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Background: Ulnar collateral ligament (UCL) injuries are a source of significant injury among baseball players, and are increasingly evaluated under ultrasound. The purpose of this study is to determine the effect of a single session of pitching upon UCL thickness and laxity via a cross sectional, controlled ultrasonographic study. We hypothesize that a single session of pitching will cause the ulnar collateral ligament to thicken and become more lax., Methods: This was a cross sectional comparative study of collegiate and high school pitchers. Pitchers underwent an ultrasonographic assessment of the UCL before and after a thirty-pitch bullpen warm-up. Laxity was measured as the change in the distance between the ulna and the trochlea with and without a 5-pound weight held in hand with the elbow at 30° of flexion. Pre- and post-throwing UCL thickness and medial laxity were statistically compared with paired tests., Results: Our study included 15 pitchers, 8 collegiate and 7 high school level athletes. All played baseball at least 6 days a week, and nearly all played for at least 10 months a year. Pitchers reported a peak velocity of 89 ± 6 (77 to 98) miles per hour. In the prior season, these pitchers pitched 56 ± 33 (10 to 120) games, throwing 62 ± 34 (25-140) pitches per game on average. After throwing, there was significantly less UCL laxity (P = .013). Post-throwing laxity was significantly positively correlated with both peak pitch velocity (P = .009) and an average number of pitches thrown per game (P = .10)., Conclusion: Throwing 30 pitches significantly decreases medial elbow laxity with stress, possibly due to flexor-pronator activation. Post-throwing medial laxity is correlated with both peak pitch velocity and average number of pitches thrown per game. Future studies should be conducted to determine the number of throws at which laxity begins to increase, as this may provide a workload management guideline for injury prevention., (Copyright © 2023 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)

Background: Overhead throwing in baseball and softball athletes induces shoulder adaptations theorized to increase risk of shoulder musculoskeletal injury (MSI) and/or pain due to range of motion (ROM) deficits., Hypothesis: Shoulder ROM adaptations are associated with a higher risk for developing shoulder MSI and pain., Study Design: Prospective cohort study., Level of Evidence: Level 3., Methods: A total of 60 National Collegiate Athletic Association Division I athletes cleared for full athletic participation and free from upper extremity MSI in the last 4 weeks (age, 19.0 ± 1.2 years; weight, 82.1 ± 13.7 kg; height, 178.6 ± 11.2 cm; softball, n = 23; baseball, n = 37). Passive glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HA) ROM were measured with the scapula stabilized and used to categorize participants with/without external rotation gain (ERG), external rotation insufficiency (ERI), glenohumeral internal rotation deficit (GIRD), pathological GIRD, and posterior shoulder tightness (PST) before the competitive season. Groups were then compared to assess the incidence of shoulder MSI prospectively and prevalence of shoulder pain at the initial evaluation., Results: Baseball and softball athletes demonstrated significantly less IR ROM in the dominant shoulder (50.6° ± 9.4°) compared with the nondominant shoulder (59.1° ± 8.6°; P < 0.01) and significantly more ER ROM (dominant, 104.6° ± 12.1°; nondominant, 97.7° ± 12.0°; P < 0.01). Incidence of shoulder MSI was 15% but was not significantly related to any shoulder adaptations. No significant relationship was found between prevalence of pain and any shoulder adaptations in the 27% of athletes with pain., Conclusion: Increased ER and decreased IR ROM adaptations in intercollegiate overhead throwing athletes do not appear to be correlated to risk of shoulder MSI or pain., Clinical Relevance: The findings of this level 3 prospective study provide clinicians working with overhead athletes information regarding shoulder MSI risk and pain. It is recommended that clinicians should not use ROM adaptations exclusively to determine increased risk of shoulder MSI., Competing Interests: The authors report no potential conflicts of interest in the development and publication of this article

Background: A large proportion of United States (U.S.) youth play basketball, baseball, softball, or T-ball. Each of the activities poses a documented risk of craniofacial and neck injuries. However, few studies have assessed the national prevalence of pediatric craniofacial and neck injuries in this population, particularly following the COVID-19 pandemic., Methods: The National Electronic Injury Surveillance System (NEISS) dataset was used to identify pediatric craniofacial and neck injuries associated with basketball, baseball, softball, or T-ball from 2003-2022 in a cross-sectional study. The annual number of injuries before and after the onset of the COVID-19 pandemic with 95% confidence intervals were calculated. Interrupted time series analysis (ITSA) was used to estimate the pandemic's impact on the monthly number of injuries incurred nationally., Results: Both overall and stratified by sport involvement, the annual number and rate of injuries identified in NEISS decreased significantly after the COVID-19 pandemic. ITSA demonstrated that the monthly number of injuries decreased -4094.4 (95% CI = -5100, -3088.7) immediately after the beginning of the pandemic. The number of injuries began increasing towards pre-pandemic levels at a rate of 110.6 (95% CI = 64, 157.2) injuries per month after the initial plunge., Conclusion: Prior to the-pandemic, there was a steady decline in craniofacial and neck injuries due to basketball, baseball, softball and T-ball among children, aged <18 years. The shutdown during the initial months of the COVID-19 pandemic resulted in a precipitous drop in such injuries. Current rates are approaching pre-pandemic levels and may exceed them. Continued efforts are needed to keep the pre-pandemic progress., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Wiener, Lundstrom. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Increase in youth sports participation, longer duration of play, and earlier starting points have increased the prevalence of acute and repetitive overuse musculoskeletal injuries. This rise in injury rates has led to increased efforts to better understand the susceptible sites of injury that are unique to the growing immature skeleton. Upper extremity injuries are currently the best studied, particularly those that occur among pediatric baseball players and gymnasts. The weak link in skeletally immature athletes is the growth plate complex that includes those injuries located at the epiphyseal and apophyseal primary physes and the peripherally located secondary physes. This article reviews the anatomy and function of these growth plate complexes, followed by a discussion of the pathophysiologic mechanisms, spectrum of imaging findings, and existing evidence-based guidelines for injury prevention and return to play., Competing Interests: None declared., (Thieme. All rights reserved.)

Background: In baseball players with elbow injuries, towel drills are clinically used before initiating active throwing exercises to gradually increase stress across the elbow. However, elbow valgus torque during towel drills remains unknown. Moreover, towel drills and active ball throws might have different relationships between biomechanical metrics, such as elbow stress, arm slot, and arm speed. Therefore, the aims of this study were 1) to demonstrate the difference in elbow valgus stress between towel drills and active ball throws and 2) to evaluate the correlation between elbow valgus torque and other biomechanical metrics including arm slot and arm speed in towel drills and active ball throws., Methods: Seventeen healthy college baseball players performed three towel drills using a face towel, short foam tube, and long foam tube, followed by full-effort throwing on flat ground. Each participant completed five consecutive trials of each task, and the elbow valgus torque, arm slot, and arm speed were measured using wearable sensors. One-way repeated analysis of variance and post-hoc tests were used to determine the differences in biomechanical metrics among the tasks. Furthermore, the correlation between the elbow valgus torque and other metrics was evaluated using Pearson correlation coefficients., Results: Elbow valgus torque was lower in towel drills compared to that of active ball throws; however, the stress during towel drills using a face towel reached almost 80% of the maximum effort of active ball throws. There was no relationship between elbow valgus stress and arm slot in either the towel or active ball throw tasks. However, a higher arm speed was associated with greater elbow valgus torque in towel drills, whereas no relationship between elbow stress and arm speed was found in active ball throws., Conclusion: Precaution must be taken in athletes following a progressive throwing program because elbow valgus stress reaches almost 80% of the full-effort throw, even when using a face towel in a towel drill. Hence, the subjective intensity must be controlled even in towel drills to gradually increase the medial elbow stress. Moreover, the mechanisms underlying changes in elbow stress may differ between towel drills and active ball throws. Future investigations on the difference between towel drills and active ball throws may help understand the underlying mechanism of alterations in elbow valgus torque during the throwing movement., (Copyright © 2023 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)

