Imaging predictors of hemorrhagic progression of a contusion after traumatic brain injury: a systematic review and meta-analysis.

The hemorrhagic progression of a contusion (HPC) after Traumatic brain injury (TBI) is one of the important causes of death in trauma patients. The purpose of this meta-analysis was to evaluate the predictive effect of imaging features of Computed tomography (CT) on HPC after TBI. A comprehensive systematic search was performed using PubMed, EMBASE, and WEB OF SCIENCE databases to identify all relevant literature. A total of 8 studies involving 2543 patients were included in this meta-analysis. Meta-analysis showed that subarachnoid hemorrhage (OR 3.28; 95% CI 2.57-4.20), subdural hemorrhage (OR 4.35; 95% CI 3.29-5.75), epidural hemorrhage (OR 1.47;95% CI 1.15-1.89), contrast extravasation (OR 11.81; 95% CI 4.86-28.71) had a predictive effect on the occurrence of HPC. Skull fracture (OR 1.64; 95% CI 0.84-3.19) showed no statistical significance, and midline displacement > 5 mm (OR 4.66; 95% CI 1.87-11.62) showed high heterogeneity. The results of this meta-analysis showed that some imaging features were effective predictors of HPC after TBI. Well-designed prospective studies are needed to more accurately assess the effective predictors of HPC after TBI.

Scratch Descriptive epidemiologic study of billiards-related injuries.

The purpose of this descriptive epidemiological study is to identify billiards-related injuries that presented to the United States emergency departments from 2000 to 2020. This is a study using secondary data from emergency departments from 2000 to 2020 and presented with billiards-related injuries. No applicable intervention, but the main outcome measure was a description of injuries sustained due to participation in billiards. Billiards-related injury was captured by the National Electronic Injury Surveillance System - All Injury Program database. We extracted information on age, gender, injury, and disposition. A collective total of 78,524 (n = 1214) estimated patients, had emergency department visits after incurring billiards-related injuries as a sample. The mean age was 24.9 years. Most injuries occurred in males, 54,915 (n = 851, 69.9%). More injuries appeared to be soft-tissue contusions and abrasions, 19,000 (24.2%, n = 280), followed by lacerations, 17,520 (22.3%, n = 269). The most common cause of injury was being struck by a ball or cue, 39,705 (51.1%, n = 643). While the majority of injured patients were discharged home after evaluation, 2527 (3.2%, n = 45) of them required hospitalization. While a small number of billiards-related injuries presented to the emergency department in comparison to other sports-related injuries, some required more intensive treatment or hospitalization.

Acute ampakines increase voiding function and coordination in a rat model of SCI.

Neurogenic bladder dysfunction causes urological complications and reduces the quality of life in persons with spinal cord injury (SCI). Glutamatergic signaling via AMPA receptors is fundamentally important to the neural circuits controlling bladder voiding. Ampakines are positive allosteric modulators of AMPA receptors that can enhance the function of glutamatergic neural circuits after SCI. We hypothesized that ampakines can acutely stimulate bladder voiding that has been impaired due to thoracic contusion SCI. Adult female Sprague-Dawley rats received a unilateral contusion of the T9 spinal cord (n = 10). Bladder function (cystometry) and coordination with the external urethral sphincter (EUS) were assessed 5 d post-SCI under urethane anesthesia. Data were compared to responses in spinal-intact rats (n = 8). The 'low-impact' ampakine CX1739 (5, 10, or 15 mg/kg) or vehicle (2-hydroxypropyl-beta-cyclodextrin [HPCD]) was administered intravenously. The HPCD vehicle had no discernible impact on voiding. In contrast, following CX1739, the pressure threshold for inducing bladder contraction, voided volume, and the interval between bladder contractions were significantly reduced. These responses occurred in a dose-dependent manner. We conclude that modulating AMPA receptor function using ampakines can rapidly improve bladder-voiding capability at subacute time points following contusion SCI. These results may provide a new and translatable method for therapeutic targeting of bladder dysfunction acutely after SCI.

Bone Bruise versus Fracture on MRI and the Relevance to Return to Play.

