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1.
Pan Afr Med J ; 34: 26, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31762894

RESUMO

Introduction: Road traffic accidents (RTAs) are the most frequent cause of traumatic spinal injuries (TSIs), which account for up to 33.6% of all spinal fractures. The Kingdom of Saudi Arabia (KSA) is one of the countries which has high rates of SCIs and bears the economic burden of that situation. Methods: 120 patients were included in this study, using a stringent set of inclusion and exclusion criteria. The patients were followed-up from the point of triage to admission and discharge. We analysed the clinical notes of the patients to determine the severity of their traumatic spinal injuries, the neurosurgical management carried out, and other prognosticating factors such as blood transfusion and the Glasgow Coma Scale (GCS). The data collected was analysed anonymously, and the confidentiality of all participants was respected. Results: Most of the patients were young adults and adolescents under the age of 40 (n = 96). There was a male preponderance of 84.1%. With respect to spinal injury stratification, 55 patients had cervical spine fractures, 10 patients had cervical lacerations, 85 patients had thoracolumbar spinal fractures, and 10 patients had thoracolumbar spinal lacerations. 35 patients had other fractures documented. All 120 patients were followed up to assess the management of their traumatic spinal injuries. 66.6% (n= 80) of all patients were managed conservatively, whereas the remaining 33.3% (n=40) were managed surgically. Conclusion: Trauma is an important cause of spinal injuries (TSIs), and untreated TSIs may lead to poor clinical outcome, especially if the cervical region is involved.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Fraturas da Coluna Vertebral/epidemiologia , Traumatismos da Coluna Vertebral/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Seguimentos , Escala de Coma de Glasgow , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Arábia Saudita/epidemiologia , Fraturas da Coluna Vertebral/etiologia , Fraturas da Coluna Vertebral/terapia , Traumatismos da Coluna Vertebral/etiologia , Traumatismos da Coluna Vertebral/terapia , Adulto Jovem
2.
Curr Sports Med Rep ; 18(10): 367-373, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31596753

RESUMO

Soccer is the most popular sport in the world, with more than 270 million participants. It is characterized by repetition of short and intense actions that require high-coordination capacity. It is a sport where interactions with other players put the athletes at risk for traumatic injuries. Lower-limb injuries are the most prevalent injuries in soccer. Spine injuries are less frequent; however, they can impose serious and debilitating sequelae on the athlete. These injuries can be associated with long recovery periods preventing return to play. Moreover, specific repetitive activities (heading, kicking, etc.) can lead to chronic injuries. The cervical spine is particularly at risk for degenerative changes. Considerations for when an athlete should undergo spinal surgery and the timing of return to play present a difficult challenge to spine specialists. The objective of this article is to review the epidemiology, diagnosis, treatment, and prevention of spinal injuries in soccer.


Assuntos
Futebol/lesões , Traumatismos da Coluna Vertebral/epidemiologia , Atletas , Humanos , Fatores de Risco
3.
Pan Afr Med J ; 33: 60, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31448022

RESUMO

Introduction: This study evaluates characteristics and risk factors of traumatic spinal injuries (TSIs) treated at a trauma center in Abuja, Nigeria. TSIs are a global concern. They are frequently disabling, leading to economic, workforce, and quality of life strain. Little is known of the epidemiology of TSIs in Nigeria. Methods: Data were collected from National Hospital Abuja's trauma registry on 3025 patients treated at the hospital between 2014 and 2017. Patient characteristics were compared between spinal and nonspinal injury groups. Multiple logistic regression was used to identify risk factors of TSIs. Results: 15% (452) of all injuries were spinal. Road traffic crashes were a significantly greater cause of spinal (77.4%) than nonspinal (59.4%) injuries (p<0.0001). Pedestrians were involved in 19% (356) of total crashes, occupying a significantly larger proportion of spinal (18.6%) than nonspinal (10.6%) injuries (p<0.0001). Three variables were modeled as risk factors of crash-related TSIs: mode of transportation, age, and gender. Only mode of transportation demonstrated statistical significance, with involvement as a pedestrian showing an adjusted odds ratio of 1.38 (95% confidence interval: 1.03-1.85, p=0.0329). Conclusion: Determining characteristics and risk factors of TSIs is an essential step in addressing this health concern in Nigeria. Crashes are a significant cause of TSIs, and a quarter of TSI patients involved in a crash are pedestrians. Involvement in a crash as a pedestrian is associated with high risk of TSI. These results can help guide both the development of spinal injury prevention policies and the allocation of resources.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Pedestres/estatística & dados numéricos , Qualidade de Vida , Traumatismos da Coluna Vertebral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Traumatismos da Coluna Vertebral/etiologia , Caminhada , Adulto Jovem
4.
Scand J Trauma Resusc Emerg Med ; 27(1): 69, 2019 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-31324221

