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Most injuries that dancers sustain are to the lower extremities, specifically the foot and ankle region. Numerous potential risk factors have been examined for dancer injuries such as technical mistakes and fatigue. The purpose of this study was to compare landing kinematics and kinetics during jumps that are common in dance pre and postfatigue. Ten adolescent advanced level dancers participated in this study. Subjects completed 3 split leaps and 3 center leaps before and after a fatigue protocol performed on a stationary bike. Live motion capture was used to record landing kinematic and kinetic data. Results of this study showed a significant increase in ankle eversion and external rotation angles for center leaps from pre- to postfatigue protocol (P =.020 and P =.020, respectively) as well as significant increases in ankle eversion and knee adduction moments for center leaps (P =.020 and P =.036, respectively). These results show that after a fatigue protocol, there are changes to the kinematics of dancers that may make them more susceptible to ankle injury. [ABSTRACT FROM AUTHOR]

Context: There is a well-established increased risk of lower-extremity (LE) musculoskeletal (MSK) injury following a sport-related concussion (SRC). Neuromuscular training programs improve biomechanics associated with LE MSK injury and reduce LE MSK injury incidence, but their relative effectiveness in athletes with history of SRC is unknown. The purpose of this study was to evaluate LE MSK injury incidence in female adolescent athletes with history of SRC following a neuromuscular training intervention. Design: Prospective case-control. Methods: Seventy-seven adolescent female athletes aged 12–18 years who participated in soccer, volleyball, or basketball were recruited from a single institutional sports medicine research and performance center to complete a 6-week neuromuscular training program prior to competitive athletic season. Group (Control, History of SRC) comparisons of athlete exposure and relative LE MSK injury risk and rates during the competitive athletic season were assessed. Results: Ten injuries were recorded by 9 athletes. Female athletes who reported history of SRC had increased injury risk (Risk Ratio 3.9, 95% CI, 1.1–13.8, P =.01) and increased injury rate (rate ratio 4.1, 95% CI, 1.1–15.8, P =.03) compared with female athletes without history of SRC. Conclusions: Female adolescent athletes with history of SRC showed a greater risk of LE MSK injury compared with athletes with no history of SRC. Future work is still needed to understand the underlying mechanisms associated with future LE MSK injury following SRC and interventions that ameliorate elevated injury risk. [ABSTRACT FROM AUTHOR]

Assessment of player's postural control following a lower limb injury is of interest to sports medicine practitioners due to its fundamental role in daily tasks and sporting activities. The aim was to longitudinally monitor professional rugby union players' postural control during each phase of the rehabilitation program (acute, middle, and late) following a lower limb injury. Seven male rugby union players (height 1.80 [0.02] m; mass 100.3 [11.4] kg; age 24 [4] y) sustained a time loss, noncontact lower limb injury. Static postural control was assessed via sway path (in meters), and dynamic postural control was assessed via vertical postural stability index. Group differences (P <.05) were reported across the acute, middle, and late phase. Smaller magnitudes of sway path were observed for eyes-open sway path, and for the middle and late phase smaller magnitudes of vertical postural stability index (P <.05) at the end session compared with first session. Whereas larger magnitudes of vertical postural stability index were found between baseline and the last session (P <.05). Large interindividual and intraindividual variation was apparent across the 3 phases of rehabilitation. Postural control improvements were identified during rehabilitation. However, postural control did not return to baseline, with altered kinetics throughout each rehabilitation phase. [ABSTRACT FROM AUTHOR]

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Football players, particularly in youth leagues, face a high risk of lower limb injuries due to improper movement patterns. While programs like FIFA 11+ help reduce injuries, they lack real-time, personalized feedback for biomechanical correction. This concept protocol outlines the development of a DAid® smart socks-based biofeedback system that integrates biomechanical monitoring with mixed reality (MR) feedback to enhance injury prevention. The DAid® smart socks, equipped with pressure sensors and inertial measurement units (IMUs), track plantar pressure distribution and the center of pressure (COP). Real-time feedback is delivered via a Meta Quest 3 MR headset, enabling athletes to adjust movement patterns instantly. This protocol establishes a framework for evaluating the system's feasibility and effectiveness in optimizing biomechanics and reducing injury risks. By combining wearable technology with MR-based feedback, this study advances injury prevention strategies, with potential applications in rehabilitation and performance training. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the radiological and clinical outcomes in two patient groups: first, varus aligned medial meniscus posterior root tear (MMPRT) patients who underwent posteromedial open wedge high tibial osteotomy (PMOWHTO) and simultaneous root repair; second, patients with varus medial knee osteoarthritis without MMPRT who underwent PMOWHTO. Methods: Patients had MMPRT repair concomitant with PMOWHTO and varus medial knee osteoarthritis without concomitant root tear patients who underwent PMOWHTO and were reviewed. Radiographic parameters, medial meniscus extrusion (MME) and Knee Society Scores [KSSs, including the following subscores: knee score (KS) and knee function score (KFS)] were evaluated. Continious variables are expressed as the median and interquartile range (IQR) [IQR: (Q1;Q3); Q1: median of lower half, Q3: median of upper half]. The minimum follow-up period was 24 months [29 (28;35) months]. Results: A total of 36 knees of 34 patients underwent PMOWHTO were included. Patients were divided into two groups according to the presence or absence of a MMPRT. Nineteen of the 36 knees had MMPRTs, and all of them had concomitant root repair (Group 1). Seventeen of the 36 patients did not have MMPRTs (Group 2). The posterior tibial slope (PTS) decreased postoperatively in a total of 36 knees (p < 0.001). There were no significant changes in MME postoperatively in any intragroup comparison. The preoperative and follow-up MMEs of Group 1 were greater than those of Group 2 (p < 0.001). The KSs and KFSs in both Group 1 and Group 2 increased during follow-up [KS; Group 1: 43 (36;53) vs. 86 (84;95), p < 0.001. Group 2: 49 (45;57) vs. 89 (80;93), p < 0.001. KFS; Group 1: 60 (50;60) vs. 90 (80;100), p < 0.001. Group 2: 60 (50;60) vs. 80 (80;90), p < 0.001]. All knees achieved minimal clinically important difference (MCID) in terms of KSs. Eighteen (95%) knees achieved MCID in Group 1, and 17 (100%) achieved MCID in Group 2 in terms of KFSs. There were no differences between Groups 1 and 2 in terms of preoperative and follow-up KSs or preoperative KFSs. The follow-up KFSs in Group 1 was significantly greater than that in Group 2 (p = 0.032). Conclusions: PMOWHTO has favourable clinical and radiological outcomes and prevents PTS increase in simultaneous MMPRT repair and varus medial knee osteoarthritis patients without concomitant root tear. Level of evidence: Level IV, case series. [ABSTRACT FROM AUTHOR]