We review the spectrum of acute osseous injuries in athletes, ranging from osseous contusion (bone bruise) injuries to nondisplaced cortical fractures. The basic biomechanical concepts, underlying histopathologic changes, and characteristic magnetic resonance imaging (MRI) features of acute osseous injuries are presented. Bone bruise injuries of varying severity are highlighted to showcase the breadth of imaging findings on MRI and methods for characterizing such lesions. We emphasize the importance of accurately assessing patterns of injury on MRI to communicate more effectively with team medical staff and recognize the implications on return to play. This article offers the foundational tools for approaching bone bruise injuries in elite athletes to add value to the diagnosis and treatment of this unique patient population.

Creating a Reproducible Model of Spinal Cord Injury in Rats: A Contusion Approach.

Spinal cord injury (SCI) is a devastating clinical condition that affects millions of people worldwide. SCI primarily affects males in younger age groups. It is characterized by a complex of neurological dysfunctions that can lead to permanent disability. We describe an adapted technique for SCI, i.e., a contusion model of SCI, in this chapter. This model is widely used to study the pathology of SCI and test potential therapies. The experimental contusion is performed by using a compression device, which allows the creation of a reproducible injury animal model through the definition of specific injury parameters. A detailed methodology has been developed and described here that utilizes a stereotactic frame and impactor to produce reproducible injuries.

Insights from Rodent Models for Improving Bench-to-Bedside Translation in Traumatic Brain Injury.

Road accidents, domestic falls, and persons associated with sports and military services exhibited the concussion or contusion type of traumatic brain injury (TBI) that resulted in chronic traumatic encephalopathy. In some instances, these complex neurological aberrations pose severe brain damage and devastating long-term neurological sequelae. Several preclinical (rat and mouse) TBI models simulate the clinical TBI endophenotypes. Moreover, many investigational neuroprotective candidates showed promising effects in these models; however, the therapeutic success of these screening candidates has been discouraging at various stages of clinical trials. Thus, a correct selection of screening model that recapitulates the clinical neurobiology and endophenotypes of concussion or contusion is essential. Herein, we summarize the advantages and caveats of different preclinical models adopted for TBI research. We suggest that an accurate selection of experimental TBI models may improve the translational viability of the investigational entity.

Significance of Contusion at the Vocal Cord and Perivocal Cord Area in Cases of Non-intubated Death.

Every finding during a neck autopsy may be essential for accurately diagnosing and explaining the mechanism of death. In this prospective study in the Department of Forensic Medicine and Toxicology of Jordan University Hospital, 17 out of 95 neck autopsies revealed contusions of the laryngeal mucosa in the vocal or perivocal area. These contusions were found to be associated with various causes of death, including mechanical asphyxia (such as throttling, ligature strangulation, hanging, smothering, choking, plastic bag asphyxia, gagging, and inhalation of blood) and other causes (such as atypical drowning, carbon monoxide poisoning, head injury due to a road traffic accident, burns, electrocution, and brain edema). This study provides insight into the mechanisms of this important lesion and may contribute to a better understanding of the cause of death.

MicroRNA-133b Dysregulation in a Mouse Model of Cervical Contusion Injury.

Our previous research studies have demonstrated the role of microRNA133b (miR133b) in healing the contused spinal cord when administered either intranasally or intravenously 24 h following an injury. While our data showed beneficial effects of exogenous miR133b delivered within hours of a spinal cord injury (SCI), the kinetics of endogenous miR133b levels in the contused spinal cord and rostral/caudal segments of the injury were not fully investigated. In this study, we examined the miR133b dysregulation in a mouse model of moderate unilateral contusion injury at the fifth cervical (C5) level. Between 30 min and 7 days post-injury, mice were euthanized and tissues were collected from different areas of the spinal cord, ipsilateral and contralateral prefrontal motor cortices, and off-targets such as lung and spleen. The endogenous level of miR133b was determined by RT-qPCR. We found that after SCI, (a) most changes in miR133b level were restricted to the injured area with very limited alterations in the rostral and caudal parts relative to the injury site, (b) acute changes in the endogenous levels were predominantly specific to the lesion site with delayed miR133b changes in the motor cortex, and (c) ipsilateral and contralateral hemispheres responded differently to unilateral SCI. Our results suggest that the therapeutic window for exogenous miR133b therapy begins earlier than 24 h post-injury and potentially lasts longer than 7 days.

Physical examination and CT to assess thoracic injury in 137 cats presented to UK referral hospitals after trauma.