Baseball players frequently injure their shoulders and elbows. Preseason risk factors for such injuries have been relatively well studied, but in-season risk factors are less known, and the relationship between the number of pitches and the incidence of such injuries in baseball pitchers of any level is unclear. Identifying the risk factors related to the number of daily pitches is particularly important to prevent baseball-related arm injuries among young pitchers. Thus, we prospectively investigated the relationship between the number of daily full-power pitches in high school baseball pitchers and the incidence of shoulder and elbow injuries. We observed that a small number of daily full-power pitches, < 30 pitches per day, in high school baseball pitchers, significantly increased the risk of shoulder and elbow injuries: these players had a 2.3-times greater risk of injuries and a 45-day earlier occurrence of injuries than those pitching ≥ 30 pitches per day. Although unexpected, this was plausible as continuous daily pitching is required to maintain physical condition in growing and maturing high school pitchers. These findings may form the basis for establishing guidelines regarding the appropriate number of daily pitches required to prevent shoulder and elbow injuries in high school baseball pitchers. [ABSTRACT FROM AUTHOR]

Objective: To determine the incidence and risk factors of musculoskeletal disorders of the elbow in baseball pitchers. Design: Systematic review. Data Sources: Medline, CINAHL, Cochrane, PubMed and SportDiscus from onset to July 7, 2018. Eligibility Criteria: Eligible studies included randomized controlled trials, cohort studies and casecontrol studies. Independent pairs of reviewers screened titles and abstracts for eligibility. Relevant articles were critically appraised for internal validity using the SIGN criteria. We included low risk of bias studies in our best evidence synthesis. Results: We retrieved 4502 articles, 39 were critically appraised and nine had a low risk of bias. These were included in the evidence synthesis. The incidence of musculoskeletal disorders of the elbow ranges from 2.3% in adolescent pitchers to 40.6% in youth pitchers. Evidence suggests that pitch characteristics, inadequate rest, biomechanical and anthropometric factors may be risk factors of UCL tears. Summary/Conclusion: Baseball pitchers develop musculoskeletal disorders of the elbow. There is little high-quality evidence to understand the etiology. Preliminary evidence suggests the risk factors are multifactorial. [ABSTRACT FROM AUTHOR]

BACKGROUND: Early prevention of hip fracture can effectively reduce the risk of hip fracture in a high-risk population. Epidemiological studies can provide guidance for the clinical prevention and treatment of such patients. OBJECTIVE: To retrospectively analyze the epidemiological distribution characteristics of patients with hip fracture admitted to the Second Hospital of Shanxi Medical University from January 1, 2016 to December 31, 2018. METHODS: To collect the patient’s age, sex, fracture type, territorial, season for injury, causes, surgical procedure, intraoperative situation, blood clots, length of hospital stay, cost, and admission to operation time, body mass index, complications, SPSS 26.0 software was used for data processing to analyze the epidemiology of hip fracture distribution characteristics in 2342 patients. RESULTS AND CONCLUSION: The average age of patients with hip fracture was (73.90±13.43) years, and hip fracture mostly occurred in the 80-90 group, accounting for 29.97%. Hip fractures were common in winter, and there was a significant difference in the seasonal distribution of femoral neck and intertrochanteric fractures. Falls resulted in the most hip fractures, accounting for 88.13%. Among the 2 108 patients with hip fractures who underwent surgical treatment, hip replacement was the major choice for femoral neck fractures, accounting for 60.03%; intramedullary fixation was the main choice for intertrochanteric fractures, accounting for 92.04%. Among the 2097 patients with hip fracture who underwent color Doppler ultrasonography, 32.38% (679/2 097) of the patients had arteriovenous thrombosis of the lower extremities, and 28.71% (195/679) of the patients had inferior vena cava filter implantation. The average hospitalization time of patients with hip fracture was (10.49±7.06) days, and the average hospitalization cost was (4.63±3.14) thousand yuan. The average hospitalization cost, average blood loss and average operation time of femoral neck fractures were significantly less than those of intertrochanteric fractures. Patients with intertrochanteric fractures were generally thinner than those with femoral neck fractures. The 44.41% of patients with hip fracture had cardiovascular and cerebrovascular diseases. These results indicate that hip fractures are mainly developed in the older adults, especially in elderly women. With the increase of age, the proportion of intertrochanteric fractures increases gradually. Falls are the main cause of hip fractures in the older adults. Surgical treatment is the main choice for hip fracture. Preoperative blood preparation and perioperative thrombosis prevention can improve the prognosis of patients. [ABSTRACT FROM AUTHOR]

Background: There is a lack of evidence regarding the success of ulnar collateral ligament (UCL) revision reconstruction. Understanding outcomes after UCL revision reconstruction is important in clinical decision making for overhead athletes. Purpose: To evaluate return to play and patient-reported outcomes after UCL revision reconstruction. Study Design: Case series; Level of evidence, 4. Methods: All patients who underwent UCL revision reconstruction, attributed to retear of the ligament or pain, between June 2004 and July 2016 at 2 surgical centers were identified. Charts were reviewed for age, sex, date of primary and revision reconstruction, sport played, level of play, graft type, and complications. Patients were contacted by telephone to determine time to return to play, current level of participation, Conway score, Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow Score, and satisfaction. Results: Of the 65 consecutive baseball players who underwent revision UCL reconstruction, 40 (62%) were contacted at a minimum 22 months after surgery. Of these, 38 (95%) were pitchers and 2 (5%) were position players. Time to return to throwing was 6.2 ± 2.3 months (mean ± SD), and the KJOC score was 74.2 ± 20.7. Based on the Conway score, 50% (20/40) had an excellent result, indicating a return to the previous competition level for at least 1 year, and 30% (12/40) had a good result, indicating a return to a lower level for at least 1 year. For those who were able to return to competition, it took 12.7 ± 3.6 months. In pitchers, 47% (18/38) returned to their previous competition levels for at least 1 year, with a KJOC score of 73.7 ± 21.1. Pitchers were able to return to throwing at 6.3 ± 2.3 months and competition at 12.8 ± 3.7 months. Conclusion: Only half of baseball players undergoing UCL revision reconstruction were able to return to their previous levels of competition. Outcomes for revision reconstructions are not as promising as primary procedures. Baseball players should be cautioned that they may not return to their previous levels of play after a revision reconstruction. [ABSTRACT FROM AUTHOR]

This study aimed to determine the effect of wrist fractures on performance metrics in Major League Baseball Players after they were hit by an errant pitch. Players who sustained wrist fractures after being struck by a pitch were identified and changes in performance metrics were calculated. In both the short- and medium-term analysis, there were no significant differences in all pre- and post-injury offensive statistics following return to play. Wrist fractures sustained after being struck by an errant pitch do not significantly impact professional baseball player performance if the player is able to return to sport. [ABSTRACT FROM AUTHOR]

