Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 105.195
Filtrar
1.
J Med Case Rep ; 18(1): 197, 2024 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-38566165

RESUMO

BACKGROUND: Collarbone fracture is a common injury, particularly among athletes involved in contact sports and participating in endurance activities. Conventional treatment requires surgery and postoperative immobilization, resulting in an average return-to-sport timeframe of approximately 13 weeks. This case challenges the established treatment protocols, aiming to expedite recovery and enable a quicker resumption of high-intensity athletic activities. CASE PRESENTATION: A 24-year-old Caucasian athlete completed a Half-Ironman Triathlon (70.3) merely three weeks post-collarbone fracture. Utilizing Extracorporeal Magneto-Transduction Therapy (EMTT) alongside surgical intervention, the patient achieved accelerated healing and remarkable performance outcomes without encountering any adverse effects. CONCLUSIONS: The integration of EMTT into the treatment paradigm for bone fractures alters the traditional understanding of recovery timelines and rehabilitation strategies. This case highlights the potential benefits of electromagnetic wave therapy in expediting the healing process and enabling athletes to resume high-level sports activities at an earlier stage.


Assuntos
Traumatismos em Atletas , Fraturas Ósseas , Humanos , Adulto Jovem , Atletas , Traumatismos em Atletas/cirurgia , Clavícula/lesões , Fixação Interna de Fraturas , Fraturas Ósseas/cirurgia , Volta ao Esporte
2.
South Med J ; 117(4): 214-219, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38569612

RESUMO

OBJECTIVES: Hamstring strain injuries (HSI) are common among football and soccer athletes. Eccentric strength imbalance is considered a contributing factor for HSI. There is, however, a paucity of data on hamstring imbalances of soccer and American football athletes as they age and advance in skill level. High school athletes will display greater interlimb discrepancies compared with collegiate and professional athletes. In addition, soccer athletes will exhibit greater hamstring asymmetry than American football athletes. METHODS: Hamstring testing was performed on soccer and American football athletes using the NordBord Hamstring Testing System (Vald Performance, Albion, Australia). Age, sex, weight, sport specialization, and sport level were recorded. Maximum hamstring forces (N), torque (N · m), and work (N · s) were measured. Hamstring imbalance (%) was calculated by dividing the absolute value of the difference in leg forces divided by their sum. One-way analysis of variance and independent sample t tests compared measurements between athlete groups. RESULTS: A total of 631 athletes completed measurements, including 88 high school male soccer, 25 college male soccer, 23 professional male soccer, 83 high school female soccer, 28 college female soccer, 288 high school football, and 96 college football athletes. High school soccer players displayed significantly greater imbalances for torque (P = 0.03) and work (P < 0.01) than football athletes. Imbalances for maximum force (P = 0.035), torque (P = 0.018), and work (P = 0.033) were significantly higher for male soccer athletes in high school compared with college- and professional-level athletes. Female high school soccer players had significantly higher imbalance in torque (P = 0.045) and work (P = 0.001) compared with female collegiate soccer players. Football athletes did not experience significant changes in force imbalances between skill levels. CONCLUSIONS: High school soccer athletes exhibit greater hamstring imbalances than football athletes. Higher levels of play in soccer, for both male and female athletes, correlate with less hamstring asymmetry.


Assuntos
Músculos Isquiossurais , Futebol , Humanos , Masculino , Feminino , Futebol/lesões , Força Muscular , Músculos Isquiossurais/lesões , Atletas
3.
Surg Laparosc Endosc Percutan Tech ; 34(2): 201-205, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38571322

