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Cehic MG, Knight C, Morris D, Essen JV, Bither N, Williams K. The burden of Finke Desert race-related trauma: A 10-year retrospective descriptive analysis. Aust J Rural Health 2024. [PMID: 38641912 DOI: 10.1111/ajr.13124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/27/2024] [Accepted: 04/02/2024] [Indexed: 04/21/2024] Open
Abstract
INTRODUCTION The Finke Desert Race is an annual motorsport race (motorbikes, cars and buggies) held in Alice Springs resulting in a significant major trauma burden. This imposes unique challenges in one of the world's most remote healthcare settings. OBJECTIVES To quantify the volume and characteristics of Finke Desert Race-related trauma presenting to the Alice Springs Hospital. DESIGN A retrospective descriptive study was undertaken to review all patients presenting to the Alice Springs Hospital with Finke Desert Race-related trauma over a 10-year period. Information collected included demographic data, injury characteristics, patient disposition and required management. FINDINGS Over the 9 years the event was held, 325 patients were admitted to the Alice Springs Hospital. Patients were almost exclusively male (98.8%), with a mean age of 34.75 and residing outside of Alice Springs (82.2%). There were a total of 460 distinct injuries with the clavicle, spine and ribs the three most commonly injured sites. A total of 129 operations were required, of which 19 required retrieval to an interstate centre. DISCUSSION Alice Springs is one of the most remote and geographically isolated centres on Earth. This rurality poses unique challenges when trying to coordinate medical and retrieval services, exacerbated for a concentrated, yet highly resource intensive event such as Finke. It has far reaching impacts, placing additional stresses on all aspects of healthcare provision. CONCLUSION This review has quantified the trauma burden of the event for the first time, enabling local and interstate stakeholders' ability to plan an adequate and sustainable response while also enabling the future effectiveness evaluation of recent safety reforms.
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Affiliation(s)
- Matthew G Cehic
- Orthopaedic Department, Alice Springs Hospital, The Gap, North Territory, Australia
| | - Casey Knight
- Orthopaedic Department, Alice Springs Hospital, The Gap, North Territory, Australia
| | - David Morris
- Orthopaedic Department, Alice Springs Hospital, The Gap, North Territory, Australia
| | - James Van Essen
- Orthopaedic Department, Alice Springs Hospital, The Gap, North Territory, Australia
| | - Nitin Bither
- Orthopaedic Department, Alice Springs Hospital, The Gap, North Territory, Australia
| | - Kanishka Williams
- Orthopaedic Department, Alice Springs Hospital, The Gap, North Territory, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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Bonsignore-Opp L, Galivanche A, El Naga AN, Gendelberg D. Return to Play Criteria After Adult Lumbar Spinal Fractures: A Review of Current Literature and Expert Recommendations. Curr Rev Musculoskelet Med 2024; 17:83-92. [PMID: 38300472 PMCID: PMC10917715 DOI: 10.1007/s12178-024-09884-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 02/02/2024]
Abstract
PURPOSE OF REVIEW Understanding the management of lumbar spinal fractures and return to play (RTP) criteria is an essential component of care for adult athletes. Appropriate management of lumbar spinal fractures must balance minimizing time away from physical activity while also minimizing risk of reinjury. The purpose of this review is to summarize current recommendations on lumbar spinal fracture management and RTP guidelines and to provide expert opinion on areas of discrepancy in the field. RECENT FINDINGS There is a paucity of high-level evidence on the management and return to play criteria for adult lumbar spine fractures in athletes. Much of the data and recommendations are based on expert opinion and studies in pediatric or osteoporotic patients, which may not be applicable to adult athletes. These data presented here may be used to aid patient-physician conversations and provide guidance on expectations for patients, coaches, and athletic trainers. In general, we recommend that patients be free of lumbar pain, neurologically intact, and have full strength and motion of the lumbar spine and lower extremities before returning to play. Adequate protective equipment is recommended to be worn at all times during practice and play.
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Affiliation(s)
- Lisa Bonsignore-Opp
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Anoop Galivanche
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Ashraf N El Naga
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA
| | - David Gendelberg
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA.
- Orthopaedic Trauma Institute at Zuckerberg San Francisco General, 2550 23rd Street Building 9, 2nd Floor, San Francisco, CA, 94110, USA.