Background: Recent research has focused on the epidemiology of shoulder and elbow injuries among high school and professional baseball players. Shoulder and elbow injury data has not been comprehensively reported among college baseball student-athletes. Purpose: The purpose of this study is to describe shoulder and elbow injury rates and their characteristics among collegiate baseball student-athletes in order to improve injury prevention. Study Design: Descriptive Epidemiology Study. Methods: Shoulder and elbow injury data were obtained from the NCAA Injury Surveillance System for baseball from 2004-2014. Incidence rate ratios and descriptive analyses described injury characteristics for the shoulder and elbow, separately. Results: The injury rate for the shoulder was 4.02/10,000 athlete-exposures and for the elbow was 2.44/10,000 athlete-exposures. During the ten-year period, the injury rate of the shoulder has approximately decreased by 75% and of the elbow by approximately 50%. Injury rates were higher during competitions compared to practice for the shoulder (rate ratio, 1.81;95% CI, 1.51, 2.18) and elbow (rate ratio, 2.19;95% CI, 1.73, 2.78). Freshmen and juniors were most likely to sustain shoulder (F=40.6%, J =29%) and elbow (F=33%, J=33.7%) injuries. Regarding shoulder injuries, surgery was required for 7.1%, and the outcome was season ending for 14.5%. More elbow injuries (17.5%) ended in surgery, and a greater proportion (28.9%) had season-ending injuries. Conclusion: In collegiate baseball, shoulder and elbow injury rates have decreased but still result in high morbidity. More granular analyses, especially during Division 1 competitions, are necessary for more specific interventions. While shoulder injuries are more common, elbow injuries result in a longer time to return to play and a higher proportion of surgical interventions. [ABSTRACT FROM AUTHOR]

Background: The number of ulnar collateral ligament (UCL) tears in professional baseball players is increasing. UCL reconstruction (UCLR) is the treatment of choice in players with failed nonoperative treatment who wish to return to sports (RTS). It is unknown if UCL tear location influences the ability of players to RTS or affects their performance upon RTS. Purpose/Hypothesis: The purpose was to compare the RTS rate and performance upon RTS in professional baseball players who underwent UCLR based on UCL tear location (proximal vs distal). It was hypothesized that no difference in RTS rate or performance upon RTS will exist between players with proximal or distal UCL tears. Study Design: Cohort study; Level of evidence, 3. Methods: All professional baseball players who underwent primary UCLR by a single surgeon between 2016 and 2018 were eligible for inclusion. Players with purely midsubstance tears or revision UCLR were excluded. Tear location was determined based on preoperative magnetic resonance imaging (MRI) and intraoperative findings. RTS rate and performance were compared between players with proximal versus distal UCL tears. Results: Overall, 25 pitchers (15 proximal and 10 distal tears) and 5 position players (2 proximal and 3 distal) underwent primary UCLR between 2016 and 2018. Of the 25 pitchers, 84% were able to RTS. Of the 5 position players, 80% were able to RTS. Among the total cohort of pitchers and position players, 12 out of 17 (71%) players with proximal tears were able to RTS, while of the 13 distal tears, 13 out of 13 (100%) players were able to RTS (P =.05). With regard to performance data, pitchers with distal tears had higher utilization postoperatively and, as such, allowed statistically more hits (P =.03), runs (P =.015), and walks (P =.021) postoperatively. However, the WHIP ([walks + hits]/innings pitched) was not different between players with proximal or distal tears, indicating that efficacy in games was not significantly different between groups. Conclusion: Professional baseball players who sustain a distal UCL tear and undergo UCLR may be more likely to RTS than those who sustain a proximal UCL tear and undergo UCLR. Players with distal UCL tears who underwent UCLR saw higher utilization postoperatively than those with proximal UCL tears. Further work is needed in this area to confirm this result. [ABSTRACT FROM AUTHOR]

Because of the unique demands of a pitch, baseball players have the greatest percentage of injuries resulting in surgery among high school athletes, with a majority of these injuries affecting the shoulder and elbow due to overuse from throwing. These injuries are believed to occur because of repeated microtrauma to soft tissues caused by the repetitive mechanical strain of throwing. Researchers and practitioners have suggested that baseball pitchers' workloads are a significant risk factor for injury in adolescent players, resulting in lost time and slowing of performance development. The purpose of our review was to investigate the current research relative to monitoring workload in baseball throwers and discuss techniques for managing and regulating cumulative stress on the arm, with a focus on preventing injury and optimizing performance in adolescent baseball pitchers. [ABSTRACT FROM AUTHOR]

Background: Gastrocnemius injuries are a common lower extremity injury in elite baseball players. There are no current epidemiological studies focused on gastrocnemius injuries in professional baseball players that provide information on the timing, distribution, and characteristics of such injuries. Hypothesis: Gastrocnemius injury in professional baseball players is a common injury that is influenced by factors such as age, player position, and time of season. Study Design: Descriptive epidemiological study. Methods: Based on Major League Baseball's (MLB's) Health and Injury Tracking System (HITS) database, gastrocnemius injuries that caused time out of play for MLB and Minor League Baseball (MiLB) players during the 2011-2016 seasons were identified. Player characteristics, including age, level of play, and position at time of injury, were collected. Injury-specific factors analyzed included date of injury, time of season, days missed, and activity leading to injury. Results: A total of 402 gastrocnemius injuries (n = 145, MLB; n = 257, MiLB) occurred during the 2011-2016 seasons. MLB players were significantly older at the time of injury (30.1 years, MLB; 23.9 years, MiLB; P <.001). Base running (36.1%) was the most common activity causing the injury, followed by fielding (23.6%), with 50.3% of base-running injuries sustained on the way to first base. In MLB players, gastrocnemius injuries were most common in infielders (48.3%), followed by pitchers (27.6%) and then outfielders (17.9%), while for MiLB players the injuries were more evenly distributed (33.5%, 28.8%, and 30.7%, respectively). The frequency of injuries in MLB players dropped off after the start of the regular season, whereas MiLB players had a consistent injury rate throughout the year. Conclusion: Gastrocnemius injuries are a common cause of lower extremity injury in professional baseball players, resulting in significant time out of play. Base running, particularly to first base, was the most common activity during injury. Outfielders had the fewest injuries; however, they required the longest time to recover. This study provides the first investigation to date with the HITS database to examine the characteristics and distribution of gastrocnemius injuries in professional baseball players, offering insight into risk factors, injury prevention, and recovery expectations. [ABSTRACT FROM AUTHOR]

Breathing exercise training with a flow-oriented incentive spirometer (or Triflo) is important in lung expansion rehabilitation for patients with lung surgery or pulmonary injury. In this article, we propose a novel technique to estimate the volume of air inhaled and the sustained inhalation time based on video processing. The proposed technique combines a randomized circle detection algorithm to detect the three balls in Triflo tubes and a normalized cross-correlation algorithm to track these three balls that rise due to inhalation. The values of inhalation and the sustained inhalation time intervals are automatically recorded as screenshots on a personal computer for later analysis by a doctor. Three major experiments were conducted to verify the advantages of this proposed system. The first experiment evaluated the performances of both the ball detection and the tracking algorithms showing 3.68% error. The second experiment applied the proposed method implemented, so that it displays in plots the changes in the inhalation rate, as the training of a postoperative volunteer progressed. In the last experiment, a healthy subject employs Triflo to test the inhalation training format for lung volume regeneration with three levels of difficulty, to record the number of successful breathing maneuvers. When the data are displayed in rate versus time plots, a graph can help a doctor to appropriately plan the training program for the benefit of patients, because a more adaptable therapy can be realized and varying degrees of difficulty can be implemented. In addition, the patients can comfortably practice in home-based rehabilitation, seeing the improvements in the inspiratory muscle performance in computer screenshots. [ABSTRACT FROM AUTHOR]

