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To evaluate results of mini-open fasciotomy (MOF) in high-level motorcycling or motocross riders with chronic exertional compartment syndrome (CECS) at long-term follow-up (minimum 5 years).Case series.IV.University Hospital/Private Practice.Fifty-four professional motorcycling riders treated with MOF for a CECS of the forearm from January 2006 to June 2011. Inclusion criteria comprised: high-level motorcycling or motocross riders, clinical symptoms of CECS for at least 6 months, diagnosis confirmed using preoperative compartment hydrostatic pressure measurement and/or magnetic resonance imaging of the forearm, minimum follow-up of 5 years.A MOF to obtain decompression of all compartments was performed in all patients.Visual analog scale; a subjective scale to measure strength; QuickDash functional scores. Time to resume full riding capacities as short-term evaluation.A total of 54 patients who underwent 77 MOF procedures overall (23 bilateral) were included. The mean age was 23.6 ± 5.2 years. Mean Visual Analog Scale decreased from a preoperative value of 68.2 to a 3-month postoperative value of 26 (P0.001). Mean QuickDash scale was 84 at preoperative registration, falling to 20, 3 months after surgery (P0.001) and down to 12 at 1-year follow-up (P = 0.017). The average time to return to full riding capacities was 3.5 ± 1 week.Mini-open fasciotomy resulted safe and effective for the treatment of chronic exertional compartment syndrome in high-level motorcycling or motocross riders. The good outcome at follow-up resulted stable at 5 years and the incidence of complications remained low. Our data demonstrate that the resolution of symptoms is reliable and durable. Pain recovery was immediate after surgery, instead functional scores showed a more gradual recovery throughout the 12 months after surgery.Mini-open fasciotomy is a reliable treatment for CECS of the forearm in professional motorcycling riders. This treatment should also be considered in young riders due to the absence of tardive relapse reported in this study.

Summary Background The MotoGP World Championship is the worldwide premier class of motorcycle road racing, divided in three competition classes: MotoGP, Moto2 and Moto3. Material and methods This study investigates the incidence, pattern, relative risk, and external factors affecting injuries recorded by the "Clinica Mobile" Medical Team during the 2014 season. A total of 101 elite motorcycle competitors were followed during the entire season. A general encounter-related database has been created: the data included age, experience, date of injury, injury diagnosis, mechanism of injury, protective gear used and total time lost of participation. Results One hundred and ninety-one injuries were recorded during the study timeframe: 28 were major injuries (14.6% of total encounters). The most common major injuries were fractures (9.9%), followed by joint dislocations. The overall injury rate in the MotoGP group was 4.14 per 1000 practice kilometers and 3.8 per 1000 race kilometers and the death rate was zero. Moto2 and Moto3 riders showed a higher injury risk than MotoGP riders. Conclusions This study showed that, in the MotoGP World Championship, both deaths and serious injuries are rare but improvement of safety rules for practice sessions and the development of more effective safety gear are keys to further reduce the incidence of those accidents.

OBJECTIVE Evaluate treatment and outcome of mini-open fasciotomy (MOF) in a population of adolescent motorcycling racers affected by forearm chronic exertional compartment syndrome (CECS). DESIGN Prospective case series. SETTING University hospital/private practice. PATIENTS Nine professional motorcycling adolescents were diagnosed with forearm CECS. All were treated with MOF between 2007 and 2012 and followed for a minimum of 5 years (range 5-10 years). Age, sex, body mass index, laterality, and profession were recorded. INTERVENTIONS A MOF to obtain decompression of all compartments was performed in all patients. MAIN OUTCOME MEASURES Visual analog scale; a subjective scale to measure strength; and Quick-DASH functional scores. Time to resume full riding capacities as the short-term evaluation. RESULTS A significant decrease in visual analog scale (P < 0.001) and Quick-DASH (P < 0.001) scores was observed in the first 3 months, stabilizing during follow-up (P = 0.521; P = 0.217). Average time to return to sport was 2.8 ± 1 week. No symptom recurrence was reported, but one patient suffered a minor complication. There were no cases of infection, hematoma, or peripheral nerve injury. CONCLUSIONS We assess that MOF can be a valid alternative for the treatment of forearm CECS in adolescent competitive motorcycling racers, as demonstrated by the good success rate and minimal incidence of complications during follow-up. LEVEL OF EVIDENCE IV, case series.

