needed to further define the cause of referred posterior thigh pain. Conclusions: Differentiating acute hamstring strains, hamstring tendon avulsions, ischial apophyseal avulsions, proximal hamstring tendinopathies, and referred posterior thigh pain is critical in determining the most appropriate treatment and expediting safe return to play. PMID:23016076

2012-01-01

2

Hamstring Injuries in Professional Football Players  

PubMed Central

Background: Magnetic resonance imaging (MRI) allows for detailed evaluation of hamstring injuries; however, there is no classification that allows prediction of return to play. Purpose: To correlate time for return to play in professional football players with MRI findings after acute hamstring strains and to create an MRI scoring scale predictive of return to sports. Study Design: Descriptive epidemiologic study. Methods: Thirty-eight professional football players (43 cases) sustained acute hamstring strains with MRI evaluation. Records were retrospectively reviewed, and MRIs were evaluated by 2 musculoskeletal radiologists, graded with a traditional radiologic grade, and scored with a new MRI score. Results were correlated with games missed. Results: Players missed 2.6 ± 3.1 games. Based on MRI, the hamstring injury involved the biceps femoris long head in 34 cases and the proximal and distal hamstrings in 25 and 22 cases, respectively. When < 50% of the muscle was involved, the average number of games missed was 1.8; if > 75%, then 3.2. Ten players had retraction, missing 5.5 games. By MRI, grade I injuries yielded an average of 1.1 missed games; grade II, 1.7; and grade III, 6.4. Players who missed 0 or 1 game had an MRI score of 8.2; 2 or 3 games, 11.1; and 4 or more games, 13.9. Conclusions: Rapid return to play (< 1 week) occurred with isolated long head of biceps femoris injures with < 50% of involvement and minimal perimuscular edema, correlating to grade I radiologic strain (MRI score < 10). Prolonged recovery (missing > 2 or 3 games) occurs with multiple muscle injury, injuries distal to musculotendinous junction, short head of biceps injury, > 75% involvement, retraction, circumferential edema, and grade III radiologic strain (MRI score > 15). Clinical Relevance: MRI grade and this new MRI score are useful in determining severity of injury and games missed—and, ideally, predicting time missed from sports. PMID:23016038

Cohen, Steven B.; Towers, Jeffrey D.; Zoga, Adam; Irrgang, Jay J.; Makda, Junaid; Deluca, Peter F.; Bradley, James P.

2011-01-01

3

Non contact Hamstring injuries in sports  

PubMed Central

Summary Hamstring muscle injuries are frequent in different sports and are a clinical challenge for Sports Medicine Teams. Injury Mechanics are import to know while assessing the injured athlete. There are at least two distinctly different types of acute hamstring injuries, which are best distinguished by the different injury situations. Classifying the severity of the injury is equally important. Active Range of motion measurements, proper imaging selection and the anatomical location of the injury must be considered. Once the diagnosis is established rehabilitation issues must be considered. Recurrence rate of the injury and prevention are issues that must always be included in our Hamstring Injuries approach as Clinicians. PMID:23738316

Malliaropoulos, Nikolaos G.

2012-01-01

4

Preseason Hamstring Muscle Weakness Associated with Hamstring Muscle Injury in Australian Footballers  

Microsoft Academic Search

Hamstring muscle strain is the most prevalent injury in Australian Rules Football, accounting for 16% of play ing time missed as a result of injury. Thirty-seven pro fessional footballers from an Australian Football League team had preseason measurements of ham string and quadriceps muscle concentric peak torque at 60, 180, and 300 deg\\/sec measured on a Cybex 340 dynamometer. Players

John Orchard; John Marsden; Stephen Lord; David Garlick

1997-01-01

5

Hamstring injuries: anatomy, imaging, and intervention.  

PubMed

Injury to the hamstring muscle complex (HMC) is extremely common in the athletic community. Anatomical and functional aspects of the HMC predispose it to injury, including the fact that the muscles cross two joints and undergo eccentric contraction during the gait cycle. Injury most commonly occurs at the muscle tendon junction but may occur anywhere between the origin and insertion. Complete hamstring avulsions require early surgical repair. The principal indication for imaging is in a triage role to rule out or confirm proximal hamstring avulsion. Acute onset and chronic posterior thigh and buttock pain may relate to pathology at the hamstring origin or muscle tendon junction that can be readily defined on magnetic resonance imaging or, less frequently, ultrasound. Some cases of buttock and thigh pain may relate to spinal pathology. In the elite athlete there is an increasing emphasis on optimizing the rehabilitation process after hamstring injury, to minimize the absence from sports and improve the final outcome. Imaging has a role in confirming the site of injury and characterizing its extent, providing some prognostic information and helping plan treatment. There is increasing interest in the use of growth factors to accelerate healing after muscle and tendon injury. Animal studies have demonstrated clear benefits in terms of accelerated healing. There are various methods of delivery of the growth factors, all involving the release of growth factors from platelets. These include plasma rich in platelets and autologous blood. Clinical studies in humans are very limited at this stage but are promising. At present the World Anti-Doping Authority bans the intramuscular administration of these agents. Other percutaneous injection therapies include the use of Actovegin and Traumeel S and antifibrotic agents. PMID:20486024

Linklater, James M; Hamilton, Bruce; Carmichael, James; Orchard, John; Wood, David G

2010-06-01

6

Anatomy and physiology of hamstring injury.  

PubMed

The hamstring muscles were analyzed anatomically and physiologically to clarify the specific reasons for the incidence of muscle strain of the hamstrings. For the anatomical study, hamstring muscles of 13 embalmed cadavers were dissected. For the physiological study, the knee flexor torque and surface electromyographic (EMG) signals were measured during isometric contraction of hamstring muscles in 10 healthy adults. The biceps femoris muscle long head (BF-L) and semimembranosus muscle (SM) had hemi-pennate architecture and their fiber length per total muscle length (FL/TML) was smaller than that of semtendinosus muscle (ST) and biceps femoris muscle short head (BF-S) with other architecture. The decrease of total muscle length per fiber length (?TML/FL) was larger in BF-L and SM than in ST and BF-S. The EMG activities at 0° of knee angle were at maximal compared with other knee angles and were of similar level in BF-L, in SM and in ST, whereas they were considerably smaller in BF-S. The EMG at 0° of knee angle activity per physiological cross-sectional area (PCSA) was about 1.6 times greater in BF-L than in SM. These results indicate the highest risk of muscle strain was in BF-L followed by SM. PMID:22895873

Kumazaki, T; Ehara, Y; Sakai, T

2012-12-01

7

Outcome of Grade I and II Hamstring Injuries in Intercollegiate Athletes  

PubMed Central

Background: Hamstring muscle strains represent a common and disabling athletic injury with variable recurrence rates and prolonged recovery times. Objectives: To present the outcomes of a novel rehabilitation protocol for the treatment of proximal hamstring strains in an intercollegiate sporting population and to determine any significant differences in the rate of reinjury and time to return to sport based on patient and injury characteristics. Study Design: Retrospective case series. Methods: A retrospective review was performed of 48 consecutive hamstring strains in intercollegiate athletes. The rehabilitation protocol consisted of early mobilization, with flexible progression through supervised drills. Athletes were allowed to return to sport after return of symmetrical strength and range of motion with no pain during sprinting. Primary outcomes included time to return to sport and reinjury rates. Results: All patients returned to their sports, and 3 sustained repeat hamstring strains (6.2% reinjury rate) after a minimum follow-up of 6 months. The average number of days missed from sport was 11.9 (range, 5-23 days). There was no statistically significant difference for time to return to sport between first-time and recurrent injuries and between first- and second-degree injuries (P > 0.05). Conclusions: Grade I and II hamstring strains may be aggressively treated with a protocol of brief immobilization followed by early initiation of running and isokinetic exercises—with an average expected return to sport of approximately 2 weeks and with a relatively low reinjury rate regardless of injury grade (I or II), injury characteristics (including first-time and recurrent injuries), or athlete characteristics. PMID:23016054

Kilcoyne, Kelly G.; Dickens, Jonathan F.; Keblish, David; Rue, John-Paul; Chronister, Ray

2011-01-01

8

Prophylaxis and management of hamstring muscle injuries in intercollegiate football players  

Microsoft Academic Search

Hamstring muscle strains were responsible for the loss of playing time of a significant number of football players at the University of Nebraska in the early 1970s. After the acquisition of a Cybex II isokinetic dynamometer, the number of injuries was noted to decrease. A retro spective study was performed over the period 1973 to 1982.Players in Group I, from

Thomas M. Heiser; Jerry Weber; George Sullivan; Patrick Clare; Rae R. Jacobs

1984-01-01

9

The effects of multidirectional soccer-specific fatigue on markers of hamstring injury risk.  

PubMed

The purpose of this work was to investigate the effect of multidirectional soccer-specific fatigue on hamstring muscle strength and angle of peak torque. Sixteen male semi-professional soccer players (mean+/-S.D.: age: 21.3+/-2.9 years; height 185.0+/-8.7 cm; body mass 81.6+/-6.7 kg) completed the SAFT(90), a multidirectional, intermittent 90-min exercise protocol based on data from English Championship soccer matches. Prior to exercise (t(0)), at half-time (t(45)) and post-exercise (t(105)), subjects performed three maximal dominant limb isokinetic contractions (Biodex, System 3) at 120 degrees s(-1) through a 90 degrees range for concentric and eccentric knee flexors and concentric knee extensors. Analysis of variance revealed significant time dependant reductions in gravity corrected eccentric hamstring peak torque, and consequently in the functional hamstring:quadriceps ratio (P<0.01). Eccentric hamstring peak torque decreased significantly during each half (t(0): 272.0+/-43.2; t(45): 240.4+/-43.3; t(105): 226.3+/-45.7 Nm). The functional hamstring:quadriceps ratio also decreased significantly during each half (t(0): 116.6+/-21.2; t(45): 107.1+/-17.6; t(105): 98.8+/-20.3%). There were no significant changes in concentric hamstring or quadriceps peak torque observed during SAFT(90) (P>0.05). Data analysis also revealed significant differences for Angle of Peak Torque for eccentric hamstrings (P<0.05) which was significantly higher at the end of each half (t(45): 37+/-15; t(105): 38+/-18 degrees ) than the pre-exercise value (t(0): 28+/-12 degrees ). There was a time dependant decrease in peak eccentric hamstring torque and in the functional strength ratio which may have implications for the increased predisposition to hamstring strain injury during the latter stages of match-play. PMID:18976956

Small, K; McNaughton, L; Greig, M; Lovell, R

2010-01-01

10

Hamstring muscle injuries among water skiers. Functional outcome and prevention.  

PubMed

Water skiing is associated with severe injuries to the proximal hamstring muscles. We wanted to define the mechanism of injury, describe the associated pathologic changes, determine the functional limitations of patients, and suggest measures to prevent injury. Twelve patients with water skiing-related hamstring injuries were included. Six patients were experienced skiers and six were novices. The mechanism of injury was identical in five of six novice skiers. Each sustained the injury while attempting to get up on one or two skis from a submerged position. In contrast, the expert skiers all sustained injury secondary to a fall while skiing. Physical examination documented evidence of complete or partial avulsion of the proximal hamstring muscle origins in all patients. In addition, six patients had magnetic resonance imaging or computed tomography scans that confirmed the location and extent of the tear. Convalescence ranged from 3 months to 1.5 years before the patient could return to vigorous activities. Seven patients (58%) returned to most of their preinjury sports, albeit at a lower level. Five patients (42%), all with complete disruptions, were unable to run or participate in sports requiring agility. Two of these patients required delayed surgical repairs because of persistent functional limitations. PMID:8775108

Sallay, P I; Friedman, R L; Coogan, P G; Garrett, W E

1996-01-01

11

How Joint Torques Affect Hamstring Injury Risk in Sprinting Swing–Stance Transition  

PubMed Central

ABSTRACT Purpose The potential mechanisms of hamstring strain injuries in athletes are not well understood. The study, therefore, was aimed at understanding hamstring mechanics by studying loading conditions during maximum-effort overground sprinting. Methods Three-dimensional kinematics and ground reaction force data were collected from eight elite male sprinters sprinting at their maximum effort. Maximal isometric torques of the hip and knee were also collected. Data from the sprinting gait cycle were analyzed via an intersegmental dynamics approach, and the different joint torque components were calculated. Results During the initial stance phase, the ground reaction force passed anteriorly to the knee and hip, producing an extension torque at the knee and a flexion torque at the hip joint. Thus, the active muscle torque functioned to produce flexion torque at the knee and extension torque at the hip. The maximal muscle torque at the knee joint was 1.4 times the maximal isometric knee flexion torque. During the late swing phase, the muscle torque counterbalanced the motion-dependent torque and acted to flex the knee joint and extend the hip joint. The loading conditions on the hamstring muscles were similar to those of the initial stance phase. Conclusions During both the initial stance and late swing phases, the large passive torques at both the knee and hip joints acted to lengthen the hamstring muscles. The active muscle torques generated mainly by the hamstrings functioned to counteract those passive effects. As a result, during sprinting or high-speed locomotion, the hamstring muscles may be more susceptible to high risk of strain injury during these two phases. PMID:24911288

SUN, YULIANG; WEI, SHUTAO; ZHONG, YUNJIAN; FU, WEIJIE; LI, LI; LIU, YU

2015-01-01

12

Isokinetic strength testing does not predict hamstring injury in Australian Rules footballers  

Microsoft Academic Search

OBJECTIVE: To determine the relation of hamstring and quadriceps muscle strength and imbalance to hamstring injury using a prospective observational cohort study METHOD: A total of 102 senior male Australian Rules footballers aged 22.2 (3.6) years were tested at the start of a football season. Maximum voluntary concentric and eccentric torque of the hamstring and quadriceps muscles of both legs

K. Bennell; H. Wajswelner; P. Lew; A. Schall-Riaucour; S. Leslie; D. Plant; J. Cirone

1998-01-01

13

Successful management of hamstring injuries in Australian Rules footballers: two case reports  

PubMed Central

Hamstring injuries are the most prevalent injury in Australian Rules football. There is a lack of evidence based literature on the treatment, prevention and management of hamstring injuries, although it is agreed that the etiology is complicated and multi-factorial. We present two cases of hamstring injury that had full resolution after spinal manipulation and correction of lumbar-pelvic biomechanics. There was no recurrence through preventative treatment over a twelve and sixteen week period. The use of spinal manipulation for treatment or prevention of hamstring injury has not been documented in sports medicine literature and should be further investigated in prospective randomized controlled trials. PMID:15967047

Hoskins, Wayne T; Pollard, Henry P

2005-01-01

14

The Influence of Prior Hamstring Injury on Lengthening Muscle Tissue Mechanics  

PubMed Central

Hamstring strain injuries often occur near the proximal musculotendon junction (MTJ) of the biceps femoris. Post-injury remodeling can involve scar tissue formation, which may alter contraction mechanics and influence re-injury risk. The purpose of this study was to assess the affect of prior hamstring strain injury on muscle tissue displacements and strains during active lengthening contractions. Eleven healthy and eight subjects with prior biceps femoris injuries were tested. All previously injured subjects had since returned to sport and exhibited evidence of residual scarring along the proximal aponeurosis. Subjects performed cyclic knee flexion-extension on an MRI-compatible device using elastic and inertial loads, which induced active shortening and lengthening contractions, respectively. CINE phase-contrast imaging was used to measure tissue velocities within the biceps femoris during these tasks. Numerical integration of the velocity information was used to estimate two-dimensional tissue displacement and strain fields during muscle lengthening. The largest tissue motion was observed along the distal MTJ, with the active lengthening muscle exhibiting significantly greater and more homogeneous tissue displacements. First principal strains magnitudes were largest along the proximal MTJ for both loading conditions. The previously injured subjects exhibited less tissue motion and significantly greater strains near the proximal MTJ. We conclude that localized regions of high tissue strains during active lengthening contractions may predispose the proximal biceps femoris to injury. Furthermore, post-injury remodeling may alter the in-series stiffness seen by muscle tissue and contribute to the relatively larger localized tissue strains near the proximal MTJ, as was observed in this study. PMID:20472238

Silder, Amy; Reeder, Scott B.; Thelen, Darryl G.

2010-01-01

15

Hamstring Strength and Morphology Progression after Return to Sport from Injury  

PubMed Central

Hamstring strain re-injury rates can reach 30% within the initial two weeks following return to sport (RTS). Incomplete recovery of strength may be a contributing factor. However, relative strength of the injured and unaffected limbs at RTS is currently unknown. PURPOSE: Characterize hamstring strength and morphology at the time of RTS and six months later. METHODS: Twenty-five athletes that experienced an acute hamstring strain injury participated, following completion of a controlled rehabilitation program. Bilateral isokinetic strength testing and magnetic resonance imaging (MRI) were performed at RTS and 6-months later. Strength (knee flexion peak torque, work, angle of peak torque) and MRI (muscle and tendon volumes) measures were compared between limbs and over time using repeated measures ANOVA. RESULTS: The injured limb showed a peak torque deficit of 9.6% compared to the uninjured limb at RTS (60°/s, p<0.001), but not 6-months following. The knee flexion angle of peak torque decreased over time for both limbs (60°/s, p<0.001). MRI revealed that 20.4% of the muscle cross-sectional area showed signs of edema at RTS with full resolution by the 6-month follow-up. Tendon volume of the injured limb tended to increase over time (p=0.108), while muscle volume decreased 4–5% in both limbs (p<0.001). CONCLUSION: Residual edema and deficits in isokinetic knee flexion strength were present at RTS, but resolved during the subsequent six months. This occurred despite MRI evidence of scar tissue formation (increased tendon volume) and muscle atrophy, suggesting that neuromuscular factors may contribute to the return of strength. PMID:23059864

Sanfilippo, Jennifer; Silder, Amy; Sherry, Marc A; Tuite, Michael J; Heiderscheit, Bryan C

2012-01-01

16

The Football Association Medical Research Programme: an audit of injuries in professional football—analysis of hamstring injuries  

Microsoft Academic Search

Objective: To conduct a detailed analysis of hamstring injuries sustained in English professional football over two competitive seasons.Methods: Club medical staff at 91 professional football clubs annotated player injuries over two seasons. A specific injury audit questionnaire was used together with a weekly form that documented each clubs’ current injury status.Results: Completed injury records for the two competitive seasons were

C Woods; R D Hawkins; S Maltby; M Hulse; A Thomas; A Hodson

2004-01-01

17

A Systematic Review of the Effectiveness of Eccentric Strength Training in the Prevention of Hamstring Muscle Strains in Otherwise Healthy Individuals  

PubMed Central

Background Hamstring strains are the most common soft-tissue injury observed in recreational and athletic activities, yet no consensus exists regarding appropriate primary and secondary strategies to prevent these strains. Eccentric exercise has been reported to reduce the incidence of ham-string strains but its role has not been clearly defined. Objective The objective of this systematic review was to determine the effectiveness of eccentric exercise in preventing hamstring strains. Data Sources Online databases, including MED-LINE, PubMed, CINAHL, PEDro, SPORTDiscus, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Web of Science were searched for relevant articles. Each database was searched from the earliest date to July 2007. Study Selection Selection criteria included diagnosis of hamstring strain, otherwise healthy individuals, and at least one group receiving an eccentric exercise intervention. Seven articles {three randomized controlled trials (RCTs) and four cohort studies} met the inclusion criteria. Data Extraction Data were extracted using a customized form. Methodological rigor of included studies was assessed using the PEDro scale and Oxford Centre for Evidence-based Medicine Levels of Evidence. Data Synthesis Studies were grouped by eccentric exercise intervention protocol: hamstring lowers, isokinetic strengthening, and other strengthening. A best-evidence synthesis of pooled data was qualitatively summarized. Conclusions Findings suggest that eccentric training is effective in primary and secondary prevention of hamstring strains. Study heterogeneity and poor methodological rigor limit the ability to provide clinical recommendations. Further RCTs are needed to support the use of eccentric training protocols in the prevention of hamstring strains. PMID:21509129

Cheong, Krystie; Grant, Andrew; Beers, Amanda; Moizumi, Trevor

2008-01-01

18

TREATMENT OF HAMSTRING STRAIN IN A COLLEGIATE POLE?VAULTER INTEGRATING DRY NEEDLING WITH AN ECCENTRIC TRAINING PROGRAM: A RESIDENT'S CASE REPORT  

PubMed Central

Background: Hamstring strain injuries are among the most common injuries seen in sports. Management is made difficult by the high recurrence rates. Typical time to return to sport varies but can be prolonged with recurrence. Eccentric strength deficits remain post?injury, contributing to reinjury. Eccentric training has shown to be an effective method at prevention of hamstring injury in multiple systematic reviews and prospective RCTs but limited prospective rehabilitation literature. Functional dry needling is a technique that has been reported to be beneficial in the management of pain and dysfunction after muscle strains, but there is limited published literature on its effects on rehabilitation or recurrence of injury. Purpose: The purpose of this case report is to present the management and outcomes of a patient with hamstring strain, treated with functional dry needling and eccentric exercise. Case Description: The subject was an 18?year?old collegiate pole?vaulter who presented to physical therapy with an acute hamstring strain and history of multiple strains on uninvolved extremity. He was treated in Physical Therapy three times per week for 3 weeks with progressive eccentric training and 3 sessions of functional dry needling. Outcomes: By day 12, his eccentric strength on the involved extremity was greater than the uninvolved extremity and he reported clinically meaningful improvement in outcome scores. By Day 20, he was able to return to full sports participation without pain or lingering strength deficits. Discussion: The patient in this case report was able to return to sport within 20 days and without recurrence. He demonstrated significant decreases in pain and dysfunction with dry needling. He had greater strength on the injured extremity compared to contra?lateral previously injured extremity. Conclusions: This case illustrates the use of functional dry needling and eccentric exercise leading to a favorable outcome in a patient with hamstring strain. Level of Evidence: Level 4 PMID:23772348

Westrick, Richard B.; Zylstra, Edo; Johnson, Michael R.

2013-01-01

19

Imaging of the hamstrings.  

PubMed

The hamstring muscles, located in the posterior thigh, include the biceps femoris, the semimembranosus, and the semitendinosus. The proximal portions of the hamstring muscles are subject to a variety of injuries and pathology. Many of these entities affect the origin of the hamstrings, including the tendinous enthesis, the underlying ischial tuberosity, and the surrounding tissues. Tendinosis and small partial tears at the origin are the result of chronic attrition. They may be accompanied by bursitis or hamstring syndrome. Apophysitis occurs in teenagers prior to complete fusion of the ischial apophysis and results from repeated traction injuries on the apophysis without discrete displacement. Abrupt injury at the origin from forced flexion of the hip results in osseous avulsions of the apophysis in teenagers and proximal tendon ruptures in adults. Other entities affect the muscles distal to the tendon origins. These injuries include strains and partial tears of the musculotendinous junction from acute indirect trauma, delayed onset muscle soreness from overuse of the muscle group without discrete remembered injury, and contusions and myositis ossificans from direct blunt impact. The imaging features of these injuries and pathology are fairly specific and diagnostic, with the exception of some cases of myositis ossificans and chronic ischial avulsions. PMID:18382942

Davis, Kirkland W

2008-03-01

20

Effect of Varying Hamstring Tension on Anterior Cruciate Ligament Strain During in Vitro Impulsive Knee Flexion and Compression Loading  

PubMed Central

Background: The hamstring muscles are well positioned to limit both anterior tibial translation and anterior cruciate ligament strain during the knee flexion phase of a jump landing. We hypothesized that systematically increasing or decreasing hamstring tension during the knee flexion phase of a simulated jump landing would significantly affect peak relative strain in the anterior cruciate ligament. Methods: Ten cadaveric knees from four male and six female donors (mean age [and standard deviation] at the time of death, 60.3 ± 23.6 years) were mounted in a custom fixture to initially position the specimen in 25° of knee flexion and simulate axial impulsive loading averaging 1700 N to cause an increase in knee flexion. Quadriceps, hamstring, and gastrocnemius muscle forces were simulated with use of pretensioned linear springs, with the tension in the hamstrings arranged to be increased, held constant, decreased, at “baseline,” or absent during knee flexion. Impulsive loading applied along the tibia and femur was monitored with use of triaxial load transducers, while uniaxial load cells monitored quadriceps and medial and lateral hamstring forces. Relative strain in the anterior cruciate ligament was measured with use of a differential variable reluctance transducer, and tibiofemoral kinematics were measured optoelectronically. For each specimen, anterior cruciate ligament strains were recorded over eighty impact trials: ten preconditioning trials, ten “baseline” trials involving decreasing hamstring tension performed before and after three sets of ten trials conducted with increasing hamstring tension, constant hamstring tension, or no hamstring tension. Peak relative strains in the anterior cruciate ligament were normalized for comparison across specimens. Results: Increasing hamstring force during the knee flexion landing phase decreased the peak relative strain in the anterior cruciate ligament by >70% compared with the baseline condition (p = 0.005). Neither a constant hamstring muscle force nor the absence of a hamstring force significantly changed the peak strain in the anterior cruciate ligament relative to the baseline condition. Conclusions: Increasing hamstring muscle force during the knee flexion phase of a simulated jump landing significantly reduces the peak relative strain in the anterior cruciate ligament in vitro. Clinical Relevance: It may be possible to proactively limit peak anterior cruciate ligament strain during the knee flexion phase of jump landings by accentuating hip flexion, thereby increasing the tension in active hamstring muscles by lengthening them. PMID:18381320

Withrow, Thomas J.; Huston, Laura J.; Wojtys, Edward M.; Ashton-Miller, James A.

2008-01-01

21

Strains and Sprains  

MedlinePLUS

... tear of ligaments (which connect two bones) or tendons (which connect muscle to bone). Sprains and strains ... Injuries Groin Strain Stretching Sports and Exercise Safety Achilles Tendonitis Hamstring Strain Ankle Sprains Knee Injuries Strains ...

22

Recurrent hamstring muscle injury: applying the limited evidence in the professional football setting with a seven-point programme  

PubMed Central

Recurrent hamstring injuries are a major problem in sports such as football. The aim of this paper was to use a clinical example to describe a treatment strategy for the management of recurrent hamstring injuries and examine the evidence for each intervention. A professional footballer sustained five hamstring injuries in a relatively short period of time. The injury was managed successfully with a seven-point programme—biomechanical assessment and correction, neurodynamics, core stability, eccentric strengthening, an overload running programme, injection therapies and stretching/relaxation. The evidence for each of these treatment options is reviewed. It is impossible to be definite about which aspects of the programme contributed to a successful outcome. Only limited evidence is available in most cases; therefore, decisions regarding the use of different treatment modalities must be made by using a combination of clinical experience and research evidence. PMID:23322894

Brukner, Peter; Nealon, Andrew; Morgan, Christopher; Burgess, Darren; Dunn, Andrew

2014-01-01

23

Recurrent hamstring muscle injury: applying the limited evidence in the professional football setting with a seven-point programme.  

PubMed

Recurrent hamstring injuries are a major problem in sports such as football. The aim of this paper was to use a clinical example to describe a treatment strategy for the management of recurrent hamstring injuries and examine the evidence for each intervention. A professional footballer sustained five hamstring injuries in a relatively short period of time. The injury was managed successfully with a seven-point programme-biomechanical assessment and correction, neurodynamics, core stability, eccentric strengthening, an overload running programme, injection therapies and stretching/relaxation. The evidence for each of these treatment options is reviewed. It is impossible to be definite about which aspects of the programme contributed to a successful outcome. Only limited evidence is available in most cases; therefore, decisions regarding the use of different treatment modalities must be made by using a combination of clinical experience and research evidence. PMID:23322894

Brukner, Peter; Nealon, Andrew; Morgan, Christopher; Burgess, Darren; Dunn, Andrew

2014-06-01

24

Biceps femoris and semitendinosus—teammates or competitors? New insights into hamstring injury mechanisms in male football players: a muscle functional MRI study  

PubMed Central

Background The hamstring injury mechanism was assessed by investigating the exercise-related metabolic activity characteristics of the hamstring muscles using a muscle functional MRI (mfMRI) protocol. Methods 27 healthy male football players and 27 football players with a history of hamstring injuries (recovered and playing fully) underwent standardised mfMR Imaging. The mfMRI protocol consisted of a resting scan, a strenuous bilateral eccentric hamstring exercise and a postexercise scan. The exercise-related T2 increase or the signal intensity shift between both scans was used to detect differences in metabolic activation characteristics (1) between the different hamstring muscle bellies and (2) between the injury group and the control group. Results A more symmetrical muscle recruitment pattern corresponding to a less economic hamstring muscle activation was demonstrated in the formerly injured group (p<0.05). The injured group also demonstrated a significantly lower strength endurance capacity during the eccentric hamstring exercise. Conclusions These findings suggest that the vulnerability of the hamstring muscles to football-related injury is related to the complexity and close coherence in the synergistic muscle recruitment of the biceps femoris and the semitendinosus. Discrete differences in neuromuscular coordination and activity distribution, with the biceps femoris partly having to compensate for the lack of endurance capacity of the semitendinosus, probably increase the hamstring injury risk. PMID:25388959

Schuermans, Joke; Van Tiggelen, Damien; Danneels, Lieven; Witvrouw, Erik

2014-01-01

25

Effectiveness of Injury Prevention Programs on Developing Quadriceps and Hamstrings Strength of Young Male Professional Soccer Players  

PubMed Central

Muscular strength is an important factor which is crucial for performance and injury prevention in most sports. The purpose of this study was to evaluate the effects of the FIFA’s Medical Assessment and Research Centre 11+ and HarmoKnee injury prevention programs on knee strength of young professional male soccer players. Thirty-six soccer players (age: 18.9 ± 1.4 years) were divided equally into three groups; the 11+, HarmoKnee and control groups. The programs were performed for 24 sessions. Hamstring and quadriceps strength was measured using the Biodex System 3 at 30°, 60° and 90° of knee flexion. The 11+ increased quadriceps strength in the dominant leg by 19.7% and 47.8% at 60°and 90° knee flexion, respectively, and in the non-dominant leg by 16%, 35.3% and 78.1 % at 30°, 60° and 90° knee flexion, respectively. The HarmoKnee group, however, showed increased quadriceps strength only at 90° i.e., by 85.7% in the dominant leg and 73.8% in the non-dominant leg. As for hamstring strength, only the 11+ group demonstrated an increment by 24.8% and 19.8% at 30° and 60° knee flexion in the dominant leg, and in the non-dominant leg, by 28.7% and 13.7% at 30° and 60° knee flexion, respectively. In conclusion, both warm-up programs improve quadriceps strength. The 11+ demonstrated improvement in hamstring strength while the HarmoKnee program did not indicate any improvement. We suggest adding eccentric hamstring components such as Nordic hamstring exercise to the HarmoKnee program in order to enhance hamstring strength. PMID:24511347

Daneshjoo, Abdolhamid; Rahnama, Nader; Mokhtar, Abdul Halim; Yusof, Ashril

2013-01-01

26

Endoscopic repair of a chronic incomplete proximal hamstring avulsion in a cheerleader.  

PubMed

: Injuries to the hamstring muscle are common among athletes, especially strains at the myotendinal junction that respond well to nonoperative treatment. Proximal hamstring avulsion injuries can be severely debilitating, and the role of endoscopic treatment for these injuries has not been explored. This article describes the case report of a 16-year-old girl who was diagnosed with incomplete proximal hamstring avulsion showing no improvement despite extensive nonoperative treatment. The patient was treated by endoscopic repair in the prone position using a novel technique. Her preoperative pain on the ischial tubercle and while sitting disappeared completely 3 months postoperatively. PMID:24042442

Lindner, Dror; Trenga, Anthony P; Stake, Christine E; Jackson, Timothy J; El Bitar, Youssef F; Domb, Benjamin G

2014-01-01

27

Elevated gastrocnemius forces compensate for decreased hamstrings forces during the weight-acceptance phase of single-leg jump landing: implications for anterior cruciate ligament injury risk.  

PubMed

Approximately 320,000 anterior cruciate ligament (ACL) injuries in the United States each year are non-contact injuries, with many occurring during a single-leg jump landing. To reduce ACL injury risk, one option is to improve muscle strength and/or the activation of muscles crossing the knee under elevated external loading. This study's purpose was to characterize the relative force production of the muscles supporting the knee during the weight-acceptance (WA) phase of single-leg jump landing and investigate the gastrocnemii forces compared to the hamstrings forces. Amateur male Western Australian Rules Football players completed a single-leg jump landing protocol and six participants were randomly chosen for further modeling and simulation. A three-dimensional, 14-segment, 37 degree-of-freedom, 92 muscle-tendon actuated model was created for each participant in OpenSim. Computed muscle control was used to generate 12 muscle-driven simulations, 2 trials per participant, of the WA phase of single-leg jump landing. A one-way ANOVA and Tukey post-hoc analysis showed both the quadriceps and gastrocnemii muscle force estimates were significantly greater than the hamstrings (p<0.001). Elevated gastrocnemii forces corresponded with increased joint compression and lower ACL forces. The elevated quadriceps and gastrocnemii forces during landing may represent a generalized muscle strategy to increase knee joint stiffness, protecting the knee and ACL from external knee loading and injury risk. These results contribute to our understanding of how muscle's function during single-leg jump landing and should serve as the foundation for novel muscle-targeted training intervention programs aimed to reduce ACL injuries in sport. PMID:25218505

Morgan, Kristin D; Donnelly, Cyril J; Reinbolt, Jeffrey A

2014-10-17

28

Hamstrings strength imbalance in professional football (soccer) players in Australia.  

PubMed

The aim of this study was to describe the isokinetic thigh muscle strength profile of professional male football players in Australia. Concentric (60° and 240°/second) and eccentric (30° and 120°/second) hamstrings and quadriceps isokinetic strength was measured with a HUMAC NORM dynamometer. The primary variables were bilateral concentric and eccentric hamstring and quadriceps peak torque ratios, concentric hamstring-quadriceps peak torque ratios, and mixed ratios (eccentric hamstring 30°/second ÷ concentric quadriceps 240°/second). Hamstring strength imbalance was defined as deficits in any two of: bilateral concentric hamstring peak torque ratio < 0.86, bilateral eccentric hamstring peak torque ratio < 0.86, concentric hamstring-quadriceps ratio < 0.47, mixed ratio < 0.80. Fifty-five strength tests involving 42 players were conducted. Ten players (24%) were identified as having hamstring strength imbalance. Athletes with strength imbalance had significantly reduced concentric and eccentric bilateral hamstring peak torque ratios at all angular velocities tested; and reduced eccentric quadriceps peak torque (30°/second) in their stance leg, compared to those without strength imbalance. Approximately one in four players had preseason hamstring strength imbalance; and all strength deficits were observed in the stance leg. Concentric and eccentric hamstrings strength imbalance may impact in-season football performance, and could have implications for the future risk of injury. PMID:25426513

Ardern, Clare L; Pizzari, Tania; Wollin, Martin; Webster, Kate E

2014-11-25

29

THE ROLE AND IMPLEMENTATION OF ECCENTRIC TRAINING IN ATHLETIC REHABILITATION: TENDINOPATHY, HAMSTRING STRAINS, AND ACL RECONSTRUCTION  

PubMed Central

The benefits and proposed physiological mechanisms of eccentric exercise have previously been elucidated and eccentric exercise has been used for well over seventy years. Traditionally, eccentric exercise has been used as a regular component of strength training. However, in recent years, eccentric exercise has been used in rehabilitation to manage a host of conditions. Of note, there is evidence in the literature supporting eccentric exercise for the rehabilitation of tendinopathies, muscle strains, and in anterior cruciate ligament (ACL) rehabilitation. The purpose of this Clinical Commentary is to discuss the physiologic mechanism of eccentric exercise as well as to review the literature regarding the utilization of eccentric training during rehabilitation. A secondary purpose of this commentary is to provide the reader with a framework for the implementation of eccentric training during rehabilitation of tendinopathies, muscle strains, and after ACL reconstruction. PMID:21655455

Reiman, Michael

2011-01-01

30

Hamstring Muscle Fatigue and Central Motor Output during a Simulated Soccer Match  

PubMed Central

Purpose To examine changes in hamstring muscle fatigue and central motor output during a 90-minute simulated soccer match, and the concomitant changes in hamstring maximal torque and rate of torque development. Method Eight amateur male soccer players performed a 90-minute simulated soccer match, with measures performed at the start of and every 15-minutes during each half. Maximal torque (Nm) and rate of torque development (RTD; Nm.s–1) were calculated from maximal isometric knee flexor contractions performed at 10° of flexion. Hamstring peripheral fatigue was assessed from changes in the size and shape of the resting twitch (RT). Hamstring central motor output was quantified from voluntary activation (%) and normalized biceps femoris (BF) and medial hamstrings (MH) electromyographic amplitudes (EMG/M). Results Maximal torque was reduced at 45-minutes by 7.6±9.4% (p<0.05). RTD in time intervals of 0–25, 0–50, and 0–75 ms post-contraction onset were reduced after 15-minutes in the first-half between 29.6 to 46.2% (p<0.05), and were further reduced at the end of the second-half (p<0.05). Maximal EMG/M was reduced for biceps femoris only concomitant to the time-course of reductions in maximal torque (p?=?0.007). The rate of EMG rise for BF and MH was reduced in early time periods (0–75 ms) post-contraction onset (p<0.05). No changes were observed for the size and shape of the RT, indicating no hamstring peripheral fatigue. Conclusion Centrally mediated reductions in maximal torque and rate of torque development provide insight into factors that may explain hamstring injury risk during soccer. Of particular interest were early reductions during the first-half of hamstring rate of torque development, and the decline in maximal EMG/M of biceps femoris in the latter stages of the half. These are important findings that may help explain why the hamstrings are particularly vulnerable to strain injury during soccer. PMID:25047547

Marshall, Paul W. M.; Lovell, Ric; Jeppesen, Gitte K.; Andersen, Kristoffer; Siegler, Jason C.

2014-01-01

31

The proximal hamstring muscle-tendon-bone unit: a review of the normal anatomy, biomechanics, and pathophysiology.  

PubMed

Proximal hamstring injuries occur during eccentric contraction with the hip and the knee on extension; hence they are relatively frequent lesions in specific sports such as water skiing and hurdle jumping. Additionally, the trend toward increasing activity and fitness training in the general population has resulted in similar injuries. Myotendinous strains are more frequent than avulsion injuries. Discrimination between the two types of lesions is relevant for patient management, since the former is treated conservatively and the latter surgically. MRI and Ultrasonography are both well suited techniques for the diagnosis and evaluation of hamstring tendon injuries. Each one has its advantages and disadvantages. The purpose of this article is to provide a comprehensive review of the anatomy and biomechanics of the proximal hamstring muscle-tendon-bone unit and the varied imaging appearances of hamstring injury, which is vital for optimizing patient care. This will enable the musculoskeletal radiologist to contribute accurate and useful information in the treatment of athletes at all levels of participation. PMID:21524864

Beltran, Luis; Ghazikhanian, Varand; Padron, Mario; Beltran, Javier

2012-12-01

32

Complete avulsion of the hamstring tendons from the ischial tuberosity. A report of two cases sustained in judo  

Microsoft Academic Search

Rupture of the hamstring tendon is a rare injury. Two cases of complete rupture of the hamstring tendons sustained while playing judo are reported. The diagnosis of a rupture of the hamstring tendons was difficult from physical examination because of severe pain on knee or hip joint movement. Magnetic resonance imaging was non-invasive and showed the lesion clearly. In one

H Kurosawa; K Nakasita; H Nakasita; S Sasaki; S Takeda

1996-01-01

33

Horizontal posterior hamstring harvest.  

PubMed

Harvesting of the gracilis and semi-tendinosus (ST) hamstring tendons is usually performed by anteromedial approach. Harvesting by a horizontal posterior approach is possible. Based on a series of 90 patients, this technical note describes the perioperative difficulties and the characteristics of the harvested tendon(s) as well as any complications. Only one unsuccessful harvest was reported. Posterior harvesting of the gracilis and ST hamstring tendons is a reliable, reproducible surgical technique with a low rate of complications. PMID:25453925

Letartre, R; Isida, R; Pommepuy, T; Miletic, B

2014-12-01

34

Association of Quadriceps and Hamstrings Cocontraction Patterns With Knee Joint Loading  

PubMed Central

Context: Sex differences in neuromuscular control of the lower extremity have been identified as a potential cause for the greater incidence of anterior cruciate ligament (ACL) injuries in female athletes compared with male athletes. Women tend to land in greater knee valgus with higher abduction loads than men. Because knee abduction loads increase ACL strain, the inability to minimize these loads may lead to ACL failure. Objective: To investigate the activation patterns of the quadriceps and hamstrings muscles with respect to the peak knee abduction moment. Design: Cross-sectional study. Setting: Neuromuscular research laboratory. Patients or Other Participants: Twenty-one recreationally active adults (11 women, 10 men). Main Outcome Measure(s): Volunteers performed 3 trials of a 100-cm forward hop. During the hop task, we recorded surface electromyographic data from the medial and lateral hamstrings and quadriceps and recorded lower extremity kinematics and kinetics. Lateral and medial quadriceps-to-hamstrings (Q?H) cocontraction indices, the ratio of medial-to-lateral Q?H cocontraction, normalized root mean square electromyographic data for medial and lateral quadriceps and hamstrings, and peak knee abduction moment were calculated and used in data analyses. Results: Overall cocontraction was lower in women than in men, whereas activation was lower in the medial than in the lateral musculature in both sexes (P < .05). The medial Q?H cocontraction index (R2 ?=? 0.792) accounted for a significant portion of the variance in the peak knee abduction moment in women (P ?=? .001). Women demonstrated less activation in the vastus medialis than in the vastus lateralis (P ?=? .49) and less activation in the medial hamstrings than in the lateral hamstrings (P ?=? .01). Conclusions: Medial-to-lateral Q?H cocontraction appears to be unbalanced in women, which may limit their ability to resist abduction loads. Because higher abduction loads increase strain on the ACL, restoring medial-to-lateral Q?H cocontraction balance in women may help reduce ACL injury risk. PMID:19478837

Palmieri-Smith, Riann M; McLean, Scott G; Ashton-Miller, James A; Wojtys, Edward M

2009-01-01

35

THE EFFECTS OF APONEUROSIS GEOMETRY ON STRAIN INJURY SUSCEPTIBILITY EXPLORED WITH A 3D MUSCLE MODEL  

PubMed Central

In the musculoskeletal system, some muscles are injured more frequently than others. For example, the biceps femoris longhead (BFLH) is the most commonly injured hamstring muscle. It is thought that acute injuries result from large strains within the muscle tissue, but the mechanism behind this type of strain injury is still poorly understood. The purpose of this study was to build computational models to analyze the stretch distributions within the BFLH muscle and to explore the effects of aponeurosis geometry on the magnitude and location of peak stretches within the model. We created a three-dimensional finite element (FE) model of the BFLH based on magnetic resonance (MR) images. We also created a series of simplified models with a similar geometry to the MR-based model. We analyzed the stretches predicted by the MR-based model during lengthening contractions to determine the region of peak local fiber stretch. The peak along-fiber stretch was 1.64 and was located adjacent to the proximal myotendinous junction (MTJ). In contrast, the average along-fiber stretch across all the muscle tissue was 0.95. By analyzing the simple models, we found that varying the dimensions of the aponeuroses (width, length, and thickness) had a substantial impact on the location and magnitude of peak stretches within the muscle. Specifically, the difference in widths between the proximal and distal aponeurosis in the BFLH contributed most to the location and magnitude of peak stretch, as decreasing the proximal aponeurosis width by 80% increased peak average stretches along the proximal MTJ by greater than 60% while slightly decreasing stretches along the distal MTJ. These results suggest that the aponeurosis morphology of the BFLH plays a significant role in determining stretch distributions throughout the muscle. Furthermore, this study introduces the new hypothesis that aponeurosis widths may be important in determining muscle injury susceptibility. PMID:20541207

Rehorn, Michael R.; Blemker, Silvia S.

2010-01-01

36

Estimation of Tensile Force in the Hamstring Muscles during Overground Sprinting.  

PubMed

The purpose of this study was to identify the period of the gait cycle during which the hamstring muscles were likely injured by estimating the magnitude of tensile force in each muscle during overground sprinting. We conducted three-dimensional motion analysis of 12 male athletes performing overground sprinting at their maximal speed and calculated the hamstring muscle-tendon length and joint angles of the right limb throughout a gait cycle during which the ground reaction force was measured. Electromyographic activity during sprinting was recorded for the biceps femoris long head, semitendinosus, and semimembranosus muscles of ipsilateral limb. We estimated the magnitude of tensile force in each muscle by using the length change occurred in the musculotendon and normalized electromyographic activity value. The study found a quick increase of estimated tensile force in the biceps femoris long head during the early stance phase of the gait cycle during which the increased hip flexion angle and ground reaction force occurred at the same time. This study provides quantitative data of tensile force in the hamstring muscles suggesting that the biceps femoris long head muscle is susceptible to a strain injury during the early stance phase of the sprinting gait cycle. PMID:25254895

Ono, T; Higashihara, A; Shinohara, J; Hirose, N; Fukubayashi, T

2015-02-01

37

Injury incidence, risk factors and prevention in Australian rules football.  

PubMed

Along with the enjoyment and the other positive benefits of sport participation, there is also the risk of injury that is elevated in contact sport. This review provides a summary of injury incidence in Australian rules football (ARF), identifies injury risk factors, assesses the efficacy of interventions to reduce injury risk and makes recommendations for future research. The most common injuries were found to be muscle strains, particularly hamstrings; joint ligament sprains, especially ankle; haematomas and concussion. The most severe joint injury was anterior cruciate ligament rupture. Mouthguards are commonly worn and have been shown to reduce orofacial injury. There is evidence that thigh pads can reduce the incidence of thigh haematomas. There is a reluctance to wear padded headgear and an attempt to assess its effectiveness was unsuccessful due to low compliance. The most readily identified risk factor was a history of that injury. There were conflicting findings as to the influence strength imbalances or deficit has on hamstring injury risk in ARF. Static hamstring flexibility was not related to risk but low hip flexor/quadriceps flexibility increased hamstring injury risk. High lower-limb and high hamstring stiffness were associated with an elevated risk of hamstring injury. Since stiffness can be modulated through strength or flexibility training, this provides an area for future intervention studies. Low postural balance ability was related to a greater risk of ankle injury in ARF, players with poor balance should be targeted for balance training. There are preliminary data signifying a link between deficiencies in hip range of motion and hip adductor strength with groin pain or injury. This provides support for future investigation into the effectiveness of an intervention for high-risk players on groin injury rate. Low cross-sectional area of core-region muscle has been associated with more severe injuries and a motor control exercise intervention that increased core muscle size and function resulted in fewer games missed due to injury. A randomized controlled trial of the effectiveness of eccentric hamstring exercise in decreasing hamstring injury rate in ARF players was unsuccessful due to poor compliance from muscle soreness; a progressive eccentric training intervention for ARF should be given future consideration. Jump and landing training reduced injury risk in junior ARF players and it would be advisable to include this component as part of a neuromuscular training intervention. A multifaceted programme of sport-specific drills for hamstring flexibility while fatigued, sport skills that load the hamstrings and high-intensity interval training to mimic match playing conditions showed some success in reducing the incidence of hamstring injuries in ARF. A countermeasure designed to reduce injury risk is more likely to be adopted by coaches and players if it also has the scope to enhance performance. PMID:23529288

Hrysomallis, Con

2013-05-01

38

Upper limb repetitive strain injuries in Manitoba.  

PubMed

A review of workers' compensation board (WCB) claims in Manitoba, Canada identified an estimated 382 upper limb repetitive strain injury (RSI) claims or 9.3% of all upper limb WCB claims accepted in 1991. Tendonitis and carpal tunnel syndrome (CTS) were the most frequent diagnoses (27.5% and 19.3%, respectively). Rates of RSI were not significantly different by gender and age. RSI claimants had been experiencing symptoms for an average of 8 months prior to filing a compensation claim. While clerical occupations accounted for 13.6% of all upper limb RSI claims, the rates for RSIs in these occupations were low (0.67/1,000 workers), in contrast to occupations with the highest RSI rates: food, beverage, and related processing occupations (14.68/1,000 workers) and fabricating, assembling, and repairing of metal products (9.32/1,000). The highest risk industries were meat and poultry processing-related (23.48/1,000) and the manufacturing of airplanes (9.06/1,000). RSI claims were significantly more costly (+5,569 vs. +2,480, p < 0.0001) and required more time loss (71.4 vs. 33.6 d, p < 0.0001) than similar musculoskeletal non-RSI claims. Similarly, RSI claimants were less likely to return to the same job (67.3% vs. 81.0%, p < 0.0001) than non-RSI claimants. It was concluded that the cost and severity of RSI claims militate for intensified preventive measures. PMID:8892552

Yassi, A; Sprout, J; Tate, R

1996-10-01

39

Allograft reconstruction for symptomatic chronic complete proximal hamstring tendon avulsion.  

PubMed

Complete proximal hamstring tendon avulsion is an uncommon injury that can cause significant disability in young, athletic individuals. Surgical reattachment is recommended and can be performed on a delayed basis if the tissue is sufficiently mobile. We report 2-year follow up for two cases where interpositional allograft tissue was used for reconstruction because the tendon was too retracted for primary repair. Two 30-year-old patients with complete proximal hamstring avulsion at least 2 years earlier reported severe hamstring weakness and restrictions with respect to sport and recreational activities. Proximal hamstring tendon reconstruction with Achilles tendon allograft was performed for both patients. They were immobilized for 8 weeks with the hip in extension and the knee in flexion using a custom orthosis, followed by physical therapy and weight bearing as tolerated. The patients were followed for over 2 years after the surgery and were evaluated with physical examination, isokinetic strength testing and detailed questions about their function. Following the procedure, both patients returned to a more active lifestyle that was greatly improved with respect to participation in sport and function. This procedure should be considered as a salvage operation as the patients did not return to completely normal function and demonstrated hamstring weakness on the operated side. PMID:18682918

Marx, Robert G; Fives, Gregory; Chu, Samuel K; Daluiski, Aaron; Wolfe, Scott W

2009-01-01

40

Achilles allograft reconstruction of a chronic complete proximal hamstring rupture.  

PubMed

Complete rupture of the origin of the hamstrings is an uncommon injury. Primary surgical repair is the treatment of choice, but in some not possible. We present a case of an avid cyclist who had significant disability from a 6-year-old injury. He underwent reconstruction with Achilles allograft and suture anchors. With the knee flexed to 90 degrees and after extensive mobilization, the retracted musculotendinous unit would not reach the ischial tuberosity. Two suture anchors were placed in the ischial tuberosity after soft tissue debridement. One limb of suture from each anchor was placed in the end of an Achilles allograft with a locking suture, with the other end used to pull the end of the graft to the ischial tuberosity. An additional suture was placed in running fashion down each side of the graft. Distally, the graft was fanned out and attached to the retracted hamstrings with interrupted sutures with the knee at 40 degrees and maximal proximal pull on the hamstrings. The patient outcome was excellent. He resumed high level cycling by 6 months after surgery with no symptoms. Isokinetic testing demonstrated a hamstring deficit of 25% at 60 degrees/s, and 20% at 180 degrees/s at 8 months. PMID:19034429

Murray, Patrick J; Lowe, Walter R

2009-11-01

41

Minimally Invasive Posterior Hamstring Harvest  

PubMed Central

Autogenous hamstring harvesting for knee ligament reconstruction is a well-established standard. Minimally invasive posterior hamstring harvest is a simple, efficient, reproducible technique for harvest of the semitendinosus or gracilis tendon or both medial hamstring tendons. A 2- to 3-cm longitudinal incision from the popliteal crease proximally, in line with the semitendinosus tendon, is sufficient. The deep fascia is bluntly penetrated, and the tendon or tendons are identified. Adhesions are dissected. Then, an open tendon stripper is used to release the tendon or tendons proximally; a closed, sharp tendon stripper is used to release the tendon or tendons from the pes. Layered, absorbable skin closure is performed, and the skin is covered with a skin sealant, bolster dressing, and plastic adhesive bandage for 2 weeks. PMID:24266003

Wilson, Trent J.; Lubowitz, James H.

2013-01-01

42

Analysis of the Three Most Prevalent Injuries in Australian Football Demonstrates a Season to Season Association Between Groin/Hip/Osteitis Pubis Injuries With ACL Knee Injuries  

PubMed Central

Background: Injuries are common in contact sports like Australian football. The Australian Football League (AFL) has developed an extensive injury surveillance database that can be used for epidemiological studies. Objectives: The purpose of this study is to identify any association between the three most prevalent injuries in the AFL. Patients and Methods: From the AFL injury surveillance data 1997-2012 the injury incidence (new injuries per club per season) and the injury prevalence data (missed games per club per season) were analysed to detect the three most common injuries that would cause a player to miss a match in the AFL. The three most prevalent injuries in the AFL are hamstring strains, groin/hip/osteitis pubis injuries and Anterior Cruciate Ligament (ACL) knee injuries. Following this, further study was undertaken to detect the presence of any statistical relationship between injury incidences of the three most prevalent injuries over this sixteen year study period. Results: Statistical analysis demonstrates for any given year that there was an association between having a groin/hip/osteitis pubis injuriy and having a knee ACL injury (P < 0.05) over the entire sixteen years. In other words if the number of groin/hip/osteitis pubis injuries in any given season were higher than average (alternatively lower) then the number of knee ACL injuries were also higher than average (alternatively lower) for that same season. Hamstring injuries had the highest variance of incidence of the three most prevalent injuries. Conclusions: Analysis of the AFL injury data demonstrates an association between incidence of groin/hip/osteitis pubis injuries and incidence of knee ACL injuries for any given playing season. This finding is difficult to explain with further research being required. PMID:25520768

Verrall, Geoffrey M.; Esterman, Adrian; Hewett, Timothy E.