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Davies M, Lawrence T, Edwards A, McKay C, Lecky FE, Stokes KA, Williams S. Sport-related major trauma incidence in young people and adults in England and Wales: a national registry-based study. Inj Prev 2024; 30:60-67. [PMID: 37875378 PMCID: PMC10850652 DOI: 10.1136/ip-2023-044887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 08/24/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVES Data on sport and physical activity (PA) injury risk can guide intervention and prevention efforts. However, there are limited national-level data, and no estimates for England or Wales. This study sought to estimate sport and PA-related major trauma incidence in England and Wales. METHODS Nationwide, hospital registry-based cohort study between January 2012 and December 2017. Following Trauma Audit and Research Network Registry Research Committee approval, data were extracted in April 2018 for people ≥16 years of age, admitted following sport or PA-related injury in England and Wales. The population-based Active Lives Survey was used to estimate national sport and PA participation (ie, running, cycling, fitness activities). The cumulative injury incidence rate was estimated for each activity. Injury severity was described by Injury Severity Score (ISS) >15. RESULTS 11 702 trauma incidents occurred (mean age 41.2±16.2 years, 59.0% male), with an ISS >15 for 28.0% of cases, and 1.3% were fatal. The overall annual injury incidence rate was 5.40 injuries per 100 000 participants. The incidence rate was higher in men (6.44 per 100 000) than women (3.34 per 100 000), and for sporting activities (9.88 per 100 000) than cycling (2.81 per 100 000), fitness (0.21 per 100 000) or walking (0.03 per 100 000). The highest annual incidence rate activities were motorsports (532.31 per 100 000), equestrian (235.28 per 100 000) and gliding (190.81 per 100 000). CONCLUSION Injury incidence was higher in motorsports, equestrian activity and gliding. Targeted prevention in high-risk activities may reduce admissions and their associated burden, facilitating safer sport and PA participation.
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Affiliation(s)
- Madeleine Davies
- Institute of Sport, Exercise and Health, UCL, London, UK
- Department for Health, University of Bath, Bath, UK
| | - Tom Lawrence
- National Institute for Health and Care Excellence, London, UK
- Division of Population Health, Trauma Audit and Research Network, The University of Manchester, Manchester, UK
| | - Antoinette Edwards
- Division of Population Health, Trauma Audit and Research Network, The University of Manchester, Manchester, UK
| | - Carly McKay
- Department for Health, University of Bath, Bath, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
| | - Fiona E Lecky
- Division of Population Health, Trauma Audit and Research Network, The University of Manchester, Manchester, UK
- Centre for Urgent and Emergency Care Research, University of Sheffield School of Health and Related Research, Sheffield, UK
| | - Keith A Stokes
- Department for Health, University of Bath, Bath, UK
- Rugby Football Union, London, UK
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Allen B, McDermott R, Clark J, Daubs G, Vashon T, Elliott I, Daubs M, Maitra S. Traumatic spinal injury patterns of on vs. off-road motorcycle crashes. TRAFFIC INJURY PREVENTION 2023; 25:85-90. [PMID: 37768949 DOI: 10.1080/15389588.2023.2259530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 09/12/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVE Two wheel motorized vehicles used in both street transportation and recreation are a common cause of severe injury in the United States (US). To date, there has been limited data describing the spinal injury patterns among these motorcycle injury patients in the US. The goal of this study is to characterize and compare differences in specific injury patterns of patients sustaining traumatic spinal injuries after motocross (off-road) and street bike (on-road) collisions in the southwestern US at a Level I Trauma Center. METHODS Trauma registry data was queried for patients sustaining a spinal injury after motorcycle collision from 2010 to 2019 at a single Level I Trauma Center. Computed tomography (CT) scan and magnetic imaging resonance imaging (MRI) reports from initial trauma evaluation were reviewed and data was manually obtained regarding injury morphology and location. RESULTS A total of 1798 injuries were identified in 549 patients who sustained a motorcycle collision, specifically 67 off-road and 482 on-road motorcycle patients. Off-road motorcycle patients were found to be significantly younger (34.75 vs. 42.66, p = 0.00015). A total of 46.2% of the off-road injuries were determined to be from compression mechanisms, compared to 32.9% in the on-road cohort (p = 0.0027). The on-road cohort was more likely to have an injury classified as insignificant, such as transverse and spinous process fractures (60.1% vs. 42.5%, p = 00.25). There was no significant difference in regards to junctional, mobile, and semirigid spine segments between the two cohorts. CONCLUSIONS Different fracture patterns were seen between the off-road and on-road motorcycle cohorts. Off road motorcyclists experienced significantly more compression and translational injuries, while on road motorcyclists experienced more frequent insignificant injury patterns. Data on the different fracture patterns may help professionals develop safety equipment for motorcyclists.
