Trauma
High failure rate seen after some ACL repairs
Anterior cruciate ligament (ACL) reconstruction using a replacement ligament from a cadaver has a high failure rate in young, active adults, according to a study reported Thursday at the American Orthopaedic Society for Sports Medicine conference in Orlando, Florida.
The ACL is a key ligament inside the knee that helps keep it stable. Located in the center of the knee joint, it runs from the thigh bone to the shin bone through the center of the knee. Typically, tearing the ACL occurs with a sudden direction change. To repair a torn ACL, a surgeon replaces the damaged ligament with a new one, either from a cadaver or the patient’s own body.
Among 64 patients younger than age 40 with high activity levels who had ACL reconstruction with a cadaver replacement ligament and were followed for a minimum of 2 years, the grafted ligament failed in 15 (23.4 percent). Graft failure was defined as need for repeat ACL reconstruction due to injury or graft failure or poor scores on a combination of orthopaedic outcome measures.
Oily fish can protect against RA, but smoking and psychosocial stress increase its risk
Paris, France, Friday 13 June 2008: New data presented today at EULAR 2008, the Annual Congress of the European League Against Rheumatism in Paris, France, show that intake of oily fish is associated with a reduced risk of developing rheumatoid arthritis (RA), whereas psychosocial work stress and smoking can increase the risk of developing the condition. The findings, all taken from a large population-based case-control study in Sweden called EIRA (Epidemiological Investigation of Rheumatoid Arthritis), shed light on the important role of environmental and social factors in the development of RA.
Intake of Oily Fish
For the first time, the intake of oily fish has been demonstrated to have a protective effect against the development of RA, reducing an individual’s risk by 20-30%. Studying 1,899 subjects with a confirmed diagnosis of RA (fulfilling ACR criteria) and 2,145 controls (randomly selected and matched for age, sex and residential area), investigators concluded that the odds ratio (OR) for developing RA was 0.8 (0.7-1.0) for those who consumed oily fish 1-7 times per week or 1-3 times per month, compared with those who never, or seldom consumed oily fish. Interestingly, no significant association with RA risk was observed for consumption of fish oil supplements.
Ways to Avoid Summer Sports Injuries
During the summer months, thousands of facial injuries occur to people of all ages. Dr. Anthony Brissett, facial plastic and reconstructive surgeon at The Methodist Hospital in Houston, says taking some basic precautions can minimize long lasting facial injuries, prevent costly medical problems and allow people to enjoy the summer injury-free.
Q: What are the main head and neck injuries you see?
A: I see a lot of patients with facial injuries, anything from lacerations to facial fractures such as broken cheek bones and noses. Whether the injuries are from baseball, basketball, bike riding, swimming or just outdoor fun, I’ve seen them all.
Q: How do you treat these kinds of facial injuries?
China girl’s legs amputated to free her from rubble
Chinese doctors amputated a teenage girl’s crushed legs on Thursday, the only way they could pull her alive from the wreckage of her school three days after an earthquake flattened swathes of the country’s southwest.
Yang Liu was trapped in what appeared to be a doorway by Monday’s massive 7.9 magnitude quake, near the top of a massive pile of bricks and concrete.
Her position likely saved her life.
Childhood Pain Trauma Unlikely Link to Adult Chronic Pain
Though some adults with chronic pain often say they experienced an adverse event in childhood (such as abuse), these events are no more common than amongst adults who are pain free, according to research presented today at the American Pain Society annual meeting.
In his plenary session address, Gary Macfarlane, MD, professor of epidemiology at University of Aberdeen (Scotland) School of Medicine, said that some pain patients hold perceptions that their pain stems from an adverse event in childhood and they more commonly remember such events.
Each finger can be moved separately
A new prosthetic hand is being tested at the Orthopedic University Hospital in Heidelberg / Grip function almost like a natural hand
It can hold a credit card, use a keyboard with the index finger, and lift a bag weighing up to 20 kg – the world’s first commercially available pros-thetic hand that can move each finger separately and has an astounding range of grip configurations. For the first time worldwide a patient at the Orthopedic University Hospital in Heidelberg has tested both the “i-LIMB” hand in comparison with another innovative prosthesis, the so called ”Flu-idhand”. Eighteen-year-old Sören Wolf, who was born with only one hand, is enthusiastic about its capabilities.
Young Athletes Paying to Play?
Soccer, football, baseball, tennis, gymnastics. Today the number of activities available to the young athlete serves up a smorgasbord of choices. “College-bound teenagers in the United States and around the world are way more active than ever before,” said Col. Tom DeBerardino, MD, the Sports Medicine Fellowship Director at Keller Army Hospital in West Point, N.Y.
“These days it seems in order to be a well-rounded student and gain admission into a good college, participating in at least one or even two extracurricular sports is a must on almost every student’s ‘to do’ list. However, increased exposure to sporting activities translates into increased risk of injuries sustained by these young student athletes,” Dr. DeBerardino noted. “Fortunately, operations and procedures to fix many of these problems are now good, too.”