2014-01-01

43

Quadriceps and Hamstrings Coactivation During Common Therapeutic Exercises  

PubMed Central

Context Anterior tibial shear force and knee valgus moment increase anterior cruciate ligament (ACL) loading. Muscle coactivation of the quadriceps and hamstrings influences anterior tibial shear force and knee valgus moment, thus potentially influencing ACL loading and injury risk. Therefore, identifying exercises that facilitate balanced activation of the quadriceps and hamstrings might be beneficial in ACL injury rehabilitation and prevention. Objective To quantify and compare quadriceps with hamstrings coactivation electromyographic (EMG) ratios during commonly used closed kinetic chain exercises. Design Cross-sectional study. Setting Research laboratory. Patients or Other Participants Twenty-seven healthy, physically active volunteers (12 men, 15 women; age = 22.1 ± 3.1 years, height = 171.4 ± 10 cm, mass = 72.4 ± 16.7 kg). Intervention(s) Participants completed 9 separate closed chain therapeutic exercises in a randomized order. Main Outcome Measure(s) Surface electromyography quantified the activity level of the vastus medialis (VM), vastus lateralis (VL), medial hamstrings (MH), and biceps femoris (BF) muscles. The quadriceps-to-hamstrings (Q:H) coactivation ratio was computed as the sum of average quadriceps (VM, VL) EMG amplitude divided by the sum of average hamstrings (MH, BF) EMG amplitude for each trial. We used repeated-measures analyses of variance to compare Q:H ratios and individual muscle contributions across exercises (? = .05), then used post hoc Tukey analyses. Results We observed a main effect for exercise (F3,79 = 22.6, P < .001). The post hoc Tukey analyses revealed smaller Q:H ratios during the single-limb dead lift (2.87 ± 1.77) than the single-limb squat (5.52 ± 2.89) exercise. The largest Q:H ratios were observed during the transverse-lunge (7.78 ± 5.51, P < .001), lateral-lunge (9.30 ± 5.53, P < .001), and forward-lunge (9.70 ± 5.90, P < .001) exercises. Conclusions The most balanced (smallest) coactivation ratios were observed during the single-limb dead-lift, lateral-hop, transverse-hop, and lateral band-walk exercises. These exercises potentially could facilitate balanced activation in ACL rehabilitation and injury-prevention programs. They also could be used in postinjury rehabilitation programs in a safe and progressive manner. PMID:22889655

Begalle, Rebecca L.; DiStefano, Lindsay J.; Blackburn, Troy; Padua, Darin A.

2012-01-01

44

Impaired endothelial function and blood flow in repetitive strain injury.  

PubMed

Repetitive Strain Injury (RSI) is a disabling upper extremity overuse injury that may be associated with pathophysiological changes in the vasculature. In this study we investigated whether RSI is associated with endothelial dysfunction and impaired exercise-induced blood flow in the affected forearm. 10 patients with RSI (age, 40.2 ± 10.3; BMI, 23.8 ± 3.3) and 10 gender- and age-matched control subjects (age, 38.0 ± 12.4; BMI, 22.7 ± 3.4) participated in this study. Brachial artery blood flow was measured at rest and during 3-min periods of isometric handgrip exercise at 15%, 30% and 45% of the individual maximal voluntary contraction. Brachial artery endothelial function was assessed as the flow mediated dilation (FMD), by measuring brachial artery diameter and velocity before and after 5-min ischemic occlusion. We found a lower exercise-induced brachial artery blood flow in patients with RSI than in controls (p=0.04). Brachial artery FMD was significantly lower in patients with RSI than in controls (p<0.01), whilst a lower FMD was also found in patient with unilateral RSI when comparing the affected arm with the non-affected arm (p=0.04). Our results suggest that patients with RSI have an attenuated exercise-induced blood flow and an impaired endothelial function in the affected arm. These findings importantly improve our understanding of the pathophysiological mechanism of RSI. PMID:22592545

Brunnekreef, J; Brunnekreef, J J; Benda, N; Benda, N M M; Schreuder, T; Schreuder, T H A; Hopman, M; Hopman, M T E; Thijssen, D; Thijssen, D H J

2012-10-01

45

Hamstrings cocontraction reduces internal rotation, anterior translation, and anterior cruciate ligament load in weight-bearing flexion.  

PubMed

Strengthening of the hamstrings is often recommended following injury and reconstruction of the anterior cruciate ligament. It has been suggested that hamstrings activity stabilizes the knee and reduces anterior cruciate ligament load during weight-bearing flexion; however, the effects of hamstrings cocontraction on the kinematics and mechanics of the normal knee have not been assessed at physiological load levels. The aim of this study was to determine whether the addition of hamstrings force affects knee rotations, translations, and joint and quadriceps force during flexion with loads at physiological levels applied to the muscles and joints. Eight cadaveric knee specimens were tested with a servohydraulic mechanism capable of applying controlled dynamic loads to simulate quadriceps and hamstrings muscle forces throughout a physiological range of motion. A constant vertical load of physiologic magnitude was applied to the hip, and quadriceps force was varied to maintain equilibrium throughout flexion. Two conditions were tested: no hamstrings force and a constant hamstrings force equivalent to the vertical load. Hamstrings force significantly reduced internal rotation (p<0.0001) and anterior translation (p<0.0001), increased quadriceps force (p<0.0001) and normal resultant force on the tibia (p<0.0001), and reversed the direction of the shear force on the tibia (p<0.0001). These results suggest that hamstrings strengthening following anterior cruciate ligament injury may benefit anterior cruciate ligament-deficient and reconstructed knees by reducing the load in the ligament; however, they also imply that this comes at the expense of efficiency and higher patellofemoral and joint forces. PMID:10632447

MacWilliams, B A; Wilson, D R; DesJardins, J D; Romero, J; Chao, E Y

1999-11-01

46

Hamstrings Activity During Knee Extensor Strength Testing: Effects of Burst Superimposition  

PubMed Central

Quadriceps muscle strength is often used as a criterion for functional progression and return to activity after knee joint injury or surgery. Previous research has demonstrated that noteworthy antagonist activity is present during knee strength testing. the countermoment associated with this antagonist muscle activity may lead to an underestimation of knee strength. the burst superimposition method of strength testing is considered by some to be the current gold standard. the effect of burst super-imposition on antagonist activity is unknown. the purpose of this study was to test the hypothesis that burst superimposition diminishes antagonistic hamstrings activity during knee extensor strength testing. Isometric knee strength testing was performed in 22 (11 males, 11 females) active young people with no history of serious lower extremity injuries using the burst superimposition method. the magnitude of hamstrings muscle activity was assessed just before and after burst superimposition. contrary to our hypothesis, a small, but statistically significant increase in antagonistic medial hamstrings activity was observed with burst superimposition (7.23 vs. 9.62; P < 0.001). Higher lateral hamstrings activity was also observed, but this did not reach statistical significance (15.03 vs. 13.50; P = 0.087). though statistically significant, the small increase in hamstrings activity is unlikely to be clinically meaningful. PMID:19223946

Krishnan, Chandramouli; Williams, Glenn N.

2008-01-01

47

Hamstring tendon graft for anterior cruciate ligament reconstruction.  

PubMed

In an age of increasing emphasis on sports, the most common contact injury of the lower extremity is anterior cruciate ligament (ACL) rupture. The classic history of an ACL injury is a sudden twisting of the knee accompanied by a popping or snapping sound. The patient usually complains of a feeling of hesitation, instability, or giving way of the knee. By the end of the day, the patient's knee will be swollen and unstable. There are many ways that the ACL can rupture, but a common method is a contact injury in which a valgus force is applied to the flexed, rotated externally knee. This can produce tears to the ACL, medial collateral ligament, and menisci. Noncontact injuries, such as those incurred while skiing or jumping, occur when the knee is extended and the tibia is internally rotated on the femur. There are several methods of repairing a ruptured ACL, such as using an allograft or autograft of the patella tendon or a hamstring tendon graft for the repair. This article focuses on the use of a hamstring tendon graft for ACL reconstruction and how to care for patients undergoing this procedure. PMID:12382466

Boni, Deborah M; Herriott, George E

2002-10-01

48

Mouse strains that lack spinal dynorphin upregulation after peripheral nerve injury do not develop neuropathic pain  

Microsoft Academic Search

Several experimental models of peripheral neuropathy show that a significant upregulation of spinal dynorphin A and its precursor peptide, prodynorphin, is a common consequence of nerve injury. A genetically modified mouse strain lacking prodynorphin does not exhibit sustained neuropathic pain after nerve injury, supporting a pronociceptive role of elevated levels of spinal dynorphin. A null mutation of the ? isoform

L. R. GARDELL; M. IBRAHIM; R. WANG; Z. WANG; M. H. OSSIPOV; T. P. MALAN JR; F Porreca; J Lai

2004-01-01

49

Sagittal Knee Kinematics following Hamstring Lengthening  

PubMed Central

The purpose of this study was to analyze sagittal knee kinematics following hamstring lengthening. A retrospective analysis was performed of 16 children (32 knees) with cerebral palsy who underwent hamstring lengthening as an isolated surgical procedure. Gait analysis was performed prior to surgery and at a minimum of one year after surgery. Decreased stance maximum knee flexion, stance minimum knee flexion, swing maximum knee flexion, and swing minimum knee flexion were noted. Total knee excursion increased. The present study confirmed the previously reported increase in total knee excursion with decrease in stance minimum and swing maximum knee flexion after hamstring lengthening. PMID:16789447

Carney, Brian T; Oeffinger, Donna; Meo, Anne Marie

2006-01-01

50

Strain-Related Differences after Experimental Traumatic Brain Injury in Rats  

PubMed Central

Abstract The present study directly compares the effects of experimental brain injury in two commonly used rat strains: Fisher 344 and Sprague-Dawley. We previously found that Fisher rats have a higher mortality rate and more frequent seizure attacks at the same injury level than Sprague-Dawley rats. Although strain differences in rats are commonly accepted as contributing to variability among studies, there is a paucity of literature addressing strain influence in experimental neurotrauma. Therefore this study compares outcome measures in two rat strains following lateral fluid percussion injury. Fisher 344 and Sprague-Dawley rats were monitored for changes in physiological measurements, intracranial pressure, and electroencephalographic activity. We further analyzed neuronal degeneration and cell death in the injured brain using Fluoro-Jade-B (FJB) histochemistry and caspase-3 immunostaining. Behavioral studies using the beam walk and Morris water maze were conducted to characterize strain differences in both motor and cognitive functional recovery following injury. We found that Fisher rats had significantly higher intracranial pressure, prolonged seizure activity, increased FJB-positive staining in the injured cortex and thalamus, and increased caspase-3 expression than Sprague-Dawley rats. On average, Fisher rats displayed a greater amount of total recording time in seizure activity and had longer ictal durations. The Fisher rats also had increased motor deficits, correlating with the above results. In spite of these results, Fisher rats performed better on cognitive tests following injury. The results demonstrate that different rat strains respond to injury differently, and thus in preclinical neurotrauma studies strain influence is an important consideration when evaluating outcomes. PMID:20392137

Rolfe, Andrew; Register, David; Levasseur, Joseph E.; Churn, Severn B.; Sun, Dong

2010-01-01

51

Angle-specific hamstring-to-quadriceps ratio: A comparison of football players and recreationally active males.  

PubMed

Abstract It is currently unclear how football participation affects knee-joint muscle balance, which is widely considered a risk factor for hamstrings injury. This study compared the angle-specific functional hamstring-to-quadriceps (H:Q) ratio (hamstrings eccentric torque as a ratio of quadriceps concentric torque at the same knee-joint angle) of football players with recreationally active controls. Ten male footballers and 14 controls performed maximal voluntary isometric and isovelocity concentric and eccentric contractions (60, 240 and 400° s(-1)) of the knee extensors and flexors. Gaussian fitting to the raw torque values was used to interpolate torque values for knee-joint angles of 100-160° (60° s(-1)), 105-160° (240° s(-1)) and 115-145° (400° s(-1)). The angle-specific functional H:Q ratio was calculated from the knee flexors eccentric and knee extensors concentric torque at the same velocity and angle. No differences were found for the angle-specific functional H:Q ratio between groups, at any velocity. Quadriceps and hamstrings strength relative to body mass of footballers and controls was similar for all velocities, except concentric knee flexor strength at 400° s(-1) (footballers +40%; P < 0.01). In previously uninjured football players, there was no intrinsic muscle imbalance and therefore the high rate of hamstring injuries seen in this sport may be due to other risk factors and/or simply regular exposure to a high-risk activity. PMID:25073098

Evangelidis, Pavlos Eleftherios; Pain, Matthew Thomas Gerard; Folland, Jonathan

2015-02-01

52

Functional performance following an ice bag application to the hamstrings.  

PubMed

This study examined the immediate and short-term (20 minute) effects of 3- and 10-minute ice bag applications to the hamstrings on functional performance as measured by the cocontraction test, shuttle run, and single-leg vertical jump. Forty-two (25 women, 17 men) recreational or collegiate athletes who were free of injury in the lower extremity 6 months before testing and who did not suffer from allergy to cryotherapy were included. Time to completion was measured in seconds for the cocontraction and the shuttle run test. Single-leg vertical jump was measured on the Vertec (Sports Imports, Columbus, Ohio) in centimeters. The 10-minute ice bag application reduced immediate post-application vertical jump performance and increased immediate post and 20-minute post shuttle run time (p hamstrings, whereas a shorter duration of ice application had no effect on these tasks. PMID:19002074

Fischer, Jennifer; Van Lunen, Bonnie L; Branch, J David; Pirone, Jamie L

2009-01-01

53

High-strain-rate brain injury model using submerged acute rat brain tissue slices.  

PubMed

Blast-induced traumatic brain injury (bTBI) has received increasing attention in recent years due to ongoing military operations in Iraq and Afghanistan. Sudden impacts or explosive blasts generate stress and pressure waves that propagate at high velocities and affect sensitive neurological tissues. The immediate soft tissue response to these stress waves is difficult to assess using current in vivo imaging technologies. However, these stress waves and resultant stretching and shearing of tissue within the nano- to microsecond time scale of blast and impact are likely to cause initial injury. To visualize the effects of stress wave loading, we have developed a new ex vivo model in which living tissue slices from rat brain, attached to a ballistic gelatin substrate, were subjected to high-strain-rate loads using a polymer split Hopkinson pressure bar (PSHPB) with real-time high-speed imaging. In this study, average peak fluid pressure within the test chamber reached a value of 1584±63.3?psi. Cavitation due to a trailing underpressure wave was also observed. Time-resolved images of tissue deformation were collected and large maximum eigenstrains (0.03-0.42), minimum eigenstrains (-0.33 to -0.03), maximum shear strains (0.09-0.45), and strain rates (8.4×10³/sec) were estimated using digital image correlation (DIC). Injury at 4 and 6?h was quantified using Fluoro-Jade C. Neuronal injury due to PSHPB testing was found to be significantly greater than injury associated with the tissue slice paradigm alone. While large pressures and strains were encountered for these tests, this system provides a controllable test environment to study injury to submerged brain slices over a range of strain rate, pressure, and strain loads. PMID:21970544

Sarntinoranont, Malisa; Lee, Sung J; Hong, Yu; King, Michael A; Subhash, Ghatu; Kwon, Jiwoon; Moore, David F

2012-01-20

54

Brain-on-a-chip microsystem for investigating traumatic brain injury: Axon diameter and mitochondrial membrane changes play a significant role in axonal response to strain injuries  

PubMed Central

Diffuse axonal injury (DAI) is a devastating consequence of traumatic brain injury, resulting in significant axon and neuronal degeneration. Currently, therapeutic options are limited. Using our brain-on-a-chip device, we evaluated axonal responses to DAI. We observed that axonal diameter plays a significant role in response to strain injury, which correlated to delayed elasticity and inversely correlated to axonal beading and axonal degeneration. When changes in mitochondrial membrane potential (MMP) were monitored an applied strain injury threshold was noted, below which delayed hyperpolarization was observed and above which immediate depolarization occurred. When the NHE-1 inhibitor EIPA was administered before injury, inhibition in both hyperpolarization and depolarization occurred along with axonal degeneration. Therefore, axonal diameter plays a significant role in strain injury and our brain-on-a-chip technology can be used both to understand the biochemical consequences of DAI and screen for potential therapeutic agents. PMID:25101309

Dollé, Jean-Pierre; Morrison, Barclay; Schloss, Rene S.; Yarmush, Martin L.

2014-01-01

55

DISEASE-SPECIFIC SUSCEPTIBILITY TO ACUTE OZONE-INDUCED INJURY AND INFLAMMATION IN EIGHT RAT STRAINS  

EPA Science Inventory

Susceptibility to environmental pollutant-induced injuries may be influenced by presence of disease and genetic make-up. To identify disease-specific susceptibility phenotype, we used eight rat strains with or without genetic cardiovascular disease. Male 12-15 wk old Sprague Dawl...

56

Repetitive stress and strain injuries: preventive exercises for the musician.  

PubMed

There are many articles that support stretching, strengthening, good nutrition, hydration, rest, and ergonomics along with many other concepts that may be helpful in preventing repetitive stress injuries. The most conclusive literature proposes early recognition of onset symptoms, and immediate reduction or cessation of the casual activity. This is not well accepted by the musician, because this means an interruption of practice and performance. Just like any worker or athlete at risk for RSI, however, the musician must learn to recognise early signs and take the steps to limit damage to muscular and neural tissues. More studies are needed to provide evidence for effective treatment and prevention of RSI. PMID:17097483

Shafer-Crane, Gail A

2006-11-01

57

Estimation of ligament strains and joint moments in the ankle during a supination sprain injury.  

PubMed

This study presents the ankle ligament strains and ankle joint moments during an accidental injury event diagnosed as a grade I anterior talofibular ligament (ATaFL) sprain. A male athlete accidentally sprained his ankle while performing a cutting motion in a laboratory setting. The kinematic data were input to a three-dimensional rigid-body foot model for simulation analyses. Maximum strains in 20 ligaments were evaluated in simulations that investigated various combinations of the reported ankle joint motions. Temporal strains in the ATaFL and the calcaneofibular ligament (CaFL) were then compared and the three-dimensional ankle joint moments were evaluated from the model. The ATaFL and CaFL were highly strained when the inversion motion was simulated (10% for ATaFL and 12% for CaFL). These ligament strains were increased significantly when either or both plantarflexion and internal rotation motions were added in a temporal fashion (up to 20% for ATaFL and 16% for CaFL). Interestingly, at the time strain peaked in the ATaFL, the plantarflexion angle was not large but apparently important. This computational simulation study suggested that an inversion moment of approximately 23 N m plus an internal rotation moment of approximately 11 N m and a small plantarflexion moment may have generated a strain of 15-20% in the ATaFL to produce a grade I ligament injury in the athlete's ankle. This injury simulation study exhibited the potentially important roles of plantarflexion and internal rotation, when combined with a large inversion motion, to produce a grade I ATaFL injury in the ankle of this athlete. PMID:23654290

Wei, Feng; Fong, Daniel Tik-Pui; Chan, Kai-Ming; Haut, Roger C

2015-01-01

58

The 5-strand hamstring graft in anterior cruciate ligament reconstruction.  

PubMed

The use of anterior cruciate ligament reconstruction in the pediatric and adolescent population has been increasing in recent years. Autograft hamstring graft is favored in this population, but these patients often have smaller hamstring tendons that yield smaller final graft constructs. These smaller grafts are associated with an increased need for revision surgery. We describe a technique for obtaining a larger-diameter anterior cruciate ligament graft construct from autologous hamstring graft without allograft supplementation. PMID:25473619

Lee, Rushyuan Jay; Ganley, Theodore J

2014-10-01

59

The 5-Strand Hamstring Graft in Anterior Cruciate Ligament Reconstruction  

PubMed Central

The use of anterior cruciate ligament reconstruction in the pediatric and adolescent population has been increasing in recent years. Autograft hamstring graft is favored in this population, but these patients often have smaller hamstring tendons that yield smaller final graft constructs. These smaller grafts are associated with an increased need for revision surgery. We describe a technique for obtaining a larger-diameter anterior cruciate ligament graft construct from autologous hamstring graft without allograft supplementation. PMID:25473619

Lee, Rushyuan Jay; Ganley, Theodore J.

2014-01-01

60

Endoscopic Proximal Hamstring Repair and Ischial Bursectomy  

PubMed Central

With the significant increase in use of the arthroscope around the hip have come several less invasive techniques to manage pathologies around this joint. This technical note with a video details one such technique that allows for the endoscopic management of proximal hamstring tears and chronic ischial bursitis, which until now have been managed exclusively with much larger open approaches. This procedure allows for complete exposure of the posterior aspect of the hip in a safe, minimally invasive fashion. PMID:23766996

Dierckman, Brian D.; Guanche, Carlos A.

2012-01-01

61

Quadruple hamstring anterior cruciate ligament reconstruction  

Microsoft Academic Search

Purpose: The use of blunt-threaded titanium interference screws for arthroscopic-assisted fixation of a quadruple-strand hamstring anterior cruciate ligament (ACL) reconstruction has recently been reported. However, the pitfalls of the low medial portal technique, rehabilitation protocol, and long-term results have not. The purpose of this multicenter study was to prospectively evaluate this technique's application to ACL instability in symptomatic patients as

Pierce E. Scranton; James E. Bagenstose; Brick A. Lantz; Marc J. Friedman; E. Edward Khalfayan; M. Kevin Auld

2002-01-01

62

Association of Nrf2 Polymorphism Haplotypes with Acute Lung Injury Phenotypes in Inbred Strains of Mice  

PubMed Central

Abstract Aims: Nrf2 is a master transcription factor for antioxidant response element (ARE)-mediated cytoprotective gene induction. A protective role for pulmonary Nrf2 was determined in model oxidative disorders, including hyperoxia-induced acute lung injury (ALI). To obtain additional insights into the function and genetic regulation of Nrf2, we assessed functional single nucleotide polymorphisms (SNPs) of Nrf2 in inbred mouse strains and tested whether sequence variation is associated with hyperoxia susceptibility. Results: Nrf2 SNPs were compiled from publicly available databases and by re-sequencing DNA from inbred strains. Hierarchical clustering of Nrf2 SNPs categorized the strains into three major haplotypes. Hyperoxia susceptibility was greater in haplotypes 2 and 3 strains than in haplotype 1 strains. A promoter SNP ?103?T/C adding an Sp1 binding site in haplotype 2 diminished promoter activation basally and under hyperoxia. Haplotype 3 mice bearing nonsynonymous coding SNPs located in (1862?A/T, His543Gln) and adjacent to (1417?T/C, Thr395Ile) the Neh1 domain showed suppressed nuclear transactivation of pulmonary Nrf2 relative to other strains, and overexpression of haplotype 3 Nrf2 showed lower ARE responsiveness than overexpression of haplotype 1 Nrf2 in airway cells. Importantly, we found a significant correlation of Nrf2 haplotypes and hyperoxic lung injury phenotypes. Innovation and Conclusion: The results indicate significant influence of Nrf2 polymorphisms and haplotypes on gene function and hyperoxia susceptibility. Our findings further support Nrf2 as a genetic determinant in ALI pathogenesis and provide useful tools for investigators who use mouse strains classified by Nrf2 haplotypes to elucidate the role for Nrf2 in oxidative disorders. Antioxid. Redox Signal. 22, 325–338. PMID:25268541

Jedlicka, Anne E.; Gladwell, Wesley; Marzec, Jacqui; McCaw, Zackary R.; Bienstock, Rachelle J.; Kleeberger, Steven R.

2015-01-01

63

Posterior mini-incision hamstring harvest.  

PubMed

Many orthopedists looking for alternatives to autograft bone-patellar-tendon-bone grafts are uncertain of their ability to harvest a hamstring graft of adequate length. They may use an allograft instead for this reason despite recent reports of high failure rates. This article presents step-by-step instructions for a posterior mini-incision hamstring harvest that offers a safe and simple method of reliably harvesting sufficient hamstring for 4 or 6 strand repair, while using tiny incisions for excellent cosmesis and minimal pain. Access from the posterior mini-incision allows easy identification and differentiation of the semitendinosus and gracilis (Gr) tendons, as well as precise placement of the anterior mini-incision for tibial tunnel drilling and fixation. Most importantly sectioning of the intertendinous cross-connections is performed under easy direct vision posteriorly, instead of at a distance from the typical anterior incision under retractors. This prevents the tendons from being cut too short by the tendon stripper and is particularly useful in large patients. In addition to the surgical procedure, details on the required equipment are presented. PMID:20160624

Prodromos, Chadwick C

2010-03-01

64

Determination of future prevention strategies in elite track and field: analysis of Daegu 2011 IAAF Championships injuries and illnesses surveillance  

PubMed Central

Objective To determine the incidence and characteristics of newly incurred injuries and illnesses during international Athletics Championships, by improving the medical surveillance coverage, in order to determine future prevention strategies. Design Prospective recording of newly occurred injuries and illnesses. Setting 13th International Association of Athletics Federations World Championships in Athletics 2011 in Daegu, Korea. Participants National team and Local Organising Committee physicians; and 1851 registered athletes. Main outcome measures Incidence and characteristics of newly incurred injuries and illnesses. Results 82% of athletes were covered by medical teams participating with a response rate of 94%. A total of 249 injuries were reported, representing an incidence of 134.5 injuries per 1000 registered athletes, and 119 (48%) resulted in time loss from sport. A total of 185 injuries affected the lower limb (74%). Hamstring strain was the main diagnosis and 67% resulted in absence from sport. Overuse (n=148; 59%) was the predominant cause. A total of 126 illnesses were reported, signifying an incidence of 68.1 per 1000 registered athletes. Upper respiratory tract infection was the most common reported diagnosis (18%), followed by exercise-induced dehydration (12%), and gastroenteritis/diarrhoea (10%). The highest incidences of injuries were found in combined events and middle and long-distance events, and of illness in race walking events. Conclusion During elite Athletics World Championships, 135 injuries, 60 time-loss injuries and 68 illnesses per 1000 registered athletes were reported. Higher risks of injuries were found in combined events and long-distance runs. Preventive interventions should focus on overuse injuries and hamstring strains, decreasing the risk of transmission of infectious diseases, appropriate event scheduling and heat acclimatisation. PMID:22522588

Alonso, Juan-Manuel; Edouard, Pascal; Fischetto, Giuseppe; Adams, Bob; Depiesse, Frédéric; Mountjoy, Margo

2012-01-01

65

Arthrogenic Muscle Response of the Quadriceps and Hamstrings With Chronic Ankle Instability  

PubMed Central

Context: An arthrogenic muscle response (AMR) of the soleus and peroneal muscles has been previously demonstrated in individuals with chronic ankle instability (CAI), but the presence of AMR in muscles acting on joints proximal to unstable ankles has not been previously explored. Objective: To determine if AMR is present in the quadriceps and hamstrings muscles of those with and without unilateral CAI. Design: Case control. Setting: University research laboratory. Patients or Other Participants: Twenty subjects with unilateral CAI (12 males, 8 females: age = 19.9 ± 3.7 years; height = 170.3 ± 15.6 cm; mass = 78.0 ± 23.1 kg) and 21 controls (16 males, 5 females: age = 23.2 ± 5.4 years; height = 173.9 ± 12.7 cm; mass = 87.2 ± 24.6 kg) with no previous ankle injuries. Main Outcome Measure(s): The central activation ratio (CAR), a measure of motoneuron pool excitability during maximal voluntary isometric contraction, for the hamstrings and quadriceps muscles was measured in both limbs using the superimposed burst technique. Results: The CAI group demonstrated quadriceps CARs that were significantly larger in their involved limbs (.87 ± .09), as compared with their uninvolved limbs (.84 ± .08), whereas no significant side-to-side difference was seen in the control group (sham involved = .80 ± .11, sham uninvolved = .81 ± .11). When values from both the involved and uninvolved limbs were averaged, the hamstrings CAR was significantly lower for the CAI group (.94 ± .03) than for the control group (.96 ± .03). Conclusions: Arthrogenic inhibition of the hamstrings muscles bilaterally and facilitation of the quadriceps muscle ipsilateral to the involved limb were noted in subjects with unilateral CAI. Motoneuron pool excitability appears to be altered in muscles that act on joints proximal to the ankle in those with unilateral CAI. PMID:18059990

Sedory, Edward J; McVey, Eric D; Cross, Kevin M; Ingersoll, Christopher D; Hertel, Jay

2007-01-01

66

Strain Differences in Response to Traumatic Brain Injury in Long-Evans Compared to Sprague-Dawley Rats  

PubMed Central

Abstract The selected strain of rodent used in experimental models of traumatic brain injury is typically dependent upon the experimental questions asked and the familiarity of the investigator with a specific rodent strain. This archival study compares the injury responsiveness and recovery profiles of two popular outbred strains, the Long-Evans (LE) and the Sprague-Dawley (SD), after brain injury induced by lateral fluid percussion injury (LFPI). General findings include a significantly longer duration of unconsciousness in LE rats, but similar durations of apnea. Both strains displayed the same level of initial FPI-induced behavioral deficits, followed by a more rapid rate of functional recovery in SD rats. Cortical volume loss was not significantly different, but close inspection of the data suggests the possibility that LE rats may be more susceptible to damage in the hemisphere contralateral to the injury site than are SD rats. It is hoped that the information provided here encourages greater attention to the subtle differences and similarities between strains in future pre-clinical efficacy studies of traumatic brain injury. PMID:19216636

Tan, Arlene A.; Quigley, Andrea; Smith, Douglas C.

2009-01-01

67

Effect of Fatigue on Hamstring Reflex Responses and Posterior-Anterior Tibial Translation in Men and Women  

PubMed Central

Anterior cruciate ligament (ACL) rupture ranks among the most common injuries in sports. The incidence of ACL injuries is considerably higher in females than in males and the underlying mechanisms are still under debate. Furthermore, it has been suggested that muscle fatigue can be a risk factor for ACL injuries. We investigated gender differences in hamstring reflex responses and posterior-anterior tibial translation (TT) before and after fatiguing exercise. We assessed the isolated movement of the tibia relative to the femur in the sagittal plane as a consequence of mechanically induced TT in standing subjects. The muscle activity of the hamstrings was evaluated. Furthermore, isometric maximum voluntary torque (iMVT) and rate of torque development (RTD) of the hamstrings (H) and quadriceps (Q) were measured and the MVT H/Q as well as the RTD H/Q ratios were calculated. After fatigue, reflex onset latencies were enhanced in women. A reduction of reflex responses associated with an increased TT was observed in females. Men showed no differences in these parameters. Correlation analysis revealed no significant associations between parameters for TT and MVT H/Q as well as RTD H/Q. The results of the present study revealed that the fatigue protocol used in this study altered the latency and magnitude of reflex responses of the hamstrings as well as TT in women. These changes were not found in men. Based on our results, it is conceivable that the fatigue-induced decrease in neuromuscular function with a corresponding increase in TT probably contributes to the higher incidence of ACL injuries in women. PMID:23573178

Behrens, Martin; Mau-Moeller, Anett; Wassermann, Franziska; Bruhn, Sven

2013-01-01

68

Regional differences in muscle activation during hamstrings exercise.  

PubMed

Schoenfeld, BJ, Contreras, B, Tiryaki-Sonmez, G, Wilson, JM, Kolber, MJ, and Peterson, MD. Regional differences in muscle activation during hamstrings exercise. J Strength Cond Res 29(1): 159-164, 2015-It is believed that regional activation within a muscle may lead to greater site-specific muscular adaptations in the activated portion of the muscle. Because the hamstrings are a biarticular muscle, it can be theorized that single-joint exercises where movement originates at the hip vs. the knee will result in differential activation of the muscle complex. The purpose of the present study was to assess electromyographic activity in the proximal and distal aspects of the medial and lateral hamstrings during performance of the stiff-legged deadlift (SLDL), a hip-dominant exercise, and the lying leg curl (LLC), a knee-dominant exercise. Ten young, resistance-trained men were recruited from a university population to participate in the study. Employing a within-subject design, participants performed the SLDL and LLC to muscular failure using a load equating to their 8 repetition maximum for each exercise. The order of performance of exercises was counterbalanced between participants so that approximately half of the subjects performed SLDL first and the other half performed LLC first. Surface electromyography was used to record mean normalized muscle activity of the upper lateral hamstrings, lower lateral hamstrings, upper medial hamstrings, and lower medial hamstrings. Results showed that the LLC elicited significantly greater normalized mean activation of the lower lateral and lower medial hamstrings compared with the SLDL (p ? 0.05). These findings support the notion that the hamstrings can be regionally targeted through exercise selection. Further investigations are required to determine whether differences in activation lead to greater muscular adaptations in the muscle complex. PMID:24978835

Schoenfeld, Brad J; Contreras, Bret; Tiryaki-Sonmez, Gul; Wilson, Jacob M; Kolber, Morey J; Peterson, Mark D

2015-01-01

69

Effects of muscle injury severity on localized bioimpedance measurements.  

PubMed

Muscle injuries in the lower limb are common among professional football players. Classification is made according to severity and is diagnosed with radiological assessment as: grade I (minor strain or minor injury), grade II (partial rupture, moderate injury) and grade III (complete rupture, severe injury). Tetrapolar localized bioimpedance analysis (BIA) at 50?kHz made with a phase-sensitive analyzer was used to assess damage to the integrity of muscle structures and the fluid accumulation 24?h after injury in 21 injuries in the quadriceps, hamstring and calf, and was diagnosed with magnetic resonance imaging (MRI). The aim of this study was to identify the pattern of change in BIA variables as indicators of fluid [resistance (R)] and cell structure integrity [reactance (Xc) and phase angle (PA)] according to the severity of the MRI-defined injury. The % difference compared to the non-injured contralateral muscle also measured 24-h after injury of R, Xc and PA were respectively: grade I (n = 11; -10.4, -17.5 and -9.0%), grade II (n = 8; -18.4, -32.9 and -16.6%) and grade III (n = 2; -14.1, -52.9 and -43.1%), showing a greater significant decrease in Xc (p < 0.001). The greatest relative changes were in grade III injuries. However, decreases in R, that indicate fluid distribution, were not proportional to the severity of the injury. Disruption of the muscle structure, demonstrated by the localized determination of Xc, increased with the severity of muscle injury. The most significant changes 24?h after injury was the sizeable decrease in Xc that indicates a pattern of disrupted soft tissue structure, proportional to the severity of the injury. PMID:25500910

Nescolarde, L; Yanguas, J; Lukaski, H; Alomar, X; Rosell-Ferrer, J; Rodas, G

2015-01-01

70

Posterolateral corner reconstruction using a hamstring allograft and a bioabsorbable tenodesis screw: description of a new surgical technique.  

PubMed

Capsuloligamentous posterolateral corner knee joint deficiencies cause increased anterior cruciate ligament forces during internal knee rotation and increased posterior cruciate ligament forces during external knee rotation. Undiagnosed posterolateral corner knee joint injury in combination with anterior cruciate ligament or posterior cruciate ligament injury can lead to failure of anterior cruciate ligament or posterior cruciate ligament reconstruction. The purpose of this technical note is to present a new posterolateral corner reconstruction technique for treating patients with chronic capsuloligamentous posterolateral corner deficiency. The technique uses a bioabsorbable tenodesis screw and a hamstring allograft to reconstruct the popliteofibular and lateral collateral ligaments. PMID:15243452

Kocabey, Yavuz; Nawab, Akbar; Caborn, David N M; Nyland, John

2004-07-01

71

High hamstring tendinopathy in 3 female long distance runners  

PubMed Central

Objective The purpose of this case report is to describe and discuss the clinical presentation, diagnosis, and management of 3 female long distance runners with high hamstring tendinopathy. Clinical Features Three female runners presented to a chiropractic office with proximal hamstring pain that was aggravated by running. Increasing mileage, hills, and/or interval training preceded the onset of symptoms in each case. The subjects all displayed weakness of the hip abductors, pelvic joint dysfunction, hamstring tightness, and ischial tuberosity tenderness. Other clinical findings included overpronation, proprioceptive weakness, and lumbar dysfunction. Intervention and Outcome All 3 patients were treated with Graston Instrument Assisted Soft Tissue Mobilization, lumbopelvic manipulation, and electrical muscle stimulation with ultrasound. Active exercise focused on hamstring stretching and strengthening, gluteal strengthening, and proprioceptive training. The 3 runners seen in this clinic had resolution of hamstring pain in an average of 13 treatments and were able to continue competing without restriction. Conclusion Runners with high hamstring tendinopathy may respond favorably to conservative chiropractic treatment and active rehabilitation with minimal time off of training. PMID:22014863

White, Kristin E.

2011-01-01

72

The management of bilateral high hamstring tendinopathy with ASTYM® treatment and eccentric exercise: a case report  

PubMed Central

High hamstring tendinopathy (HHT) is an overuse injury that occurs most commonly in runners. The management of HHT is often challenging and the research supporting many interventions is limited. Eccentric exercise has been proven effective in the treatment of various tendinopathies but has not been thoroughly studied with HHT. Soft tissue mobilization, including ASTYM, is often utilized in the treatment of tendinopathies, though there is limited evidence supporting this approach. The purpose of this paper is to present the case of a patient referred to physical therapy with bilateral HHT. The patient was a 41-year-old recreational runner that had an insidious onset of right buttock pain 12 months prior to initiating therapy and left buttock pain 9 months prior. Her primary complaints included an inability to run, pain with prolonged or brisk walking, and pain with sitting on hard surfaces. The patient was treated in physical therapy two times per week for 16 visits with treatment focused on eccentric hamstring strengthening and ASTYM. By her eighth visit, the patient was able to walk 2·5 miles without pain and by her 12 visit, she was able to jog 1 mile before the onset of pain. After 16 visits, the patient reported that she was approximately 95% improved, was able to run 2·5 miles without pain, and had no pain with sitting on hard surfaces. This case suggests that eccentric exercise combined with ASTYM may be an effective treatment for HHT. PMID:23904753

McCormack, Joshua R

2012-01-01

73

The management of bilateral high hamstring tendinopathy with ASTYM® treatment and eccentric exercise: a case report.  

PubMed

High hamstring tendinopathy (HHT) is an overuse injury that occurs most commonly in runners. The management of HHT is often challenging and the research supporting many interventions is limited. Eccentric exercise has been proven effective in the treatment of various tendinopathies but has not been thoroughly studied with HHT. Soft tissue mobilization, including ASTYM, is often utilized in the treatment of tendinopathies, though there is limited evidence supporting this approach. The purpose of this paper is to present the case of a patient referred to physical therapy with bilateral HHT. The patient was a 41-year-old recreational runner that had an insidious onset of right buttock pain 12 months prior to initiating therapy and left buttock pain 9 months prior. Her primary complaints included an inability to run, pain with prolonged or brisk walking, and pain with sitting on hard surfaces. The patient was treated in physical therapy two times per week for 16 visits with treatment focused on eccentric hamstring strengthening and ASTYM. By her eighth visit, the patient was able to walk 2·5 miles without pain and by her 12 visit, she was able to jog 1 mile before the onset of pain. After 16 visits, the patient reported that she was approximately 95% improved, was able to run 2·5 miles without pain, and had no pain with sitting on hard surfaces. This case suggests that eccentric exercise combined with ASTYM may be an effective treatment for HHT. PMID:23904753

McCormack, Joshua R

2012-08-01

74

Endoscopic transtendinous repair for partial-thickness proximal hamstring tendon tears.  

PubMed

Partial tears of the proximal hamstring tendon can successfully be managed with tendon repair in cases of failed conservative management. As in partial-thickness gluteus medius repair, a transtendinous technique can be used to repair partial-thickness undersurface tears of the hamstring origin. This report details an endoscopic transtendinous approach for the treatment of partial-thickness hamstring tendon tears. PMID:24749032

Jackson, Timothy J; Trenga, Anthony; Lindner, Dror; El-Bitar, Youseff; Domb, Benjamin G

2014-02-01

75

Endoscopic Transtendinous Repair for Partial-Thickness Proximal Hamstring Tendon Tears  

PubMed Central

Partial tears of the proximal hamstring tendon can successfully be managed with tendon repair in cases of failed conservative management. As in partial-thickness gluteus medius repair, a transtendinous technique can be used to repair partial-thickness undersurface tears of the hamstring origin. This report details an endoscopic transtendinous approach for the treatment of partial-thickness hamstring tendon tears. PMID:24749032

Jackson, Timothy J.; Trenga, Anthony; Lindner, Dror; El-Bitar, Youseff; Domb, Benjamin G.

2014-01-01

76

Cerebrovascular injury caused by a high strain rate insult in the thorax  

E-print Network

Primary blast-induced traumatic brain injury (TBI) has increased in documented incidence and public prominence in recent conflicts. Evidence for a thoracic mechanism of blast-induced TBI was recently reviewed and, while the totality is compelling, data from experiments isolating this mechanism is sparse. Notably, one recent study showed pericapillar haemorrhage in brain tissue from victims of single, fatal gunshot wounds to the chest. Here, qualitative results are reported for a small field study that isolated a thoracic mechanism for TBI caused by a high strain rate insult in white-tailed deer (Odocoileus virginianus, mass 49-80 kg) in a natural environment. In each of three cases, petechiae were present on the surface of the frontal, occipital and/or left parietal lobes, along with capillary damage in the choroid plexus. The location of the projectile impact to the thorax seemed to affect the degree of damage. This may be due to the proximity to the great vessels. The data reported here provides direct evid...

Courtney, Amy

2011-01-01

77

Two patients with a complete proximal rupture of the hamstring.  

PubMed

Two men visited our Emergency Room because of a water-ski-accident. At physical examination, there was hematoma at the upper leg with loss of strength at extension of the hip and flexion of the knee. Both patients had a palpable gap just distal of the ischial tuberosity. Further imaging by sonography and MR-scan showed a rupture of the proximal hamstring tendon. Treatment was operative refixation of the hamstring tendons at the ischial tuberosity. After treatment consisted of brace for 4 weeks after operation. Both patients returned to their pre-operatively sports, though at a lower level. Surgical treatment of a complete proximal rupture of the hamstrings is recommended in case of sportive patients. PMID:19688217

Floor, Sebastiaan; van der Veen, Alex H; Devilee, Roger J

2010-04-01

78

Gender dimorphic ACL strain in response to combined dynamic 3D knee joint loading: Implications for ACL injury risk  

Microsoft Academic Search

While gender-based differences in knee joint anatomies\\/laxities are well documented, the potential for them to precipitate gender-dimorphic ACL loading and resultant injury risk has not been considered. To this end, we generated gender-specific models of ACL strain as a function of any six degrees of freedom (6DOF) knee joint load state via a combined cadaveric and analytical approach. Continuously varying

Kiyonori Mizuno; Jack T. Andrish; Antonie J. van den Bogert; Scott G. McLean

2009-01-01

79

Triceps reconstruction using hamstring graft for triceps insufficiency or recurrent rupture.  

PubMed

Triceps ruptures are relatively rare injuries. When they occur, primary surgical repair of the tendon to the proximal ulna is recommended. However, some patients require reconstruction using tendon grafting due to shortening or insufficiency of the native triceps tendon. Triceps ruptures associated with biological abnormalities (such as renal insufficiency or metabolic disease) or recurrence of rupture represent situations where a stout augmented repair is desirable. Multiple allograft and autologous tendons have been described for augmentation, but the use of gracilis and semitendinosus tendons provides superior length and size for use in triceps reconstruction. Using an illustrative case example, the evaluation of triceps insufficiency and the need for additional graft is shown. The technique of autologous hamstring augmentation for triceps insufficiency is described in detail. The importance of graded rehabilitation is emphasized with a complete program of triceps strengthening over time. PMID:18776780

Wolf, Jennifer Moriatis; McCarty, Eric C; Ritchie, Paul D

2008-09-01

80

Development of a strain rate dependent material model of human cortical bone for computer-aided reconstruction of injury mechanisms.  

PubMed

Computer-aided methods such as finite-element simulation offer a great potential in the forensic reconstruction of injury mechanisms. Numerous studies have been performed on understanding and analysing the mechanical properties of bone and the mechanism of its fracture. Determination of the mechanical properties of bones is made on the same basis used for other structural materials. The mechanical behaviour of bones is affected by the mechanical properties of the bone material, the geometry, the loading direction and mode and of course the loading rate. Strain rate dependency of mechanical properties of cortical bone has been well demonstrated in literature studies, but as many of these were performed on animal bones and at non-physiological strain rates it is questionable how these will apply in the human situations. High strain-rates dominate in a lot of forensic applications in automotive crashes and assault scenarios. There is an overwhelming need to a model which can describe the complex behaviour of bone at lower strain rates as well as higher ones. Some attempts have been made to model the viscoelastic and viscoplastic properties of the bone at high strain rates using constitutive mathematical models with little demonstrated success. The main objective of the present study is to model the rate dependent behaviour of the bones based on experimental data. An isotropic material model of human cortical bone with strain rate dependency effects is implemented using the LS-DYNA material library. We employed a human finite element model called THUMS (Total Human Model for Safety), developed by Toyota R&D Labs and the Wayne State University, USA. The finite element model of the human femur is extracted from the THUMS model. Different methods have been employed to develop a strain rate dependent material model for the femur bone. Results of one the recent experimental studies on human femur have been employed to obtain the numerical model for cortical femur. A forensic application of the model is explained in which impacts to the arm have been reconstructed using the finite element model of THUMS. The advantage of the numerical method is that a wide range of impact conditions can be easily reconstructed. Impact velocity has been changed as a parameter to find the tolerance levels of injuries to the lower arm. The method can be further developed to study the assaults and the injury mechanism which can lead to severe traumatic injuries in forensic cases. PMID:24529781

Asgharpour, Zahra; Zioupos, Peter; Graw, Matthias; Peldschus, Steffen

2014-03-01

81

Standing and Supine Hamstring Stretching Are Equally Effective.  

PubMed

OBJECTIVE: To evaluate the relative effectiveness of standing and supine hamstring stretching in increasing hamstring flexibility as measured by increasing range of motion at the knee. DESIGN AND SETTING: The trial was randomized, and the setting was local academic physical therapy and physical therapist assistant programs. SUBJECTS: Twenty-nine healthy subjects who exhibited limited hamstring muscle flexibility bilaterally (22 women, 7 men, 25.9 +/- 6.13 years of age) volunteered to participate in this study. Subjects were randomly assigned a different stretch for each leg. Each leg was stretched 3 days per week for 3 weeks (3 x 30 seconds). Stretching sessions were supervised. MEASUREMENTS: We measured supine active knee extension. Measurements were taken before and after the 3-week stretching phase by the same investigator, who was blind to limb assignment. We calculated a 2-way mixed-design analysis of variance and Tukey Honestly Significant Difference post hoc tests to analyze data. An independent t test was performed to determine whether the change scores in the stretching groups differed by sex. RESULTS: Prestretching and poststretching measurements were significantly different for both the standing and supine stretch (<0.05). No significant difference (P > .05) in change score existed between the 2 stretches or between the sexes. CONCLUSIONS: The standing and supine hamstring stretches were comparably effective in improving flexibility. PMID:15592605

Decoster, Laura C; Scanlon, Rebecca L; Horn, Kevin D; Cleland, Joshua

2004-12-01

82

Reconstruction of the anterior cruciate ligament: a comparison between bone-patellar tendon-bone grafts and fourstrand hamstring grafts  

PubMed Central

Background: Disruption of anterior cruciate ligament (ACL) is a common ligamentous injury of the knee. The choice of graft for (ACL) reconstruction remains controversial. This prospective, randomized clinical trial aimed to compare clinical results of bone-patellar tendon-bone (BPTB) grafts and four-strand semitendinosus-gracilis (ST) grafts for ACL reconstruction over a 3-year follow-up interval. Methods: Seventy-one patients with an average age of 29± 4.5yearswere treated for torn ACL between 2008 and 2009. Forty-sixpatients underwent reconstruction with BPTB autograft, and 41 were treated with ST autograft. At the time of final follow-up, 37 patients in patella group and 34 patients in hamstring group were evaluated in terms of return to pre-injury activity level, pain, knee stability, range of motion, IKDC (International Knee Documentation Committee) score and complications. Results: At 36thmonth of follow-up, 34 (92%) and 28 (82%) patients in BPTB and ST group, respectively had good-to-excellent IKDC score (p > 0.05). The activity levels were higher in BPTB group (p> 0.05). At 3rd yearof follow up, the Lachman test was graded normal, for 23 (62%) and 11 (32%) patients in BPTB and ST group, respectively (p=0.019). Regarding the pivot-shift test, 29 (79%) and 15 (44%) patients in patella and hamstring group, respectively had normal test at the latest follow-up (p=0.021).There were no significant differences in terms of thigh circumference difference, effusion, knee range of motion, pain and complications. Conclusion: The results indicate a trend toward increased graft laxity and pivot-shift grades in patients undergoing reconstruction with hamstring autograft compared with patella tendon. However, the two groups had comparable results in terms of activity level and knee function.

Razi, Mohammad; Sarzaeem, Mohammad Mahdi; Kazemian, Gholam Hossein; Najafi, Farideh; Najafi, Mohammad Amin

2014-01-01

83

The genetic basis of strain-dependent differences in the early phase of radiation injury in mouse lung  

SciTech Connect

Substantial differences between mouse strains have been reported in the lesions present in the lung during the early phase of radiation injury. Some strains show only classical pneumonitis, while other strains develop substantial fibrosis and hyaline membranes which contribute appreciably to respiratory insufficiency, in addition to pneumonitis. Other strains are intermediate between these extremes. These differences correlate with intrinsic differences in activities of lung plasminogen activator and angiotensin converting enzyme. The genetic basis of these differences was assessed by examining histologically the early reaction in lungs of seven murine hybrids available commercially after whole-thorax irradiation. Crosses between fibrosing and nonfibrosing parents were uniformly nonfibrosing, and crosses between fibrosing and intermediate parents were uniformly intermediate. No evidence of sex linkage was seen. Thus the phenotype in which fibrosis is found is controlled by autosomal recessive determinants. Strains prone to radiation-induced pulmonary fibrosis and hyaline membranes exhibited intrinsically lower activities of lung plasminogen activator and angiotensin converting enzyme than either the nonfibrosing strains or the nonfibrosing hybrid crosses. The median time of death of the hybrids was genetically determined primarily by the longest-lived parent regardless of the types of lesions expressed.

Franko, A.J.; Sharplin, J.; Ward, W.F.; Hinz, J.M. (Cross Cancer Institute, Edmonton (Canada))

1991-06-01

84

Murine patellar tendon biomechanical properties and regional strain patterns during natural tendon-to-bone healing after acute injury.  

PubMed

Tendon-to-bone healing following acute injury is generally poor and often fails to restore normal tendon biomechanical properties. In recent years, the murine patellar tendon (PT) has become an important model system for studying tendon healing and repair due to its genetic tractability and accessible location within the knee. However, the mechanical properties of native murine PT, specifically the regional differences in tissue strains during loading, and the biomechanical outcomes of natural PT-to-bone healing have not been well characterized. Thus, in this study, we analyzed the global biomechanical properties and regional strain patterns of both normal and naturally healing murine PT at three time points (2, 5, and 8 weeks) following acute surgical rupture of the tibial enthesis. Normal murine PT exhibited distinct regional variations in tissue strain, with the insertion region experiencing approximately 2.5 times greater strain than the midsubstance at failure (10.80±2.52% vs. 4.11±1.40%; mean±SEM). Injured tendons showed reduced structural (ultimate load and linear stiffness) and material (ultimate stress and linear modulus) properties compared to both normal and contralateral sham-operated tendons at all healing time points. Injured tendons also displayed increased local strain in the insertion region compared to contralateral shams at both physiologic and failure load levels. 93.3% of injured tendons failed at the tibial insertion, compared to only 60% and 66.7% of normal and sham tendons, respectively. These results indicate that 8 weeks of natural tendon-to-bone healing does not restore normal biomechanical function to the murine PT following injury. PMID:24210849

Gilday, Steven D; Casstevens, E Chris; Kenter, Keith; Shearn, Jason T; Butler, David L

2014-06-27

85

Rapid hamstrings/quadriceps strength capacity in professional soccer players with different conventional isokinetic muscle strength ratios.  

PubMed

Muscle strength imbalance can be an important factor in hamstrings muscle strain. A hamstrings/quadriceps (H/Q) strength ratio based on concentric peak torque values (Hcon:Qcon) has traditionally been used to describe the potential for knee-joint destabilization. Because certain standard actions in soccer are explosive, the analysis of the H/Q strength ratio based on the rate of torque development (Hrtd:Qrtd) might also be useful in the evaluation of joint stability. The objective of this study was to compare the Hrtd:Qrtd between professional soccer players with heterogeneous values of Hcon:Qcon. Thirty-nine professional soccer players took part in the following procedures on different days: 1) Familiarization session with the isokinetic dynamometer, and 2) Two maximal isometric actions and five maximal concentric actions at 60°·s(-1) for hamstrings (H) and quadriceps (Q). Participants were ranked according to their Hcon:Qcon ratio. The median third was excluded to form a high torque group (HTG), and a low torque group (LTG). Peak isometric (H) and concentric (H and Q) torques and rate of torque development (H) were significantly greater in the HTG group. Similarly, Hcon:Qcon (0.68 ± 0.02 vs. 0.52 ± 0.03) and Hrtd:Qrtd (0.54 ± 0.12 vs. 0.43 ± 0.16) were significantly greater in the HTG group than in the LTG group. There was no significant correlation between Hcon:Qcon and Hrtd:Qrtd. It can be concluded that Hcon:Qcon and Hrtd:Qrtd are determined, but not fully defined, by shared putative physiological mechanisms. Thus, the physiologic and clinical significance of Hcon:Qcon and Hrtd:Qrtd to an athlete's individual evaluation might be different. Key pointsSoccer players with high (0.66-0.70) and low (0.50-0.54) conventional concentric hamstrings:quadriceps ratios (Hcon:Qcon) tend to demonstrate similar profiles (i.e., high and low, respectively) in their rate of the torque development H/Q ratio (Hrtd:Qrtd).The lack of a significant relationship between Hcon:Qcon and Hrtd:Qrtd suggests that these ratios are determined, but not fully defined, by shared putative physiological mechanisms.Preseason screening programs that monitor hamstrings:quadriceps ratios should recognize that the physiologic and clinical significance of Hcon:Qcon and Hrfd:Qrfd to an athlete's individual evaluation might be different. PMID:24149348

Greco, Camila C; Da Silva, Wendell L; Camarda, Sérgio R A; Denadai, Benedito S

2012-01-01

86

Rapid Hamstrings/Quadriceps Strength Capacity in Professional Soccer Players with Different Conventional Isokinetic Muscle Strength Ratios  

PubMed Central

Muscle strength imbalance can be an important factor in hamstrings muscle strain. A hamstrings/quadriceps (H/Q) strength ratio based on concentric peak torque values (Hcon:Qcon) has traditionally been used to describe the potential for knee-joint destabilization. Because certain standard actions in soccer are explosive, the analysis of the H/Q strength ratio based on the rate of torque development (Hrtd:Qrtd) might also be useful in the evaluation of joint stability. The objective of this study was to compare the Hrtd:Qrtd between professional soccer players with heterogeneous values of Hcon:Qcon. Thirty-nine professional soccer players took part in the following procedures on different days: 1) Familiarization session with the isokinetic dynamometer, and 2) Two maximal isometric actions and five maximal concentric actions at 60°·s-1 for hamstrings (H) and quadriceps (Q). Participants were ranked according to their Hcon:Qcon ratio. The median third was excluded to form a high torque group (HTG), and a low torque group (LTG). Peak isometric (H) and concentric (H and Q) torques and rate of torque development (H) were significantly greater in the HTG group. Similarly, Hcon:Qcon (0.68 ± 0.02 vs. 0.52 ± 0.03) and Hrtd:Qrtd (0.54 ± 0.12 vs. 0.43 ± 0.16) were significantly greater in the HTG group than in the LTG group. There was no significant correlation between Hcon:Qcon and Hrtd:Qrtd. It can be concluded that Hcon:Qcon and Hrtd:Qrtd are determined, but not fully defined, by shared putative physiological mechanisms. Thus, the physiologic and clinical significance of Hcon:Qcon and Hrtd:Qrtd to an athlete’s individual evaluation might be different. Key pointsSoccer players with high (0.66-0.70) and low (0.50-0.54) conventional concentric hamstrings:quadriceps ratios (Hcon:Qcon) tend to demonstrate similar profiles (i.e., high and low, respectively) in their rate of the torque development H/Q ratio (Hrtd:Qrtd).The lack of a significant relationship between Hcon:Qcon and Hrtd:Qrtd suggests that these ratios are determined, but not fully defined, by shared putative physiological mechanisms.Preseason screening programs that monitor hamstrings:quadriceps ratios should recognize that the physiologic and clinical significance of Hcon:Qcon and Hrfd:Qrfd to an athlete’s individual evaluation might be different. PMID:24149348

Greco, Camila C.; Da Silva, Wendell L.; Camarda, Sérgio R.A.; Denadai, Benedito S.

