Primary repair of complete Achilles tear augmented with amnion allograft wrap in college basketball player with a history of contralateral Achilles rupture: a case report.

Background: The Achilles tendon is the thickest tendon in the human body and is responsible for plantar flexion with muscle contraction. It is able to withstand tensile loads as large as ten times the body's weight or greater at times of peak stress on the tendon. Due to the repetitive and massive stress inflicted on the Achilles tendon, it is prone to injuries, especially in running and jumping athletes. Ruptures typically present after unsustainable stress placed on the tendon from rapid contraction with classic presentation of a sudden "pop". These injuries tend to occur in middle-aged men after atypical physical exertion with complaints of immense pain in the posterior lower leg. Case Description: This case examines a 20-year-old athlete presenting to the emergency department after sustaining a left calf injury while playing basketball. The patient suffered a full-thickness tear of the Achilles tendon with retraction and subsequent anterior and posterior tibiofibular ligament deficiency. This presentation is unique as he has a past medical history of an Achilles tear in the contralateral limb. Conclusions: This study concluded that the bilateral Achilles tears in such a young patient were caused by anatomical blood supply watershed area to the Achilles tendon and anatomical ankle alignment abnormalities. This study provided a viable option to successfully repair complex Achilles tears via close reduction internal fixation (CRIF) with allograft matrix.

Outcomes after stairway falls in a rural Appalachian trauma center.

BACKGROUND: Injuries due to falls represent one of the most common etiologies of traumatic injury in the United States. Stairway-related falls in particular can lead to significant morbidity, mortality, and concomitant long-term disability and economic costs. Our study aims to evaluate the outcomes of patients presenting to a rural academic trauma center after experiencing a fall down stairs. METHODS: This was a single institution retrospective analysis of data extracted from our trauma registry. The study was considered exempt by Ballad Health Institutional Review Board. The data included patients aged 18 years or older who presented to the emergency department after a fall down stairs between January 1, 2017, and June 17, 2022. Patients who experienced falls other than those involving stairs were excluded. RESULTS: Of the 439 patients evaluated for falls down stairs, 259 (58.9%) were aged ≥65 years. Compared with younger patients, older patients required significantly longer hospital admissions (4.8 vs 3.6 days, P < .003), had significantly higher injury severity scores (9.1 vs 6.8, P < .05), and were more likely to be discharged to a posthospital care facility (51% vs 14.9%, P < .05). There was no difference in length of intensive care unit stay (3.8 vs 3.6 days, P < .72), ventilator days (3.3 vs 3.3 days, P < .97), or mortality (7% vs 3%, P < .08). When considering sex, male patients had significantly worse outcomes in injury severity score (9.0 vs 7.6, P < .02) and mortality (10% vs 2%, P < .0002) but no difference in hospital (4.5 vs 4.0 days, P < .20), intensive care unit (3.8 vs 3.5 days, P < .59) or ventilator days (2.8 vs 4.3 days, P < .27) when compared with female patients. CONCLUSION: Patients aged 65 years or older who experience a fall down stairs are more severely injured and require more posthospital care. Our findings demonstrate that males have an elevated risk of mortality and increased injury severity compared to female patients. Previous findings from our institution examining injuries from falls, including a sub-analysis on ground-level falls, have shown similar sex disparity. This study shows the necessity of preventing stair-related falls, especially in the older population.

Energy-Dependent π

Focusing on three-pion states with maximal isospin (π^{+}π^{+}π^{+}), we present the first nonperturbative determination of an energy-dependent three-hadron scattering amplitude from first-principles QCD. The calculation combines finite-volume three-hadron energies, extracted using numerical lattice QCD, with a relativistic finite-volume formalism, required to interpret the results. To fully implement the latter, we also solve integral equations that relate an intermediate three-body K matrix to the physical three-hadron scattering amplitude. The resulting amplitude shows rich analytic structure and a complicated dependence on the two-pion invariant masses, represented here via Dalitz-like plots of the scattering rate.

Finite-Volume Effects in (g-2)_{µ}

An analytic expression is derived for the leading-order finite-volume effects arising in lattice QCD calculations of the hadronic-vacuum-polarization contribution to the muon's magnetic moment a_{µ}^{HVP,LO}≡(g-2)_{µ}^{HVP,LO}/2. For calculations in a finite spatial volume with periodicity L, a_{µ}^{HVP,LO}(L) admits a transseries expansion with exponentially suppressed L scaling. Using a Hamiltonian approach, we show that the leading finite-volume correction scales as exp[-M_{π}L] with a prefactor given by the (infinite-volume) Compton amplitude of the pion, integrated with the muon-mass-dependent kernel. To give a complete quantitative expression, we decompose the Compton amplitude into the spacelike pion form factor F_{π}(Q^{2}) and a multiparticle piece. We determine the latter through next-to leading order in chiral perturbation theory and find that it contributes negligibly and through a universal term that depends only on the pion decay constant, with all additional low-energy constants dropping out of the integral.