This study investigates the effects of electrical stimulation (EMS) combined with strength training on lower limb muscle activation and badminton jump performance, specifically during the "jump smash" movement. A total of 25 male badminton players, with a minimum of three years of professional training experience and no history of lower limb injuries, participated in the study. Participants underwent three distinct conditions: baseline testing, strength training, and EMS combined with strength training. Each participant performed specific jump tests, including the jump smash and static squat jump, under each condition. Muscle activation was measured using electromyography (EMG) sensors to assess changes in the activation of key lower limb muscles. The EMS intervention involved targeted electrical pulses designed to stimulate both superficial and deep muscle fibers, aiming to enhance explosive strength and coordination in the lower limbs. The results revealed that the EMS + strength condition significantly improved performance in both the jump smash and static squat jump, as compared to the baseline and strength-only conditions (F = 3.39, p = 0.042; F = 3.67, p = 0.033, respectively). Additionally, increased activation of the rectus femoris (RF) was observed in the EMS + strength condition, indicating improved muscle recruitment and synchronization, likely due to the activation of fast-twitch fibers. No significant differences were found in the eccentric-concentric squat jump (F = 0.59, p = 0.561). The findings suggest that EMS, when combined with strength training, is an effective method for enhancing lower limb explosiveness and muscle activation in badminton players, offering a promising training approach for improving performance in high-intensity, explosive movements. [ABSTRACT FROM AUTHOR]

Axillary crutches assist people with lower limb injuries but can lead to upper limb strain with extended use. Spring-loaded crutches offer a potential solution, yet they are rarely tested in clinical settings. This study developed spring-loaded crutches with an integrated force-measuring system to analyze gait dynamics. Three prototypes, each with different spring constants (k), were tested. To measure ground reaction force (GRF), a Nylamid cover was around the crutch stem. Two participants with different weights completed a 15-m route using both the designed spring-loaded and standard crutches. Findings showed that spring-loaded crutches increased mean GFR and impulse, with the prototype matched to the user's weight yielding the best results. The study's findings suggest that when properly adjusted to the user's weight, spring-loaded crutches can offer significant improvements in gait, which may have important implications for the design of mobility assistive devices. [ABSTRACT FROM AUTHOR]