2012-01-01

87

Differential effects of post-natal development, animal strain and long term recovery on the restoration of neuromuscular function after neuromyotoxic injury in rat.  

PubMed

We have analysed the effect of long term recovery, post-natal development and animal strain on the extent of restoration of neuromuscular function after neuromyotoxic injury in the rat (Rattus norvegicus). Muscle isometric contractile properties of soleus muscle in response to nerve stimulation were measured in situ in snake venom injured muscles and compared to contralateral uninjured muscles. We show here that neuromuscular function was not fully recovered until 24 weeks after injury in young adult (2-3 month old) Wistar rats. Moreover, the level of functional recovery 3 weeks after injury induced in juvenile rats (1 month old) was not globally different from that in younger adult, adult (10 month old) and older adult (24 month old) Wistar rats. Furthermore, the level of recovery of some contractile parameters differed between Wistar and Sprague-Dawley strains 3 weeks after injury. In conclusion, a very long time (>12 weeks) is required for full neuromuscular recovery following neuromyotoxic injury of young adult rats. Moreover, neuromuscular recovery during post-natal development is not markedly different from that during adult stage in the Wistar rat strain. Finally, some rat strain differences are observed in the recovery after injury of young adult rats. PMID:16426897

Vignaud, A; Caruelle, J P; Martelly, I; Ferry, A

2006-05-01

88

Moderate Dynamic Compression Inhibits Pro-Catabolic Response of Cartilage to Mechanical Injury, TNF-? and IL-6, but Accentuates Degradation Above a Strain Threshold  

PubMed Central

Objective Traumatic joint injury can initiate early cartilage degeneration in the presence of elevated inflammatory cytokines (e.g., TNF-? and IL-6). The positive/negative effects of post-injury dynamic loading on cartilage degradation and repair in vivo is not well-understood. This study examined the effects of dynamic strain on immature bovine cartilage in vitro challenged with TNF-? + IL-6 and its soluble receptor (sIL-6R) with/without initial mechanical injury. Methods Groups of mechanically injured or non-injured explants were cultured in TNF-? + IL-6/sIL-6R for 8 days. Intermittent dynamic compression was applied concurrently at 10%, 20%, or 30% strain amplitude. Outcome measures included sGAG loss (DMMB), aggrecan biosynthesis (35S-incorporation), aggrecanase activity (Western blot), chondrocyte viability (fluorescence staining) and apoptosis (nuclear blebbing via light microscopy), and gene expression (qPCR). Results In bovine explants, cytokine-alone and injury-plus-cytokine treatments markedly increased sGAG loss and aggrecanase activity, and induced chondrocyte apoptosis. These effects were abolished by moderate 10% and 20% strains. However, 30% strain-amplitude greatly increased apoptosis and had no inhibitory effect on aggrecanase activity. TNF+IL-6/sIL-6R downregulated matrix gene expression and upregulated expression of inflammatory genes, effects that were rescued by moderate dynamic strains but not by 30% strain. Conclusions Moderate dynamic compression inhibits the pro-catabolic response of cartilage to mechanical injury and cytokine challenge, but there is a threshold strain-amplitude above which loading becomes detrimental to cartilage. Our findings support the concept of appropriate loading for post-injury rehabilitation. PMID:24007885

Li, Yang; Frank, Eliot H.; Wang, Yang; Chubinskaya, Susan; Huang, Han-Hwa; Grodzinsky, Alan J.

2013-01-01

89

Hamstring graft size and anthropometry in south Indian population  

PubMed Central

Background and Aim The role of anthropometric measurements in the prediction of hamstring autograft size in Indian population remains unclear. Till now, no studies have been done on Indian population. Methods We evaluated 41 consecutive patients (34 males, 7 females) prospectively with anterior cruciate ligament deficiency scheduled for reconstruction using hamstring autograft at our institution between June 2011 and June 2013. Preoperatively we recorded age, gender, height, weight, body mass index, and activity level. Intraoperative measurements of semitendinosus tendon like absolute length, diameter before fashioning the graft and final diameter of the tripled graft using sizing tubes calibrated to 1 mm. Correlation coefficient (Pearson's r) analysis was used. Results As per study there is no correlation between graft diameter, age, sex, weight, activity, and body mass index, of patients. Height of patients correlated to graft diameter in both Indian men and women (p < 0.001). Conclusion Anthropometric measurements such as weight, gender, activity level cannot be used as definitive predictors for the hamstring graft diameter during harvest but height of the patients can be taken as good predictor in Indian population.

Challa, Supradeeptha; Satyaprasad, Jonnalagedda

2013-01-01

90

The effect of hamstring muscle compensation for anterior laxity in the ACL-deficient knee during gait  

Microsoft Academic Search

The hamstring muscles have been recognized as an important element in compensating for the loss of stability in the ACL-deficient knee, but it is still not clear whether the hamstring muscle force can completely compensate for the loss of ACL, and the consequences of increased hamstring muscle force. A two-dimensional anatomical knee model in the sagittal plane was developed to

Wen Liu; Murray E. Maitland

2000-01-01

91

Interference screw divergence in femoral tunnel fixation during endoscopic anterior cruciate ligament reconstruction using hamstring grafts  

Microsoft Academic Search

Purpose:To compare the divergence angles between bioabsorbable interference screws inserted into the femoral tunnel with the screwdriver placed through the anteromedial portal to those inserted with the screwdriver placed through the tibial tunnel and to examine the effect of the femoral tunnel interference screws’ divergence angles on fixation strength of hamstring grafts after anterior cruciate ligament (ACL) reconstruction using hamstring

Christopher M. Miller; James E. Tibone; Michael Hewitt; F. Daniel Kharrazi; Neal S. ElAttrache

2002-01-01

92

Interactions of high hydrostatic pressure, pressurization temperature and pH on death and injury of pressure-resistant and pressure-sensitive strains of foodborne pathogens  

Microsoft Academic Search

The objective of this study is to determine the interactions between high hydrostatic pressure, pressurization temperature, time and pH during pressurization on death and injury of pressure-resistant and pressure-sensitive strains of four foodborne pathogens: Staphylococcus aureus 485 and 765, Listeria monocytogenes CA and OH2, Escherichia coli O157:H7 933 and 931, Salmonella enteritidis FDA and Salmonella typhimurium E21274. Among these strains

H Alpas; N Kalchayanand; F Bozoglu; B Ray

2000-01-01

93

Ultrasound assessment of hamstring muscle size using posterior thigh muscle thickness.  

PubMed

Several studies have investigated the relationship between ultrasound-measured muscle thickness (MT) and individual muscle cross-sectional area (CSA) and muscle volume (MV) in extremity and trunk muscles; however, the hamstring muscle has not been studied. The purpose of this study was to examine the relationship between posterior thigh MT by ultrasound and the muscle CSA and MV of the hamstring obtained by magnetic resonance imaging (MRI). Ten young women aged 20-31 had MT measured by ultrasound at three sites on the medial anterior (50% of thigh length; TL) and posterior (50% and 70% of TL) aspects of the thigh. On the same day, a series of continuous muscle CSA along the thigh was measured by MRI. In each slice, the anatomical CSA of the hamstring (biceps femoris, semitendinosus and semimembranosus) and quadriceps muscle was analysed, and the CSAs at 50% and 70% of TL and maximal CSA of the hamstring (CSAmax ) were determined. MV was calculated by multiplying CSA by slice thickness. A significant correlation was observed between posterior 50% MT and 50% hamstring CSA (r = 0·848, P = 0·002) and between posterior 70% MT and 70% hamstring CSA (r = 0·679, P = 0·031). Posterior 50% MT (r = 0·732, P = 0·016) and 50% MTxTL (r = 0·873, P = 0·001) were also correlated to hamstring MV. Anterior:posterior 50% thigh MT ratio was correlated to MV ratio of quadriceps and hamstring muscles (r = 0·803, P = 0·005). Our results suggest that posterior thigh MT reflects hamstring muscle CSA and MV. The anterior:posterior MT ratio may serve as a surrogate for MV ratio of quadriceps and hamstring. PMID:25363847

Abe, Takashi; Loenneke, Jeremy P; Thiebaud, Robert S

2014-11-01

94

Imaging "brain strain" in youth athletes with mild traumatic brain injury during dual-task performance.  

PubMed

Mild traumatic brain injury (mTBI) is a common cause of injury in youth athletes. Much of what is known about the sequelae of mTBI is yielded from the adult literature, and it appears that it is mainly those with persistent post-injury symptoms who have ongoing cognitive and neural abnormalities. However, most studies have employed single-task paradigms, which may not be challenging enough to uncover subtle deficits. We sought to examine the neural correlates of dual-task performance in male athletes aged 9-15 years using a functional neuroimaging protocol. Participants included 13 youths with a history of mTBI three to six months prior to testing and 14 typically-developing controls. All participants completed a working memory task in isolation (single-task) and while completing a concurrent motor task (dual-task); neural activity during performance was then compared between groups. Although working memory performance was similar during the single-task condition, increased working memory load resulted in an altered pattern of neural activation in key working memory areas (i.e., dorsolateral prefrontal and parietal cortices) in youth with mTBI relative to controls. During the dual-task condition, accuracy was similar between groups but injured youth performed slower than typically-developing controls, suggesting a speed-accuracy tradeoff in the mTBI group only. The injured youths also exhibited abnormal recruitment of brain structures involved in both working memory and dual-tasking. These data show that the dual-task paradigm can uncover functional impairments in youth with mTBI who are not highly symptomatic and who do not exhibit neuropsychological dysfunction. Moreover, neural recruitment abnormalities were noted in both task conditions, which we argue suggests mTBI-related disruptions in achieving efficient cognitive control and allocation of processing resources. PMID:24902051

Sinopoli, Katia J; Chen, Jen-Kai; Wells, Greg; Fait, Philippe; Ptito, Alain; Taha, Tim; Keightley, Michelle

2014-11-15

95

Stress and strain analysis on the anastomosis site sutured with either epineurial or perineurial sutures after simulation of sciatic nerve injury?  

PubMed Central

The magnitude of tensile stress and tensile strain at an anastomosis site under physiological stress is an important factor for the success of anastomosis following suturing in peripheral nerve injury treatment. Sciatic nerves from fresh adult cadavers were used to create models of sciatic nerve injury. The denervated specimens underwent epineurial and perineurial suturing. The elastic modulus (40.96 ± 2.59 MPa) and Poisson ratio (0.37 ± 0.02) of the normal sciatic nerve were measured by strain electrical measurement. A resistance strain gauge was pasted on the front, back, left, and right of the edge of the anastomosis site after suturing. Strain electrical measurement results showed that the stress and strain values of the sciatic nerve following perineurial suturing were lower than those following epineurial suturing. Scanning electron microscopy revealed that the sciatic nerve fibers were disordered following epineurial compared with perineurial suturing. These results indicate that the effect of perineurial suturing in sciatic nerve injury repair is better than that of epineurial suturing.

Liu, Guangyao; Zhang, Qiao; Jin, Yan; Gao, Zhongli

2012-01-01

96

Ankle Injury TYPES OF ANKLE INJURIES  

E-print Network

Ankle Injury TYPES OF ANKLE INJURIES: Ankle injuries can be acute or chronic in nature. Inverting (turning in) of the ankle, accounts for most acute injuries. Damage occurs when ankle is twisted or moved beyond its normal range. Overuse of the ankle can cause tearing of the ligaments or strain tendon fibers

Virginia Tech

97

Lower hamstring extensibility in men compared to women is explained by differences in stretch tolerance  

PubMed Central

Background This study examined whether passive hamstring tissue stiffness and/or stretch tolerance explain the relationship between sex and hamstring extensibility. Methods Ninety healthy participants, 45 men and 45 women (mean?±?SD; age 24.6?±?5.9 years, height 1.72?±?0.09 m, weight 74.6?±?14.1 kg) volunteered for this study. The instrumented straight leg raise was used to determine hamstring extensibility and allow measurement of stiffness and stretch tolerance (visual analog pain score, VAS). Results Hamstring extensibility was 9.9° greater in women compared to men (p?=?0.003). VAS scores were 16 mm lower in women (p?=?0.001). Maximal stiffness (maximal applied torque) was not different between men and women (p?=?0.42). Passive stiffness (slope from 20-50° hip flexion) was 0.09 Nm.°-1 lower in women (p?=?0.025). For women, linear and stepwise regression showed that no predictor variables were associated with hamstring extensibility (adjusted r2?=?-0.03, p?=?0.61). For men, 44% of the variance in hamstring extensibility was explained by VAS and maximal applied torque (adjusted r2?=?0.44, p?hamstring extensibility, but this relationship is only manifest in men. PMID:25000977

2014-01-01

98

Hip extension strength following hamstring tendon harvest for ACL reconstruction.  

PubMed

Hamstring autograft harvest for ACL reconstruction may have an effect on hip extension strength and this may be important especially in sports that involve high speed running such as soccer, rugby, American football and the sprint disciplines of track and field. This aspect of hamstring tendon harvesting has not been looked at before. We have performed a non-randomised prospective case control study comparing isokinetic hip extension strength following four strand semitendinosus and gracilis tendons (4SHS) and bone-patellar tendon-bone (BPTB) autografts in ACL reconstruction. Isokinetic hip extension was assessed at 3 and 12 months post-operatively using a Kin-Com machine at a speed of 30 degrees per second. Three months post-operatively there was a significant decrease (p<0.05) in the peak force of concentric hip extension in the 4SHS group. There was no evidence that hip extension is weaker following ACL reconstruction with 4SHS tendon autograft than ACL reconstruction with BPTB autograft at 12 months post-operatively. We find no contra-indication to the use of 4SHS tendon autografts in ACL reconstruction in patients who wish to preserve hip extension strength for their sporting activities. PMID:17627827

Geoghegan, John M; Geutjens, Guido G; Downing, Nicholas D; Colclough, Karen; King, Richard J

2007-10-01

99

Strain and stress variations in the human amniotic membrane and fresh corpse autologous sciatic nerve anastomosis in a model of sciatic nerve injury?  

PubMed Central

A 10-mm long sciatic nerve injury model was established in fresh normal Chinese patient cadavers. Amniotic membrane was harvested from healthy maternal placentas and was prepared into multilayered, coiled, tubular specimens. Sciatic nerve injury models were respectively anastomosed using the autologous cadaveric sciatic nerve and human amniotic membrane. Tensile test results showed that maximal loading, maximal displacement, maximal stress, and maximal strain of sciatic nerve injury models anastomosed with human amniotic membrane were greater than those in the autologous nerve anastomosis group. The strain-stress curves of the human amniotic membrane and sciatic nerves indicated exponential change at the first phase, which became elastic deformation curves at the second and third phases, and displayed plastic deformation curves at the fourth phase, at which point the specimens lost their bearing capacity. Experimental findings suggested that human amniotic membranes and autologous sciatic nerves exhibit similar stress-strain curves, good elastic properties, and certain strain and stress capabilities in anastomosis of the injured sciatic nerve.

Peng, Chuangang; Zhang, Qiao; Yang, Qi; Zhu, Qingsan

2012-01-01

100

Hamstring anterior cruciate ligament reconstruction: a comparison of bioabsorbable interference screw and endobutton-post fixation  

Microsoft Academic Search

PurposeThe purpose of this study was to evaluate hamstring anterior cruciate ligament (ACL) reconstruction using aperture fixation with bioabsorbable interference screw (BIS) and distant fixation using EndoButton (Smith & Nephew, Andover, MA) and screw-post (ENDO).

C. Benjamin Ma; Kimberly Francis; Jeffrey Towers; Jay Irrgang; Freddie H Fu; Christopher H Harner

2004-01-01

101

EFFECT OF AXIAL TIBIAL TORQUE DIRECTION ON ACL RELATIVE STRAIN AND STRAIN RATE IN AN IN VITRO SIMULATED PIVOT LANDING  

PubMed Central

Anterior cruciate ligament (ACL) injuries most frequently occur under the large loads associated with a unipedal jump landing involving a cutting or pivoting maneuver. We tested the hypotheses that internal tibial torque would increase the anteromedial (AM) bundle ACL relative strain and strain rate more than would the corresponding external tibial torque under the large impulsive loads associated with such landing maneuvers. Twelve cadaveric female knees [mean (SD) age: 65.0 (10.5) years] were tested. Pretensioned quadriceps, hamstring and gastrocnemius muscle-tendon unit forces maintained an initial knee flexion angle of 15°. A compound impulsive test load (compression, flexion moment and internal or external tibial torque) was applied to the distal tibia while recording the 3-D knee loads and tibofemoral kinematics. AM-ACL relative strain was measured using a 3mm DVRT. In this repeated measures experiment, the Wilcoxon Signed-Rank test was used to test the null hypotheses with p<0.05 considered significant. The mean (± SD) peak AM-ACL relative strains were 5.4±3.7 % and 3.1±2.8 % under internal and external tibial torque, respectively. The corresponding mean (± SD) peak AM-ACL strain rates reached 254.4±160.1 %/sec and 179.4±109.9 %/sec, respectively. The hypotheses were supported in that the normalized mean peak AM-ACL relative strain and strain rate were 70% and 42% greater under internal than external tibial torque, respectively (p=0.023, p=0.041). We conclude that internal tibial torque is a potent stressor of the ACL because it induces a considerably (70%) larger peak strain in the AM-ACL than does a corresponding external tibial torque. PMID:22025178

Oh, Youkeun K.; Kreinbrink, Jennifer L.; Wojtys, Edward M.; Ashton-Miller, James A.

2011-01-01

102

Integrative Metabolome and Transcriptome Profiling Reveals Discordant Energetic Stress between Mouse Strains with Differential Sensitivity to Acrolein-Induced Acute Lung Injury  

PubMed Central

A respiratory irritant, acrolein is generated by overheating cooking oils or by domestic cooking using biomass fuels, and is in tobacco smoke, an occupational health hazard in the restaurant workplace. To better understand the metabolic role of the lung and to generate insights into the pathogenesis of acrolein-induced acute lung injury, SM/J (sensitive) and 129×1/SvJ (resistant) inbred mouse strains were exposed and the lung metabolome was integrated with the transcriptome profile. A total of 280 small molecules were identified and mean values (log 2 >0.58 or strain comparisons or within-strain responses to acrolein treatment. At baseline, 24 small molecules increased and 33 small molecules decreased in the SM/J mouse lung as compared to 129×1/SvJ mouse lung. Notable among the increased compounds was malonyl carnitine. Following acrolein exposure, several compounds indicative of glycolysis and branched chain amino acid metabolism increased similarly in both strains, whereas SM/J mice were less effective in generating metabolites related to fatty acid ?-oxidation. These findings suggest management of energetic stress varies between these strains, and that the ability to evoke auxiliary energy generating pathways rapidly and effectively may be critical in enhancing survival during acute lung injury in mice. PMID:21823223

Fabisiak, James P.; Medvedovic, Mario; Alexander, Danny C.; McDunn, Jonathan E.; Concel, Vincent J.; Bein, Kiflai; Jang, An Soo; Brendt, Annerose; Vuga, Louis J.; Brant, Kelly A.; Pope-Varsalona, Hannah; Dopico, Richard A.; Ganguly, Koustav; Upadhyay, Swapna; Li, Qian; Hu, Zhen; Kaminski, Naftali; Leikauf, George D.

2012-01-01

103

Hamstring\\/quadriceps ratios in college football players: A high velocity evaluation  

Microsoft Academic Search

Hamstring\\/quadriceps ratios were assessed on 60 in tercollegiate football players at functional speeds of 90, 180, and 300 deg\\/sec on the Cybex II. The ratio rose as velocity of exercise increased and the quadriceps was stronger than the hamstrings at all speeds. The flexor\\/extensor ratio differed bilaterally at all speeds with ratio lower for the dominant knee.The study helped establish

Maureen G. Stafford; William A. Grana

1984-01-01

104

Contributors to Fatigue Resistance of the Hamstrings and Quadriceps in Cerebral Palsy  

PubMed Central

Background The purpose of this study was to elucidate relationships between quadriceps and hamstrings voluntary muscle fatigue and upper motor lesion impairments in cerebral palsy in order to gain a better understanding of their contribution to the observed fatigue resistance. Methods Seventeen ambulatory subjects with cerebral palsy (mean age: 17.0, SD = 4.8 years) were recruited. Quantitative measures of strength, spasticity, cocontraction, and stiffness for both muscle groups were collected on an isokinetic dynamometer and entered in a factor analysis. The resulting factors were used as independent variables in a multiple regression analysis with quadriceps and hamstrings fatigue as dependent variables. Findings Five independent factors explained 90% of the variance. In order of loadings, higher hamstring cocontraction and spasticity and lower hamstring strength were associated with lower levels of hamstring fatigue. Higher quadriceps cocontraction and lower quadriceps strength were the most predictive of lower levels of quadriceps fatigue. Interpretation Greater motor impairments of the agonist muscle, particularly cocontraction, spasticity, and weakness, were associated with lower rates of muscle fatigue of the same muscle during performance of a voluntary fatigue protocol for the hamstrings and quadriceps. Muscles are highly adaptable; therefore, the results of this study suggest that the observed fatigue resistance may be due to the effect of the primary neural insult on motor unit recruitment and rate modulation or the result of secondary adaptations to spasticity, weakness, or excessive cocontraction. PMID:19264384

Moreau, Noelle G; Li, Li; Geaghan, James P; Damiano, Diane L

2009-01-01

105

The Comparison of the Effects of Three Physiotherapy Techniques on Hamstring Flexibility in Children: A Prospective, Randomized, Single-Blind Study  

PubMed Central

The aim of the study was to evaluate changes in hamstring flexibility in 120 asymptomatic children who participated in a 6-week program consisting of one physiotherapy session per week and daily home exercises. The recruitment criteria included age (10–13 years), no pain, injury or musculoskeletal disorder throughout the previous year, physical activity limited to school sport. Subjects were randomly assigned to one of the three groups: (1) post-isometric relaxation – PIR (n?=?40), (2) static stretch combined with stabilizing exercises – SS (n?=?40) and (3) stabilizing exercises – SE (n?=?40). Hamstring flexibility was assessed with straight leg raise (SLR), popliteal angle (PA) and finger-to-floor (FTF) tests. The examinations were conducted by blinded observers twice, prior to the program and a week after the last session with the physiotherapist. Twenty-six children who did not participate in all six exercise sessions with physiotherapists were excluded from the analysis. The results obtained by 94 children were analyzed (PIR, n?=?32; SS, n?=?31; SE, n?=?31). In the PIR and SS groups, a significant (P<0.01) increase in SLR, PA, FTF results was observed. In the SE group, a significant (P<0.001) increase was observed in the SLR but not in the PA and FTF (P>0.05). SLR result in the PIR and SS groups was significantly (P<0.001) higher than in the SE group. As far as PA results are concerned, a significant difference was observed only between the SS and SE groups (P?=?0.014). There were no significant (P?=?0.15) differences regarding FTF results between the three groups. Post-isometric muscle relaxation and static stretch with stabilizing exercises led to a similar increase in hamstring flexibility and trunk forward bend in healthy 10–13-year-old children. The exercises limited to straightening gluteus maximus improved the SLR result, but did not change the PA and FTF results. PMID:23951281

Czaprowski, Dariusz; Leszczewska, Justyna; Kolwicz, Aleksandra; Paw?owska, Paulina; K?dra, Agnieszka; Janusz, Piotr; Kotwicki, Tomasz

2013-01-01

106

Hamstrings Loading Contributes to Lateral Patellofemoral Malalignment and Elevated Cartilage Pressures: An In Vitro Study  

PubMed Central

Background Hamstrings loading has previously been shown to increase tibiofemoral posterior translation and external rotation, which could contribute to patellofemoral malalignment and elevated patellofemoral pressures. The current study characterizes the influence of forces applied by the hamstrings on patellofemoral kinematics and the pressure applied to patellofemoral cartilage. Methods Ten knees were positioned at 40°, 60° and 80° of flexion in vitro, and loaded with 586 N applied through the quadriceps, with and without an additional 200 N applied through the hamstrings. Patellofemoral kinematics were characterized with magnetic sensors fixed to the patella and the femur, while the pressure applied to lateral and medial patellofemoral cartilage was measured with pressure sensors. A repeated measures ANOVA with three levels, combined with paired t-tests at each flexion angle, determined if loading the hamstrings significantly (P < 0.05) influenced the output. Findings Loading the hamstrings increased the average patellar flexion, lateral tilt and lateral shift by approximately 1°, 0.5° and 0.2 mm, respectively. Each increase was significant for at least two flexion angles. Loading the hamstrings increased the percentage of the total contact force applied to lateral cartilage by approximately 5%, which was significant at each flexion angle, and the maximum lateral pressure by approximately 0.3 MPa, which was significant at 40° and 60°. Interpretation The increased lateral shift and tilt of the patella caused by loading the hamstrings can contribute to lateral malalignment and shifts pressure toward the lateral facet of the patella, which could contribute to overloading of lateral cartilage. PMID:21543144

Elias, John J.; Kirkpatrick, Marcus S.; Saranathan, Archana; Mani, Saandeep; Smith, Laura G.; Tanaka, Miho J.

2011-01-01

107

Joint infection unique to hamstring tendon harvester used during anterior cruciate ligament reconstruction surgery.  

PubMed

Joint infection after anterior cruciate ligament (ACL) reconstruction is a rare but important clinical issue that must be resolved quickly to prevent secondary joint damage and preserve the graft. After careful analysis, we observed 3 infection cases within a 12-month period after ACL reconstruction, which represented an abnormally elevated risk. All reconstructions were performed by the same surgeon and used hamstring tendon allograft. For each surgery, the Target Tendon Harvester (DePuy Mitek, Raynham, MA) was used to harvest hamstring tendons. Through our review, we learned that this instrument was sterilized while assembled. It is our belief that ineffective sterilization of this hamstring graft harvester served as the origin for these infections. We have determined that appropriate sterilization technique involves disassembly of this particular hamstring tendon harvester before sterilization because of the tube-within-a-tube configuration. We have since continued to use the Target Tendon Harvester, disassembling it before sterilization. There have been no infections in the ensuing 12 months during which the surgeon performed over 40 primary ACL reconstructions via hamstring autograft. The information from this report is intended to provide arthroscopists with information about potential sources of infection after ACL reconstruction surgery. PMID:18442698

Tuman, Jeffrey; Diduch, David R; Baumfeld, Joshua A; Rubino, L Joseph; Hart, Joseph M

2008-05-01

108

Treatment of Knee Osteoarthritis in Relation to Hamstring and Quadriceps Strength  

PubMed Central

[Purpose] To assess the effect of hamstring and quadriceps strengthening exercises on pain intensity, gait velocity, maximum isometric strength, and activities of daily living of patients with knee osteoarthritis (OA). [Subjects and Methods] A total of 20 patients with knee OA, 50 to 65?years of age (57.65 ± 4.78?years), received hot packs, strengthening exercises for the quadriceps and the hamstring muscles and stretching exercises for hamstring muscles. Outcome measures included: the Western Ontario and McMaster Universities OA index questionnaire (WOMAC) scores for assessing health status and health outcomes of knee OA; self-reported pain intensity scores, measured using a visual analogue scale; the 50 ft walk test (a measure of gait velocity and function); and handheld dynamometry (a tool used to measure maximum isometric strength of knee extension and flexion). [Results] There was a significant difference between pre- and post-intervention measures of pain intensity, 50 ft walk times, hamstring strength, and quadriceps strength. Significant differences in WOMAC measures were also observed in the subscales of pain, stiffness and physical function, as well as WOMAC total scores. [Conclusion] Strengthening the hamstring muscles in addition to strengthening the quadriceps muscles proved to be beneficial for perceived knee pain, range of motion, and decreasing the limitation of functional performance of patients with knee OA. PMID:24396198

Hafez, Ashraf Ramadan; Al-Johani, Ahmed H.; Zakaria, Abdul Rahim; Al-Ahaideb, Abdulaziz; Buragadda, Syamala; Melam, Ganeswara Rao; Kachanathu, SJ

2013-01-01

109

Comparative Study of Hamstring and Quadriceps Strengthening Treatments in the Management of Knee Osteoarthritis  

PubMed Central

[Purpose] Osteoarthritis (OA) of the knee is the most common form of joint disease. It is one of the major causes of impaired function that reduces quality of life (QOL) worldwide. The purpose of this study was to compare exercise treatments for hamstring and quadriceps strength in the management of knee osteoarthritis. [Subjects and Methods] Forty patients with OA knee, aged 50–65 years were divided into 2 groups. The first group (57.65±4.78 years) received hot packs and performed strengthening exercises for the quadriceps and hamstring, and stretching exercises for the hamstring. The second group (58.15±5.11 years) received hot packs and performed strengthening exercises for only the quadriceps, and stretching exercise for the hamstring. Outcome measures were the WOMAC (Western Ontario and McMaster Universities OA index questionnaire), Visual Analogue Scale (VAS) assessment of pain, the Fifty-Foot Walk Test (FWS), and Handheld dynamometry. [Results] There was a significant difference between the groups. The first group showed a more significant result than the second group. [Conclusion] Strengthening of the hamstrings in addition to strengthening of the quadriceps was shown to be beneficial for improving subjective knee pain, range of motion and decreasing the limitation of functional performance of patients with knee osteoarthritis. PMID:25013274

Al-Johani, Ahmed H; Kachanathu, Shaji John; Ramadan Hafez, Ashraf; Al-Ahaideb, Abdulaziz; Algarni, Abdulrahman D; Meshari Alroumi, Abdulmohsen; Alenazi, Aqeel M.

2014-01-01

110

Isokinetic Hamstrings:Quadriceps Ratios in Intercollegiate Athletes  

PubMed Central

Objective: To compare the differences in the concentric hamstrings:quadriceps (H:Q) ratio among athletes in different sports at 3 velocities. Design and Setting: We measured the H:Q ratio of both knees using the Biodex Pro Isokinetic Device. Subjects: Eighty-one male and female collegiate athletes. Measurements: We performed analyses for sport, velocity, and side of body for each sex. To compare the means of the concentric H:Q ratios for mean peak torque and mean total work, a 2 × 3 × 4 mixed-factorial analysis of variance was computed for women and a 2 × 2 × 3 mixed-factorial analysis of variance was computed for men. Results: We observed no significant interactions for men and women for the concentric H:Q ratio for mean peak torque. There was a significant mean difference among velocity conditions and a significant difference for men with respect to velocity. No significant differences were found for side of body or sport. Conclusions: The H:Q ratio increased as velocity increased. No differences existed for the H:Q ratio for sport or side of body. PMID:12937479

Fogarty, Tracey D.; Mahaffey, Brian L.

2001-01-01

111

Autologous hamstring tendon used for revision of quadiceps tendon tears.  

PubMed

A paucity of literature exists on quadriceps tendon reruptures. Failed quadriceps tendon repair can cause significant morbidity and disability. Surgical management of quadriceps tendon rerupture can be challenging due to tissue degeneration, tendon retraction, muscle atrophy, and poor bone fixation. A lack of guidance in the literature exists on the appropriate surgical techniques for managing quadriceps tendon reruptures.This article describes the case of a male recreational athlete with a failed primary quadriceps tendon repair who presented 10 months after rerupture. Examination was significant for morbid obesity, assisted ambulation, and a significant defect at the superior pole of the patella on the affected side. Intraoperative findings were consistent with a 2.0- to 4.5-cm tendon defect across the extensor mechanism with complete retinaculi tears. The authors performed a novel surgical approach for revision of quadriceps tears using a bilateral hamstring autograft through a quadriceps tendon weave and a transosseous patellar repair. Tendon length was restored, and extensor mechanism tension was reapproximated. Postoperatively, the patient achieved a good outcome and had returned to full, painless, sport participation at 2-year follow-up.This surgical technique is suitable for revision quadriceps tendon repairs of large tendon gap defects, repairs desiring tendon-to-bone in-growth, and repairs requiring large-force transmission across the repair. PMID:23590798

McCormick, Frank; Nwachukwu, Benedict U; Kim, Jaehon; Martin, Scott D

2013-04-01

112

A 10-week randomized trial comparing eccentric vs. concentric hamstring strength training in well-trained soccer players  

Microsoft Academic Search

Purpose: To compare the effects of a 10-week training program with two different exercises - traditional hamstring curl (HC) and Nordic hamstrings (NH), a partner exercise focusing the eccentric phase - on muscle strength among male soccer players. Methods: Subjects were 21 well- trained players who were randomized to NH training (n 5 11) or HC training (n 5 10).

Roald Mjolsnes; Arni Arnason; Tor osthagen; Truls Raastad; Roald Bahr

2004-01-01

113

Sprains, Strains, and Tears  

MedlinePLUS

Sprains, Strains and Tears A sprain is an injury to a ligament, while a strain is an injury to a muscle or tendon. Both can result in significant lost time from sports. SPRAINS A sprain is an injury to a ligament, the ...

114

Sciatic Nerve Injury Caused by a Stretching Exercise in a Trained Dancer  

PubMed Central

Sciatic nerve injury after stretching exercise is uncommon. We report a case of an 18-year-old female trained dancer who developed sciatic neuropathy primarily involving the tibial division after routine stretching exercise. The patient presented with dysesthesia and weakness of the right foot during dorsiflexion and plantarflexion. The mechanism of sciatic nerve injury could be thought as hyperstretching alone, not caused by both hyperstretching and compression. Electrodiagnostic tests and magnetic resonance imaging revealed evidence of the right sciatic neuropathy from the gluteal fold to the distal tibial area, and partial tear of the left hamstring origin and fluid collection between the left hamstring and ischium without left sciatic nerve injury. Recovery of motor weakness was obtained by continuous rehabilitation therapy and some evidence of axonal regeneration was obtained by follow-up electrodiagnostic testing performed at 3, 5, and 12 months after injury. PMID:24466525

Shim, Ho Yong; Bae, Keun Hwan; Park, Seok Min; Lee, Ju Kang; Park, Ki Deok

2013-01-01

115

Simplified MRI sequences for postoperative control of hamstring anterior cruciate ligament reconstruction  

Microsoft Academic Search

Introduction Usually, standard radiographs are used for postoperative quality follow-up after ACL reconstruction. However, with the use of hamstring grafts and bioabsorbable implants, accurate assessment of the tunnel and implant position is impossible. The graft and its relation to anatomical landmarks cannot be evaluated directly. MRI is an alternative to radiography, permitting direct graft visualization and 3-dimensional assessment of the

J. D. Agneskirchner; M. Galla; P. Landwehr; H. P. Lobenhoffer

2004-01-01

116

Interference screw position and hamstring graft location for anterior cruciate ligament reconstruction  

Microsoft Academic Search

Anterior cruciate ligament reconstruction with hamstring tendon graft and interference screw fixation has recently been considered. Concerns for the use of interference screws with soft tissue grafts include damage to the graft during screw insertion, decreased fixation strength, and a decrease in the bone-tendon contact area for healing within the tunnel when the screw is placed in an eccentric position.

PT Simonian; PS Sussmann; TH Baldini; HC Crockett; TL Wickiewicz

1998-01-01

117

Hamstring tendon fixation using interference screws: a biomechanical study in calf tibial bone  

Microsoft Academic Search

It has recently been shown that graft fixation close to the ACL insertion site is optimal in order to increase anterior knee stability. Hamstring tendon fixation using interference screws offers this possibility and a round threaded titanium interference screw has been previously developed. The use of a round threaded biodegradable interference screw may be equivalent. In addition, to increase initial

A Weiler; RF Hoffmann; AC Stähelin; HJ Bail; CJ Siepe; NP Südkamp

1998-01-01

118

Journal of Biomechanics 34 (2001) 437447 Rotational moment arms of the medial hamstrings and adductors  

E-print Network

with cerebral palsy frequently walk with a crouched, internally rotated gait. Spastic medial hamstrings exhibited by 21 subjects with cerebral palsy and excessive hip internal rotation. We found Ltd. All rights reserved. Keywords: Musculoskeletal model; Hip; Anteversion; Gait; Cerebral palsy 1

Delp, Scott

119

Criterion-Related Validity of Sit-and-Reach Tests for Estimating Hamstring and Lumbar Extensibility: a Meta-Analysis  

PubMed Central

The main purpose of the present meta-analysis was to examine the scientific literature on the criterion-related validity of sit-and-reach tests for estimating hamstring and lumbar extensibility. For this purpose relevant studies were searched from seven electronic databases dated up through December 2012. Primary outcomes of criterion-related validity were Pearson´s zero-order correlation coefficients (r) between sit-and-reach tests and hamstrings and/or lumbar extensibility criterion measures. Then, from the included studies, the Hunter- Schmidt´s psychometric meta-analysis approach was conducted to estimate population criterion- related validity of sit-and-reach tests. Firstly, the corrected correlation mean (rp), unaffected by statistical artefacts (i.e., sampling error and measurement error), was calculated separately for each sit-and-reach test. Subsequently, the three potential moderator variables (sex of participants, age of participants, and level of hamstring extensibility) were examined by a partially hierarchical analysis. Of the 34 studies included in the present meta-analysis, 99 correlations values across eight sit-and-reach tests and 51 across seven sit-and-reach tests were retrieved for hamstring and lumbar extensibility, respectively. The overall results showed that all sit-and-reach tests had a moderate mean criterion-related validity for estimating hamstring extensibility (rp = 0.46-0.67), but they had a low mean for estimating lumbar extensibility (rp = 0. 16-0.35). Generally, females, adults and participants with high levels of hamstring extensibility tended to have greater mean values of criterion-related validity for estimating hamstring extensibility. When the use of angular tests is limited such as in a school setting or in large scale studies, scientists and practitioners could use the sit-and-reach tests as a useful alternative for hamstring extensibility estimation, but not for estimating lumbar extensibility. Key Points Overall sit-and-reach tests have a moderate mean criterion-related validity for estimating hamstring extensibility, but they have a low mean validity for estimating lumbar extensibility. Among all the sit-and-reach test protocols, the Classic sit-and-reach test seems to be the best option to estimate hamstring extensibility. End scores (e.g., the Classic sit-and-reach test) are a better indicator of hamstring extensibility than the modifications that incorporate fingers-to-box distance (e.g., the Modified sit-and-reach test). When angular tests such as straight leg raise or knee extension tests cannot be used, sit-and-reach tests seem to be a useful field test alternative to estimate hamstring extensibility, but not to estimate lumbar extensibility. PMID:24570599

Mayorga-Vega, Daniel; Merino-Marban, Rafael; Viciana, Jesús

2014-01-01

120

Arthroscopy-assisted anterior cruciate ligament reconstruction with patellar tendon or hamstring autografts.  

PubMed

Isolated ACL reconstructions were performed in 138 patients between 1994 and 1998. Patellar bone-patellar tendon-bone, and hamstring tendon autografts were used in 88 patients, and allografts were used in 50 patients. Eighty-eight knees of 88 patients with autograft reconstructions (17 female, 71 male) were included in this study and evaluation of the patients with allograft reconstruction reported separately. The mean age at the time of the operation was 32 years. All ACL reconstructions were performed arthroscopically. Twenty-seven bone-patellar tendon-bone, and 61 hamstring tendon autografts were used. The mean follow-up was 29 months. In the postoperative course the Lachman test was negative in 62 patients, 1+ in 22 patients, and 2+ in 4 patients. In 17 patients, anterior drawer sign were 1+ in comparison to the contralateral side. Pivot shift test was moderately positive only in 5 cases in the bone-patellar tendon-bone and hamstring tendon autograft groups postoperatively. There were 3 patients with subjective "giving way" symptoms. Second look arthroscopy revealed rupture of the neo-ligament. Arthroscopic washout and debridement were performed, and no revision ligamentoplasties were performed. Two of these patients improved with accelerated proprioceptive physical therapy, and one had to decrease his previous level of activity. There were no cases of arthrofibrosis, infection, or extension lag. Clinical results of patellar bone-tendon-bone and hamstring groups did not show any significant clinical difference. Avoiding the disturbance of the extensor mechanism of the knee is probably the most significant advantage of the hamstring autograft. PMID:10983256

Doral, M N; Leblebicioglu, G; Atay, O A; Baydar, M L; Tetik, O; Atik, S

2000-01-01

121

MRP-1 expression levels determine strain-specific susceptibility to sodium arsenic-induced renal injury between C57BL/6 and BALB/c mice  

SciTech Connect

To clarify the pathophysiological mechanism underlying acute renal injury caused by acute exposure to arsenic, we subcutaneously injected both BALB/c and C57BL/6 mice with sodium arsenite (NaAs; 13.5 mg/kg). BALB/c mice exhibited exaggerated elevation of serum blood urea nitrogen (BUN) and creatinine (CRE) levels, compared with C57BL/6 mice. Moreover, half of BALB/c mice died by 24 h, whereas all C57BL/6 mice survived. Histopathological examination on kidney revealed severe hemorrhages, acute tubular necrosis, neutrophil infiltration, cast formation, and disappearance of PAS-positive brush borders in BALB/c mice, later than 10 h. These pathological changes were remarkably attenuated in C57BL/6 mice, accompanied with lower intrarenal arsenic concentrations, compared with BALB/c mice. Among heavy metal inducible proteins including multidrug resistance-associated protein (MRP)-1, multidrug resistance gene (MDR)-1, metallothionein (MT)-1, and arsenite inducible, cysteine- and histidine-rich RNA-associated protein (AIRAP), intrarenal MDR-1, MT-1, and AIRAP gene expression was enhanced to a similar extent in both strains, whereas NaAs challenge augmented intrarenal MRP-1 mRNA and protein expression levels in C57BL/6 but not BALB/c mice. Moreover, the administration of a specific inhibitor of MRP-1, MK-571, significantly exaggerated acute renal injury in C57BL/6 mice. Thus, MRP-1 is crucially involved in arsenic efflux and eventually prevention of acute renal injury upon acute exposure to NaAs.

Kimura, Akihiko [Department of Forensic Medicine, Wakayama Medical University, 641-8509 Wakayama (Japan); Ishida, Yuko [Department of Forensic Medicine, Wakayama Medical University, 641-8509 Wakayama (Japan); Division of Molecular Bioregulation, Kanazawa University Cancer Research Institute, Kanazawa (Japan); Wada, Takashi [Department of Gastroenterology and Nephrology, Graduate School of Medical Science and Division of Blood Purification, Kanazawa University, Kanazawa (Japan); Yokoyama, Hitoshi [Department of Gastroenterology and Nephrology, Graduate School of Medical Science and Division of Blood Purification, Kanazawa University, Kanazawa (Japan); Mukaida, Naofumi [Division of Molecular Bioregulation, Kanazawa University Cancer Research Institute, Kanazawa (Japan); Kondo, Toshikazu [Department of Forensic Medicine, Wakayama Medical University, 641-8509 Wakayama (Japan)]. E-mail: kondot@wakayama-med.ac.jp

2005-02-15

122

Clinical Outcome of Anterior Cruciate Ligament Reconstruction with Quadrupled Hamstring Tendon Graft and Bioabsorbable Interference Screw Fixation  

Microsoft Academic Search

Background: To date, there has been no publication of clinical follow-up data on patients who have undergone quadrupled hamstring tendon autograft anterior cruciate ligament reconstruction with bioabsorbable screw fixation.Purpose: To report the results of quadrupled hamstring tendon autograft anterior cruciate ligament reconstruction with bioabsorbable interference screw fixation.Study Design: Retrospective review.Methods: Sixty-five patients (66 knees) were retrospectively identified by chart review

William P. H. Charlton; Donald A. Randolph; Stephen Lemos; Clarence L. Shields

2003-01-01

123

Peak Torque, average power, and hamstring\\/quadriceps ratios in nondisabled adults and adults with mental retardation  

Microsoft Academic Search

Objective: To compare isokinetic hamstring and quadriceps peak torque (Nm), average power (watts), and corresponding hamstring\\/quadriceps (HQ) ratios (as percentages) of adult men with Down syndrome (DS), with mental retardation without Down syndrome (NDS), and nondisabled sedentary controls (SC).Design: Repeated measures analysis of variance.Setting: Subjects were tested at a university exercise science laboratory.Subjects: Volunteer sample of 35 subjects: SC (n

Ronald V. Croce; Kenneth H. Pitetti; Michael Horvat; John Miller

1996-01-01

124

The effect of hip rotation on shear elastic modulus of the medial and lateral hamstrings during stretching.  

PubMed

Regarding hamstring stretching methods, many studies have investigated the effect of stretching duration or frequency on muscle stiffness. However, the most effective stretching positions for hamstrings are unclear because it is impossible to quantify muscle elongation directly and noninvasively in vivo. Recently, a new ultrasound technology, ultrasonic shear wave elastography, has permitted noninvasive and reliable measurement of muscle shear elastic modulus, which has a strong linear relationship to the amount of muscle elongation. This study aimed to investigate the effect of hip internal and external rotation on shear elastic modulus of the lateral and medial hamstrings, respectively, during stretching in vivo using ultrasonic shear wave elastography. Twenty-three healthy men (age, 23.0 ± 2.1 years) were recruited for this study. To investigate the effect of hip rotation on the elongation of the medial and lateral hamstrings, shear elastic modulus of the biceps femoris (BF) and semitendinosus (ST) was measured at rest (a supine position with 90° knee flexion, 90° hip flexion, and hip neutral rotation) and in seven stretching positions (with 45° knee flexion and hip internal, external, and neutral rotation) using ultrasonic shear wave elastography. In both BF and ST, the shear elastic modulus in the rest position was significantly lower than that in all stretching positions. However, no significant differences were seen among stretching positions. Our results suggest that adding hip rotation at a stretching position for the hamstrings may not have a significant effect on muscle elongation of the medial and lateral hamstrings. PMID:25194631

Umegaki, Hiroki; Ikezoe, Tome; Nakamura, Masatoshi; Nishishita, Satoru; Kobayashi, Takuya; Fujita, Kosuke; Tanaka, Hiroki; Ichihashi, Noriaki

2015-02-01

125

Patellar tendon length after anterior cruciate ligament reconstruction: a comparative magnetic resonance imaging study between patellar and hamstring tendon autografts.  

PubMed

Patellar tendon shortening after anterior cruciate ligament reconstruction may be associated with anterior knee pain or patellofemoral arthritis. The present study was designed to compare postoperative changes in patellar tendon length after anterior cruciate ligament reconstruction between patellar tendon and hamstring tendon autograft. Magnetic resonance images of both knees (operated and healthy) and functional outcome were documented at least 1 year postoperatively in 16 patellar tendon harvested patients and in 32 hamstrings harvested patients. Patellar tendon length, patella length and Insall-Salvati ratio were measured. The operated knee values were compared to the respective values of the non-operated control knees. A significant 4.2 mm or 9.7% patellar tendon shortening in patellar tendon group and a non-significant 1.14 mm or 2.6% shortening in hamstrings group was detected. No significant difference was detected in terms of major shortening-patella baja-(6% for the patellar tendon group vs. 0% for the hamstring group). There was no significant difference in anterior knee problems between the two groups as evidenced by the Shelbourne score (94 for the patellar tendon group vs. 98 for the hamstring group). Harvesting of the patellar tendon for anterior cruciate ligament reconstruction resulted in a significant shortening of the remaining tendon. In contrast harvesting of the hamstring tendons did not affect significantly the patellar tendon length. However, the incidence of patella baja and overall functional outcome was not significantly different between the two groups. PMID:17225175

Hantes, Michael E; Zachos, Vasilios C; Bargiotas, Konstantinos A; Basdekis, Georgios K; Karantanas, Apostolos H; Malizos, Konstantinos N

2007-06-01

126

Epidemiology of time-loss injuries in English community-level rugby union  

PubMed Central

Objectives Using a prospective cohort study design, to establish the incidence and nature of time-loss injuries in English community rugby and to assess the differences between different playing levels. Setting English community rugby clubs. Participants Injury information for 4635 matches was collected during seasons 2009/2010 (46 clubs), 2010/2011(67 clubs) and 2011/2012 (76 clubs). Clubs were subdivided into groups A (semiprofessional), B (amateur) and C (recreational) for analysis. Primary and secondary outcome measures Any injury resulting in 8?days or greater absence from match play was reported by injury management staff at the clubs. The primary outcome measure was injury incidence (per 1000 player match-hours) and the secondary outcome measure was severity (ie, days absence). Results Overall match injury incidence was 16.9 injuries per 1000 player match-hours. Incidence was higher for group A (21.7; 95% CI 19.8 to 23.6) compared with group B (16.6; 95% CI 15.2 to 17.9) and C (14.2; 95% CI 13.0 to 15.5, both p<0.001). The mean time-loss was 7.6?weeks absence, with knee and shoulder injuries the most severe with mean absences of 11.6 and 9.3?weeks, respectively. Half of all injuries occurred to the lower limb, with knee and ankle joint/ligament injuries the most common diagnoses. Shoulder joint/ligament injuries were the most common and severe upper limb injuries. Contact events accounted for 80% of all injuries and tackles accounted for 50%. Running was the most common non-contact injury event, of which 56% were hamstring injuries. Conclusions More time-loss injuries occur at higher levels of community rugby. Injury prevention strategies should focus on good technique in the tackle and conditioning exercises for the knee, ankle, hamstrings and shoulder. PMID:24240143

Roberts, Simon P; Trewartha, Grant; England, Mike; Shaddick, Gavin; Stokes, Keith A

2013-01-01

127

Hamstring tendon harvesting--Effect of harvester on tendon characteristics and soft tissue disruption; cadaver study.  

PubMed

The purpose of this study was to determine whether the type of hamstring tendon harvester used can influence harvested tendon characteristics and soft tissue disruption. We compared two different types of tendon harvesters with regard to the length of tendon obtained and soft tissue disruption during hamstring tendon harvesting. Thirty six semitendinosus and gracilis tendons were harvested using either a closed stripper or a blade harvester in 18 paired knees from nine human fresh cadavers. Use of the blade harvester gave longer lengths of usable tendon whilst minimising the stripping of muscle and of any non-usable tendon. Our results suggest that the type of harvester per se can influence the length of tendon harvested as well as soft tissue disruption. Requesting such data from the industry prior to deciding which harvester to use seems desirable. PMID:19272780

Charalambous, C P; Alvi, F; Phaltankar, P; Gagey, O

2009-06-01

128

Effects on Hamstring Muscle Extensibility, Muscle Activity, and Balance of Different Stretching Techniques  

PubMed Central

[Purpose] The purpose of this study was to investigate the effects of two different stretching techniques on range of motion (ROM), muscle activation, and balance. [Subjects] For the present study, 48 adults with hamstring muscle tightness were recruited and randomly divided into three groups: a static stretching group (n=16), a PNF stretching group (n=16), a control group (n=16). [Methods] Both of the stretching techniques were applied to the hamstring once. Active knee extension angle, muscle activation during maximum voluntary isometric contraction (MVC), and static balance were measured before and after the application of each stretching technique. [Results] Both the static stretching and the PNF stretching groups showed significant increases in knee extension angle compared to the control group. However, there were no significant differences in muscle activation or balance between the groups. [Conclusion] Static stretching and PNF stretching techniques improved ROM without decrease in muscle activation, but neither of them exerted statistically significant effects on balance. PMID:24648633

Lim, Kyoung-Il; Nam, Hyung-Chun; Jung, Kyoung-Sim

2014-01-01

129

Compaction Versus Extraction Drilling for Fixation of the Hamstring Tendon Graft in Anterior Cruciate Ligament Reconstruction  

Microsoft Academic Search

Initial strength of quadrupled hamstring tendon grafts fixed with titanium interference screws was assessed in 30 pairs of porcine tibiae. Bone tunnels were drilled with either compaction drilling (stepped routers) or conventional extraction drilling (cannulated drill bits). Fifteen pairs of specimens were subjected to a single-cycle load-to-failure test, while the rest underwent a cyclic-loading test to further assess the quality

Janne T. Nurmi; Teppo L. N. Järvinen; Pekka Kannus; Harri Sievänen; Jani Toukosalo; Markku Järvinen

2002-01-01

130

Anterior cruciate ligament reconstruction in patients over 40 years using hamstring autograft  

Microsoft Academic Search

Anterior cruciate ligament (ACL) reconstruction is becoming increasingly popular in active middle-aged patients with symptomatic\\u000a instability. The purpose of this study was to retrospectively evaluate the results of ACL reconstruction in patients over\\u000a the age of 40. Twenty-one patients with a median age of 44 (range 40–56) who had arthroscopically assisted reconstruction\\u000a using four-stranded hamstring autograft were reviewed. RCI titanium

R. M. Khan; V. Prasad; R. Gangone; J. C. Kinmont

2010-01-01

131

Bilateral eccentric and concentric torque of quadriceps and hamstring muscles in females and males  

Microsoft Academic Search

Summary  This study assessed maximum eccentric (ECC) and concentric (CON) torque of quadriceps (QUAD) and hamstring (HAM) muscle groups\\u000a in healthy females (n=13) and males (n=27). Peak torques (PT) of bilateral muscle actions were recorded at constant angular velocities of 0.52, 1.57 and 2.61 rad·s?1. The QUADcon and HAMcon PT decreased (pecc and HAMecc PT increased (pecc PT decreased (pecc PT

Erland B. Colliander; Per A. Tesch

1989-01-01

132

Duration of static stretching influences muscle force production in hamstring muscles.  