RESUMO

BACKGROUND: With the aging of the global population, the incidence rate of acute cholecystitis is increasing. Laparoscopic cholecystectomy is considered as the first choice to treat acute cholecystitis. How to effectively avoid serious intraoperative complications such as bile duct and blood vessel injury is still a difficult problem that puzzles surgeons. This paper introduces the application of laparoscopic cholecystectomy, a new surgical concept, in acute difficult cholecystitis. METHODS: This retrospective analysis was carried out from January 2019 to January 2021. A total of 36 patients with acute difficult cholecystitis underwent 3-step laparoscopic cholecystectomy. The general information, clinical features, surgical methods, surgical results, and postoperative complications of the patients were analyzed. RESULTS: All patients successfully completed the surgery, one of them was converted to laparotomy, and the other 35 cases were treated with 3-step laparoscopic cholecystectomy. Postoperative bile leakage occurred in 2 cases (5.56%), secondary choledocholithiasis in 1 case (2.78%), and hepatic effusion in 1 case (2.78%). No postoperative bleeding, septal infection, and other complications occurred, and no postoperative colon injury, gastroduodenal injury, liver injury, bile duct injury, vascular injury, and other surgery-related complications occurred. All 36 patients were discharged from hospital after successful recovery. No one died 30 days after surgery, and there was no abnormality in outpatient follow-up for 3 months after surgery. CONCLUSIONS: Three-step laparoscopic cholecystectomy seems to be safer and more feasible for acute difficult cholecystitis patients. Compared with traditional laparoscopic cholecystectomy or partial cholecystectomy, 3-step laparoscopic cholecystectomy has the advantages of safe surgery and less complications, which is worth trying by clinicians.


Assuntos
Colecistectomia Laparoscópica , Colecistite Aguda , Humanos , Colecistectomia Laparoscópica/métodos , Estudos Retrospectivos , Colecistectomia/métodos , Colecistite Aguda/cirurgia , Colecistite Aguda/etiologia , Ductos Biliares/lesões
4.
Scand J Med Sci Sports ; 34(4): e14619, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38572910

RESUMO

OBJECTIVES: Hamstring strain injuries (HSIs) commonly affect the proximal biceps femoris long head (BFlh) musculotendinous junction. Biomechanical modeling suggests narrow proximal BFlh aponeuroses and large muscle-to-aponeurosis width ratios increase localized tissue strains and presumably risk of HSI. This study aimed to determine if BFlh muscle and proximal aponeurosis geometry differed between limbs with and without a history of HSI. METHODS: Twenty-six recreationally active males with (n = 13) and without (n = 13) a history of unilateral HSI in the last 24 months underwent magnetic resonance imaging of both thighs. BFlh muscle and proximal aponeurosis cross-sectional areas, length, volume, and interface area between muscle and aponeurosis were extracted. Previously injured limbs were compared to uninjured contralateral and control limbs for discrete variables and ratios, and along the relative length of tissues using statistical parametric mapping. RESULTS: Previously injured limbs displayed significantly smaller muscle-to-aponeurosis volume ratios (p = 0.029, Wilcoxon effect size (ES) = 0.43) and larger proximal BFlh aponeurosis volumes (p = 0.019, ES = 0.46) than control limbs with no history of HSI. No significant differences were found between previously injured and uninjured contralateral limbs for any outcome measure (p = 0.216-1.000, ES = 0.01-0.36). CONCLUSIONS: Aponeurosis geometry differed between limbs with and without a history of HSI. The significantly larger BFlh proximal aponeuroses and smaller muscle-to-aponeurosis volume ratios in previously injured limbs could alter the strain experienced in muscle adjacent to the musculotendinous junction during active lengthening. Future research is required to determine if geometric differences influence the risk of re-injury and whether they can be altered via targeted training.


Assuntos
Músculos Isquiossurais , Lesões dos Tecidos Moles , Entorses e Distensões , Masculino , Humanos , Músculos Isquiossurais/fisiologia , Aponeurose , Entorses e Distensões/diagnóstico por imagem , Imageamento por Ressonância Magnética , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/lesões
5.
Tunis Med ; 102(2): 70-73, 2024 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-38567470

