Manubrium sterni stress fracture: an unusual complication of non-contact sport.

Tremendous force is usually required to cause sternal fractures. Normally this is caused either by a direct blow to the chest or by an indirect injury from hyperflexion of the torso. A case is presented of a fracture of the manubrium sterni in a young man as a complication of body building exercises-a non-contact sport. It appears that this has not been reported before.     

Masking effects of social desirability response set on relations between psychosocial factors and sport injuries: a methodological note.

Social desirability has long been viewed as a potential source of error variance in self-report measures. We suggest that social desirability (whether in the form of impression management or self-deception) has the capacity to mask relations between psychosocial variables and sport-related outcome or criterion measures that are not measured by selfreport. To illustrate what can occur, we present data from a longitudinal study in which life stress and psychological coping skills were studied as predictors of behaviorally-defined athletic injuries. When data from the entire sample of 352 athletes were analyzed, virtually no injury variance was accounted for by life stress, psychological coping skills, or their interaction. In contrast, deletion from the sample of athletes with high social desirability response set scores resulted in significant predictive relations involving both life stress and coping skills, as well as a significant moderator effect for coping skills. We propose that social desirability masking effects can significantly increase the likelihood of Type II errors in sports medicine research that involves self-report measures, and that social desirability responding needs to be controlled or minimized.     

Research approaches to describe the mechanisms of injuries in sport: limitations and possibilities

A number of different methodological approaches have been used to describe the inciting event for sports injuries. These include interviews of injured athletes, analysis of video recordings of actual injuries, clinical studies (clinical findings of joint damage are studied to understand the injury mechanism, mainly through plain radiography, magnetic resonance imaging, arthroscopy, and computed tomography scans), in vivo studies (ligament strain or forces are measured to understand ligament loading patterns), cadaver studies, mathematical modelling and simulation of injury situations, and measurement/estimation from "close to injury" situations. In rare cases, injuries have even occurred during biomechanical experiments. This review describes each research approach and assesses its strengths and weaknesses in contributing to the understanding and prevention of sports injuries.     

Trends in sports injuries, 1982-1988: an in-depth study on four types of sport.

In this study, we analyzed the records of both inpatients and outpatients which were treated for acute sports injuries in the Trauma Department of the University of Groningen (The Netherlands) during the years 1982 to 1988. We examined whether there was a trend in sports injuries in this time period. The study comprised four types of sports, i.e., soccer, volleyball, gymnastics, and martial arts. The absolutely highest rates of injuries across the seven years were found in soccer, followed by gymnastics, volleyball, and martial arts. Injuries sustained at participating in soccer, volleyball, and gymnastics involved for the major part the lower extremities, followed by injuries of the upper extremities, whereas the reverse pattern was observed for patients who participated in martial arts. For all four types of sport, the ankle and foot were the most frequently site of injury of the lower extremities. Sprains and strains were the major types of injury. Most injuries were seen at ages between 10 and 30 years. The ratio of male to female patients within age groups did not differ significantly across the seven years. We concluded that, except for martial arts, the increased participation in sports in the last decade was not accompanied with a change in the patterns of sports injuries by the patients' age, sex, and number and nature of the injury. This consistency in results can be used to guide the development of prevention programs aimed at a reduction of injuries in specific sports.     

Priorities for reducing the burden of injuries in sport: the example of Australian football.

The promotion of safe sports participation has become a public health issue due to rising obesity rates and the potential for parental concerns about safety to inhibit sports participation. The safety of Australian football and its elite game, the Australian Football League (AFL), is often the focus of media commentary. Participation in the modified version of the game (Auskick) has been shown to be safer but by the time children reach the under-15 age group, adult rules are in place and the umbrella of safety provided by modified rules is gone. Figures released recently by the AFL suggest that injury rates at the elite-level are at an historical low, but equivalent information for the more than 400,000 non-elite participants is not available. Published literature related to preventing injuries in Australian football highlights a significant knowledge gap with respect to the aetiology of injuries in non-elite participants and only a very small evidence base for prevention of injuries in this sport. Gains in reducing the public health impact of football injuries, and injury-related barriers to Australian football participation, will only come from substantial investment in large-scale trials at the non-elite level, and a co-ordinated and multidisciplinary approach to dealing with safety and injury issues across all levels of play. Active and committed collaboration of key stakeholders such as government health agencies, peak sports bodies, sports administrators, clinicians, researchers, clubs, coaches and the participants themselves will be necessary.     