PubMed

The purpose of the present study was to investigate whether duration of static stretching could affect the maximal voluntary contraction (MVC). Volunteer male subjects (n = 10) underwent 2 different durations of static stretching of their hamstring muscles in the dominant leg: 30 and 60 seconds. No static stretching condition was used as a control condition. Before and after each stretching trial, hamstring flexibility was measured by a sit and reach test. MVC was then measured using the maximal effort of knee flexion. The hamstring flexibility was significantly increased by 30 and 60 seconds of static stretching (control: 0.5 +/- 1.1 cm; 30 seconds: 2.1 +/- 1.8 cm; 60 seconds: 3.0 +/- 1.6 cm); however, there was no significant difference between 30 and 60 seconds of static stretching conditions. The MVC was significantly lowered with 60 seconds of static stretching compared to the control and 30 seconds of the stretching conditions (control: 287.6 +/- 24.0 N; 30 seconds: 281.8 +/- 24.2 N; 60 seconds: 262.4 +/- 36.2 N). However, there was no significant difference between control and 30 seconds of static stretching conditions. Therefore, it was concluded that the short duration (30 seconds) of static stretching did not have a negative effect on the muscle force production. PMID:17685679

Ogura, Yuji; Miyahara, Yutetsu; Naito, Hisashi; Katamoto, Shizuo; Aoki, Junichiro

2007-08-01

133

Posterior cruciate ligament reconstruction using hamstring tendon graft with remnant augmentation.  

PubMed

Despite good early functional results, the posterior laxity of the knee is not completely eliminated after posterior cruciate ligament (PCL) reconstruction. The PCL can retain the normal tension only when the injured ligament is maintained anatomically. This article describes a technique of PCL reconstruction using hamstring tendon graft with PCL remnant augmentation. The harvested hamstring tendons were quadrupled, sized, and pretensioned before use. The PCL remnants and the synovium were preserved. Minimal debridement was performed to gain access to the insertion sites. The tibia and femoral tunnels were created with graft size-matched reamers. The graft was transfixed at 70 degrees of knee flexion with a 15-lb anterior drawer force on the proximal tibia. This surgical technique has several advantages. The hamstring graft acts as an independent PCL reconstruction and maintains the PCL remnant tension. The PCL remnants and synovium may be beneficial to ligament healing and postoperative rehabilitation. The procedure is technically feasible and cosmetically acceptable. The selection of autograft precludes the risks of allograft and artificial ligament. The short-term results are encouraging, but long-term results are needed to confirm the value of this technique for PCL reconstruction. PMID:16325098

Wang, Ching-Jen; Chan, Yi-Sheng; Weng, Lin-Hsiu

2005-11-01

134

A taxonomically unique acinetobacter strain with proteolytic and hemolytic activities recovered from a patient with a soft tissue injury.  

PubMed

A taxonomically unique bacterial strain, Acinetobacter sp. A47, has been recovered from several soft tissue samples from a patient undergoing reconstructive surgery owing to a traumatic amputation. The results of 16S rRNA, rpoB, and gyrB gene comparative sequence analyses showed that A47 does not belong to any of the hitherto-known taxa and may represent an as-yet-unknown Acinetobacter species. The recognition of this novel organism contributes to our knowledge of the taxonomic complexity underlying infections caused by Acinetobacter. PMID:25392359

Almuzara, Marisa; Traglia, German Matías; Krizova, Lenka; Barberis, Claudia; Montaña, Sabrina; Bakai, Romina; Tuduri, Alicia; Vay, Carlos; Nemec, Alexandr; Ramírez, María Soledad

2015-01-01

135

Tibial Tunnel Widening After Hamstring Tendon Anterior Cruciate Ligament ReconstructionThe Effect of Supplemental Aperture Fixation With Autogenous Bone Cores  

Microsoft Academic Search

Background: Tibial tunnel widening is a common phenomenon seen with hamstring anterior cruciate ligament reconstruction. Concern exists that increased tunnel widening can lead to delayed graft incorporation, graft laxity, or difficulties in revision surgery.Hypothesis: Supplemental aperture fixation with autogenous bone cores or bioabsorbable interference screws will decrease tibial tunnel widening in hamstring anterior cruciate ligament reconstruction.Study Design: Cohort study; Level

W. Randall Schultz; Russell C. McKissick; Jesse C. DeLee

2007-01-01

136

Comparing the PEF resistance and occurrence of sublethal injury on different strains of Escherichia coli, Salmonella Typhimurium, Listeria monocytogenes and Staphylococcus aureus in media of pH 4 and 7  

Microsoft Academic Search

The effect of pulsed electric fields (PEF) on the reduction of the population and on the occurrence of sublethal injury in five strains of two Gram-positive (Listeria monocytogenes and Staphylococcus aureus) and two Gram-negative (Escherichia coli and Salmonella Typhimurium) microorganisms was investigated in media of pH 4.0 and 7.0. Samples were subjected to 50 exponential waveform pulses of 15, 20,

G. Saldaña; E. Puértolas; N. López; D. García; I. Álvarez; J. Raso

2009-01-01

137

Can we use peroneus longus in addition to hamstring tendons for anterior cruciate ligament reconstruction?  

PubMed Central

Background: The aim of this study is to evaluate the possible effects of removing the peroneus longus on the ankle and gait parameters, in order to add insufficient hamstring tendons for anterior cruciate ligament (ACL) reconstruction. Materials and Methods: In this controlled clinical trial, 375 patients with ACL rupture who underwent ACL reconstruction arthroscopically using hamstring tendons in the orthopedic clinics of Isfahan University of Medical Sciences in 2010 and 2011 were selected. Fifteen patients were included because their hamstring tendon diameter was lower than 8 mm and peroneus longus was added. After 6 months, the patients were followed using “Kistler force plate” to detect 3D kinematics and kinetics of the ankles and spatiotemporal walking parameters. Results: There was a significant difference between both operated and non-operated ankles in flexion/extension range of motion (P < 0.05). There was no significant difference between the moments of both ankles in sagittal and coronal planes (P > 0.05), but there was a significant difference between the moments of both ankles in the transverse plane (P = 0.006). There was a significant difference in the force of operated and non-operated ankles in all three planes (P < 0.05). There was no significant difference in the mean values of spatiotemporal gait parameters between operated and non-operated sides (P > 0.05). Conclusion: Removing the peroneus longus tendon has no effect on gait parameters and does not lead to instability of the ankle. So, it can be used as an autogenous graft in orthopedic surgeries. PMID:24949286

Nazem, Khalilallah; Barzegar, Mohammadreza; Hosseini, Alireza; Karimi, Mohammadtaghi

2014-01-01

138

Plasma microRNAs are sensitive indicators of inter-strain differences in the severity of liver injury induced in mice by a choline- and folate-deficient diet  

SciTech Connect

MicroRNAs (miRNAs) are a class of small, conserved, tissue-specific regulatory non-coding RNAs that modulate a variety of biological processes and play a fundamental role in the pathogenesis of major human diseases, including nonalcoholic fatty liver disease (NAFLD). However, the association between inter-individual differences in susceptibility to NAFLD and altered miRNA expression is largely unknown. In view of this, the goals of the present study were (i) to determine whether or not individual differences in the extent of NAFLD-induced liver injury are associated with altered miRNA expression, and (ii) assess if circulating blood miRNAs may be used as potential biomarkers for the noninvasive evaluation of the severity of NAFLD. A panel of seven genetically diverse strains of inbred male mice (A/J, C57BL/6J, C3H/HeJ, 129S/SvImJ, CAST/EiJ, PWK/PhJ, and WSB/EiJ) were fed a choline- and folate-deficient (CFD) diet for 12 weeks. This diet induced liver injury in all mouse strains; however, the extent of NAFLD-associated pathomorphological changes in the livers was strain-specific, with A/J, C57BL/6J, and C3H/HeJ mice being the least sensitive and WSB/EiJ mice being the most sensitive. The morphological changes in the livers were accompanied by differences in the levels of hepatic and plasma miRNAs. The levels of circulating miR-34a, miR-122, miR-181a, miR-192, and miR-200b miRNAs were significantly correlated with a severity of NAFLD-specific liver pathomorphological features, with the strongest correlation occurring with miR-34a. These observations suggest that the plasma levels of miRNAs may be used as biomarkers for noninvasive monitoring the extent of NAFLD-associated liver injury and susceptibility to NAFLD. -- Highlights: ? Choline- and folate-deficiency induces a strain-specific fatty liver injury in mice. ? The extent of liver pathology was accompanied by the changes in microRNA expression. ? The levels of circulating microRNAs mirror the magnitude of fatty liver injury. ? Plasma microRNAs may be sensitive noninvasive indicators of the fatty liver injury.

Tryndyak, Volodymyr P. [Division of Biochemical Toxicology, National Center for Toxicological Research, Jefferson, AR 72079 (United States)] [Division of Biochemical Toxicology, National Center for Toxicological Research, Jefferson, AR 72079 (United States); Latendresse, John R. [Toxicologic Pathology Associates, National Center for Toxicological Research, Jefferson, AR 72079 (United States)] [Toxicologic Pathology Associates, National Center for Toxicological Research, Jefferson, AR 72079 (United States); Montgomery, Beverly [Division of Biochemical Toxicology, National Center for Toxicological Research, Jefferson, AR 72079 (United States)] [Division of Biochemical Toxicology, National Center for Toxicological Research, Jefferson, AR 72079 (United States); Ross, Sharon A. [Division of Cancer Prevention, National Cancer Institute, Bethesda, MD 20892 (United States)] [Division of Cancer Prevention, National Cancer Institute, Bethesda, MD 20892 (United States); Beland, Frederick A. [Division of Biochemical Toxicology, National Center for Toxicological Research, Jefferson, AR 72079 (United States)] [Division of Biochemical Toxicology, National Center for Toxicological Research, Jefferson, AR 72079 (United States); Rusyn, Ivan [Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, NC 27599 (United States)] [Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, NC 27599 (United States); Pogribny, Igor P., E-mail: igor.pogribny@fda.hhs.gov [Division of Biochemical Toxicology, National Center for Toxicological Research, Jefferson, AR 72079 (United States)

2012-07-01

139

Mechanisms of Noncontact Anterior Cruciate Ligament Injury  

PubMed Central

Objective: To examine and summarize previous retrospective and observational studies assessing noncontact anterior cruciate ligament (ACL) injury mechanisms and to examine such reported ACL injury mechanisms based on ACL loading patterns due to knee loadings reported in in vivo, in vitro, and computer simulation studies. Data Sources: We searched MEDLINE from 1950 through 2007 using the key words anterior cruciate ligament + injury + mechanisms; anterior cruciate ligament + injury + mechanisms + retrospective; and anterior cruciate ligament + injury + mechanisms + video analysis. Study Selection: We selected retrospective studies and observational studies that specifically examined the noncontact ACL injury mechanisms (n ?=? 7) and assessed ACL loading patterns in vivo, in vitro, and using computer simulations (n ?=? 33). Data Extraction: The motion patterns reported as noncontact ACL injury mechanisms in retrospective and observational studies were assessed and critically compared with ACL loading patterns measured during applied external or internal (or both) forces or moments to the knee. Data Synthesis: Noncontact ACL injuries are likely to happen during deceleration and acceleration motions with excessive quadriceps contraction and reduced hamstrings co-contraction at or near full knee extension. Higher ACL loading during the application of a quadriceps force when combined with a knee internal rotation moment compared with an external rotation moment was noted. The ACL loading was also higher when a valgus load was combined with internal rotation as compared with external rotation. However, because the combination of knee valgus and external rotation motions may lead to ACL impingement, these combined motions cannot be excluded from the noncontact ACL injury mechanisms. Further, excessive valgus knee loads applied during weight-bearing, decelerating activities also increased ACL loading. Conclusions: The findings from this review lend support to ACL injury prevention programs designed to prevent unopposed excessive quadriceps force and frontal-plane or transverse-plane (or both) moments to the knee and to encourage increased knee flexion angle during sudden deceleration and acceleration tasks. PMID:18668173

Shimokochi, Yohei; Shultz, Sandra J

2008-01-01

140

Hamstring and psoas length of crouch gait in cerebral palsy: a comparison with induced crouch gait in age- and sex-matched controls  

PubMed Central

Background Previous studies have shown that hamstring lengths are often not short in patients with cerebral palsy, which raises concerns over the benefits of distal hamstring lengthening in patients with crouch gait. In this study, the authors measured lengths of hamstrings and psoas muscles in normal subjects mimicking crouch gait and compared these with lengths in cerebral palsy patients with crouch gait. Methods Thirty-six patients with cerebral palsy and crouch gait were included in this study, and in addition, 36 age- and sex-matched normal controls were recruited. Hamstring and psoas muscle lengths in patients were evaluated using gait analysis and interactive musculoskeletal modeling software. Muscle lengths were also measured in the normal control group during normal gait and while mimicking crouch gait, and these were compared with those of cerebral palsy patient with crouch gait. Results No significant differences were observed between maximum hamstring (p=0.810) and maximum psoas (p=0.456) lengths of patients and controls mimicking crouch gait. However, patients showed significantly shorter excursions of hamstring (p=0.022) and psoas (p=0.036) muscles than controls, whereas no significant excursion differences were observed between controls during normal gait and mimicking crouch gait. Conclusions Normal controls mimicking crouch gait and cerebral palsy patients with crouch gait demonstrate similar muscle length patterns. However, mimicked crouch gait did not reproduce the excursion pattern shown by patients with crouch gait, which suggests that reduced hamstring and psoas excursion is an innate characteristic of pathologic crouch gait. PMID:23363928

2013-01-01

141

THE EFFECTS OF INJURY PREVENTION WARM-UP PROGRAMMES ON KNEE STRENGTH IN MALE SOCCER PLAYERS  

PubMed Central

The study investigates the effects of the 11+ and HarmoKnee injury prevention programmes on knee strength in male soccer players. Under-21-year-old players (n=36) were divided equally into: the 11+, HarmoKnee and control groups. The programmes were performed for 24 sessions (20-25 min each). The hamstrings and quadriceps strength were measured bilaterally at 60°·s-1, 180°·s-1 and 300°·s-1. The concentric quadriceps peak torque (PT) of the 11+ increased by 27.7% at 300°·s-1 in the dominant leg (p<0.05). The concentric quadriceps PT of HarmoKnee increased by 36.6%, 36.2% and 28% in the dominant leg, and by 31.3%, 31.7% and 20.05% at 60°·s-1, 180°·s-1 and 300°·s-1 in the non-dominant leg respectively. In the 11+ group the concentric hamstring PT increased by 22%, 21.4% and 22.1% at 60°·s-1, 180°·s-1 and 300°·s-1, respectively in the dominant leg, and by 22.3%, and 15.7% at 60°·s-1 and 180°·s-1, in the non-dominant leg. In the HarmoKnee group the hamstrings in the dominant leg showed an increase in PT by 32.5%, 31.3% and 14.3% at 60°·s-1, 180°·s-1 and 300°·s-1, and in the non-dominant leg hamstrings PT increased by 21.1% and 19.3% at 60°·s-1 and 180°·s-1 respectively. The concentric hamstrings strength was significantly different between the 11+ and control groups in the dominant (p=0.01) and non-dominant legs (p=0.02). The HarmoKnee programme enhanced the concentric strength of quadriceps. The 11+ and HarmoKnee programmes are useful warm-up protocols for improving concentric hamstring strength in young professional male soccer players. The 11+ programme is more advantageous for its greater concentric hamstring strength improvement compared to the HarmoKnee programme. PMID:24795499

Mokhtar, AH.; Rahnama, N.; Yusof, A.

2013-01-01

142

Effects of whole-body cryotherapy on recovery after hamstring damaging exercise: a crossover study.  

PubMed

The purpose of this study was to examine the effects of whole-body cryotherapy (WBC) on biochemical, pain, and performance parameters during the 5-day recovery period after damaging exercise for hamstrings. Participants completed a bout of damaging exercise for the hamstring muscles on two separate occasions (control and experimental condition) separated by 10 weeks. During the control condition, subjects received no treatment after the damaging exercise. The experimental condition consisted of WBC everyday during the recovery period. WBC included single 3-min daily exposures to low temperatures (-140 to -19 °C) in the cryo-cabin. During the recovery period, subjects were tested for biochemical markers, perceived pain sensation, and physical performance (squat jump, counter movement jump, maximal isometric torque production, and maximally explosive isometric torque production). Majority of the observed variables showed statistically significant time effects (P < 0.05) in control group, which indicates the presence of muscle damage. Significant interaction between the control and WBC condition was evident for the rate of torque development (P < 0.05). Pain measures substantially differed between the WBC and the control condition after the exercise. Results of this study are not completely supportive of the use of WBC for recovery enhancement after strenuous training. PMID:23614691

Fonda, B; Sarabon, N

2013-10-01

143

Head Injuries  

MedlinePLUS

... before. Usually, the injury is minor because your skull is hard and it protects your brain. But ... injuries can be more severe, such as a skull fracture, concussion, or traumatic brain injury. Head injuries ...

144

Comparison of EMG activity of medial and lateral hamstrings during isometric contractions at various cuff weight loads  

Microsoft Academic Search

Since both the medial head (MH) and lateral head (LH) of the hamstring muscles contribute to knee flexion, this study investigated whether the relative electrical activity of these heads remained constant with respect to each other or changed during isometric contractions at five different resistance levels. The relative electrical activity of these two heads was determined by comparing their integrated

Ira M Fiebert; Neil I Spielholz; E. Brooks Applegate; Christina Fox; Jonathan Jaro; Laurel Joel; Laurie Raper

2001-01-01

145

Comparison of Lower Body Specific Resistance Training on the Hamstring to Quadriceps Strength Ratios in Men and Women  

ERIC Educational Resources Information Center

In this study, we compared hamstring (H) and quadriceps (Q) strength changes in men and women, as well as changes in conventional and functional H:Q ratios following an identical 12-week resistance training program. An isokinetic dynamometer was used to assess 14 male and 14 female participants before and after the intervention, and conventional…

Dorgo, Sandor; Edupuganti, Pradeep; Smith, Darla R.; Ortiz, Melchor

2012-01-01

146

Effect of knee joint laxity on long-loop postural reflexes: evidence for a human capsular-hamstring reflex.  

PubMed

The onset latency and discharge amplitude of preprogrammed postural responses were evaluated in order to determine if the structure of synergistic activation could be altered by ligamentous laxity at the knee joint. Twelve subjects with unilateral and one subject with bilateral anterior cruciate ligament (ACL) insufficiency were tested while standing on a moveable platform. External balance perturbations (6 cm anterior or posterior horizontal displacements of the platform) were presented at velocities ranging from 15 to 35 cm/s. Perturbations were presented under the following experimental conditions: unilateral and bilateral stance, knees fully straight or flexed, and with ankle motion restricted or free. These stance, knee position, and ankle motion conditions were introduced to alter the stress transmitted to the knee joint during movement of the support surface. The automatic postural response was recorded from the tibialis anterior (T), quadriceps (Q), and medial hamstrings muscles (H) bilaterally. The normal response to an externally induced backward sway involved the automatic activation of T and Q at latencies of 80 ms and 90 ms respectively. Activation of the hamstrings in the non-injured extremity was not coupled with the postural response. Hamstrings are not typically involved in the correction posterior sway because H activation would tend to pull the center of mass further backwards. However, when the response in the ACL-deficient extremity was compared to the non-injured limb: (1) the automatic postural response in the ACL-deficient extremity was restructured to include hamstrings activation (100 ms latency), (2) H activation time was faster and less variable in the ACL-deficient limb, and (3) the ratio of H/Q discharge amplitude integrated over 100 ms and 200 ms from the onset of EMG activation showed a dominance of hamstring activity during unilateral stance on the lax limb. In addition, H/Q ratios integrated over 200 ms showed dominant hamstring activity in the ACL-deficient limb during bilateral stance. (4) Cross-limb comparisons showed greater normalized IEMG amplitudes for T, H, and Q during unilateral stance on the lax limb. These results suggest that a capsular-hamstring reflex is integrated into the existing structure of a preprogrammed postural synergy in order to compensate for ligamentous laxity. Furthermore, the generalized increase of response gain observed during perturbations of unilateral stance on the lax limb indicates that joint afference can modulate central programming to control localized joint hypermobility. A concept of postural control is discussed with respect to the capsular reflex, joint loading and displacement of the center of gravity. PMID:1521607

Di Fabio, R P; Graf, B; Badke, M B; Breunig, A; Jensen, K

1992-01-01

147

The Interaction of Trunk-Load and Trunk-Position Adaptations on Knee Anterior Shear and Hamstrings Muscle Forces During Landing  

PubMed Central

Abstract Context: Because anterior cruciate ligament (ACL) injuries can occur during deceleration maneuvers, biomechanics research has been focused on the lower extremity kinetic chain. Trunk mass and changes in trunk position affect lower extremity joint torques and work during gait and landing, but how the trunk affects knee joint and muscle forces is not well understood. Objective: To evaluate the effects of added trunk load and adaptations to trunk position on knee anterior shear and knee muscle forces in landing. Design: Crossover study. Setting: Controlled laboratory environment. Patients or Other Participants: Twenty-one participants (10 men: age ?=? 20.3 ± 1.15 years, height ?=? 1.82 ± 0.04 m, mass ?=? 78.2 ± 7.3 kg; 11 women: age ?=? 20.0 ± 1.10 years, height ?=? 1.72 ± 0.06 m, mass ?=? 62.3 ± 6.4 kg). Intervention(s): Participants performed 2 sets of 8 double-leg landings under 2 conditions: no load and trunk load (10% body mass). Participants were categorized into one of 2 groups based on the kinematic trunk adaptation to the load: trunk flexor or trunk extensor. Main Outcome Measure(s): We estimated peak and average knee anterior shear, quadriceps, hamstrings, and gastrocnemius forces with a biomechanical model. Results: We found condition-by-group interactions showing that adding a trunk load increased peak (17%) and average (35%) knee anterior shear forces in the trunk-extensor group but did not increase them in the trunk-flexor group (peak: F1,19 ?=? 10.56, P ?=? .004; average: F1,19 ?=? 9.56, P ?=? .006). We also found a main effect for condition for quadriceps and gastrocnemius forces. When trunk load was added, peak (6%; F1,19 ?=? 5.52, P ?=? .030) and average (8%; F1,19 ?=? 8.83, P ?=? .008) quadriceps forces increased and average (4%; F1,19 ?=? 4.94, P ?=? .039) gastrocnemius forces increased, regardless of group. We found a condition-by-group interaction for peak (F1,19 ?=? 5.16, P ?=? .035) and average (F1,19 ?=? 12.35, P ?=? .002) hamstrings forces. When trunk load was added, average hamstrings forces decreased by 16% in the trunk-extensor group but increased by 13% in the trunk-flexor group. Conclusions: Added trunk loads increased knee anterior shear and knee muscle forces, depending on trunk adaptation strategy. The trunk-extensor adaptation to the load resulted in a quadriceps-dominant strategy that increased knee anterior shear forces. Trunk-flexor adaptations may serve as a protective strategy against the added load. These findings should be interpreted with caution, as only the face validity of the biomechanical model was assessed. PMID:20064042

Kulas, Anthony S.; Hortobágyi, Tibor; DeVita, Paul

2010-01-01

148

Dynamic neuromuscular analysis training for preventing anterior cruciate ligament injury in female athletes.  

PubMed

Female athletes are four to six times more likely to sustain an anterior cruciate ligament (ACL) injury than male athletes. Since the enactment of Title IX, male athletic participation at the high school level has remained steady (3.8 million), whereas female athletic participation has increased tenfold (from 0.3 to 3.0 million). Geometric growth in athletic participation and the higher injury rate in female athletes have led to gender inequity in ACL injury rates. Most ACL injuries occur as a result of noncontact mechanisms such as during landing from a jump or while making a lateral pivot. Dynamic knee instability, caused by ligament dominance (decreased dynamic neuromuscular control of the joint), quadriceps dominance (decreased hamstring strength and recruitment), and leg dominance (side-to-side differences in strength and coordination) may be responsible for gender inequity in ACL injury rates. PMID:17472323

Hewett, Timothy E; Myer, Gregory D; Ford, Kevin R; Slauterbeck, James R

2007-01-01

149

Reducing muscle injuries and reinjuries in one italian professional male soccer team  

PubMed Central

Summary Background. The incidence rate of muscle injuries and re-injuries in professional elite soccer players actually is very high and may interfere with the fate of a championship. Purpose. To investigate the effect of a two-tiered injury prevention programme on first injury and re-injury incidence in top level male soccer players. Study design Case Series Study. Muscle injuries and re-injuries sustained by a group of 36 soccer player of an italian elite soccer team have been collected during 2010–2011 season. These data have been compared with those collected during the previous season in the same elite soccer team. Results. A total of 64 injuries occurred, 36 (56%) of which during practice and 28 (44%) during matches. Muscle injuries accounted for 31.3% of the total (n=20), 70% (n=14) of which occurred during practice and 30% (n=6) during matches. Hamstring were the muscles most often injured (n=11) In all, 3 re-injuries occurred (15% of muscle injuries). No early re-injuries occurred. The incidence was 2.5 injuries/1000 hours and the burden was 37 days absence/1000 hours. Conclusions. Through the implementation of a group and personalized injury prevention program, we were able to reduce the total number of muscle injuries and days absent because of injury, in a team of elite soccer players, as compared to the previous season. Specifically, muscle injuries accounted for 31% of all injuries, as compared to 59% of all injuries sustained by the team during the previous season. The number of injuries/1000 hours of exposure was reduced by half (from 5.6 to 2.5) and the days absent/1000 hours fell from 106 to 37. PMID:24596697

Melegati, Gianluca; Tornese, Davide; Gevi, Maurizio; Trabattoni, Alessandro; Pozzi, Grazia; Schonhuber, Herbert; Volpi, Piero

2013-01-01

150

Biomechanical evaluation of a bioabsorbable expansion bolt for hamstring graft fixation in ACL reconstruction: an experimental study in calf tibial bone  

Microsoft Academic Search

Introduction: The purpose of our study was to evaluate and compare the primary fixation strength of a novel bioabsorbable two shell expansion bolt (EB) with that of a well-established interference screw-fixation technique in hamstring reconstruction of the anterior cruciate ligament. Materials and methods: Thirty calf tibia plateaus (age 5–6 months) were assigned to three groups: In group I (n=10) triple-stranded hamstring

S. Piltz; R. Dieckmann; L. Meyer; P. Strunk; W. Plitz; G. Lob

2005-01-01

151

Compaction Drilling Does Not Increase the Initial Fixation Strength of the Hamstring Tendon Graft in Anterior Cruciate Ligament Reconstruction in a Cadaver Model  

Microsoft Academic Search

Background: Compaction of the bone tunnel walls has been proposed to increase the fixation strength of soft tissue grafts fixed with an interference screw in anterior cruciate ligament reconstructions.Hypothesis: Compaction drilling does not increase the initial fixation strength of the hamstring tendon graft in comparison with conventional extraction drilling.Study Design: Randomized experimental study.Methods: Initial fixation strength of quadrupled hamstring tendon

Janne T. Nurmi; Pekka Kannus; Harri Sievänen; Markku Järvinen; Teppo L. N. Järvinen

2003-01-01

152

Arthroscopic Reconstruction of the Anterior Cruciate Ligament With Hamstring Tendon Autograft and Fresh-Frozen Allograft: A Prospective, Randomized Controlled Study  

Microsoft Academic Search

Background: Most studies of allograft versus autograft for anterior cruciate ligament reconstruction have been of bone–patellar tendon–bone; outcome reports evaluating anterior cruciate ligament reconstruction with hamstring tendon autograft versus allograft are rare.Purpose: This study was undertaken to compare the clinical outcome of arthroscopic anterior cruciate ligament reconstruction with hamstring tendon autograft versus allograft.Study Design: Randomized controlled trial; Level of evidence,

Kang Sun; Jihua Zhang; Yan Wang; Changsuo Xia; Cailong Zhang; Tengbo Yu; Shaoqi Tian

2011-01-01

153

An in vivo analysis of the effect of transcutaneous electrical stimulation of the quadriceps and hamstrings on anterior cruciate ligament deformation  

Microsoft Academic Search

Transcutaneous electrical muscle stimulation (TEMS) has been advocated as a method to rehabilitate the postoperative ACL repaired\\/reconstructed lower ex tremity. Isolated quadriceps contraction can potentially disrupt the ACL repair\\/reconstruction; to minimize this risk simultaneous quadriceps and hamstring stimulation has been used. This study measured the in vivo defor mation of the ACL during TEMS of the quadriceps and hamstrings.Six legs

Christopher C. Kain; John A. McCarthy; Steve Arms; Malcolm H. Pope; J. Richard Steadman; Paul R. Manske; Robert A. Shively

1988-01-01

154

Early versus late start of open kinetic chain quadriceps exercises after ACL reconstruction with patellar tendon or hamstring grafts: a prospective randomized outcome study  

Microsoft Academic Search

The purpose of the present investigation was to evaluate physical outcome after anterior cruciate ligament (ACL) reconstruction\\u000a with early versus late initiation of open kinetic chain (OKC) exercises for the quadriceps in patients operated on either\\u000a patellar tendon or hamstring grafts. Sixty-eight patients, 36 males and 32 females, with either patellar tendon graft (34\\u000a patients) or hamstring graft (34 patients)

Annette Heijne; Suzanne Werner

2007-01-01

155

Mechanical evaluation of cross pins used for femoral fixation of hamstring grafts in ACL reconstructions.  

PubMed

The goal of this study was to test the mechanical strength of 4 different cross pins currently available for femoral fixation by loading each cross pin to failure as received and determine the effect of 1 million cycles of fatigue loading. Additionally, the strength of resorbable pins was tested after prolonged exposure to biologic conditions. Six implants each of the Arthrotek LactoSorb (Biomet, Warsaw, Indiana), Mitek RigidFix (DePuy Mitek Inc, Raynham, Massachusetts), Arthrotek Bone Mulch Screw (Biomet), cortical allograft, and control were tested for 3-point failure without prior loading and after cyclic loading between 50 to 200 N at 10 Hz for 1 million cycles. The bioabsorbable pins were placed in sterile water at 37°C and tested after 2, 4, and 6 months for 3-point failure strength. All implants tested without antecedent loading demonstrated adequate strength for initial fixation for hamstring grafts. During fatigue testing, RigidFix implants (n=6) failed at 18,893±8365 cycles (with a central deformation of 0.48±0.11 mm prior to fracture). All of the other implants tested endured 1 million cycles of loading (50-200 N) without fracture or 1.5 mm central deformation. Neither of the bioabsorbable pins demonstrated a significant change in yield strength after prolonged exposure to water. All implants tested demonstrated adequate strength for initial fixation of hamstring grafts. The metal and bone implants far exceed the strength required to sustain mechanical fixation until biological fixation occurs; both polymeric implants demonstrated that they maintained enough mechanical strength to achieve this goal. PMID:20954667

Bellisari, Gregory E; Kaeding, Christopher C; Litsky, Alan S

2010-10-01

156

Strains and Sprains  

MedlinePLUS

... too far. It's common for people to strain the muscles in their backs, necks, or legs. What do you do to prevent strains and other sports injuries? Bones meet at joints, such as elbows, knees, or shoulders. That's where your body bends ...

157

The importance of quadriceps and hamstring muscle loading on knee kinematics and in-situ forces in the ACL  

Microsoft Academic Search

This study investigated the effect of hamstring co-contraction with quadriceps on the kinematics of the human knee joint and the in-situ forces in the anterior cruciate ligament (ACL) during a simulated isometric extension motion of the knee. Cadaveric human knee specimens (n=10) were tested using the robotic\\/universal force–moment sensor (UFS) system and measurements of knee kinematics and in-situ forces in

G Li; T. W Rudy; M Sakane; A Kanamori; C. B Ma; S. L.-Y Woo

1999-01-01

158

The combined effect of cycling cadence and crank resistance on hamstrings and quadriceps muscle activities during cycling.  

PubMed

The effect of cycling cadence and crank resistance on the activity of hamstrings and quadriceps muscles was investigated during cycling movements of able-bodied subjects on a stationary bike with slow and fast speed against different resistance conditions. The ratio of average EMG amplitudes obtained in the two speed conditions (fast/slow) was computed in each resistance condition. This ratio is higher for both muscles if cycling against higher resistance. This shows that in higher resistance condition muscle activities are not only increased but the change of muscle activities with respect to cadence change varied according to resistance condition. Average EMG amplitudes increased at a higher rate with respect to change of cadence when cycling was performed in higher resistance condition. Besides, when cycling faster, hamstrings activity increased generally at a higher rate than that of quadriceps. The correlation between cadence and EMG amplitudes were also investigated. Considering hamstrings, this correlation was low and decreased as resistance increased. The correlation between the time required to drive one cycle and EMG amplitude is negative but in absolute value it is larger than the correlation of cadence and EMG amplitude. PMID:25532958

Katona, P; Pilissy, T; Tihanyi, A; Laczkó, József

2014-12-01

159

Cross Pins versus Endobutton Femoral Fixation in Hamstring Anterior Cruciate Ligament Reconstruction: Minimum 4-Year Follow-Up  

PubMed Central

Purpose We aimed to compare cross-pin fixation and Endobutton femoral fixation for hamstring anterior cruciate ligament (ACL) reconstruction with respect to clinical and radiographic results, including tunnel widening and the progression of knee osteoarthritis (OA). Materials and Methods Between August 2002 and August 2005, 126 autogenous hamstring ACL reconstructions were performed using either cross pins or Endobutton for femoral fixation. Fifty-six of 75 patients in the cross-pin group and 35 of 51 patients in the Endobutton group were followed up for a minimum of 4 years. We compared the clinical and radiological results between the groups using the International Knee Documentation Committee (IKDC) evaluation form, the KT-2000 arthrometer side to side difference, the amount of tunnel widening and the advancement of OA on radiographs. Results There were no significant differences in the IKDC grades between the groups at the 4 year follow-up. There was no significant difference in the side to side difference according to KT-2000 arthrometer testing. Also, there were no significant differences in terms of tunnel widening or advancement of OA on radiographs. Conclusions Endobutton femoral fixation showed good results that were comparable to those of cross pins fixation in hamstring ACL reconstruction. PMID:22570850

Kong, Chae-Gwan; Kim, Geon-Hyeong; Ahn, Chi-Young

2012-01-01

160

Comparison of hamstring muscle behavior for anterior cruciate ligament (ACL) patient and normal subject during local marching  

NASA Astrophysics Data System (ADS)

This study aims to investigate the hamstring muscle activity after the surgery by carrying out an electromyography experiment on the hamstring and to compare the behavior of the ACL muscle activity between ACL patient and control subject. Electromyography (EMG) is used to study the behavior of muscles during walking activity. Two hamstring muscles involved which are semitendinosus and bicep femoris. The EMG data for both muscles were recorded while the subject did maximum voluntary contraction (MVC) and marching. The study concluded that there were similarities between bicep femoris of the ACL and control subjects. The analysis showed that the biceps femoris muscle of the ACL subject had no abnormality and the pattern is as normal as the control subject. However, ACL patient has poor semitendinosus muscle strength compared to that of control subject because the differences of the forces produced. The force of semitendinosus value for control subject was two times greater than that of the ACL subject as the right semitendinosus muscle of ACL subject was used to replace the anterior cruciate ligament (ACL) that was injured.

Amineldin@Aminudin, Nurul Izzaty Bt.; Rambely, A. S.

2014-09-01

161

Changes in Locomotor Muscle Activity After Treadmill Training in Subjects With Incomplete Spinal Cord Injury  

PubMed Central

Intensive treadmill training after incomplete spinal cord injury can improve functional walking abilities. To determine the changes in muscle activation patterns that are associated with improvements in walking, we measured the electromyography (EMG) of leg muscles in 17 individuals with incomplete spinal cord injury during similar walking conditions both before and after training. Specific differences were observed between subjects that eventually gained functional improvements in overground walking (responders), compared with subjects where treadmill training was ineffective (nonresponders). Although both groups developed a more regular and less clonic EMG pattern on the treadmill, it was only the tibialis anterior and hamstring muscles in the responders that displayed increases in EMG activation. Likewise, only the responders demonstrated decreases in burst duration and cocontraction of proximal (hamstrings and quadriceps) muscle activity. Surprisingly, the proximal muscle activity in the responders, unlike nonresponders, was three- to fourfold greater than that in uninjured control subjects walking at similar speeds and level of body weight support, suggesting that the ability to modify muscle activation patterns after injury may predict the ability of subjects to further compensate in response to motor training. In summary, increases in the amount and decreases in the duration of EMG activity of specific muscles are associated with functional recovery of walking skills after treadmill training in subjects that are able to modify muscle activity patterns following incomplete spinal cord injury. PMID:19073799

Gorassini, Monica A.; Norton, Jonathan A.; Nevett-Duchcherer, Jennifer; Roy, Francois D.; Yang, Jaynie F.

2009-01-01

162

Changes in locomotor muscle activity after treadmill training in subjects with incomplete spinal cord injury.  

PubMed

Intensive treadmill training after incomplete spinal cord injury can improve functional walking abilities. To determine the changes in muscle activation patterns that are associated with improvements in walking, we measured the electromyography (EMG) of leg muscles in 17 individuals with incomplete spinal cord injury during similar walking conditions both before and after training. Specific differences were observed between subjects that eventually gained functional improvements in overground walking (responders), compared with subjects where treadmill training was ineffective (nonresponders). Although both groups developed a more regular and less clonic EMG pattern on the treadmill, it was only the tibialis anterior and hamstring muscles in the responders that displayed increases in EMG activation. Likewise, only the responders demonstrated decreases in burst duration and cocontraction of proximal (hamstrings and quadriceps) muscle activity. Surprisingly, the proximal muscle activity in the responders, unlike nonresponders, was three- to fourfold greater than that in uninjured control subjects walking at similar speeds and level of body weight support, suggesting that the ability to modify muscle activation patterns after injury may predict the ability of subjects to further compensate in response to motor training. In summary, increases in the amount and decreases in the duration of EMG activity of specific muscles are associated with functional recovery of walking skills after treadmill training in subjects that are able to modify muscle activity patterns following incomplete spinal cord injury. PMID:19073799

Gorassini, Monica A; Norton, Jonathan A; Nevett-Duchcherer, Jennifer; Roy, Francois D; Yang, Jaynie F

2009-02-01

163

Spinal injury  

MedlinePLUS

... Pa: Elsevier Mosby; 2009:chap 40. Torg JS. Cervical Spine Injuries: 1. Cervical spine injuries in the adult. In: DeLee JC, Drez ... chap 16, section A. Pizzutillo PD, Herman MJ. Cervical spine injuries: 2. Cervical spine injuries in the child. ...

164

Arthrogenic quadriceps inhibition and rehabilitation of patients with extensive traumatic knee injuries.  

PubMed

1. The relationship between joint damage, quadriceps weakness and arthrogenic muscle inhibition was investigated in eight patients who had sustained extensive traumatic knee injury. Isometric and isokinetic quadriceps and hamstring voluntary strength, and quadriceps arthrogenic muscle inhibition during isometric contractions, were measured before and after 4 weeks (approximately 100 h) of intensive rehabilitation. 2. Compared with the uninjured leg, before rehabilitation the injured leg had larger amounts of quadriceps arthrogenic muscle inhibition (P < 0.025), quadriceps (P < 0.0001) and hamstring (P < 0.0001) weakness and severe functional joint instability. There was a negative correlation between the amount of arthrogenic muscle inhibition and quadriceps voluntary contraction force (P < 0.025). 3. After rehabilitation in the injured leg there were small hamstring strength increases (P < 0.05-0.025), but no overall significant quadricep strength increase. Arthrogenic muscle inhibition was statistically unchanged. Severe functional joint instability was still reported by all patients. 4. Previous studies have shown that minimal joint damage evokes relatively less arthrogenic muscle inhibition that does not impede rehabilitation. These data indicate that greater joint damage is associated with greater arthrogenic muscle inhibition, quadriceps weakness and joint instability. Furthermore, intensive rehabilitation had little affect on either quadriceps arthrogenic muscle inhibition or atrophy. PMID:8156741

Hurley, M V; Jones, D W; Newham, D J

1994-03-01

165

An In Vitro Uniaxial Stretch Model for Axonal Injury  

Microsoft Academic Search

We have developed a unique uniaxial stretching device to study axonal injury and neural cell death resulting from brain tissue deformations common in traumatic head injuries. Using displacement control rather than force control, this device is capable of achieving strains >70% and strain rates up to 90 s-1, well above those currently used for studying axonal injury. We have demonstrated

Bryan J. Pfister; Timothy P. Weihs; Michael Betenbaugh; Gang Bao

2003-01-01

166

Plasma microRNAs are sensitive indicators of inter-strain differences in the severity of liver injury induced in mice by a choline- and folate-deficient diet  

PubMed Central

MicroRNAs (miRNAs) are a class of small, conserved, tissue-specific regulatory non-coding RNAs that modulate a variety of biological processes and play a fundamental role in pathogenesis of major human diseases, including nonalcoholic fatty liver disease (NAFLD). However, the association between inter-individual differences in susceptibility to NAFLD and altered miRNA expression is largely unknown. In view of this, the goals of the present study were (i) to determine whether or not individual differences in the extent of NAFLD-induced liver injury are associated with altered miRNA expression, and (ii) assess if circulating blood miRNAs may be used as potential biomarkers for the noninvasive evaluation of the severity of NAFLD. A panel of seven genetically diverse strains of inbred male mice (A/J, C57BL/6J, C3H/HeJ, 129S/SvImJ, CAST/EiJ, PWK/PhJ, and WSB/EiJ) were fed a choline- and folate-deficient (CFD) diet for 12 weeks. This diet induced liver injury in all mouse strains; however, the extent of NAFLD-associated pathomorphological changes in the livers was strain-specific, with A/J, C57BL/6J, and C3H/HeJ mice being the least sensitive and WSB/EiJ mice being the most sensitive. The morphological changes in the livers were accompanied by differences in the levels of hepatic and plasma miRNAs. The levels of circulating miR-34a, miR-122, miR-181a, miR-192, and miR-200b miRNAs were significantly correlated with a severity of NAFLD-specific liver pathomorphological features, with the strongest correlation occurring with miR-34a. These observations suggest that the plasma levels of miRNAs may be used as biomarkers for noninvasive monitoring the extent of NAFLD-associated liver injury and susceptibility to NAFLD. PMID:22561871

Tryndyak, Volodymyr P.; Latendresse, John R.; Montgomery, Beverly; Ross, Sharon A.; Beland, Frederick A.; Rusyn, Ivan; Pogribny, Igor P.

2014-01-01

167

A descriptive study of a manual therapy intervention within a randomised controlled trial for hamstring and lower limb injury prevention  

Microsoft Academic Search

BACKGROUND: There is little literature describing the use of manual therapy performed on athletes. It was our purpose to document the usage of a sports chiropractic manual therapy intervention within a RCT by identifying the type, amount, frequency, location and reason for treatment provided. This information is useful for the uptake of the intervention into clinical settings and to allow

Wayne Hoskins; Henry Pollard

2010-01-01

168

The comparison of the immediate effects of application of the suboccipital muscle inhibition and self-myofascial release techniques in the suboccipital region on short hamstring  

PubMed Central

[Purpose] The purpose of this study was to research the effect of performing the suboccipital muscle inhibition (SMI) and self-myofascial release (SMFR) techniques in the suboccipital area on the flexibility of the hamstring. [Subjects] Fifty persons with short hamstrings participated in this research. According to the results of the finger-floor distance (FFD) test, the subjects were allocated to SMI and SMFR groups of 25 subjects each. [Methods] The SMI and SMFR techniques were applied to the groups. For the analysis, we used the FFD test and the straight leg raise (SLR) test for the flexibility of hamstring. The evaluator was blindfolded. [Results] In the SMI group, FFD, SLR, and PA were significantly changed after the intervention, and in the SMFR group, there was a significant change in SLR after the intervention. In a comparison between the groups, FED was found to be significantly increased in the SMI group. [Conclusion] Application of the SMI and SMFR to persons with short hamstrings resulted in immediate increases in flexibility of the hamstring. However, we could see that the SMI technique was more effective. PMID:25642072

Cho, Sung-Hak; Kim, Soo-Han; Park, Du-Jin

2015-01-01

169

Tibial Inlay Technique Using Hamstring Graft for Posterior Cruciate Ligament Reconstruction and Remnant Revision  

PubMed Central

The posterior tibial inlay technique is currently accepted as a standard operation for the posterior cruciate ligament–deficient knee. The classical technique requires a graft construct consisting of a bony part to be fitted into the posterior tibial socket. When an autogenous source is chosen, morbidity at the donor site generated by obtaining the graft with a bony part (e.g., bone–patellar tendon–bone or quadriceps tendon–bone) can be more serious than when obtaining the soft-tissue graft (e.g., hamstring). This study describes an alternative use of soft-tissue graft anchored in a bone socket at the posterior tibial margin by a transfixing cancellous screw. The graft is secured on top by a “bone washer” harvested from this bone socket to provide biological bone-tendon-bone healing. The posterior cruciate ligament remnant with integral fibers at the femur can have its tibial part revised, tensioned, and reattached concomitantly. This additional procedure is deemed to enhance joint stability and promote graft healing. PMID:23767002

Laupattarakasem, Wiroon; Boonard, Manusak; Laupattarakasem, Pat; Kosuwon, Weerachai

2012-01-01

170

Anatomic double-bundle posterior cruciate ligament reconstruction using hamstring tendons.  

PubMed

Recent biomechanical studies have shown that an anatomic double-bundle posterior cruciate ligament (PCL) reconstruction is superior in restoring normal knee laxity compared with the conventional single-bundle isometric reconstruction. We describe a modification of an endoscopic PCL reconstruction technique using a double-bundle Y-shaped hamstring tendon graft. A double- or triple-bundle semitendinosus-gracilis tendon graft is used and directly fixed with soft threaded biodegradable interference screws. In the medial femoral condyle, 2 femoral tunnels are created inside-out through a low anterolateral arthroscopic portal. First, in 80 degrees of flexion, the double-stranded gracilis graft is fixed with an interference screw inside the lower femoral socket, representing the insertion site of the posteromedial bundle. In full extension the combined semitendinosus-gracilis graft is pretensioned and fixed inside the posterior aspect of the single tibial tunnel. The double- or triple-stranded semitendinosus tendon is inserted in the higher femoral tunnel, presenting the insertion site of the anterolateral bundle. Finally, pretension is applied to the semitendinosus bundle in 70 degrees of flexion and a third screw is inserted. Using this technique, the stronger semitendinosus part of the double-bundle graft, which mimics the anterolateral bundle of the PCL, is fixed in flexion, whereas the smaller gracilis tendon part (posteromedial bundle) is fixed in full extension. Thus, a fully arthroscopic anatomic PCL reconstruction technique is available that may better restore normal knee kinematics as compared to the single-stranded isometric reconstruction. PMID:11154375

Stähelin, A C; Südkamp, N P; Weiler, A

2001-01-01

171

Hamstrings-to-quadriceps strength and size ratios of male professional soccer players with muscle imbalance.  

PubMed

The aim of this study was to determine the correlation between the concentric hamstrings/quadriceps muscle strength (Hcon :Qcon ) and cross-sectional area ratios (Hcsa :Qcsa ) in professional soccer players with Hcon :Qcon imbalance. Nine male professional soccer players (25·3 ± 4·1 years) performed five maximal concentric contractions of the knee extensors (KE) and flexors (KF) at 60 s(-1) to assess Hcon :Qcon . The test was performed using the dominant (preferred kicking), and non-dominant limb with a 5-min recovery period was allowed between them. Only players with Hcon :Qcon  < 0·60 (range: 0·45-0·59) in both limbs were included in this study. The muscle cross-sectional area (CSA) of KE and KF was determined by magnetic resonance imaging. The correlations between Hcon :Qcon and Hcsa :Qcsa in the dominant leg (r = -0·33), non-dominant leg (r = 0·19) and in the both legs combined (r = 0·28) were not statistically significant (P>0·05). Thus, the Hcon :Qcon seems not to be determined by Hcsa :Qcsa in professional soccer players with Hcon :Qcon imbalance. PMID:25348722

Denadai, Benedito Sérgio; de Oliveira, Felipe Bruno Dias; Camarda, Sérgio Ricardo de Abreu; Ribeiro, Leandro; Greco, Camila Coelho

2014-10-27

172

Alterations in quadriceps and hamstrings coordination in persons with medial compartment knee osteoarthritis  

PubMed Central

Altered muscle coordination strategies in persons with knee osteoarthritis (OA) result in an increase in co-contraction of the quadriceps and hamstrings during walking. While this may increase intersegmental joint contact force and expedite disease progression, it is not currently known whether the magnitude of co-contraction increases with a progressive loss of joint space or whether the level of co-contraction is dependent on walking speed. The purposes of this study were to (1) determine if co-contraction increased with OA severity and (2) discern whether differences in co-contraction were a result of altered freely chosen walking speeds or rather an inherent change associated with disease progression. Forty-two subjects with and without knee osteoarthritis were included in the study. Subjects were divided into groups based on disease severity. When walking at a controlled speed of 1.0 m/s, subjects with moderate and severe knee OA showed significantly higher co-contraction when compared to a healthy control group. At freely chosen walking speeds only the moderate OA group had significantly higher co-contraction values. Increased walking speed also resulted in a significant increase in co-contraction, regardless of group. The results of this study demonstrate that persons with knee OA develop higher antagonistic muscle activity. This occurs despite differences in freely chosen walking speed. Although subjects with OA had higher co-contraction than the control group, co-contraction may not increase with disease severity. PMID:19223203

Zeni, Joseph A.; Rudolph, Katherine; Higginson, Jill S.

2009-01-01

173

Avaliação da funcionalidade dos trabalhadores com LER\\/DORT: a construção do Core Set da CIF para LER\\/DORT Evaluation of the functionality of workers with Repetitive Strain Injury (RSI)\\/ Work related musculoskeletal disorders (MSDs): the construction of the ICF Core Set for RSI\\/ MSDs  

Microsoft Academic Search

This study presents the ICF Core Set for Repetitive Strain Injury (RSI)\\/ Work-related musculoskeletal disorders (MSDs) and its cons- truction process. It is the report of the creation of a Core Set based on an interdisciplinary approach. The ICF Core Set for RSI\\/MSDs was created through successive consensuses among specialists in the workers' healthcare area throughout six phases, which involved

Mônica Angelim; Gomes de Lima; Robson da Fonseca Neves; Márcia Oliveira Staffa Tironi; Ana Márcia; Francesca de Brito Magalhães

2008-01-01

174

Treatment for strained back (image)  

MedlinePLUS

... to treat and alleviate symptoms of a strained back. Anti-inflammatory medications (such as ibuprofen) can help, and stretching and strengthening of the back muscles is important to avoid another back injury.

175

Football Injuries  

MedlinePLUS

... usually be treated by a quadriceps strengthening program. Heat Injuries Heat injuries are a major concern for youth football ... cooling and fluid replacement, this can progress to heat exhaustion and heat stroke — which can even result ...

176

The effect of an eccentrically-biased hamstring strengthening home program on knee flexor strength and the length-tension relationship.  

PubMed

The purposes of this study were to document relative activation intensities of the hamstrings and gluteus maximus during 4 eccentric hamstring strengthening exercises and to assess the effects of a short-term strengthening program comprised of these exercises on knee flexor strength and the length-tension relationship. Twelve healthy subjects participated in this study. Electromyographic activities from the biceps femoris, semitendinosus and gluteus maximus were recorded as subjects performed: (1) standing hip extension with elastic resistance, (2) trunk flexion in single limb stance (Diver), (3) standing split (Glider), and (4) supine sliding bridge (Slider). Baseline isometric knee flexor strength was measured at 90, 70, 50 and 30 degrees of flexion at the knee with the subject seated and the hip flexed to 50 degrees from horizontal. After completing the four-week training program, strength tests were repeated. Repeated-measures ANOVA were used to compare EMG activity between muscles and to assess angle-specific strength improvements. Hamstring activity exceeded gluteus maximus activity for resisted hip extension, Glider and Slider exercises (p < 0.001) but not for the Diver (p = 0.087). Hamstring activation was greatest during the Slider and resisted hip extension and lowest during the Glider and the Diver. Knee flexor strength improved by 9.0% (p = 0.005), but was not angle-specific (Training by Angle p = 0.874). The short-term home training program effectively targeted the hamstrings and resulted in strength gains that were similar at short and long muscle lengths. These data demonstrate that hamstring strength can be improved using eccentrically biased unilateral exercises without the use of weights or other equipment. PMID:25226327

Orishimo, Karl F; McHugh, Malachy P

2014-09-15

177

Skateboard injuries  

Microsoft Academic Search

One hundred and nineteen cases of injuries sustained by skateboard users are reviewed. A significant proportion of the injuries sustained were fractures. The absence of adequate protective measures was noted. A decrease in the popularity of the sport, as judged by the annual incidence of skateboard injuries, is apparent in this series.

M. Sheila Christian; O. Khan

1980-01-01

178

Isokinetic concentric quadriceps and hamstring normative data for elite collegiate American football players participating in the NFL Scouting Combine.  

PubMed

Isokinetic concentric quadriceps and hamstring strength data using a Cybex dynamometer are collected for elite collegiate American football players invited to the annual National Football League Scouting Combine. We constructed a normative (reference) database of the Cybex strength data for the purpose of allowing comparison of an individual's values to his peers. Data reduction was performed to construct frequency distributions of hamstring/quadriceps (H/Q) ratios and side-to-side strength differences. For the cohort (n = 1,252 players), a statistically significant but very small (1.9%) mean quadriceps strength preference existed for dominant side vs. nondominant side. Peak torque (Newton meters, best repetition) for quadriceps and hamstrings was significantly correlated to player body mass (weight) (the same relationship was found for other variables using peak torque in the calculation). Peak torque varied by player position, being greatest for offensive linemen and lowest for kickers (p < 0.0001). Adjusting for body weight overcorrected these differences. The H/Q ratios and frequency distributions were similar across positions, with a mean of 0.6837 ± 0.137 for the cohort dominant side vs. 0.6940 ± 0.145 for the nondominant side (p = 0.021, n = 1,252). Considerable variation was seen for dominant-to-nondominant side difference for peak torque. For quadriceps, 47.2% of players had differences between -10% and +10%, 21.0% had a peak torque dominant-side deficit of 10% or greater compared to nondominant side, and for 31.8% of players, dominant-side peak torque was greater than 10% compared to nondominant side. For hamstrings, 57.0% of players had differences between -10% and +10%, 19.6% had a peak torque dominant-side deficit of 10% or greater compared to nondominant side, and 23.4% of players, dominant-side peak torque was greater than 10% compared to nondominant side. We observed that isokinetic absolute strength variables are dependent on body weight and vary across player position. The H/Q ratios vary only within a relatively narrow range. Side-to-side differences in strength variables >10% are common, not the exception. PMID:23820564

Zvijac, John E; Toriscelli, Todd A; Merrick, W Shannon; Papp, Derek F; Kiebzak, Gary M

2014-04-01

179

Fatigue and rapid hamstring/quadriceps force capacity in professional soccer players.  