RESUMO

INTRODUCTION: To enhance players' performance and implement effective injury prevention protocols and surveillance programs in football, it is essential to conduct epidemiological studies. Since significant disparities in injury rates across various football competitions were reported, it is important to characterize injuries in the context of the African cup of nation (AFCON) competition. AIM: To determine the incidence and factors associated with injuries among African footballers during the 2024 AFCON competition, which will be held in Ivory Coast from January 13 to February 11, 2024. METHODS: Two expert physician in sports medicine will perform an analytical study (i.e.; a video-based analysis) of the 52 matches that will be played during the 2024 AFCON. The following parameters will be noted: i) Injury incidence, ii) Characteristics of injured players such as age, on-field position, and player league continent, iii) Characteristics ofinjuries such as mechanism, body location, moment of injury in terms of the minute of play and the round of the match, place of the injury in term of stadium zone, replacement consequent to the injury, absence next match, re-injury, recurrence of the injury with the same location during the competition, referee decision, and stoppage time for on-field injury, and iv) Characteristics of matches such as the match' schedule, ambient temperature, humidity, and wind speed. CONCLUSION: This study will allow enriching the existing literature with additional data regarding the injuries and the players' characteristics in the African context.


Assuntos
Traumatismos em Atletas , Futebol Americano , Humanos , Côte d'Ivoire/epidemiologia , Traumatismos em Atletas/epidemiologia , Incidência , Futebol Americano/lesões
6.
Eur Rev Med Pharmacol Sci ; 28(6): 2317-2321, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38567594

RESUMO

OBJECTIVE: Metacarpal fractures are one of the most common orthopedic injuries seen in emergency departments. Despite this, only a few data have been published about the epidemiology of metacarpal fractures. Simple radiographs are the standard imaging modality used to diagnose boxer fractures and determine the degree of angulation. Fractures and angulations should be identified by anteroposterior and lateral radiographs. The aim of this study was to follow the healing after closed reduction of fifth metacarpal neck fractures in a pediatric population using the QuickDASH score to determine whether it results in clinically significant improvement. SUBJECTS AND METHODS: Between 2020 and 2022, our clinical record database for all metacarpal fractures treated at our institution was searched retrospectively every month. Children aged 18 years and younger with fifth metacarpal neck fractures treated with closed reduction and immobilization in our tertiary care emergency clinic were retrospectively reviewed. RESULTS: 52 pediatric patients were included in the study. The mean age at the time of injury was 14.04 years (SD=2.10, range=10-18 years). 92.30% (n=48) of the patients were male, and 7.70% (n=4) were female. CONCLUSIONS: Accurate diagnosis and appropriate treatment are crucial in the management of childhood fifth metacarpal fractures to ensure proper healing, prevent long-term complications, and facilitate optimal functional recovery.


Assuntos
Fraturas Ósseas , Traumatismos da Mão , Ossos Metacarpais , Humanos , Masculino , Feminino , Criança , Adolescente , Ossos Metacarpais/diagnóstico por imagem , Ossos Metacarpais/lesões , Estudos Retrospectivos , Resultado do Tratamento , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/terapia , Consolidação da Fratura , Traumatismos da Mão/terapia
7.
J Med Case Rep ; 18(1): 138, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38556889

RESUMO

BACKGROUND: To our knowledge, there is no previous report in the literature of non-traumatic neglected complete cervical spine dislocation characterized by anterior spondyloptosis of C4, extreme head drop, and irreducible cervicothoracic kyphosis. CASE PRESENTATION: We report the case of a 33-year-old Caucasian man with a 17-year history of severe immune polymyositis and regular physiotherapy who presented with severe non-reducible kyphosis of the cervicothoracic junction and progressive tetraparesia for several weeks after a physiotherapy session. Radiographs, computed tomography, and magnetic resonance imaging revealed a complete dislocation at the C4-C5 level, with C4 spondyloptosis, kyphotic angulation, spinal cord compression, and severe myelopathy. Due to recent worsening of neurological symptoms, an invasive treatment strategy was indicated. The patient's neurological status and spinal deformity greatly complicated the anesthetic and surgical management, which was planned after extensive multidisciplinary discussion and relied on close collaboration between the orthopedic surgeon and the anesthetist. Regarding anesthesia, difficult airway access was expected due to severe cervical angulation, limited mouth opening, and thyromental distance, with high risk of difficult ventilation and intubation. Patient management was further complicated by a theoretical risk of neurogenic shock, motor and sensory deterioration, instability due to position changes during surgery, and postoperative respiratory failure. Regarding surgery, a multistage approach was carefully planned. After a failed attempt at closed reduction, a three-stage surgical procedure was performed to reduce displacement and stabilize the spine, resulting in correct spinal realignment and fixation. Progressive complete neurological recovery was observed. CONCLUSION: This case illustrates the successful management of a critical situation based on a multidisciplinary collaboration involving radiologists, anesthesiologists, and spine surgeons.