Background: In the 21st century, disasters (particularly earthquakes, which remain the leading cause of death) continue to be among the foremost issues requiring global emergency response. While the impact of advancing technologies on the environmental and human damage caused by earthquakes is still a subject of debate, search and rescue (SAR) teams and emergency departments (ED), specifically emergency physicians (EPs), play a crucial role in the most acute management of the effects of these earthquakes on human life. This study aims to examine the injury dynamics of two catastrophic earthquakes that occurred in Turkey 24 years apart from the perspective of EPs, utilizing archival records from the SAR teams in which EPs served. Method: This study is a cross-sectional investigation analyzing the injury and SAR dynamics of casualties, based on the archives of SAR teams that included 12 EPs, during the 1999 Marmara and 2023 Kahramanmaraş (Maraş) earthquakes (groups). Results: In this study, a total of 160 injured individuals who were rescued alive from the rubble were included, with 26.3% (n = 42) from the Maraş group and 73.8% (n = 118) from the Marmara group. Identification of the injured was achieved in 54.8% (n = 23) of the Maraş group and 88.1% (n = 104) of the Marmara group, with an overall identification rate of 79.4% (n = 127) (p < 0.001). The most common injuries among the injured were lower extremity injuries (53.1%, n = 85) and upper extremity injuries (49.4%, n = 79), with the most frequent scenario being the extraction of two individuals from the same location (33.8%, n=54). The most common interventions provided to the injured were intravenous fluid therapy (63.8%, n =102) and oxygen support (57.5%, n =92). The rate of intubation at the scene was 16.1% (n = 19) in the Marmara group and 4.8% (n = 2) in the Maraş group (p < 0.05). Additionally, cardiopulmonary resuscitation (CPR) was administered at the scene in 13.6% (n = 16) of the Marmara group, compared to 2.4% (n = 1) in the Maraş group (p < 0.05). When examining the challenges encountered during SAR operations, the most frequent issue in the Maraş group was identification, affecting 57.1% of the cases (p < 0.001), whereas the most common issue in the Marmara group was entrapment, occurring in 50.0% of cases (p < 0.001). Lighting difficulties were observed at similar rates in both earthquakes (19.0% in Maraş, 19.5% in Marmara; p = 1.000). Additionally, weather conditions posed a challenge in 11.9% of cases in the Maraş group, whereas this issue was not encountered in the Marmara group (p < 0.001). Conclusion: The 24 years of experience and expertise gained by EPs who served in Türkiye in these operations constitute a valuable global resource. Disseminating this knowledge is crucial not only for managing earthquakes but also for preparing for other catastrophic events that could cause widespread destruction. Harnessing this accumulated experience can significantly enhance knowledge-sharing and the development of more effective preparedness strategies. [ABSTRACT FROM AUTHOR]

Ankle sprains are considered to be the most common musculoskeletal lower limb injury, accounting for a high percentage of all sport injuries in football. Motor imagery (MI) has been widely used for sports performance optimization purposes, suggesting that athletes' ability to reenact a motor action can improve sports performance and rehabilitation. The aim of the present study was to explore the role of MI as an adjunct intervention in VO2max and lactate in football players with Grade II ankle sprains during the return-to-play period. Fifty-eight professional football players were randomly divided into two groups: first, the MI (n = 29) and second, the placebo (n = 29). The MI group received recorded MI instructions, whereas the placebo group received only relaxation instructions. A one-way ANOVA revealed statistically significant results within the first 4 weeks following the interventions in both groups. Additionally, a t-test showed statistically significant differences between the two groups in VO2max (t = −6.04, p = 0.000, two-tailed, p < 0.05) and lactate (t = 4.33, p = 0.000, two-tailed, p < 0.05). Further research across various sports is needed to better understand the role of MI in the return-to-play period, particularly regarding injury management and sports performance. [ABSTRACT FROM AUTHOR]

Cholesterol crystal embolism (CCE) accompanied by a lower extremity wound is occasionally difficult to differentiate from chronic limb-threatening ischemia (CLTI) and treat. The present multi-center retrospective observational study investigated the clinical characteristics and prognosis of CCE with lower extremity wounds. Consecutive patients (n = 58) clinically diagnosed as CCE with lower extremity wounds between April 2010 and December 2019 were studied. CCE was diagnosed using histological findings, foot condition, renal impairment, and eosinophilia. The primary outcome was 1-year wound healing rate. Patients with CCE were compared with 1309 patients diagnosed with CLTI with tissue loss during the same study period. The CCE group had a significantly more severe Wound, Ischemia, and foot Infection (WIfI) classification compared with the CLTI group. After Kaplan–Meier analysis, the CCE group had a similar 1-year wound healing (55.1 vs 58.3%, P =.096) as the CLTI group. In multivariate stratified Cox regression analysis by WIfI stages, CCE was significantly associated with poor wound healing compared with CLTI [hazard ratio.36 (95% confidence interval.21–.62)]. In conclusion, among the similar WIfI clinical stages, wound healing was significantly worse in the CCE group than in the CLTI group. [ABSTRACT FROM AUTHOR]

Background: Open fractures have been associated with a higher risk of infection if antibiotics are not administered within 1 h of presentation in adult trauma patients. Time to antibiotic administration for open fractures is frequently used as a quality metric for trauma centers, but there have been no large studies evaluating this topic for pediatric patients. Methods: The 2019 Trauma Quality Improvement Program dataset was queried for patients ≤ 16 years old with isolated open femur or tibia fractures undergoing operative intervention after blunt trauma. Patients transferred from another hospital were excluded. Pediatric patients receiving early antibiotics (EA) within 1 h were compared to patients receiving delayed antibiotics (DA) greater than or equal to 1 h from arrival. Multivariate logistic regression was used to evaluate risk of surgical site infection (SSI). Results: There were 150 patients with open lower extremity fractures: 98 (64.9%) EA vs 52 (34.4%) DA. There was no difference in the rate of SSI between the 2 groups (EA: 1.0% vs DA: 1.9%, P = 0.65). There remained similar associated risk of infection after adjusting for lower extremity abbreviated injury scale >3, blood transfusion requirement, and vital signs on arrival (OR 0.62, 95% CI 0.04-10.24, P = 0.74). Conclusions: Most pediatric trauma patients with open lower extremity fracture received antibiotics within 1 h of presentation. However, SSI was rare and the risk of SSI was not associated with antibiotic administration within 1 h. Therefore, timing of antibiotic administration for pediatric open lower extremity fractures should be re-evaluated as a quality metric. Level of Evidence: Level III [ABSTRACT FROM AUTHOR]