RESUMO

INTRODUCTION: Alpine winter sports have become increasingly popular over recent decades, with a similar increase in accident incidence. This review provides an overview of the most recent literature concerning spinal injury epidemiology, mechanisms, patterns and prevention strategies in the context of alpine winter sports. MATERIAL AND METHODS: The PubMed, Cochrane Library, and EMBASE databases were searched using the keywords spine injury, alpine injury, spine fracture, skiing injuries, snowboard injuries. 64 published studies in English and German met a priori inclusion criteria and were reviewed in detail by the authors. RESULTS: There are various mechanisms of injury in alpine winter sports (high speed falls in skiing, jumping failure in snowboarding) whilst regionality and injury severity are broadly similar. The thoracolumbar spine is the most common region for spinal injury. Spinal cord injury is relatively rare, usually accompanying distraction and rotation type fractures and is most commonly localised to the cervical spine. Disc injuries seem to occur more commonly in alpine winter sport athletes than in the general population. DISCUSSION: Despite awareness of increasing rates and risks of spinal injuries in alpine winter sports, there has been little success in injury prevention.


Assuntos
Traumatismos em Atletas/epidemiologia , Estações do Ano , Traumatismos da Coluna Vertebral/etiologia , Saúde Global , Humanos , Incidência , Masculino , Traumatismos da Coluna Vertebral/epidemiologia
5.
Pan Afr Med J ; 32: 153, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31303924

RESUMO

Introduction: traumatic spinal fracture is a painful and disabling injury associated with poor long-term functional outcome. The objective of the present study was to assess the frequency of spinal fractures in road traffic accident (RTA) victims, their management, mortality rate and associated injuries. This study reveals and adds useful insights to the literature from Kingdom of Saudi Arabia (KSA) in terms of incidence of RTA-related spinal fractures, including their management and mortality rate. Methods: a cross-sectional study was conducted at King Khalid Hospital and Prince Sultan Center for Health Services (KKH & PSCHS) in AlKharj, KSA from September 2016 to June 2017. A total of 120 patients suffering from spinal/vertebral fractures due to RTAs were included in this study. The data was collected from patients' charts, including age, gender, region or distribution of the spinal fracture, associated fractures, number of fractures, degrees of shock, admission to intensive care unit (ICU), treatment modalities, along with the management of spinal fractures, days of hospital stay, referral and discharges or deaths. Results: the mean age of patients was 29.21. The most common anatomic region of the fracture was the cervical region (35%). Injuries associated with traumatic spinal fracture were predominated by clavicular fractures. More than half of the victims (58.30%) had a cervical brace applied before leaving the hospital. 29.20% patients required posterior stabilization with pedicle screws. Anterior corpectomy, grafting and plating was done to 4.30% patients. Conclusion: traumatic spinal fractures require prompt diagnosis and timely management in order to improve the outcome.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Fraturas da Coluna Vertebral/epidemiologia , Traumatismos da Coluna Vertebral/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Incidência , Lactente , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Equipamentos Ortopédicos , Parafusos Pediculares , Estudos Retrospectivos , Arábia Saudita/epidemiologia , Fraturas da Coluna Vertebral/etiologia , Fraturas da Coluna Vertebral/mortalidade , Traumatismos da Coluna Vertebral/etiologia , Traumatismos da Coluna Vertebral/mortalidade , Adulto Jovem
6.
World Neurosurg ; 130: e368-e374, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31229750

RESUMO

OBJECTIVE: The AOSpine Subaxial Cervical Spine Injury Classification System was introduced to improve communication, clinical management, and research. Here, the system was studied in relation to injury severity along with admission and long term neurologic follow-up. METHODS: A retrospective study was performed in subaxial cervical spine injury patients. Morphology was classified using the AOSpine Subaxial Cervical Spine Injury Classification System. Six major morphology subtypes were selected for analysis. The American Spinal Injury Association (ASIA) motor and Abbreviated Injury Severity (AIS) scores were recorded at admission and at follow-up >6 months. Admission intramedullary lesion length (IMLL) on MRI was recorded. RESULTS: In all, 82 patients met criteria for analysis. The mean follow-up time was 11 months (range, 6-33 months). The were 36 patients with morphology subtypes A0, 4 with A1/A2, 9 with A3/A4, 8 with B2, 11 with B3, and 14 with C. The A1/2 subtype had the least severe injuries on admission. The C and A3/A4 subtypes had the most severe injuries. The subtype C had the lowest ASIA Motor Score (AMS) and second highest percentage of complete injuries. A3/A4 patients had the highest percentage of complete injuries on admission. At follow-up, A3/A4 patients had the lowest AMS, and 33% of patients continued to have complete injuries. C subtype injuries all converted to AIS incomplete injuries on follow-up (P = 0.04). IMLL was found to be significantly different compared across multiple morphologic subtypes. Surgical management for each morphology subtype was reported. CONCLUSION: The AOSpine Subaxial Cervical Spine Injury Classification System successfully associated injury morphology with IMLL along with admission and long-term neurologic function and recovery.