With the advent of next-generation sequencing, investigators have access to higher quality sequencing data. However, to sequence all samples in a study using next generation sequencing can still be prohibitively expensive. One potential remedy could be to combine next generation sequencing data from cases with publicly available sequencing data for controls, but there could be a systematic difference in quality of sequenced data, such as sequencing depths, between sequenced study cases and publicly available controls. We propose a regression calibration (RC)-based method and a maximum-likelihood method for conducting an association study with such a combined sample by accounting for differential sequencing errors between cases and controls. The methods allow for adjusting for covariates, such as population stratification as confounders. Both methods control type I error and have comparable power to analysis conducted using the true genotype with sufficiently high but different sequencing depths. We show that the RC method allows for analysis using naive variance estimate (closely approximates true variance in practice) and standard software under certain circumstances. We evaluate the performance of the proposed methods using simulation studies and apply our methods to a combined data set of exome sequenced acute lung injury cases and healthy controls from the 1000 Genomes project. [ABSTRACT FROM AUTHOR]

Background and Aims Carnivorous plants can enhance photosynthetic efficiency in response to prey nutrient uptake, but the underlying mechanisms of increased photosynthesis are largely unknown. Here we investigated photosynthesis in the pitcher plant Nepenthes × ventrata in response to different prey-derived and root mineral nutrition to reveal photosynthetic constrains. Methods Nutrient-stressed plants were irrigated with full inorganic solution or fed with four different insects: wasps, ants, beetles or flies. Full dissection of photosynthetic traits was achieved by means of gas exchange, chlorophyll fluorescence and immunodetection of photosynthesis-related proteins. Leaf biochemical and anatomical parameters together with mineral composition, nitrogen and carbon isotopic discrimination of leaves and insects were also analysed. Key Results Mesophyll diffusion was the major photosynthetic limitation for nutrient-stressed Nepenthes × ventrata , while biochemistry was the major photosynthetic limitation after nutrient application. The better nutrient status of insect-fed and root-fertilized treatments increased chlorophyll, pigment–protein complexes and Rubisco content. As a result, both photochemical and carboxylation potential were enhanced, increasing carbon assimilation. Different nutrient application affected growth, and root-fertilized treatment led to the investment of more biomass in leaves instead of pitchers. Conclusions The study resolved a 35-year-old hypothesis that carnivorous plants increase photosynthetic assimilation via the investment of prey-derived nitrogen in the photosynthetic apparatus. The equilibrium between biochemical and mesophyll limitations of photosynthesis is strongly affected by the nutrient treatment. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the prevalence, location and configuration of bifid mandibular canals so as to avoid injury to the nerve and inadequate anesthesia during surgical procedures. Materials and Methods: CBCT scan of 203 patients (125 males and 78 females) was evaluated for the presence and the type of the bifid mandibular canal. They were classified according to Nortje et al. The prevalence rates were determined according to gender, location, and type of bifid mandibular canal. Statistical analysis was performed using IBM SPSS software version 24. Results: The prevalence rate of bifid mandibular canals was found to be 10.3% with 12.8% in males and 6.4% in females. The Chi-square test reveals there is a statistically significant difference between the different locations of bifid mandibular canals and most of the canals were present on the right side. The most frequent type of bifid mandibular canal observed was type II dental canal (38.1%), followed by type III forward canal (28.6%), type I retromolar canal (14.3%), and type IV buccolingual canal (14.3%). Conclusion: CBCT is suggested for a detailed evaluation and identification of bifid mandibular canals before any surgical procedures to avoid post-operative complications. [ABSTRACT FROM AUTHOR]

Background/aim: Active participation in sports is a risk factor for maxillofacial fractures. The aim of this retrospective multicentre study was to survey and evaluate the characteristics of mandibular fractures, and dental injuries that occurred during the practice of baseball and softball in Sendai, Japan.Material and Methods: The records of 454 patients with maxillofacial fractures from three departments of Oral and Maxillofacial Surgery across a period 14 years were analysed. Fifty-one patients with 56 mandible fractures and dental injuries that occurred playing baseball or softball were included in this multicenter retrospective study. Patients were divided according to age, gender, sites of fractures, mechanism of fractures and treatment methods.Results: There were 42 males and nine females, with a male-to-female ratio of 4.7:1.0. The mean age was 19.9 years old (range: 13-47 years old). As for the site, body of the mandible fractures prevailed, followed by the condyle, symphysis and angle. Fractures were mostly caused by the impact of a ball (42; 82.4%), followed by collisions with another player (5; 9.8%) and direct strike of a bat (4; 7.8%). All patients with mandibular fractures were treated with open reduction and internal fixation, except for six patients with condylar head fractures who were managed conservatively.Conclusions: The impact of a thrown ball against the batter's mandible can cause a condylar fracture when playing baseball and softball. [ABSTRACT FROM AUTHOR]

Background: Baseball pitchers frequently develop varying levels of posterior shoulder tightness (PST) and often present with characteristics associated with subacromial impingement. Purpose: To determine if a group of baseball pitchers with excessive PST (bilateral internal rotation ROM difference >18° and bilateral total arc of motion difference >5°) have differences in subacromial joint space, forward scapular posture, or glenohumeral elevation range of motion (ROM) when compared to a control group. Study Design: Descriptive, cross-sectional study. Methods: Thirty-five asymptomatic professional baseball pitchers with excessive PST were matched with 35 pitchers with acceptable levels of PST. The investigators measured subacromial space using diagnostic ultrasound, glenohumeral elevation ROM using a digital goniometer, and scapular posture using a double square, and were blinded to the group of each participant. Separate t-tests were used to determine significant differences between groups (p < 0.05), Results: The excessive PST group presented with significantly less subacromial space (p = .0007) and glenohumeral elevation ROM [p= .03) compared to the acceptable level PST group. The excessive PST group also had significantly more forward scapular posture than the control group (p= .03). Conclusion: The baseball pitchers with excessive PST had less subacromial space and glenohumeral elevation ROM, as well as more forward scapular posture in their throwing arms compared to pitchers with acceptable levels of PST. Level of Evidence: 3 [ABSTRACT FROM AUTHOR]

BACKGROUND: Stress fractures of lower limbs are common for recruits and athletes, and affect their training to different extent. OBJECTIVE: To summarize the risk factors for the occurrence and development of stress fracture of lower extremity, then to raise the awareness of stress fracture of lower extremity and provide ideas for its prevention. METHODS: A computer-based search was conducted in PubMed, Wan fang and CNKI databases from January 2009 to July 2019 with the keywords of "stress fracture, fatigue fracture, overuse injury, risk factors, recruits" in English and Chinese, respectively. A total of 786 relevant articles were retrieved, and 76 articles were eligible for the inclusion criteria. RESULTS AND CONCLUSION: (1) Sex and history of stress fracture have been identified as risk factors for stress fracture. Future studies should be inclined to identify the specific roles of other risk factors in the development of stress fracture. (2) In addition, biomechanical factors are likely to affect the occurrence of stress fracture of the lower limbs of recruits. (3) Therefore, improving the abnormal biomechanical parameters of the lower extremity during the training of recruits can develop a method to prevent the stress fracture of the lower limbs, and reduce the incidence of stress fracture through appropriate management. [ABSTRACT FROM AUTHOR]

