Hand injuries in sports - a retrospective analysis of 364 cases

Differences in Injury Profiles Between Female and Male Athletes Across the Participant Classification Framework: A Systematic Review and Meta-Analysis

BACKGROUND

Female sex is a significant determinant of anterior cruciate ligament (ACL) injury. It is not understood if sex is a key determinant of other sports-related injuries.

OBJECTIVE

The aim of this systematic review was to identify where differences in injury profiles are most apparent between the sexes in all sports across the six-tiered participant classification framework.

METHODS

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the 'implementing PRISMA in Exercise, Rehabilitation, Sport medicine and SporTs science'(PERSiST) guidance. The databases PubMed, CINAHL, Web of Science, SPORTDiscus, Medline, Scopus, Cochrane Library and EBSCO were searched from database inception to 24 April 2023. Longitudinal, prospective and retrospective cohort studies and cross-sectional and descriptive epidemiology studies that used standard injury data collection were included. Studies were excluded if injuries were not medically diagnosed and if injuries were not reported and/or analysed by sex. Two reviewers independently extracted data and assessed study quality using the Downs and Black checklist.

RESULTS

Overall, 180 studies were included (8 tier-5, 40 tier-4, 98 tier-3, 30 tier-2, 5 tier-1 studies; one study included data in two tiers). Of those, 174 studies were of moderate quality and six studies were of limited quality. In sex-comparable sports, there was moderate evidence that female athletes had greater risk of knee injury (relative risk (RR) 2.7; 95% CI 1.4-5.5), foot/ankle injuries (RR 1.25; 95% CI 1.17-1.34), bone stress injury (RR 3.4; 95% CI 2.1-5.4) and concussion (RR 8.46; 95% CI 1.04-68.77) than male athletes. Male athletes were at increased risk of hip/groin injuries (RR 2.26; 95% CI 1.31-3.88) and hamstring injuries (RR 2.4; 95% CI 1.8-3.2) compared with females, particularly in dynamic sports. Male athletes were 1.8 (1.37-2.7) to 2.8 (2.45-3.24) times more likely to sustain acute fractures than female athletes, with the highest risk in competition.

DISCUSSION

Most studies in all cohorts were of moderate quality (mean/range of scores tier-5: 17 ± 2.2 [14-20], tier-4: 16.9 ± 1.9 [11-21], tier-3: 16.9 ± 1.5 [11-20], tier-2: 16.3 ± 2.2 [11-20], tier-1 studies: 15.6 ± 1.3 [14-17] out of 28 on the Downs and Black checklist), with only six studies of limited quality. Female athletes' propensity for bone stress injuries highlights opportunities to reinforce development of optimal bone health during adolescence and to outline the effects of energy availability. Earlier strength development and exposure to neuromuscular training programmes and modification of skill development in female athletes may be effective strategies for reducing lower limb injury risk. Key components of neuromuscular training programmes could be beneficial for reducing hip/groin and hamstring injury risk in male athletes. There may be a need for sex-specific prevention and return-to-sport protocols for sports-related concussion in female athletes.

CONCLUSIONS

Female sex was a key determinant of sports-related injuries beyond ACL injury including foot/ankle injury, bone stress injury and sports-related concussion. Male sex was a key determinant of hip/groin, hamstring injury and upper limb injury.

TRIAL REGISTRY

PROSPERO registration number: CRD42017058806 (last updated on 7th June 2023).

HOW TO PREVENT HAND INJURIES - REVIEW OF EPIDEMIOLOGICAL DATA IS THE FIRST STEP IN HEALTH CARE MANAGEMENT

BACKGROUND

Hand injuries are common affecting all ages, genders, and geographic regions. They can result in long term disability and mortality, while they place a significant financial burden in society. Although, hand injuries can be prevented. Preventive strategies can be designed, but knowledge of injuries' epidemiological characteristics is required beforehand.

METHODS

We performed a review of the current literature related to hand injuries to identify their incidence, patients' demographics, type, mode, and time of the injury.

RESULTS

Hand injuries constitute 6.6% to 28.6% of all injuries presenting to the Emergency Department and 28% of injuries to the musculoskeletal system. They mainly affect young male labourers. Occupational and home accidents are the commonest injury modalities, while traffic road accidents constitute a significant reason for hand injuries as well. Lacerations account for most hand injuries, followed by crush injuries, fractures and amputations. Most occupational injuries occur in the beginning of the week and especially during the morning shift, while there has been identified an increase in the number of hand injuries during the summer months.

CONCLUSIONS

Hand injuries are an important health problem with impact on patient's life and on the society. Although they can be prevented. Preventive strategies need to be addressed towards many directions and people's activities, since prevention will have an important impact on people's quality of life and society's well-being.

Adverse drug reactions in geriatric psychiatry-retrospective cohort study of a 6-year period

OBJECTIVE

To investigate the frequency and characteristics of adverse drug reactions (ADRs) that occurred on the gerontopsychiatric ward of Hannover Medical School over a 6-year period.

DESIGN

Retrospective monocentric cohort study.

RESULTS

Six hundred thirty-four patient cases (mean age 76.6 ± 7.1 years; 67.2% female) were analysed. In total, 92 ADRs in 56 patient cases were registered in the study population. The overall ADR prevalence, the ADR prevalence upon hospital admission, and the ADR prevalence during hospitalisation were 8.8%, 6.3%, and 4.9%, respectively. The most frequent ADRs were extrapyramidal symptoms, alterations in blood pressure or heart rate, and electrolyte disturbances. Of note, two cases of asystole and one case of obstructive airway symptoms related to general anaesthesia in the context of electroconvulsive therapy (ECT) were detected. The presence of coronary heart disease was associated with an increased risk of ADR occurrence (odds ratio (OR) 2.92, 95% confidence interval (CI) 1.37-6.22), while the presence of dementia was associated with a decreased risk of ADR development (OR 0.45, 95% CI 0.23-0.89).

CONCLUSIONS

Type and prevalence of ADRs in the present study were largely in accordance with previous reports. By contrast, we did not observe a relationship between advanced age or female sex and ADR occurrence. We detected a risk signal for cardiopulmonary ADRs related to general anaesthesia in the context of ECT that warrants further investigation. Elderly psychiatric patients should be carefully screened for cardiopulmonary comorbidities before initiation of ECT.

PREVENTION OF PHYSICAL INJURIES IN OUTDOOR SPORTS PRACTITIONERS

ABSTRACT Introduction: Outdoor sports are a recreational sports, and mountaineering and hiking are the basic forms of this sport. Occasionally there are injuries in the practice of this activity that can damage the health of its practitioners, in addition to bringing adverse effects to the daily work environment. Objective: Provide relevant protection measures to prevent physical injuries caused to outdoor sports practitioners. Methods: Volunteer exercisers participated in a questionnaire survey that collected the location of sports injuries and the causes of these injuries. On this information, statistics were processed considering the location of the injuries and their causes. Protective measures were based on the updated scientific literature. Results: The most injured body parts in outdoor sports are ankle joints, knee joints, and skin tissue contusions. The main reason for these injuries is the lack of awareness of protection by the athletes. Conclusion: Attention to preparation activities before outdoor sports and organization in the exercise load are the main factors for preventing physical injuries in outdoor sports practitioners. In this way, injuries can be avoided in outdoor sports. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.