PubMed

The aim of this study was to investigate the effect of fatigue induced by an exhaustive laboratory-based soccer-specific exercise on different hamstrings/quadriceps (H:Q) ratios of soccer players. Twenty-two male professional soccer players (23·1 ± 3·4 year) performed maximal eccentric (ecc) and concentric (con) contractions for knee extensors (KE) and flexors (KF) at 60° s(-1) and 180° s(-1) to assess conventional (H(con) :Q(con)) and functional (H(ecc) :Q(con)) ratios. Additionally, they performed maximal voluntary isometric contraction for KE and KF, from which the maximal muscle strength, rate of force development (RFD) and RFD H:Q strength ratio (RFDH:Q) were extracted. Thereafter, subjects were performed an exhaustive laboratory-based soccer-specific exercise and a posttest similar to the pretest. There was significant reduction in H(con) :Q(con) (0·60 ± 0·06 versus 0·58 ± 0·06, P<0·05) and in H(ecc) :Q(con) (1·29 ± 0·2 versus 1·16 ± 0·2, P<0·01) after the soccer-specific exercise. However, no significant difference between Pre and Post exercise conditions was found for RFDH:Q at 0-50 (0·53 ± 0·23 versus 0·57 ± 0·24, P>0·05) and 0-100 ms (0·53 ± 0·17 versus 0·55 ± 0·17, P>0·05). In conclusion, H:Q strength ratios based on peak force values are more affected by fatigue than RFDH:Q obtained during early contraction phase. Thus, fatigue induced by soccer-specific intermittent protocol seems not reduce the potential for knee joint stabilization during the initial phase of voluntary muscle contraction. PMID:23216761

Greco, Camila C; da Silva, Wendell L; Camarda, Sérgio R A; Denadai, Benedito S

2013-01-01

180

Waterbike injuries.  

PubMed

Jet skiing is a rapidly growing sport. The craft incorporate safety features and the manufacturers issue detailed safety instructions. Racing is conducted with adequate attention to clothing, safety and insurance. However, casual use is widespread and is sometimes irresponsible. Serious injuries to riders are uncommon: dental and knee injuries are described. A case of renal contusion and a head injury were caused by other riders and two potentially fatal injuries illustrate the risk for other water users. The number of injuries associated with the use of personal watercraft is likely to increase and may be influenced by appropriate organization or regulation. PMID:1810620

Jeffery, R S; Caiach, S

1991-12-01

181

Injury and injury rates in Muay Thai kick boxing  

PubMed Central

Objective—To determine the type and number of injuries that occur during the training and practice of Muay Thai kick boxing and to compare the data obtained with those from previous studies of karate and taekwondo. Methods—One to one interviews using a standard questionnaire on injuries incurred during training and practice of Muay Thai kick boxing were conducted at various gyms and competitions in the United Kingdom and a Muay Thai gala in Holland. Results—A total of 152 people were questioned, 132 men and 20 women. There were 19 beginners, 82 amateurs, and 51 professionals. Injuries to the lower extremities were the most common in all groups. Head injuries were the second most common in professionals and amateurs. Trunk injuries were the next most common in beginners. The difference in injury distribution among the three groups was significant (p?0.01). Soft tissue trauma was the most common type of injury in the three groups. Fractures were the second most common in professionals, and in amateurs and beginners it was sprains and strains (p?0.05). Annual injury rates were: beginners, 13.5/1000 participants; amateurs, 2.43/1000 participants; professionals, 2.79/1000 participants. For beginners, 7% of injuries resulted in seven or more days off training; for amateurs and professionals, these values were 4% and 5.8% respectively. Conclusions—The results are similar to those found for karate and taekwondo with regard to injury distribution, type, and rate. The percentage of injuries resulting in time off training is less. Key Words: injury rates; Muay Thai kick boxing PMID:11579062

Gartland, S; Malik, M; Lovell, M

2001-01-01

182

Feet injuries in rock climbers  

PubMed Central

While injuries of the upper extremity are widely discussed in rock climbers, reports about the lower extremity are rare. Nevertheless almost 50 percent of acute injuries involve the leg and feet. Acute injuries are either caused by ground falls or rock hit trauma during a fall. Most frequently strains, contusions and fractures of the calcaneus and talus. More rare injuries, as e.g., osteochondral lesions of the talus demand a highly specialized care and case presentations with combined iliac crest graft and matrix associated autologous chondrocyte transplantation are given in this review. The chronic use of tight climbing shoes leads to overstrain injuries also. As the tight fit of the shoes changes the biomechanics of the foot an increased stress load is applied to the fore-foot. Thus chronic conditions as subungual hematoma, callosity and pain resolve. Also a high incidence of hallux valgus and hallux rigidus is described. PMID:24147257

Schöffl, Volker; Küpper, Thomas

2013-01-01

183

Feet injuries in rock climbers.  

PubMed

While injuries of the upper extremity are widely discussed in rock climbers, reports about the lower extremity are rare. Nevertheless almost 50 percent of acute injuries involve the leg and feet. Acute injuries are either caused by ground falls or rock hit trauma during a fall. Most frequently strains, contusions and fractures of the calcaneus and talus. More rare injuries, as e.g., osteochondral lesions of the talus demand a highly specialized care and case presentations with combined iliac crest graft and matrix associated autologous chondrocyte transplantation are given in this review. The chronic use of tight climbing shoes leads to overstrain injuries also. As the tight fit of the shoes changes the biomechanics of the foot an increased stress load is applied to the fore-foot. Thus chronic conditions as subungual hematoma, callosity and pain resolve. Also a high incidence of hallux valgus and hallux rigidus is described. PMID:24147257

Schöffl, Volker; Küpper, Thomas

2013-01-01

184

Characterization of the dose response relationship for lung injury following acute radiation exposure in three well-established murine strains: developing an interspecies bridge to link animal models with human lung.  

PubMed

Approval of radiation countermeasures through the FDA Animal Rule requires pivotal efficacy screening in one or more species that are expected to react with a response similar to humans (21 C.F.R. § 314.610, drugs; § 601.91, biologics). Animal models used in screening studies should reflect the dose response relationship (DRR), clinical presentation, and pathogenesis of lung injury in humans. Over the past 5 y, the authors have characterized systematically the temporal onset, dose-response relationship (DRR), and pathologic outcomes associated with acute, high dose radiation exposure in three diverse mouse strains. In these studies, C57L/J, CBA/J, and C57BL/6J mice received wide field irradiation to the whole thorax with shielding of the head, abdomen, and forelimbs. Doses were delivered at a rate of 69 cGy min using an x-ray source operated at 320 kVp with half-value layer (HVL) of 1 mm Cu. For all strains, radiation dose was associated significantly with 180 d mortality (p < 0.0001). The lethal dose for 50% of animals within the first 180 d (LD50/180) was 11.35 Gy (95% CI 11.1-11.6 Gy) for C57L/J mice, 14.17 Gy (95% CI 13.9-14.5 Gy) for CBA/J mice, and 14.10 Gy (95% CI 12.2-16.4 Gy) for C57BL/6J mice. The LD50/180 in the C57L/J strain was most closely analogous to the DRR for clinical incidence of pneumonitis in non-human primates (10.28 Gy; 95% CI 9.9-10.7 Gy) and humans (10.60 Gy; 95% CI 9.9-12.1 Gy). Furthermore, in the C57L/J strain, there was no gender-specific difference in DRR (p = 0.5578). The reliability of the murine models is demonstrated by the reproducibility of the dose-response and consistency of disease presentation across studies.Health Phys. 106(1):000-000; 2014. PMID:24276549

Jackson, Isabel L; Xu, Pu-Ting; Nguyen, Giao; Down, Julian D; Johnson, Cynthia S; Katz, Barry P; Hadley, Caroline C; Vujaskovic, Zeljko

2014-01-01

185

Elbow injuries.  

PubMed

The elbow is a commonly injured joint, yet physicians may be less comfortable treating injuries to the elbow compared with knee and shoulder injuries. Common injuries involving the elbow are tendinosis, instability, tendon ruptures, osteochondritis dissecans, and fractures. Tendinosis is a common overuse injury and may occur on the lateral, medial, or infrequently, the posterior side of the elbow. Injury to the medial or lateral ulnar collateral ligaments may result in instability. Repetitive trauma from overuse is the most common etiologic factor in athletes. Distal biceps and triceps tendon injuries may result in elbow disability in active individuals. Partial tears are more difficult to diagnose than complete ruptures. Osteochondritis dissecans of capitellum affects adolescents involved in overhead throwing athletics. Fractures about the elbow most commonly involve the radial head in adults, and the distal humerus in children. Athletes are prone to elbow injuries resulting from both overuse and acute trauma. Our purpose is to describe the diagnosis and treatment of these common elbow injuries in athletes of all ages. PMID:11845021

Kandemir, Utku; Fu, Freddie H; McMahon, Patrick J

2002-03-01

186

Diaphragmatic injuries  

Microsoft Academic Search

Objectives: (1) To determine the actual incidence rate of blunt and penetrating diaphragmatic injuries (DI); (2) to evaluate the effectiveness of urgent surgical intervention for treatment of DI; and (3) to reveal main causes of postoperative complications. Methods: We reviewed: (1) forensic medical examination charts of 3353 subjects, who died due to polytrauma (including injuries to the chest and\\/or abdomen)

Romaldas Rubikas

2001-01-01

187

Rationale and implementation of anterior cruciate ligament injury prevention warm-up programs in female athletes.  

PubMed

The sex disparity in anterior cruciate ligament (ACL) injury risk and the subsequent adverse effects on knee joint health, psychosocial well-being, and financial costs incurred have produced a surge in research on risk factors and interventions designed to decrease this disparity and overall incidence. Biomechanical and neuromuscular differences have been identified throughout the trunk and lower extremity that may increase noncontact ACL injury risk in female athletes. Evidence demonstrates that many risk factors are modifiable with intervention programs and that athletic performance measures can be enhanced. No universally accepted ACL injury prevention program currently exists, and injury prevention programs are diverse. Anterior cruciate ligament injury prevention programs introduced in a warm-up format offer multiple benefits, primarily, improved compliance based on improved practicality of implementation. However, drawbacks of warm-up style formats also exist, most notably that a lack of equipment and resources may preclude measurable improvements in athletic performance that foster improved compliance among participants. The purpose of this review is to analyze the current literature researching possible biomechanical and neuromuscular risk factors in noncontact ACL injury in female athletes and the most effective means of implementing critical elements of a program to decrease ACL injury risk in female athletes while improving athletic performance. Hip and hamstring training, core stabilization, plyometrics, balance, agility, neuromuscular training with video and verbal feedback to modify technique, and stretching appear to be essential components of these programs. Further research is critical to determine ideal training program volume, intensity, duration, and frequency. PMID:21116195

Bien, Daniel P

2011-01-01

188

High school football injuries: Identifying the risk factors  

Microsoft Academic Search

This epidemiologic survey of the literature on the factors contributing to the high number of high school football injuries consolidates the current information on the characteristics and risk factors associated with these injuries. To reduce the incidence of knee sprains and strains, the most common injuries to this population, the following preventive recommendations are pre sented : 1) optimum maintenance

Brian Halpern; Nancy Thompson; Walton W. Curl; James R. Andrews; Stephen C. Hunter; John R. Boring

1987-01-01

189

Biomechanical comparison of hamstring tendon fixation devices for anterior cruciate ligament reconstruction: part 1. Five femoral devices.  

PubMed

We conducted a study to biomechanically compare 5 femoral hamstring tendon fixation devices commonly used in anterior cruciate ligament reconstruction. Quadrupled human semitendinosus-gracilis tendon grafts were fixed into porcine femurs using 5 separate fixation devices. For each device, 10 specimens were tested (1500-cycle loading test at 50-200 N). Specimens surviving the cyclic loading then underwent a single load-to-failure (LTF) test. Failure mode, stiffness, ultimate load, and rigidity were recorded. Two of 10 Delta screw (Arthrex), 10 of 10 Bio-TransFix (Arthrex), 10 of 10 Bone Mulch screw (Arthrotek), 10 of 10 EZLoc (Arthrotek), and 10 of 10 Zip Loop (Arthrotek) devices completed the 1500-cycle loading test. Residual displacement was lowest for Bio-TransFix (4.1 mm) followed by Bone Mulch (5.2 mm), EZLoc (6.4 mm), Zip Loop (6.8 mm), and Delta (8.2 mm). Mean stiffness was significantly (P < .001) higher for Bone Mulch (218 N/mm) than for Bio-TransFix (171 N/mm), EZLoc (122 N/mm), Zip Loop (105 N/mm), or Delta (84 N/mm). Mean LTF was significantly ( P < .001) higher for Bone Mulch (867 N) than for Zip Loop (615 N), Bio-TransFix (552 N), EZLoc (476 N), or Delta (410 N). The Bone Mulch screw demonstrated superior strength in the fixation of hamstring grafts in the femur. Bio-TransFix was close behind. The Delta screw demonstrated poor displacement, stiffness, and LTF. When used as the sole femoral fixation device, a device with low LTF, decreased stiffness, and high residual displacement should be used cautiously in patients undergoing aggressive rehabilitation. PMID:25566554

Scannell, Brian P; Loeffler, Bryan J; Hoenig, Michael; Peindl, Richard D; D'Alessandro, Donald F; Connor, Patrick M; Fleischli, James E

2015-01-01

190

Genital injury  

MedlinePLUS

... It is important to rule out sexual abuse, rape, and assault. The health care provider should ask the girl how the object was placed there. In young boys, common causes of genital injury include: Having the toilet seat ...

191

Football Injuries  

MedlinePLUS

Football is one of the most popular sports played by young athletes, and it leads all other ... in emergency rooms, doctor’s offices, and clinics for football-related injuries, according to the U.S. Product Safety ...

192

Overuse Injuries  

MedlinePLUS

... and terrain, hard versus soft surface in aerobic dance or running. HOW ARE OVERUSE INJURIES USUALLY DIAGNOSED? ... for any predisposing anatomic or biomechanical factors. Physical therapy and athletic training services may also be helpful. ...

193

Blast Injuries  

MedlinePLUS

Search form Search Basket Contact Us DVBIC Defense and Veterans Brain Injury Center Main menu Service Members & Veterans Family & Friends Medical Providers About DVBIC & TBI Educational Materials Research DVBIC Locations Press ...

194

Electrical injury  

MedlinePLUS

... injuries. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive ... burns. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive ...

195

Elbow Injuries  

Microsoft Academic Search

\\u000a Sports-related elbow injuries have increased over the last decade. With one in every four members of a household participating\\u000a in sports, both clinics and radiology departments are seeing more patients with elbow injuries. The most common clinical presentation\\u000a is lateral elbow pain. Familiar terms such as “tennis elbow,” “golfer’s elbow,” and “little leaguer’s elbow,” are mostly due\\u000a to the popularity

Kenneth S. Lee; Michael J. Tuite; Humberto G. Rosas

196

Differences in Neuromuscular Control and Quadriceps Morphology Between Potential Copers and Noncopers Following Anterior Cruciate Ligament Injury  

PubMed Central

Study Design Prospective cross-sectional study. Objectives To compare knee muscle morphology and voluntary neuromuscular control in individuals who sustained an anterior cruciate ligament (ACL) injury and were identified as being capable of avoiding surgery (potential copers) and those who were recommended for surgery (noncopers), within 6 months of injury. Background Quadriceps atrophy and poor neuromuscular control have been found in noncopers. However, the reasons why some noncopers may be able to avoid surgery remain elusive. Methods Twenty participants (10 ACL-deficient noncopers and 10 ACL-deficient potential copers) were included in this study. Axial spin-echo, T1-weighted magnetic resonance imaging data of the lower extremities were captured. The volume and maximum cross-sectional area (CSA) of each muscle of the quadriceps and hamstrings were calculated following digital reconstruction. In addition, voluntary neuromuscular control was evaluated using an established target-matching task that required participants to produce static isometric loads across the knee joint. Electromyography was acquired from 5 muscles as participants performed the target-matching task. Circular statistics were used to calculate a specificity index to describe how well focused each muscle was activated toward its primary direction of muscle action. The ACL-deficient limb was then compared to the uninvolved limb of the noncopers and potential copers. Results The vasti (vastus medialis and vastus intermedius) of the involved limb of the noncopers were significantly smaller (P<.031) in comparison to those of their uninvolved limb. The potential copers' vastus lateralis maximum CSA (P = .047), total quadriceps muscle volume (P = .020) and maximum CSA (P = .015), and quadriceps-hamstring ratio volume (P = .021) and maximum CSA (P = .007) demonstrated quadriceps atrophy. However, only the ACL-deficient limb of the older (mean ± SD age, 27.4 ± 11.4 versus 19.9 ± 3.3 years; P = .032) and lower-activity-level (3.3 ± 0.5 versus 3.6 ± 0.5; P = .098) noncoper group demonstrated reduced rectus femoris (P = .057) and lateral hamstring (P = .064) neuromuscular control in comparison to their uninvolved limb. Conclusion These findings suggest that quadriceps and hamstring muscle function, rather than muscle size, may be an important factor in the varied response early after ACL injury. PMID:24261930

Macleod, Toran D.; Snyder-Mackler, Lynn; Buchanan, Thomas S.

2015-01-01

197

Strain Details  

Cancer.gov

Newly Accepted Strain Details Strain Code: 01XBU  Common Strain Name: p16INKa4a L   Strain Nomenclature: B6.129(Cg)-Cdkn2atm2.1Nesh/Nci/Nci  Register Interest in this Strain Strain Description: Conditional knockout for p16INK4a gene when deleted somatically

198

Strain Details  

Cancer.gov

Newly Accepted Strain Details Strain Code: 01XJA  Common Strain Name: PML (conventional k/o) - C57BL/6  Strain Nomenclature: B6.129S7-Pmltm1Ppp>/Nci  Register Interest in this Strain Strain Description: The promyelocytic leukemia gene PML was originally

199

Early versus late start of open kinetic chain quadriceps exercises after ACL reconstruction with patellar tendon or hamstring grafts: a prospective randomized outcome study.  

PubMed

The purpose of the present investigation was to evaluate physical outcome after anterior cruciate ligament (ACL) reconstruction with early versus late initiation of open kinetic chain (OKC) exercises for the quadriceps in patients operated on either patellar tendon or hamstring grafts. Sixty-eight patients, 36 males and 32 females, with either patellar tendon graft (34 patients) or hamstring graft (34 patients) were enrolled in this study. All patients were randomly allocated to either early (the 4th postoperative week) or late (the 12th postoperative week) start of OKC exercises for the quadriceps, resulting in four subgroups: patellar tendon reconstruction, early start (P4) or late start (P12) of OKC quadriceps exercises, hamstring tendon reconstruction, early start (H4) or late start (H12) of quadriceps OKC exercises. Prior to surgery and 3, 5 and 7 months later, assessments of range of motion (goniometer), anterior knee laxity (KT-1000), postural sway (KAT 2000), thigh muscle torques (Kin-Com dynamometer) and anterior knee pain (anterior knee pain score) were evaluated. No significant group differences were found in terms of range of motion 3, 5 and 7 months postoperatively. The H4 group showed a significantly higher mean difference of laxity over time of 1.0 mm (CI: 0.18-1.86) than the P4 group (P=0.04). Within the same type of surgery, the H4 against the H12, the mean difference over time was 1.2 mm (0.37-2.1) higher in the H4 group than in the H12 group (P=0.01). There were no significant group differences in terms of postural sway or anterior knee pain at the different test occasions. Significant differences in trends (changes over time) were found when comparing the four groups, for both quadriceps muscle torques (P<0.001) and hamstring muscle torques (P<0.001). All groups, except the P4 group, reached preoperative values of quadriceps muscle torques at the 7 months follow-up. In the H4 and the H12 groups, significantly lower hamstring muscle torques at the 7 months follow-up compared with preoperative values were found. In conclusion, early start of OKC quadriceps exercises after hamstring ACL reconstruction resulted in significantly increased anterior knee laxity in comparison with both late start and with early and late start after bone-patellar tendon-bone ACL reconstruction. Furthermore, the early introduction of OKC exercises for quadriceps did not influence quadriceps muscle torques neither in patients operated on patellar tendon nor hamstring tendon grafts. On the contrary, it appears as if the choice of graft affected the strength of the specific muscle more than the type of exercises performed. Our results could not determine the appropriate time for starting OKC quadriceps exercises for patients who have undergone ACL reconstruction with hamstring tendon graft. Future studies of long-term results of anterior knee laxity and functional outcome are needed. PMID:17219226

Heijne, Annette; Werner, Suzanne

2007-04-01

200

Biomechanical evaluation of patellar and hamstring tendon graft fixation for anterior cruciat ligament reconstruction using a poly-(D, L-lactide) interference screw  

Microsoft Academic Search

Summary  \\u000a Anterior cruciate ligament (ACL) reconstruction using autologous hamstring tendons are being performed more frequently and\\u000a satisfactory results have been reported. Advantages such as low donor site morbidity and ease of harvest as well as disadvantages\\u000a like low initial construct stiffness have been described. Recently, it has been demonstrated that graft fixation close to\\u000a the original ACL insertion sites increases

A. Weiler; R. F. G. Hoffmann; N. P. Südkamp; C. J. Siepe; N. P. Haas

1999-01-01

201

Augmentation of Femoral Fixation in Hamstring Anterior Cruciate Ligament Reconstruction With a Bioabsorbable BeadA Prospective Single-Blind Randomized Clinical Trial  

Microsoft Academic Search

Background: The EndoPearl is an adjunct to bioabsorbable interference screw fixation in the femoral tunnel in anterior cruciate ligament (ACL) reconstruction. The purpose of the study was to assess the clinical effectiveness of the EndoPearl using the KT-1000 Knee Arthrometer and the Mohtadi ACL Quality of Life (ACL-QOL) Questionnaire.Hypothesis: The application of the EndoPearl in hamstring ACL reconstruction has no

Shalinder Arneja; Warren Froese; Peter MacDonald

2004-01-01

202

Criterion-related validity of sit-and-reach and toe-touch tests as a measure of hamstring extensibility in athletes.  

PubMed

The aims of this study were (a) to determine and compare the concurrent hamstring criterion-related validity of the sit-and-reach (SR) and toe-touch (TT) tests in different athletes (tennis players, kayakers, canoeists, and cyclists); (b) to determine the criterion-related validity of the pelvic tilt assessed by the Spinal Mouse system as a measure of hamstring flexibility in athletes; and (c) to evaluate the influence of spinal posture, pelvic tilt, and hamstring muscle flexibility in the SR and TT scores. Twenty-four tennis players, 30 canoeists, 43 kayakers, and 44 cyclists were recruited. Passive straight leg raise (PSLR), SR, and TT tests were randomly performed. Spinal curvatures and pelvic tilt were evaluated with a Spinal Mouse system when the maximal trunk flexion was achieved in the SR and TT tests. Tennis players and cyclists showed moderate correlations between PSLR with respect to SR (? = 0.78 and ? = 0.76, respectively) and TT (? = 0.77 and ? = 0.74, respectively). Correlations were slightly lower in canoeists (SR, ? = 0.64; TT, ? = 0.75). Kayakers showed the lowest correlation values (SR, ? = 0.53; TT, ? = 0.57). Correlation values between PSLR and pelvic tilt angle in both the SR and TT tests were ? < 0.70 in all the groups of athletes. Stepwise multiple regression analysis showed a high variance explained from pelvic tilt and lumbar spine in the SR score. In conclusion, the SR and TT tests can be appropriate measures to determine spine flexibility and pelvic tilt range of motion but not to evaluate the hamstring muscle flexibility in tennis players, canoeists, kayakers, and cyclists. PMID:24476746

Muyor, José M; Vaquero-Cristóbal, Raquel; Alacid, Fernando; López-Miñarro, Pedro A

2014-02-01

203

A Cost-Effectiveness Analysis Comparing 3 Anterior Cruciate Ligament Graft Types: Bone–Patellar Tendon–Bone Autograft, Hamstring Autograft, and Allograft  

Microsoft Academic Search

Background: Anterior cruciate ligament (ACL) reconstruction, despite being one of the most common surgical interventions, is also one of the least agreed upon surgeries when it comes to optimum graft choice. Three graft choices stand among the most widely used in this procedure: (1) bone–patellar tendon–bone autograft (BPTB), (2) quadruple hamstring tendon autograft (HS), and (3) allograft.Hypothesis: Bone–patellar tendon–bone ACL

James W. Genuario; Scott C. Faucett; Martin Boublik; Theodore F. Schlegel

2012-01-01

204

[Frostbite injuries].  

PubMed

Frostbite injuries occur mainly in toes, fingers, ears, nose and cheek. Typically an initial vasoconstriction in the skin will protect from drop in core temperature. Ice crystal development occurs when tissue temperature drops to -2 degrees C, leading to increased osmolality of the extracellular fluid and intracellular dehydration. An additional insult occurs with thawing due to reperfusion of the tissue and thereby release of inflammatory mediators. Symptoms of frostbite injury are: White-cyanotic discoloration, pain and numbness followed by hypoaesthesia. General hypothermia should be prevented and treated before managing the local frostbite injuries. Direct contact with warm skin without rubbing should be used in superficial injuries. More severe and deeper injuries should not be thawed until definite treatment could be given in a hospital. Re-freezing and mechanical influence on the injured parts must be avoided. Thawing should preferably be done in stirred water of 40-42 degrees C with mild soap. Antibiotics may be indicated when the skin barrier is broken. Surgical debridement should be postponed until a clear demarcation occurs. PMID:10074836

Berg, A; Aas, P; Lund, T

1999-01-30

205

Blast injury.  

PubMed

The shock wave generated by an explosion ("blast wave") may cause injury in any or all of the following: (1) direct impact on the tissues of variations in environmental pressure; (2) flying glass and other debris set in motion by it; (3) propulsion of the body. Injuries in the first category affect gas-containing organs (ears, lungs and intestines), and acute death is attributed to air forced into the coronary vessels via damaged pulmonary alveoli. It is estimated that overpressure sufficient to cause lung injury may occur up to five miles from a 20-megaton nuclear explosion. The greatest single hazard from blast is, however, flying glass, and serious wounding from this cause is possible up to 12 miles from an explosion of this magnitude. PMID:6015742

de Candole, C A

1967-01-28

206

Blast Injury  

PubMed Central

The shock wave generated by an explosion (“blast wave”) may cause injury in any or all of the following: (1) direct impact on the tissues of variations in environmental pressure; (2) flying glass and other debris set in motion by it; (3) propulsion of the body. Injuries in the first category affect gas-containing organs (ears, lungs and intestines), and acute death is attributed to air forced into the coronary vessels via damaged pulmonary alveoli. It is estimated that overpressure sufficient to cause lung injury may occur up to five miles from a 20-megaton nuclear explosion. The greatest single hazard from blast is, however, flying glass, and serious wounding from this cause is possible up to 12 miles from an explosion of this magnitude. PMID:6015742

de Candole, C. A.

1967-01-01

207

Nonfreezing Tissue Injuries  

MedlinePLUS

... Resources for Help and Information The One-Page Merck Manual of Health Medical Terms Conversion Tables Manuals ... of Cold Injuries Hypothermia Nonfreezing Tissue Injuries Frostbite Merck Manual > Patients & Caregivers > Injuries and Poisoning > Cold Injuries ...

208

[Liver injuries].  

PubMed

Mortality in blunt hepatic trauma is still high, death being most frequently caused by hemorrhage. Associated injuries are present in nearly all cases. A variety of possible surgical procedures allow treatment tailored to fit the individual situation. Even the sophisticated intensive care required by the frequent posttraumatic complications is not a substitute for adequate surgery. PMID:3520808

Glinz, W; Stoffel, D; Zellweger, G; Largiadèr, J

1986-04-26

209

Diagnosis and management of quadriceps strains and contusions  

Microsoft Academic Search

Injuries to the quadriceps muscle group occur frequently in sports and athletic activities. Muscle strains and contusions\\u000a constitute the majority of these injuries. The clinical presentation and assessment of quadriceps strains and contusions are\\u000a reviewed along with discussion of appropriate imaging used in diagnosis. Treatment protocols for acute injuries are reviewed\\u000a including rehabilitation techniques frequently utilized during recovery. Special consideration

Joel M. Kary

2010-01-01

210

Crossbow injuries.  

PubMed

The crossbow is an uncommon source of fatal injury. In Los Angeles County, two crossbow homicides have occurred in the past 20 years. Following the second case, a crossbow was test-fired into a fresh pork thigh, resulting in distinctive wounds. Experimental studies also showed that the vanes of the bolt (arrow) may be a source of trace material found in the wound. PMID:2391480

Rogers, C; Dowell, S; Choi, J H; Sathyavagiswaran, L

1990-07-01

211

Natural Strain  

NASA Technical Reports Server (NTRS)

Logarithmic strain is the preferred measure of strain used by materials scientists, who typically refer to it as the "true strain." It was Nadai who gave it the name "natural strain," which seems more appropriate. This strain measure was proposed by Ludwik for the one-dimensional extension of a rod with length l. It was defined via the integral of dl/l to which Ludwik gave the name "effective specific strain." Today, it is after Hencky, who extended Ludwik's measure to three-dimensional analysis by defining logarithmic strains for the three principal directions.

Freed, Alan D.

1997-01-01

212

THE RELATIONSHIP BETWEEN OZONE-INDUCED LUNG INJURY, ANTIOXIDANT COMPENSATION AND UNDERLYING CARDIOVASCULAR DISEASE (CVD).  

EPA Science Inventory

Increased levels of oxidants and compromised compensatory response are associated with CVD susceptibility. We hypothesized that rat strains demonstrating genetic CVD will have lower levels of antioxidants and greater ozone-induced pulmonary injury relative to healthy strains. Mal...

213

Martial Arts Injuries  

Microsoft Academic Search

Objective: To review the current evidence for the epidemiology of pediatric injuries in martial arts. Data sources: The relevant literature was searched using SPORT DISCUS (keywords: martial arts injuries, judo injuries, karate injuries, and taekwondo injuries and ProQuest (keywords: martial arts, taekwondo, karate, and judo), as well as hand searches of the reference lists. Main results: In general, the absolute

W. Pieter

2005-01-01

214

Injuries about the shoulder in skiing and snowboarding.  

PubMed

There has been a decrease in the overall injury rate, particularly the rate of lower-extremity injuries, for alpine skiing, with a resultant increase in the ratio of upper-extremity to lower-extremity injuries. The upper extremity is injured nearly twice as often during snowboarding than alpine skiing, with approximately half of all snowboarding injuries involving the upper extremity. Shoulder injuries are likely under-reported, as many patients seek evaluation for minor shoulder injuries with their local physicians, and not at the ski medical clinic, where most epidemiology studies obtain their data. Shoulder injuries account for 4 to 11% of all alpine skiing injuries and 22 to 41% of upper-extremity injuries. During snowboarding, shoulder injuries account for 8 to 16% of all injuries and 20 to 34% of upper-extremity injuries. Falls are the most common mechanism of shoulder injury, in addition to pole planting during skiing and aerial manoeuvres during snowboarding. Common shoulder injuries during skiing and snowboarding are rotator cuff strains, glenohumeral dislocations, acromioclavicular separations and clavicle fractures. It is still unclear, when comparing snowboarding and skiing injury data, which sport has the higher incidence of shoulder injuries. Stratifying shoulder injuries by type allows better delineation as to which sport has an increased incidence of certain injury patterns. The differing mechanisms of injury combined with distinct equipment for each sport plays a role in the type and frequency of shoulder injuries seen in these two subgroups. With the increased ratio of upper- to lower-extremity injuries during alpine skiing and the boom in popularity of snowboarding, shoulder injuries are seen with increasing frequency by those who care for alpine sport injuries. According to recent epidemiological data, only clavicle and humerus fractures have shown increased rates of incidence among alpine skiers. Over the past 30 years, there has been a general decrease in both upper- and lower-extremity injuries which can be attributed to improved designs of protective equipment, increased awareness of injury patterns and emphasis on prevention. In the future, physicians and therapists who treat this population must be comfortable and confident in their treatment algorithms to help keep skiers and snowboarders conditioned and ready for the slopes and develop strategies for the prevention of upper-extremity injuries associated with these activities. PMID:19945981

McCall, D; Safran, M R

2009-12-01

215

Natural Strain  

NASA Technical Reports Server (NTRS)

The purpose of this paper is to present a consistent and thorough development of the strain and strain-rate measures affiliated with Hencky. Natural measures for strain and strain-rate, as I refer to them, are first expressed in terms of of the fundamental body-metric tensors of Lodge. These strain and strain-rate measures are mixed tensor fields. They are mapped from the body to space in both the Eulerian and Lagrangian configurations, and then transformed from general to Cartesian fields. There they are compared with the various strain and strain-rate measures found in the literature. A simple Cartesian description for Hencky strain-rate in the Lagrangian state is obtained.

Freed, Alan D.

1995-01-01

216

Arthroscopically Assisted Combined Anterior and Posterior Cruciate Ligament Reconstruction with Autologous Hamstring Grafts–Isokinetic Assessment with Control Group  

PubMed Central

Objective The aim of the study was to: 1) evaluate the differences in pre-post operative knee functioning, mechanical stability, isokinetic knee muscle strength in simultaneous arthroscopic patients after having undergone an anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) with hamstring tendons reconstruction, 2) compare the results of ACL/PCL patients with the control group. Design Controlled Laboratory Study. Materials and Methods Results of 11 ACL/PCL patients had been matched with 22 uninjured control participants (CP). Prior to surgery, and minimum 2 years after it, functional assessment (Lysholm and IKDC 2000), mechanical knee joint stability evaluation (Lachman and “drawer” test) and isokinetic tests (bilateral knee muscle examination) had been performed. Different rehabilitation exercises had been used: isometric, passive exercises, exercises increasing the range of motion and proprioception, strength exercises and specific functional exercises. Results After arthroscopy no significant differences had been found between the injured and uninjured leg in all isokinetic parameters in ACL/PCL patients. However, ACL/PCL patients had still shown significantly lower values of strength in relative isokinetic knee flexors (p?=?0.0065) and extensors (p?=?0.0171) compared to the CP. There were no differences between groups regarding absolute isokinetic strength and flexors/extensors ratio. There was statistically significant progress in IKDC 2000 (p?=?0.0044) and Lysholm (p?=?0.0044) scales prior to (44 and 60 points respectively) and after the reconstruction (61 for IKDC 2000 and 94 points for Lysholm). Conclusions Although harvesting tendons of semitendinosus and/or gracilis from the healthy extremity diminishes muscle strength of knee flexors in comparison to the CP, flexor strength had improved. Statistically significant improvement of the knee extensor function may indicate that the recreation of joint mechanical stability is required for restoring normal muscle strength. Without restoring normal muscle function and strength, surgical intervention alone may not be sufficient enough to ensure expected improvement of the articular function. PMID:24386099

Piontek, Tomasz; Ciemniewska-Gorzela, Kinga; Szulc, Andrzej; Naczk, Jakub; Wardak, Martyna; Trzaska, Tadeusz; Dudzinski, Witold; Grygorowicz, Monika

2013-01-01

217

What Causes Pediatric Injury?  

MedlinePLUS

... parents, caregivers, and families about ways to prevent childhood injury, safety recommendations, and product warnings and recalls. For ... Ballesteros, M. F., Sleet, D. A. (2008). CDC childhood injury report: patterns of unintentional injuries among 0-19 ...

218

Growth Plate Injuries  

MedlinePLUS

Growth Plate Injuries May 2014 Questions and Answers about Growth Plate Injuries This publication contains general information about ... Classification of Growth Plate Injuries What Is the Growth Plate? The growth plate, also known as the ...

219

High knee abduction moments are common risk factors for patellofemoral pain (PFP) and anterior cruciate ligament (ACL) injury in girls: Is PFP itself a predictor for subsequent ACL injury?  

PubMed Central

Background Identifying risk factors for knee pain and anterior cruciate ligament (ACL) injury can be an important step in the injury prevention cycle. Objective We evaluated two unique prospective cohorts with similar populations and methodologies to compare the incidence rates and risk factors associated with patellofemoral pain (PFP) and ACL injury. Methods The ‘PFP cohort’ consisted of 240 middle and high school female athletes. They were evaluated by a physician and underwent anthropometric assessment, strength testing and three-dimensional landing biomechanical analyses prior to their basketball season. 145 of these athletes met inclusion for surveillance of incident (new) PFP by certified athletic trainers during their competitive season. The ‘ACL cohort’ included 205 high school female volleyball, soccer and basketball athletes who underwent the same anthropometric, strength and biomechanical assessment prior to their competitive season and were subsequently followed up for incidence of ACL injury. A one-way analysis of variance was used to evaluate potential group (incident PFP vs ACL injured) differences in anthropometrics, strength and landing biomechanics. Knee abduction moment (KAM) cut-scores that provided the maximal sensitivity and specificity for prediction of PFP or ACL injury risk were also compared between the cohorts. Results KAM during landing above 15.4 Nm was associated with a 6.8% risk to develop PFP compared to a 2.9% risk if below the PFP risk threshold in our sample. Likewise, a KAM above 25.3 Nm was associated with a 6.8% risk for subsequent ACL injury compared to a 0.4% risk if below the established ACL risk threshold. The ACL-injured athletes initiated landing with a greater knee abduction angle and a reduced hamstrings-to-quadriceps strength ratio relative to the incident PFP group. Also, when comparing across cohorts, the athletes who suffered ACL injury also had lower hamstring/quadriceps ratio than the players in the PFP sample (p<0.05). Conclusions In adolescent girls aged 13.3 years, >15 Nm of knee abduction load during landing is associated with greater likelihood of developing PFP. Also, in girls aged 16.1 years who land with >25 Nm of knee abduction load during landing are at increased risk for both PFP and ACL injury. PMID:24687011

Myer, Gregory D; Ford, Kevin R; Di Stasi, Stephanie L; Foss, Kim D Barber; Micheli, Lyle J; Hewett, Timothy E

2014-01-01

220

Thermal injury.  

PubMed

The burned patient is a challenging problem to the emergency physician. The vast majority of burns are minor and can be managed effectively on an outpatient basis. There are many therapeutic options, and specific burn care must be based on an understanding of the pathophysiology, tailoring it to the patient's needs. The major burn victim may have life-threatening circulatory and pulmonary problems that must be addressed through aggressive fluid therapy and airway management. Multisystem complications may follow, and one needs to be aware of these to prevent their occurrence. Specific directed therapy begins in the field and continues through the Emergency Department until the patient is stabilized and sent to his or her final destination. Early assessment of burn extent, location, and severity is important in determining therapy and disposition. Close monitoring of the patient and accurate record keeping is essential, as thermal injury is a dynamic process. Transfer to burn center often will be necessary and requires early contact with the center to ensure appropriate treatment and transfer arrangement. Certain other injuries require close follow-up care by physicians experienced in burn care. PMID:1559476

Griglak, M J

1992-05-01

221

Upper extremity injuries associated with strength training.  

PubMed

Most injuries sustained during strength training are mild strains that resolve with appropriate rest. More severe injuries include traumatic shoulder dislocations, tendon ruptures of the pectoralis major, biceps, and triceps; stress fractures of the distal clavicle, humerus, radius, and ulna; traumatic fractures of the distal radius and ulna in adolescent weightlifters; and compressive and stretch neuropathies. These more severe injuries are usually the result of improperly performing a strength training exercise. Educating athletes regarding proper strength-training techniques serves to reverse established injury patterns and to prevent these injuries in the first place. Recognizing the association of anabolic steroid use to several of the injury patterns further reinforces the need for medical specialists to counsel athletes against their use. With the increasing use of supplements such as creatine, the incidence and nature of strength-training injuries may change further. Greater emphasis on the competitive performance of younger athletes undoubtedly will generate enthusiasm for strength training at earlier ages in both sexes. The importance of proper supervision of these young athletes by knowledgeable persons will increase. As the popularity of strength training grows, there will be ample opportunity to continue to catalog the injury patterns associated with this activity. PMID:11494836

Haupt, H A

2001-07-01

222

Work-related injuries in drywall installation.  

PubMed

Administrative data sources were used to describe the work-related injuries of drywall carpenters, to calculate rates of occurrence, and to explore high risk sub-groups. Health insurance eligibility files were used to identify a cohort of active union carpenters affiliated with a union local whose predominant work involved drywall installation in the state of Washington. These files contained the hours worked by each individual for each month between January 1989 and December 1995, providing person-hours at risk as a union carpenter. The Washington Department of Labor and Industries (L&I) provided records of workers' compensation claims filed by these individuals. Over seven years 1773 drywall carpenters filed 2567 workers' compensation claims representing an overall rate of 53.3 per 200,000 hours worked. These claims were filed by 1046 different individuals, or 59.0 percent of the cohort. Claims resulting in paid lost time from work were filed at a rate of 12.5 per 200,000 hours worked (n = 609) by 445 (25.1%) different individuals. The most common mechanisms of injury involved being struck (38.3%), overexertion (28.1%), and falls (13.2%). Struck by injuries most commonly involved cuts to the upper extremity. Overexertion injuries were most commonly described as sprains or strains involving the back. Sheetrock was associated with over 40 percent of these injuries. Falls most commonly involved injuries to the knee followed by the back and multiple injuries. Struck by injuries decreased steadily with increasing age and increasing time in the union. There was a steady increase in the rate of falls with increasing age. Overexertion injuries were responsible for the greatest proportion of costs for medical care, permanent impairment, and paid lost days. The high rates of overexertion injuries among these workers is consistent with known ergonomic stresses on drywall jobs. However, these workers are also at high risk of acute traumatic injuries. PMID:11036730

Lipscomb, H J; Dement, J M; Gaal, J S; Cameron, W; McDougall, V

2000-10-01

223

Revision anterior capsular shoulder stabilization using hamstring tendon autograft and tibialis tendon allograft reinforcement: minimum two-year follow-up.  

PubMed

Surgical treatment of anterior shoulder capsular deficiency has been a challenge for orthopaedic surgeons dealing with failed anterior shoulder stabilization procedures. We have used hamstring tendon autograft or tibialis tendon allograft to reinforce deficient anterior capsular tissue in patients with failed anterior shoulder stabilization. We performed a clinical follow-up of 15 patients at a minimum of 2 years after surgery, using the American Shoulder and Elbow Surgeons questionnaire, a physical examination, and radiographs. Thirteen patients were satisfied with their surgery. The mean American Shoulder and Elbow Surgeons score was 73, (range, 7-100). There were no postoperative dislocations. The operative shoulder had decreased range of motion compared with the contralateral shoulder. The operative arm lacked 10 degrees of forward flexion, 21 degrees of external rotation at the side, 24 degrees of external rotation with the arm in abduction, and 4 spinal levels of internal rotation. Two patients required total shoulder arthroplasty for painful glenohumeral arthritis. Clinical failure was related to glenohumeral arthritis or residual anterior shoulder apprehension. Our results support the use of hamstring autograft or tibialis anterior allograft for the reconstruction of the anterior capsule during revision shoulder stabilization surgery. PMID:17321165

Alcid, Jess G; Powell, Scott E; Tibone, James E

2007-01-01

224

Patellar tendon and hamstring moment-arms and cross-sectional area in patients with anterior cruciate ligament reconstruction and controls.  

PubMed

The purpose of this study was to examine the moment-arm and cross-sectional area (CSA) of the patellar tendon (PT) and the hamstrings after anterior cruciate ligament (ACL) reconstruction. The right knee of five males who underwent ACL reconstruction with a PT graft and five age-matched controls was scanned using magnetic resonance image scans. Based on three-dimensional (3D) solids of the PT, CSAs and moment-arms of semitendinous (ST), biceps femoris (BF) long head and semimembranosus (SM) were estimated. Analysis of variance indicated no significant group differences in muscle moment-arms (p>0.05). 3D moment-arms of PT, ST and BF were significantly lower than the corresponding 2D values (p < 0.05). The ACL group displayed a significantly higher maximum BF CSA, a lower ST CSA (p < 0.05) but similar PT and SM CSAs compared with controls. It is concluded that any alterations in PT properties 1 year after harvesting do not affect knee muscle moment-arms compared with age-matched controls. Moment-arm estimation differed between 3D and 2D data, although it did not affect comparisons between ACL reconstruction group and controls. Design of rehabilitation programmes should take into consideration a potential alteration in hamstring morphology following surgery with a PT graft. PMID:24460238

Kellis, Eleftherios; Karagiannidis, Evaggelos; Patsika, Glykeria

2015-08-01

225

Bilateral Simultaneous Anterior Cruciate Ligament Injury: A Case Report and National Survey of Orthopedic Surgeon Management Preference  

PubMed Central

Unilateral anterior cruciate ligament (ACL) tear is a common injury seen by sports medicine orthopedic surgeons. However, a bilateral simultaneous ACL injury is extremely rare and has been reported only three times in the literature. We present a young female skier with simultaneous bilateral ACL tears that were managed with staged ACL reconstruction. We then conducted a nationwide survey (United States) to determine the prevalence of simultaneous bilateral ACL tear and preferred management strategies by sports medicine orthopedic surgeons. Sports medicine fellowship directors were contacted and asked to send an 8-item survey to colleagues (sports medicine fellowship trained surgeons) asking about overall number of ACL reconstructions performed, number of bilateral simultaneous ACL injuries seen and optimal management strategies of such an injury. Out of 43 responses, only 22 (51.2%) surgeons had seen a bilateral simultaneous ACL injury. Of these, 16 (76.2%) preferred staged reconstruction. Graft choice was mixed between autograft and allograft, but a large majority preferred either patellar tendon autograft (58%) or hamstring autograft (41%) were the most common choice. Staged reconstruction is the treatment of choice by surgeons surveyed in our study. PMID:25568728

Saadat, Ehsan; Curry, Emily J.; Li, Xinning; Matzkin, Elizabeth G.

2014-01-01

226

Bilateral simultaneous anterior cruciate ligament injury: a case report and national survey of orthopedic surgeon management preference.  

PubMed

Unilateral anterior cruciate ligament (ACL) tear is a common injury seen by sports medicine orthopedic surgeons. However, a bilateral simultaneous ACL injury is extremely rare and has been reported only three times in the literature. We present a young female skier with simultaneous bilateral ACL tears that were managed with staged ACL reconstruction. We then conducted a nationwide survey (United States) to determine the prevalence of simultaneous bilateral ACL tear and preferred management strategies by sports medicine orthopedic surgeons. Sports medicine fellowship directors were contacted and asked to send an 8-item survey to colleagues (sports medicine fellowship trained surgeons) asking about overall number of ACL reconstructions performed, number of bilateral simultaneous ACL injuries seen and optimal management strategies of such an injury. Out of 43 responses, only 22 (51.2%) surgeons had seen a bilateral simultaneous ACL injury. Of these, 16 (76.2%) preferred staged reconstruction. Graft choice was mixed between autograft and allograft, but a large majority preferred either patellar tendon autograft (58%) or hamstring autograft (41%) were the most common choice. Staged reconstruction is the treatment of choice by surgeons surveyed in our study. PMID:25568728

Saadat, Ehsan; Curry, Emily J; Li, Xinning; Matzkin, Elizabeth G

2014-10-27

227

Boxing, Wrestling, and Martial Arts Related Injuries Treated in Emergency Departments in the United States, 2002-2005  

PubMed Central

The incidence of injury in combat sports has not been adequately reported although it is important to identify the nature and frequency of injuries prior to the implementation of prevention programs. This study compared injury rates treated in Hospital Emergency Departments between different combat sports of boxing, wrestling, and martial arts. A secondary objective described anatomic region and diagnosis of these injuries. Data were obtained on all boxing, wrestling, and martial arts-related injuries that were in the National Electronic Injury Surveillance System database and resulted in Emergency Department visits between 2002 and 2005. Pearson’s chi-square statistics were calculated to compare injury rates for each activity accounting for complex sample design. Martial arts had lower injury rates compared to boxing and wrestling for all diagnoses (p<0.001). Boxing had lower injury rates compared to wrestling for strains/sprains and dislocations. Boxing and wrestling had similar injury rates for concussions. Injury prevention efforts should consider the distribution of injuries and concentrate on preventing strains/sprains in wrestling, concussions in boxing and wrestling, and fractures for all three activities. The findings of the present study do not provide evidence that combat sports have alarmingly high rates of injuries resulting in emergency department visits. Key points Martial arts have lower emergency department injury rates compared to boxing and wrestling. Wrestling has higher strains/sprains and dislocation injury rates compared to boxing. Combat sports do not appear to have higher injury rates compared to non-combat sports. PMID:24198705

Pappas, Evangelos

2007-01-01

228

C. Jessie Jones, Roberta E. Rikli, Julie Max, and Guillermo Nofall. (1998). The Reliability and Validity of a Chair Sit-and-Reach Test as a Measure of Hamstring Flexibility in Older Adults. Research  

E-print Network

C. Jessie Jones, Roberta E. Rikli, Julie Max, and Guillermo Nofall. (1998). The Reliability and Validity of a Chair Sit-and-Reach Test as a Measure of Hamstring Flexibility in Older Adults. Research-retest reliability and the criterion validity of a newly developed chair sit-and-reach (CSR) test as a measure

de Lijser, Peter

229

How the fixation method stiffness and initial tension affect anterior load–displacement of the knee and tension in anterior cruciate ligament grafts: a study in cadaveric knees using a double-loop hamstrings graft  

Microsoft Academic Search

There were two objectives to this study. The first was to investigate the relationship of graft fixation stiffness and graft initial tension on the anterior load–displacement behavior of knees reconstructed with a double-loop hamstrings tendon graft. The second was to determine the corresponding graft tensions at 225 N of anterior force applied to the knee. To satisfy these objectives, the

Paul Eagar; M. L. Hull; S. M. Howell

2004-01-01

230

Eye Injuries in Sports  

MedlinePLUS

... most eye injuries, followed by water sports and racquet sports. When it comes to eye injuries, sports can be classified as low risk, high ... baseball, basketball, hockey, football, lacrosse, tennis and other racquet sports, ... eye injuries? Common types of eye injuries are blunt trauma, ...

231

Nutrition, illness, and injury in aquatic sports.  

PubMed

In this review, we outline key principles for prevention of injury and illness in aquatic sports, detail the epidemiology of injury and illness in aquatic athletes at major international competitions and in training, and examine the relevant scientific evidence on nutrients for reducing the risk of illness and injury. Aquatic athletes are encouraged to consume a well-planned diet with sufficient calories, macronutrients (particularly carbohydrate and protein), and micronutrients (particularly iron, zinc, and vitamins A, D, E, B6, and B12) to maintain health and performance. Ingesting carbohydrate via sports drinks, gels, or sports foods during prolonged training sessions is beneficial in maintaining energy availability. Studies of foods or supplements containing plant polyphenols and selected strains of probiotic species are promising, but further research is required. In terms of injury, intake of vitamin D, protein, and total caloric intake, in combination with treatment and resistance training, promotes recovery back to full health and training. PMID:24937101

Pyne, David B; Verhagen, Evert A; Mountjoy, Margo

2014-08-01

232

Rectus abdominis muscle strains in tennis players  

PubMed Central

Rectus abdominis muscle strains are common and debilitating injuries among competitive tennis players. Eccentric overload, followed by forced contraction of the non?dominant rectus abdominis during the cocking phase of the service motion is the accepted injury mechanism. A tennis?specific rehabilitation program emphasising eccentrics and plyometric strengthening of the abdominal wall muscles, contributes to the complete functional recovery in tennis players, and could help reduce recurrences. PMID:17957025

Maquirriain, Javier; Ghisi, Juan P; Kokalj, Antonio M

2007-01-01

233

Posterior calf injury.  

PubMed

Acute injuries of the Achilles tendon are common among athletes and non-athletes alike. Injuries of other posterior calf muscles are far less common but should be considered in the differential, to ensure proper diagnosis and treatment of patients with calf injuries. This article focuses on these calf injuries, including injuries of the gastrocnemius, plantaris, soleus, and flexor hallucis longus, which may occasionally be mistaken for Achilles tendon disorders. PMID:19857847

Campbell, John T

2009-12-01

234

Wood burning related injuries.  

PubMed

During the past two years, 80 patients were seen in the emergency department of The Mary Imogene Bassett Hospital (Cooperstown, NY) for injuries related to the use of wood burning stoves. The types of injuries included 25 lacerations, 19 crush injuries, 10 fractures, 7 eye injuries and 7 burns. Seven of these patients required hospitalization, and five required operative procedures. There was no mortality. Physician and patient education about the potential dangers of wood stove use may help prevent these injuries. PMID:2733888

Nicholson, J J; Dietz, P A

1989-05-01

235

The application of musculoskeletal modeling to investigate gender bias in non-contact ACL injury rate during single-leg landings.  

PubMed

The central tenet of this study was to develop, validate and apply various individualised 3D musculoskeletal models of the human body for application to single-leg landings over increasing vertical heights and horizontal distances. While contributing to an understanding of whether gender differences explain the higher rate of non-contact anterior cruciate ligament (ACL) injuries among females, this study also correlated various musculoskeletal variables significantly impacted by gender, height and/or distance and their interactions with two ACL injury-risk predictor variables; peak vertical ground reaction force (VGRF) and peak proximal tibia anterior shear force (PTASF). Kinematic, kinetic and electromyography data of three male and three female subjects were measured. Results revealed no significant gender differences in the musculoskeletal variables tested except peak VGRF (p = 0.039) and hip axial compressive force (p = 0.032). The quadriceps and the gastrocnemius muscle forces had significant correlations with peak PTASF (r = 0.85, p < 0.05 and r = - 0.88, p < 0.05, respectively). Furthermore, hamstring muscle force was significantly correlated with peak VGRF (r = - 0.90, p < 0.05). The ankle flexion angle was significantly correlated with peak PTASF (r = - 0.82, p < 0.05). Our findings indicate that compared to males, females did not exhibit significantly different muscle forces, or ankle, knee and hip flexion angles during single-leg landings that would explain the gender bias in non-contact ACL injury rate. Our results also suggest that higher quadriceps muscle force increases the risk, while higher hamstring and gastrocnemius muscle forces as well as ankle flexion angle reduce the risk of non-contact ACL injury. PMID:23387967

Ali, Nicholas; Andersen, Michael Skipper; Rasmussen, John; Robertson, D Gordon E; Rouhi, Gholamreza

2014-01-01

236

Low-back injuries in a heavy industry. I. Worker and workplace factors.  