• Applying XGBoost, identified key factors are injury location, race, age, safety compliance, and substance use. • Core clusters include older drivers, impaired young drivers, driver ethnicity, and motorcyclists. • Around 56% of injured roadway users tested positive for alcohol, THC, or other substances. • Young adults (21–34) with high BACs had higher severe injury rates. • Motorcyclists with inconsistent helmet use and substance involvement had high leg injuries. Alcohol and drugs, including Tetrahydrocannabinol (THC), significantly impact roadway safety by impairing cognitive functions, coordination, and reaction times, leading to increased crash risk and severity. This study examines the prevalence of alcohol and drugs among 4,586 injured roadway users (drivers, riders, and passengers) in the U.S. from 2019 to 2021, utilizing an XGBoost model to identify key variables associated with Injury Severity Score (ISS) in substance-related traffic crashes, and highlighting influential factors such as injury location, demographic characteristics (age, race), safety compliance, and alcohol and drug presence. These risk factors were further analyzed through Cluster Correspondence Analysis (CCA) to reveal patterns and trends affecting injury severity across different demographic and behavioral groups. The findings reveal that 55.8% of the injured tested positive for substances, with cannabinoids being the most common, followed by alcohol, stimulants, and opioids. This study identified six core crash clusters, each with distinct characteristics, including older drivers, impaired young drivers, specific driver ethnicities, and motorcyclists. Key findings from clusters indicate that older drivers, despite high safety compliance and negative substance tests, faced crash risks potentially due to age-related limitations. Impaired young adult crashes are characterized by risky behavior, including alcohol and THC use combined with low safety compliance, while motorcyclists with high substance involvement and inconsistent helmet use, are identified as a high-risk group, frequently experiencing severe leg injuries. These insights underscore the need for comprehensive traffic safety policies targeting substance use and promoting effective safety measures to mitigate crash risks and improve road safety. [ABSTRACT FROM AUTHOR]

Background: The co-occurrence of anterior cruciate ligament (ACL) rupture with medial collateral ligament (MCL) rupture is a compound injury that can be associated with meniscal tears. Purpose: To report the characteristics of meniscal tears in knees with isolated ACL versus combined ACL and MCL injuries, analyzing their frequency, distribution by site, and lesion type. Study Design: Cross-sectional study; Level of evidence, 3. Method: This prospective, multicenter, case-control study, conducted across 10 hospitals in France as part of a symposium of the national French Society of Arthroscopy, compared patients undergoing ACL reconstruction with and without MCL injury. The 2 groups were matched by sex, age (±3 years), and body mass index (±3) to minimize imbalances between groups. All operations were performed by senior surgeons, who systematically explored for ramp, root, and other types of meniscal lesions as well as corner injuries. The primary outcome focused on meniscal injury frequency, with secondary outcomes examining lesion sites and types. A subgroup analysis was performed to compare these outcomes depending on the injury chronicity. Acute ACL injuries were those treated within 3 months of injury, and chronic lesions were those treated after this period. Results: A total of 722 patients were included, with a mean age of 30.32 ± 10.78 years. Meniscal injuries were observed more frequently in the ACL+MCL group, with 217 of 408 patients (53.2%) affected, compared with 130 of 314 patients (41.4%) in the isolated ACL group (P =.001). Lateral meniscal lesions were significantly more common in the ACL+MCL group at 41.9% compared with 20.8% in the isolated ACL group (P <.001). The same pattern was found independent of chronicity. Medial meniscal lesions were significantly more common in the isolated ACL group regardless of chronicity status. In terms of types of medial lesions, the ACL+MCL group primarily experienced longitudinal (45.9%) and ramp lesions (28.7%), whereas the isolated ACL group experienced mostly ramp lesion (58.3%; P <.001). No significant difference was observed in the distribution of lateral meniscal injury types. Conclusion: This study demonstrated a higher prevalence of meniscal injuries associated with ACL+MCL injuries compared with isolated ACL injuries, with lateral meniscal lesions particularly more frequent, independent of chronicity status. [ABSTRACT FROM AUTHOR]