OBJECTIVES: The aim of the study was to describe clinical examination and thoracic CT (TCT) findings in cats after trauma, and to identify physical examination findings associated with both abnormalities on TCT and the need for therapeutic interventions. METHODS: A multicentre, retrospective, observational study was conducted. Cats admitted to the participating hospitals with a history of blunt trauma and that underwent TCT were eligible. Data were collected on signalment, history, physical examination, TCT findings and subsequent interventions. RESULTS: In total, 137 cats were included. Road traffic accidents (RTAs) were the most frequently reported cause of trauma (69%). Tachypnoea (32%), pale mucous membranes (22%) and dyspnoea (20%) were the most common abnormal findings on thoracic examination. The most frequently identified thoracic pathologies on TCT were atelectasis (34%), pulmonary contusions (33%), pneumothorax (29%) and pleural effusion (20%). Thoracocentesis was the most commonly performed intervention (12%), followed by chest drain placement (7%). A total of 45 (33%) cats had no physical examination abnormalities but did have abnormalities detected on TCT; six of these cats required interventions. Increasing numbers of thoracic abnormalities on clinical examination were associated with increasing likelihood of having abnormal findings on TCT (odds ratio [OR] 2.04, 95% confidence interval [CI] 1.21-3.44, P = 0.008) and of requiring an intervention (OR 1.82, 95% CI 1.32-2.51, P <0.001). CONCLUSIONS AND RELEVANCE: RTAs were the most common reported cause of blunt trauma. Atelectasis, pulmonary contusions and pneumothorax were the most common abnormalities identified on TCT, and thoracic drainage was the most utilised intervention. TCT may be useful in identifying cats with normal thoracic physical examination findings that have significant thoracic pathology, and a high number of abnormal findings on thoracic examination should raise suspicion for both minor and major thoracic pathology. The results of this study can be used to assist in selecting appropriate cases for TCT after blunt trauma.

Visibility of inflicted bruises by alternate light: Results of a randomized controlled trial.

Difficulty visualizing bruises resulting from interpersonal violence, especially in individuals with dark skin, contributes to disparities in access to justice. The purpose of this analysis was to compare bruise visibility of detected injuries using white light versus alternate light sources (ALS). Visibility was assessed using the 5-point Bruise Visibility Scale (BVS) for white light and the ALS Visibility Scale (AVS) for ALS. Bruises were induced using controlled application of a paintball to the upper arm on 157 healthy adults across six skin color categories. Using a crossover design, the light source used first to assess the bruise (white light or ALS) was randomized. Each bruise was examined up to 21 times over 4 weeks using white light and 10 combinations of wavelengths (350 nanometer [nm] - 535 nm) and colored filters (yellow, orange, and red). Multilevel modeling was used to analyze the repeated measures data with a total 20,103 bruise assessments. Results revealed 415 nm with yellow filter resulted in an almost 0.5-point increase in BVS/AVS score across all skin colors (Estimate = 0.46; 95% CI: 0.43, 0.49; p < 0.001), a clinically significant improvement in ability to visualize bruises. Conversely, 515 nm (Estimate = -0.80; 95% CI: -0.84, -0.76; p < 0.001) and 535 nm (Estimate = -0.64, 95% CI: -0.67, -0.60; p < 0.001) with red filter resulted in more than 0.5-point decrease in BVS/AVS score. The use of ALS is supported by the data and results in improved bruise visibility during medical forensic examinations.

Benchmarking the United States bison meat industry: stakeholder perceptions, production parameters, and live animal factors affecting meat quality.