PubMed

The costs and circumstances of low-back strains, low-back impact injuries, and non-low-back injuries among field employees of an offshore petroleum drilling company, 1979-1985, were compared. The objectives were to identify worker and workplace factors associated with low-back injuries, to identify factors differentially associated with lost-time injuries, and to formulate recommendations for the control of low-back injuries. Low-back-impact injuries resulted largely from falls. Efforts to prevent falls would have a potential to reduce other serious consequences as well as back injuries. Workers performing the heaviest physical labor were at highest risk of low-back strains. Based on activities precipitating the injury, modifications of work site, equipment, and procedures to help reduce low-back strains are recommended. Only job was a predictor of whether a low-back strain was likely to be associated with lost time. Even this association was lacking for low-back impact injuries. Cost control by preventing the small proportion of high cost injuries may not be feasible. Rather, subsets of low-back injuries defined, for example, by work site or activity can suggest options for intervention. PMID:1833829

Clemmer, D I; Mohr, D L; Mercer, D J

1991-07-01

237

Shoulder Injuries During Alpine Skiing  

Microsoft Academic Search

We retrospectively reviewed alpine skiing injuries at a destination ski resort during three seasons to charac terize the incidence and types of shoulder injuries. A total of 3451 injuries in 3247 patients were reviewed. The overall injury rate was 4.44 injuries per 1000 skier- days. Injuries to the upper extremity represented 29.1% (N = 1004) of all alpine ski injuries.

Mininder S. Kocher; John A. Feagin

1996-01-01

238

Bodygraphic Injury Surveillance System  

NASA Astrophysics Data System (ADS)

This paper proposes a new technology,``a bodygraphic injury surveillance system (BISS)'' that not only accumulates accident situation data but also represents injury data based on a human body coordinate system in a standardized and multilayered way. Standardized and multilayered representation of injury enables accumulation, retrieval, sharing, statistical analysis, and modeling causalities of injury across different fields such as medicine, engineering, and industry. To confirm the effectiveness of the developed system, the authors collected 3,685 children's injury data in cooperation with a hospital. As new analyses based on the developed BISS, this paper shows bodygraphically statistical analysis and childhood injury modeling using the developed BISS and Bayesian network technology.

Tsuboi, Toshiki; Kitamura, Koji; Nishida, Yoshihumi; Motomura, Yoichi; Takano, Tachio; Yamanaka, Tatsuhiro; Mizoguchi, Hiroshi

239

The effects of multiple daily applications of ice to the hamstrings on biochemical measures, signs, and symptoms associated with exercise-induced muscle damage.  

PubMed

There is inconclusive evidence for the effectiveness of cryotherapy for the treatment of exercised-induced muscle damage (EIMD). Small sample sizes and treatment applications that did not correspond to evidence-based practice are limitations in previous studies that may have contributed to these equivocal findings. The purpose of this study was to examine the effectiveness of daily multiple applications of ice on EIMD throughout the 72-hour recovery period, an icing protocol that more closely resembles current clinical practice. Thirty-three subjects were assigned to either the cryotherapy group (n = 23) or control group (n = 10). The EIMD was induced through repeated isokinetic eccentric contractions of the right hamstring muscle group. The experimental group received ice immediately after induction of EIMD and continued to ice thrice a day for 20 minutes throughout the 72 hours; the control group received no intervention. Isometric torque, hamstring length, pain, and biochemical markers (creatine kinase [CK], alanine aminotransferase, and aspartate aminotransferase [AST]) were assessed at baseline, 24, 48, and 72 hours. Both groups demonstrated a significant change (p < 0.05) in all dependent variables compared with that at baseline, but there was no difference between groups except for pain. The cryotherapy group had significantly (p = 0.048) less pain (3.0 ± 2.1 cm) compared with the control (5.35 ± 2.5 cm) at 48 hours. Although not statistically significant, the cryotherapy group had a greater range of motion and lower CK and AST means at 72 hours compared with that of the control group. Repeated applications of ice can decrease the pain associated with EIMD significantly at 48 hours post EIMD. Although the results may not be unique, the methodology in this study was distinctive in that we used a larger sample size and an icing protocol similar to current recommended treatment practice. PMID:23364294

Oakley, Elizabeth T; Pardeiro, Rafael B; Powell, Joseph W; Millar, Audrey L

2013-10-01

240

Biomechanical comparison between single-bundle and double-bundle anterior cruciate ligament reconstruction with hamstring tendon under cyclic loading condition  

PubMed Central

Purpose The purpose of this study was to compare the anterior tibial translation (ATT) of the anterior cruciate ligament (ACL) reconstructed-knee between single-bundle and double-bundle ACL reconstruction under cyclic loading. Methods Single-bundle and double-bundle reconstructions of the knee were performed sequentially in randomized order on the same side using eight human amputated knees. After each reconstruction, the reconstructed-knee was subjected to 500-cycles of 0 to 100-N anterior tibial loads using a material testing machine. The ATT before and after cyclic loading and “laxity increase”, which indicated a permanent elongation of the graft construct, was also determined. Results The ATT after cyclic loading increased in both single-bundle and double-bundle reconstruction techniques compared to that without cyclic loading. Changes in ATT before and after cyclic loading were 3.9?±?0.9 mm and 2.9?±?0.6 mm respectively, and were significantly different. Laxity increase was also significantly different (4.3?±?0.9 mm and 3.2?±?0.8 mm respectively). Although no graft rupture or graft fixation failure was found during cyclic loading, the graft deviated into an eccentric position within the tunnel. Conclusions Although ATT was significantly increased in both single-bundle and double-bundle reconstruction with hamstring tendon after cyclic loading test, there was significant difference. Double-bundle reconstruction might be superior to prevent increasing ATT under cyclic loading. Deformation of hamstring tendon after cyclic loading might result in deterioration of knee stability after ACL reconstruction, and is one of disadvantages of soft tissue graft. PMID:22747942

2012-01-01

241

The Relationships Among Sagittal-Plane Lower Extremity Moments: Implications for Landing Strategy in Anterior Cruciate Ligament Injury Prevention  

PubMed Central

Context: Excessive quadriceps contraction with insufficient hamstrings muscle cocontraction has been shown to be a possible contributing factor for noncontact anterior cruciate ligament (ACL) injuries. Assessing the relationships among lower extremity internal moments may provide some insight into avoiding muscle contraction patterns that increase ACL injury risk. Objective: To examine the relationships of knee-extensor moment with ankle plantar-flexor and hip-extensor moments and to examine the relationship between knee moment and center of pressure as a measure of neuromuscular response to center-of-mass position. Design: Cross-sectional study. Setting: Applied Neuromechanics Research Laboratory. Patients or Other Participants: Eighteen healthy, recreationally active women (age ?=? 22.3 ± 2.8 years, height ?=? 162.5 ± 8.1 cm, mass ?=? 57.8 ± 9.3 kg). Intervention(s): Participants performed a single-leg landing from a 45-cm box onto a force plate. Kinetic and kinematic data were collected. Main Outcome Measure(s): Pearson product moment correlation coefficients were calculated among the net peak knee-extensor moment (KEMpk), sagittal-plane ankle (AM) and hip (HM) net internal moments, and anterior-posterior center of pressure relative to foot center of mass at KEMpk (COP). Results: Lower KEMpk related to both greater AM (r ?=? ?0.942, P < .001) and HM (r ?=? ?0.657, P ?=? .003). We also found that more anterior displacement of COP was related to greater AM (r ?=? ?0.750, P < .001) and lower KEMpk (r ?=? 0.618, P ?=? .006). Conclusions: Our results suggest that participants who lean the whole body forward during landing may produce more plantar-flexor moment and less knee-extensor moment, possibly increasing hip-extensor moment and decreasing knee-extensor moment production. These results suggest that leaning forward may be a technique to decrease quadriceps contraction demand while increasing hamstrings cocontraction demand during a single-leg landing. PMID:19180216

Shimokochi, Yohei; Yong Lee, Sae; Shultz, Sandra J; Schmitz, Randy J

2009-01-01

242

Finite element modeling of blast lung injury in sheep.  

PubMed

A detailed 3D finite element model (FEM) of the sheep thorax was developed to predict heterogeneous and volumetric lung injury due to blast. A shared node mesh of the sheep thorax was constructed from a computed tomography (CT) scan of a sheep cadaver, and while most material properties were taken from literature, an elastic-plastic material model was used for the ribs based on three-point bending experiments performed on sheep rib specimens. Anesthetized sheep were blasted in an enclosure, and blast overpressure data were collected using the blast test device (BTD), while surface lung injury was quantified during necropsy. Matching blasts were simulated using the sheep thorax FEM. Surface lung injury in the FEM was matched to pathology reports by setting a threshold value of the scalar output termed the strain product (maximum value of the dot product of strain and strain-rate vectors over all simulation time) in the surface elements. Volumetric lung injury was quantified by applying the threshold value to all elements in the model lungs, and a correlation was found between predicted volumetric injury and measured postblast lung weights. All predictions are made for the left and right lungs separately. This work represents a significant step toward the prediction of localized and heterogeneous blast lung injury, as well as volumetric injury, which was not recorded during field testing for sheep. PMID:25411822

Gibbons, Melissa M; Dang, Xinglai; Adkins, Mark; Powell, Brian; Chan, Philemon

2015-04-01

243

Injury Free Coalition for Kids  

MedlinePLUS

... Free Sites Safety Resources Staff Donate Online! Injury Free News Dawne Gardner of Injury Free Cincinnati receives ... Free Site -- Injury Free Call for Proposals Injury Free is supported by the generous contributions of organizations ...

244

Hand and Wrist Injuries  

MedlinePLUS

... AND WRIST INJURIES INJURY CAUSES/DESCRIPTIONSYMPTOMS TREATMENTRETURN TO PLAY Jammed Finger Striking the end of the finger Pain, swelling at the joint, Ice, rest, buddy tape As tolerated with while ...

245

Snowboarding injuries in children  

PubMed Central

Objective To study injury patterns of snowboarding trauma in children. Design A retrospective case series. Setting A major pediatric trauma centre. Patients A cohort of 113 children (97 boys, 16 girls), mean age 13.9 years, who sustained 118 injuries secondary to snowboarding. Interventions All fractures were treated by immobilization in a cast; 19 children required a closed reduction. Outcome measures Sex and age of patients, mechanism of injury, injury sustained, treatments and complications. Results Falls on the outstretched hand from a loss of balance accounted for 66 (57%) of the injuries, uncontrolled falls for 42 (36%) and collisions for 5 (4%). Seventy-nine percent of the injuries were to the upper extremity, whereas 7% were to the lower extremity. Conclusions The predominance of snowboarding injuries of the upper extremity seen in children differs significantly from those in adults in whom lower extremity injuries are more common. PMID:11764877

Drkulec, John A.; Letts, Mervyn

2001-01-01

246

Traumatic Brain Injury  

MedlinePLUS

... Resilience, Mental Health Resources The Center for the Study of Traumatic Stress at the Uniformed Services University ... on PTSD, TBI DOD Establishes Tissue Bank to Study Brain Injuries Defense Brain Injury Center, Two Decades ...

247

Head injury - first aid  

MedlinePLUS

... Head injury. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and ... Landry GL. Head and neck injuries. In: Kliegman RM, Stanton BF, St. Geme JW III, et al., ...

248

Posttraumatic mossy fiber sprouting is related to the degree of cortical damage in three mouse strains  

PubMed Central

Summary Controlled cortical impact injury was used to examine relationships between focal posttraumatic cortical damage and mossy fiber sprouting (MFS) in the dentate gyrus in three mouse strains. Posttraumatic MFS was more robust when cortical injury impinged upon the hippocampus, versus contusions restricted to neocortex, and was qualitatively similar among CD-1, C57BL/6, and FVB/N background strains. Impact parameters influencing injury severity may be critical in reproducing epilepsy-related changes in neurotrauma models. PMID:22047981

Hunt, Robert F.; Haselhorst, Laura A.; Schoch, Kathleen M.; Bach, Eva C.; Rios-Pilier, Jennifer; Scheff, Stephen W.; Saatman, Kathryn E.; Smith, Bret N.

2011-01-01

249

Contractional Strain  

NSDL National Science Digital Library

Students use gesture to describe the bulk deformation and local deformation apparent in images of a contractional analog experiment. Students then calculate bulk shortening and bulk thickening for the experiment and describe the structures accommodating that strain.

Ormand, Carol

250

Assessment of Ankle Injuries  

ERIC Educational Resources Information Center

School nurses are faced with the challenge of identifying and treating ankle injuries in the school setting. There is little information guiding the assessment and treatment of these children when an injury occurs. It is essential for school nurses to understand ankle anatomy, pathophysiology of the acute ankle injury, general and orthopedic…

Mai, Nicholas; Cooper, Leslie

2009-01-01

251

Traumatic Brain Injury  

NSDL National Science Digital Library

Very concise description of what constitutes a traumatic brain injury and the cost to society in hospitalizations, injuries and deaths resulting from traumatic brain injury. It also looks very concisely at new understandings of the nature of TBIs and the research being done to find better treatments.

Dr. Leslie Nader (MSMR)

2000-02-01

252

Muscle morphometric effect of anterior cruciate ligament injury measured by computed tomography: aspects on using non-injured leg as control  

PubMed Central

Background Anterior cruciate ligament (ACL) tears are common, functionally disabling, and predispose to subsequent injuries and early onset of osteoarthritis in the knee. Injuries result in muscular atrophy and impaired muscular activation. To optimize surgical methods and rehabilitation strategies, knowledge of the effects of ACL injuries on muscles size and function is needed. Asymmetry due to limb dominance implies that the effect of ACL-injury might be different in right-sided and left-sided injuries which, should be taken in account when evaluating the effect of an injury. Evaluation of the effects of injuries is usually made with the contralateral leg as control. The aim of this study is to describe the effect of ACL-injuries on thigh muscle size and also to analyze feasibility of using contralateral limb as control. Methods Sixty-two patients scheduled to undergo ACL reconstruction were examined with computed tomography (CT). Muscle cross sectional area (CSA) was recorded for quadriceps, hamstrings, gracilis and sartorius 15 cm above the knee joint. Comparisons were made between the injured and non-injured side and between individuals separated by gender and side of injury. Comparisons were also made for patients with or without concomitant meniscal tear, for patients differing in time between injury and examinations and for patients with different level of physical activity after the injury. Results Quadriceps CSA was 5% smaller on the injured side. There was an indication that the muscles of the right thigh were generally bigger than those of the left thigh. The difference between the injured and the non-injured side was larger for right-sided injuries than for left-sided. There was also a greater difference in semimembranosus for women than for men. There were no differences related to meniscal injury, time since injury or physical activity. Conclusion The use of contralateral leg for evaluating the effect of ACL-injury is often the only available alternative but our study indicates that the difference in CSA between injured and non-injured side does not necessarily reflect the true degree of atrophy, as there are side differences both in muscle size in general and in the effect of an ACL-injury on muscle size. PMID:23628130

2013-01-01

253

An in vitro uniaxial stretch model for axonal injury.  

PubMed

We have developed a unique uniaxial stretching device to study axonal injury and neural cell death resulting from brain tissue deformations common in traumatic head injuries. Using displacement control rather than force control, this device is capable of achieving strains >70% and strain rates up to 90 s(-1), well above those currently used for studying axonal injury. We have demonstrated that the deformation of the specimen was uniaxial, uniform and highly reproducible; the prespecified displacement profiles could be realized almost precisely; and adequate cell adhesion could be achieved readily. The entire device can fit into a biological safety cabinet to maintain sterility, and the specimens are convenient for cell culture. This device can be used to investigate a wide range of biomechanical issues involved in diffuse axonal injury. PMID:12757202

Pfister, Bryan J; Weihs, Timothy P; Betenbaugh, Michael; Bao, Gang

2003-05-01

254

Major peripheral veins injuries.  

PubMed

The injury was severe in wounded limb patients of this series who suffered from an associated major peripheral vein trauma. The presence of such an injury weighed heavily on the prognosis. Thirty eight patients with major peripheral veins injuries are reviewed. The injury had resulted from war wounds, work or road accidents. The superficial femoral vein was the most frequently injured vein. Associated injuries were frequently noted: soft tissues injuries in 35 patients, fractures in 33, arterial injuries in 32 and peripheral nerve injuries in 22 patients. Shock was more often present and more severe in patients who suffered also from a vein injury than in patients with an arterial injury only. The lacerated femoral vein was ligated in the majority of patients. Attempts were made to repair the lacerated popliteal veins. Repair of the vein was usually done by anastomosis of debrided ends. When an arterial injury was also present, it was repaired first. The postoperative complications were frequent and included infections, thrombophlebitis and pulmonary embolisations. Twenty four patients were discharged with a viable limb. Complete function was recovered in seven patients only. Partial neurological deficit remained in twelve patients and complete paralysis in five. Twelve patients underwent subsequent amputation of the injured limb. Indications for amputation were ischemia in eight, infection or extensive destruction of tissues in four. Two patients died. PMID:961040

Romanoff, H; Goldberger, S

1976-01-01

255

STRAIN GAGE TECHNICAL DATA STRAIN GAGE  

E-print Network

E-3 STRAIN GAGE TECHNICAL DATA STRAIN GAGE MEASUREMENT The most universal measuring device for the electrical measurement of mechanical quantities is the strain gage. Several types of strain gages depend, and the strain is found by measuring the change in resistance. The bonded resistance strain gage is low in cost

Lynch, Jerome P.

256

Development of brain injury criteria (BrIC).  

PubMed

Rotational motion of the head as a mechanism for brain injury was proposed back in the 1940s. Since then a multitude of research studies by various institutions were conducted to confirm/reject this hypothesis. Most of the studies were conducted on animals and concluded that rotational kinematics experienced by the animal's head may cause axonal deformations large enough to induce their functional deficit. Other studies utilized physical and mathematical models of human and animal heads to derive brain injury criteria based on deformation/pressure histories computed from their models. This study differs from the previous research in the following ways: first, it uses two different detailed mathematical models of human head (SIMon and GHBMC), each validated against various human brain response datasets; then establishes physical (strain and stress based) injury criteria for various types of brain injury based on scaled animal injury data; and finally, uses Anthropomorphic Test Devices (ATDs) (Hybrid III 50th Male, Hybrid III 5th Female, THOR 50th Male, ES-2re, SID-IIs, WorldSID 50th Male, and WorldSID 5th Female) test data (NCAP, pendulum, and frontal offset tests) to establish a kinematically based brain injury criterion (BrIC) for all ATDs. Similar procedures were applied to college football data where thousands of head impacts were recorded using a six degrees of freedom (6 DOF) instrumented helmet system. Since animal injury data used in derivation of BrIC were predominantly for diffuse axonal injury (DAI) type, which is currently an AIS 4+ injury, cumulative strain damage measure (CSDM) and maximum principal strain (MPS) were used to derive risk curves for AIS 4+ anatomic brain injuries. The AIS 1+, 2+, 3+, and 5+ risk curves for CSDM and MPS were then computed using the ratios between corresponding risk curves for head injury criterion (HIC) at a 50% risk. The risk curves for BrIC were then obtained from CSDM and MPS risk curves using the linear relationship between CSDM - BrIC and MPS - BrIC respectively. AIS 3+, 4+ and 5+ field risk of anatomic brain injuries was also estimated using the National Automotive Sampling System - Crashworthiness Data System (NASS-CDS) database for crash conditions similar to the frontal NCAP and side impact conditions that the ATDs were tested in. This was done to assess the risk curve ratios derived from HIC risk curves. The results of the study indicated that: (1) the two available human head models - SIMon and GHBMC - were found to be highly correlated when CSDMs and max principal strains were compared; (2) BrIC correlates best to both - CSDM and MPS, and rotational velocity (not rotational acceleration) is the mechanism for brain injuries; and (3) the critical values for angular velocity are directionally dependent, and are independent of the ATD used for measuring them. The newly developed brain injury criterion is a complement to the existing HIC, which is based on translational accelerations. Together, the two criteria may be able to capture most brain injuries and skull fractures occurring in automotive or any other impact environment. One of the main limitations for any brain injury criterion, including BrIC, is the lack of human injury data to validate the criteria against, although some approximation for AIS 2+ injury is given based on the angular velocities calculated at 50% probability of concussion in college football players instrumented with 5 DOF helmet system. Despite the limitations, a new kinematic rotational brain injury criterion - BrIC - may offer a way to capture brain injuries in situations when using translational accelerations based HIC alone may not be sufficient. PMID:24435734

Takhounts, Erik G; Craig, Matthew J; Moorhouse, Kevin; McFadden, Joe; Hasija, Vikas

2013-11-01

257

Histopathological findings, phenotyping of inflammatory cells, and expression of markers of nitritative injury in joint tissue samples from calves after vaccination and intraarticular challenge with Mycoplasma bovis strain 1067  

PubMed Central

Background The pathogenesis of caseonecrotic lesions developing in lungs and joints of calves infected with Mycoplasma bovis is not clear and attempts to prevent M. bovis-induced disease by vaccines have been largely unsuccessful. In this investigation, joint samples from 4 calves, i.e. 2 vaccinated and 2 non-vaccinated, of a vaccination experiment with intraarticular challenge were examined. The aim was to characterize the histopathological findings, the phenotypes of inflammatory cells, the expression of class II major histocompatibility complex (MHC class II) molecules, and the expression of markers for nitritative stress, i.e. inducible nitric oxide synthase (iNOS) and nitrotyrosine (NT), in synovial membrane samples from these calves. Furthermore, the samples were examined for M. bovis antigens including variable surface protein (Vsp) antigens and M. bovis organisms by cultivation techniques. Results The inoculated joints of all 4 calves had caseonecrotic and inflammatory lesions. Necrotic foci were demarcated by phagocytic cells, i.e. macrophages and neutrophilic granulocytes, and by T and B lymphocytes. The presence of M. bovis antigens in necrotic tissue lesions was associated with expression of iNOS and NT by macrophages. Only single macrophages demarcating the necrotic foci were positive for MHC class II. Microbiological results revealed that M. bovis had spread to approximately 27% of the non-inoculated joints. Differences in extent or severity between the lesions in samples from vaccinated and non-vaccinated animals were not seen. Conclusions The results suggest that nitritative injury, as in pneumonic lung tissue of M. bovis-infected calves, is involved in the development of caseonecrotic joint lesions. Only single macrophages were positive for MHC class II indicating down-regulation of antigen-presenting mechanisms possibly caused by local production of iNOS and NO by infiltrating macrophages. PMID:25162202

2014-01-01

258

Sports hip injuries: assessment and management.  

PubMed

Over the past 10 years, the understanding, assessment, and management of hip pain and injuries in the athlete have improved. Traditionally, the evaluation of hip pain and injuries was limited to obvious disorders, such as hip arthritis and fractures, or disorders that were previously considered to be simply soft-tissue strains and contusions, such as groin pulls, hip pointers, and bursitis. Two parallel tracks of progress have improved understanding of the complexities of hip joint athletic injuries and the biomechanical basis of early hip disease. In the field of sports medicine, improved diagnostic skills now allow better interpretation of debilitating intra-articular hip disorders and their effects on core performance. In the field of hip preservation, there has been an evolution in understanding the effects of biomechanical mismatches between the femoral head and the acetabulum on the development of early hip damage, injury, and arthritis. The integration of these two parallel fields has accelerated the understanding of the importance of hip biomechanics and early hip injury in human performance and function. PMID:23395055

Kelly, Bryan T; Maak, Travis G; Larson, Christopher M; Bedi, Asheesh; Zaltz, Ira

2013-01-01

259

Strain hardening at large strains  

SciTech Connect

The strain hardening properties of various fcc metals have been investigated at large strains by means of torsion tests of short thin-walled cylinders. The results show that Stage IV occurs in all cases provided that a low enough test temperature is used; it is a nearly constant hardening rate of 2.10/sup /minus/4/ G in terms of resolved flow stress. Stage IV strain hardening has been modeled by considering the effects of accumulation of dislocation debris, such as dipoles and loops, in the ''saturation'' stress. The ''saturation'' stress that can be obtained by extrapolation of Stage III is now a limiting flow stress that slowly increases with the accumulation of debris. The model reproduces the sharp transition from Stage III to Stage IV that occurs experimentally at low temperatures and, for a reasonable choice of parameters, the rate of hardening in Stage IV. 15 refs., 8 figs.

Rollett, A.D.; Kocks, U.F.; Embury, J.D.; Stout, M.G.; Doherty, R.D.

1988-01-01

260

Perioperative Organ Injury  

PubMed Central

In spite of the fact that a surgical procedure may have been performed for the appropriate indication and in a technically perfect manner, patients are threatened by perioperative organ injury. For example, stroke, myocardial infarction, acute respiratory distress syndrome, acute kidney injury, or acute gut injury are among the most common causes for morbidity and mortality in surgical patients. In the present review, we discuss the pathogenesis of perioperative organ injury, and provide select examples for novel treatment concepts that have emerged over the past decade. Indeed, we believe that research to provide mechanistic insight into acute organ injury and to identify novel therapeutic approaches for the prevention or treatment of perioperative organ injury represents the most important opportunity to improve outcomes of anesthesia and surgery. PMID:24126264

Bartels, Karsten; Karhausen, Jörn; Clambey, Eric T.; Grenz, Almut; Eltzschig, Holger K.

2014-01-01

261

The influence of hamstring autograft size on patient reported outcomes and risk of revision following anterior cruciate ligament reconstruction: A MOON cohort study  

PubMed Central

Purpose The purpose of this study is to evaluate the effect of graft size on patient-reported outcomes and revision risk following ACL reconstruction. Methods A retrospective chart review of prospectively collected cohort data, 263 of 320 consecutive patients (82.2%) undergoing primary ACL reconstruction with hamstring autograft were evaluated. Graft size, femoral tunnel drilling technique, patient age, sex, and BMI at the time of ACL reconstruction, pre-operative and 2-year post-operative KOOS and IKDC scores, and whether each patient underwent revision ACL reconstruction during the 2 year follow-up period were recorded. Revision was used as a marker for graft failure. The relationship between graft size and patient-reported outcomes was determined by multiple linear regression. The relationship between graft size and risk of revision was determined by dichotomizing graft size at 8mm and stratifying by age. Results After controlling for age, sex, operative side, surgeon, BMI, graft choice, and femoral tunnel drilling technique, a 1 mm increased in graft size was noted to correlate with 3.3-point increase in the KOOS-pain subscale (p = 0.003), a 2.0-point increased in the KOOS activities of daily living subscale (p = 0.034), a 5.2-point increase in the KOOS-sport/recreation function subscale (p = 0.004), and a 3.4-point increase in the subjective IKDC score (p = 0.026). Revision was required in 0 of 64 patients (0.0%) with grafts greater than 8mm in diameter and 14 of 199 patients (7.0%) with 8 mm or smaller grafts (p = 0.037). Among patients age 18 and under, revision was required in 0 of 14 patients (0.0%) with grafts greater than 8mm in diameter and 13 of 71 patients (18.3 %) with 8 mm or smaller grafts. Conclusions Smaller hamstring autograft size is a predictor of poorer KOOS Sport and Recreation function 2 years following primary ACL reconstruction. Larger sample size is required to confirm the relationship between graft size and risk of revision ACL reconstruction. Level of Evidence Level 3 PMID:24140144

Mariscalco, Michael W.; Flanigan, David C.; Mitchell, Joshua; Pedroza, Angela D.; Jones, Morgan H.; Andrish, Jack T.; Parker, Richard D.; Kaeding, Christopher C.; Magnussen, Robert A.

2013-01-01

262

Common Injuries in Gymnasts  

Microsoft Academic Search

\\u000a Both acute injuries as well as chronic overuse injuries should be considered when evaluating examinations of elite gymnastic\\u000a athletes. Injuries of the growing skeleton are typically seen in gymnasts. Imaging in gymnasts comprises mainly conventional\\u000a radiographs, MR imaging and CT. There is an important additional role for Multi detector Helical CT when MR imaging is suggestive\\u000a of disease: CT will

Maaike P. Terra; Mario Maas; Charlotte M. Nusman; Ana Navas-Canete; Milko C. de Jonge

263

Traumatic Head Injuries  

Microsoft Academic Search

\\u000a Head injuries are common among children, and they result in a significant number of visits to emergency departments and physicians’\\u000a offices each year. In children 15yr old and under, the estimated incidence of traumatic brain injury is 180 per 100,000 children\\u000a per year, totaling more than 1 million injuries annually in the United States and accounting for more than 10%

Laura Purcell

264

Ischemia-Reperfusion Injury  

Microsoft Academic Search

The term ischemia-reperfusion injury describes the experimentally and clinically prevalent finding that tissue ischemia with\\u000a inadequate oxygen supply followed by successful reperfusion initiates a wide and complex array of inflammatory responses that\\u000a may both aggravate local injury as well as induce impairment of remote organ function. Conditions under which ischemia-reperfusion\\u000a injury is encountered include the different forms of acute vascular

Bernhard Dorweiler; Diethard Pruefer; Terezia B. Andrasi; Sasa M. Maksan; Walther Schmiedt; Achim Neufang; Christian F. Vahl

2007-01-01

265

Design of a New Stretching Apparatus and the Effects of Cyclic Strain and Substratum on Mouse Lung Epithelial-12 Cells  

E-print Network

Design of a New Stretching Apparatus and the Effects of Cyclic Strain and Substratum on Mouse Lung. There is considerable evidence that mechanical ventilation in the setting of acute lung injury (ALI) can exacerbate pre-existing lung injury in the form of ventilator induced lung injury (VILI).4,5,10,24 In the case of severe

266

Musculoskeletal injuries in adolescents.  

PubMed

This article reviews the anatomy of the physis and the most common classification of injuries or fractures through the physis. The common apophyseal injuries of Osgood-Schlatter, Severs disease and iliac apophysitis, are reviewed in addition to a review of the most common osteochondritides, including Panner's disease and Osteochondritis Dessicans of the femur and talus. An understanding of these is key to diagnosis and treatment of adolescent musculoskeletal injuries. This article also reviews slipped capital femoral epiphysis, little leaguer's elbow, anterior cruciate and collateral ligament injuries, patella problems, ankle sprains and several common fractures in children. PMID:9469924

Kaeding, C C; Whitehead, R

1998-03-01

267

Eye injuries in sport.  

PubMed

Most ocular injuries involve only the external eye. However, in approximately one-third of cases the intraocular structures are damaged with potentially sight threatening consequences. A small number of sports, such as soccer, rugby, hockey and the racquet sports are responsible for most injuries. Sport is responsible for between 25-40% of all eye injuries severe enough to require hospital admission. Most of these are recognised as being largely preventable and methods of reducing the number and severity of such injuries are of prime importance. PMID:20533697

MacEwen, C J; McLatchie, G R

2010-05-01

268

Head injuries in sport.  

PubMed Central

Injuries to the head and neck are the most frequent catastrophic sports injury, and head injuries are the most common direct athletic cause of death. Although direct compressive forces may injure the brain, neural tissue is particularly susceptible to injury from shearing stresses, which are most likely to occur when rotational forces are applied to the head. The most common athletic head injury is concussion, which may very widely in severity. Intracranial haemorrhage is the leading cause of head injury death in sports, making rapid initial assessment and appropriate follow up mandatory after a head injury. Diffuse cerebral swelling is another serious condition that may be found in the child or adolescent athlete, and the second impact syndrome is a major concern in adult athletes. Many head injuries in athletes are the result of improper playing techniques and can be reduced by teaching proper skills and enforcing safety promoting rules. Improved conditioning (particularly of the neck), protective headgear, and careful medical supervision of athletes will also minimise this type of injury. PMID:9015588

Cantu, R C

1996-01-01

269

Acute injuries in Taekwondo.  

PubMed

Although Taekwondo is becoming an increasingly popular sport, there is a lack of reliable epidemiologic data on Taekwondo injuries. To perform an epidemiologic study on the variety of types of injury in professional and amateur Taekwondo athletes and to find a relation between Taekwondo style, skill level, weight-class and warm-up routine and the occurrence of injuries, we analysed the injury data using a 7-page questionnaire from a total of 356 Taekwondo athletes who were randomly selected. Overall, we registered a total of 2,164 injuries in 356 athletes. Most traumas were contusions and sprains in the lower extremities. Professional Taekwondo athletes have an increased risk of injury in comparison to recreational athletes. Taekwondo style, weight class and tournament frequency have an influence on the athlete's injury profile. Warm-up routines were found to have a positive effect on injury rates. Overall, Taekwondo may be considered a rather benign activity, if injuries during Taekwondo tournaments can be avoided. If not, Taekwondo can result in serious musculoskeletal problems. PMID:21563037

Schlüter-Brust, K; Leistenschneider, P; Dargel, J; Springorum, H P; Eysel, P; Michael, J W-P

2011-08-01

270

[Blunt heart injuries].  

PubMed

Cardiac injuries were present in 16% of our patients suffering from blunt chest trauma. 25% of these cases had no concomitant rib fractures. Sonography is extremely important for evaluation. In myocardial contusion the electrocardiogram reveals mainly disturbances in repolarisation (66 out of 108 patients) and rhythm disturbances (59 patients). A ratio of CK-MB isoenzyme/total CK of over 8% is highly suggestive of myocardial injury. Continuous monitoring in ICU is mandatory. Prognosis is mainly based on additional injuries. Heart wall rupture and luxation of the heart require operative treatment. Lesions of the aortic valves are the most frequent valve injuries. PMID:3807506

Glinz, W; Turina, M

1986-01-01

271

Lightning and thermal injuries.  

PubMed

Electrical burns are classified as either high voltage (1000 volts and higher) or low voltage (<1000 volts). The typical injury with a high-voltage electrical contact is one where subcutaneous fat, muscles, and even bones are injured. Lower voltages may have lesser injuries. The electrical current has the potential to injure via three mechanisms: injury caused by current flow, an arc injury as the current passes from source to an object, and a flame injury caused by ignition of material in the local environment. Different tissues also have different resistance to the conduction of electricity. Voltage, current (amperage), type of current (alternating or direct), path of current flow across the body, duration of contact, and individual susceptibility all determine what final injury will occur. Devitalized tissue must be evaluated and debrided. Ocular cataracts may develop over time following electrical injury. Lightning strikes may conduct millions of volts of electricity, yet the effects can range from minimal cutaneous injuries to significant injury comparable to a high-voltage industrial accident. Lightning strikes commonly result in cardiorespiratory arrest, for which CPR is effective when begun promptly. Neurologic complications from electrical and lightning injuries are highly variable and may present early or late (up to 2 years) after the injury. The prognosis for electricity-related neurologic injuries is generally better than for other types of traumatic causes, suggesting a conservative approach with serial neurologic examinations after an initial CT scan to rule out correctable causes. One of the most common complications of electrical injury is a cardiac dysrhythmia. Because of the potential for large volumes of muscle loss and the release of myoglobin, the presence of heme pigments in the urine must be evaluated promptly. Presence of these products of breakdown of myoglobin and hemoglobin puts the injured at risk for acute renal failure and must be treated. The exact mechanism of nerve injury has not been explained, but both direct injury by electrical current overload or a vascular cause receive the most attention. Because electrical injuries carry both externally visible cutaneous injuries and possible hidden musculoskeletal damage, conventional burn resuscitation formulas based on body surface area injured may not provide enough fluid to maintain urine output. Damaged muscle resulting in swelling within the investing fascia of an extremity may result in compartment syndromes, requiring further attention. If myoglobin has been detected in the urine, treatment is aggressive volume resuscitation and possibly alkalinization of the urine or mannitol is given IV push to minimize pigment precipitation in the renal tubules. Approximately 15% of electrical burn victims also sustain traumatic injuries. This is because of falls from height or being thrown against an object. The tetanic contractions that result from exposure to electrical injury cause imbalance in flexor versus extensor muscles, with the flexor groups being stronger. Not only is the victim unable to release from the electrical contact, but they are at risk for fracture of bones from this prolonged muscular contracture. Neurologic and psychological symptoms were the most common sequelae of electrical and lightning injuries. Many of these symptoms are nonspecific, and they often do not appear until several months after the injury. A full neurologic examination must be performed on admission, documenting initial presentation and at any change in symptoms. Electrical injuries can have devastating consequences. Prevention of electrical injuries is clearly the preferable strategy for treatment. PMID:24365365

Sanford, Arthur; Gamelli, Richard L

2014-01-01

272

Acute Injury Phase Clinical Trials in Acute Traumatic Brain Injury  

E-print Network

TREatments for the Prevention of secondary Injury and Disability following TBI (A Randomized, Double Brain Injury From Brain Trauma Foundation Website Traumatic Brain Injury (TBI) is the leading cause

VandeVord, Pamela

273

Injury rates of the German Women's American Football National Team from 2009 to 2011.  

PubMed

American football is one of the leading causes of athletic-related injuries. Injury rates in female elite players are mostly unknown. We hypothesized that the injury rates of female was comparable to those in men's football during practice, as well as games. From 2009 to 2011, injury data were collected from the German female national team during training camps, World Championship 2010 and International friendly matches. The injury was categorized by location on the body and recorded as fracture/dislocation, strain, concussion, contusion or other injury. Injury rates were determined based on the exposure of an athlete to a game or practice event. The injury rate was calculated as the ratio of injuries per 1000 athlete exposures (AE). The rate of injury was significantly higher during games (58.8/1000 AE) than practices [16.3/1000 AE, (P<0.01)]. Furthermore, the injury rate in the tryouts was significantly higher (24.05/1000 AE) compared to other training sessions with the national team (11.24/1000 AE). Our findings show that the injury rates in female elite American football players can be compared to those described for male players. Higher injury rates during matches than in training should also be underlined. PMID:23066496

Ezechieli, Marco; Berger, Stephan; Siebert, Christian-Helge; Miltner, Oliver

2012-09-01

274

Overview of injuries in the young athlete.  

PubMed

It is estimated that 30 million children in the US participate in organised sports programmes. As more and more children participate in sports and recreational activities, there has been an increase in acute and overuse injuries. Emergency department visits are highest among the school-age to young adult population. Over one-third of school-age children will sustain an injury severe enough to be treated by a doctor or nurse. The yearly costs have been estimated to be as high as 1.8 billion US dollars. There are physical and physiological differences between children and adults that may cause children to be more vulnerable to injury. Factors that contribute to this difference in vulnerability include: children have a larger surface area to mass ratio, children have larger heads proportionately, children may be too small for protective equipment, growing cartilage may be more vulnerable to stresses and children may not have the complex motor skills needed for certain sports until after puberty. The most commonly injured areas of the body include the ankle and knee followed by the hand, wrist, elbow, shin and calf, head, neck and clavicle. Contusions and strains are the most common injuries sustained by young athletes. In early adolescence, apophysitis or strains at the apophyses are common. The most common sites are at the knee (Osgood-Schlatter disease), at the heel (Sever's disease) and at the elbow (Little League Elbow). Non-traumatic knee pain is one of the most common complaints in the young athlete. Patellar Femoral Pain Syndrome (PFPS) has a constellation of causes that include overuse, poor tracking of the patellar, malalignment problems of the legs and foot problems, such as pes planus. In the child, hip pathology can present as knee pain so a careful hip exam is important in the child presenting with an insidious onset of knee pain. Other common injuries in young athletes discussed include anterior cruciate ligament injuries, ankle sprains and ankle fractures. Prevention of sports and recreation-related injuries is the ideal. There are six potential ways to prevent injuries in general: (i) the pre-season physical examination; (ii) medical coverage at sporting events; (iii) proper coaching; (iv) adequate hydration; (v) proper officiating; and (vi) proper equipment and field/surface playing conditions. PMID:12477379

Adirim, Terry A; Cheng, Tina L

2003-01-01

275

Gait Characteristics, Range of Motion, and Spasticity Changes in Response to Massage in a Person with Incomplete Spinal Cord Injury: Case Report  

PubMed Central

Purpose: Our study set out to measure the effect of a specific routine of massage on gait characteristics, range of motion, and spasticity in a person with incomplete spinal cord injury. Methods: This descriptive, pre–post case study, conducted at the outpatient program of a rehabilitation facility, used neuromuscular techniques in massage for a 42-year-old man with incomplete chronic C5 spinal cord injury. The massage was applied to the iliopsoas, triceps surae, and hamstring muscle groups for 3 consecutive days. Main Outcome Measures: Pre- and post-intervention testing included standard goniometric measurement of joint range of motion in the lower extremities, spasticity evaluation using the modified Ashworth scale, and evaluation of gait characteristics using GAITRite Walkway (CIR Systems, Havertown, PA, USA) pressure mapping for ambulation time, cadence, velocity, stride length, base of support, and single- and double-limb support. Results: After the therapeutic intervention, the following gait changes were demonstrated: increase in velocity and cadence of gait, decrease in ambulation time, increase in stride length, and improvements in the percentages of the swing and stance phases of the gait cycle. Conclusions: Specific application of massage therapy influenced gait speed, stride length, and swing and stance phase percentages in one person with incomplete spinal cord injury. Further study is warranted to determine the extent to which massage may affect musculoskeletal and neural impairments that limit gait in people with incomplete spinal cord injury, and the method or routine whose application will yield the most benefit. PMID:21589693

Manella, Christine; Backus, Deborah

2011-01-01

276

Mouse Repository Strain Details  

Cancer.gov

Available Strain Details Order Form for Cryoarchived Strains   Strain Number: 01XB8  Common Strain Name: Brca1 floxed (FVB;129)  Strain Nomenclature: FVB;129-Brca1tm1Brn/Nci  Release Category (Required for MTA form): C2 , D Sample MTA for this strain Strain

277

Work related injuries in small scale commercial fishing  

PubMed Central

Objective: To describe the epidemiology of work related injury in a group of small scale, independent commercial fishers. Design: Cross sectional survey (baseline instrument of a prospective cohort study). Setting and subjects: Commercial fishers in eastern North Carolina. Results: A cohort of 219 commercial fishers was established and 215 subjects completed an injury questionnaire. The main types of fishing conducted by the cohort were finfishing (159/215) and crabbing (154/215). Of the 215 fishers, 83 reported that they had suffered an injury event in the previous 12 months, a retrospective recall incidence proportion of 38.6 per 100 workers (95% confidence interval 32.1 to 45.1). The 83 injury events resulted in 94 injuries; 47% were penetrating wounds and 24% were strains/sprains. Half of injuries were to the hand/wrist/digits and 13% were to the back. Of the penetrating wounds, 87% were to the hand/wrist/digits, 32% became infected, and 80% were caused by contact with finfish, shellfish, or other marine animal. Of the strains/sprains, 48% were to the back and 26% were to the shoulder. Seventy percent of strains/sprains were caused by moving heavy objects, mainly either while hauling in nets, pots, or lines or loading/unloading the boat. Conclusion: In this group of small scale, independent fishers, the most common reported injuries were penetrating wounds to the hand/wrist/digits from marine animals and strains/sprains to the back while moving heavy objects. PMID:15314048

Marshall, S; Kucera, K; Loomis, D; McDonald, M; Lipscomb, H

2004-01-01

278

The NF-?B inhibitors attenuate hepatic injury in bile duct ligated rats  

Microsoft Academic Search

Cholestasis-induced liver injury during bile duct obstruction causes an inflammatory response and this inflammatory process may be an important source of tissue injury. We hypothesized that NF-?B inhibition would decrease liver injury in a rat model of extrahepatic biliary obstruction. A total of 40 female rats of Sprague-Dawley strain were allocated to four groups. First group was sham operated control.

Sava? Demirbilek; Melih Ak?n; Kubilay Gürünlüo?lu; Nasuhi E. Ayd?n; Memet H. Emre; Erkan Ta?; Rauf T. Aksoy; Selma Ay

2006-01-01

279

On the Role of a Nonlinear Stress-Strain Relation in Brain Trauma  

E-print Network

On the Role of a Nonlinear Stress-Strain Relation in Brain Trauma Igor Szczyrba School-strain relation (that leads to a stiffening of the brain matter under strain) influences the brain dynamics head using our generalization of the viscoelastic Kelvin-Voigt brain injury model that includes

Burtscher, Martin

280

Injuries and injury prevention during foot marching.  

PubMed

Since the beginning of recorded history, Soldiers have carried arms and equipment on their bodies. More recently, loads have substantially increased, driven by improvements in weapons technology and personal protection. As Soldier loads increase, there are increases in energy cost, altered gait mechanics, increased stress on the musculoskeletal system, and more rapid fatigue, factors that may increase the risk of injury. Common injuries and symptoms experienced by Soldiers on load-carriage missions include foot blisters, metatarsalgia, knee problems, and back problems. This article discusses these problems, providing diagnoses, injury mechanisms, and preventive measures. In general, lighter loads, improving load distribution, using appropriate physical training, selecting proper equipment, and using specific prevention techniques will facilitate load carriage and provide Special Operations Forces with a higher probability of mission success. PMID:25399383

Knapik, Joseph J

2014-01-01

281

Mechanism of whiplash injury  

Microsoft Academic Search

Objective. To propose a different hypothesis of whiplash injury mechanism based on a series of experimental studies summarized in this communication.Design. A series of biomechanical studies simulating whiplash trauma using isolated human cadaveric spine specimens.Background. Whiplash injuries are on the rise as reported in several recent studies, due primarily to the increased traffic density. Although the symptoms associated with whiplash

Manohar M. Panjabi; Jacek Cholewicki; Kimio Nibu; Jonathan N. Grauer; Lawrence B. Babat; Jiri Dvorak

1998-01-01

282

update: acute KIDNEY INJURY  

E-print Network

Guidelines update: acute KIDNEY INJURY August 2012, Issue 8 Tlaleletso is a monthly publication that have acute kidney injury. We review the common presentations and causes, especially in patients living it to cover, please send us your feedback­ either on content or format. Respectfully, Mike Reid Acute kidney

Bushman, Frederic

283

Study of aeroball injuries.  

PubMed Central

OBJECTIVE: To present the risks of aeroball, a new sport played by either two or four players on a trampoline court surrounded by specially constructed fabric walls, and to propose ways to increase awareness and reduce the incidence of injury, in particular, ankle injury. METHOD: A study was carried out to document the nature of aeroball related incidents, between 1991 and 1995, at Lancaster University Sports Centre. Lace-up ankle supports were introduced in April 1992, and their effect on the incidence of ankle injury was recorded. RESULTS: The lower limb received most injuries (90%), followed by the upper limb (6%), then the face (3%) and cervical spine (1%). The most common category of injuries was sprains (83%), followed by fractures (8%), contusions (5%), and dislocations (4%). The most common site of injury was the ankle (73%). It is during doubles play that injury is most likely to occur. Since the introduction of ankle supports, there has been a gradual decline in the incidence of ankle injury, 31 in 1991 to nine in 1995. CONCLUSION: Aeroball has become a popular sport, but it is not without risks. Leaflets have been produced to promote the objectives, rules, and safety of the game. Trained full-time staff should be present to explain the nature of the game. The use of prophylactic ankle stabilisers in aeroball is strongly recommended. Images Figure 1 Figure 4 PMID:9298553

Sinha, A; McGlone, R G; Montgomery, K

1997-01-01

284

Conquering Athletic Injuries.  

ERIC Educational Resources Information Center

The purpose of this book is to be a source of complete, reliable, and practical sports medicine information. Experts from the American Running and Fitness Association describe in clear language how overuse injuries occur, how to recognize and self-treat them, when to seek professional help, and how to prevent future injuries. The book also…

Taylor, Paul M., Ed.; Taylor, Diane K., Ed.

285

Management of Tracheobronchial Injuries  

PubMed Central

Tracheobronchial injury is one of cases which are relatively uncommon, but must be suspected to make the diagnosis and managed immediately. In such a case, primary initial goals are to stabilize the airway and localize the injury and then determine its extend. These can be possible mostly with flexible bronchoscopy conducted by a surgeon who can repair the injury. Most of the penetrating injuries occur in the cervical region. On the other hand, most of the blunt injuries occur in the distal trachea and right main bronchus and they can be best approached by right posterolateral thoracotomy. The selection of the manner and time of approaching depends on the existence and severity of additional injuries. Most of the injuries can be restored by deploying simple techniques such as individual sutures, while some of them requires complex reconstruction techniques. Apart from paying attention to the pulmonary toilet, follow-up is crucial for determination of anastomotic technique or stenosis. Conservative treatment may be considered an option with a high probability of success in patients meeting the criteria, especially in patients with iatrogenic tracheobronchial injury. PMID:25610327

Altinok, Tamer; Can, Atilla

2014-01-01

286

Traumatic Brain Injury  

Microsoft Academic Search

Approximately 250 per 100,000 of the population sustain traumatic brain injury (TBI) annually (Cassidy et al., 2004), making it the most commonly occurring neurological condition. Of these 102 per 100,000 are hospitalised (Chesnut, Carney, Maynard, Patterson, Mann, & Helfand, 1998). Because of advances in trauma care these individuals are surviving injuries that would previously have been fatal (Klimczak, Donovick, &

Janet M. Leathem; Muriel Christianson

287

DISCUSSION ON SPINAL INJURIES  

PubMed Central

(1).—Varieties of spinal injuries, the three groups of common usage: fractures, dislocations, fracture-dislocations. Shall not refer in detail to fractures of the spinous or transverse processes. (2) Mechanics of injury to vertebræ. Two variables: (1) the nature of the bones; (2) the qualities of the force. Spinal injury usually caused by indirect violence. (3) The different results of injuries applied to the head; may break skull, failing that, the neck. Atlas fracture. Difference in qualities of the force causing atlas fracture and low cervical dislocation. (4) The compound nature of the vertebral body. The two columns, anterior, spongy; posterior, compact. The nature of wedge-compression of the vertebral body. Variations in the shape of the wedge. Reasons. Occur at all levels, including cervical spine. (5) Frequency of injury at different levels of vertebral column. “Localization” of injury. The two places of the graph of injury. The cervical at C. 5. Reason. The thoracic-lumbar peak at T. 12, L. 1 industrial. Is there a third peak at C. 2? (6) The effects of violent flexion of the spine: cervical flexion causes luxation at C. 5 or so. Extension causes fracture of odontoid. Violent flexion and extension therefore cause injury at very different levels. Thoracic region, why is there no “peak” of injury at T.6, 7? Lumbar region. (7) Displacement of fragments. Continuation of violence after the essential injury has been effected. Kümmell's disease, no inflammatory process involved. (8) Injury to the intervertebral discs, essential for displacement. Imperfect rupture a cause for difficulty in reducing luxations. The worst cases those in which it is most easily done, but most of these have cord damage. (9) Spinal injury from minimal violence. Examples of trivial cases, diving, brushing hair and so forth. Vertebral displacement in disease a much more serious thing. (10) Curious stability of many cervical luxations. Reasons. Locking of the inferior zygaphophyses. (11) Injury to nervous elements left principally to other speakers. Cord compression very rare. Immediate and irremediable damage. Root injuries. Falling mortality of modern statistics due to better diagnosis. (12) Primary operation for fractures of spine relegated to oblivion. Rarity of indications for open operation. Reduction the best treatment. ImagesFig. 5Fig. 6 PMID:19986314

1928-01-01

288

Distal biceps tendon injuries--current treatment options.  

PubMed

Three percent of all biceps tendon ruptures occur at the distal aspect, where the tendon inserts into the radial tuberosity. Distal bicep tendon ruptures typically occur in middle-aged males after an eccentric extension load is applied to the elbow. Patients usually complain of a sudden, sharp, and painful tearing sensation in the antecubital region, with a palpable defect. The biceps squeeze and hook tests are specific maneuvers by which to diagnose distal biceps ruptures on physical examination. Magnetic resonance imaging (MRI) or ultrasound maybe be helpful to distinguish between partial and complete tears. Anatomic studies suggest there are two distinct insertions for the short and long heads of the distal biceps. The short head may be a more powerful flexor, and the long head may be a more powerful supinator. Nonoperative treatment typically results in loss of flexion and supination strength and endurance. Early anatomic re-attachment is the goal. Surgical approaches include one- or two-incision techniques, and tendon fixation methods include the use of suture anchors, bone tunnels, an endobutton, or biotenodesis screws. Biomechanical studies have shown that endobuttons have higher load-to-failure strengths, compared to the other fixation methods. However, clinical studies have demonstrated that patients do well regardless of surgical approach or fixation method. Possible complications include nerve injuries, heterotopic ossification, postoperative fracture, tendon rerupture, complex regional pain syndrome, and wound infection. Partial ruptures are significantly less common and initially can be treated conservatively. Chronic tears are more difficult to treat because of possible tendon retraction and poor tissue quality. Tendon grafts using semitendinosus, fascia lata, hamstring, Achilles (calcaneal), or flexor carpi radialis have been successfully used for length restoration in these cases. PMID:20632985

Quach, Tony; Jazayeri, Reza; Sherman, Orrin H; Rosen, Jeffrey E

2010-01-01

289

A four year prospective study of injuries in elite Ontario youth provincial and national soccer players during training and matchplay  

PubMed Central

Introduction: With over 200 million amateur players worldwide, soccer is one of the most popular and internationally recognized sports today. By understanding how and why soccer injuries occur we hope to reduce prevalent injuries amongst elite soccer athletes. Methods: Via a prospective cohort, we examined both male and female soccer players eligible to train with the Ontario Soccer Association provincial program between the ages of 13 to 17 during the period of October 10, 2008 and April 20, 2012. Data collection occurred during all player exposures to potential injury. Exposures occurred at the Soccer Centre, Ontario Training grounds and various other venues on multiple playing surfaces. Results: A total number of 733 injuries were recorded. Muscle strain, pull or tightness was responsible for 45.6% of all injuries and ranked as the most prevalent injury. Discussion: As anticipated, the highest injury reported was muscular strain, which warrants more suitable preventive programs aimed at strengthening and properly warming up the players’ muscles.

Mohib, Milad; Moser, Nicholas; Kim, Richard; Thillai, Maathavan; Gringmuth, Robert

2014-01-01

290

Sports related ocular injuries  

PubMed Central

Every year > 600,000 sports and recreation related eye injuries occur, out of which roughly 13,500 of these result in permanent loss of sight. Up to 90% of these sports related eye injuries are preventable by using adequate eye protection equipment. Protective eyewear is made of polycarbonate, a highly impact-resistant plastic which is now easily available as prescription and non-prescription eyewear and all players should be encouraged to use them. The medical officers by educating their patients regarding the risks of eye injuries in various sports and the confirmed benefits of using protective equipment have the potential to prevent injury to over thousands of eyes every year. The medical fraternity can also play a very important role in educating the coaches, parents, and children and thus put an end to unnecessary blindness and vision loss from sports related ocular injuries, therefore ensuring a lifetime of healthy vision. PMID:24532883

Mishra, Avinash; Verma, Ashok K.

2012-01-01

291

Mole gun injury.  

PubMed

A mole gun is a weapon, which is used to trap and kill moles. This report provides an overview of the state of knowledge of mole gun injuries, comparable to blast injuries caused by fireworks, explosive or gunshot. Over a 2-year period, the authors reported their experience with ten hand injuries caused by mole gun. Radial side of the hand was often concerned, particularly the thumb. The authors explain their choices in the management of such lesions. Surgery was performed primarily and a large debridement currently seemed to offer the best outcome for the patient. Blast, crush, burns and lacerations may explain the higher rate of amputation to the digits. A long period of physiotherapy, specifically of the hand, was needed before the patient could return to work. This ballistic hand trauma encountered by surgeons requires knowledge and understanding of these injuries. It should be in accordance with firearms law because of severe injuries encountered and possible lethal wounds. PMID:23746826

Pistré, V; Rezzouk, J

2013-09-01

292

Welder eye injuries.  