Background: Ankle and lower leg injuries are very common in sports, and numerous studies have discussed their diagnosis and management. Our study differs in that we report lower leg injuries in professional baseball players spanning the 2011-2016 seasons by utilizing a comprehensive injury surveillance system developed by Major League Baseball (MLB). Purpose: To determine the injury characteristics of ankle and lower leg injuries in professional baseball players during the 2011-2016 seasons by utilizing the MLB injury surveillance system. Study Design: Descriptive epidemiology study. Methods: Our study is a descriptive epidemiological evaluation through a retrospective review of injury data from the MLB Health and Injury Tracking System (HITS) since its implementation in 2010. We included any professional baseball player (MLB and Minor League Baseball [MiLB]) who was identified as having an ankle or lower leg injury between January 1, 2011, and February 28, 2017. Results: Over the study period, there were a total of 4756 injuries, of which 763 (16%) occurred in MLB players and 3993 (84%) occurred in MiLB players. The mean number of days missed for all players was 27.8 ± 141.4 days, with a median of 3 days. From 2011 through 2016, it was estimated that there were 414,912 athlete exposures (AEs) in MLB and 1,796,607 AEs in MiLB. Of the 4756 injuries recorded, 550 (12%) took place during the MLB regular season, and 3320 (70%) took place during the MiLB regular season. Injuries in MLB players, however, were 1.7 times more likely to require surgery (P <.001). Additionally, rates of injury to the lower leg were stratified by position, with infield players experiencing injuries at a 1.6 times greater rate than any other position (P <.001). Conclusion: In conclusion, this is the only epidemiological study to focus primarily on ankle and lower leg injuries in professional baseball players, utilizing an injury surveillance system developed by MLB. [ABSTRACT FROM AUTHOR]

Poractant alfa and Calsurf are two natural surfactants widely used in China for the treatment of neonatal respiratory distress syndrome, which are extracted from porcine and calf lungs, respectively. The purpose of this experimental study was to compare their in vitro characteristics and in vivo effects in the improvement of pulmonary function and protection of lung injury. The biophysical properties, ultrastructure, and lipid composition of both surfactant preparations were respectively analysed in vitro by means of Langmuir-Blodgett trough (LBT), atomic force microscopy (AFM), and liquid-chromatography mass-spectrometry (LC-MS). Then, as core pharmacological activity, both head-to-head (100 and 200 mg/kg for both surfactants) and licensed dose comparisons (70 mg/kg Calsurf vs. 200 mg/kg Poractant alfa) between the two surfactants were conducted as prophylaxis in preterm rabbits with primary surfactant deficiency, assessing survival time and rate and dynamic compliance of the respiratory system (Cdyn). Intrapulmonary surfactant pools, morphometric volume density as alveolar expansion (Vv), and lung injury scores were determined post mortem. AFM and LC-MS analysis revealed qualitative differences in the ultrastructure as well as in the lipid composition of both preparations. Calsurf showed a longer plateau region of the LBT isotherm and lower film compressibility. In vivo, both surfactant preparations improved Cdyn at any dose, although maximum benefits in terms of Vv and intrapulmonary surfactant pools were seen with the 200 mg/kg dose in both surfactants. The group of animals treated with 200 mg/kg of Poractant alfa showed a prolonged survival time and rate compared to untreated but ventilated controls, and significantly ameliorated lung injury compared to Calsurf at any dose, including 200 mg/kg. The overall outcomes suggest the pulmonary effects to be dose dependent for both preparations. The group of animals treated with 200 mg/kg of Poractant alfa showed a significant reduction of mortality. Compared to Calsurf, Poractant alfa exerted better effects if licensed doses were compared, which requires further investigation. [ABSTRACT FROM AUTHOR]

Keywords: hockey; commodification of sport; elite players; extractive peripheries; British Columbia; marchandisation du sport; joueurs d'élite; rapports centre-périphérie; Colombie-Britannique Many aspects of the system have become elitist - including feverish scouting for possible talent; the schooling of young players in hockey academies; costly specialized training; ownership and exclusive use of hockey rinks and training facilities; early adoption by sports agents; and the pressured coaching of teams, increasingly over a 12-month season with little downtime. In bygone days, sports were played seasonally and improvement came by local coaching and playing (often by unpaid volunteers), whereas current training is more intensive with specialized schools and academies owned privately or by sports enterprises that offer dedicated equipment and facilities designed to produce elite players (Jackson [32]). Privatization and professionalization of training and playing the sport in hockey academies and HPTCs has grown rapidly - 2019 marks the first year that there will not be a Bantam AAA Western Championship because the MHA's best players have been recruited by hockey academies. Vancouver, formerly almost devoid of hockey, but now with an NHL team and numerous elite training facilities, is now branded a hockey city. [Extracted from the article]

Noncontact three‐dimensional (3D) surface scanning methods are used within forensic medicine to record traumas and other related findings. A structured light scanning technique is one of these methods and the most suitable for the forensic field. An assessment of the efficiency of different structured light scanners with forensic injuries is essential to validate this technique for wound documentation. The purpose of this study was to evaluate the capability of the HP structured light scanner Pro S3 for digitizing open injuries having complicated areas and depths. Fifteen simulated injuries on mannequins were scanned and assessed. Comparisons between 3D and direct wound measurements were made. The results showed that the technique was able to create detailed 3D results of the extensive injuries. Statistical significance tests revealed no difference between the two measurement methods. Because the scanner is applicable for routine work, it should be considered to confirm the same results on real cadavers and actual wounds. [ABSTRACT FROM AUTHOR]

Background: The effect that an anterior cruciate ligament injury requiring reconstructive surgery has on the professional advancement and performance of amateur baseball players selected in the Major League Baseball draft is not known. Return to sports after anterior cruciate ligament reconstruction (ACLR) in professional athletes has been shown to be high, but mixed results with regard to performance and return to preinjury level have been demonstrated in other sports. Purpose: To (1) investigate the highest level of professional advancement among Major League Baseball draftees with a history of ACLR before entering the draft, (2) examine how much time these players spent on the disabled list (DL) and determine if it was related to the knee, and (3) compare the batting and pitching performance of these players against healthy matched controls. Study Design: Cohort study; Level of evidence, 3. Methods: Predraft medical records of all players selected in the Major League Baseball draft from 2004 to 2008 were reviewed. Players with a documented anterior cruciate ligament injury treated with ACLR before the draft were included. For each study player, 3 controls were identified. Data were accumulated from the time when players were drafted through the 2015 season. Outcome variables included highest professional level of advancement, DL time, and batting and pitching performance. Results: Forty draftees with a history of ACLR (22 pitchers, 18 position players) were identified and matched to 120 controls (66 pitchers, 54 position players). The difference in the highest level of professional advancement between the groups was not statistically significant (P =.488). The mean total number of times and the mean total number of days on the DL were similar between the groups (1.83 vs 1.47, P =.297; 121.54 vs 109.62, P =.955); however, the mean number of times on the DL because of a knee injury was significantly different (0.28 vs 0.11, P =.004), as was the mean number of days on the DL because of a knee injury (17.36 vs 7.72, P =.009). Among pitchers, there were no differences in performance. Similarly, there were no differences among position players in batting performance. Conclusion: There was no difference between draftees with a history of ACLR and their controls in terms of advancement from the minor to the major leagues. Additionally, pitching and batting performance were similar. Although the 2 groups spent similar time on the DL, the ACLR group spent more time on the DL because of a knee injury than the control group. [ABSTRACT FROM AUTHOR]