Assuntos
Cifose , Compressão da Medula Espinal , Traumatismos da Coluna Vertebral , Masculino , Humanos , Adulto , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Vértebras Cervicais/lesões , Compressão da Medula Espinal/diagnóstico por imagem , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/cirurgia , Traumatismos da Coluna Vertebral/complicações , Radiografia , Cifose/diagnóstico por imagem , Cifose/etiologia , Cifose/cirurgia
8.
Br J Hosp Med (Lond) ; 85(3): 1-8, 2024 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-38557096

RESUMO

Fractures of the scapula are rare injuries, accounting for 3-5% of all shoulder girdle fractures. They are frequently the result of high energy trauma and often present with concurrent and life-threatening injuries to adjacent structures, leading to significant morbidity and mortality. Patients presenting with scapula fractures must receive a thorough and systematic clinical assessment as directed by national trauma guidelines. Appropriate imaging is essential in delineating fracture morphology and should at the very least include anteroposterior, anteroposterior oblique (Grashey) and axillary or scapula 'Y' view of the shoulder. Computed tomography imaging with three-dimensional reconstruction allows better delineation of the fracture morphology and helps with surgical planning. A lack of randomised controlled trials comparing the efficacy of conservative and operative management of scapula fractures has resulted in limited consensus for surgical indications. Nevertheless, most extra-articular fractures can be managed conservatively while intra-articular fractures of the glenoid frequently require surgical fixation.


Assuntos
Fraturas Ósseas , Fraturas do Ombro , Traumatismos Torácicos , Humanos , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/cirurgia , Escápula/diagnóstico por imagem , Escápula/lesões , Escápula/cirurgia , Ombro , Fixação Interna de Fraturas/métodos , Tomografia Computadorizada por Raios X
9.
J Orthop Surg Res ; 19(1): 211, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38561767

RESUMO

BACKGROUND: Although short-segment posterior spinal fixation (SSPSF) has shown promising clinical outcomes in thoracolumbar burst fractures, the treatment may be prone to a relatively high failure rate. This study aimed to assess the effectiveness of machine learning models (MLMs) in predicting factors associated with treatment failure in thoracolumbar burst fractures treated with SSPSF. METHODS: A retrospective review of 332 consecutive patients with traumatic thoracolumbar burst fractures who underwent SSPSF at our institution between May 2016 and May 2023 was conducted. Patients were categorized into two groups based on treatment outcome (failure or non-failure). Potential risk factors for treatment failure were compared between the groups. Four MLMs, including random forest (RF), logistic regression (LR), support vector machine (SVM), and k-nearest neighborhood (k-NN), were employed to predict treatment failure. Additionally, LR and RF models were used to assess factors associated with treatment failure. RESULTS: Of the 332 included patients, 61.4% were male (n = 204), and treatment failure was observed in 44 patients (13.3%). Logistic regression analysis identified Load Sharing Classification (LSC) score, lack of index level instrumentation, and interpedicular distance (IPD) as factors associated with treatment failure (P < 0.05). All models demonstrated satisfactory performance. RF exhibited the highest accuracy in predicting treatment failure (accuracy = 0.948), followed by SVM (0.933), k-NN (0.927), and LR (0.917). Moreover, the RF model outperformed other models in terms of sensitivity and specificity (sensitivity = 0.863, specificity = 0.959). The area under the curve (AUC) for RF, LR, SVM, and k-NN was 0.911, 0.823, 0.844, and 0.877, respectively. CONCLUSIONS: This study demonstrated the utility of machine learning models in predicting treatment failure in thoracolumbar burst fractures treated with SSPSF. The findings support the potential of MLMs to predict treatment failure in this patient population, offering valuable prognostic information for early intervention and cost savings.