Assuntos
Vértebras Cervicais/lesões , Traumatismos da Coluna Vertebral/classificação , Traumatismos da Coluna Vertebral/diagnóstico , Vértebras Cervicais/patologia , Feminino , Hospitalização , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fraturas da Coluna Vertebral/classificação , Fraturas da Coluna Vertebral/diagnóstico , Fraturas da Coluna Vertebral/epidemiologia , Fraturas da Coluna Vertebral/patologia , Traumatismos da Coluna Vertebral/epidemiologia , Traumatismos da Coluna Vertebral/patologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-31035444

RESUMO

This study aimed to measure the subsequent health and health service cost burden of a cohort of workers hospitalised after sustaining work-related traumatic spinal injuries (TSI) across New South Wales, Australia. A record-linkage study (June 2013-June 2016) of hospitalised cases of work-related spinal injury (ICD10-AM code U73.0 or workers compensation) was conducted. Of the 824 individuals injured during this time, 740 had sufficient follow-up data to analyse readmissions ≤90 days post-acute hospital discharge. Individuals with TSI were predominantly male (86.2%), mean age 46.6 years. Around 8% (n = 61) experienced 119 unplanned readmission episodes within 28 days from discharge, over half with the primary diagnosis being for care involving rehabilitation. Other readmissions involved device complications/infections (7.5%), genitourinary or respiratory infections (10%) or mental health needs (4.3%). The mean ± SD readmission cost was $6946 ± $14,532 per patient. Unplanned readmissions shortly post-discharge for TSI indicate unresolved issues within acute-care, or poor support services organisation in discharge planning. This study offers evidence of unmet needs after acute TSI and can assist trauma care-coordinators' comprehensive assessments of these patients prior to discharge. Improved quantification of the ongoing personal and health service after work-related injury is a vital part of the information needed to improve recovery after major work-related trauma.


Assuntos
Acidentes de Trabalho , Readmissão do Paciente , Traumatismos da Coluna Vertebral/complicações , Traumatismos da Coluna Vertebral/epidemiologia , Adulto , Idoso , Estudos de Coortes , Cuidados Críticos , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , New South Wales , Alta do Paciente , Estudos Retrospectivos , Adulto Jovem
8.
Am Surg ; 85(5): 549-555, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31126370

RESUMO

Survivors of near-hangings suffer anoxic brain injuries, but it remains uncertain whether the incidence of associated injuries warrants extensive workup or trauma activation. An 11-year retrospective review was conducted on adult patients with a hanging mechanism who underwent trauma workup and management. The majority of patients (n = 98) were white (88.8%) males (75.5%) with an average age of 30 ± 12.3 years. Two-hundred fifty-four CT and magnetic resonance scans were performed and eight injuries were uncovered: three thyroid cartilage/hyoid fractures; three vertebral injuries; and two cervical vascular injuries. Anoxic brain injury was diagnosed clinically in 35 patients (35.7%) and was present in all 19 patients (19.4%) who died. Only one patient had intra-abdominal injury requiring surgical intervention. Injuries were more likely in patients with abnormal Glasgow Coma Scale (GCS) versus normal GCS (55% vs 10.5%, respectively). Patients who present after near-hanging have a low incidence of associated injuries. Workup can be restricted to patients with abnormal GCS scores and for specific signs and symptoms or high-risk energy mechanisms. The trauma team can be activated for signs of trauma.


Assuntos
Lesões Encefálicas/epidemiologia , Vértebras Cervicais/lesões , Hipóxia Encefálica/epidemiologia , Lesões do Pescoço/epidemiologia , Traumatismos da Coluna Vertebral/epidemiologia , Tentativa de Suicídio , Adolescente , Adulto , Lesões Encefálicas/diagnóstico , Lesões Encefálicas/terapia , Feminino , Humanos , Hipóxia Encefálica/diagnóstico , Hipóxia Encefálica/terapia , Masculino , Lesões do Pescoço/diagnóstico , Lesões do Pescoço/terapia , Estudos Retrospectivos , Traumatismos da Coluna Vertebral/diagnóstico , Traumatismos da Coluna Vertebral/terapia , Adulto Jovem
9.
Biol Pharm Bull ; 42(5): 778-785, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31061320

RESUMO

Fragility fractures associated with age-related bone loss are of urgent concern worldwide because they reduce QOL and pose financial burdens for health care services. Currently, national data in Japan are limited. This study provides quantitative data for older patients throughout Japan who, although otherwise relatively healthy, sustained fragility fractures and were hospitalized for them. The National Database of Health Insurance Claims and Specific Health Checkups of Japan was accessed to target patients aged 65 years or older who sustained fractures between May 2013 and September 2014 and were not hospitalized for at least 13 months prior to fracture. We investigated whether the first fracture sustained was fragility related at any of four locations (proximal humerus, distal radius, vertebra, or femoral neck) and whether it necessitated hospitalization. Fragility fractures were identified in 490138 of 1188754 patients (41.2%, 345980 patients/year; 1 : 4 male-to-female ratio). Regardless of gender, vertebral fractures were most common across the age cohorts studied (43286 males and 162767 females/year), and femoral neck fractures increased markedly with increased patient age. Approximately 80% of patients with femoral neck fractures were hospitalized (62.3% of males, 71.1% of females) compared with up to 10.4% of patients with other fragility fractures. Data provided in this study can be used as a baseline for evaluating the health economy and establishing health policy in Japan.