A new nothospecies in the genus Nepenthes discovered at 900-1000 m above sea level (a.s.l.) in Terengganu, Peninsular Malaysia, is described. A population of at least 12 individuals was observed to be growing amongst undergrowth in sandy loam, whose mature plants produced dark climbing stems and upper pitchers. The pitcher plants have been assigned here as a natural cross of N. macfarlanei and N. gracilis, due to the shared characteristics observed in the hybrid and sympatric occurrence of the two parental species. Diagnosis, descriptions, photographs, leaf anatomy, morphological comparisons and field keys of N. ×setiuensis with its putative parents (N. gracilis and N. macfarlanei) are provided in this paper. Characteristics of N. gracillima and N. ramispina are also included for comparison. [ABSTRACT FROM AUTHOR]

Road traffic crashes have a devastating impact on societies by claiming more than 1.35 million lives each year and causing up to 50 million injuries. Improving the efficiency of emergency management systems constitutes a key measure to reduce road traffic deaths and injuries. In this work, we propose a comprehensive crowdsensing-based solution for the real-time collection and the analysis of accident scene intelligence as a means to improve the efficiency of the emergency response process and help reduce road fatalities. The solution leverages sensory, mobile, and web technologies for the real-time monitoring of accident scenes, and employs Artificial Intelligence for the automatic analysis of the accident scene data, to allow the automatic generation of accident intelligence reports. Police officers and rescue teams can use those reports for fast and accurate situational assessment and effective response to emergencies. The proposed system was fully implemented and its operation was successfully tested using a variety of scenarios. This work gives interesting insights into the possibility of leveraging crowdsensing and artificial intelligence for offering emergency situational awareness and improving the efficiency of emergency response operations. [ABSTRACT FROM AUTHOR]

Context: Humeral torsion (HT) has been linked to various injuries and benefits. However, the exact interplay between HT, shoulder range of motion (ROM), competition level differences, and injury risk is unclear.Objective: To determine the relationship between HT, ROM, and injury risk in baseball players. Secondarily, to determine HT based on competition level.Data Sources: PubMed, Embase, Web of Science, CINAHL, and Cochrane databases were searched from inception until November 4, 2018.Study Selection: Inclusion criteria consisted of (1) HT measurements and (2) arm injury or shoulder ROM.Study Design: Systematic review.Level Of Evidence: Level 3.Data Extraction: Two reviewers recorded patient demographics, competition level, HT, shoulder ROM, and injury data.Results: A total of 32 studies were included. There was no difference between baseball players with shoulder and elbow injuries and noninjured players (side-to-side HT difference: mean difference [MD], 1.75 [95% CI, -1.83 to 2.18]; dominant arm: MD, 0.17 [95% CI, -1.83 to 2.18]). Meta-regression determined that for every 1° increase in shoulder internal rotation (IR), there was a subsequent increase of 0.65° in HT (95% CI, 0.28 to 1.02). HT did not explain external rotation (ER ROM: 0.19 [95% CI, -0.24 to 0.61]) or horizontal adduction (HA ROM: 0.18 [95% CI, -0.46 to 0.82]). There were no differences between HT at the high school, college, or professional levels.Conclusion: No relationship was found between HT and injury risk. However, HT explained 65% of IR ROM but did not explain ER ROM or HA ROM. There were no differences in HT pertaining to competition level. The majority of IR may be nonmodifiable. Treatment to restore and maintain clinical IR may be important, especially in players with naturally greater torsion. HT adaptation may occur prior to high school, which can assist in decisions regarding adolescent baseball participation. [ABSTRACT FROM AUTHOR]

Medial epicondylitis, or inflammation of the medial elbow most often occurring at the origin of the wrist flexor tendons, is used for a diagnostic classification for medial elbow pain. Medial elbow pain is common in throwing athletes due to the load placed on the elbow during the cocking and acceleration phase of throwing. The current case review describes a collegiate baseball pitcher who experienced medial elbow pain with neurological symptoms and was treated with neurodynamic median and ulnar sliders. Medial epicondylitis, or inflammation of the medial elbow most often occurring at the origin of the wrist flexor tendons, is used for a diagnostic classification for medial elbow pain. Medial elbow pain is common in throwing athletes due to the load placed on the elbow during the cocking and acceleration phase of throwing. The current case review describes a collegiate baseball pitcher who experienced medial elbow pain with neurological symptoms and was treated with neurodynamic median and ulnar sliders. [[Athletic Training & Sports Health Care. 2020;12(2):90–93.] [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the relationship between baseball participation and health (musculoskeletal, general, and psychological health) and to identify research gaps in the existing literature. DESIGN: Systematic scoping review. LITERATURE SEARCH: Medical databases and gray literature were systematically searched from inception to November 2018. STUDY SELECTION CRITERIA: All studies that investigated constructs related to the health of current or former baseball players were included. DATA SYNTHESIS: Data were extracted for thematic summaries. RESULTS: Ten thousand five hundred seventy-four titles/abstracts were screened, and 578 studies were included. Ninety percent of articles included only baseball players playing in the United States, 34% of articles investigated professional baseball players, and 11% studied college baseball players. Five hundred eighty-three (86%) studies investigated musculoskeletal health, 77 (11%) general health, and 18 (3%) psychological health. Injury incidence (injuries per 1000 athlete exposures) ranged from 0.7 to 3.6 in professional, 4.7 to 5.8 in college, and 0.8 to 4.0 in high school baseball. Among baseball players, 31% to 50% reported regular tobacco use. There was limited research investigating psychological health in current or former baseball players at all competition levels. CONCLUSION: Almost 90% of all articles investigated musculoskeletal health, with few articles studying general or psychological health. Baseball players have high tobacco, alcohol, and drug use compared to the general population, which may have negative health outcomes. Little is understood about the long-term musculoskeletal, general, and psychological health of baseball players. [ABSTRACT FROM AUTHOR]

Background: This study aims to explore the epidemiological patterns of shoulder injuries in professional baseball. Methods: The transaction lists of the 'Major League Baseball' website were screened for injuries from 2011 to 2016, inclusive. Only players that were placed on the 'Disabled List' were included in the study. Our database included the player's position, injury location, injury cause, and time spent on the Disabled List. Results: A total of 3090 injuries were recorded; 511 (17%) were shoulder injuries, making it the most vulnerable anatomic location in baseball (N = 511). Of the 511 shoulder injuries, 132 (25.8%) were due to inflammation, making it the most common cited cause of shoulder injury. Most shoulder injuries occurred in April with 125 (24%) injuries, while June and May came in second and third with 89 (17%) and 81 (16%) injuries, respectively. The pitcher was the player most prone to injury, as it constituted 78% of the injuries. The average time spent off by a shoulder injury was 69 days, which implicated substantial economic losses for the injured athlete's club. Conclusion: Shoulder injuries are prevalent in professional baseball. The overhead pitching motion puts the shoulder at risk and accounts for the high incidence of its injuries. [ABSTRACT FROM AUTHOR]

