Trauma
If the Shoe Fits…or Does It?
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Many young children are wearing shoes that are too small, according to a new study presented today at the 2009 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). As a result, these children may be at high risk for developing serious foot deformities.
The study, which took place in Switzerland, included nearly 250 boys and girls from age 5 to age 10. Researchers measured the children’s feet as well as their indoor and outdoor footwear to determine whether the children were wearing properly sized shoes. They also compared the footwear measurements to the sizes given on the manufacturers’ labels to see if the shoes were marked properly. Finally, they measured the angles of the children’s toes to learn whether any of the subjects were developing a foot deformity called hallux valgus.
Hallux valgus is a condition that occurs when the big toe begins to angle sideways, toward the second toe, causing a bump on the side of the foot just below the big toe. This bump is called a bunion, and can become swollen and painful. Shoes that are too tight are believed to be one of the leading causes of this condition.
Delayed surgery may affect fracture recovery
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An elderly person who has fractured their femur - the large thigh bone that connects the leg to the hip - may want to have surgery sooner rather than later, according to a study linking longer times to surgery to a somewhat increased risk of post-surgery complications.
Dr. Rudiger Smektala from Ruhr University Bochum in Bochum, Germany, and colleagues used data from a study on hip fractures at 286 hospitals to determine whether elderly patients benefit from early surgical treatment for these common fractures.
Just over a quarter of patients had surgery within 12 hours of the fracture, 41 percent had surgery within 12 to 36 hours, and roughly 32 percent more than 36 hours after the fracture.
MRI shows new types of injuries in young gymnasts
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Adolescent gymnasts are developing a wide variety of arm, wrist and hand injuries that are beyond the scope of previously described gymnastic-related trauma, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).
“The broad constellation of recent injuries is unusual and might point to something new going on in gymnastics training that is affecting young athletes in different ways,” said the study’s lead author, Jerry Dwek, M.D., an assistant clinical professor of radiology at the University of California, San Diego and a partner of San Diego Imaging at Rady Children’s Hospital and Health Center.
Previous studies have reported on numerous injuries to the growing portion of adolescent gymnasts’ bones. However, this study uncovered some injuries to the bones in the wrists and knuckles that have not been previously described. In addition, the researchers noted that these gymnasts had necrosis, or “early death,” of the bones of their knuckles.
Sexual difficulties common after major trauma
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Nearly one third of people who suffer severe injuries are likely to have sexual problems a year later, according to findings recently presented at the meeting of the American College of Surgeons.
“Previous studies have shown that men and women who sustain pelvic fractures and spinal cord injuries are at risk for sexual dysfunction. However, no studies have looked at the broad population of patients who sustained other injuries,” Dr. Mathew D. Sorensen, from the University of Washington, Seattle, told Reuters Health.
His team theorized that just sustaining a severe injury might bring on sexual problems. “This might be due to physical or emotional limitations, since patients who sustain severe injuries have persistent issues even one year after their injury.”
High failure rate seen after some ACL repairs
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Anterior cruciate ligament (ACL) reconstruction using a replacement ligament from a cadaver has a high failure rate in young, active adults, according to a study reported Thursday at the American Orthopaedic Society for Sports Medicine conference in Orlando, Florida.
The ACL is a key ligament inside the knee that helps keep it stable. Located in the center of the knee joint, it runs from the thigh bone to the shin bone through the center of the knee. Typically, tearing the ACL occurs with a sudden direction change. To repair a torn ACL, a surgeon replaces the damaged ligament with a new one, either from a cadaver or the patient’s own body.
Among 64 patients younger than age 40 with high activity levels who had ACL reconstruction with a cadaver replacement ligament and were followed for a minimum of 2 years, the grafted ligament failed in 15 (23.4 percent). Graft failure was defined as need for repeat ACL reconstruction due to injury or graft failure or poor scores on a combination of orthopaedic outcome measures.
Oily fish can protect against RA, but smoking and psychosocial stress increase its risk
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Paris, France, Friday 13 June 2008: New data presented today at EULAR 2008, the Annual Congress of the European League Against Rheumatism in Paris, France, show that intake of oily fish is associated with a reduced risk of developing rheumatoid arthritis (RA), whereas psychosocial work stress and smoking can increase the risk of developing the condition. The findings, all taken from a large population-based case-control study in Sweden called EIRA (Epidemiological Investigation of Rheumatoid Arthritis), shed light on the important role of environmental and social factors in the development of RA.
Intake of Oily Fish
For the first time, the intake of oily fish has been demonstrated to have a protective effect against the development of RA, reducing an individual’s risk by 20-30%. Studying 1,899 subjects with a confirmed diagnosis of RA (fulfilling ACR criteria) and 2,145 controls (randomly selected and matched for age, sex and residential area), investigators concluded that the odds ratio (OR) for developing RA was 0.8 (0.7-1.0) for those who consumed oily fish 1-7 times per week or 1-3 times per month, compared with those who never, or seldom consumed oily fish. Interestingly, no significant association with RA risk was observed for consumption of fish oil supplements.
Ways to Avoid Summer Sports Injuries
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During the summer months, thousands of facial injuries occur to people of all ages. Dr. Anthony Brissett, facial plastic and reconstructive surgeon at The Methodist Hospital in Houston, says taking some basic precautions can minimize long lasting facial injuries, prevent costly medical problems and allow people to enjoy the summer injury-free.
Q: What are the main head and neck injuries you see?