Assuntos
Fraturas Ósseas/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Feminino , Colo do Fêmur/lesões , Hospitalização , Humanos , Úmero/lesões , Japão/epidemiologia , Masculino , Programas Nacionais de Saúde , Osteoporose/epidemiologia , Rádio (Anatomia)/lesões , Traumatismos da Coluna Vertebral/epidemiologia
10.
South Med J ; 112(5): 271-275, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31050794

RESUMO

OBJECTIVE: Military providers frequently treat civilians, including pediatric patients. Cervical spine injuries in pediatric trauma patients occur infrequently, with limited data on the incidence. The aim of this study was to describe the incidence of cervical spine injuries in pediatric patients in Iraq and Afghanistan. METHODS: We queried the Department of Defense Trauma Registry for all pediatric encounters from January 2007 to January 2016. We searched within that dataset for all cervical spine fractures. RESULTS: From January 2007 through January 2016 there were 3439 pediatric encounters. There were 36 subjects identified (1.0%) with a cervical spine fracture. Of those with a cervical spine fracture, 6 (17%) had a prehospital cervical collar placed, which did not improve survival to hospital discharge (collar, 66.7% vs no collar, 83.3%, P = 0.573). Of those with a cervical spine fracture, 6 (17%) had a documented spinal cord injury. The median age of subjects with a cervical spine fracture was 9.5 years and the majority (63.9%) were male. Most were injured by explosion (41.7%). The median composite injury score was higher in subjects with a cervical spine fracture compared with those without one (16.5 vs 10, P < 0.001). Subjects with a cervical spine fracture had longer lengths of stay in the intensive care unit (median 3 days vs 1, P = 0.012) and a trend toward worse survival to hospital discharge (80.6%, n = 29, vs 90.3%, n = 3074, P = 0.079). CONCLUSIONS: Cervical spine injuries occurred infrequently in pediatric patients in Iraq and Afghanistan. When a fracture was present, almost one in five patients had spinal cord involvement. The pediatric prehospital literature would benefit from the development of a clinical decision tool to guide prehospital personnel as to when a cervical collar is indicated. Moreover, appropriate size equipment should be available when caring for host national civilians.


Assuntos
Vértebras Cervicais/lesões , Serviços Médicos de Emergência/estatística & dados numéricos , Sistema de Registros , Traumatismos da Coluna Vertebral/epidemiologia , Afeganistão/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Iraque/epidemiologia , Masculino
11.
Isr Med Assoc J ; 21(4): 279-282, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31032572

RESUMO

BACKGROUND: Horse riding has become increasingly popular in recent years and is a common activity among children. As a result, pediatric horse-related injuries are frequently encountered in emergency departments. OBJECTIVES: To examine the characteristics of horse-related injuries in the pediatric population. METHODS: We collected and analyzed the data on all pediatric horse-related injuries presented to a tertiary hospital, level one trauma center, during the years 2006-2016. RESULTS: A total of 53 children with horse-related injuries were documented. Forty-two patients were male (79%) and their mean age was 11.13 ± 4.72 years. The most common mechanism of injury was falling off a horse (31 patients, 58%) and the most common type of injury was skeletal (32 patients, 60%). Head injuries occurred in 16 patients (30%) and facial injuries in 12 (23%). The mean Injury Severity Score (ISS) was 10.5 ± 6.32, and 15 patients (28%) had severe trauma (ISS > 15). Twenty-nine patients (55%) required trauma team intervention, 12 (23%) were admitted to the intensive care unit, and 24 (45%) required surgery. The mean length of hospitalization was 4.3 ± 3.14 days. CONCLUSIONS: Our study suggests that horse-related trauma may involve serious injuries and it exhibits typical injury patterns. Young boys are at highest risk. The potential severity of these injuries merits a thorough evaluation. We suggest that these injuries be triaged appropriately, preferably to a medical facility with proper trauma capabilities.


Assuntos
Traumatismos Abdominais/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Traumatismos Craniocerebrais/epidemiologia , Fraturas Ósseas/epidemiologia , Traumatismos da Coluna Vertebral/epidemiologia , Ferimentos não Penetrantes/epidemiologia , Fatores Etários , Animais , Criança , Feminino , Cavalos , Hospitalização/estatística & dados numéricos , Humanos , Escala de Gravidade do Ferimento , Israel , Tempo de Internação/estatística & dados numéricos , Masculino , Fatores Sexuais
12.
Ulus Travma Acil Cerrahi Derg ; 25(2): 167-171, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30892669

