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Purpose: The objective of this study was to determine the current Swedish epidemiology of sport‐related eye injuries and to analyse the effect of the increased popularity of the racquet sport padel. Methods: This was a retrospective, register‐based, cohort study of medical records in the county of Jönköping, Sweden. All individuals with a sports‐related eye injury needing healthcare between January 2017 and December 2021 were included. For these individuals, data about background, consequences and treatment of the injuries were obtained. Results: During the 5‐year study period, 255 patients sought care for sports‐related eye injuries at the ophthalmological clinics in Jönköping County. Floorball caused the largest proportion of eye injuries (39%) followed by padel (20%) and football (15%). However, the proportion of injuries caused by padel increased during the study period to be the dominating cause in 2021. Compared to floorball, patients with eye injuries from padel were older and had female gender to a higher extent. The ball caused almost all injuries from padel; the majority occurred in the right eye. Most the eye injuries from padel were mild or moderate but 4% had severe consequences with an imminent risk of long‐term complications. Conclusions: In a short time period, padel has become the leading cause of sports‐related eye injuries in Sweden. To reduce the number of eye injuries, protective eyewear could be recommended. [ABSTRACT FROM AUTHOR]

Objectives: Investigate the characteristics of wrist, hand and finger (WHF) injuries in Australian footballers presenting to EDs and determine if injury profiles differed between females and males, and between children and adults. Methods: In this prospective observational study that took place during an entire football season, patients attended 1 of 10 EDs in Victoria, Australia with a WHF injury sustained while playing Australian football. Data were extracted from patient medical records by trained researchers. Data included injury type (e.g. fracture), body part (e.g. metacarpal) and mechanism of injury. Males versus females, and children versus adults were compared using chi‐squared tests or Fisher's exact tests. Results: In total, 528 patients had a WHF injury, of which 105 (19.9%) were female and 308 (59.2%) were children. Fractures and sprains were the most common injury types (45.3% and 38.6%, respectively). Fingers were more often injured than wrists or hands (62.5%, 23.5% and 15.0%, respectively). Ball contact was the most common mechanism of injury (38.1% of injuries). Females were more likely than males to (i) have a sprain/strain injury, (ii) injure a finger (rather than wrist or hand) and (iii) injure themselves through ball contact. Children were more likely to injure their wrists, have a sprain/strain injury, or be injured falling to the ground. Adults were more likely to dislocate a joint or injure their hands. Conclusions: Differences in injury type, location and mechanism between females and males, and children and adults, suggest an opportunity for customised injury prevention and management strategies by sex and age. [ABSTRACT FROM AUTHOR]

Objective: Investigate the economic consequences of injuries to female Australian footballers from a health sector and societal perspective. Methods: This prospective observational study invited 242 females to complete an online questionnaire 3–6 months following an Australian football injury which involved presentation to an ED in Victoria, Australia. The questionnaire inquired regarding healthcare use, time off work, return to playing football and extent of recovery following injury. Relevant information was also extracted from respondents' medical records regarding injury‐type, body part injured, investigations and treatments. Healthcare costs were determined for each respondent's ED presentation, hospital admission/s (when relevant), and subsequent healthcare use. Societal costs were determined as lost income to the respondent and/or carer. Results: A total of 108 people responded to the questionnaire. Sprains/strains and fractures accounted for 84.2% of respondents' injuries. Sixteen respondents (14.8%) required admission to hospital at the time of injury and 81 (75.0%) required subsequent healthcare appointments following discharge from the ED or hospital. Time off work or school following the injury was common (64.8% of respondents) and 27.8% of respondents had a carer take time off work. More than 80% of respondents missed training and matches following the injury. The median healthcare cost per respondent was AUD$753 and the median cost due to work absence was AUD$1393. One‐quarter of respondents reported a full recovery. Conclusions: Injuries to female Australian footballers can produce substantial healthcare and societal costs, which has important implications for healthcare provision and prioritising and implementing injury prevention programmes and post‐injury rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: Understanding epidemiological patterns in patients with severe sports-related injuries between children and adults is important for injury prevention. We ought to describe the characteristics and outcomes of patients with severe sports-related injuries and compare the characteristics between children and adults. Methods: We conducted a retrospective analysis of the Japan Trauma Data Bank (JTDB). We included patients with sports-related injury and an ISS of at least 16, who were admitted between 2004 and 2018. We compared characteristics between children (< 18 years) and adults (≥ 18 years). We performed a multivariable logistic regression analysis to compare in-hospital mortality. Results: We identified 1369 eligible patients (children, n = 326; adults, n = 1043). The most common season was April–June and July–September in children (28.5% and 27.9%) and January–March in adults (42.1%). Injuries to the head/neck (58.9% vs. 40.8%, p < 0.001) and abdomen (16.0% vs. 8.3%, p < 0.001) were significantly more frequent in children than adults, while injuries to the thorax (8.0% vs. 27.2%, p < 0.001), pelvis/lower extremity (0.6% vs. 6.0%, p < 0.001), and spine (23.9% vs. 35.3%, p < 0.001) were less frequent in children. We did not observe a statistically significant difference in in-hospital mortality between children and adults. Conclusions: We conducted a comprehensive analysis of severe sports-related injuries using a nationwide trauma database and demonstrated different patterns of severe sports-related injuries in children and adults. [ABSTRACT FROM AUTHOR]