The Landing Error Scoring System (LESS) is a common assessment used to determine biomechanical landing errors. However, this assessment is completed as a single motor task, which does not require additional attentional resources. It is unclear if the LESS can be used to detect cognitive-motor interference (ie, dual-task cost) in biomechanical errors associated with lower extremity injury. To determine if the LESS is a suitable clinical assessment of dual-task performance in uninjured women and to evaluate whether specific landing criteria are more affected by an additional cognitive load than others. Cross-sectional study. University research laboratory. A total of 20 uninjured, physically active female participants (age = 22.4 ± 2.5 years, height = 1.68 ± 0.07 m, mass = 67.0 ± 13.8 kg, Tegner Activity Scale = 5.9 ± 1.1). Participants performed the LESS under 3 different conditions: baseline landing with no cognitive distraction (Single), a visual-based dual task (Visual), and a number-based dual task (Number). Mean sagittal-plane, frontal-plane, and total LESS scores were compared between conditions using a 1-way repeated-measures analysis of variance with Tukey post hoc correction. A Cohen d effect size with a 95% confidence interval was used to determine the magnitude of differences. The frequency of errors for each LESS item under the 3 conditions was compared using χ2 analysis. Participants exhibited greater sagittal-plane (P =.02, d = 0.91; 95% confidence interval, 0.26–1.56) and total (P =.008, d = 1.03; 95% confidence interval, 0.37–1.69) errors during the Visual condition than during the Single condition. The frequency of errors observed for each LESS item did not differ between conditions (all P >.05). The LESS was able to detect a dual-task cost in landing errors during both the Visual conditions. We recommend developing clinically oriented solutions to incorporate similar dual-task paradigms in traditional injury risk-reduction programs. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess physical performance and injury risk factors during an undergraduate dance program. The measures examined in this study were joint range of motion (JROM) and manual voluntary isokinetic contraction (MMT) of the hip and ankle, gait, and prevalence of pain and injury. The 30 female participants had been dancing for an average of 13 years. Fifty-two percent reported having had one or more injuries during their dance training years, and 85% reported experiencing pain in the legs or back. Asymmetry was found between the right and left legs during the JROM, MMT, and gait measures. Gait velocity, cadence, JROM, and MMT measures were at the lower end of the reported normal ranges. The results of this study provide evidence for recommending that undergraduate dance programs assess their students using a variety of measures to improve physical performance and reduce injury rates. [ABSTRACT FROM AUTHOR]

The anatomy of the sciatic nerve allows it to be blocked at different levels using various anesthetic approaches. However, for several reasons, performing these approaches may be challenging or disadvantageous in specific categories of patients, particularly in obese patients. The objective of this brief technical report is to describe a new technical approach to sciatic nerve block, designed to simplify the procedure for certain categories of patients and less experienced practitioners. Since 2010, more than 5000 procedures have been performed by both experienced anesthesiologists and novice trainees in several hospitals. The ultrasound lateral mid-shaft technique appears to be a safe and effective method for performing a sciatic nerve block, even in obese patients with significant subcutaneous fat and unclear ultrasound images. This approach is particularly beneficial given the various anatomical variations that can occur. By targeting the mid-thigh area, the ultrasound beam accesses anatomical structures that are more superficial, improving the technique's efficacy. Various hospital groups have been performing this technique as a routine procedure, achieving a success rate of nearly 100%. This impressive success rate exceeds that of other conventional techniques documented in the literature. Additionally, there have been significant improvements in comfort and ease for anesthetists. This method allows the anesthetic to spread around the paraneural sheath, covering the posterior femoral cutaneous nerve. Finally, it is performed in the supine position without the need to mobilize the lower limbs, ensuring patient comfort, especially in cases of fractures or lower limb injuries. Further studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We sought to develop recommendations to inform a framework for comprehensively assessing upper and lower limb pain in athletes including the key assessment items sports physiotherapists should consider. DESIGN: Real-time Delphi. METHODS: We recruited sports physiotherapists who were currently working with athletes through the International Federation of Sports Physical Therapists and Irish Society of Chartered Physiotherapists. Participants voted on 86 pain assessment items chosen using best available evidence. The real-time Delphi method facilitated independent anonymous voting, commenting, and immediate review of consensus. Participants indicated level of agreement for inclusion in an upper and lower limb athlete pain assessment framework on a 6-point Likert scale from strongly disagree to strongly agree, and how often they are/will be required in practice on a 5-point scale from never to always. Criteria for consensus agreement and inclusion were (1) >70% sports physiotherapists voting agree/strongly agree AND (2) median vote selected by physiotherapists was agree or strongly agree. RESULTS: Forty-one sports physiotherapists (female, n = 20; male, n = 21), visited the survey an average of 5.3 times (±5), resulting in a completion rate of 98%. Sixty-four assessment items (neurophysiology, n = 20; biomechanical, n = 15; affective, n = 8; cognitive, n = 3; socioenvironmental, n = 10; general assessment aspects of assessment, n = 8) met the criteria for consensus. Frequency of use in practice was always for 28 items often for 32 items and sometimes for 4 items. CONCLUSION: We have presented stakeholder-generated recommendations and priorities for assessing athletes' pain [ABSTRACT FROM AUTHOR]

BACKGROUND: The highest incidence of spinal fracture is in the thoracolumbar segment, and its symptoms are back pain, posterior convexity deformity, activity limitation, or with spinal cord nerve injury causing lower limb pain, numbness, and even paraplegia and other complications. The finite element method is a digital computer modeling technique, which can simulate the physical model and carry out force analysis realistically. OBJECTIVE: To review the application of finite element method in thoracolumbar spine fractures. METHODS: We searched the Chinese and English literature databases PubMed, Web of Science, and CNKI for relevant literature on the application of the finite element analysis method in spinal thoracolumbar fracture published before March 2024. The search terms in Chinese and English were: finite element analysis methods, biomechanical phenomena, stress analysis, thoracolumbar fractures, spinal fractures. Finally, 55 papers were included. RESULTS AND CONCLUSION: (1) The exploration of thoracolumbar fractures caused by different etiologies (osteoporotic, traumatic, and pathological) through the finite element method is conducive to a deeper understanding of the biomechanics of various types of thoracolumbar fractures, and to improve the individualized and fine-tuned treatment of thoracolumbar fractures. (2) The finite element analysis of a single sample or a small number of samples has the chance, and a larger number of samples are required for the future finite element analysis to reduce the chance caused by the sample. (3) The rigid structure of bones alone cannot meet the biomechanical working conditions of the integrity of the physical object, and future finite element models need to incorporate all the structures of the physical object (e.g., soft tissues, such as muscles and ligaments) as far as possible. (4) The finite element method has been used in more studies on osteoporotic and traumatic thoracolumbar spine fractures, which will need to be more in-depth in the future, and less in the field of pathologic thoracolumbar fractures, which has a wider scope for future research. [ABSTRACT FROM AUTHOR]

