Orthopedic Injury Profiles in Adolescent Elite Athletes: A Retrospective Analysis From a Sports Medicine Department

Epidemiological Pattern of Musculoskeletal Injuries in Children Aged 16 Years and Below in a Regional Trauma Centre in Nigeria

Introduction Injuries in children and adults contribute a large percentage to the global burden of disease. Findings in this study will help authorities and governments in our clime to make policies aimed at the prevention and reduction of this burden. Methods This study is a retrospective review of cases of musculoskeletal injuries in children aged 0-16 years seen at the National Orthopaedic Hospital, Lagos, Nigeria, over a period of three years (from January 2017 to December 2019). Results Ninety children were included in this study, made up of 58 males (64.4%) and 32 females (35.4%), presenting a male: female ratio of 1.8:1. The combined average age of the children of both sexes was 8.15+/-4.03 years. The home was the most common place (47.8%) where injuries took place, followed by streets/roads (25.6%). Fall was the commonest etiology/mode of injury (57.8%), followed by traffic accidents (23.3%). The 90 patients studied had 96 injuries, of which 92 (95.8%) were close injuries, and the rest were open injuries. The children sustained 101 fractures of individual bones; the femur was the most frequently fractured bone (36, 35.6%), followed by the humerus (30, 29.7%). Treatment modalities offered included closed reduction with casting, open/closed reduction and K-wire fixation of fractures, wound debridement/care for open injuries, and others. Conclusion Falls and traffic accidents were responsible for most of the injuries in the children studied. Appropriate policies by those in government/authority and the right measures by parents and caregivers will help to reduce the incidence of these largely preventable injuries.

Comparison of pediatric performance athlete injuries presenting to emergency departments

OBJECTIVE

Pediatric injuries in performance sports represent a significant healthcare burden and account for over 50,000 annual Emergency Department (ED) visits in the United States. The objective of this study was to characterize and compare pediatric injury presentation across the most common performance sports.

METHODS

The National Electronic Injury Surveillance System (NEISS) database was retrospectively analyzed for pediatric injuries (3-18 years) related to gymnastics, dance, or cheerleading from 2015-2019. Cases were categorized as children (˂11 years) or adolescent (≥11 years). Injuries were categorized as orthopedic (fractures, dislocations, sprain, strains), non-orthopedic (contusion, internal injury, laceration), concussion, or other/unknown. Case narratives were used to categorize mechanism of injury as contact or non-contact. Appropriate sample NEISS weights estimation was applied for statistical analysis and Confidence Intervals (CI).

RESULTS

A total of 393,110 injuries were observed over the five-year study period, with a mean of 78,622 annual injuries. Gymnastics, dance, and cheerleading accounted for 136,422 injuries, 96,416 injuries, and 160,272 injuries, respectively. Most cases were adolescent (71%; 95% CI: 68-74%) and occurred in a sports-related setting (65%, 95% CI: 57-72%). Gymnastics had the highest proportion of injuries among children (50%) as compared to dancers (25%) or cheerleaders (12%) (p < 0.01). Non-contact injuries most affected the lower extremity (43-68%) and resulted in an orthopedic diagnosis (63-71%), and contact injuries had a higher proportion of injuries affecting the head, neck, and face (29-51%) and non-orthopedic diagnoses (29-38%). Gymnastics had the most upper extremity non-contact injuries (42%) and dance the most lower extremity non-contact injuries (68%) (p < 0.01). Cheerleading had the highest incidence of overall concussions (8%), contact injuries (47%), and concussions due to contact injury (15%).

CONCLUSION

Pediatric gymnasts, cheerleaders, and dancers have important similarities and differences in injury pattern which may lead to the development of sport-specific injury prevention programs for pediatric performance athletes.

WITHDRAWN: Construction of the evaluation system of snowboarders' motor function and the risk evaluation of health sports

Ahead of Print article withdrawn by publisher.

Thigh muscle activation patterns and dynamic knee valgus at peak ground reaction force during drop jump landings: Reliability, youth competitive alpine skiing-specific reference values and relation to knee overuse complaints

OBJECTIVES

(1) To evaluate the reliability of quantifying thigh muscle activation patterns and dynamic knee valgus during drop jump landings, (2) to provide reference values for female and male youth alpine skiers, and (3) to study their associations with age, anthropometrics, biological maturation and knee overuse complaints.

DESIGN

Cross-sectional biomechanical experiment including questionnaires.

METHODS

One hundred fourteen skiers of the under 16 category (main experiment) and twelve healthy participants (reliability experiment) volunteered. Quadriceps-to-hamstring-activation ratio and medial knee displacementat peak ground reaction force during drop jump landings were measured using marker-based motion analysis, force plates and electromyography. Additionally, age, anthropometrics, biological maturation and knee overuse complaints were assessed.

RESULTS

There were good test-retest reliabilities and moderate standardized typical errors for both quadriceps-to-hamstring-activation ratio (intraclass correlation coefficient(3,1) = 0.84 [95% confidence interval: 0.69, 0.94]; standardized typical errors = 0.43 [0.35, 0.56]) and medial knee displacement (intraclass correlation coefficient(3,1) = 0.87 [0.74, 0.95]; standardized typical errors = 0.39 [0.32, 0.50]). Male skiers had a significantly higher quadriceps-to-hamstring-activation ratio (3.9 ± 2.0 vs. 2.9 ± 1.4, p = 0.011), whilst medial knee displacement was comparable to females (12 mm ± 11 mm vs. 13 mm ± 9 mm; p = 0.419). In male skiers, medial knee displacement correlated with anthropometrics and maturity offset; in female skiers, quadriceps-to-hamstring-activation ratio and medial knee displacement were associated with knee overuse complaints (p < 0.05).

CONCLUSIONS

Female and male youth skiers use different thigh muscle activation strategies, but show comparable dynamic knee valgus motions during drop jump landings. In females, a combination of increased relative quadriceps activity and medial knee displacement may favour knee overuse complaints.