PubMed

During 1985, welders submitted 21% of all claims for eye injuries received by the Workers' Compensation Board of Alberta. Since then the proportion of similar claims has remained high. A descriptive study of welder eye injury claims reveals that, although most injuries are reversible (55% of workers return to work in less than 2 days and 95% in less than 7 days), some workers sustain permanent visual impairment. Eye injuries occur most frequently in metal-work industries, and cold particles, most often metal, are the most common source of injury. Preventive measures should stress the importance of wearing eye protection constantly while working with metal pieces and in metal industries. Goggles probably should not be removed upon extinguishing the welding torch. PMID:2533251

Reesal, M R; Dufresne, R M; Suggett, D; Alleyne, B C

1989-12-01

293

Prevention of youth injuries.  

PubMed Central

There are four categories of causes responsible for the majority of injuries in youth 10-19 years of age: 1) motor vehicle traffic; 2) violence (intra-familial, extra-familial, self, pregnancy-related); 3) recreational; and 4) occupational. This article presents data from the National Center for Health Statistics mortality data and the National Pediatric Trauma Registry morbidity data. Nationwide, the pediatric injury death rate is highest among adolescents 15-19 years of age. Motor vehicle-related deaths account for 41% and firearm-related deaths account for 36% of injury deaths in this age group. For youths aged 10-14 years, motor vehicle-related deaths account for 38% and; firearm-related deaths account for 26% of injury deaths. For both age groups, occupant motor vehicle-related deaths account for the majority of deaths and underscore the need for seat belt use. Using theoretical principles based on the Haddon matrix and a knowledge of adolescent development, proposed interventions to decrease injuries and deaths related to motor vehicles and firearms include graduated licensing, occupant restraint, speed limits, conflict resolution, and gun control. Occupational injuries, particularly injury associated with agricultural production, account for an estimated 100,000 injuries per year. Preventive strategies include OSHA regulations imposing standards for protective devices and further study for guidelines for adolescent work in agriculture. Injuries related to recreation include drowning and sports injuries. Preventive strategies may include proper supervision and risk reduction with respect to use of alcohol/drugs. The data presented support the use of primary prevention to achieve the most effective, safe community interventions targeting adolescents. PMID:10599188

Laraque, D.; Barlow, B.; Durkin, M.

1999-01-01

294

Descriptive Epidemiology of Collegiate Men's Ice Hockey Injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 Through 2003–2004  

PubMed Central

Objective: To review 16 years of National Collegiate Athletic Association (NCAA) injury surveillance data for men's ice hockey and to identify potential areas for injury prevention initiatives. Background: The NCAA began injury surveillance of men's ice hockey during the 1988–1989 academic year. These data represent all 3 NCAA divisions; the last Division II championship, however, was held during the 1998–1999 academic year. Main Results: The rate of injury was more than 8 times higher in games than in practices (16.27 versus 1.96 injuries per 1000 athlete-exposures [A-Es], rate ratio = 8.3, 95% confidence interval [CI] = 7.9, 8.8). A significant average annual increase of 1.3% in game injury rates occurred over the sample period ( P = .05), but practice rates stayed static ( P = .77). Preseason practice injury rates were more than twice as high as regular-season practice rates (5.05 versus 1.94 injuries per 1000 A-Es, rate ratio = 2.6, 95% CI = 2.4, 2.9, P < .01). The majority of game and practice injuries occurred to the lower extremity. Knee internal derangement (13.5%) was the most common lower extremity injury reported for games, whereas pelvis and hip muscle strains (13.1%) were the most common injury reported during practices. Player-to-player contact was the most frequent game mechanism of injury (50.0%). The majority of injuries occurred between the blue line and face-off circles (28.0%), in the corner (23.5%), and in the neutral zone (21.4%). Recommendations: Preventive efforts should focus on strategies that limit player-to-player contact in the neutral zone and at the top of the offensive and defensive zones. In addition, clinicians and researchers should identify risk factors and interventions for muscle strains at the pelvis and hip region. PMID:17710172

Agel, Julie; Dompier, Thomas P; Dick, Randall; Marshall, Stephen W

2007-01-01

295

Descriptive Epidemiology of Collegiate Women's Basketball Injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 Through 2003–2004  

PubMed Central

Objective: To review 16 years of National Collegiate Athletic Association (NCAA) injury surveillance data for women's basketball and to identify potential areas for injury prevention initiatives. Background: The number of colleges participating in women's college basketball has grown over the past 25 years. The Injury Surveillance System (ISS) has enabled the NCAA to collect and report injury trends over an extended period of time. This has allowed certified athletic trainers and coaches to be more informed regarding injuries and to adjust training regimens to reduce the risk of injury. It also has encouraged administrators to make rule changes that attempt to reduce the risk of injury. Main Results: From 1988–1989 through 2003–2004, 12.4% of schools across Divisions I, II, and III that sponsor varsity women's basketball programs participated in annual ISS data collection. Game and practice injury rates exhibited significant decreases over the study period. The rate of injury in a game situation was almost 2 times higher than in a practice (7.68 versus 3.99 injuries per 1000 athlete-exposures, rate ratio = 1.9, 95% confidence interval = 1.9, 2.0). Preseason-practice injury rates were more than twice as high as regular-season practice injury rates (6.75 versus 2.84 injuries per 1000 athlete-exposures, rate ratio = 2.4, 95% confidence interval = 2.2, 2.4). More than 60% of all game and practice injuries were to the lower extremity, with the most common game injuries being ankle ligament sprains, knee injuries (internal derangements and patellar conditions), and concussions. In practices, ankle ligament sprains, knee injuries (internal derangements and patellar conditions), upper leg muscle-tendon strains, and concussions were the most common injuries. Recommendations: Appropriate preseason conditioning and an emphasis on proper training may reduce the risk of injury and can optimize performance. As both player size and the speed of the women's game continue to increase, basketball's evolution from a finesse sport to a high-risk contact sport also will continue. The rates of concussions and other high-energy trauma injuries likely will increase. The NCAA ISS is an excellent tool for identifying new risk factors that may affect injury rates and for developing consistent injury definitions in order to improve the research and provide a source of clinically relevant data. PMID:17710168

Agel, Julie; Olson, David E; Dick, Randall; Arendt, Elizabeth A; Marshall, Stephen W; Sikka, Robby S

2007-01-01

296

EFFECTS OF SIMULATED INJURY ON THE ANTEROINFERIOR GLENOHUMERAL CAPSULE  

PubMed Central

Glenohumeral dislocation results in permanent deformation (nonrecoverable strain) of the glenohumeral capsule which leads to increased range of motion and recurrent instability. Minimal research has examined the effects of injury on the biomechanical properties of the capsule which may contribute to poor patient outcome following repair procedures. The objective of this study was to determine the effect of simulated injury on the stiffness and material properties of the AB-IGHL during tensile deformation. Using a combined experimental and computational methodology, the stiffness and material properties of six AB-IGHL samples during tensile elongation were determined before and after simulated injury. The AB-IGHL was subjected to 12.7±3.2% maximum principal strain which resulted in 2.5±0.9% nonrecoverable strain. The linear region stiffness and modulus of stress-stretch curves between the normal (52.4±30.0 N/mm, 39.1±26.6 MPa) and injured (64.7±21.3N/mm, 73.5±53.8MPa) AB-IGHL increased significantly (p=0.03, p=0.04). These increases suggest that changes in the tissue microstructure exist following simulated injury. The injured tissue could contain more aligned collagen fibers and may not be able to support a normal range of joint motion. Collagen fiber kinematics during simulated injury will be examined in the future. PMID:23054378

Rainis, Carrie A.; Brown, Andrew J.; McMahon, Patrick J.; Debski, Richard E.

2012-01-01

297

The physical basis of ventilator-induced lung injury  

PubMed Central

Although mechanical ventilation (MV) is a life-saving intervention for patients with acute respiratory distress syndrome (ARDS), it can aggravate or cause lung injury, known as ventilator-induced lung injury (VILI). The biophysical characteristics of heterogeneously injured ARDS lungs increase the parenchymal stress associated with breathing, which is further aggravated by MV. Cells, in particular those lining the capillaries, airways and alveoli, transform this strain into chemical signals (mechanotransduction). The interaction of reparative and injurious mechanotransductive pathways leads to VILI. Several attempts have been made to identify clinical surrogate measures of lung stress/strain (e.g., density changes in chest computed tomography, lower and upper inflection points of the pressure–volume curve, plateau pressure and inflammatory cytokine levels) that could be used to titrate MV. However, uncertainty about the topographical distribution of stress relative to that of the susceptibility of the cells and tissues to injury makes the existence of a single ‘global’ stress/strain injury threshold doubtful. PMID:20524920

Plataki, Maria; Hubmayr, Rolf D

2010-01-01

298

Sport injuries in adolescents  

PubMed Central

In spite of the wide range of injuries in adolescents during sports activities, there are only a few studies investigating the type and frequency of sport injuries in puberty. However, this information may help to prevent, diagnose and treat sports injuries among teens. 4468 injuries in adolescent patients were treated over a ten year period of time: 66,97% were boys and 32.88% girls. The most frequent sports injuries were football (31.13%) followed by handball (8.89%) and sports during school (8.77%). The lower extremity was involved in 68.71% of the cases. Knee problems were seen in 29.79% of the patients; 2.57% spine and 1.99% head injuries. Injuries consisted primarily of distortions (35.34%) and ligament tears (18.76%); 9,00% of all injuries were fractures. We found more skin wounds (6:1) and fractures (7:2) in male patients compared to females. The risk of ligament tears was highest during skiing. Three of four ski injuries led to knee problems. Spine injuries were observed most often during horse riding (1:6). Head injuries were seen in bicycle accidents (1:3). Head injuries were seen in male patients much more often then in female patients (21:1). Fractures were noted during football (1:9), skiing (1:9), inline (2:3), and during school sports (1:11). Many adolescents participate in various sports. Notwithstanding the methodological problems with epidemiological data, there is no doubt about the large number of athletes sustain musculoskeletal injuries, sometimes serious. In most instances, the accident does not happened during professional sports and training. Therefore, school teachers and low league trainer play an important role preventing further accidence based on knowledge of individual risk patterns of different sports. It is imperative to provide preventive medical check-ups, to monitor the sport-specific needs for each individual sports, to observe the training skills as well as physical fitness needed and to evaluation coaches education. PMID:22355484

Habelt, Susanne; Hasler, Carol Claudius; Steinbrück, Klaus; Majewski, Martin

2011-01-01

299

[Overuse injury syndromes of the knee].  

PubMed

Overuse injuries are frequent in the knee joint. The reason for this is that the knee joint is engaged in all sports activities. Furthermore, the joint area has numerous attachment points for muscles and tendons and numerous bursae. Another reason is that the specific joint between the patella and femur (patellofemoral joint) constitutes a part of the knee joint. Speaking in general terms, all overuse injuries in the knee joint can be divided in four groups according to the aspect: anterior aspect--patellofemoral pain syndrome, patellar tendinitis (jumper's knee), Osgood-Schlatter disease, Sinding Larson Johanson disease, stress fracture of the patella, fat pad syndrome; medial aspect--plica syndrome, semimembranosus tendinitis, pes anserinus tendinitis (bursitis), breaststroker's knee, medial retinaculitis; lateral aspect--Iliotibial band friction syndrome (runner's knee), Popliteal Tendinitis, Bicipital tendinitis; posterior aspect--fabellitis, medial gastrocnemius strain. There are numerous possible reasons for pain caused by overuse injuries around the knee joint, but two are the most frequent: patellar tendinitis (jumper's knee) and Iliotibial band friction syndrome (runner's knee). This paper gives a brief overview of overuse injuries of the knee joint including their definition, anatomy, aetiology, clinical symptoms and signs, and non-operative and surgical treatment. PMID:11831126

Pe?ina, M; Bojani?, I; Haspl, M

2001-12-01

300

Gasoline immersion injury  

SciTech Connect

Chemical burns and pulmonary complications are the most common problems encountered in the patient immersed in gasoline. Our patient demonstrated a 46-percent total-body-surface area, partial-thickness chemical burn. Although he did not develop bronchitis or pneumonitis, he did display persistent atelectasis, laryngeal edema, and subsequent upper airway obstruction. This had not previously been reported in gasoline inhalation injuries. Hydrocarbon hepatitis secondary to the vascular endothelial damage is apparently a reversible lesion with no reported long-term sequelae. Gasoline immersion injuries may be a series multisystem injury and require the burn surgeon to take a multisystem approach to its diagnosis and treatment.

Simpson, L.A.; Cruse, C.W.

1981-01-01

301

Sex Differences in “Weightlifting” Injuries Presenting to United States Emergency Rooms  

PubMed Central

Benefits of resistance training include improved muscle strength and sports performance, and may include reduced injuries. However, few studies have examined sex differences in resistance training related injuries. The objective of this investigation was to evaluate sex differences in injuries associated with weightlifting, in adolescents and young adults by type (sprains and strains, fractures), mechanism (accidental, non-accidental) and location (head, trunk, arm, hand, leg, foot) of injury. We hypothesized that there would be sex differences in type, mechanism and location of “weightlifting” injuries. The US Consumer Product Safety Commission (CPSC) National Electronic Injury Surveillance System (NEISS) was queried from 2002-2005, using the CPSC code for “Weightlifting.” Subjects between the ages of 14 and 30 were included in the study. CPSC sampling weights were used to calculate national estimates from the sample of 3,713 patients (Males= 3,102; Females= 611). Weighted Chi-square analyses were used to compare differences in mechanism, type, and location of injury for males versus females. Males had significantly more sprains and strains (P=0.004), while females demonstrated increased accidental injuries compared to males (P<0.001). The trunk was the most commonly injured body part for both males (36.9%) and females (27.4%). However, males had more trunk injuries than females (P<0.001), while females had more foot (P<0.001) and leg (P=0.03) injuries than males (P<0.001). The findings indicate that males may suffer more exertional type resistance injuries during weightlifting (sprains and strains) compared to females, especially at the trunk. Conversely, females may be more susceptible to lower extremity injuries resulting from accidents during resistance training. PMID:19855331

Quatman, Carmen E.; Myer, Gregory D.; Khoury, Jane; Wall, Eric J.; Hewett, Timothy E.

2009-01-01

302

Traumatic Brain Injuries. Guidelines Paper.  

ERIC Educational Resources Information Center

This paper on traumatic brain injuries begins with statistics on the incidence of the disorder, especially as they relate to Colorado. Traumatic brain injury is then defined, and problems caused by traumatic brain injury are discussed. The components of effective programming for students with traumatic brain injuries are described, followed by the…

Colorado State Dept. of Education, Denver. Special Education Services Unit.

303

Catastrophic injuries among young athletes  

Microsoft Academic Search

While very rare, catastrophic injuries in youth sports have a major impact on athletes and their families when they do occur. This article reviews and summarises the sparse research on direct catastrophic injuries in youth sports, a direct catastrophic sports injury being defined as a sport injury that resulted from participation in the skills of the sport, and resulted in

E D Zemper

2010-01-01

304

What Is Spinal Cord Injury?  

MedlinePLUS

... addition, there are two degrees of SCI severity : Complete injury is the situation when the injury is so ... National Spinal Cord Injury Association. Understanding spinal cord injury . Retrieved May 21, 2012, from http://www.spinalcord.org/resource-center/askus/index.php?pg=kb. ...

305

Tendon injuries of the hand  

PubMed Central

Tendon injuries are the second most common injuries of the hand and therefore an important topic in trauma and orthopedic patients. Most injuries are open injuries to the flexor or extensor tendons, but less frequent injuries, e.g., damage to the functional system tendon sheath and pulley or dull avulsions, also need to be considered. After clinical examination, ultrasound and magnetic resonance imaging have proved to be important diagnostic tools. Tendon injuries mostly require surgical repair, dull avulsions of the distal phalanges extensor tendon can receive conservative therapy. Injuries of the flexor tendon sheath or single pulley injuries are treated conservatively and multiple pulley injuries receive surgical repair. In the postoperative course of flexor tendon injuries, the principle of early passive movement is important to trigger an “intrinsic” tendon healing to guarantee a good outcome. Many substances were evaluated to see if they improved tendon healing; however, little evidence was found. Nevertheless, hyaluronic acid may improve intrinsic tendon healing. PMID:22720265

Schöffl, Volker; Heid, Andreas; Küpper, Thomas

2012-01-01

306

Wrist Injuries and Disorders  

MedlinePLUS

... can damage your wrist. Everyday activities like typing, racquet sports or sewing can cause pain, or even carpal tunnel syndrome. Wrist pain with bruising and swelling can be a sign of injury. The signs of a possible fracture include misshapen ...

307

Survey of laser injury  

NASA Astrophysics Data System (ADS)

Laser use is pervasive and steadily expanding both in the private sector and the Department of Defense (DoD). For more than 20 years, Rockwell Laser Industries, the U.S. Army, and the Food and Drug Administration's Center for Devices and Radiological Health have separately collected data on injuries occurring during, or resultant from, the use of lasers. However, data from these sources is incomplete and has not recently undergone a thorough compiling, statistical analysis, review and summarization. It is our belief that in order to evaluate current related medical surveillance, safety and training procedures, this data needs such an examination. Persons maintaining these databases were contacted and any available data on laser injury was collected. The data was analyzed and examined for pertinent similarities and differences among a wide range of parameters. We summarize these findings in this paper and also comment on the injuries, current safety measures and injury reporting protocols associated with laser use.

Johnson, Thomas E.; Dunn, J. C., II; Roach, William P.

2002-06-01

308

[Treating frostbite injuries].  

PubMed

Frostbite injuries rarely occur in healthy Dutch persons. However, as the number of people engaging in winter and outdoor activities and travelling to high altitudes increases, the risk of frostbite also increases. Frostbite is a cold-induced injury which results from two processes: freezing and microvascular occlusion. Adequate first aid, which focuses on the prevention of refreezing and mechanical injury, and rapid rewarming together with the administration of ibuprofen, are of the greatest importance for limiting eventual tissue damage. Iloprost infusion and possibly (r)tPA are indicated if a patient presents within 24 hours after the tissue has thawed and the injury is such that severe morbidity can be expected. If the patient presents after this time period, hyperbaric oxygen therapy may be considered; however, the evidence available on this type of treatment is limited. PMID:22748369

Berendsen, Remco R; Kolfschoten, Nikki E; de Jong, Vincent M; Frima, Herman; Daanen, Hein A M; Anema, Helen A

2012-01-01

309

Finger Joint Injuries.  

PubMed

Finger joint dislocations and collateral ligament tears are common athletic hand injuries. Treatment of the athlete requires a focus on safe return to play and maximizing function. Certain dislocations, such as proximal interphalangeal and distal interphalangeal volar dislocations, may be associated with tendon injuries and must be treated accordingly. Treatment of other dislocations is ultimately determined by postreduction stability, with many dislocations amenable to nonoperative treatment (ie, immobilization followed by rehabilitation). Protective splinting does not necessarily preclude athletic participation. Minor bone involvement typically does not affect the treatment plan, but significant articular surface involvement may necessitate surgical repair or stabilization. Percutaneous and internal fixation are the mainstays of surgical treatment. Treatment options that do not minimize recovery or allow the patient to return to protected play, such as external fixation, are generally avoided during the season of play. Undertreated joint injuries and unrecognized ligament injuries can result in long term disability. PMID:25455398

Prucz, Roni B; Friedrich, Jeffrey B

2015-01-01

310

Head injury criterion  

E-print Network

In the design of robotic systems that safely interact with people, it is useful to have validated criteria for measuring injury risks. To this end, some researchers have advocated the use of metrics developed for assessing ...

Wampler, Charles Wilson

311

Pistol crossbow injuries.  

PubMed

This article describes the wounding potential of pistol crossbows to prepare nurses who may have to provide immediate care for patients with injuries from these inexpensive and readily available weapons. PMID:19552331

Tremayne, Vincent

2009-06-01

312

Penetrating craniofacial arrow injury.  

PubMed

Arrow injuries are an extinct form of injury in most parts of the developed world, but are still seen, albeit infrequently in developing countries. Reports of penetrating injuries of the craniofacial region secondary to projectiles are few and far between. The morbidity-free outcome of surgical removal, in case of penetrating arrow injuries, despite the delay in presentation and, moreover, in the emergency surgical practice, are the salient points to be remembered whilst managing such cases, for 'what the mind knows is what the eyes see and what the eyes see is what can be practiced'. We report the case of a patient who was attacked by a projectile fired from a crossbow. Immediate surgery under general anesthesia was required to remove the arrow, with utmost care to avoid any neurovascular compromise to the facial nerve, as well as minimize postoperative complications such as otitis media and subsequent meningitis. PMID:21799612

Jain, Dk; Aggarwal, Gaurav; Lubana, Ps; Moses, Sonia

2010-01-01

313

Playground Injuries: Fact Sheet  

MedlinePLUS

... Fractures among Older Adults Falls in Nursing Homes Data & Statistics Cost of Fall Injuries Publications & Resources Preventing Falls: What Works. A CDC Compendium of Effective Community–based Interventions ...

314

Seasonal Hand Injuries  

MedlinePLUS

... Media ACEP in Social Media Take Care Seasonal Hand Injuries Studies show that many people visit the ... the ladder. BREAKING A FALL WITH AN OUTSTRETCHED HAND Use both hands to help catch yourself so ...

315

Medline Plus: Sports Injuries  

NSDL National Science Digital Library

Exercising and playing sports can lead to a sound mind and body, but sports-related injuries can be frustrating for anyone. This very helpful site, offered as part of the Medline Plus series from the U.S. National Library of Medicine, contains dozens of fact sheets, media presentations, and other items regarding various sports injuries. Visitors who know exactly what they need can click on over to the "Related Topics" area on the right-hand side of the homepage, where they will find resources on everything from ankle injuries to general wellness. Their homepage also contains sections like "Basics", "Research", and "Multimedia & Cool Tools". Two items that are definitely worth checking out are the tennis elbow tutorial and the basic overview of sports injuries offered by the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

316

Brachial plexus injury.  

PubMed Central

A 28-year-old man shot himself in the left posterior triangle of the neck with a shotgun. At the initial operation secondary repair of the resultant brachial plexus injury was decided upon in view of the difficulty in assessing lesions in continuity at this point after injury. The patient had total brachial plexus palsy. Nine weeks after the injury sensory and motor function were returning and the only element of the brachial plexus not showing evidence of nerve fibre continuity was the musculocutaneous nerve. Sural nerve autografts were sutured between the trimmed proximal and distal stumps of this nerve. By 4 months after the injury there was further improvement in both sensory and motor function, and by 18 months there was sensation in the autonomous zones of both median and ulnar nerves and good return of muscle power. Images FIG. 1 FIG. 2 PMID:603845

Hudson, A. R.; Dommisse, I.

1977-01-01

317

Injury reduction at Fermilab  

SciTech Connect

In a recent DOE Program Review, Fermilab's director presented results of the laboratory's effort to reduce the injury rate over the last decade. The results, shown in the figure below, reveal a consistent and dramatic downward trend in OSHA recordable injuries at Fermilab. The High Energy Physics Program Office has asked Fermilab to report in detail on how the laboratory has achieved the reduction. In fact, the reduction in the injury rate reflects a change in safety culture at Fermilab, which has evolved slowly over this period, due to a series of events, both planned and unplanned. This paper attempts to describe those significant events and analyze how each of them has shaped the safety culture that, in turn, has reduced the rate of injury at Fermilab to its current value.

Griffing, Bill; /Fermilab

2005-06-01

318

Spinal Cord Injury 101  

MedlinePLUS Videos and Cool Tools

... Braingate" research? What is the status of stem-cell research? How would stem-cell therapies work in the treatment of spinal cord injuries? What does stem-cell research on animals tell us? When can we ...

319

Traumatic Brain Injury (TBI)  

MedlinePLUS

... appointed director of NICHD’s National Center for Medical Rehabilitation Research NICHD Co-Sponsors White House Disability Summit NICHD Funds Research on Traumatic Brain Injury (TBI) All related news Home Accessibility Contact Disclaimer ...

320

Genital injuries in adults.  

PubMed

The examination of the rape victim should focus on the therapeutic, forensic and psychological needs of the individual patient. One aspect will be an examination for ano-genital injuries. From a medical perspective, they tend to be minor and require little in the way of treatment. They must be considered when assessing the risk of blood-borne viruses and the need for prophylaxis. From a forensic perspective, an understanding of genital injury rates, type of injury, site and healing may assist the clinician to interpret the findings in the context of the allegations that have been made. There are many myths and misunderstandings about ano-genital injuries and rape. The clinician has a duty to dispel these. PMID:23219384

White, Catherine

2013-02-01

321

Neurologic injury in snowmobiling  

PubMed Central

Background: Snowmobiles are increasingly popular recreational, all-terrain utility vehicles that require skill and physical strength to operate given their inherent maneuverability, acceleration, and top speed capabilities. These same characteristics increase the risk of injury with the operation of these vehicles, particularly neurological injury. We characterize our series of 107 patients involved in snowmobiling accidents. Methods: From January 2004 to January 2012, all snowmobiling-related injuries referred to our regional trauma center were reviewed. Information had been recorded in the hospital's trauma registry and medical records were retrospectively reviewed for data pertaining to the injuries, with particular emphasis on neurological injuries and any associated details. Results: A total of 107 patients were identified. Ninety percent of injured riders were male. The mean age was 34.4 years (range 10-70), with 7% younger than age 16. The mean Injury Severity Score was 12.0 ± 0.69 (range 1-34). Although not documented in all patients, alcohol use was found in 7.5% of the patients and drug use found in one patient. Documentation of helmet use was available for only 31 of the patients; of which 13% were not helmeted. Causes included being thrown, flipped, or roll-over (33%), striking a stationary object (27%), being struck by a snowmobile (9%), striking another snowmobile (5.5%) or a car, train, or truck (5.5%), being injured by the machine itself (9%), other (2%) or unspecified (18%). Head injuries occurred in 35% patients, including concussion, subarachnoid hemorrhage, subdural hematoma, contusion, and facial/skull fracture. Spinal fractures occurred in 21% of the patients. Fractures to the thoracic spine were the most common (50%), followed by the cervical (41%) and lumbar (36%) spine. There were also three brachial plexus injuries, one tibial nerve injury, and one internal carotid artery dissection. Average length of stay was 4.98 ± 0.56 days. Disposition was home (78%), home with services (12%), rehabilitation placement (9%), and one death. Details regarding other systemic injuries will also be reviewed. Conclusions: Snowmobiles are a significant source of multi-trauma, particularly neurological injury. Neurosurgeons can play key roles in advocating for neurological safety in snowmobiling. PMID:25024887

Plog, Benjamin A.; Pierre, Clifford A.; Srinivasan, Vasisht; Srinivasan, Kaushik; Petraglia, Anthony L.; Huang, Jason H.

2014-01-01

322

Injury and disability in matched men's and women's intercollegiate sports.  

PubMed Central

Eight matched men's and women's intercollegiate varsity teams were studied prospectively for one academic year to determine the incidence of athletic injury and resulting disability. Sports in which both men and women participated in a comparable manner were chosen: basketball, fencing, gymnastics, swimming, tennis, indoor track, outdoor track, and volleyball. Men (232) and women (150) were injured at comparable rates, 42 percent versus 39 percent. When adjusted for exposure time, seven of the eight sports continued to show similar injury rates. Women gymnasts, however, experienced .82 injuries per 100 person-hours of exposure as compared to .21 injuries for the men (p = .0001). Disability was greater in women gymnasts, 7.44 days per 100 person-hours versus 1.15 days for men (p = .0004). Percent of season lost to injury was also greater for women gymnasts. Types and sites of injury were similar for men and women, with sprains and strains accounting for over half of all injuries. We found no evidence for gender differences in matched sports except for gymnastics, in which technically diverse events may have accounted for the differences observed. PMID:2240330

Lanese, R R; Strauss, R H; Leizman, D J; Rotondi, A M

1990-01-01

323

Bridging spinal cord injuries  

E-print Network

Minireview Bridging spinal cord injuries James W Fawcett Address: Cambridge University Centre for Brain Repair, Robinson Way, Cambridge CB2 0PY, UK. Email: jf108@cam.ac.uk Repair of the injured spinal cord has been one of the great quests... why not transplant Abstract One strategy for spinal cord injury repair is to make cellular bridges that support axon regeneration. However, the bridging cells often fail to integrate with host tissue and may lead to increased pain sensitivity. Recent...

2008-10-15

324

High temperature strain gage apparent strain compensation  

NASA Technical Reports Server (NTRS)

Once an installed strain gage is connected to a strain indicating device and the instrument is balanced, a subsequent change in temperature of the gage installation will generally produce a resistance change in the gage. This purely temperature-induced resistance will be registered by the indicating device as a strain and is referred to as 'apparent strain' to distinguish it from strain due to applied stress. One desirable technique for apparent strain compensation is to employ two identical gages with identical mounting procedures which are connected with a 'half bridge' configuration where gages see the same thermal environment but only one experiences a mechanical strain input. Their connection in adjacent arms of the bridge will then balance the thermally induced apparent strains and, in principle, only the mechanical strain remains. Two approaches that implement this technique are discussed.

Holmes, Harlan K.; Moore, T. C., Sr.

1992-01-01

325

Craniocerebral injury promotes the repair of peripheral nerve injury  

PubMed Central

The increase in neurotrophic factors after craniocerebral injury has been shown to promote fracture healing. Moreover, neurotrophic factors play a key role in the regeneration and repair of peripheral nerve. However, whether craniocerebral injury alters the repair of peripheral nerve injuries remains poorly understood. Rat injury models were established by transecting the left sciatic nerve and using a free-fall device to induce craniocerebral injury. Compared with sciatic nerve injury alone after 6–12 weeks, rats with combined sciatic and craniocerebral injuries showed decreased sciatic functional index, increased recovery of gastrocnemius muscle wet weight, recovery of sciatic nerve ganglia and corresponding spinal cord segment neuron morphologies, and increased numbers of horseradish peroxidase-labeled cells. These results indicate that craniocerebral injury promotes the repair of peripheral nerve injury. PMID:25374593

Wang, Wei; Gao, Jun; Na, Lei; Jiang, Hongtao; Xue, Jingfeng; Yang, Zhenjun; Wang, Pei

2014-01-01

326

Reducing chest injuries in automobile collisions: rib fracture timing and implications for thoracic injury criteria.  

PubMed

The purpose of this study was to quantify the biomechanical response of the human thorax during dynamic shoulder belt loading representative of that seen in a severe automotive collision. Two post-mortem human surrogates (PMHSs) (one male and one female) were instrumented with 26 single-axis strain gages on the ribs, sternum, and clavicle. The thorax of each PMHS was placed on a custom spine support bracket designed to support the thorax on either side of the spinous process, thereby allowing free motion at the costovertebral joints. In addition, the support bracket raised the thorax above the flat base plate, which could otherwise constrain the deformation and motion of the posterior region of the rib cage. The thorax of each PMHS was then loaded using a custom table-top belt loading system that generated thoracic displacement rates representative of a severe automotive collision, 1.3 m/s for the male PMHS and 1.0 m/s for the female PMHS. The rib fracture timing data, determined by analyzing the strain gage time histories, showed that severe thoracic injury (AIS = 3) occurred at 16% chest compression for the male and 12% chest compression for the female. However, these values are well below the current thoracic injury criteria of 29% chest compression for the male and 23% chest compression for the female. This data illustrates that serious thoracic injury (AIS = 3) occurs at lower chest compressions than the current ATD thoracic injury criteria. Overall, this study provides critical data that can be used in the design and validation of advanced ATDs and finite element models, as well as the establishment of improved, more stringent thoracic injury criteria. PMID:21512892

Kemper, A R; Kennedy, E A; McNally, C; Manoogian, S J; Stitzel, J D; Duma, S M

2011-08-01

327

Phase-Dependent Modulation of Percutaneously Elicited Multisegmental Muscle Responses After Spinal Cord Injury  

PubMed Central

Phase-dependent modulation of monosynaptic reflexes has been reported for several muscles of the lower limb of uninjured rats and humans. To assess whether this step-phase-dependent modulation can be mediated at the level of the human spinal cord, we compared the modulation of responses evoked simultaneously in multiple motor pools in clinically complete spinal cord injury (SCI) compared with noninjured (NI) individuals. We induced multisegmental responses of the soleus, medial gastrocnemius, tibialis anterior, medial hamstring, and vastus lateralis muscles in response to percutaneous spinal cord stimulation over the Th11–Th12 vertebrae during standing and stepping on a treadmill. Individuals with SCI stepped on a treadmill with partial body-weight support and manual assistance of leg movements. The NI group demonstrated phase-dependent modulation of evoked potentials in all recorded muscles with the modulation of the response amplitude corresponding with changes in EMG amplitude in the same muscle. The SCI group demonstrated more variation in the pattern of modulation across the step cycle and same individuals in the SCI group could display responses with a magnitude as great as that of modulation observed in the NI group. The relationship between modulation and EMG activity during the step cycle varied from noncorrelated to highly correlated patterns. These findings demonstrate that the human lumbosacral spinal cord can phase-dependently modulate motor neuron excitability in the absence of functional supraspinal influence, although with much less consistency than that in NI individuals. PMID:20357075

Dy, Christine J.; Gerasimenko, Yury P.; Edgerton, V. Reggie; Dyhre-Poulsen, Poul; Courtine, Grégoire

2010-01-01

328

Dancers' and musicians' injuries.  

PubMed

This overview is based on the over 30 years of performing arts medicine experience of the author, an orthopaedic surgeon who devoted his professional life entirely to the prevention, diagnostics, and treatment of dancers' and musicians' injuries. After a short introduction on the specific demands of professional dance and music making, it describes some general principles of orthopaedic dance medicine and causes of injuries in dancers. The relation of dance injuries with compensatory mechanisms for insufficient external rotation in the hips is explained, as well as hypermobility and the importance of 'core-stability'. As a general principle of treatment, the physician must respect the 'passion' of the dancer and never give an injured dancer the advice to stop dancing. Mental practice helps to maintain dance technical capabilities. The specific orthopaedic dance-medicine section deals with some common injuries of the back and lower extremities in dancers. An important group of common dance injuries form the causes of limited and painful 'relevé' in dancers, like 'dancer's heel' (posterior ankle impingement syndrome), 'dancer's tendinitis' (tenovaginitis of the m.flexor hallucis longus) and hallux rigidus. The second half of the overview deals with the general principles of orthopaedic musicians' medicine and causes of injuries in musicians, like a sudden change in the 'musical load' or a faulty playing posture. Hypermobility in musicians is both an asset and a risk factor. As a general principle of treatment, early specialized medical assessment is essential to rule out specific injuries. Making the diagnosis in musicians is greatly facilitated by examining the patient during playing the musical instrument. The playing posture, stabilisation of the trunk and shoulder girdle and practising habits should always be checked. Musicians in general are intelligent and the time spent on extensive explanation and advice is well spent. In overuse injuries, relative rest supported by 'mental practice' is effective. The specific orthopaedic musicians' medicine section deals with some common injuries of the neck and upper extremities, like (posture related) cervicobrachialgia, and thoracic outlet syndrome. An important group of causes of musicians' injuries form the entrapment neuropathies (especially ulnaropathy), osteoarthritis of the hands and hypermobility. PMID:23572035

Rietveld, A B M Boni

2013-04-01

329

Mouse Repository Strain Details  

Cancer.gov

Available Strain Details Order Form for Live Mice   Strain Number: 01XBL  Common Strain Name: Myf6-ires-cre knock-in  Strain Nomenclature: B6;129-Myf6tm2(cre)Mrc/Nci  Release Category (Required for MTA form): C1 , D Sample MTA for this strain Animal

330

Mouse Repository Strain Details  

Cancer.gov

Available Strain Details Order Form for Live Mice   Strain Number: 01XD8  Common Strain Name: Fabp1-Cre  Strain Nomenclature: FVB/N-Tg(Fabp1-Cre)1Jig/Nci  Release Category (Required for MTA form): B1 , D Sample MTA for this strain Animal Health Report

331

Mouse Repository Strain Details  

Cancer.gov

Available Strain Details Order Form for Live Mice   Strain Number: 01XG2  Common Strain Name: MMTV/c-myc  Strain Nomenclature: FVB-Tg(MMTV-Myc)141-3Led/Nci  Release Category (Required for MTA form): B5 , D Sample MTA for this strain Animal Health

332

Mouse Repository Strain Details  

Cancer.gov

Available Strain Details Order Form for Cryoarchived Strains   Strain Number: 01X67  Common Strain Name: CAG-LSL-EGFR-WT  Strain Nomenclature: STOCK Col1a1tm1(CAG-EGRF)Char/Nci  Release Category (Required for MTA form): B3 , D Sample MTA for this

333

Mouse Repository Strain Details  

Cancer.gov

Available Strain Details Order Form for Live Mice   Strain Number: 01X62  Common Strain Name: Arf floxed  Strain Nomenclature: B6.129-Cdkn2atm4Cjs/Nci  Release Category (Required for MTA form): B1 Sample MTA for this strain Animal Health Report in

334

Mouse Repository Strain Details  

Cancer.gov

Available Strain Details Order Form for Live Mice   Strain Number: 01XB2  Common Strain Name: Ink4a/Arf null (FVB)  Strain Nomenclature: FVB.129-Cdkn2atm1Rdp/Nci  Release Category (Required for MTA form): C3 Sample MTA for this strain Animal Health

335

Repetitive strain injury to the foot in elite women kendoka  

Microsoft Academic Search

OBJECTIVE: To account for the apparent high incidence of pain in the feet of elite women kendo players. METHODS: A clinical evaluation was done by a chiropractor, the women were interviewed about their kendo experience, and the conditions and frequency of training and ground reaction forces were measured on a Kistler force plate during the kendo attacking action. RESULTS: Four

N R Nunn; J W Dyas; I P Dodd

1997-01-01

336

Repetitive strain injury to the foot in elite women kendoka.  

PubMed Central

OBJECTIVE: To account for the apparent high incidence of pain in the feet of elite women kendo players. METHODS: A clinical evaluation was done by a chiropractor, the women were interviewed about their kendo experience, and the conditions and frequency of training and ground reaction forces were measured on a Kistler force plate during the kendo attacking action. RESULTS: Four out the five women presented with plantar fasciitis. They had all practised for some time on wooden floors laid on concrete, for between two to four hours a week. They warmed up conscientiously but cool down was more cursory. The force plate results showed that they were hitting the floor with a mean force of four times body weight during a transient impact. CONCLUSIONS: High motivation for practice and training, hard floors, ignoring painful feet, and cursory postpractice cool down probably produced the condition. Postpractice icing and stretching were found to be most effective in the short term. In the longer term reducing the level of impact, either by training on sprung floors or changing the footwork, might reduce the incidence and intensity of the fasciitis. PMID:9132217

Nunn, N R; Dyas, J W; Dodd, I P

1997-01-01

337

Prevention of Eye Injuries  

PubMed Central

In Canada 30,000 people are registered as blind; in one third of these, blindness might have been avoided. Prevention is the key to reducing the number of eye injuries and blind eyes. The role of the family physician in early identification of treatable conditions and in the education of patients is discussed, but responsibility for prevention belongs to all physicians. The success of prevention is seen in the great reduction in eye injuries in industry and sports since eye protectors have been commonly used. However, many dangers to the eyes are either not recognized or are not taken seriously enough. This paper discusses some of the common causes of serious eye injuries in the home, in sports and in industry. Imagesp464-aFig. 1Fig. 2Fig. 3Fig. 4 PMID:21289691

Pashby, Tom

1981-01-01

338

Measuring burn injury outcomes.  

PubMed

Burn injury affects all facets of life. Burn care has improved over time. Improved survival after burn injury has resulted in a shift in outcome measurement from inpatient morbidity and mortality to long-term functional and health-related quality-of-life measures. Integration of professionals from different disciplines has enabled burn centers to develop collaborative methods of assessing the quality of care delivered to patients with burns based on their ability to reintegrate into their normal physical, social, psychological, and functional activities. Burn outcomes will continue to develop on the foundation that has been built and will generate evidence-based best practices in the future. PMID:25085096

Palmieri, Tina L; Przkora, Rene; Meyer, Walter J; Carrougher, Gretchen J

2014-08-01

339

Severe Traumatic Injury  

PubMed Central

Objectives The public health implications of regional variation in incidence and outcome of severe traumatic injury remain to be analyzed. The objective of this study was to determine whether the incidence and outcome associated with severe traumatic injury differs across geographic regions of North America. Methods A prospective, observational study was conducted of the Resuscitation Outcomes Consortium of all patients in 9 North American sites (6 US and 3 Canadian) sustaining severe traumatic injury from April 1, 2006 to March 31, 2007 followed to hospital discharge. Eligible patients were assessed by organized emergency medical services, and had field-based physiologic criteria including systolic blood pressure ?90 mm Hg, Glasgow Coma Scale score ?12, respiratory rate <10 or >29 per minute, advanced airway procedure, or traumatic death in the field. Census data were used to determine rates adjusted for age and sex. The main outcome measures were incidence rate, mortality rate, case fatality rate, and survival to discharge for patients sustaining severe traumatic injury assessed by EMS. Results The total catchment population of 20.5 million yielded 7080 cases of severe traumatic injury. Median age was 36 years and 67% were male. The median incidence of EMS-assessed severe traumatic injury per 100,000 population across sites was 37.4 (interquartile range [IQR] = 24.6 – 69.6); survival ranged from 39.8% to 80.8%, with a median of 64.5% (IQR = 55.5–78.4). About 942 cases were pronounced dead at the scene and 5857 patients were transported to hospital; 4477 (63.2%) were discharged alive. The median incidence of severe trauma due to a blunt mechanism, transported to hospital, was 25.8 (IQR = 13.1–44.3); survival ranged from 52.6% to 87.3%, with a median of 78.0% (IQR = 68.4–83.5). The median incidence of severe penetrating trauma, transported to hospital, was 2.6 (IQR = 1.5–10.4); survival ranged from 37.5% to 84.7%, with a median of 67.5% (IQR = 54.1–75.9). All P values for differences across sites for incidence and survival were <0.001. Conclusions In this study involving 9 geographic regions in North America, there were significant and important regional differences in severe traumatic injury, incidence, and outcome. These differences were sustained for patients with either isolated blunt or penetrating injury mechanisms. PMID:20531005

Minei, Joseph P.; Schmicker, Robert H.; Kerby, Jeffrey D.; Stiell, Ian G.; Schreiber, Martin A.; Bulger, Eileen; Tisherman, Samuel; Hoyt, David B.; Nichol, Graham

2014-01-01

340

Extensor tendons injuries.  

PubMed

Extensor mechanism injuries are frequently encountered in athletes and can lead to permanent disability or deformity if not promptly and properly treated. This article reviews basic anatomy, and then discusses mallet finger injuries, boutonniere deformity, and sagittal band rupture. Once treatment has begun, return to sport is highly variable because of the varied needs of each athlete and where they fall on the spectrum of disease. As such, each athlete must be carefully evaluated and closely followed to ensure a safe, prompt, and judicious return to athletic pursuits. PMID:25455403

McMurtry, John T; Isaacs, Jonathan

2015-01-01

341

Determining the Prevalence and Assessing the Severity of Injuries in Mixed Martial Arts Athletes  

PubMed Central

Background Mixed martial arts (MMA) is currently the fastest growing sport in the United States and has recently surpassed boxing as the most popular full contact sport. Due to the physical nature of the sport, MMA is associated with various types of injuries. Objective The purpose of this study was aimed at identifying prevalence and assessing the severity, location, and type of injuries in MMA athletes sustained during MMA related activities in the twelve month period prior to the survey. Methods A total of fifty-five subjects between the ages of 18 to 39 participated in the study. Participants were given a two-part questionnaire to collect demographic and injury data. Results Two hundred seven injuries were reported in the study. Low belt ranks had significantly more injuries more than any other belt rank, resulting in more than two times higher injury rate. Professional fighters had significantly more injuries than amateur fighters, resulting in three times higher injury rate. The most common body region injured was the head/neck/face (38.2%), followed by the lower extremities (30.4%), upper extremities (22.7%), torso (8.2%), and groin (0.5%). Injuries to the nose (6.3%), shoulder (6.3%), and toe (6.3%) were the most common. The most common type of injury was contusions (29.4%), followed by strains (16.2%), sprains (14.9%), and abrasions (10.1%). Conclusion Injury prevention efforts should consider the prevalence and distribution of injuries and focus on reducing or preventing injuries to the head/neck/face in MMA related activities. Preventative measures should focus on improving protective equipment during training, and possible competition rule modifications to further minimize participant injury. PMID:21509103

2009-01-01

342

Body's Response to Traumatic Injury  

MedlinePLUS

... what happens to the body after a serious physical injury. Your browser does not support iframes. Share Print E-mail Related Links Inside Life Science Article: Life After Traumatic Injury: How the Body ...

343

Pedestrian Injuries: Emergency Care Considerations  

E-print Network

Brunn MA, Garcia VF. Cervical spine injuries in children: aand the potential for cervical spine trauma, carefulcervical injuries. Regardless of this fact, a review of one database showed that pediatric C-spine

Chakravarthy, Bharath; Lotfipour, Shahram; Vaca, Federico E

2007-01-01

344

TRAUMATIC BRAIN INJURY (TBI) DATABASE  

EPA Science Inventory

The Traumatic Brain Injury National Data Center (TBINDC) at Kessler Medical Rehabilitation Research and Education Center is the coordinating center for the research and dissemination efforts of the Traumatic Brain Injury Model Systems (TBIMS) program funded by the National Instit...

345

Management of blunt pulmonary injury.  

PubMed

Thoracic injuries account for 25% of all civilian deaths. Blunt force injuries are a subset of thoracic injuries and include injuries of the tracheobronchial tree, pleural space, and lung parenchyma. Early identification of these injuries during initial assessment and resuscitation is essential to reduce associated morbidity and mortality rates. Management of airway injuries includes definitive airway control with identification and repair of tracheobronchial injuries. Management of pneumothorax and hemothorax includes pleural space drainage and control of ongoing hemorrhage, along with monitoring for complications such as empyema and chylothorax. Injuries of the lung parenchyma, such as pulmonary contusion, may require support of oxygenation and ventilation through both conventional and nonconventional mechanical ventilation strategies. General strategies to improve pulmonary function and gas exchange include balanced fluid resuscitation to targeted volume-based resuscitation end points, positioning therapy, and pain management. PMID:25340419

Gallagher, John J

2014-01-01

346

FastStats: All Injuries  

MedlinePLUS

... this? Submit What's this? Submit Button NCHS Home All Injuries Share Compartir Data are for the U.S. ... first-listed diagnostic categories [PDF - 58 KB] Mortality All injury deaths Number of deaths: 187,464 Deaths ...

347

Exertion injuries in female athletes.  

PubMed Central

Because sports injuries in men form most of the available statistics, the reportage of injuries in female athletes is sparse. We describe exertion injuries and disorders in 281 women athletes, all of which hampered athletic training or performances. Sixty per cent of the injuries occurred to girls ages between 12-19 years, and about forty-eight per cent were track and field athletes. The most common sites of injury were the ankle, foot, heel and leg. Osteochondritic disorders were the most typical injuries in the series, and the chronic medical tibial syndrome was the injury that needed surgical treatment most frequently. Overuse injuries seem to differ very little from each other in the events included in this survey. Images p229-a p229-b p229-c PMID:6797496

Orava, S.; Hulkko, A.; Jormakka, E.

1981-01-01

348

Wild Boar Inflicted Human Injury  

Microsoft Academic Search

Interaction between human and animals has increased in recent time regarding the fight for habitats. Animal inflicted injuries\\u000a are mostly associated with the soft tissue injury and facial fractures. As literature has documented, this type of injuries\\u000a are most commonly seen in rural communities. This article discusses a report a case of soft tissue injury associated with\\u000a mandibular fracture undisplaced

Hirkani Attarde; Samprati Badjate; S. Ramakrishna Shenoi

2011-01-01

349

Evaluation after Traumatic Brain Injury  

ERIC Educational Resources Information Center

It is important to determine if a traumatic brain injury (TBI) has occurred when an individual is assessed in a hospital emergency room after a car accident, fall, or other injury that affects the head. This determination influences decisions about treatment. It is essential to screen for the injury, because the sooner they begin appropriate…

Trudel, Tina M.; Halper, James; Pines, Hayley; Cancro, Lorraine

2010-01-01

350

Throwing Injuries of the Shoulder.  

ERIC Educational Resources Information Center

The majority of shoulder injuries occurring in throwing sports involve the soft tissue structures. Injuries often occur when the unit is overstretched to a point near its greatest length, involving the elastic tissues. The other injury mechanism involves the contractural unit of the muscle, which occurs near the midpoint of contractions, involving…

McCue, Frank C., III; and Others

351

CDC Vital Signs: Child Injury  

MedlinePLUS

... Issue Details Injuries are the #1 cause of death among children. Car crashes, suffocation, drowning, poisoning, fires, and falls are some of the most common causes of injury. Learn how you can help save lives and prevent these injuries. View larger image and text. What Can Be Done States and ...

352

Brain Injury Association of America  

MedlinePLUS

... TO THANK OUR SPONSORS... Brain Injury Preferred Attorneys Brain Injury Rehabilitation Services Seek medical attention if you are experiencing: Numbness Excessive drowsiness Severe Headache Weakness in your arms or legs Dizziness or loss of vision Slurred speech Loss of ... © 2014 Brain Injury ...

353

JAMA Patient Page: Head Injury  

MedlinePLUS

... of care for the injury, persons with traumatic brain injury often receive intensive rehabilitation to maximize their functional level (what they are able to do) and improve their overall recovery. PREVENTING BRAIN INJURY T R A U M A The Journal ...

354

Blast injury research models  

PubMed Central

Blast injuries are an increasing problem in both military and civilian practice. Primary blast injury to the lungs (blast lung) is found in a clinically significant proportion of casualties from explosions even in an open environment, and in a high proportion of severely injured casualties following explosions in confined spaces. Blast casualties also commonly suffer secondary and tertiary blast injuries resulting in significant blood loss. The presence of hypoxaemia owing to blast lung complicates the process of fluid resuscitation. Consequently, prolonged hypotensive resuscitation was found to be incompatible with survival after combined blast lung and haemorrhage. This article describes studies addressing new forward resuscitation strategies involving a hybrid blood pressure profile (initially hypotensive followed later by normotensive resuscitation) and the use of supplemental oxygen to increase survival and reduce physiological deterioration during prolonged resuscitation. Surprisingly, hypertonic saline dextran was found to be inferior to normal saline after combined blast injury and haemorrhage. New strategies have therefore been developed to address the needs of blast-injured casualties and are likely to be particularly useful under circumstances of enforced delayed evacuation to surgical care. PMID:21149352

Kirkman, E.; Watts, S.; Cooper, G.

2011-01-01

355

Acoustic shock injury (ASI)  

Microsoft Academic Search

Conclusion. The potential severity and persistence of ASI symptoms has significant clinical and medico-legal implications. With the rapid growth of call centres around the world, professionals providing tinnitus and hyperacusis therapy are increasingly likely to encounter some or all of the cluster of ASI symptoms in their clients. Background. Acoustic shock injury (ASI), occurring as a result of exposure to

Myriam Westcott

2006-01-01

356

Principal Strain Calculator  

NSDL National Science Digital Library

Given the strain components ex, ey, and exy, this calculator computes the principal strains e1 and e2, the principal angle qp, the maximum shear strain exy max and its angle qs. It also illustrates an approximate Mohr's cirlce for the given strain state.

2008-05-22

357

Elevated depressive symptoms and adolescent injury: examining associations by injury frequency, injury type, and gender  

PubMed Central

Background Key risk factors for adolescent injury have been well documented, and include structural, behavioural, and psychosocial indicators. While psychiatric distress has been associated with suicidal behaviour and related self-harm, very little research has examined the role of depression in shaping adolescent injury. This study examines the association of elevated depressive symptoms with injury, including total number of injuries and injury type. Gender differences are also considered. Methods Data were drawn in 2010–11 from a representative sample of 2,989 high school students (14 to18 years of age) from Nova Scotia, Canada. Self-reported injury outcomes were examined using the 17-item Adolescent Injury Checklist, which captures past six-month injuries. Elevated depressive symptoms were assessed using the Centers for Epidemiological Studies Depression scale. Associations of elevated depressive symptoms with total number of injuries were estimated with negative binomial regression, while associations with specific injury types were estimated with logistic regression. Analyses were conducted in 2012. Results Adolescents with elevated depressive symptoms experienced a 40% increase in the total number of injury events occurring in the past six months. The association of elevated depressive symptoms with injury was consistent across injury type; violence-related (OR 2.21, 95% CI 1.61 to 3.03), transport-related (OR 1.53, 95% CI 1.10 to 2.13), and unintentional injuries (OR 1.65, 95% CI 1.20 to 2.27). Gender differences were also observed. Conclusion Elevated depressive symptoms play a role in shaping adolescent injury. Interventions aimed at reducing adolescent injury should look to minimize psychosocial antecedents, such as poor mental health, that put adolescents at an elevated risk. PMID:24555802

2014-01-01

358

Ankle injuries in basketball: injury rate and risk factors  

PubMed Central

Objectives—To determine the rate of ankle injury and examine risk factors of ankle injuries in mainly recreational basketball players. Methods—Injury observers sat courtside to determine the occurrence of ankle injuries in basketball. Ankle injured players and a group of non-injured basketball players completed a questionnaire. Results—A total of 10 393 basketball participations were observed and 40 ankle injuries documented. A group of non-injured players formed the control group (n = 360). The rate of ankle injury was 3.85 per 1000 participations, with almost half (45.9%) missing one week or more of competition and the most common mechanism being landing (45%). Over half (56.8%) of the ankle injured basketball players did not seek professional treatment. Three risk factors for ankle injury were identified: (1) players with a history of ankle injury were almost five times more likely to sustain an ankle injury (odds ratio (OR) 4.94, 95% confidence interval (CI) 1.95 to 12.48); (2) players wearing shoes with air cells in the heel were 4.3 times more likely to injure an ankle than those wearing shoes without air cells (OR 4.34, 95% CI 1.51 to 12.40); (3) players who did not stretch before the game were 2.6 times more likely to injure an ankle than players who did (OR 2.62, 95% CI 1.01 to 6.34). There was also a trend toward ankle tape decreasing the risk of ankle injury in players with a history of ankle injury (p = 0.06). Conclusions—Ankle injuries occurred at a rate of 3.85 per 1000 participations. The three identified risk factors, and landing, should all be considered when preventive strategies for ankle injuries in basketball are being formulated. Key Words: basketball; ankle; injury; risk; prevention PMID:11273971

McKay, G; Goldie, P; Payne, W; Oakes, B

2001-01-01

359

CONSENSUS CRITERIA FOR DEFINING ‘SUCCESSFUL OUTCOME’ AFTER ACL INJURY AND RECONSTRUCTION: A DELAWARE-OSLO ACL COHORT INVESTIGATION  

PubMed Central

Background No gold standard exists for identifying successful outcomes 1 and 2 years after operative and non-operative management of anterior cruciate ligament (ACL) injury. This limits the ability of researcher and clinicians to compare and contrast results of interventions. Purpose to establish a consensus based on expert consensus of measures that define successful outcomes 1 and 2 years after ACL injury or reconstruction. Methods Members of international sports medicine associations, including the American Orthopaedic Society for Sports Medicine (AOSSM), the European Society for Sports Traumatology, Surgery, and Knee Arthroscopy (ESSKA), and the American Physical Therapy Association (APTA), were sent a survey via e-mail. Blinded responses were analyzed for trends with frequency counts. A summed importance percentage (SIP) was calculated and 80% SIP operationally indicated consensus. Results 1779 responses were obtained. Consensus was achieved for six measures in operative and non-operative management: the absence of giving way, patient return to sports, quadriceps and hamstrings strength greater than 90% of the uninvolved limb, the patient having no more than a mild knee joint effusion, and using patient reported outcomes (PRO). No single PRO achieved consensus, but threshold scores between 85 and 90 were established for PROs concerning patient performance. Conclusion The consensus identified six measures important for successful outcome after ACL injury or reconstruction. These represent all levels of the International Classification of Functioning; effusion, giving way, muscle strength (body structure and function), PRO (activity and participation), and return to sport (participation) and should be included to allow for comparison between interventions. PMID:23881894

Lynch, Andrew D.; Logerstedt, David S.; Grindem, Hege; Eitzen, Ingrid; Hicks, Gregory E.; Axe, Michael J.; Engebretsen, Lars; Arna Risberg, May; Snyder-Mackler, Lynn

2013-01-01

360

Overuse injuries in youth sports.  