Prevalence of injuries among young adults in sport centers: relation to the type and pattern of activity

The rate of injuries resulting from physical exercise in sport centers as well as related factors has not yet been described. The aims of this study were to describe the prevalence of self‐reported activity‐specific injuries, to identify the relations between injury profile and different types and patterns of physical activity and to assess whether gender is a modifying variable in that connection. Four hundred and fifty‐seven men and women aged 20–35 years participated in this cross‐sectional study. A questionnaire was used to evaluate the types and patterns of physical activity performed in the 12 months preceding the study and sports injuries sustained during that time. One hundred and ninety of the 457 subjects reported an injury as a result of exercising (41.6%). A relationship was found between weight training and injuries of the upper extremity (UE) for men and between spinning classes and knee injuries for women. Among those who participated in weight‐training exercises, more frequent and longer duration exercise was associated with UE injury, and among those who participated in spinning classes more frequent exercise was associated with knee injury. Future injury prevention programs in sport centers should pay special attention to men who participate in weight training and to women who participate in spinning classes.     

More than just stones: a pictorial review of common and less common gallbladder pathologies

Although stone disease is by far the most commonly encountered pathology of the gallbladder, there are several other important disease processes affecting it. These include adenomyomatosis, cholesterolosis, polyps, porcelain gallbladder, acalculous cholecystitis, xanthogranulomatous cholecystitis, emphysematous cholecystitis, gallbladder cancer, and gallbladder hemorrhage. The purpose of this article was to review the different gallbladder pathologies encountered in everyday radiological practice and to describe their features in the standard imaging modalities.     

More than learning technical skills: The importance of mentorship and coaching during a brachytherapy fellowship

Brachytherapy exposure during residency varies between residency training programs. As a result, many graduating radiation oncology residents do not feel competent or confident in performing brachytherapy procedures. A brachytherapy fellowship encompasses hands-on procedural skills in addition to clinical decision-making, radiotherapy treatment planning, as well as post-treatment care. During this time, a fellow develops interpersonal relationships with their faculty supervisors in the form of mentorship, sponsorship, and coaching in addition to clinical teaching. The objective of this article is to review these important relationships focusing on brachytherapy fellowship training as an example.     

Equestrian injuries: a comparison of professional and amateur injuries in Berkshire.

A retrospective study of horse riding injuries in Berkshire was undertaken over a one year period from November 1983. The information was obtained from the Ambulance Service, the Jockey Club and the St. John Ambulance Brigade. There was a total of 103 injured persons with no deaths. Information from the Jockey Club was compared with the other two groups, the former sustaining more limb injuries and the latter more head injuries. A questionnaire was sent to all 42 ambulance patients. Thirty-eight had radiographs taken, 16 of which showed a fracture. Forty-one were wearing some form of hard hat, but if a safety strap was available it was attached in 24 cases. The dangers of riding are highlighted and the importance of adequate protective clothing emphasised.     

Back injuries to fast bowlers in cricket: a prospective study.

Eighty-two high performance young male fast bowlers (mean age 16.8 years) were tested immediately prior to the season for selected kinanthropometric and physiological data. Subjects were also filmed both laterally (200 Hz) and from above (100 Hz) while bowling so that their front foot impacted a force platform during the delivery stride. The players then completed a log book over the ensuing season that detailed their training and playing programmes. All cricket related injuries over this season were assessed by a sports physician who used computerized tomography to assist in the diagnosis of spinal injuries. At the completion of this season the players were grouped according to their injury status (Group 1--bony injury to a vertebra; Group 2--soft tissue injury to the back that caused the player to miss at least one game, and Group 3--no injuries). A one-way analysis of variance was used to identify if any variables were significantly (P less than 0.05) different between the three groups, and a Scheffe post hoc comparison was used to determine which groups were significantly different. Eleven per cent of the players sustained a stress fracture to a vertebra(e) (L4 to S1), while 27 per cent sustained a soft tissue injury to the back. Bowlers with a low longitudinal foot arch were more likely to develop a stress fracture than those with a high arch. Shoulder depression and horizontal flexion strength for the preferred limb and quadriceps power in the non-preferred limb were also significantly related to back injuries. Results suggest that bowlers with the above physical characteristics, who bowl with these biomechanical techniques for extended periods, are predisposed to back injuries.     