Handball is a high-intensity contact sports activity characterized by repetitive movements, leading to sport-specific muscle patterns. However, at some stage, this pattern may turn into imbalance, predisposing athletes for injuries. The complexity of muscular interactions often makes it difficult to see a whole picture of an athlete's postural disorders and assess them within the framework of his stereotyped movements. We attempted to find an association between the muscle pattern and the number of injuries in a limited group of handball players by constructing a static logistical model. The constructed decision table of the static logistical model included seven conditional attributes of the muscle imbalance as preconditions for injury development and one decision attribute representing the number of experienced injuries of 25 university handball players. The findings displayed a sport-specific pattern of muscle alignment in athletes without or only one injury. However, all players with repetitive injuries had unilateral m. gluteus maximus weakness. In the latter case, impaired core body musculature can lead to increased share forces and stress for the gluteus maximus muscle leading to weakness of this crucial dynamic stabilizer. The logistical model allowed defining muscle imbalance associated with sports-related injuries in a limited group of athletes. [ABSTRACT FROM AUTHOR]

A sex-specific manner in running tasks is considered a potential internal injury risk factor in runners. The current study aimed to investigate the sex differences in running stability in recreational runners during self-preferred speed treadmill running by focusing on a whole-body movement. To this end, principal component analysis (PCA) was applied to kinematic marker data of 22 runners (25.7 ± 3.3 yrs.; 12 females) for decomposing the whole-body movements of all participants into a set of principal movements (PMs), representing different movement synergies forming together to achieve the task goal. Then, the sex effects were tested on three types of PCA-based variables computed for individual PMs: the largest Lyapunov exponent (LyE) as a measure of running variability; the relative standard deviation (rSTD) as a measure of movement structures; and the root mean square (RMS) as a measure of the magnitude of neuromuscular control. The results show that the sex effects are observed in the specific PMs. Specifically, female runners have lower stability (greater LyE) in the mid-stance-phase movements (PM4−5) and greater contribution and control (greater rSTD and RMS) in the swing-phase movement (PM1) than male runners. Knowledge of an inherent sex difference in running stability may benefit sports-related injury prevention and rehabilitation. [ABSTRACT FROM AUTHOR]