RESUMO

BACKGROUND: Injuries caused by motorcycle accidents have been reported in several studies with an examination from a general trauma point of view. However, to our knowledge, there is no detailed study specific to central nervous system injuries. This research was focused on central nervous system injuries associated with motorcycle accidents. METHODS: The medical records of 540 patients who were admitted to the emergency department between 2008 and 2016 as the result of a motorcycle accident were retrospectively evaluated. Data were collected from electronic medical records, follow-up forms, and radiological images. Information on patient age, gender, type and site of injury, helmet use, alcohol level, Glasgow Coma Scale score on admission, length of stay in the intensive care unit and hospital, neurological status on discharge, and follow-up was collected and analyzed. RESULTS: A total of 486 of 540 patients (90%) were male, 54 (10%) were female, and the mean age was 31+-18 years (range: 2-85 years, median: 25 years). Cranial injuries were detected in 320 cases (59%). The distribution of cranial injuries was: epidural hemorrhage (12.6%), subdural hemorrhage (15.2%), depressed fracture (10.4%), linear fracture (23%), skull base fracture (5.5%), diffuse axonal injury (9.3%), subarachnoid hemorrhage (25.2%), intracerebral hemorrhage (13.5%), and contusion (26.3%). Spinal fractures were detected in 52 cases (9.6%). Twenty-two (4.07%) of the spinal fractures were observed in the cervical region, 10 (1.85%) in the thoracic region, and 20 (3.7%) in the lumbar region. The mean length of stay in the hospital was 8.2+-4 days and 7 days in the intensive care unit. Sixty-eight patients (12.6%) died. Traumatic cranial entities other than linear fracture were associated with an elevated level of mortality. A Glasgow Coma Scale score of 6 or less was associated with significant mortality (68%). CONCLUSION: A detailed report of motorcycle accident-associated central nervous system injuries is provided. The use of protective equipment, such as helmets, significantly reduced the rate of cerebral injury and death.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Traumatismos Craniocerebrais , Motocicletas , Traumatismos da Coluna Vertebral , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Traumatismos Craniocerebrais/diagnóstico , Traumatismos Craniocerebrais/epidemiologia , Traumatismos Craniocerebrais/terapia , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Traumatismos da Coluna Vertebral/diagnóstico , Traumatismos da Coluna Vertebral/epidemiologia , Traumatismos da Coluna Vertebral/cirurgia , Adulto Jovem
13.
World Neurosurg ; 122: e540-e545, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30889777

RESUMO

BACKGROUND: Although several investigations have examined the epidemiology of cervical spine injuries in sports, few studies have analyzed the nationwide incidence and sex-specific epidemiology of cervical spine injuries. METHOD: The National Electronic Injury Surveillance System database, which collects information on patients presenting to the emergency department at 100 hospitals across the United States, was queried for neck sprains and cervical fractures associated with sporting activities from 2000-2015. RESULT: A total of 26,380 neck sprains and 1166 fractures were identified. Compared with females, the incidence for injuries in males was 1.7 times greater for neck sprains and 3.6 times greater for fractures (P < 0.0001). Football was the most common cause of cervical sprains in males, followed by cycling and weightlifting/aerobics. Females sustained most neck sprains in weightlifting/aerobics, trampoline, and cheerleading. From 2000 to 2015, the incidence of neck sprains from aerobics increased from 15.5 to 25.3 per million person-years (P < 0.0001). Similarly, the incidence of cervical fractures from cycling increased from 0.67 to 2.7 per million (P < 0.0001). For males, cycling was the most common cause of fracture, followed by diving/swimming and football. For females, horseback riding was most common, followed by cycling and diving/swimming. CONCLUSIONS: Football is the leading cause of cervical sprains in the United States. The most common cause of cervical fracture in men is cycling, while in women it is horseback riding. The incidence of sport-related cervical fractures has increased by 35% from 2000 to 2015, which has been driven by an increase in cycling-related injuries.


Assuntos
Traumatismos em Atletas/epidemiologia , Fraturas da Coluna Vertebral/epidemiologia , Traumatismos da Coluna Vertebral/epidemiologia , Medicina Esportiva , Adolescente , Adulto , Traumatismos em Atletas/complicações , Monitoramento Epidemiológico , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fraturas da Coluna Vertebral/etiologia , Traumatismos da Coluna Vertebral/etiologia , Estados Unidos , Adulto Jovem
14.
World Neurosurg ; 126: e1494-e1502, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30910750

RESUMO

OBJECTIVE: Spine trauma management in children varies from one team to another, and to date, no clear consensus has been reached. The goal of this study was to describe the epidemiology of spine trauma in children and evaluate the timing and techniques of surgery when it was required. METHODS: A retrospective review of all patients admitted to our pediatric trauma center for spine traumas that required surgical management, between 2005 and 2016, was performed. All patients were followed with clinical and radiologic examination to evaluate the quality of fusion and realignment. RESULTS: Seventy-three children, with a mean age of 14.1 years, were admitted. Spinal injuries were more common in the teenage group (14-18 years). The predominant etiology of spine injuries was motor vehicle collision (36%). The spinal level of injury varied according to the age group: young children presented more cervical traumas (P < 0.01), while teenagers presented more lumbar traumas. There were more fractures alone in the teenage group (P < 0.005), while there were more luxations alone in the school-age group (P < 0.05). Median timing for surgical intervention in patients with neurologic deficits was 1 day. Patients with posterior wall recession >5 mm underwent surgical management quicker than patients with no posterior wall recession (P < 0.03). At follow-up, out of the 37 patients with initial neurologic deficits, 14 had improved (38%). CONCLUSIONS: Diskoligament maturation is an essential concept in spine traumas in children, as well as in surgical management. Surgical procedures should be carried out as soon as possible when patients present with neurologic deficits. At the thoracolumbar junction, a 2-level up-and-down fixation is recommended.