A: I see a lot of patients with facial injuries, anything from lacerations to facial fractures such as broken cheek bones and noses. Whether the injuries are from baseball, basketball, bike riding, swimming or just outdoor fun, I’ve seen them all.
Q: How do you treat these kinds of facial injuries?
China girl’s legs amputated to free her from rubble
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Chinese doctors amputated a teenage girl’s crushed legs on Thursday, the only way they could pull her alive from the wreckage of her school three days after an earthquake flattened swathes of the country’s southwest.
Yang Liu was trapped in what appeared to be a doorway by Monday’s massive 7.9 magnitude quake, near the top of a massive pile of bricks and concrete.
Her position likely saved her life.
Childhood Pain Trauma Unlikely Link to Adult Chronic Pain
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Though some adults with chronic pain often say they experienced an adverse event in childhood (such as abuse), these events are no more common than amongst adults who are pain free, according to research presented today at the American Pain Society annual meeting.
In his plenary session address, Gary Macfarlane, MD, professor of epidemiology at University of Aberdeen (Scotland) School of Medicine, said that some pain patients hold perceptions that their pain stems from an adverse event in childhood and they more commonly remember such events.
Each finger can be moved separately
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A new prosthetic hand is being tested at the Orthopedic University Hospital in Heidelberg / Grip function almost like a natural hand
It can hold a credit card, use a keyboard with the index finger, and lift a bag weighing up to 20 kg – the world’s first commercially available pros-thetic hand that can move each finger separately and has an astounding range of grip configurations. For the first time worldwide a patient at the Orthopedic University Hospital in Heidelberg has tested both the “i-LIMB” hand in comparison with another innovative prosthesis, the so called ”Flu-idhand”. Eighteen-year-old Sören Wolf, who was born with only one hand, is enthusiastic about its capabilities.
Young Athletes Paying to Play?
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Soccer, football, baseball, tennis, gymnastics. Today the number of activities available to the young athlete serves up a smorgasbord of choices. “College-bound teenagers in the United States and around the world are way more active than ever before,” said Col. Tom DeBerardino, MD, the Sports Medicine Fellowship Director at Keller Army Hospital in West Point, N.Y.
“These days it seems in order to be a well-rounded student and gain admission into a good college, participating in at least one or even two extracurricular sports is a must on almost every student’s ‘to do’ list. However, increased exposure to sporting activities translates into increased risk of injuries sustained by these young student athletes,” Dr. DeBerardino noted. “Fortunately, operations and procedures to fix many of these problems are now good, too.”
Dr. DeBerardino cited the following statistics on newly arriving cadets at West Point:
• In 1998, 10 to 12 cadets reported having major reconstructive shoulder surgery
before college.
• By 2008, at least 50 cadets had already had this surgery before arriving on campus.
Many can return to sport after hamstring surgery
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Surgical repair of a ruptured hamstring offers the most promise for individuals who want to return to high or full activity levels, researchers report.
Individuals who have suffered a hamstring detachment may “feel a pop in the buttock area that is followed by bruising over the posterior thigh and knee,” Dr. Christopher M. Larson told Reuters Health.
Rehabilitation alone may result in persistent weakness, poor leg control, and difficulty returning to higher levels of activity. By contrast, surgery results in improved strength and a high return to sports, said Larson, of the Minnesota Sports Medicine Orthopaedic Sports Medicine Fellowship, in Eden Prairie.
High-trauma fractures in older adults linked to osteoporosis, increased risk of another fracture
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Contrary to a widely held assumption, high-trauma nonspine fractures in older women and men, such as from a car crash, are associated with low bone mineral density and an increased risk of a subsequent fracture, according to a study in the November 28 issue of JAMA. These findings suggest that older adults who experience these fractures should be evaluated for osteoporosis.
УЕ it is widely believed, without supporting evidence, that high-trauma fractures [those resulting from motor vehicle crashes or falls from greater than standing height] are not related to low bone mineral density (BMD) or subsequent fracture risk and therefore are presumed not to be manifestations of osteoporosis,Ф the authors write. They add that these beliefs have several consequences, including the clinical opinions that an older adult who has a high-trauma fracture does not require evaluation for osteoporosis, and that high-trauma fractures cannot be prevented by osteoporosis treatments that increase BMD and bone strength.
Fewer soldiers losing limbs after battlefield injury
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In previous wars, battlefield surgeons often had to take the limb of a soldier with a bleeding leg or arm wound in order to save his life, but now with advances in vascular surgery, lives can often be saved without sacrificing a limb, a new study indicates.
“The purpose of our study was to show that with the proper resuscitation strategy, you have the option of saving the limb,” lead researcher Dr. Charles J. Fox, from the Walter Reed Army Medical Center in Washington, DC, told Reuters Health.
Obesity Increases Risk of Injury on the Job
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Having a body mass index (BMI) in the overweight or obese range increases the risk of traumatic workplace injury, according to researchers at the Johns Hopkins Bloomberg School of Public Health’s Center for Injury Research and Policy. Employer-sponsored weight loss and maintenance programs should be considered as part of a well-rounded workplace safety plan. The study was Advance Access published on May 7, 2007, by the American Journal of Epidemiology.
BMI is a measure of body fat based on an adult’s height and weight. It is used to screen for weight categories that may lead to health problems. According to the Centers for Disease Control and Prevention, a BMI below 18.5 is considered underweight, 18.5–24.9 is normal; 25–29.9 is overweight and over 30 is obese.