PubMed

Although youth sports participation is beneficial on many levels, it is also associated with an increased risk of injury. Risk factors for injury in children and adolescents include the presence of growth cartilage, existence of muscle imbalance, and pressure to compete despite pain and fatigue. Overuse injuries, such as patellofemoral pain, Osgood-Schlatter disease, calcaneal apophysitis, Little League elbow, Little League shoulder, spondylolysis, and osteochondritis dissecans, are common injuries in organized sports. However, proper education, supervision, and training can help reduce the risk of these injuries and facilitate early intervention. PMID:20631469

Stein, Cynthia J; Micheli, Lyle J

2010-06-01

361

Superlattice strain gage  

DOEpatents

A strain gage comprising a strained-layer superlattice crystal exhibiting piezoelectric properties is described. A substrate upon which such a strained-layer superlattice crystal has been deposited is attached to an element to be monitored for strain. A light source is focused on the superlattice crystal and the light reflected from, passed through, or emitted from the crystal is gathered and compared with previously obtained optical property data to determine the strain in the element. 8 figs.

Noel, B.W.; Smith, D.L.; Sinha, D.N.

1988-06-28

362

Cricket injuries: an orthopaedist's perspective.  

PubMed

A decade ago, cricket has traditionally been regarded as relatively injury free, although it has been classified as having a "moderate" injury risk. At present, cricket has evolved into shorter and more competitive versions involving greater aggression and often played for long periods of time. This has expectedly ensued in an increase in the number of cricketing injuries similar to those seen in other sports which involve running, throwing, or being hit by a hard object. However, there are some injuries to look out for especially in cricket players. In this article, we have reviewed information about cricket injuries that will help orthopaedists make the correct diagnoses and initiate appropriate treatment. Orthopaedic surgeons and physiotherapists should work as a team to detect treatable cricket injuries at an early stage and ensure that every precaution is taken to minimize the risks of injury. PMID:24890289

Shafi, Mohamed

2014-05-01

363

Cartilage Pressure Distributions Provide a Footprint to Define Female Anterior Cruciate Ligament Injury Mechanisms  

PubMed Central

Background Bone bruises located on the lateral femoral condyle and posterolateral tibia are commonly associated with anterior cruciate ligament (ACL) injuries and may contribute to the high risk for knee osteoarthritis after ACL injury. The resultant footprint (location) of a bone bruise after ACL injury provides evidence of the inciting injury mechanism. Purpose/Hypothesis (1) To analyze tibial and femoral articular cartilage pressure distributions during normal landing and injury simulations, and (2) to evaluate ACL strains for conditions that lead to articular cartilage pressure distributions similar to bone bruise patterns associated with ACL injury. The hypothesis was that combined knee abduction and anterior tibial translation injury simulations would demonstrate peak articular cartilage pressure distributions in the lateral femoral condyle and posterolateral tibia. The corollary hypothesis was that combined knee abduction and anterior tibial translation injury conditions would result in the highest ACL strains. Study Design Descriptive laboratory study. Methods Prospective biomechanical data from athletes who subsequently suffered ACL injuries after testing (n = 9) and uninjured teammates (n = 390) were used as baseline input data for finite element model comparisons. Results Peak articular pressures that occurred on the posterolateral tibia and lateral femoral condyle were demonstrated for injury conditions that had a baseline knee abduction angle of 5°. Combined planar injury conditions of abduction/anterior tibial translation, anterior tibial translation/internal tibial rotation, or anterior tibial translation/external tibial rotation or isolated anterior tibial translation, external tibial rotation, or internal tibial rotation resulted in peak pressures in the posterolateral tibia and lateral femur. The highest ACL strains occurred during the combined abduction/anterior tibial translation condition in the group that had a baseline knee abduction angle of 5°. Conclusion The results of this study support a valgus collapse as the major ACL injury mechanism that results from tibial abduction rotations combined with anterior tibial translation or external or internal tibial rotations. Clinical Relevance Reduction of large multiplanar knee motions that include abduction, anterior translation, and internal/external tibial motions may reduce the risk for ACL injuries and associated bone bruises. In particular, prevention of an abduction knee posture during initial contact of the foot with the ground may help prevent ACL injury. PMID:21487121

Quatman, Carmen E.; Kiapour, Ali; Myer, Gregory D.; Ford, Kevin R.; Demetropoulos, Constantine K.; Goel, Vijay K.; Hewett, Timothy E.

2012-01-01

364

Kinesio taping in treatment and prevention of sports injuries: a meta-analysis of the evidence for its effectiveness.  

PubMed

Kinesio tape (KT) is an elastic therapeutic tape used for treating sports injuries and a variety of other disorders. Chiropractor, Dr Kenso Kase, developed KT taping techniques in the 1970s. It is claimed that KT supports injured muscles and joints and helps relieve pain by lifting the skin and allowing improved blood and lymph flow. The profile of KT rose after the tape was donated to 58 countries for use during the 2008 Olympic Games, and was seen on high-profile athletes. Practitioners are asking whether they should use KT over other elastic adhesive tapes. The aim of this review was to evaluate, using meta-analysis, the effectiveness of KT in the treatment and prevention of sports injuries. Electronic databases including SPORTDiscus, Scopus, MEDLINE, ScienceDirect and sports medicine websites were searched using keywords 'kinesio taping/tape'. From 97 articles, ten met the inclusion criteria (article reported data for effect of KT on a musculoskeletal outcome and had a control group) and were retained for meta-analyses. Magnitude-based inferences were used to assess clinical worth of positive outcomes reported in studies. Only two studies investigated sports-related injuries (shoulder impingement), and just one of these involved injured athletes. Studies attending to musculoskeletal outcomes in healthy participants were included on the basis that these outcomes may have implications for the prevention of sporting injuries. The efficacy of KT in pain relief was trivial given there were no clinically important results. There were inconsistent range-of-motion outcome results, with at least small beneficial results seen in two studies, but trivial results in two other studies across numerous joint measurements. There was a likely beneficial effect for proprioception regarding grip force sense error, but no positive outcome for ankle proprioception. Seven outcomes relating to strength were beneficial, although there were numerous trivial findings for quadriceps and hamstrings peak torque, and grip strength measures. KT had some substantial effects on muscle activity, but it was unclear whether these changes were beneficial or harmful. In conclusion, there was little quality evidence to support the use of KT over other types of elastic taping in the management or prevention of sports injuries. KT may have a small beneficial role in improving strength, range of motion in certain injured cohorts and force sense error compared with other tapes, but further studies are needed to confirm these findings. The amount of case study and anecdotal support for KT warrants well designed experimental research, particularly pertaining to sporting injuries, so that practitioners can be confident that KT is beneficial for their athletes. PMID:22124445

Williams, Sean; Whatman, Chris; Hume, Patria A; Sheerin, Kelly

2012-02-01

365

Meniscal injury: II. Management.  

PubMed

Meniscal repair is a viable alternative to resection in many clinical situations. Repair techniques traditionally have utilized a variety of suture methods, including inside-out and outside-in techniques. Bioabsorbable implants permit all-inside arthroscopic repairs. The success of meniscal repair depends on appropriate meniscal bed preparation and surgical technique and is also influenced by biologic factors such as tear rim width and associated ligamentous injury. Successful repair in >80% of cases has been reported in conjunction with anterior cruciate ligament reconstruction. Success rates are lower for isolated repairs. Complications related to repair include neurologic injury, postoperative loss of motion, recurrence of the tear, and infection. Meniscal allograft transplantation may provide a treatment option when meniscus salvage is not possible or when a previous total meniscectomy has been done. PMID:12041939

Greis, Patrick E; Holmstrom, Michael C; Bardana, Davide D; Burks, Robert T

2002-01-01

366

Self Injury Inhibitor  

NASA Technical Reports Server (NTRS)

There are approximately 50,000 autistic and retarded people in the United States alone, and many of them engage in self-injurious behavior, principally compulsive headbanging. Hope is offered by an automated unit, manufactured at Johns Hopkins University, called the Self-Injurious Behavior Inhibiting System (SIBIS). Components of SIBIS are stimulus module which is worn on upper arm or leg, and headgear which includes an impact detector and a transmitter on back of head. When there is a blow to the head it is sensed by impact detector which generates a coded signal that is automatically transferred to stimulus module which delivers a mild electrical stimulus to the skin for less than 1/10 of a second. Stimulus is sufficient to halt headbanging. Microprocessor computes impacts allowing measurement of patient progress.

1988-01-01

367

Survived crossbow injuries.  

PubMed

The Hamburg University Institute of Legal Medicine presents 2 cases of injuries of crossbow arrows where the patients survived. Crossbows are used nowadays as sports and hunting weapons. They are freely obtainable, and since people without practice can shoot them, there are constant injuries and fatal cases. Crossbow arrows have a high penetration force and can even pierce bone. Depending on the tip of the arrow used, they bore or cut through tissue, here damage to the tissue being restricted to the direct surroundings. Due to the elasticity of the tissue, the arrow shaft in the wound track may have the effect of an incomplete tamponade so that major hemorrhaging is prevented. In this condition, the injured person may be conscious and capacitated. From the medical viewpoint, crossbow arrows should therefore be invariably left in the wound, secured against displacement during transport, and only removed in the hospital. PMID:16936511

Krukemeyer, Manfred George; Grellner, Willi; Gehrke, Gerd; Koops, Emil; Püschel, Klaus

2006-09-01

368

Acute Inhalation Injury  

PubMed Central

Inhaled substances may cause injury in pulmonary epithelium at various levels of respiratory tract, leading from simple symptoms to severe disease. Acute inhalation injury (AII) is not uncommon condition. There are certain high risk groups but AII may occur at various places including home or workplace. Environmental exposure is also possible. In addition to individual susceptibility, the characteristics of inhaled substances such as water solubility, size of substances and chemical properties may affect disease severity as well as its location. Although AII cases may recover in a few days but AII may cause long-term complications, even death. We aimed to discuss the effects of short-term exposures (minutes to hours) to toxic substances on the lungs.

Gorguner, Metin; Akgun, Metin

2010-01-01

369

Soccer injuries in children  

Microsoft Academic Search

Soccer is the most popular sport in the world, with FIFA recognising more than 265 million amateur players. Despite the fact\\u000a that soccer is a contact sport, it is perceived to be relatively safe to play, a factor that has contributed to its status\\u000a as the fastest growing team sport in the USA. Acute and minor injuries predominate in the

Anne Paterson

2009-01-01

370

Esophageal and Gastric Injuries  

Microsoft Academic Search

\\u000a Traumatic lesions of the esophagus can be classified into. Primary lesions, Perforations, Ruptures, Secondary lesions, Fistulas,\\u000a Strictures Perforations: Perforations are due to internal or external forces. The vast majority of esophageal perforations\\u000a occur iatrogenic (e.g., endoscopy, dilatation, transesophageal echocardiography (TEE), Sengstaken–Blakemore tubes, endotracheal\\u000a tubes). Penetrating injuries due to external forces (e.g., stab wounds, gunshots) are less frequent. For the therapeutic

Paul M. Schneider; Georg Lurje; Peter Bauerfeind; Marc Schiesser

371

Self-Injurious Behavior  

Microsoft Academic Search

?Self-injurious behavior (SIB) viewed as a general area of pathology (e.g., McAllister, 2003) has been associated with obvious significant danger and persistence (Emerson et al. 2001), uncertain etiology (Pooley, Houston, Hawton & Harrison, 2003), and controversy in its treatments (Boyce, Carter, Penrose-Wall, Wilhelm, & Goldney, 2003; Linscheid & Reichenbach, 2002). At the broadest level, SIB could be considered to include

W. Larry Williams; Michele Wallace

372

Traumatic Brain Injury  

Microsoft Academic Search

Patients with traumatic brain injury (TBI) pose an enormous clinical, emotional, and intellectual challenge to rehabilitation\\u000a professionals. For public policymakers, the cost of care for approximately 6 million survivors of TBI is measured in the billions\\u000a of dollars. In addition to the motor, sensory, and language deficits commonly seen in nontraumatic etiologies, the patient\\u000a with TBI often experiences cognitive and\\/or

Ramnik Singh; Michael W. O’Dell

373

A Modified Controlled Cortical Impact Technique to Model Mild Traumatic Brain Injury Mechanics in Mice  

PubMed Central

For the past 25?years, controlled cortical impact (CCI) has been a useful tool in traumatic brain injury (TBI) research, creating injury patterns that includes primary contusion, neuronal loss, and traumatic axonal damage. However, when CCI was first developed, very little was known on the underlying biomechanics of mild TBI. This paper uses information generated from recent computational models of mild TBI in humans to alter CCI and better reflect the biomechanical conditions of mild TBI. Using a finite element model of CCI in the mouse, we adjusted three primary features of CCI: the speed of the impact to achieve strain rates within the range associated with mild TBI, the shape, and material of the impounder to minimize strain concentrations in the brain, and the impact depth to control the peak deformation that occurred in the cortex and hippocampus. For these modified cortical impact conditions, we observed peak strains and strain rates throughout the brain were significantly reduced and consistent with estimated strains and strain rates observed in human mild TBI. We saw breakdown of the blood–brain barrier but no primary hemorrhage. Moreover, neuronal degeneration, axonal injury, and both astrocytic and microglia reactivity were observed up to 8?days after injury. Significant deficits in rotarod performance appeared early after injury, but we observed no impairment in spatial object recognition or contextual fear conditioning response 5 and 8?days after injury, respectively. Together, these data show that simulating the biomechanical conditions of mild TBI with a modified cortical impact technique produces regions of cellular reactivity and neuronal loss that coincide with only a transient behavioral impairment. PMID:24994996

Chen, YungChia; Mao, Haojie; Yang, King H.; Abel, Ted; Meaney, David F.

2014-01-01

374

Strain-Specific Differences in Mouse Hepatic Wound Healing are Mediated by Divergent T Helper Cytokine Responses  

Microsoft Academic Search

Hepatic fibrosis represents the generalized response of the liver to injury and is characterized by excessive deposition of extracellular matrix. The cellular basis of this process is complex and involves interplay of many factors, of which cytokines are prominent. We have identified divergent fibrosing responses to injury among mouse strains and taken advantage of these differences to examine and contrast

Zengdun Shi; Adil E. Wakil; Don C. Rockey

1997-01-01

375

Modeling acute traumatic injury.  

PubMed

Acute traumatic injury is a complex disease that has remained a leading cause of death, which affects all ages in our society. Direct mechanical insult to tissues may result in physiological and immunologic disturbances brought about by blood loss, coagulopathy, as well as ischemia and reperfusion insults. This inappropriate response leads to an abnormal release of endogenous mediators of inflammation that synergistically contribute to the incidence of morbidity and mortality. This aberrant activation and suppression of the immune system follows a bimodal pattern, wherein activation of the innate immune responses is followed by an anti-inflammatory response with suppression of the adaptive immunity, which can subsequently lead secondary insults and multiple organ dysfunction. Traumatic injury rodent and swine models have been used to describe many of the underlying pathologic mechanisms, which have led to an improved understanding of the morbidity and mortality associated with critically ill trauma patients. The enigmatic immunopathology of the human immunologic response after severe trauma, however, has never more been apparent and there grows a need for a clinically relevant animal model, which mimics this immune physiology to enhance the care of the most severely injured. This has necessitated preclinical studies in a more closely related model system, the nonhuman primate. In this review article, we summarize animal models of trauma that have provided insight into the clinical response and understanding of cellular mechanisms involved in the onset and progression of ischemia-reperfusion injury as well as describe future treatment options using immunomodulation-based strategies. PMID:25481528

Valparaiso, Apple P; Vicente, Diego A; Bograd, Benjamin A; Elster, Eric A; Davis, Thomas A

2014-10-22

376

Treatment of Radiation Injury  

PubMed Central

Significance: Radiation exposure as a result of radiation treatment, accident, or terrorism may cause serious problems such as deficiency due to necrosis or loss of function, fibrosis, or intractable ulcers in the tissues and organs. When the skin, bone, oral mucous membrane, guts, or salivary glands are damaged by ionizing radiation, the management and treatment are very lengthy and difficult. Critical Issues: In severe and irreversible injuries, surgery remains the mainstay of treatment. Several surgical procedures, such as debridement, skin grafting, and local and free-vascularized flaps, are widely used. Recent Advances: In specific cases of major morbidity or in high-risk patients, a newly developed therapy using a patient's own stem cells is safe and effective. Adipose tissue, normally a rich source of mesenchymal stem cells, which are similar to those from the bone marrow, can be harvested, since the procedure is easy, and abundant tissue can be obtained with minimal invasiveness. Future Directions: Based on the molecular basis of radiation injuries, several prospective treatments are under development. Single-nucleotide polymorphisms focus on an individual's sensitivity to radiation in radiogenomics, and the pathology of radiation fibrosis or the effect of radiation on wound healing is being studied and will lead to new insight into the treatment of radiation injuries. Protectors and mitigators are being actively investigated in terms of the timing of administration or dose. PMID:24761339

Akita, Sadanori

2014-01-01

377

Vascular Injuries: Trends in Management  

PubMed Central

Abstract Vascular injury presents a great challenge to the emergency resident because these injuries require urgent intervention to prevent loss of life or limb. Sometimes serious vascular injury presents with only subtle or occult signs or symptoms. The patient may present weeks or months after initial injury with symptoms of vascular insufficiency, embolization, pseudoaneurysm, arteriovenous fistula etc. Although the majority of vascular injuries are caused by penetrating trauma from gunshot wounds, stabbing or blast injury, the possibility of vascular injury needs to be considered in patients presenting with displaced long bone fractures, crush injury, prolonged immobilization in a fixed position by tight casts or bandages and various invasive procedures. iatrogenic vascular injuries constitute about 10% of cases in most series; however the incidence is an increasing trend because more endovascular procedures such as angioplasty and cardiac catheterization are being performed routinely. Civilian trauma is more frequently seen in young males. However, it can occur at any age due to road accidents, firearms, bomb blasts and diagnostic procedures. Most of the time, civilian trauma causes less tissue damage. There is an epidemic of vascular injuries in Kashmir valley because of problems in law and order in the past two decades. This review deals with the topic in detail. PMID:24350103

Wani, Mohd Lateef; Ahangar, Ab Gani; Ganie, Farooq Ahmad; Wani, Shadab Nabi; Wani, Nasir-ud-din

2012-01-01

378

Functional Genomics of Chlorine-induced Acute Lung Injury in Mice  

PubMed Central

Acute lung injury can be induced indirectly (e.g., sepsis) or directly (e.g., chlorine inhalation). Because treatment is still limited to supportive measures, mortality remains high (?74,500 deaths/yr). In the past, accidental (railroad derailments) and intentional (Iraq terrorism) chlorine exposures have led to deaths and hospitalizations from acute lung injury. To better understand the molecular events controlling chlorine-induced acute lung injury, we have developed a functional genomics approach using inbred mice strains. Various mouse strains were exposed to chlorine (45 ppm × 24 h) and survival was monitored. The most divergent strains varied by more than threefold in mean survival time, supporting the likelihood of an underlying genetic basis of susceptibility. These divergent strains are excellent models for additional genetic analysis to identify critical candidate genes controlling chlorine-induced acute lung injury. Gene-targeted mice then could be used to test the functional significance of susceptibility candidate genes, which could be valuable in revealing novel insights into the biology of acute lung injury. PMID:20601635

Leikauf, George D; Pope-Varsalona, Hannah; Concel, Vincent J.; Liu, Pengyuan; Bein, Kiflai; Brant, Kelly A.; Dopico, Richard A.; Di, Y. Peter; Jang, An-Soo; Dietsch, Maggie; Medvedovic, Mario; Li, Qian; Vuga, Louis J.; Kaminski, Naftali; You, Ming; Prows, Daniel R.

2010-01-01

379

Nonfatal Occupational Injury Rates and Musculoskeletal Symptoms among Housekeeping Employees of a Hospital in Texas  

PubMed Central

Objectives. To determine the prevalence of musculoskeletal disorders in hospital cleaners. Methods. Injury data on all hospital employees were extracted from occupational health records and compared. Additionally an interview-based modified Nordic Questionnaire (response rate 98.14%) was conducted. Results. The mean total injury rate for cleaners was 35.9?per 100?full-time equivalent (FTE), while that for other employees was 13.64 per 100?FTE. Slips/trips/falls and MMH contributed 4.39 and 2.37 per 100?FTE among cleaners and rest of the hospital employees, respectively. The most common type of injury was strain while the most common cause of injury was a striking object. Conclusion. The cleaners have higher injury rates and morbidity as compared to other employees of the hospital. The lower back was most commonly affected. PMID:21776437

Salwe, Kirtigandha; Kumar, Shrawan; Hood, Joyce

2011-01-01

380

Recovery of Intellectual Ability following Traumatic Brain Injury in Childhood: Impact of Injury Severity and Age at Injury  

Microsoft Academic Search

Traumatic brain injury (TBI) may have a profound impact on a child’s ongoing development. Various risk factors have been found to predict outcome, but considerable variability remains unexplained. This study used a prospective, longitudinal design to examine the relationship between recovery, injury severity, age at injury and pre-injury ability. 124 children were divided according to (1) age at injury: ‘young’

Vicki Anderson; Cathy Catroppa; Sue Morse; Flora Haritou; Jeffrey Rosenfeld

2000-01-01

381

A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome. The joint undertaking to monitor and prevent ACL injury (JUMP-ACL) cohort  

PubMed Central

Background Patellofemoral pain syndrome (PFPS) is one of the most common chronic knee injuries; however, little research has been done to determine the risk factors for this injury. Hypothesis Altered lower extremity kinematics and kinetics, decreased strength, and altered postural measurements will be risk factors. Study Design Prospective cohort. Methods 1597 participants were enrolled in this investigation and prospectively followed from the date of their enrollment (July 2005, July 2006, or July 2007) through January 2008. Each participant underwent baseline data collection during their pre-freshman summer at the United States Naval Academy. Baseline data collection included three-dimensional motion analysis during a jump-landing task, six lower extremity isometric strength tests, and postural alignment measurements (navicular drop and Q-angle). Participants were prospectively followed from their date of enrollment to January 2008 (maximum of 2.5 years of follow up). Results Risk factors for the development of PFPS included decreased knee flexion angle, decreased vertical ground reaction force, and increased hip internal rotation angle during the jump-landing task. Additionally, decreased quadriceps and hamstring strength, increased hip external rotator strength, and increased navicular drop were risk factors for the development of PFPS. Conclusions Multiple modifiable risk factors for PFPS pain have been identified in this investigation. In order to decrease the incidence of this chronic injury, the risk factors for PFPS need to be targeted in injury prevention programs. Clinical Relevance Prevention programs should focus on increasing strength of the lower extremity musculature along with instructing proper mechanics during dynamic movements in order to decrease the incidence of PFPS. PMID:19797162

Boling, Michelle C.; Padua, Darin A; Marshall, Stephen W.; Guskiewicz, Kevin; Pyne, Scott; Beutler, Anthony

2010-01-01

382

Macrophage-mediated injury and repair after ischemic kidney injury.  

PubMed

Acute ischemic kidney injury is a common complication in hospitalized patients. No treatment is yet available for augmenting kidney repair or preventing progressive kidney fibrosis. Animal models of acute kidney injury demonstrate that activation of the innate immune system plays a major role in the systemic response to ischemia/reperfusion injury. Macrophage depletion studies suggest that macrophages, key participants in the innate immune response, augment the initial injury after reperfusion but also promote tubular repair and contribute to long-term kidney fibrosis after ischemic injury. The distinct functional outcomes seen following macrophage depletion at different time points after ischemia/reperfusion injury suggest heterogeneity in macrophage activation states. Identifying the pathways that regulate the transitions of macrophage activation is thus critical for understanding the mechanisms that govern both macrophage-mediated injury and repair in the postischemic kidney. This review examines our understanding of the complex and intricately controlled pathways that determine monocyte recruitment, macrophage activation, and macrophage effector functions after renal ischemia/reperfusion injury. Careful delineation of repair and resolution pathways could provide therapeutic targets for the development of effective treatments to offer patients with acute kidney injury. PMID:24442822

Huen, Sarah C; Cantley, Lloyd G

2015-02-01

383

Traumatic injury among drywall installers, 1992 to 1995.  

PubMed

This study examined the traumatic-injury characteristics associated with one of the high-risk occupations in the construction industry--drywall installers--through an analysis of the traumatic-injury data obtained from the Bureau of Labor Statistics. An additional objective was to demonstrate a feasible and economic approach to identify risk factors associated with a specific occupation by using an existing database. An analysis of nonfatal traumatic injuries with days away from work among wage-and-salary drywall installers was performed for 1992 through 1995 using the Occupational Injury and Illness Survey conducted by the Bureau of Labor Statistics. Results from this study indicate that drywall installers are at a high risk of overexertion and falls to a lower level. More than 40% of the injured drywall installers suffered sprains, strains, and/or tears. The most frequently injured body part was the trunk. More than one-third of the trunk injuries occurred while handling solid building materials, mainly drywall. In addition, the database analysis used in this study is valid in identifying overall risk factors for specific occupations. PMID:11094789

Chiou, S S; Pan, C S; Keane, P

2000-11-01

384

Epidemiologic Approaches to Injury and Violence  

PubMed Central

This volume of Epidemiologic Reviews features 13 articles covering a variety of injury problems and research topics. In this commentary, the authors highlight the remarkable achievements in injury control and the important role the Haddon Matrix has played in understanding injury causation and developing preventive strategies; comment on the individual articles included in this volume in the broad categories of research methods, childhood injury, motor-vehicle-related injury, alcohol-related injury, intentional injury, and occupational injury; and outline research gaps and future directions in injury epidemiology and prevention. PMID:22180470

Baker, Susan P.; Li, Guohua

2012-01-01

385

Competitive Wrestling-related Injuries in School Aged Athletes in U.S. Emergency Departments  

PubMed Central

Objective To describe the characteristics of wrestling injuries occurring in male athletes aged 7–17 treated in United States (U.S.) emergency departments (ED) from 2000–2006, and to compare injury patterns between younger & older youth wrestlers. Methods A stratified probability sample of U.S. hospitals providing emergency services in the National Electronic Injury Surveillance System was used for 2000–2006. ED visits for injuries sustained in organized wrestling were analyzed for male patients ages 7–17 years old (subdivided into 7–11 years old [youth group] and 12–17 years old [scholastic group]). Results During the study period, there were an estimated 167,606 ED visits for wrestling injuries in 7–17 years old U.S. males, with 152,710 (91.1%) occurring in the older (12–17 years old) group. The annual injury incidence was 6.49 injuries/1,000 wrestlers in the youth group and 29.57 injuries/1,000 wrestlers in the scholastic group. The distribution of diagnoses was similar in both age groups, with sprain/strain as the most common diagnosis, followed by fracture and contusion/abrasion. Distributions of injury by location were significantly different between groups (p=0.02), although both groups exhibited approximately 75% of all injuries from the waist up. Overexertion and struck by/against were the most common precipitating and direct mechanisms in both groups, respectively. Over 97% of all injured wrestlers were treated and released. Conclusion The types of injury in youth (7–11 years old) wrestlers are similar to those of scholastic (12–17 years old) wrestlers, although the distribution of body parts injured differs between the age groups. The majority of injuries occurs above the waist and may be a target for prevention strategies. PMID:21293763

Myers, Richard J.; Linakis, Seth W.; Mello, Michael J.; Linakis, James G.

2010-01-01

386

Pediatric nasal injuries and management.  

PubMed

Although serious trauma injuries are uncommon in the pediatric population, nasal injuries are a more common problem. In this population, many physicians are uncomfortable managing these injuries. The evaluation and treatment of nasal trauma differ considerably in children compared with adult nasal fractures. Poor patient cooperation during the physical exam coupled with significant anatomic differences can present the nasal surgeon with a difficult diagnostic dilemma. The surgical management of pediatric nasoseptal injuries is not without controversy, as disturbing the nasal growth centers can have significant effect on future nasal and midfacial development. This article reviews the diagnostic and therapeutic challenges presented by these injuries for children and provides recommendations to successfully manage nasal injuries in this population. PMID:22028012

Wright, Richard J; Murakami, Craig S; Ambro, Bryan T

2011-10-01

387

Large Wire Strain Gauges  

NASA Technical Reports Server (NTRS)

Wires yield data on average strains over distances ranging from inches to many feet. Long constantan wires used to measure average strains over distances characteristic of vehicles or buildings. Connected in bridge circuit, wires measure strain accurately within 1 percent, and linearly, within 0.1 percent. Wires stretch as much as 0.15 percent and still return to zero residual strain after release.

Bryner, B. D.

1987-01-01

388

Nanoscale Strain Metrology SEMICONDUCTORS  

E-print Network

nanodevices by developing novel methods to measure and model strain with nanoscale resolution hinges on accurate prediction and measurement of strain at unprecedented length scales. Objective Impact for Semiconductors, 2007). Novel tools for measuring strain will enable more efficient process development, more

389

Ocular injuries from automobile batteries.  

PubMed

The incidence of eye injuries related to automobile batteries has sharply increased, currently comprising nearly 1% of all unscheduled eye visits to one medical center. A series of 93 cases obtained over 81/2 years was reviewed and follow-up information obtained. While two thirds of the injuries were relatively minor, 10% (9) of the patients sustained permanent ocular damage or required hospitalization. All of the severe injuries and the majority of the other injuries were caused by battery explosions. Not only should the inherent danger of the lead-acid storage battery be reduced, but the public must be alerted to the hazard. PMID:929798

Holekamp, T L

1977-01-01

390

Preventing head and neck injury.  

PubMed

A wide range of head and neck injury risks are present in sport, including catastrophic injury. The literature since 1980 on prevention of head and neck injury in sport was reviewed, focusing on catastrophic and brain injury and identifying the range of injury prevention methods in use. There have been few formal evaluations of injury prevention methods. Approaches that are considered, or have been proven, to be successful in preventing injury include: modification of the baseball; implementation of helmet standards in ice hockey and American football and increased wearing rates; use of full faceguards in ice hockey; changes in rules associated with body contact; implementation of rules to reduce the impact forces in rugby scrums. Helmets and other devices have been shown to reduce the risk of severe head and facial injury, but current designs appear to make little difference to rates of concussion. Research methods involving epidemiological, medical, and human factors are required in combination with biomechanical and technological approaches to reduce further injury risks in sport. PMID:15911597

McIntosh, A S; McCrory, P

2005-06-01

391

School Environment and School Injuries  

PubMed Central

Background: Although injuries at school are an important issue in public health, environmental factors in schools and school yards have seldom been the focus of school injury research. The goal of our investigation was to examine the effect of environmental factors on school injuries. Methods: Nine comprehensive Finnish schools registered school injuries over a period of two school years. Injuries were classified as being associated with environmental factors, suspected environmental factors, and others. The consensus between two independent classifiers was 81%. Results: A total of 722 injuries were classified. In 11.6% of these injuries, the physical environment factor was evident, and in 28.1% of the injuries, physical environment was suspected of being a contributory risk factor. Thus the physical environment of the school was a contributing factor in over a third (39.7%) of injuries occurring in the school, on the school yard or during the journey to, or from school. In this study, conducted in Finland, ice on the ground was mentioned most frequently as an environmental risk factor. Conclusion: In Finland, the Nordic weather conditions are not taken into account in the school yard and playground plans as they ought to from the safety point of view. An initiative has been launched on a mandatory wintertime master plan for every school yard. PMID:24455667

Salminen, Simo; Kurenniemi, Marja; Råback, Mirka; Markkula, Jaana; Lounamaa, Anne

2013-01-01

392

Penetrating abdominal injuries: management controversies  

PubMed Central

Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries. PMID:19374761

Butt, Muhammad U; Zacharias, Nikolaos; Velmahos, George C

2009-01-01

393

Traumatic brain injury and diet.  

PubMed

Increasing attention is being paid to nutritional and metabolic management of traumatic brain injury patients. The gross metabolic changes that occur after injury have been found to be influenced by both macronutrients, that is, dietary ratios of fat, carbohydrates, and protein, and micronutrients, for example, vitamins and minerals. Alterations in diet and nutritional strategies have been shown to decrease both morbidity and mortality after injury. Despite this knowledge, defining optimal nutritional support following traumatic brain injury continues to be an ongoing challenge. PMID:23670252

Greco, Tiffany; Prins, Mayumi L

2013-08-01

394

Management of acromioclavicular joint injuries.  

PubMed

Although recent advances have been made in the treatment of acromioclavicular (AC) joint injuries, they are still challenging for shoulder surgeons. There is a consensus that type I and II injuries should be treated nonoperatively, whereas acute type IV, V, and VI injuries should be treated surgically. There is no algorithm for correctly diagnosing and treating type III injuries, but the current trend is toward nonoperative treatment except for those with persistent symptoms and functional limitations after a course of conservative management. If surgery is indicated, newer anatomic techniques of reconstructing the coracoclavicular (CC) and AC ligaments are recommended. PMID:25435035

Stucken, Charlton; Cohen, Steven B

2015-01-01

395

Descriptive Epidemiology of Collegiate Women's Lacrosse Injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 Through 2003–2004  

PubMed Central

Objective: To review 16 years of National Collegiate Athletic Association injury surveillance data for women's lacrosse and identify potential areas for injury prevention initiatives. Background: Women's lacrosse is a fast-paced, primarily noncontact sport. Participation in collegiate women's lacrosse almost doubled between the 1988–1989 and 2003–2004 seasons. Lacrosse equipment consists of sticks made of wood or a synthetic material and a hard rubber ball. Until recently, mouth guards were the only required protective equipment. Main Results: Collegiate women's lacrosse game injury rates increased over the 16-year study period. More than 60% of all severe game injuries were lower extremity sprains and strains and knee internal derangements, most frequently the result of noncontact incidents. The most common injury scenarios by injury mechanism and player activity were no contact while ball handling (16.4%) and contact from a stick while ball handling (10.5%). Contact from a stick or a ball accounted for 5.6% and 5.2% of injuries sustained during shooting activities, respectively. Approximately 22% of all game and 12% of all practice injuries involved the head and neck. Contact from a stick accounted for the majority (56.0%) of above-the-neck injuries in games; contact from the ball accounted for 20.0% of these injuries. Participants had 5 times the risk of sustaining a concussion in a game as in a practice (0.70 versus 0.15 injuries per 1000 athletic-exposures, rate ratio = 4.7, 95% confidence interval = 3.8, 6.5). Recommendations: To reduce the lower extremity injuries that comprise the greatest injury burden in women's lacrosse, future researchers should evaluate proprioceptive, plyometric, and balance training interventions designed specifically for female players. Other research areas of great interest involve determining whether protective eyewear (mandated in 2004) reduces injuries to the eye, orbit, and nasal area and identifying any unintended consequences of the mandate, such as increased risk of injuries to other areas of the face or more aggressive play. PMID:17710175

Dick, Randall; Lincoln, Andrew E; Agel, Julie; Carter, Elizabeth A; Marshall, Stephen W; Hinton, Richard Y

2007-01-01

396

Hyperoxic Acute Lung Injury  

PubMed Central

Prolonged breathing of very high FIO2 (FIO2 ? 0.9) uniformly causes severe hyperoxic acute lung injury (HALI) and, without a reduction of FIO2, is usually fatal. The severity of HALI is directly proportional to PO2 (particularly above 450 mm Hg, or an FIO2 of 0.6) and exposure duration. Hyperoxia produces extraordinary amounts of reactive O2 species that overwhelms natural antioxidant defenses and destroys cellular structures through several pathways. Genetic predisposition has been shown to play an important role in HALI among animals, and some genetics-based epidemiologic research suggests that this may be true for humans as well. Clinically, the risk of HALI likely occurs when FIO2exceeds 0.7, and may become problematic when FIO2 exceeds 0.8 for an extended period of time. Both high-stretch mechanical ventilation and hyperoxia potentiate lung injury and may promote pulmonary infection. During the 1960s, confusion regarding the incidence and relevance of HALI largely reflected such issues as the primitive control of FIO2, the absence of PEEP, and the fact that at the time both ALI and ventilator-induced lung injury were unknown. The advent of PEEP and precise control over FIO2, as well as lung-protective ventilation, and other adjunctive therapies for severe hypoxemia, has greatly reduced the risk of HALI for the vast majority of patients requiring mechanical ventilation in the 21st century. However, a subset of patients with very severe ARDS requiring hyperoxic therapy is at substantial risk for developing HALI, therefore justifying the use of such adjunctive therapies. PMID:23271823

Kallet, Richard H; Matthay, Michael A

2013-01-01

397

Mild traumatic brain injury.  

PubMed

Mild traumatic brain injury (mTBI) can have a profoundly negative effect on the injured person's quality of life, producing cognitive, physical, and psychological symptoms; impeding postinjury family reintegration; creating psychological distress among family members; and often having deleterious effects on spousal and parental relationships. This article reviews the most commonly reported signs and symptoms of mTBI, explores the condition's effects on both patient and family, and provides direction for developing nursing interventions that promote patient and family adjustment. PMID:25319524

Hyatt, Kyong S

2014-11-01

398

Restricting the Time of Injury in Fatal Inflicted Head Injuries.  

ERIC Educational Resources Information Center

Review of the cases of 95 fatal head injuries in children found that brain swelling could be detected as early as 1 hour 17 minutes postinjury using computerized topography scans. Results also suggested that a reported history of a lucid interval in a case not involving an epidural hematoma is likely to be false and the injury probably inflicted.…

Willman, Kristal Y.; Bank, David E.; Scenic, Melvin; Catwalk, David L.

1997-01-01

399

15 CFR 990.51 - Injury assessment-injury determination.  

Code of Federal Regulations, 2014 CFR

...direct physical contact with a natural resource, or caused an indirect...injury or an impairment of a natural resource service has occurred...result of the incident. (f) Selection of injuries to include in the...factors such as: (1) The natural resources and services of...

2014-01-01

400

15 CFR 990.51 - Injury assessment-injury determination.  

Code of Federal Regulations, 2011 CFR

...direct physical contact with a natural resource, or caused an indirect...injury or an impairment of a natural resource service has occurred...result of the incident. (f) Selection of injuries to include in the...factors such as: (1) The natural resources and services of...

2011-01-01

401

15 CFR 990.51 - Injury assessment-injury determination.  

Code of Federal Regulations, 2013 CFR

...direct physical contact with a natural resource, or caused an indirect...injury or an impairment of a natural resource service has occurred...result of the incident. (f) Selection of injuries to include in the...factors such as: (1) The natural resources and services of...

2013-01-01

402

15 CFR 990.51 - Injury assessment-injury determination.  

Code of Federal Regulations, 2010 CFR

...direct physical contact with a natural resource, or caused an indirect...injury or an impairment of a natural resource service has occurred...result of the incident. (f) Selection of injuries to include in the...factors such as: (1) The natural resources and services of...

2010-01-01

403

15 CFR 990.51 - Injury assessment-injury determination.  

Code of Federal Regulations, 2012 CFR

...direct physical contact with a natural resource, or caused an indirect...injury or an impairment of a natural resource service has occurred...result of the incident. (f) Selection of injuries to include in the...factors such as: (1) The natural resources and services of...

2012-01-01

404

7 CFR 51.2290 - Insect injury.  

Code of Federal Regulations, 2013 CFR

...Agriculture 2 2013-01-01 2013-01-01 false Insect injury. 51.2290 Section 51.2290 Agriculture...Walnuts (Juglans Regia) Definitions § 51.2290 Insect injury. Insect injury means that the insect, web, frass or...

2013-01-01

405

7 CFR 51.2290 - Insect injury.  

Code of Federal Regulations, 2011 CFR

...Agriculture 2 2011-01-01 2011-01-01 false Insect injury. 51.2290 Section 51.2290 Agriculture...Walnuts (Juglans Regia) Definitions § 51.2290 Insect injury. Insect injury means that the insect, web, frass or...

2011-01-01

406

7 CFR 51.2290 - Insect injury.  

Code of Federal Regulations, 2012 CFR

...Agriculture 2 2012-01-01 2012-01-01 false Insect injury. 51.2290 Section 51.2290 Agriculture...Walnuts (Juglans Regia) Definitions § 51.2290 Insect injury. Insect injury means that the insect, web, frass or...

2012-01-01

407

7 CFR 51.2290 - Insect injury.  

Code of Federal Regulations, 2014 CFR

...Agriculture 2 2014-01-01 2014-01-01 false Insect injury. 51.2290 Section 51.2290 Agriculture...Walnuts (Juglans Regia) Definitions § 51.2290 Insect injury. Insect injury means that the insect, web, frass or...

2014-01-01

408

Penile injuries: A 10-year experience  

PubMed Central

We report our 10-year experience with penile injuries. We retrospectively reviewed the records of 156 cases of male external genitalia injuries between May 2002 and December 2012. Of these, only 26 patients presented without urethral injuries and were included in this study. Patients were divided into 4 groups: Group 1 (n = 12) with patients with penile fractures injuries; Group 2 (n = 5) with patients with penile amputation injuries; Group 3 (n = 2) with patients with penile penetrating injuries; and Group 4 (n = 7) with patients with penile soft tissue injuries. Grading of injury was done using the American Association for the Surgery of Trauma (AAST)-Organ injury scale of penile injury. Penile injuries without urethral injuries are urological emergencies which require immediate attention. PMID:25295134

Krishna Reddy, S.V.; Shaik, Ahammad Basha; Sreenivas, K.

2014-01-01

409

7 CFR 51.2127 - Injury.  

Code of Federal Regulations, 2010 CFR

...STANDARDS) United States Standards for Grades of Shelled Almonds Definitions § 51.2127 Injury. Injury means any...than slightly detracts from the appearance of the individual almond. The following shall be considered as injury: (a)...

2010-01-01

410

Metallothionein-induced zinc partitioning exacerbates hyperoxic acute lung injury  

PubMed Central

Hypozincemia, with hepatic zinc accumulation at the expense of other organs, occurs in infection, inflammation, and aseptic lung injury. Mechanisms underlying zinc partitioning or its impact on extrahepatic organs are unclear. Here we show that the major zinc-binding protein, metallothionein (MT), is critical for zinc transmigration from lung to liver during hyperoxia and preservation of intrapulmonary zinc during hyperoxia is associated with an injury-resistant phenotype in MT-null mice. Particularly, lung-to-liver zinc ratios decreased in wild-type (WT) and increased significantly in MT-null mice breathing 95% oxygen for 72 h. Compared with female adult WT mice, MT-null mice were significantly protected against hyperoxic lung injury indicated by reduced inflammation and interstitial edema, fewer necrotic changes to distal airway epithelium, and sustained lung function at 72 h hyperoxia. Lungs of MT-null mice showed decreased levels of immunoreactive LC3, an autophagy marker, compared with WT mice. Analysis of superoxide dismutase (SOD) activity in the lungs revealed similar levels of manganese-SOD activity between strains under normoxia and hyperoxia. Lung extracellular SOD activity decreased significantly in both strains at 72 h of hyperoxia, although there was no difference between strains. Copper-zinc-SOD activity was ?4× higher under normoxic conditions in MT-null compared with WT mice but was not affected in either group by hyperoxia. Collectively the data suggest that genetic deletion of MT-I/II in mice is associated with compensatory increase in copper-zinc-SOD activity, prevention of hyperoxia-induced zinc transmigration from lung to liver, and hyperoxia-resistant phenotype strongly associated with differences in zinc homeostasis during hyperoxic acute lung injury. PMID:23275622

Lee, Sang-Min; McLaughlin, Joseph N.; Frederick, Daniel R.; Zhu, Lin; Thambiayya, Kalidasan; Wasserloos, Karla J.; Kaminski, Iris; Pearce, Linda L.; Peterson, Jim; Li, Jin; Latoche, Joseph D.; Peck Palmer, Octavia M.; Stolz, Donna Beer; Fattman, Cheryl L.; Alcorn, John F.; Oury, Tim D.; Angus, Derek C.; Pitt, Bruce R.

2013-01-01

411

Rehabilitation of spinal cord injuries.  

PubMed

Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion. The most common causes of SCI in the world are traffic accidents, gunshot injuries, knife injuries, falls and sports injuries. There is a strong relationship between functional status and whether the injury is complete or not complete, as well as the level of the injury. The results of SCI bring not only damage to independence and physical function, but also include many complications from the injury. Neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular problems, and depressive disorders are frequent complications after SCI. SCI leads to serious disability in the patient resulting in the loss of work, which brings psychosocial and economic problems. The treatment and rehabilitation period is long, expensive and exhausting in SCI. Whether complete or incomplete, SCI rehabilitation is a long process that requires patience and motivation of the patient and relatives. Early rehabilitation is important to prevent joint contractures and the loss of muscle strength, conservation of bone density, and to ensure normal functioning of the respiratory and digestive system. An interdisciplinary approach is essential in rehabilitation in SCI, as in the other types of rehabilitation. The team is led by a physiatrist and consists of the patients' family, physiotherapist, occupational therapist, dietician, psychologist, speech therapist, social worker and other consultant specialists as necessary. PMID:25621206

Nas, Kemal; Yazmalar, Levent; ?ah, Volkan; Ayd?n, Abdulkadir; Öne?, Kadriye

2015-01-18

412

Management of popliteal artery injuries.  

PubMed

In a series of seven popliteal artery injuries including two concomitant popliteal vein injuries and three knee dislocations, only one failure occurred. With appropriate training of emergency medical technicians and adequate supportive services such as blood banking and arteriography, the vascular surgeon in a small hospital setting can manage peripheral vascular trauma with acceptable results. PMID:451802

Abernathy, C; Dickinson, T C; Lokey, H

1979-06-01

413

Computational analysis of brain injury  

Microsoft Academic Search

Brain injury has been of continuing interest to researchers in impact biomechanics. It is a frequent cause of fatalities and of permanent disability among survivors. However, the etiology of many types of brain injury is still unknown. The current research investigates brain response in terms of stress, stain, stain energy, intracranial pressure, and brain\\/skull relative displacement, using finite element modeling

Aiman Sharef Al-Bsharat

2000-01-01

414

High school football injuries: Evaluation  

Microsoft Academic Search

An epidemiologic survey of the literature on high school football injuries revealed methodologic problems. These numerator-denominator inconsistencies and other con founding factors are discussed. The authors suggest a more reliable system of reporting these parameters to further reduce the risk of high school football injuries.

Nancy Thompson; Brian Halpern; Walton W. Curl; James R. Andrews; Stephen C. Hunter; William D. McLeod

1987-01-01

415

Major injuries in Norwegian football  

Microsoft Academic Search

All Norwegian football players are insurance covered and most of the severe injuries occurring in Norwegian football are therefore reported to the Norwegian Football Association. Based on these reports a survey of major injuries in Norwegian football in the period 1970-1974 is given. This study has already led to recommendations to the Football Association in order to reduce the number

A. Roaas; S. Nilsson

1979-01-01

416

Rehabilitation of spinal cord injuries  

PubMed Central

Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion. The most common causes of SCI in the world are traffic accidents, gunshot injuries, knife injuries, falls and sports injuries. There is a strong relationship between functional status and whether the injury is complete or not complete, as well as the level of the injury. The results of SCI bring not only damage to independence and physical function, but also include many complications from the injury. Neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular problems, and depressive disorders are frequent complications after SCI. SCI leads to serious disability in the patient resulting in the loss of work, which brings psychosocial and economic problems. The treatment and rehabilitation period is long, expensive and exhausting in SCI. Whether complete or incomplete, SCI rehabilitation is a long process that requires patience and motivation of the patient and relatives. Early rehabilitation is important to prevent joint contractures and the loss of muscle strength, conservation of bone density, and to ensure normal functioning of the respiratory and digestive system. An interdisciplinary approach is essential in rehabilitation in SCI, as in the other types of rehabilitation. The team is led by a physiatrist and consists of the patients’ family, physiotherapist, occupational therapist, dietician, psychologist, speech therapist, social worker and other consultant specialists as necessary. PMID:25621206

Nas, Kemal; Yazmalar, Levent; ?ah, Volkan; Ayd?n, Abdulkadir; Öne?, Kadriye

2015-01-01

417

Disarming Facts about Firearm Injuries  

MedlinePLUS

... having a gun in your home increases your risk of violent injury or death. Be alert for signs of depression in friends and siblings ... having a gun in your home increases your risk of violent injury or death. Be alert for signs of depression in friends and siblings ...

418

Ocular injuries caused by fireworks  

Microsoft Academic Search

What are the consequences of suddenly legalizing fireworks sales in a largely rural society? Would the spectrum of ocular injuries caused by fireworks differ from those found in the Western world? This is the first study on ocular injuries caused by fireworks conducted in the Republic of South Africa. We analyzed the presenting features and prospectively followed up all patients

Lewis Mark Levitz; Joanne Karen Miller; Matthias Uwe Harald Drüsedau

1999-01-01

419

RADIATION INJURIES BY NUCLEAR WEAPONS  

Microsoft Academic Search

Various types of injury of humans from thermonuclear detonations are ; discussed, including those resulting from blast, heat, and radiation. The ; characteristics of early fallout are described, and the symptoms, pathology, and ; treatment of the acute radiation syndrome occurring in response to exposure to ; fallout are outlined and discussed. Skin injuries from fallout are considered, ; especially

F. C. Pace; W. R. Waters

1961-01-01

420

How I Manage Abdominal Injuries.  

ERIC Educational Resources Information Center

In sports, abdominal injuries occur most frequently in cycling, horseback riding, and skiing. Most involve children, not adults. Any athlete sustaining a severe blow to the abdomen should be examined. Guidelines are provided for recognizing and treating injuries to the abdominal muscles, kidneys, spleen, and liver. (Author/MT)

Haycock, Christine E.

1986-01-01

421

Dr. Pribut's Running Injuries Page  

NSDL National Science Digital Library

Dr. Pribut's Running and Sports Injuries: A Web Hypertext presents a variety of lower extremity running injuries and both self treatment and office treatment. Also running physiology and how to stay out of the doctor's office. Links to other sports areas are also available.

422

Epidemiology of injuries in hurling: a prospective study 2007–2011  

PubMed Central

Objectives Hurling is a stick handling game which, although native to Ireland, has international reach and presence. The aim of this study was to report incidence and type of injuries incurred by elite male hurling players over five consecutive playing seasons. Design Prospective cohort study. Setting Male intercounty elite sports teams participating in the National GAA Injury Database, 2007–2011. Participants A total of 856 players in 25 county teams were enrolled. Primary and secondary outcomes Incidence, nature and mechanism of injury were recorded by team physicians or physiotherapists to a secure online data collection portal. Time-loss injury rates per 1000 training and match play hours were calculated and injury proportions were expressed. Results In total 1030 injuries were registered, giving a rate of 1.2 injuries per player. These were sustained by 71% (n=608) of players. Injury incidence rate was 2.99 (95% CI 2.68 to 3.30) per 1000 training hours and 61.75 (56.75 to 66.75) per 1000 match hours. Direct player-to-player contact was recorded in 38.6% injuries, with sprinting (24.5%) and landing (13.7%) the next most commonly reported injury mechanisms. Median duration of time absent from training or games, where the player was able to return in the same season, was 12?days (range 2–127?days). The majority (68.3%) of injuries occurred in the lower limbs, with 18.6% in the upper limbs. The trunk and head/neck regions accounted for 8.6% and 4.1% injuries, respectively. The distribution of injury type was significantly different (p<0.001) between upper and lower extremities: fractures (upper 36.1%, lower 1.5%), muscle strain (upper 5.2%, lower 45.8%). Conclusions These data provide stable, multiannual data on injury patterns in hurling, identifying the most common injury problems. This is the first step in applying a systematic, theory-driven injury prevention model in the sport. PMID:24948748

Blake, Catherine; O'Malley, Edwenia; Gissane, Conor; Murphy, John C

2014-01-01

423

Epidemiology of traumatic dental injuries.  

PubMed

The oral region comprises 1% of the total body area, yet it accounts for 5% of all bodily injuries. In preschool children, oral injuries make up as much as 17% of all bodily injuries. The incidence of traumatic dental injuries is 1%-3%, and the prevalence is steady at 20%-30%. The annual cost of treatment is US $2-$5 million per 1 million inhabitants. Etiologic factors vary between countries and with age groups. Important public health implications such as how to best organize emergency dental care and how to prevent dental injuries, decrease cost, and increase lay knowledge are important factors needed to change epidemiologic data toward more favorable figures in the future. PMID:23635975

Andersson, Lars

2013-01-01

424

Epidemiology of traumatic dental injuries.  

PubMed

The oral region comprises 1% of the total body area, yet it accounts for 5% of all bodily injuries. In preschool children, oral injuries make up as much as 17% of all bodily injuries. The incidence of traumatic dental injuries is 1%-3%, and the prevalence is steady at 20%-30%. The annual cost of treatment is US $2-$5 million per 1 million inhabitants. Etiologic factors vary between countries and with age groups. Important public health implications such as how to best organize emergency dental care and how to prevent dental injuries, decrease cost, and increase lay knowledge are important factors needed to change epidemiologic data toward more favorable figures in the future. PMID:23439040

Andersson, Lars

2013-03-01

425