BACKGROUND: In the clinical treatment of distal tibiofibular syndesmosis injury, Suture-Button fixation technique can achieve similar results to, even better results than, those of screws, but it cannot fully recover the anatomical reduction and activity to those before injury. However, the optimal treatment of distal tibiofibular syndesmosis injury is still controversial. OBJECTIVE: To systematically evaluate Suture-Button fixation and screw fixation for the treatment of distal tibiofibular syndesmosis injury. METHODS: EMBASE, Cochrane database, PubMed database, Wanfang database, and CNKI were searched to retrieve randomized or non-randomized controlled trials regarding Suture-Button fixation and screw fixation for the treatment of distal tibiofibular syndesmosis injury published from January 2005 to January 2019. The quality of the included studies was strictly evaluated. Relevant data were extracted. A meta-analysis of all outcome measures was performed using RevMan 5.3 software. RESULTS AND CONCLUSION: (1) Twelve studies were included, including 4 randomized controlled trials and 8 cohort studies, involving 564 patients. (2) Meta-analysis results showed that Suture-Button fixation had shorter full weight-bearing time [WMD=-1.50, 95%CI(-2.08, -0.92), P < 0.05] than screw fixation method. Suture-Button fixation resulted in better AOFAS scores than screw fixation at 3, 6, 12, and 24 months after surgery [WMD=6.50. 95%CI(3.41, 9.58), P < 0.05; WMD=2.87, 95%CI(O. 75, 4.98), P < 0.05; WMD=2.67, 95%CI(0.09, 5.24), P < 0.05; WMD=5. 79, 95%CI(1.41, 10.18), P < 0.05]. There were no significant differences in operation time, tibiofibular overlap at the last follow-up. tibiofibular clear space at the last follow-up, and the incidence of total postoperative complications alter surgery between two fixation methods (P > 0.05). (3) These findings suggest that compared with screw fixation, Suture-Button fixation for the treatment of distal tibiofibular syndesmosis injury leads to better recovery of ankle joint function and an earlier time point for full weight bearing and does not need to consider the risk of screw fracture during the surgery. In addition to screw fixation, Suture-Button fixation is an effective way to treat distal tibiofibular syndesmosis injury. [ABSTRACT FROM AUTHOR]

Introduction: Burn injuries sustained by the Indian women while cooking food in the kitchen or working place comprise a unique entity in the Accidental burn epidemiology. Burn deaths in females are a major public health problem in our country. Materials and Methods : Present study based on autopsy for the period of 2 year to evaluate epidemiological aspects of burn injury in the mortuary & Hospital situated in the metropolitan city of India. Results: 55.05% victims belonged to lower middle class, Hindu (69.19%). Housewives (84.34%), Married (86.87 %) females, educated middle school (26.77%), belonged to Suburban area (55.05%). Age group 21-25 yrs was more common affected (31.31%), married since more than 7 yrs (41.41%), victims survived for period of more than 7 days (32.83%). Accidental burns were most commonly by stove blast (74.75%) & victims sustained 51-75% TBSA burns (45.96 %), died from Septicemia (80.50%) Conclusion: Most common married, housevies, belonged to young age were victims of Accidental burn injury. Considering the morbidity and mortality owing to burns, government and other social organizations need to put special efforts for the prevention and education programs against burn injuries. [ABSTRACT FROM AUTHOR]

Background: Achilles tendon rupture (AT) is considered a subversive injury for the young athletes since its full recovery takes12 months. In addition to this, there is escalation in the risk of re-injury of the same tendon. Objective: In this review, we aim to assess and evaluate Achilles tendon rupture mechanism of injury, and its diagnosis and management published in the current literature. Method: A comprehensive search was done using biomedical databases including Medline, and PubMed, for studies concerned with evaluation of Achilles Tendon Rupture published in English language. Keywords used in our search through the databases were "Achilles Tendon Rupture Mechanism and Pathophysiology", "Achilles Tendon Rupture Management", and "Achilles Tendon Rupture Diagnosis". Conclusion: The incidence of Achilles tendon rapture among athletes is common and increasing. Determining the best management option is still controversy among orthopedic surgeons. Open surgery is associated with the lowest rates of re- rupture incidence, but increase risk of other complications. Percutaneous repair was found to have a low complications rate in comparison to open surgery, but it is associated with increased risk of sural nerve injury. The recent studies have clearly demonstrated the effectiveness of functional rehabilitation techniques, with biotherapy as potential future for development. [ABSTRACT FROM AUTHOR]

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Background: Subperiosteal hematoma of the iliac bone is reported as a rare disorder that specifically occurs in young patients after obvious trauma. This report presents seven cases of male adolescent athletes with subperiosteal iliac hematoma without blunt trauma that was identified as an incidental radiolucent lesion on the iliac bone mimicking neoplasm. The purpose of this report is to describe clinical features and radiological findings of silent subperiosteal hematoma of the iliac bone. Subjects and methods: We retrospectively reviewed the clinical data and radiological appearance of 7 patients who presented with subperiosteal hematoma of iliac bone. Results: All seven patients had no obvious trauma and no serious symptoms. All patients were middle school or high school male students who regularly participated in vigorous sports activity; five soccer players, one baseball catcher, and one basketball player. The X-ray showed radiolucent lesion on the iliac bone. Lens-shaped mass without involvement of psoas muscle with ghost native cortex sign and overlying periosteal calcification on CT scan was characteristic radiological finding on subperiosteal iliac hematoma. Conclusion: Subperiosteal iliac hematomas can be caused by vigorous sports activity in adolescence. This condition is not always associated with serious symptom. It can be identified as a radiolucent lesion mimicking a neoplasm. [ABSTRACT FROM AUTHOR]

The article discusses the softball pitching motion and recommends an approach to injury prevention. It describes the role of the muscles of the lower extremity during the dynamic movement of the windmill softball pitch. It relates that the incidence of softball injuries is higher than the occurrence of baseball injuries. Information is presented on the phases of the windmill softball pitch. It emphasizes the importance of focusing on the development of a high degree of neuromuscular control of the hips and pelvis in injury prevention.

Context: Elbow injuries are widely reported among baseball players. The elbow is susceptible to injury when elbow-flexor and -extensor forces are imbalanced during pitching or throwing. Assessment of muscle-strength ratios may prove useful for diagnosing elbow injury. Objective: The purpose of this study was to assess the relationship between the elbow-flexor and -extensor functional isokinetic ratios and elbow injury in baseball players. Design: Retrospective study. Setting: Biomechanics laboratory. Participants: College baseball players with (n = 9) and without (n = 12) self-reported elbow pain or loss of strength were recruited. Intervention and Main Outcome Measures: Trials were conducted using a dynamometer to assess dominant-arm flexor and extensor concentric and eccentric strength at angular velocities of 60° and 240°/s. Functional isokinetic ratios were calculated and compared between groups. Results: Regression analysis revealed that a ratio of biceps concentric to triceps concentric strength greater than 0.76 (the median value) significantly predicted elbow injury (P = .01, odds ratio of injury = 24). No other ratios or variables (including position played) were predictive of injury status. Conclusions: These findings suggest that the ratio of biceps concentric to triceps concentric functional strength strongly predicts elbow-injury status in baseball players. Assessment of this ratio may prove useful in a practical setting for training purposes and both injury diagnosis and rehabilitation. [ABSTRACT FROM AUTHOR]

Context: Many studies have explored closed kinetic chain (CKC) shoulder exercises (SEs) with a sling because they are safer and more effective than open-chain exercises, especially in early stages of treatment. However, the application of CKC SE in youth baseball players has rarely been attempted, although teenage baseball players also experience shoulder pain. Objective: To investigate the effects of CKC SE on the peak torque of shoulder internal rotation (IR) and external rotation (ER) in youth baseball players. Design: Single-group pretest, posttest. Setting: Biomechanics laboratory. Participants: 23 Little League Baseball players with subacromial impingement syndrome. Interventions: The CKC SE with a sling was CKC shoulder-flexion exercise, extension exercise, IR exercise, and ER exercise. This exercise regimen was conducted 2 or 3 times/wk for 8 wk. Main Outcome Measures: The peak torque of shoulder IR and ER was measured using an isokinetic dynamometer. Concentric shoulder rotation was performed, with 5 repetitions at an angular velocity of 60°/s and 15 at 180°/s. Results: The IR and ER peak torque significantly increased at each angular velocity after the exercise program. In particular, the increase in IR and ER peak torque values was statistically significant at an angular velocity of 180°/s. Conclusions: CKC SE was effective in increasing shoulder IR and ER strength, demonstrating its potential benefits in the prevention and treatment of shoulder injury. In addition, increased IR peak torque appears to improve throwing velocity in baseball players. [ABSTRACT FROM AUTHOR]

The article presents a case study on a 19-year-old male baseball player struck in the head by a wooden baseball bat. The study focuses on the patient's skull fracture and brain contusion. While the patient did not lose consciousness following the injury, he later experienced slowed mental functioning and headaches.