Context: Current lower-extremity return to sport testing primarily considers the physical status of an athlete; however, sport participation requires continuous cognitive dual-task engagement. Therefore, the purpose was to develop and evaluate the reliability of a visual-cognitive reactive (VCR) triple hop test that simulates the typical sport demand of combined online visual-cognitive processing and neuromuscular control to improve return to sport testing after lower-extremity injury. Design: Test–retest reliability. Methods: Twenty-one healthy college students (11 females, 23.5 [3.7] y, 1.73 [0.12] m, 73.0 [16.8] kg, Tegner Activity Scale 5.5 [1.1] points) participated. Participants performed a single-leg triple hop with and without a VCR dual task. The VCR task incorporated the FitLight system to challenge peripheral response inhibition and central working memory. Maximum hop distance, reaction time, cognitive errors, and physical errors were measured. Two identical testing visits were separated by 12 to 17 days (14 [1] d). Results: Traditional triple hop (intraclass correlation coefficients: ICC(3,1) =.96 [.91–.99]; standard error of the measurement = 16.99 cm) and the VCR triple hop (intraclass correlation coefficients(3,1) =.92 [.82–.97]; standard error of the measurement = 24.10 cm) both demonstrated excellent reliability for the maximum hop distance, and moderate reliability for the VCR triple hop reaction time (intraclass correlation coefficients(3,1) =.62 [.09–.84]; standard error of the measurement = 0.09 s). On average, the VCR triple hop resulted in a hop distance deficit of 8.17% (36.4 [5.1] cm; P <.05, d = 0.55) relative to the traditional triple hop. Conclusions: Hop distance on the VCR triple hop had excellent test–retest reliability and induced a significant physical performance deficit when compared with the traditional triple hop assessment. The VCR triple hop reaction time also demonstrated moderate reliability. [ABSTRACT FROM AUTHOR]

BackgroundObjectiveMethodsResultsConclusionThe Upper Quarter Y Balance Test (YBT-UQ) assesses upper limb dynamic balance in able-bodied individuals but lacks a reliable version for those with disabilities.This study aimed to introduce a modified YBT-UQ (mYBT-UQ) for physically impaired individuals (PI) and establish its validity and reliability.The study involved 33 male athletes aged 18–55, divided into three equal groups: able-bodied, spinal cord injury with trunk control (SCI), and below-the-knee amputation (BKA). To ensure test validity, able-bodied athletes completed both tests. Test-retest reliability was evaluated by repeating the mYBT-UQ seven days after the first test by PI groups. The validity was assessed using the Pearson correlation and Bland-Altman plot. The intraclass correlation coefficient (ICC) (2,1), standard error of measurement (SEM), and the minimal detectable change with 95% confidence (MDC95%) were calculated to assess relative and absolute reliability.There were significant differences and excellent relationships between YBT-UQ and the mYBT-UQ. Also, the Bland-Altman plot showed minimal bias and an acceptable range of agreement. In athletes with BKA, the ICC (2,1) was above 0.90 for both limbs. The SEM ranged from 2.4%-2.7%, and MDC95% ranged from 6.7%-7.5%. In athletes with SCI, the ICC (2,1) ranged from 0.72–0.80. The SEM ranged from 3.1%-3.2% and MDC95% ranged from 8.6%-8.9%.The results indicate that the mYBT-UQ is a reliable test to assess upper quarter dynamic balance in athletes with SCI and BKA. However, regarding the small sample size of the study, there is a need to conduct other research to establish the validity of the test. [ABSTRACT FROM AUTHOR]

Objective: This study aims to identify significant factors influencing lower limb injury trends during integrated active–passive collision processes, and further analyze the influence of automatic emergency braking (AEB) on lower limb injuries. Methods: First, an integrated active–passive simulation environment is being established. Subsequently, nine sets of simulations are being designed using the orthogonal experiment method to identify significant factors related to AEB. Finally, impact simulations are being conducted based on the significant factors, and the disparities in lower limb injuries between AEB-activated and nonactivated conditions are being compared. Results: The analysis of variance (ANOVA) shows that the duration of AEB has a significant effect on lower limb injury, and the main effect value of left femoral force increases by 19.33% (0.79kN) when AEB lasts for 300ms compared with 100ms. An acetabular fracture has been found in the AEB-activated condition, which is a serious injury not found in the AEB-nonactivated condition, indicating the importance of careful application of the AEB. Discussion and Limitations: Lower limb injuries warrant attention in future research on integrated active and passive safety. The negative effect of AEB on lower limb injury can be attributed to dangerous pre-impact body posture resulting from inadequate performance of the restraint system. The study investigates the respective levels of AEB parameters on lower limb injuries and quantitatively analyzes the effects of AEB, providing a process reference for future integrated active–passive safety assessments. [ABSTRACT FROM AUTHOR]