The objectives of this study were 1) to understand stakeholder perceptions regarding the bison industry, 2) to benchmark live animal characteristics and production parameters of the bison industry, and 3) to identify live animal factors related to animal welfare and their effect on specific quality characteristics of bison meat. A survey was conducted both online and in-person at the National Bison Association Winter Conference (2022). Descriptive statistics were performed on a total of 110 surveys. Most stakeholders (94%, n = 104) agreed that the industry should continue to grow, and the majority (99%, 108) agreed that animal welfare impacts meat quality. Facility design (80%, n = 88), animal handling (78%, 86), employee training (56%, 62), and transportation duration (56%, 62) were selected as the factors that affect animal welfare. More than half of the stakeholders selected flavor (67%, n = 74) as the most important quality attribute of bison meat. For the in-plant antemortem and postmortem parameters data was collected from three plants in the United States over the course of a year. A total of 2,284 bison (bulls: n = 1,101; cows: n = 199; heifers: n = 984) were included in the study. Antemortem measurements such as distance traveled, vocalization, prod use, mobility, and head bumps were measured, followed by postmortem measurements that included bruise score, live weight, dressing percentage, ribeye area, and instrumental color. Approximately 97% of bison (n = 2,213) had at least one bruise. The average distance traveled from producer to slaughter plant was (mean ±â€…SD; 823 ±â€…583 km) and the average dressing percentage was (mean ±â€…SD; 60.5 ±â€…3.3%). Average (mean ±â€…SD) fat thickness and ribeye area were 1.4 ±â€…1.1 cm and 62.6 ±â€…9.8 cm2, respectively. Approximately 30% (n = 676) of the bison in this study head bumped between 1 and 5 times in the restraining chute or the single-file gate before being stunned. Linear regression indicated that differences in lean a* were associated with plant, number of head bumps in the chute, ribeye area, fat thickness, live weight, and sex class (P < 0.05). Logistic regression indicated that season, sex class, live weight, plant, and season were associated with differences (P < 0.05) in bruising. These results can be used as a baseline for current production parameters and serve as the foundation for future research to monitor improvement.

This project evaluated bison industry stakeholder perceptions on management, animal welfare, and meat quality with in-person and online surveys. Additionally, multiple live animal factors were measured to benchmark their influence on specific meat quality attributes. From the stakeholder surveys, animal handling, bison behavior, employee training, facility design, and transportation duration were identified as the most critical factors that could impact animal welfare in the bison production system. Moreover, the stakeholders understood that animal welfare is a critical component for bison production and that it directly affects meat quality. Live animal production parameters such as distance traveled, season, number of head bumps in the chute, sex class, and live weight were associated with differences in fat thickness, ribeye area, blood splash presence, and instrumental color of bison meat. The results from this study can be used as a baseline for industry improvements and future research.

Automated Impactor for Contusive Spinal Cord Injury Model in Mice.

Spinal cord injury (SCI) due to traumatic injuries such as car accidents and falls is associated with permanent spinal cord dysfunction. Creation of contusion models of spinal cord injury by impacting the spinal cord results in similar pathologies to most spinal cord injuries in clinical practice. Accurate, reproducible, and convenient animal models of spinal cord injury are essential for studying spinal cord injury. We present a novel automated spinal cord injury contusion device for mice, the Guangzhou Jinan University smart spinal cord injury system, that can produce spinal cord injury contusion models with accuracy, reproducibility, and convenience. The system accurately produces models of varying degrees of spinal cord injury via laser distance sensors combined with an automated mobile platform and advanced software. We used this system to create three levels of spinal cord injury mice models, determined their Basso mouse scale (BMS) scores, and performed behavioral as well as staining assays to demonstrate its accuracy and reproducibility. We show each step of the development of the injury models using this device, forming a standardized procedure. This method produces reproducible spinal cord injury contusion mice models and reduces human manipulation factors via convenient handling procedures. The developed animal model is reliable for studying spinal cord injury mechanisms and associated treatment approaches.

From suicide to accident - Case report - The significance of the medico-legal autopsies.

INTRODUCTION: Suicide is the intentional and voluntary act of destroying one's own life, while an accident is an unintended event that involuntarily causes injury to one's health or destruction of life. CASE PRESENTATION: We report a case of a 54-year-old male who was found in a forest in late November, approximately 500 m away from his car. He was positioned bent over a trunk of a tree with his head beneath the rest of his body. His pants were down to his knees, and there were soiled blades of grass and leaves on his body. Investigation of the case circumstances revealed that he had attempted suicide by carbon monoxide poisoning, using a hose connected to the exhaust pipe and running it through the window into the cabin. Window on the driver's side was broken with glass particles on the driver's seat. Wrappers from "Rivotril" tablets, a generic benzodiazepine, were also found in the car. Autopsy revealed the following: postmortem hypostasis was of a cherry red color and well pronounced on the upper part of the front of the body and face. Numerous bruises, contusions, and erosions were present all over the body. Frostbites were especially pronounced in the knees and elbows area. The synovial membranes were partially bloodstained and reddish in color. Opening the stomach revealed erosions of the gastric mucosa (Wischnewsky sign). Chemical toxicological analysis detected presence of benzodiazepines and carboxyhemoglobin (25%). CONCLUSION: Based on the autopsy findings, chemical toxicological analyses, and investigation of the case circumstances, it has been concluded that the death occurred due to the combined effects of hypothermia, postural asphyxia and carboxyhemoglobin and benzodiazepine intoxication. The manner of death in this case is a combination of accidental and suicidal, as the victim attempted suicide but ultimately died due to exposure to low external temperature.