Assuntos
Fraturas por Compressão , Fraturas da Coluna Vertebral , Humanos , Masculino , Feminino , Fixação Interna de Fraturas , Vértebras Lombares/cirurgia , Vértebras Lombares/lesões , Vértebras Torácicas/cirurgia , Vértebras Torácicas/lesões , Fraturas da Coluna Vertebral/cirurgia , Fraturas da Coluna Vertebral/etiologia , Falha de Tratamento , Estudos Retrospectivos , Fraturas por Compressão/etiologia
10.
Ann Med ; 56(1): 2334907, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38599225

RESUMO

This study assessed the knowledge, behavior, and needs of competitive adolescent (16-18 years) distance runners and distance running coaches enrolled as part of England Athletics' Youth Talent Programme in relation to the prevention of running-related injury (RRI). Two online surveys were developed and distributed to the distance runners (survey one) and coaches (survey two). Both surveys included sections related to: (1) current knowledge; (2) current behavior; (3) need and support for RRI prevention measures; and (4) possible content and form of RRI prevention measures. A total of 39 distance runners (36% of total possible sample) completed survey 1, and 29 coaches (32% of total possible sample) completed survey 2. Key findings included that the majority of distance runners and coaches: (1) agreed that it is 'very important' to try to prevent RRI; (2) are currently implementing something in practice (e.g., strength training) to prevent RRI; and (3) view the creation of RRI prevention measures as an important initiative. Differences between distance runners and coaches were identified in relation to their understanding of the most common causes of RRI. Interestingly, distance runners identified a modifiable cause of RRI (i.e., too much training) as the most common cause of RRI, while coaches selected a non-modifiable cause of RRI (i.e., growth and maturation). These key findings were supplemented by competitive adolescent runners and distance running coaches detailing their delivery preferences for such RRI prevention measures. Results from this study will help inform subsequent steps of the larger co-creation process, with an emphasis on developing multifaceted and context-specific RRI prevention measures that are deemed to be feasible and acceptable for real-world implementation.


The majority of competitive adolescent distance runners and distance running coaches who took part in this study agreed that it is 'very important' to try to prevent RRI and view the creation of RRI prevention measures as an important initiative.Alongside this support, interesting differences between the distance runners and coaches were also identified, including, for example: (1) their understanding of the most common causes of RRI and (2) their preferences about where and when to complete RRI prevention measures.Results from this study will help inform subsequent steps of the larger co-creation process, with an emphasis on developing multifaceted and context-specific RRI prevention measures that are deemed to be feasible and acceptable for real-world implementation.


Assuntos
Atletas , Corrida , Humanos , Adolescente , Corrida/lesões , Inquéritos e Questionários , Inglaterra
12.
Sud Med Ekspert ; 67(2): 17-19, 2024.
Artigo em Russo | MEDLINE | ID: mdl-38587153

RESUMO

OBJECTIVE: To examine the applicability of IHC staining method: with TGF-ß1 antibodies (serial examination, statistically processed results) and with mast cell tryptase antibodies for injuries vitality determination. MATERIAL AND METHODS: 261 skin autopsy samples with mechanical injuries from 29 persons were divided to 3 groups (87 in each group): vital injuries, postmortal injuries, control non-injured samples. A routine histological examination using standard H&E stain and IHC both with TGF-ß1 and mast cells tryptase antibodies was performed. RESULTS AND CONCLUSION: The positive TGF-ß1 staining (score 2-3) was found in keratinocytes in vitally injured skin and the negative or weak one (score 0-1) was found in control postmortally injured and non-injured samples. Additionally, dermal TGF-ß1 expression was found in some vitally injured skin samples. The difference between vitally injured skin and control samples was statistically significant (p<0.05). No significant difference of dermal mast cells density in groups 1, 2, 3 was found.