Kumagai, H, Miyamoto-Mikami, E, Kikuchi, N, Kamiya, N, Zempo, H, and Fuku, N. A rs936306 C/T polymorphism in the CYP19A1 is associated with stress fractures. J Strength Cond Res 36(8): 2322–2325, 2022—A stress fracture (SF) is an overuse injury, and low bone mineral density (BMD) is the risk factor for the SF. Estrogen is suggested to have a crucial role in bone metabolism, and estrogen-related genetic polymorphisms are associated with BMD. However, the possible association between SF and estrogen-related genetic polymorphisms has not been clarified yet. Therefore, we aimed to clarify whether estrogen-related genetic polymorphisms are associated with a history of SFs in Japanese athletes. A total of 1,311 (men: n = 868, women: n = 443) top-level Japanese athletes who participated in various sports and at different levels were analyzed. The history of SFs was assessed using a questionnaire, and the cytochrome P450 aromatase gene (CYP19A1) rs936306 C/T and estrogen receptor α gene (ESR1) rs2234693 T/C polymorphisms were analyzed using the TaqMan genotyping assay. The genotype frequency of the CYP19A1 C/T polymorphism was significantly different between the injured group and noninjured group under the C allele additive genetic model (odds ratio = 1.31, 95% confidence interval = 1.01–1.70), especially in men and in women with irregular menstruation. On the other hand, there were no significant differences with the ESR1 T/C polymorphism. This study demonstrated that the C allele in the CYP19A1 rs936306 polymorphism is a risk factor for SFs in top-level Japanese athletes. [ABSTRACT FROM AUTHOR]

The combined model of testing the athletes encompasses the assessment of basic motor skills, psychological stress testing, and genetic testing, whereby genetic predisposition is important for determining the athletes’ predisposition for specific disciplines and risk of sports-related injuries. The insertion/deletion (I/D) allele of the angiotensin-converting enzyme gene (ACE) (rs1799752) is one of the most studied polymorphisms, with the I allele linked to enhanced performance in runners and rowers and generally in disciplines requiring endurance, while the D allele is associated with sports requiring strength and power. The ACTN3 (alpha-actinin-3) rs1815739 polymorphism is linked to athletic performance, with the 577R allele associated with lower risk of training-related injuries and a better response to intensive exercises and training process, while the 577X variant is found in fewer athletes and is associated with increased likelihood of injuries due to intensive training process, thus requiring additional caution. We are hereby presenting the first results of genetic testing of 32 young Alpine skiers over these two genetic polymorphisms. DNA isolation from whole blood samples was done using the PureLink™ Genomic DNA Mini kit, followed by amplification of target polymorphisms using real-time PCR with TaqMan SNP assays. Regarding ACTN3 genotypes, 58.1% of successfully analyzed participants were C/C homozygotes (577RR), 32.3% were T/C heterozygotes (577RX), and 9.7% were T/T homozygotes (577XX). The results were inconclusive for one participant. Regarding ACE testing, 25 participants were successfully genotyped and none of them carried Alu sequence (i.e., all participants were D/D homozygotes). The results of genetic testing could serve as valuable guidance for optimizing training based on the obtained results, potentially reducing the frequency of athletes’ injuries. [ABSTRACT FROM AUTHOR]

Background: This research explored the experience of footballers who had experienced a sports‐related injury and sought psychological and/or counselling support. What interventions did athletes find helpful/not helpful for coping with such an experience? Method: Drawing upon the principles of phenomenology, hermeneutics, and ideography, interpretative phenomenological analysis (IPA) was used to provide insight into the athletes' experiences and their personal perceptions of the injury. Semi‐structured interviews with six Maltese top‐level football players who have sustained and overcome a sports‐related injury were used for the collection of data. Findings: The athletes' appraisals of their injury were explored, and their attitudes towards the different forms of support received and the psychological interventions used were identified. Despite the psychological support sought and received on a personal level, the participants suggested that their mental health was often overlooked by their clubs, leaving them with feelings of helplessness and insecurity. Recommendations: Recommendations, which can be adopted to create sports environments that promote athletes' psychological well‐being, are presented. These include recruiting professional service providers such as counsellors and sport psychologists within clubs, as well as the promotion of such services to diminish the stigma around athletes' mental health. Since sport psychologists usually focus on sports' performance enhancement, it may be wise for clubs to create transdisciplinary teams, which include other health professionals, such as counsellors, for more in‐depth one‐to‐one counselling related to readiness to play. This suggests the implementation of holistic sport education programmes promoting mental well‐being. Recommendations for further research are also discussed. [ABSTRACT FROM AUTHOR]