The lower limbs play an important role in daily human activities. Therefore, a 3D tibial model is constructed, and finite element analysis is performed to investigate the biomechanical characteristics and injury tolerance of lower limb flexion movement. The maximum equivalent stress at 30° flexion was 19.1 MPa and 31.2 MPa in the normal and dynamic eversion positions, respectively, of the knee joint, 1.4 MPa and 1.1 MPa in the medial tibial plateau, and 1.8 MPa and 1.2 MPa in the lateral tibial plateau. The peak contact force was generally approximately 4000 N when different positions of the tibia were impacted. The maximum contact force of the frontal impact was larger than that of the external impact at 4109 N and 3927 N, respectively. The dynamic knee valgus posture and lateral impacts are more likely to cause tibial injury. The findings of this study provide information for the prevention of sports injuries and rehabilitation treatment. [ABSTRACT FROM AUTHOR]

Guidance recommends that prescribed opioids for acute pain should not be continued beyond the expected period of healing and may lead to long-term use if a large supply is provided or repeat prescriptions are requested. This project investigated how opioids are used by opioid-naïve trauma patients in the first 6 months following discharge from hospital. The findings indicate that patients are frequently discharged from hospital with an opioid prescription and for some this will continue beyond the recommended maximum duration of 3 months and will include dose escalation. Clinicians should be aware of the potential risks associated with prolonged opioid use, including the increased risk of accidental overdose and potential death, and be able to identify which patients are at most risk. Screening for indicators for long-term use may prove more useful than formal risk stratification tools in an acute pain population. [ABSTRACT FROM AUTHOR]

Thai classical dance has earned recognition across the world, however, attention on the health of dancers has not been well implemented. This study aimed to report on the prevalence of musculoskeletal injuries in Thai classical dancers. The descriptive cross-sectional survey study was implemented. A total of 356 (amateur = 221, professional = 135) Thai classical dancers participated (male = 111 and female = 245). The questionnaire was applied to harvest the key information. The results presented that amateurs (39.84%) had a higher rate of injury than professional dancers (11.48%), and males (60.36%) had a higher rate of past injury than females (49.80%). The most common past injuries of both amateur and professional dancers were: knee (22.62%, 12.59%), ankle (12.67%, 9.63%), and foot (12.2%, 8.15%), respectively. The number of past injury sites per person was significant differences between males and females (p < 0.04). Present injury sites in both amateur and professional dancers were: knee (16.06%, 25.68%), ankle (9.84%, 9.46%), and lower back (8.29%, 9.46%), respectively. In conclusion, the lower extremity injury is commonly presented in both amateur and professional dancers. Clinicians and dance educators might use these injury results in clinic and educate Thai classical dancers for safety and prevention. [ABSTRACT FROM AUTHOR]

Aims: Pain can create physical and psychosocial discomfort. Pain management of patients with opioid misuse history can be challenging, in part due to their tolerance to opioids. Clonidine is an alpha‐2 agonist that has been used for the reduction of anxiety and pain. The aim of this study was to investigate the effect of oral clonidine on pain outcomes in patients with a history of opioid use disorder presenting with orthopaedic fractures in the emergency room. Methods: In this blinded clinical trial in the emergency department, 70 opioid‐dependent patients with orthopaedic fractures were divided into a control group of 35 and an intervention group of 35 subjects. Initially, 0.2 mg of oral clonidine was given to the intervention group and the control group received placebo tablets. Pain levels were recorded based on the Numerical Rating Scale rating before intervention, at 30 min, 1 h after intervention and at disposition from the emergency room (3‐6 h after intervention). The total morphine requirement was also recorded. Results: The pain score of the clonidine group was significantly lower than that of the control group at 1 h and at disposition time. The amount of morphine required was significantly reduced in the clonidine group (P < 0.05). Oral clonidine had no significant effect on pulse rate. Oral clonidine was more effective for pain reduction in lower limb injuries. Conclusion: Oral clonidine significantly reduced pain and the need for morphine in opioid‐dependent patients with orthopaedic fractures. [ABSTRACT FROM AUTHOR]

