[A NOVEL GENDER-SPECIFIC VEST FOR FEMALE INFANTRY RECRUITS DOES NOT REDUCE THE INCIDENCE OF OVERUSE PAIN SYNDROMES: A PROSPECTIVE RANDOMIZED STUDY AMONG 240 RECRUITS].

INTRODUCTION: Overuse pain syndromes constitute a troublesome byproduct of military infantry training, particularly in female fighters. These injuries result in lost days of training, pain and discomfort and can affect fitness and fighting abilities. We hypothesized that a gender specific vest would reduce the incidence of overuse pain syndromes in a population of female recruits during basic training. OBJECTIVE: The purpose of this study was therefore to examine the effect of a novel gender-specific combat vest on the incidence of lower back pain (LBP), anterior knee pain syndrome (AKPS), and plantar heel foot pain (PHFP) among female recruits. MATERIAL AND METHODS: A prospective randomized study was conducted among 243 female border police infantry recruits who were followed over 4-months of basic training. In this group, 101 females were equipped with standard unisex special unit fighting vest (SUFV) and compared to 139 females who were equipped with a novel well-padded new fighting vest (NFV), specifically designed to fit the upper body morphology of females. This novel vest was supplied in three sizes, and equipped with adjustable straps. Information regarding the occurrence of overuse injuries was collected every two weeks. Medical records and clinic visits were evaluated. Attention was given to complaints of low back pain (LBP), anterior knee pain (AKP) and plantar heel foot pain (PHFP). RESULTS: Two hundred and forty recruits completed the study. Three recruits were lost to follow-up. Anterior knee pain was recorded in 65% of recruits in the SUFV group versus 62% in the NFV group (p = ns). Lower back pain was recorded in 86% of the SUFV group versus 82% in the NFV group (p = ns), and plantar heel foot pain was recorded in 73% of the SUFV group versus 69% in the NFV group (p = ns). DISCUSSION: Overuse pain injuries are more commonly reported among female fighters. These injuries result in lost days of training, pain and discomfort and can affect combat ability. Several researchers have found that changes in fighting equipment, such as size and weight, can affect the rates of these injuries. There is still a lack of information regarding changes related to gender-based fighting equipment and their effects. CONCLUSION: A gender-specific combat vest, designed to fit the upper female body, did not have any protective effect on the occurrence of overuse pain syndromes of the back, knee and foot in this study. It seems that in order to reduce the incidence of these injuries in female recruits, emphasis should be directed at other factors such as modifications in equipment weight, as well as modifications in the intensity of the training programs.

A rare complication of a rare pediatric injury: Transient drop foot following a floating knee injury.

Floating Knee is a rare injury caused by high velocity, and has rarely been described in children. The purpose of this report is to present a case of a six-year-old female after a fall down three and a half flights of stairs, suffering from this rare injury and a rare complication, and her rehabilitation. She suffered fractures of the femur and tibia (Floating Knee type), and was operated on the day of the injury with closed reduction and internal fixation (CRIF). Following the operation, painful drop-foot was evident, related to the fractured bone pressure on the sciatic nerve and a very high level of anxiety. The patient was transferred to a rehabilitation hospital, where she received a total of about 350 physical therapy, hydrotherapy, psychology and occupational therapy treatments over a period of one year. Treatment also consisted of an ankle-foot orthosis (AFO) and transcutaneous electrical stimulation, and were assisted with examinations at the motion analysis laboratory using surface electromyography. The combined orthopedic and physical therapy treatment, and cooperation with psychology in the intervention and training for the care team, enabled achievement of all rehabilitation goals. The patient returned to a high functional level and full participation in daily life activities with her peers, without the need for the AFO or further treatment in the community. A re-examination after about six months showed continued functional improvement according to objective indicators. This case raises awareness of rare injuries and complications in pediatric orthopedic patients, that require multidisciplinary rehabilitation treatment and cooperation between the surgical and rehabilitation teams. Closed injury of the sciatic nerve can be followed for a long period without additional invasive studies or formal nerve exploration, and complete recovery can be achieved.

Does capsular closure influence patient-reported outcomes in hip arthroscopy for femoroacetabular impingement and labral tear?

Capsulotomy is necessary to facilitate instrument manoeuvrability within the joint capsule in many arthroscopic hip surgical procedures. In cases where a clear indication for capsular closure does not exist, surgeon's preference and experience often determines capsular management. The purpose of this study was to assess the influence of capsular closure on clinical outcome scores and satisfaction in patients who underwent hip arthroscopy surgery for femoroacetabular impingement (FAI) and labral tear. Data were prospectively collected and retrospectively analysed for hip arthroscopy surgeries with a minimum 2 years follow-up. Patients with developmental dysplasia of the hip, previous back or hip surgeries, and degenerative changes to this hip and secondary gains were excluded. Demographic data, intraoperative findings and patient-reported outcome scores were recorded, including the Modified Harris Hip Score (MHHS) and Hip Outcome Score (HOS). A total of 29 and 35 patients were included in the non-closure and closure groups, respectively. The mean follow-up time was over 3 years for both groups. The mean pre-operative and post-operative HOS scores and MHHS scores did not significantly differ between groups (pre-operative HOS: 65.6 and 66.3, P = 0.898; post-operative HOS: 85.4 and 87.2, P = 0.718; pre-operative MHHS: 63.2 and 58.4, P = 0.223; post-operative MHHS: 85.7 and 88.7, P = 0.510). Overall patient satisfaction did not differ significantly between groups (non-closure 86.3%, closure group 88.6%; P = 0.672). Capsular closure did not significantly influence satisfaction or clinical outcome scores in patients who underwent arthroscopic hip surgery for FAI or labral tear.