Objective: The correct identification of concussion symptoms is vital for mild traumatic brain injury recognition, diagnosis, and injury management. Numerous surveys of symptom recognition have been conducted, including with athletes at-risk for injury. This critical, methodologically focused review aimed to: (1) discover which concussion symptoms are recognized, and (2) provide recommendations for future research. Data Sources: A quasi-systematic literature search was conducted to identify studies that used the Rosenbaum Concussion Knowledge and Attitudes Survey. Study Selection: Eighty-five publications were identified, 8 of which were retained after screening. Data Extraction: The identification of individual concussion symptoms was coded as good (a correct response by >90% of the sample), moderate (a correct response by 75%–90% of the sample), or poor (a correct response by <75% of the sample). Data Synthesis: The pooled data comprised responses from more than 2000 individuals, most of whom were male, young adult, sport players. Overall, there was good recognition of 3 concussion symptoms (headaches, dizziness, and confusion), poor recognition of sleep disturbances, nausea, and loss of consciousness, and misattribution to concussion of 2 distractor symptoms (weakness of neck range of motion, difficulty speaking). The methodological evaluation revealed significant variability in symptom measurement. Conclusions: The identified trends for concussion symptom recognition must be regarded as tentative because of the significant methodological variation in the reviewed studies. This variability affected the number, wording, and classification of items, and it restricted the data synthesis. This problem must be addressed in future research and recommendations are provided. [ABSTRACT FROM AUTHOR]

Abstract Objective To describe the frequency and the distribution of degenerative disc disease (DDD) detected in athletes who underwent spine MRI in the 2016 Summer Olympic Games in Rio de Janeiro. Methods Data on spine MRI examinations from the 2016 Summer Olympics were retrospectively analyzed. We assessed the frequency of DDD of the cervical (Cs), thoracic (Ts), and lumbar (Ls) spine using Pfirrmann’s classification. Grade II and III were considered as mild, grade IV as moderate, and grade V as severe disc degeneration. Data were analyzed according to the location of the degenerative disc, type of sport, age-groups, and gender of the athletes. Results One hundred out of 11,274 athletes underwent 108 spine MRI’s (21 C, 6 T, and 81 L) (53% Females (F), 47% Males (M)). The frequency of DDD was 40% (42% F, 58% M) over the entire spine (28% mild, 9% moderate and 3% severe). There were 58% (12%F, 88%M) of the cervical spine discs that showed some degree of degeneration (44% mild, 13.5% moderate and 1% severe). Athletics, Boxing, and Swimming were the sports most affected by DDD in the Cs. There were 12.5% of the thoracic discs that showed some degree of degeneration, all were mild DDD and were exclusively seen in female athletes. There were 39% (53% F, 47% M) of the lumbar discs with DDD (26% mild, 9% moderate, and 4% severe). Conclusion Athletes who underwent spine MRI during the 2016 Summer Olympic Games show a high frequency of DDD of cervical and lumbar spines. Recognition of these conditions is important to develop training techniques that may minimize the development of degenerative pathology of the spine.

Objectives: To compare injury-profiles of females and males presenting to Emergency Departments (EDs) with an Australian Football injury.Design: Prospective observational study.Methods: All patients presenting to one of 10 EDs in Victoria, Australia, with an Australian Football injury were included in the study. Data were prospectively collected over a 10 month period, coinciding with a complete Australian Football season, including pre-season training and practice matches. Relevant information was extracted from patient medical records regarding injury-type, body part injured, investigations and treatments required. Female and male data were compared with chi-squared and Fisher's exact tests.Results: 1635 patients were included, of whom 242 (14.8%) were female. Females had a higher proportion of hand/finger injuries (34.3% v 23.4%), neck injuries (6.6% v 2.5%) and patella dislocations (2.9% v 0.6%). Males had a higher proportion of shoulder injuries (11.5% v 5.8%), skin lacerations (8.0% v 1.7%), and thorax/abdominal/pelvic injuries (5.7% v 2.1%). Concussion rates were similar between the genders, occurring in 14.1% of all patients. Anterior cruciate ligament injuries were infrequent (1.0%) and not significantly different between genders. Females received more imaging investigations (83.1% v 74.7%) and analgesia (62.4% v 48.5%). A higher proportion of males required admission to hospital (5.0% v 2.1%), usually for surgery.Conclusion: Australian Football injury profiles differed between females and males. Gender-specific injury prevention and management programs would be indicated based on the study findings. [ABSTRACT FROM AUTHOR]