Assuntos
Traumatismos da Coluna Vertebral/cirurgia , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Fatores Etários , Criança , Pré-Escolar , Feminino , Seguimentos , Fixação Intramedular de Fraturas , Humanos , Lactente , Vértebras Lombares/lesões , Masculino , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/etiologia , Estudos Retrospectivos , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Traumatismos da Coluna Vertebral/diagnóstico por imagem , Traumatismos da Coluna Vertebral/epidemiologia , Tempo para o Tratamento , Tomografia Computadorizada por Raios X
15.
Injury ; 50(5): 1153-1155, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30773215

RESUMO

INTRODUCTION: "Blobbing" is a modern outdoor activity where a participant sits on the end of a partially inflated air bag ("blobber") and is launched into the water when another participant jumps onto the air bag from a platform on the opposite side ("jumper"). This is the first study to evaluate the injury patterns associated with blobbing. PATIENTS AND METHODS: A retrospective data analysis was conducted based on 86 patients who sustained blobbing injuries between January 2011 and December 2016. The date of birth, gender, day of injury, diagnosis, body region of trauma, and treatment were recorded for the patients. Treatment was subclassified into conservative or surgical treatment. The position of the participant was recorded as either a jumper or a blobber. RESULTS: One-third of the patients sustained a spine injury, which was the most common body part injured. The most frequent type of injury was cervical spine distortion. All shoulder (n = 9), elbow (n = 3), hand (n = 2), knee (n = 3), and foot (n = 12) injuries occurred in jumpers, whereas all ear (n = 6) and lung (n = 5) injuries occurred in blobbers. Head (n = 5) and spine (n = 33) injuries were distributed in jumpers and blobbers. Sixty-nine patients were treated with conservative treatment. Three ankle fractures and two spine fractures were treated with immediate surgical treatment. Twelve patients were treated with conservative treatment but were referred for potential surgery at their hospital at home. CONCLUSION: Both jumpers and blobbers were prone to injuries. More severe injuries with the potential for surgical treatment occurred in jumpers, presumably because of bad landings. This analysis of the injury patterns in blobbers might lead to the introduction of protective gear and changes in the behavior of participants in order to reduce the risk of injury.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Traumatismos em Atletas/epidemiologia , Traumatismos Craniocerebrais/etiologia , Fraturas Ósseas/etiologia , Traumatismos da Coluna Vertebral/etiologia , Prevenção de Acidentes , Adolescente , Adulto , Criança , Traumatismos Craniocerebrais/epidemiologia , Extremidades/lesões , Feminino , Fraturas Ósseas/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Traumatismos da Coluna Vertebral/epidemiologia , Adulto Jovem
16.
Traffic Inj Prev ; 20(1): 84-92, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30715907

RESUMO

OBJECTIVE: Motor vehicle occupants aged 8 to 12 years are in transition, in terms of both restraint use (booster seat or vehicle belt) and anatomical development. Rear-seated occupants in this age group are more likely to be inappropriately restrained than other age groups, increasing their vulnerability to spinal injury. The skeletal anatomy of an 8- to 12-year-old child is also in developmental transition, resulting in spinal injury patterns that are unique to this age group. The objective of this study is to identify the upper spine injuries commonly experienced in the 8- to 12-year-old age group so that anthropomorphic test devices (ATDs) representing this size of occupant can be optimized to predict the risk of these injuries. METHODS: Motor vehicle crash cases from the National Trauma Data Bank (NTDB) were analyzed to characterize the location and nature of cervical and thoracic spine injuries in 8- to 12-year-old crash occupants compared to younger (age 0-7) and older age groups (age 13-19, 20-39). RESULTS: Spinal injuries in this trauma center data set tended to occur at more inferior vertebral levels with older age, with patients in the 8- to 12-year-old group diagnosed with thoracic injury more frequently than cervical injury, in contrast to younger occupants, for whom the proportion of cases with cervical injury outnumbered the proportion of cases with thoracic injury. With the cervical spine, a higher proportion of 8- to 12-year-olds had upper spine injury than adults, but a substantially lower proportion of 8- to 12-year-olds had upper spine injury than younger children. In terms of injury type, the 8- to 12-year-old group's injury patterns were more similar to those of teens and adults, with a higher relative proportion of fracture than younger children, who were particularly vulnerable to dislocation and soft tissue injuries. However, unlike for adults and teens, catastrophic atlanto-occipital dislocations were still more common than any other type of dislocation for 8- to 12-year-olds and vertebral body fractures were particularly frequent in this age group. CONCLUSIONS: Spinal injury location in the cervical and thoracic spine moved downward with age in this trauma center data set. This shift in injury pattern supports the need for measurement of thoracic and lower cervical spine loading in ATDs representing the 8- to 12-year-old age group.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Vértebras Lombares/lesões , Traumatismos da Coluna Vertebral/epidemiologia , Traumatismos Torácicos/epidemiologia , Vértebras Torácicas/lesões , Adolescente , Criança , Sistemas de Proteção para Crianças/estatística & dados numéricos , Bases de Dados Factuais , Feminino , Fraturas Ósseas/epidemiologia , Humanos , Masculino , Veículos Automotores/estatística & dados numéricos , Fatores de Risco , Centros de Traumatologia , Estados Unidos
17.
Mymensingh Med J ; 28(1): 182-192, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30755568