Assuntos
Lesões dos Tecidos Moles , Fator de Crescimento Transformador beta1 , Humanos , Fator de Crescimento Transformador beta1/metabolismo , Pele/lesões , Autopsia
13.
BMC Musculoskelet Disord ; 25(1): 270, 2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38589862

RESUMO

BACKGROUND: Fractures of hands and feet are common in children, but relevant epidemiological studies are currently lacking. We aim to study the epidemiological characteristics of hand and foot fractures and growth plate injuries in children and provide a theoretical basis for their prevention, diagnosis, and treatment. METHODS: We retrospectively analyzed the data of children with hand and foot fractures who were hospitalized at Shenzhen Children's Hospital between July 2015 and December 2020. Data on demographic characteristics, fracture site, treatment method, etiology of injury, and accompanying injuries were collected. The children were divided into four age groups: infants, preschool children, school children, and adolescents. The fracture sites were classified as first-level (the first-fifth finger/toe, metacarpal, metatarsal, carpal, and tarsal) and second-level (the first-fifth: proximal phalanx, middle phalanx, distal phalanx, metacarpal, and metatarsal) sites. The changing trends in fracture locations and injury causes among children in each age group were analyzed. RESULTS: Overall, 1301 children (1561 fractures; 835 boys and 466 girls) were included. The largest number of fractures occurred in preschool children (n = 549, 42.20%), with the distal phalanx of the third finger being the most common site (n = 73, 15.57%). The number of fractures in adolescents was the lowest (n = 158, 12.14%), and the most common fracture site was the proximal phalanx of the fifth finger (n = 45, 29.61%). Of the 1561 fractures, 1143 occurred in the hands and 418 in the feet. The most and least common first-level fracture sites among hand fractures were the fifth (n = 300, 26.25%) and first (n = 138, 12.07%) fingers, respectively. The most and least common first-level foot fracture locations were the first (n = 83, 19.86%) and fourth (n = 26, 6.22%) toes, respectively. The most common first-level and second level etiologies were life related injuries (n = 1128, 86.70%) and clipping injuries (n = 428, 32.90%), respectively. The incidence of sports injuries gradually increased with age, accounting for the highest proportion in adolescents (26.58%). Hand and foot fractures had many accompanying injuries, with the top three being nail bed injuries (570 cases, 36.52%), growth plate injuries (296 cases, 18.96%), and distal severed fracture (167 cases, 10.70%). Among the 296 growth plate injuries, 246 occurred on the hands and 50 on the feet. CONCLUSIONS: In contrast to previous epidemiological studies on pediatric hand and foot fractures, we mapped the locations of these fractures, including proximal, shaft, distal, and epiphyseal plate injuries. We analyzed the changing trends in fracture sites and injury etiologies with age. Hand and foot fractures have many accompanying injuries that require attention during diagnosis and treatment. Doctors should formulate accident protection measures for children of different ages, strengthen safety education, and reduce the occurrence of accidental injuries.


Assuntos
Traumatismos do Pé , Fraturas Ósseas , Traumatismos da Mão , Ossos Metacarpais , Fraturas Salter-Harris , Masculino , Pré-Escolar , Lactente , Feminino , Adolescente , Criança , Humanos , Estudos Retrospectivos , Fraturas Salter-Harris/complicações , Fraturas Ósseas/epidemiologia , Fraturas Ósseas/etiologia , Fraturas Ósseas/diagnóstico , Traumatismos da Mão/epidemiologia , Traumatismos da Mão/etiologia , Traumatismos da Mão/terapia , Ossos Metacarpais/lesões , Traumatismos do Pé/epidemiologia , Traumatismos do Pé/etiologia , Traumatismos do Pé/terapia
14.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 42(2): 249-255, 2024 Apr 01.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-38597085

RESUMO

Complicated crown root fracture is a serious combined fracture of the enamel, dentin, and cementum in dental trauma. The treatment method is complicated. During the procedure, the condition of pulp, periodontal, and tooth body should be thoroughly evaluated, and a multidisciplinary approach combined with sequential treatment is recommended. This case reported the different treatment and repair processes of one case of two affected teeth after complicated crown root fracture of upper anterior teeth, including regrafting of broken crown after flap surgery at the first visit, direct resin repair to remove broken fragments, and pulp treatment and post-crown repair at the second visit. After 18 months of follow-up, the preservation treatment of the affected teeth with complicated crown root fracture was achieved. Therefore, fragment reattachment and post-crown restoration are feasible treatment options for children with complicated crown root fracture.