This study examined the incidence and trends of surfing-related and mild traumatic brain injuries that presented to United States emergency departments between 2001 and 2016. Subjects with surging-related head injuries were retrieved from the National Electronic Injury Surveillance System. A weighted total of 34,337 surfing-related head injuries were identified. The annual incidence of surfing-related head injuries insignificantly decreased from 2001 to 2016 (R2 =.119; p =.19). Most common injuries included lacerations (50.4%), blunt head injuries (25.7%), and mild traumatic brain injuries (16.1%). Mild traumatic brain injury incidence and annual percentage increased significantly during the study period (R2 =.251; p =.05 and R2 =.346; p =.02, respectively). [ABSTRACT FROM AUTHOR]

Objective: To describe the frequency and the distribution of degenerative disc disease (DDD) detected in athletes who underwent spine MRI in the 2016 Summer Olympic Games in Rio de Janeiro.Methods: Data on spine MRI examinations from the 2016 Summer Olympics were retrospectively analyzed. We assessed the frequency of DDD of the cervical (Cs), thoracic (Ts), and lumbar (Ls) spine using Pfirrmann's classification. Grade II and III were considered as mild, grade IV as moderate, and grade V as severe disc degeneration. Data were analyzed according to the location of the degenerative disc, type of sport, age-groups, and gender of the athletes.Results: One hundred out of 11,274 athletes underwent 108 spine MRI's (21 C, 6 T, and 81 L) (53% Females (F), 47% Males (M)). The frequency of DDD was 40% (42% F, 58% M) over the entire spine (28% mild, 9% moderate and 3% severe). There were 58% (12%F, 88%M) of the cervical spine discs that showed some degree of degeneration (44% mild, 13.5% moderate and 1% severe). Athletics, Boxing, and Swimming were the sports most affected by DDD in the Cs. There were 12.5% of the thoracic discs that showed some degree of degeneration, all were mild DDD and were exclusively seen in female athletes. There were 39% (53% F, 47% M) of the lumbar discs with DDD (26% mild, 9% moderate, and 4% severe).Conclusion: Athletes who underwent spine MRI during the 2016 Summer Olympic Games show a high frequency of DDD of cervical and lumbar spines. Recognition of these conditions is important to develop training techniques that may minimize the development of degenerative pathology of the spine. [ABSTRACT FROM AUTHOR]

Intracranial penetrating traumas (IPTs) are rarely encountered in neurosurgery practice. Here, we report the case of a patient with orbital and cranial trauma caused by an unexpected object. A 37-year-old male presenting with a right orbital penetrating injury was referred to our emergency department. Neurologic examination of the patient revealed right periorbital ecchymosis, a dilated and fixed right pupil, and right hemiparesis. Cranial computed tomography showed fractures of the right orbital medial wall and the anterior skull base, as well as bifrontal and left parietal intracerebral hemorrhage accompanied by a metallic foreign body artifact. Emergency left frontoparietal decompressive craniectomy was performed, and the foreign body, identified as a fishing sinker, was removed. No additional postoperative complications were observed, and cranioplasty was performed 6 months postoperatively. IPTs have high morbidity and mortality rates. Early surgical intervention is often the first treatment option. Intracranial injury caused by a fishing sinker is an extremely rare low-energy intracranial penetrating trauma, and in the literature, this is the first reported case in which the patient survived. [ABSTRACT FROM AUTHOR]

Several previous studies have shown that floorball belongs to a high-risk group of sports in terms of eye injuries. Protective eyewear is available, but the extent of its use and impact on eye injuries are unknown. The purpose of this study was to investigate the current incidence of eye injuries caused by floorball and to compare it with the present use of protective eyewear. Medical records were used to identify all eye injuries suffered while playing floorball in Jönköping County from 2008 to 2011 ( N = 167). All these patients were sent a questionnaire that included inquiries about the use of protective eyewear. The study shows that floorball caused more eye injuries than all other sports combined (56%). Prolonged decreased visual acuity was very unusual (0.5%), but moderate eye injuries with some risk of future problems were seen in 62% of the sample. More than one fifth of the injured patients reported some kind of vision-related problem 2-7 years after the original injury. Only one player had been using protective eyewear at the time of injury. Our results underline the importance of protective eyewear to prevent floorball-related injuries. [ABSTRACT FROM AUTHOR]

