[Sports-related concussions: are we (fully) aware of the consequences?]. / Commotions cérébrales dans le sport: est-on (pleinement) conscient des conséquences?

Contact sports and sports with high risk of head traumatism are increasingly becoming more popular. This trend leads to a 60% increase of sport-related concussions in the decade. It is therefore important to summarize the current knowledge in this field (diagnosis, risk factors...) in order to help clinicians to improve this pathology management. Short and long term consequences are too often minimized by clinicians, while related clinical disorders should not be neglected (e.g. headaches, cognitive troubles, vestibular troubles, depression...). Complications risks are directly linked to the number of concussions or if patients return to play before complete recovery. Correct knowledge of symptoms and of the various assessment tests are consequently therefore important to know in order identity and tackle long term complications of sport-related concussions.

Prediction of the drilling path to surgically pin the femoral neck from the spatial location of pelvic and femoral anatomical landmarks: A cadaver validation study.

Several clinical applications rely on accurate guiding information when drilling along the femoral neck (e.g., pin insertion in case of neck fracture). Currently, applications rely on real-time X-ray imaging, which results in irradiation issues for the surgeon conducting the operation. The goal of this paper was to develop an X-ray-free method that would allow for a pathway to be drilled between the lateral aspect of the femoral diaphysis (the so-called piercing point), the femoral neck and the head centres. The method is based on on-the-fly computational predictions relying on a biomechanical database that includes morphological data related to the femoral neck and head and various palpable anatomical landmarks located on the pelvis and the femoral bone. From the spatial location of the anatomical landmarks, scalable multiple regressions allow for the prediction of the most optimal drilling pathway. The method has been entirely validated using in vitro experiments that reproduce surgical conditions. Further, a surgical ancillary prototype that integrates the method of guiding the pin drilling has been developed and used during in vitro and in situ validation using nine hip joints. Pin insertion was controlled after drilling using medical imaging and show successful result for each of the nine trials. The mean accuracy of the estimated hip joint centre and neck orientation was 6.0 ± 2.8mm and 7.1 ± 3.8°, respectively.

Precision of shoulder anatomical landmark calibration by two approaches: a CAST-like protocol and a new anatomical palpator method.

The objective of the study was to compare the precision of shoulder anatomical landmark palpation using a CAST-like method and a newly developed anatomical palpator device (called A-Palp) using the forefinger pulp directly. The repeated-measures experimental design included four examiners that twice repeated measurements on eleven scapula and humerus anatomical landmarks during two sessions. Inter-session and inter-examiner precision was determined on volunteers. A-Palp accuracy was obtained from in vitro measurements and using virtual palpation on 3D bone models. Error propagation on the motion representation was also analyzed for a continuous motion of abduction movement performed in the shoulder joint. Palpation results showed that CAST and A-Palp methods lead to similar precision with the Maximal A-Palp calibration error being 1.5mm. In vivo precision of the CAST and A-Palp methods varied between 4mm (inter-session) and 8mm (inter-examiner). Mean propagation of the palpation error on the motion graph representation was 2 degrees and 5 degrees for scapula and humerus, respectively. A-Palp accuracy was 3.6 and 8.1mm for scapula and humerus, respectively. The A-Palp seems promising and could probably become an additional method next to today's marker-based motion analysis systems (i.e., Helen-Hayes configuration, CAST method).