Assuntos
Fraturas dos Dentes , Raiz Dentária , Criança , Humanos , Incisivo/lesões , Coroa do Dente/lesões , Fraturas dos Dentes/terapia , Exposição da Polpa Dentária/terapia , Coroas
15.
PLoS One ; 19(4): e0298870, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38564629

RESUMO

Physical fitness (PF) includes various factors that significantly impacts athletic performance. Analyzing PF is critical in developing customized training methods for athletes based on the sports in which they compete. Previous approaches to analyzing PF have relied on statistical or machine learning algorithms that focus on predicting athlete injury or performance. In this study, six machine learning algorithms were used to analyze the PF of 1,489 male adolescent athletes across five sports, including track & field, football, baseball, swimming, and badminton. Furthermore, the machine learning models were utilized to analyze the essential elements of PF using feature importance of XGBoost, and SHAP values. As a result, XGBoost represents the highest performance, with an average accuracy of 90.14, an area under the curve of 0.86, and F1-score of 0.87, demonstrating the similarity between the sports. Feature importance of XGBoost, and SHAP value provided a quantitative assessment of the relative importance of PF in sports by comparing two sports within each of the five sports. This analysis is expected to be useful in analyzing the essential PF elements of athletes in various sports and recommending personalized exercise methods accordingly.


Assuntos
Traumatismos em Atletas , Futebol Americano , Humanos , Masculino , Adolescente , Atletas , Futebol Americano/lesões , Natação , Aptidão Física
16.
J Vet Sci ; 25(2): e22, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38568824

RESUMO

BACKGROUND: Achilles tendon is composed of dense connective tissue and is one of the largest tendons in the body. In veterinary medicine, acute ruptures are associated with impact injury or sharp trauma. Healing of the ruptured tendon is challenging because of poor blood and nerve supply as well as the residual cell population. Platelet-rich plasma (PRP) contains numerous bioactive agents and growth factors and has been utilized to promote healing in bone, soft tissue, and tendons. OBJECTIVE: The purpose of this study was to evaluate the healing effect of PRP injected into the surrounding fascia of the Achilles tendon after allograft in rabbits. METHODS: Donor rabbits (n = 8) were anesthetized and 16 lateral gastrocnemius tendons were fully transected bilaterally. Transected tendons were decellularized and stored at -80°C prior to allograft. The allograft was placed on the partially transected medial gastrocnemius tendon in the left hindlimb of 16 rabbits. The allograft PRP group (n = 8) had 0.3 mL of PRP administered in the tendon and the allograft control group (n = 8) did not receive any treatment. After 8 weeks, rabbits were euthanatized and allograft tendons were transected for macroscopic, biomechanical, and histological assessment. RESULTS: The allograft PRP group exhibited superior macroscopic assessment scores, greater tensile strength, and a histologically enhanced healing process compared to those in the allograft control group. CONCLUSIONS: Our results suggest administration of PRP on an allograft tendon has a positive effect on the healing process in a ruptured Achilles tendon.


Assuntos
Tendão do Calcâneo , Plasma Rico em Plaquetas , Traumatismos dos Tendões , Coelhos , Animais , Tendão do Calcâneo/cirurgia , Tendão do Calcâneo/lesões , Tendão do Calcâneo/patologia , Traumatismos dos Tendões/terapia , Traumatismos dos Tendões/veterinária , Traumatismos dos Tendões/patologia , Cicatrização , Aloenxertos/patologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-38569093

RESUMO

Patellar tendon ruptures can be debilitating injuries. When incomplete, partial tears can be managed nonsurgically with immobilization and progressive rehabilitation. Although complete ruptures remain a relatively uncommon injury, they portend a high level of morbidity. Ruptures typically result from an acute mechanical overload to the extensor mechanism, such as with forced quadriceps contraction and knee flexion. However, chronically degenerated tendons are also predisposed to failure from low-energy injuries. Diagnosis can often be made clinically with recognition of a palpable defect to the tendon, localized patellar tendon tenderness, and inability to actively extend the knee. Diagnosis and surgical planning can be established with radiograph, ultrasonography, or magnetic resonance imaging. Surgical repair is the mainstay of treatment, and there have been many recent advances in repair technique, optimal reconstruction strategies, and supplemental fixation. Time to surgery for complete tears remains the most important prognosticator for success. Direct primary repair can be completed with transosseous tunnels, suture anchor repair, or end-to-end repair. Tendon reconstruction can be achieved with or without mechanical or biologic augments. Rehabilitation programs vary in specifics, but return to sport can be expected by 6 months postoperatively.