Copyright of Spor Hekimligi Dergisi/Turkish Journal of Sports Medicine is the property of Turkish Journal of Sports Medicine / Spor Hekimleri Dernegi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Both chronic subdural hematoma and arachnoid cysts are common lesions in neurosurgical practice. Arachnoid cysts are a well-known predisposing factor for chronic subdural hematoma. Here, we present a 12-year-old taekwondo athlete with chronic subdural hematoma associated with arachnoid cysts. The chronic subdural hematoma was evacuated through 2 burr holes and the patient was discharged in good condition. To our knowledge, this is the first case of chronic subdural hematoma with associated arachnoid cysts in a taekwondo athlete. We also review the literature on sports-related chronic subdural hematomas associated with arachnoid cysts in children. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: As many as 30% of all maxillofacial fractures (MFFs) and skull base fractures (SBFs) are reported to be sports-related. Participation in sporting activities has grown worldwide and the number of cases of sports-related injuries has also increased. The aim of this study was to evaluate the data of 3596 patients hospitalized by MFF or SBF over a 6-year period; 147 (4%) of these cases were sports-related (mean age 29.7±12.8 years). The highest incidence was found in patients aged 20–29 years (35%), and the fractures resulted mostly from ball sports (74%), especially soccer (59%) and handball (8%). The injuries involved different areas, with a significant prevalence of the midface complex (67%) compared with the mandible region (29%) and the skull base (4%). The commonest diagnoses associated with MFF and SBF were brain concussion (19%), laceration of the skin and soft tissue (16%), and dental injury (8%). Surgery was required for 88% of midface fractures. In cases of mandible fractures 52% were supplied with osteosynthesis. This study identified the significant number of severe sports-related injuries that occur each year, suggesting that changes of rules and safety standards are needed for the prevention of such injuries. [ABSTRACT FROM AUTHOR]

Surfing is a popular recreational sport that carries a substantial risk of injury. Although head injuries are frequently documented in the surfing population, an in depth assessment of the prevalence of surfing-related head injury has not been reported. A web-based survey was conducted in May of 2015. Participants were asked a series of questions regarding surfing-related injuries and demographic characteristics. A total of 50 responses were obtained, of which 35 (70%) reported sustaining a head injury. The most common injury was laceration of the head/face (n=27), followed by concussion (n=13). Other injuries, such as skull fracture and broken nose, were also reported. Only 2 of the 50 participants reported wearing a protective helmet. Neurosurgical intervention was required in 2 instances. Increased emphasis on preventative measures by the medical community may reduce the future incidence of such injuries. Medical professionals should be aware of the most common forms of injury sustained by the surfing population in order to better recognize and treat these conditions. [ABSTRACT FROM AUTHOR]

Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The objectives of this study were to determine the distribution of different sports-related eye injuries and to identify injury types to enable recommendations to be made about the use of protective eyewear. The study population comprises all 565 eye trauma patients examined at the Ophthalmology Emergency Clinic of the Helsinki University Central Hospital over a 6-month period. Data were collected from patient histories and questionnaires. In addition, three severe floorball eye injury cases are presented. Of the 565 eye traumas, 94 (17%) were sports related. Of these, 42 (45%) were associated with floorball. Countrywide, in Finland, estimated over 300 (+95% CI 228–415) floorball eye injuries occur annually. The mean age of floorball patients was 22 years. The most common finding (55%) in sports injury patients was hyphema. Clinically severe eye injuries during this period accounted for one-fourth of all cases. During the study period, no eye injury was found in an organized junior ice hockey, where facial protection is mandatory. Floorball is estimated to belong to the highest risk group in sports, and thus, the use of protective eyewear is strongly recommended. We conclude that national floorball federations should make protective eyewear mandatory. [ABSTRACT FROM AUTHOR]

Professional and recreational sporting activities have increased substantially in recent years and have led to a rise in the number of sports-related and overuse injuries. Magnetic resonance (MR) imaging has become an important tool for evaluating the lower leg for providing the necessary information for patient management and rehabilitation following this injury. The purpose of this essay is to give an overview of the MR findings of common overuse injuries and sports-related injuries to the bones and soft-tissue structures of the hind foot and ankle. [Copyright &y& Elsevier]

