Incidence and Risk Factors for Upper Extremity Climbing Injuries in Indoor Climbers.

The purpose of this study was to describe the prevalence, incidence and risk factors for climbing-related injuries of the upper extremities in recreational climbers. A total of 426 recreational climbers were recruited from indoor climbing halls. The baseline questionnaire included questions on potential risk factors for climbing injuries: personal factors, climbing-related factors and upper extremity injuries that had occurred in the previous 12 months. Follow-up questionnaires collected information on new injuries that occurred during the follow-up period. The incidence of climbing-related injuries during one-year follow-up was 42.4% with 13 injuries per 1000 h of climbing. The finger was the most frequently affected injury location (36.0%). The following risk factors were associated with the occurrence of upper extremity injuries: higher age (OR 1.03, 95% CI 1.01;1.05), performing a cooling-down (OR 2.02, 95% CI 1.28;3.18), climbing with campus board (OR 2.48, 95% CI 1.23;5.02), finger strength middle finger (OR 1.12, 95% CI 1.05;1.18) and previous injuries (OR 3.05, 95% CI 2.01;4.83). Climbing injuries of the upper body extremities are very common among recreational climbers in indoor halls and several risk factors can be identified that are related to a higher injury risk.

[Arm injuries due to sport climbing]. / Blessures aan de arm bij sportklimmers.

There are 26 large climbing centres and 44 smaller indoor or outdoor climbing walls in The Netherlands at this time. Hand and finger injuries are the most common types of sport climbing injuries. Most injuries are caused by overstraining. Injuries include avulsion fractures, arthrosis, pulley rupture, damage to joint capsule and collateral ligaments, 'gamekeeper's thumb', 'climber's finger', lumbrical shift syndrome, 'climber's elbow', shoulder injuries and nerve compression syndromes. Treatment is usually conservative. Depending on the extent of damage surgical intervention may be indicated.

[Septic arthritis after intra-articular injection is rare: does the Taskforce Infection Prevention use a sledgehammer to crack a nut?] / Septische artritis na gewrichtspunctie is zeldzaam.

OBJECTIVE: To determine the incidence of septic arthritis (SA) after a joint puncture and reconsider the value of the hygiene measures stipulated by the Taskforce Infection Prevention (TIF). DESIGN: Prospective study. METHOD: We determined the number of joint punctures among general practitioners and specialists in the Apeldoorn area during a three-month period (from October 1, 2013 to December 31, 2013). Secondly, we performed an analysis on the incidence of SAs in this period and the subsequent month, and ascertained if these were related to a joint puncture. Finally, we conducted a retrospective analysis on joint puncture related SA during the period January 2008 - December 2013. This was executed to determine whether our results were representative. RESULTS: The incidence of SA after a joint puncture was 1 in 27,000. CONCLUSION: The incidence of SA after a joint puncture can be considered low. Due to the low baseline incidence, we anticipate that it is unlikely that the prescriptive measures outlined by TIF will lead to a cost-effective reduction in incidence of SA.

Haemobilia 2 weeks after a low thoracic stab wound.

BACKGROUND: Haemobilia occurs in only 1.2-5% of patients with accidental liver trauma. We describe an unusual case 2 weeks after penetrating thoracic injury. CASE OUTLINE: A 27-year-old man underwent laparotomy for hepatic bleeding after a low thoracic stab wound. Two weeks later rectal blood loss occurred. CT scan and angiography revealed intrahepatic contrast extravasation at the previous stab wound site. Coils were successfully placed into two branches of the right hepatic artery. DISCUSSION: Haemobilia should be considered in patients presenting with gastrointestinal blood loss after liver injury. It is diagnosed with angiography and preferably treated by embolisation.