To know the clinical signs and radiological findings of different types of maxillofacial fractures following facial trauma in road traffic accidents. In this retrospective study, the medical records and computerized tomography scans of 100 patients who have sustained facial fractures in road traffic accident during 2021–2022 were reviewed at Raichur Institute of Medical Sciences, Raichur; for maxillofacial fractures. Data was tabulated and statistically analysed using SPSS software version 21. 100 patients who have sustained maxillofacial injuries in road traffic accident were included in the study. Male to female ratio was 8:1. Most common age group involved was 21–30 years. Maximum number of accidents occurred during night and 38% contributed to driving under the influence of alcohol. Clinical examination findings ranged from simple abrasion, swelling/odema/haematoma, contusion to lacerations and loss of tissue. Of 66 patients with Ear Nose Throat (ENT) bleed, 26 had ear bleed, 34 had nose bleed and 17 had oral cavity bleed. Maximum individuals in the study had orbital fractures (44%). 45% had associated head injury. 30 patients had associated injuries of upper limbs, 25 had lower limb injuries and 8% had blunt trauma. 47% patients required neurosurgical intervention, 44% ophthalmology, 39% faciomaxillary surgeon intervention. Maxillofacial injuries following road traffic accidents are more common as face is the most exposed part of the body. Managing patients with road traffic accidents requires multi disciplinary approach. Safety precautions while driving like use of driving accessories, following traffic rules plays major role. This study will help the policy makers to evolve a better trauma care program by focusing on the target groups and introducing cost effective preventive measures. [ABSTRACT FROM AUTHOR]

Vinegaroons in the high desert grasslands of southeastern Arizona spend much of the year in deep sealed underground cells and dig to the surface when the first summer rains begin in late June or during July. They are active only at night, when they are large apex ambush predators that prey on a variety of small, surface-dwelling animals. Adult and last instar immature vinegaroons were frequently observed, whereas the smaller first three instars were rarely seen. Using mark-capture techniques, the density of individuals in the area was found to be at least 95 individuals/ha to as high as 680 individual/ha. The population profile remained mostly steady over several years with adults and 4th instar immatures constituting 90% of the observed population. Females were mainly present during the earlier part of the foraging season. In contrast, males were active much longer and until the end of season. The three first instars of vinegaroons spent little time on the surface of the ground partly because they are vulnerable to predators and partly because they require few prey items to accumulate the necessary reserves for molting to the next instar. About 12% of the population had injuries, or signs of previous injuries. Most injuries were to their tail-like flagellum, with a few sensory leg injuries. Short, regrown flagella in field individuals showed their ability to regenerate these lost appendages and laboratory experiments demonstrated that vinegaroons can regenerate lost parts of sensory legs and even their hard, powerful pedipalps. [ABSTRACT FROM AUTHOR]

Achilles tendinopathy (AT) is a common debilitating tendon disorder in the lower extremity. Clinical presentation of AT might differ from place to place, depending on different variables including cultural factors. This study was conducted to determine the clinical picture of AT in a group of clients referring to an outpatient orthopedics clinic in Shiraz, southern Iran. In this cross-sectional study, a convenient sample of 61 (46 female and 15 male) patients attending to a referral outpatient clinic affiliated to Shiraz University of Medical Sciences with a definite diagnosis of AT was studied. Patients with partial- or full-thickness tear of Achilles tendon, history of radicular pain or lower extremity injury, previous history of surgery on their lower extremity, and pregnant women were excluded from the study. We used Maffulli et al. (Foot Ankle Surg 26:240–9, 2020) criteria for the diagnosis of AT in our patients. The patients had a mean age of 47.7 (SD 11.1) years and mean BMI of 28.7 (4.2) kg/m2. There was no significant correlation between the age and body mass index of the participants (Pearson's r = –0.028, p = 0.832). The prevalence of insertional AT among 58 patients with only one site affected, was 84% (95% CI 72–92%), significantly (p < 0.001) higher than that of midportional AT (16%). Women were more frequently affected than men (p < 0.001). The clinical presentation of AT in southern Iran is somewhat different from those reported in other parts of the world. Further studies on larger groups of patients should be done to determine the causes of the observed differences. [ABSTRACT FROM AUTHOR]

Background: A landing error scoring system (LESS) is widely used to evaluate landing maneuvers. Poor landing maneuvers, such as lateral bending of the trunk, are thought to be associated with a risk of lower-extremity injury. However, no studies have examined the association between landing and trunk muscle function, which is associated with a high risk of lower-extremity injury. Hypothesis/Purpose: This study examined whether an association exists between landing movements and a high risk of lower-extremity injury and trunk muscle function. It was hypothesized that athletes with poor activation of deep trunk muscle (transversus abdominis and internal oblique) would have lower LESS scores. Study Design: Cross-sectional study Methods: The trunk muscle thickness at rest and during the plank was measured using ultrasonography. The percent of change in muscle thickness (during plank/at rest) was calculated. The LESS was measured using the Physimax. Based on the LESS scores, patients were divided into high- (LESS > 6) and low-risk (5 > LESS) groups for lower extremity injury. The relationship between the high-risk group and trunk muscle thickness was examined using a stepwise regression analysis. Results: The high-risk group had significantly lower muscle thicknesses of the transversus abdominis (p=0.02) and transversus abdominis plus internal oblique abdominis (p=0.03) muscles during the plank. Additionally, the high-risk group showed significantly lower percent of change in muscle thickness of the internal oblique (p=0.02) and transversus abdominis plus internal oblique (p=0.01) muscles. Only the percentage of change in the thickness of the internal oblique and transverse abdominal muscles was extracted from the regression as a factor. Conclusion: The findings indicated that athletes with landing movements and a high risk of injury, as determined based on the LESS results, had low trunk muscle function, and a relationship was observed between the change in thickness of transversus abdominis and internal oblique abdominis muscles. Level of Evidence: 3B [ABSTRACT FROM AUTHOR]