Dr. DeBerardino cited the following statistics on newly arriving cadets at West Point:
• In 1998, 10 to 12 cadets reported having major reconstructive shoulder surgery
before college.
• By 2008, at least 50 cadets had already had this surgery before arriving on campus.
Many can return to sport after hamstring surgery
Surgical repair of a ruptured hamstring offers the most promise for individuals who want to return to high or full activity levels, researchers report.
Individuals who have suffered a hamstring detachment may “feel a pop in the buttock area that is followed by bruising over the posterior thigh and knee,” Dr. Christopher M. Larson told Reuters Health.
Rehabilitation alone may result in persistent weakness, poor leg control, and difficulty returning to higher levels of activity. By contrast, surgery results in improved strength and a high return to sports, said Larson, of the Minnesota Sports Medicine Orthopaedic Sports Medicine Fellowship, in Eden Prairie.
High-trauma fractures in older adults linked to osteoporosis, increased risk of another fracture
Contrary to a widely held assumption, high-trauma nonspine fractures in older women and men, such as from a car crash, are associated with low bone mineral density and an increased risk of a subsequent fracture, according to a study in the November 28 issue of JAMA. These findings suggest that older adults who experience these fractures should be evaluated for osteoporosis.
УЕ it is widely believed, without supporting evidence, that high-trauma fractures [those resulting from motor vehicle crashes or falls from greater than standing height] are not related to low bone mineral density (BMD) or subsequent fracture risk and therefore are presumed not to be manifestations of osteoporosis,Ф the authors write. They add that these beliefs have several consequences, including the clinical opinions that an older adult who has a high-trauma fracture does not require evaluation for osteoporosis, and that high-trauma fractures cannot be prevented by osteoporosis treatments that increase BMD and bone strength.
Fewer soldiers losing limbs after battlefield injury
In previous wars, battlefield surgeons often had to take the limb of a soldier with a bleeding leg or arm wound in order to save his life, but now with advances in vascular surgery, lives can often be saved without sacrificing a limb, a new study indicates.
“The purpose of our study was to show that with the proper resuscitation strategy, you have the option of saving the limb,” lead researcher Dr. Charles J. Fox, from the Walter Reed Army Medical Center in Washington, DC, told Reuters Health.
Obesity Increases Risk of Injury on the Job
Having a body mass index (BMI) in the overweight or obese range increases the risk of traumatic workplace injury, according to researchers at the Johns Hopkins Bloomberg School of Public Health’s Center for Injury Research and Policy. Employer-sponsored weight loss and maintenance programs should be considered as part of a well-rounded workplace safety plan. The study was Advance Access published on May 7, 2007, by the American Journal of Epidemiology.
BMI is a measure of body fat based on an adult’s height and weight. It is used to screen for weight categories that may lead to health problems. According to the Centers for Disease Control and Prevention, a BMI below 18.5 is considered underweight, 18.5–24.9 is normal; 25–29.9 is overweight and over 30 is obese.
Pediatricians and pathologists see traumatic brain injury differently
Confronted with the same hypothetical scenarios of traumatic brain injuries to children, pediatricians and pathologists were unable to agree half the time whether the deaths should be investigated as potential child abuse, researchers at Indiana University School of Medicine found.
The study demonstrates the need for improved, uniform definitions if research is to prevent such abuse, said Antoinette Laskey, M.D., M.P.H., a forensic pediatrician and assistant professor of pediatrics at the Indiana University School of Medicine, and her colleagues. They reported on their efforts to develop a framework to help researchers compare cases in the April issue of the journal Child Abuse and Neglect.
Kids with head injury apt to have another
Children who suffer a head injury are quite likely to have a similar injury subsequently, researchers report.
“We do not really understand the mechanism behind repetitive head injuries in children,” Dr. Bonnie R. Swaine, of the University of Montreal, Canada, told Reuters Health. “These results support anecdotal evidence of the phenomenon.”
Impact of Brain Injury on Family Members
After a traumatic brain injury medical professionals tend to focus on the patient but research shows a great impact on family members as well. Studies in the 1970s began to recognize these issues, while other work in the 1980s documented emotional distress that persisted for up to seven years and many studies in the 1990s identified tremendous levels of stress on caregivers and family members. The special April issue of the journal NeuroRehabilitation sheds light on the substantial advances in the science of family member and caregiver research with six special articles by experts in the field, exploring ways in which interventions can be targeted for optimum effectiveness.
In spite of growing evidence of family/caregiver distress after injury, developing appropriate intervention strategies to help families and caregivers has lagged behind.
Teenagers with retail, service jobs at risk of injury, robberies, sleep deprivation
Despite federal regulations intended to protect them, many teenagers in the U.S. use dangerous equipment or work long hours during the school week, according to a University of North Carolina at Chapel Hill study.
The national study was based on telephone surveys of 928 teenaged workers, 14 to 18 years old. The results show 52 percent of males and 43 percent of females use dangerous equipment such a box crushers and slicers, or serve and sell alcohol where it is consumed, despite federal child labor laws prohibiting these practices.
The results were published in the March 1, 2007 editor of the journal Pediatrics.