Elbow varus torque is a primary factor in the risk of elbow injury during pitching. To examine the effects of shoulder abduction and lateral trunk tilt angles on elbow varus torque, we conducted simulation and regression analyses on 33 college baseball pitchers. Motion data were used for computer simulations in which two angles—shoulder abduction and lateral trunk tilt—were systematically altered. Forty-two simulated motions were generated for each pitcher, and the peak elbow varus torque for each simulated motion was calculated. A two-way analysis of variance was performed to analyze the effects of shoulder abduction and trunk tilt on elbow varus torque. Regression analyses of a simple regression model, second-order regression model, and multiple regression model were also performed. Although regression analyses did not show any significant relationship, computer simulation indicated that the peak elbow varus torque was affected by both angles, and the interaction of those angles was also significant. As trunk tilt to the contralateral side increased, the shoulder abduction angle producing the minimum peak elbow varus torque decreased. It is suggested that shoulder abduction and lateral trunk tilt may be only two of several determinants of peak elbow varus torque. [ABSTRACT FROM AUTHOR]

Posterior glenohumeral dislocations are rare, comprising only 4 percent of all shoulder dislocations. While early and accurate diagnosis of a posterior dislocation increases the likelihood of success with non-operative management, traditional rehabilitation may not adequately address the sensorimotor deficits that are evident following dislocation. Restoration of the sensorimotor system is critical to successfully return a throwing athlete safely to sports. The use of functional neuromuscular rehabilitation (FNR) attempts to address deficits in the compromised sensorimotor system. With a good understanding of the specific demands placed on the overhead athlete's shoulder, knowledge of glenohumeral and scapulothoracic joints' biomechanics, respect for the athlete's level of symptoms and pain, adherence to soft tissue healing, and application of a rehabilitation program that incorporates FNR, an athlete can successfully return to a high level of competition following an acute posterior glenohumeral dislocation. [ABSTRACT FROM AUTHOR]

Objectives: Ulnar Collateral Ligament (UCL) tears are common in baseball players. When nonoperative management fails; reconstruction or repair may be necessary to restore physical function. There is no clear consensus regarding the indications for surgery based on magnetic resonance imaging (MRI) tear characteristics, or the indications for selecting repair over reconstruction. The purpose of this study was to define the indications for UCL surgery based on MRI and to elucidate indications for UCL repair vs reconstruction. Methods: Twenty-six orthopaedic surgeons who treat baseball players were surveyed. Forty-five MRIs were reviewed: 15 without UCL tears, 15 with intra-operatively confirmed partial-thickness tears, and 15 with full-thickness tears. Factors investigated included ligament characteristics (periligamentous or osseous edema, ligament hypertrophy, calcification, partial or full-thickness tearing) and location (proximal, mid-substance, or distal). Surgeons were given a clinical scenario and asked whether 1) surgery was indicated and 2) whether repair or reconstruction was recommended. Odds ratios (OR) and 95% confidence intervals (95%CI) helped identify significant predictors for both queries. Results: The odds of recommending surgical treatment compared to non-operative treatment were 2.4x more likely for a proximal partial-thickness tear, 3.2x for distal partial-thickness tear, 5.1x for distal full- thickness tear, and 7.0x for proximal full-thickness tear (p<0.001). Significant indications for repair included distal partial (OR=1.6, 95%CI 1.0, 2.1, p<0.001) and full-thickness tears (OR=1.7, 95%CI 1.1, 2.3, p<0.001). Repair was 3x less likely recommended for mid-substance full-thickness tears (OR=3.0, 95%CI - 5.0, -1.0, p=0.004). Ultrasound stress testing was requested in 78% of partial tears. Conclusions: Among surgeons surveyed, the highest odds for recommending operative treatment were proximal full-thickness tears, then distal full-thickness, distal partial-thickness, and proximal partial- thickness tears. Repair was most appropriate for partial and full-thickness distal tears, but relatively contraindicated for complete mid-substance UCL tears. Ultrasound stress testing was frequently requested for partial tears. Given the lack of consensus among surgeons, future prospective registries are necessary to determine whether these factors associate with clinical outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Sport-related injuries remain a significant problem for collegiate baseball players. Prevention and management program of the injuries can be developed through epidemiological research aimed at defining the nature of injuries related to baseball. However, there is little information regarding the incidence and characteristics of the injuries among collegiate baseball players. The purpose of this study was to examine the current trends of sport-related injuries among collegiate baseball players in the PAC-12 conference. Methods: Demographic and injury data were obtained from a database of the PAC-12 Health Analytics Program (HAP) between 2016 and 2021. Injury incidence, type, mechanism, and outcome were analyzed. The annual injury incidence was defined as the number of injuries per total players for one year. Linear regression model was used to assess trends of the number of injuries over the 6 years. Results: A total of 2188 injuries (1434 sport-related injuries, 66%; 754 non-sport-related injuries, 34%) occurred in 6 years. The number of sport-related injuries significantly increased from 2016 (n = 75; annual incidence, 8.5 per 100 player-years) to 2021 (n = 378; annual incidence, 43.0 per 100 player-years) (R² = .735; P = .029) (Figure 1). Most of the sport-related injuries occurred in pitchers (33.6%). The majority of sport-related injuries were acute (76.6%), resulted in missed time (68.8%), and were new injuries (86.9%). Most sport-related injuries were caused by non-contact events (53.2%) and occurred during in-season games (39.9%) and practice (47.4%). Only 1.3% of sport-related injuries did not result in a return to previous activity level. The shoulder was the most commonly-injured anatomic area, followed by the arm/elbow. Shoulder impingement-related injuries were the most common specific diagnoses (n = 98), followed by ulnar collateral ligament (UCL) injuries (n = 63), hamstring muscle strains (n = 60), ankle ligament sprains (n = 46), and hand/wrist fractures (n = 40). Surgical interventions were performed on 5.1% of shoulder impingement-related injuries, 41.3% of UCL injuries, 35.0% of hand/wrist fractures, and none on hamstring muscle strains or ankle ligament sprains. The average days to clearance for shoulder impingement-related injuries, UCL injuries, hamstring muscle strains, ankle ligament sprains, and hand/wrist fractures were 23 ± 62, 167 ± 197, 18 ± 30, 33 ± 155, and 40 ± 51 days, respectively. Conclusions: The number of sport-related injuries among collegiate baseball players has increased over the past 6 years. Shoulder impingement-related injuries followed by UCL injuries, hamstring muscle strains, ankle ligament sprains, and hand/wrist fractures are the most common specific diagnoses among this cohort of collegiate baseball players. Of the most common specific diagnoses, UCL injuries often require surgical interventions and most impact playing time. [ABSTRACT FROM AUTHOR]