Activated Human Adipose Tissue Transplantation Promotes Sensorimotor Recovery after Acute Spinal Cord Contusion in Rats.

Traumatic spinal cord injuries (SCIs) often result in sensory, motor, and vegetative function loss below the injury site. Although preclinical results have been promising, significant solutions for SCI patients have not been achieved through translating repair strategies to clinical trials. In this study, we investigated the effective potential of mechanically activated lipoaspirated adipose tissue when transplanted into the epicenter of a thoracic spinal contusion. Male Sprague Dawley rats were divided into three experimental groups: SHAM (uninjured and untreated), NaCl (spinal cord contusion with NaCl application), and AF (spinal cord contusion with transplanted activated human fat). Pro-inflammatory cytokines (IL-1ß, IL-6, TNF-α) were measured to assess endogenous inflammation levels 14 days after injury. Sensorimotor recovery was monitored weekly for 12 weeks, and gait and electrophysiological analyses were performed at the end of this observational period. The results indicated that AF reduced endogenous inflammation post-SCI and there was a significant improvement in sensorimotor recovery. Moreover, activated adipose tissue also reinstated the segmental sensorimotor loop and the communication between supra- and sub-lesional spinal cord regions. This investigation highlights the efficacy of activated adipose tissue grafting in acute SCI, suggesting it is a promising therapeutic approach for spinal cord repair after traumatic contusion in humans.

Clinical characteristics and associated factors of posttraumatic epilepsy after traumatic brain injury in children: A retrospective case-control study.

BACKGROUND: Traumatic brain injury (TBI) affects approximately 69 million individuals annually, often resulting in well-documented complications such as epilepsy. Although numerous studies have been performed on posttraumatic epilepsy (PTE) in adults over the past decade, research on chronic consequences of TBI in children remains limited. Herein, we retrospectively assessed children who had experienced moderate to severe TBI to determine their clinical characteristics and identify associated factors associated with the development of PTE in the pediatric population. METHODS: The study population comprised children aged 0-18 years who had experienced moderate to severe TBI and underwent treatment at the Children's Hospital of Chongqing Medical University between 2011 and 2021. They were categorized into two groups: the PTE group, comprising individuals diagnosed with PTE within a one-year follow-up period, and the nPTE group, consisting of those who did not develop PTE during the same timeframe. The primary objective was to investigate the clinical characteristics and identify related associated factors. The relationship between various clinical factors and the incidence of PTE was assessed through univariate and multivariate logistic regression. RESULTS: A total of 132 patients were assessed. Most participants were male (65%) and the age distribution skewed towards younger children, with a median age of 41.0 months (interquartile range: 45.3). Upon their last clinical visit, 64 children (49%) were diagnosed with PTE. Notably, the first posttraumatic seizure predominantly occurred within the first week following the traumatic event. Further analyses revealed that increasing injury severity, as indicated by a lower Glasgow Coma Scale (GCS) score (odds ratio [OR]: 0.78, 95% confidence interval [CI]: 0.54-1.12, p= 0.018), a contusion load ≥3 (OR: 8.1, 95% CI: 2.3-28.9, p= 0.001), immediate posttraumatic seizures (IPTS) (OR: 8.9, 95% CI: 2.5-31.2, p < 0.001), and early posttraumatic seizures (EPTS) (OR: 54, 95% CI: 11-276, p < 0.001), were all significantly associated with a higher risk of developing PTE. CONCLUSION: This study highlights that the onset of PTE was associated with the markers of injury severity or PTS and identified GCS scores, contusion loads of ≥3, IPTS, and EPTS as independent associated factors significantly associated with the development of PTE.

[Complications after conservative vs. operative treatment of severe thoracic trauma]. / Komplikationen nach operativer vs. konservativer Versorgung des schweren Thoraxtraumas.