RESUMO

Spine injuries, a common component in Polytrauma are usually affects the young people and is a major cause of morbidity and poses a significant health care expenditure and considerable threats to survival and quality of life. We retrospectively assess the demographics, incidence, mode of trauma, associated spine injuries, complications, neurological improvement and mortality. Records of total 1695 admitted patients, spinal injuries were 262 patients. Among them 30(11.45%) patients were associated with Polytrauma victims. Eleven patients (36.67%) were admitted through Ortho emergency dept, 14(46.67%) patients through Intensive care unit (ICU), 5(16.66%) patients through other department (CVS, Urology). Most (56%) of the patients were young in the age range of 16 to 40 years. Cervical spines were most commonly (44%) affected followed by lumbar (31%), thoracic (13%), thoraco-lumbar (9%) and Cervico-thoracic (3%) spines. Road traffic accident was the common cause (80%). Twelve patients (40%) had problems at various steps of management and maximum problems occur in step III. Nineteen patients (63.33%) management needs co-ordination between various specialties. Significant number of patients (76.67%) required operative treatment (p<0.05) and 13.33% were managed conservatively. Mortality rate (10%) was insignificant (p>0.05%). Of these patients, 73.33% had shown neurological improvement of at least one ASIA grade. The treatment of spinal injury in polytrauma patient should follow the principle of Advanced Trauma Life Support (ATLS). Once life and limb-threatening injuries have been identified and addressed, suspected spinal cord injury patients should be immobilized as early as possible to reduced the secondary injury, improve motor and sensory function as well as reduced the extend of permanent paralysis.


Assuntos
Traumatismo Múltiplo/cirurgia , Traumatismos da Medula Espinal/cirurgia , Traumatismos da Coluna Vertebral/cirurgia , Adolescente , Adulto , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Traumatismo Múltiplo/epidemiologia , Qualidade de Vida , Estudos Retrospectivos , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Coluna Vertebral/epidemiologia , Centros de Atenção Terciária , Resultado do Tratamento , Adulto Jovem
18.
Eur J Trauma Emerg Surg ; 45(3): 393-401, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29589039

RESUMO

PURPOSE: The precise incidence of trauma in pregnancy is not well-known, but trauma is estimated to complicate nearly 1 in 12 pregnancies and it is the leading non-obstetrical cause of maternal death. METHODS: A retrospective study of all pregnant women presented to national level 1 trauma center from July 2013 to June 2015 was conducted. Descriptive and inferential statistics applied for data analysis. RESULTS: Across the study period, a total of 95 pregnant women were presented to the trauma center. The average incidence rate of traumatic injuries was 250 per 1000 women of childbearing age presented to the Hamad Trauma Center. The mean age of patients was 30.4 ± SD 5.6 years, with age ranging from 20 to 42 years. The mean gestational age at the time of injury was 24.7 ± 8.7 weeks which ranged from 5 to 37 weeks. The majority (47.7%) was in the third trimester of the pregnancy. In addition, the large majority of injuries was due to MVCs (74.7%) followed by falls (15.8%). CONCLUSIONS: Trauma during pregnancy is not an uncommon event particularly in the traffic-related crashes. As it is a complex condition for trauma surgeons and obstetrician, an appropriate management protocol and multidisciplinary team are needed to improve the outcome and save lives of both the mother and fetus.


Assuntos
Acidentes de Trânsito/tendências , Complicações na Gravidez/epidemiologia , Ferimentos não Penetrantes/epidemiologia , Traumatismos Abdominais/epidemiologia , Descolamento Prematuro da Placenta/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Adulto , Feminino , Sofrimento Fetal/epidemiologia , Mortalidade Fetal , Fraturas Ósseas/epidemiologia , Idade Gestacional , Humanos , Incidência , Escala de Gravidade do Ferimento , Mortalidade Materna , Trabalho de Parto Prematuro/epidemiologia , Obstetrícia , Equipe de Assistência ao Paciente , Gravidez , Catar/epidemiologia , Estudos Retrospectivos , Traumatismos da Coluna Vertebral/epidemiologia , Centros de Traumatologia , Traumatologia , Violência/estatística & dados numéricos , Adulto Jovem
19.
Phys Sportsmed ; 47(1): 96-121, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30246587