Background and aim of the work: Intersection syndrome is an uncommon and underdiagnosed condition, especially found in sport overuse. This case report describes the treatment of a professional motor biker who presented intense wrist pain and swelling after training sessions. Methods: The athlete was treated with rest, the use of a wrist splint combined with NSAIDs, physical therapy, including pulsed Nd-YAG laser therapy and exercise, such as stretching and release, massage and eccentric training. Results: The applied therapeutic protocol was successful and allowed the biker to completely resolve the symptoms and return to training session and professional races at full power. The results are durable at 5 months post injury follow up. Conclusions: This experience suggests that pulsed Nd-YAG laser therapy can be an additional useful tool in the global approach treatment for intersection syndrome, contributing with splint and manual therapy, to full recovery even in mechanically stressful conditions. (www.actabiomedica.it)

Hypothermia is an independent predictor of increased morbidity and mortality in patients with trauma. Several strategies and products have been developed to minimise patients' heat loss in the prehospital arena, but there is little evidence to inform the clinician concerning their effectiveness.We used a human torso model consisting of two 5.5-litre fluid bags to simultaneously compare four passive (space blanket, bubble wrap, Blizzard blanket, ambulance blanket) and one active (Ready-Heat II blanket) temperature preservation products. A torso model without any temperature preservation device provided a control. For each test, the torso models were warmed to 37°C and left outdoors. Core temperatures were recorded every 10 min for 1 h in total; tests were repeated 10 times.A significant difference in temperature was detected among groups at 30 and 60 min (F (1.29, 10.30)=103.58, p0.001 and F (1.64, 14.78)=163.28, p0.001, respectively). Mean temperature reductions (95% CI) after 1 h of environmental exposure were the following: 11.6 (10.3 to 12.9) °C in control group, 4.5 (3.9 to 5.1) °C in space blanket group, 3.6 (3 to 4.3) °C in bubble-wrap group, 2.1 (1.7 to 2.5) °C in Blizzard blanket group, 6.1 (5.8 to 6.5) °C in ambulance blanket group and 1.1 (0.7 to 1.6) °C in Ready-Heat II blanket group.In this study, using a torso model based on two 5 L dialysate bags we found the Ready-Heat II heating blanket and Blizzard blanket were associated with lower rates of heat loss after 60 min environmental exposure than the other devices tested.

The manuscript reports the case of a 16-year-old boy who fell from a height of 15 meters while having a cellphone conversation. Surprisingly, only minor injuries were reported. Prognostic factors related to falls from height are still debated; the present case is a further contribution to the discussion.

Maternal hypotension during spinal anaesthesia for Caesarean delivery is a common event, with potential detrimental consequences. We led a prospective, randomized study to compare the effects of two strategies on neonatal and maternal wellbeing.Parturients scheduled for elective Caesarean section in spinal anaesthesia were preoperatively studied with a supine stress test. Those with a positive test were enrolled in the study and received a solution of 0.5% hyperbaric bupivacaine 12.5 mg and 0.02% morphine 200 µg intrathecally. Patients received a 37.5 mg/h preventive intravenous (IV) infusion of ephedrine (Pharmacologic Group), or a 15° left lateral tilt (Non-Pharmacologic Group). In Pharmacolgic Group hypotension was treated for 20% drops in systolic blood pressure; in Non-Pharmacolgic Group only severe hypotension - defined as a 40% drop in systolic blood pressure - was treated.Thirty-six patients were studied. Study groups were statistically similar in terms of demographic variables and intraoperative times. No statistical differences were found in terms of umbilical arterial blood base excess [-1.4 (-3.7 to -0.3) mEq/l Pharmacologic Group vs. -1.7 (-2.7 to -1.0) mEq/l Non-Pharmacologic Group; p=0.815] and other umbilical blood gas values. Apgar scores were statistically similar between study groups. Treatment for hypotension was required by 13 (72.2%) patients in Pharmacologic Group and 9 (50%) patients in Non-Pharmacologic Group (p=0.171). No differences were found at the analysis of serial changes in vital signs.Both studied strategies guaranteed a comparable safe outcome in terms of maternal and neonatal wellbeing. (www.actabiomedica.it).