BACKGROUND: Thoracic trauma is a frequent injury in the routine treatment of injured patients. Due to the increasing demographic changes a further increase is to be expected, especially after low-energy trauma. OBJECTIVE: Expected complications after conservative vs. operative treatment of various injury patterns of thoracic trauma. MATERIAL AND METHODS: Evaluation of a selective literature search regarding possible complications after thoracic trauma and formulation of instructions for action as expert recommendations. CONCLUSION: Both conservative and operative treatment of thoracic trauma have their specific complications, which have to be known to the treating physician. Lung contusions are often underestimated in the initial radiological diagnostics but often lead to relevant problems during the further course of treatment. After conservative treatment of rib fractures persistent pain, functional limitations or even relevant deformities due to secondary dislocation, can remain. There is a significant risk of overlooking or underestimating relevant injuries during the initial diagnostics which then leads to secondary complications. By far the most frequent risk of surgical treatment is an incorrect positioning of chest tubes. Overall, postoperative infections after chest trauma are relatively rare.

Non-contrast ultrasound image analysis for spatial and temporal distribution of blood flow after spinal cord injury.

Ultrasound technology can provide high-resolution imaging of blood flow following spinal cord injury (SCI). Blood flow imaging may improve critical care management of SCI, yet its duration is limited clinically by the amount of contrast agent injection required for high-resolution, continuous monitoring. In this study, we aim to establish non-contrast ultrasound as a clinically translatable imaging technique for spinal cord blood flow via comparison to contrast-based methods and by measuring the spatial distribution of blood flow after SCI. A rodent model of contusion SCI at the T12 spinal level was carried out using three different impact forces. We compared images of spinal cord blood flow taken using both non-contrast and contrast-enhanced ultrasound. Subsequently, we processed the images as a function of distance from injury, yielding the distribution of blood flow through space after SCI, and found the following. (1) Both non-contrast and contrast-enhanced imaging methods resulted in similar blood flow distributions (Spearman's ρ = 0.55, p < 0.0001). (2) We found an area of decreased flow at the injury epicenter, or umbra (p < 0.0001). Unexpectedly, we found increased flow at the periphery, or penumbra (rostral, p < 0.05; caudal, p < 0.01), following SCI. However, distal flow remained unchanged, in what is presumably unaffected tissue. (3) Finally, tracking blood flow in the injury zones over time revealed interesting dynamic changes. After an initial decrease, blood flow in the penumbra increased during the first 10 min after injury, while blood flow in the umbra and distal tissue remained constant over time. These results demonstrate the viability of non-contrast ultrasound as a clinical monitoring tool. Furthermore, our surprising observations of increased flow in the injury periphery pose interesting new questions about how the spinal cord vasculature reacts to SCI, with potentially increased significance of the penumbra.

Influence of changes in foot morphology and temperature on bruised toenail injury risk during running.

Despite runners frequently suffering from dermatologic issues during long distance running, there is no compelling evidence quantitatively investigating their underlying injury mechanism. This study aimed to determine the foot morphology and temperature changes during long distance running and reveal the effect of these alterations on the injury risk of bruised toenail by measuring the subjective-perceived hallux comfort and gap length between the hallux and toebox of the shoe. Ten recreational runners participated in the experimental tests before (baseline), immediately after 5 and 10 km of treadmill running (12 km/h), in which the foot morphology was measured by a 3D foot scanner, the foot temperature was detected by an infrared camera, the perceived comfort was recorded by a visual analogue scale, and the gap length in the sagittal plane was captured by a high-speed camera. Ball width became narrower (106.39 ± 6.55 mm) and arch height (12.20 ± 2.34 mm) was reduced greatly after the 10 km run (p < 0.05). Foot temperature increased significantly after 5 and 10 km of running, and the temperature of dorsal hallux (35.12 ± 1.46 °C), dorsal metatarsal (35.92 ± 1.59 °C), and medial plantar metatarsal (37.26 ± 1.34 °C) regions continued to increase greatly from 5 to 10 km of running (p < 0.05). Regarding hallux comfort, the perceived scores significantly reduced after 5 and 10 km of running (2.10 ± 0.99, p < 0.05). In addition, during one running gait cycle, there was a significant increase in gap length at initial contact (39.56 ± 6.45 mm, p < 0.05) for a 10 km run, followed by a notable decrease upon reaching midstance (29.28 ± 6.81 mm, p < 0.05). It is concluded that the reduced ball width and arch height while increased foot temperature during long-distance running would exacerbate foot-shoe interaction, potentially responsible for bruised toenail injuries.