We report a case of rotatory atlantoaxial dislocation due to a rugby injury in an adult. The patient presented with torticollis 4 weeks after the injury. The neurological evaluation was normal. Reduction proved difficult to obtain and required 10 days of skull traction followed by gentle manipulation. After reduction, dynamic cervical radiographs showed no instability and magnetic resonance imaging (MRI) confirmed that the transverse ligament was intact. After 6 weeks of immobilization in a Minerva jacket, a dynamic rotatory computed tomography (CT) scan confirmed that the atlantoaxial joint was stable. Such cases of atlantoaxial joint dislocation in adults treated by traction after a considerable delay are rare. In our patient, demonstration by MRI that the transverse ligament was intact led to the decision to use conservative therapy, which proved successful. [ABSTRACT FROM AUTHOR]

Objective: Sports injuries are known to present a high risk of spinal trauma. The authors hypothesized that different sports predispose participants to different injuries and injury severities., Methods: The authors conducted a retrospective cohort analysis of adult patients who experienced a sports-related traumatic spinal injury (TSI), including spinal fractures and spinal cord injuries (SCIs), encoded within the National Trauma Data Bank from 2011 through 2014. Multiple imputation was used for missing data, and multivariable linear and logistic regression models were estimated., Results: The authors included 12,031 cases of TSI, which represented 15% of all sports-related trauma. The majority of patients with TSI were male (82%), and the median age was 48 years (interquartile range 32-57 years). The most frequent mechanisms of injury in this database were cycling injuries (81%), skiing and snowboarding accidents (12%), aquatic sports injuries (3%), and contact sports (3%). Spinal surgery was required during initial hospitalization for 9.1% of patients with TSI. Compared to non-TSI sports-related trauma, TSIs were associated with an average 2.3-day increase in length of stay (95% CI 2.1-2.4; p < 0.001) and discharge to or with rehabilitative services (adjusted OR 2.6, 95% CI 2.4-2.7; p < 0.001). Among sports injuries, TSIs were the cause of discharge to or with rehabilitative services in 32% of cases. SCI was present in 15% of cases with TSI. Within sports-related TSIs, the rate of SCI was 13% for cycling injuries compared to 41% and 49% for contact sports and aquatic sports injuries, respectively. Patients experiencing SCI had a longer length of stay (7.0 days longer; 95% CI 6.7-7.3) and a higher likelihood of adverse discharge disposition (adjusted OR 9.69, 95% CI 8.72-10.77) compared to patients with TSI but without SCI., Conclusions: Of patients with sports-related trauma discharged to rehabilitation, one-third had TSIs. Cycling injuries were the most common cause, suggesting that policies to make cycling safer may reduce TSI.

Sports-related injury is frequently associated with repeated diffuse and mild traumatic brain injury (mTBI). We combined two existing models for inducing TBI in rats, the Impact Acceleration and Controlled Cortical Impact models, to create a new method relevant to the study of cognitive sequelae of repeat mTBI in adolescent athletes. Repeated mTBI, such as those incurred in sports, can result in a wide range of outcomes, with many individuals experiencing no chronic sequela while others develop profound cognitive and behavioral impairments, typically in the absence of lasting motor symptoms or gross tissue loss appreciable antemortem. It is critical to develop models of mTBI and repeat mTBI that have the flexibility to assess multiple parameters related to injury (e.g. number and magnitude of impacts, inter-injury interval, etc) that are associated with brain vulnerability compared to normal recovery. We designed a 3D-printed plastic implant to permanently secure a metal disc to the skull of adolescent rats in order to induce multiple injuries without performing multiple survival surgeries and also to minimize pre-injury anesthesia time. Rats were randomly assigned to sham injury (n = 12), single injury (n = 12; injury on P41), or repeat injury (n = 14; injuries on P35, P38, and P41) groups. Compared to single injury and sham injury, repeat injuries caused increased toe pinch reflex latency (F (2,34) = 4.126, p <.05) and diminished weight gain (F (2, 34) = 4.767, p <.05). Spatial navigation was tested using Morris water maze, beginning one week after the final injury (P48). While there were no differences between groups during acquisition, both single and repeat injuries resulted in deficits on probe trial performance (p <.01 and p <.05 respectively). Single injury animals also exhibited a deficit in working memory deficit across three days of testing (p <.05). Neither injury group had neuronal loss in the hilus or CA3, according to stereological quantification of NeuN. Therefore, by implanting a helmet we have created a relevant model of sports-related injury and repeated mTBI that results in subtle but significant changes in cognitive outcome in the absence of significant hippocampal cell death. [ABSTRACT FROM AUTHOR]