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Affiliation(s)
- Brett Allen
- Department of Orthopaedics, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada
| | - Ryland McDermott
- Department of Orthopaedics, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada
| | - James Clark
- Department of Orthopaedics, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada
| | - Gregory Daubs
- Department of Orthopaedics, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada
| | - Toure Vashon
- Department of Orthopaedics, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada
| | - Iain Elliott
- Department of Orthopaedics, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada
| | - Michael Daubs
- Department of Orthopaedics, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada
| | - Sukanta Maitra
- Department of Orthopaedics, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada
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Hay B, Singh R, Hay S. The Perils of Riding Motocross: A Summary of this Extensive, Prospective Study. Indian J Orthop 2023; 57:404-409. [PMID: 36777072 PMCID: PMC9904869 DOI: 10.1007/s43465-022-00815-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/31/2022] [Indexed: 02/10/2023]
Abstract
Background Motocross is a high-risk form of motorbiking where serious injuries occur regularly, although little data have been collected to illustrate this relationship. Over 5 years, teams from RJAH Oswestry and RSH sought to demonstrate the impact of Motocross on orthopaedic presentation and workload. Method Data were collected prospectively over 5 years including 615 orthopaedic injuries associated with both recreational and competitive motocross. Results An increase in injury and operation frequency was observed, young males were identified as the highest risk participant. This was evident over winter and weekends, during the competitive racing season. A variety of injuries have been implicated, some with life threatening or disabling consequences. Conclusion Motocross has seen exponential growth in popularity with increases in injuries and operations. This implicates major impacts on finances and healthcare, especially at times of seasonal vulnerability. The authors encourage event organisers to explore the avenues of rider safety in this increasingly popular sport.
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Affiliation(s)
- Bruce Hay
- grid.417145.20000 0004 0624 9990University Hospital Wishaw, 50 Netherton St, Wishaw, ML2 0DP UK
| | - Rohit Singh
- grid.439417.c0000 0004 0472 4225Royal Shrewsbury Hospital, The Shrewsbury and Telford Hospital NHS Trust, Mytton Oak Road, Shrewsbury, SY3 8XQ UK ,grid.412943.90000 0001 0507 535XThe Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, SY10 7AG UK
| | - Stuart Hay
- grid.412943.90000 0001 0507 535XThe Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, SY10 7AG UK ,grid.9757.c0000 0004 0415 6205Keele University Medical School, Newcastle-under-Lyme, UK
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Kilper A, Schütz L, Langenhan R, Reimers N. Injuries in supercross - Evaluation of trauma during a two-day international indoor motocross event. J Orthop 2021; 24:233-238. [PMID: 33814814 DOI: 10.1016/j.jor.2021.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/31/2021] [Indexed: 10/22/2022] Open
Abstract
Introduction Supercross is characterized by fast and skillful movements, with high concentration being required on an indoor competition circuit, due to the demanding jumps and short distances to the next obstacle. The injuries can turn out to be diverse, including polytraumatization. This paper aims to evaluate the accidents and possible injuries in a single Supercross competition. To what extent is the presence of medical staff required? Methods During the 17th International Supercross Event in Chemnitz, 93 participants started in 5 classes. Severe injuries were treated at the track, through the emergency department and hospital stay to their discharge. Results Overall 5 participants (4.65%) had to be admitted to the clinic. Conclusion Injuries from risky jumps at relatively high speed can range from minor contusions to fractures and serious injuries. The permanent readiness of medical staff and emergency doctors at the site is therefore justified and required. The variety of injuries in a Supercross event can affect the head and face, the upper- and lower extremities, thoracal- and abdominal traumas and especially the spine. In addition, a special training concept in terms of preventive measures to prevent falls would be desirable.
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Affiliation(s)
- Anica Kilper
- Medical Center of Chemnitz, Department of Orthopaedics, Trauma and Hand Surgery, Flemmingstr. 2, 09116, Chemnitz, Germany
| | - Ludwig Schütz
- Medical Center of Chemnitz, Department of Orthopaedics, Trauma and Hand Surgery, Flemmingstr. 2, 09116, Chemnitz, Germany
| | - Ronny Langenhan
- Department of Orthopaedic Surgery, Hegau-Bodensee-Klinikum Singen, Germany
| | - Niklas Reimers
- Medical Center of Chemnitz, Department of Orthopaedics, Trauma and Hand Surgery, Flemmingstr. 2, 09116, Chemnitz, Germany
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