Assuntos
Traumatismos do Joelho , Ligamento Patelar , Traumatismos dos Tendões , Humanos , Ligamento Patelar/diagnóstico por imagem , Ligamento Patelar/cirurgia , Ligamento Patelar/lesões , Traumatismos dos Tendões/diagnóstico por imagem , Traumatismos dos Tendões/cirurgia , Traumatismos do Joelho/diagnóstico por imagem , Traumatismos do Joelho/cirurgia , Tendões/cirurgia , Ruptura/cirurgia
18.
BMC Musculoskelet Disord ; 25(1): 262, 2024 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-38570760

RESUMO

BACKGROUND: Radiculopathy of the lower limb after acute osteoporotic vertebral fractures (OVFs) in the lower lumbar spine is uncommon in geriatric patients. Moreover, surgical intervention is generally recommended in patients who are irresponsive to conservative treatment. Determining an optimum surgical strategy is challenging considering the poor general condition of this population. Thus, herein, we established an algorithm for surgically managing this clinical scenario, hoping to provide a reference for making a surgical decision. METHODS: We retrospectively studied patients who suffered from new-onset radiculopathy of the lower limb after acute single-level OVFs in the lower lumbar spine and eventually underwent surgical intervention at our department. Information on the demographics, bone quality, AO spine classification of the vertebral fracture, pre-existing degenerative changes, including foraminal stenosis and lumbar disc herniation, and surgical intervention type was collected. Additionally, clinical outcomes, including preoperative and postoperative visual analog scale (VAS) scores for back and leg pain, Oswestry disability index (ODI), and MacNab criterion for response to surgery, were evaluated. RESULTS: From September 2019 to December 2021, a total of 22 patients with a mean age of 68.59 ± 9.74 years were analyzed. The most involved vertebra was L5 (54.5%), followed by L4 (27.3%) and L3 (18.2%). Among the 22 patients, 15 (68.2%) were diagnosed with the A1 type fracture of AO classification, and among them, 11 (73.3%) were characterized by the collapse of the inferior end plate (IEP). Three patients (13.6%) suffered from A2-type fractures, whereas four patients (18.2%) suffered from A3-type fractures. Pre-existing degenerative changes were observed in 12 patients (54.5%) of the patients. A total of 16 patients (72.7%) were treated by percutaneous kyphoplasty (PKP). Additionally, three patients underwent posterior instrumentation and fusion, two patients underwent a secondary endoscopic foraminoplasty, and one patient underwent a secondary radiofrequency ablation. The mean follow-up period was 17.42 ± 9.62 months. The mean VAS scores for leg and back pain and ODI decreased significantly after the surgery (P < 0.05). The total satisfaction rate at the last follow-up was 90.9% per the Macnab criterion. CONCLUSION: Patients with OVFs in the IEP are predisposed to suffer from radiculopathy of the lower limb. PKP alone or in combination with other minimally invasive surgical strategies is safe and effective in treating stable fractures. Additionally, aggressive surgical intervention should be considered in patients with unstable fractures or severe foraminal encroachment.


Assuntos
Fraturas por Compressão , Cifoplastia , Fraturas por Osteoporose , Radiculopatia , Fraturas da Coluna Vertebral , Humanos , Idoso , Pessoa de Meia-Idade , Estudos Retrospectivos , Fraturas da Coluna Vertebral/complicações , Fraturas da Coluna Vertebral/diagnóstico por imagem , Radiculopatia/diagnóstico por imagem , Radiculopatia/etiologia , Radiculopatia/cirurgia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Vértebras Lombares/lesões , Perna (Membro) , Fraturas por Osteoporose/diagnóstico por imagem , Fraturas por Osteoporose/cirurgia , Resultado do Tratamento , Fraturas por Compressão/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...