Guidance regarding the decision to remove an adolescent from athletic competition immediately following an acute concussive injury and the safe return of play in the short term is widely accepted and supported by clinical evidence, local institutional policies, and state and federal laws. There is considerably less guidance regarding the decision to permanently retire an adolescent athlete for medical reasons due to concussive injuries. In this article, we discuss the clinical and non-clinical considerations that should guide clinicians in discussions regarding the adolescent athlete's permanent retirement by emphasizing the ethical obligation to protect the child's right to an open future as possibly determinative in otherwise ambiguous cases.

This study examined the incidence and trends of surfing-related and mild traumatic brain injuries that presented to United States emergency departments between 2001 and 2016. Subjects with surging-related head injuries were retrieved from the National Electronic Injury Surveillance System. A weighted total of 34,337 surfing-related head injuries were identified. The annual incidence of surfing-related head injuries insignificantly decreased from 2001 to 2016 (R 2 = .119; p = .19). Most common injuries included lacerations (50.4%), blunt head injuries (25.7%), and mild traumatic brain injuries (16.1%). Mild traumatic brain injury incidence and annual percentage increased significantly during the study period (R 2 = .251; p = .05 and R 2 = .346; p = .02, respectively)., Competing Interests: No conflicts of interest., (© 2019 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.)

Sports-related concussion has emerged as a public health crisis due to increased diagnosis of the condition and increased participation in organized and recreational athletics worldwide. Under-recognition of concussions can lead to premature clearance for athletic participation, leaving athletes vulnerable to repeat injury and subsequent short- and long-term complications. There is overwhelming evidence that assessment and management of sports-related concussions should involve a multifaceted approach. A number of assessment criteria have been developed for this purpose. It is important to understand the available and emerging diagnostic testing modalities for sports-related concussions. The most commonly used tools for evaluating individuals with concussion are the Post-Concussion Symptom Scale (PCSS), Standard Assessment of Concussion (SAC), Standard Concussion Assessment Tool (SCAT3), and the most recognized computerized neurocognitive test, the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). The strengths and limitations of each of these tools, and the Concussion Resolution Index (CRI), CogSport, and King-Devick tests were evaluated. Based on the data, it appears that the most sensitive and specific of these is the ImPACT test. Additionally, the King-Devick test is an effective adjunct due to its ability to test eye movements and brainstem function., Competing Interests: The authors have declared financial relationships, which are detailed in the next section.

Background Few neurologic diseases have captured the nation's attention more completely than chronic traumatic encephalopathy (CTE), which has been discovered in the autopsies of professional athletes, most notably professional football players. The tragic case of Junior Seau, a Hall of Fame, National Football League linebacker, has been the most high-profile confirmed case of CTE. Here we describe Seau's case, which concludes an autopsy conducted at the National Institutes of Health that confirmed the diagnosis. Case Description Since 1990, Junior Seau had a highly distinguished 20-year career playing for the National Football League as a linebacker, from which he sustained multiple concussions. He committed suicide on May 2, 2012, at age 43, after which an autopsy confirmed a diagnosis of CTE. His clinical history was significant for a series of behavioral disturbances. Seau's history and neuropathologic findings were used to better understand the pathophysiology, diagnosis, and possible risk factors for CTE. Conclusions This high-profile case reflects an increasing awareness of CTE as a long-term consequence of multiple traumatic brain injuries. The previously unforeseen neurologic risks of American football have begun to cast doubt on the safety of the sport. [ABSTRACT FROM AUTHOR]