Volleyball injuries: a survey of injuries of Scottish National League male players.

Injuries sustained in male volleyball players in the first division of the Scottish National League during the 1989-1990 season were investigated by means of a questionnaire survey. Forty-six injuries were reported, representing an incidence of 0.53 injuries per player. Damage to muscles, tendons and ligaments accounted for most of the injuries. The cause of most injuries was blocking or spiking. In 74% of cases the injured players were able to resume training and playing within 2 weeks of the injury. In 10% of cases the injured players were unable to train or play for 7-14 weeks.     

A controlled study on the effects of hyperthermia at 434 MHz and conventional ultrasound upon muscle injuries in sport.

BACKGROUND: Hyperthermia equipment using a 434 MHz applicator with water bolus elevate to therapeutic temperatures (from 41 to 45 degrees C) delineated volumes of tissue target, down to a depth of 3 to 5 cm. The aim of our study was to evaluate the efficacy of hyperthermia in the treatment of muscle injuries, in comparison with a conventional modality like ultrasound. METHODS: A prospective randomised controlled design was used. Forty patients, 29 males and 11 females, with mean age of 26.2+/-3 ranging between 18 and 35 years affected by acute muscular injuries of different sites and severity participated this study. Twenty-one patients received hyperthermia (group A) and the remaining 19 (group B) ultrasound. Both groups received nine applications, three times per week with a duration of 30' for the group (A), and 15' for the group (B). All the patients underwent a clinical examination including a pain measurement and a ultrasound scanning before, at the end and after one month follow-up. An additional ultrasonography was made after the fourth session to compare the effect of each treatment on the initial course of haematoma resolution. RESULTS: Both groups had a significant decrease of the pain (p< 0.001). The hyperthermia group showed a significantly higher effect on VAS score and on haematoma resolution after two weeks of treatment. CONCLUSIONS: Even with a limited number of cases our results show that the hyperthermia is a highly innovative, safe and reliable modality for the treatment of acute sport muscle injuries.     

Aetiology of handball injuries: a case--control study.

This article presents the results of a case--control study regarding the background to handball injuries among players of 12 years and older. Data were collected by means of a written questionnaire on the nature, location and direct causes of the injuries as well as information on risk factors. Injured players (n = 130) are compared with non-injured players (n = 512). The response for the cases was 67% and for the controls 75%. These injuries are frequently located at the lower extremities (54% of injuries), especially the ankle, and the majority involve distortions (35%) and strains (26%). Players greater than 20 years have a significantly greater risk of injury than players less than 20 years (odds ratio 1.9). Several factors seem to increase the injury risk, although not significantly: having greater than 5 years experience, not doing stretching exercises and not wearing tape or bandages. Another factor, not wearing elbow protectors, appears to decrease the injury risk significantly. It is advisable to interpret the results of this study with some caution, as selection and information bias might have influenced the validity to some extent. Furthermore, the reliability of the data is limited due to the relatively small number of injured players in the study. Some guidelines for future studies are formulated.     

Facial injuries due to criminal violence: a retrospective study of hospital attenders.

The material comprised 222 assault victims whose injuries required attention at the Departments of Oral Surgery and Ear, Nose, and Throat diseases, the Central Hospital in Falun or corresponding departments at the Karolinska Institutet, Stockholm or the University Hospital in Huddinge. Information was obtained from patient records. One hundred and thirty-eight patients had fractures and the remainder had flesh-wounds, haematomas or swellings. The most frequent fracture site was the nasal bone followed by the jaws. Forty-one per cent of the patients in Falun and 28 per cent in Stockholm reported the assaults to the police: in Falun the proportion of women victims who reported the assault was significantly higher than those who did not. The willingness to notify the police of the violence was not influenced by the use of drugs or the seriousness of the injuries. The study showed that violence in suburban Stockholm was aggravated: one-third of the patients in the study required hospitalization compared to a quarter in a rural area.