RESUMO

OBJECTIVES: To identify all studies of gymnastics injuries and assess injury rates, types, locations, and causes. METHODS: Seven electronic and two grey literature databases were searched. Two reviewers independently assessed titles/abstracts, abstracted data, and calculated average rates weighted by study size. RESULTS: One study (n = 963) of three Olympic games (2008,2012,2016) provided injury rates for females of 86.4/1000gymnasts and males 79.9. For 29 databases one study of males (n = 64) provided a rate of 8.8 injuries/1000hours/AE (AE = athletic-exposure) and three of females varied rates (8.5, 9.4, and 91). Three studies for males (n = 153) provided a weighted average rate of 1.4 injuries/1000hours/training, and for females six studies (n = 476) 1.5 injuries. Four studies of males (n = 286) provided a weighted average of 678 injuries/1000gymnasts per year and eight studies of females (n = 1,764) a rate of 306. Of 19 surveys, eight provided rates for females (n = 1,463) of 596 injuries/gymnast per year and two for males (n = 40) a rate of 1,036. In the Olympics injuries were preponderately lower limb (63%) then trunk (23%) and upper limb (14%); injury type was sprains (35%) followed by tendinopathy/arthritis/impingements (17%), contusions (10%), and fractures (7%). Five database studies provided injury location data for 274 males: averages weighted by study size were upper extremity 42.8%, lower extremity 33.6%, torso/spine 11.8%, and head/neck 4.9% and 12 studies with 843 females provided average rates for lower extremity 51%, upper extremity 30.8%, torso/spine 13% and head/neck 0.8%. Official gymnastics organizations' websites provide no readily available data about injury rates or methods of prevention. CONCLUSIONS: Studies need to collect comprehensive data for injury rates by training/competitions, gender, age, injury location/type/cause. Studies could assess whether trainers and physiotherapists monitoring gymnasts closely for injury risk would reduce injuries. Studies including randomized controlled trials (RCTs) of interventions in training, videotaping and performance feedback to reduce injury rates would be helpful.


Assuntos
Traumatismos em Atletas/epidemiologia , Ginástica/lesões , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/prevenção & controle , Contusões/epidemiologia , Traumatismos Craniocerebrais/epidemiologia , Feminino , Fraturas Ósseas/epidemiologia , Humanos , Extremidade Inferior/lesões , Masculino , Lesões do Pescoço/epidemiologia , Traumatismos da Coluna Vertebral/epidemiologia , Entorses e Distensões/epidemiologia , Tendinopatia/epidemiologia , Tronco/lesões , Extremidade Superior/lesões
20.
J Pediatr Orthop ; 39(2): 85-89, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27662382

RESUMO

BACKGROUND: Although rare, spinal injuries associated with abuse can have potentially devastating implications in the pediatric population. We analyzed the association of pediatric spine injury in abused children and determined the anatomic level of the spine affected, while also focusing on patient demographics, length of stay, and total hospital charges compared with spine patients without a diagnosis of abuse. METHODS: A retrospective review of the Kids' Inpatient Database was conducted from 2000 to 2012 to identify pediatric patients (below 18 y) who sustained vertebral column fractures or spinal cord injuries. Patients with a documented diagnosis of abuse were identified using ICD-9-CM diagnosis codes. Our statistical models consisted of multivariate linear regressions that were adjusted for age, race, and sex. RESULTS: There were 22,192 pediatric patients with a diagnosis of spinal cord or vertebral column injury during the study period, 116 (0.5%) of whom also had a documented diagnosis of abuse. The most common type of abuse was physical (75.9%). Compared with nonabused patients, abused patients were more likely to be below 2 years of age (OR=133.4; 95% CI, 89.5-198.8), female (OR=1.67; 95% CI, 1.16-2.41), and nonwhite (black: OR=3.86; 95% CI, 2.31-6.45; Hispanic: OR=2.86; 95% CI, 1.68-4.86; other: OR=2.33; 95% CI, 1.11-4.86). Abused patients also presented with an increased risk of thoracic (OR=2.57; 95% CI, 1.67-3.97) and lumbar (OR=1.67; 95% CI, 1.03-2.72) vertebral column fractures and had a multivariate-adjusted mean length of stay that was 62.2% longer (P<0.001) and mean total charges that were 52.9% higher (P<0.001) compared with nonabused patients. Furthermore, 19.7% of all pediatric spine patients under 2 years of age admitted during the study period belonged to the abused cohort. CONCLUSIONS: Spine injuries are rare but can be found in the pediatric population. With an additional documented diagnosis of abuse, these injuries affect younger patients in the thoracolumbar region of the spine, and lead to longer lengths of stay and higher hospital costs when compared with nonabused patients. Because of these findings, physicians should maintain a higher level of suspicion of abuse in patients with spine injuries, especially patients under 2 years of age. LEVEL OF EVIDENCE: Level III evidence-a case-control study.


Assuntos
Maus-Tratos Infantis/estatística & dados numéricos , Pacientes Internados/estatística & dados numéricos , Traumatismos da Coluna Vertebral/etiologia , Pré-Escolar , Bases de Dados Factuais , Feminino , Seguimentos , Humanos , Incidência , Masculino , Estudos Retrospectivos , Traumatismos da Coluna Vertebral/diagnóstico , Traumatismos da Coluna Vertebral/epidemiologia , Índices de Gravidade do Trauma , Estados Unidos/epidemiologia
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