Orthopaedic Injuries Associated With Cell Phone Use Resulting in Emergency Department Visits: A 20-Year Analysis

Orthopaedic Injury Patterns Related to Ice Skating, Inline Skating, and Roller Skating: A 20-Year Epidemiologic Analysis

Background

Ice skating, inline skating, and roller skating are popular sports in the United States (US). Although they are similar, injuries incurred may be distinct and may have evolved over time.

Purpose

To characterize injuries related to ice skating, inline skating, and roller skating and track injury patterns over a 20-year period.

Study Design

Descriptive epidemiology study.

Methods

The current study utilized the National Electronic Injury Surveillance System, a database reporting consumer product-related injuries seen at emergency departments in the US. All ice skating, inline skating, and roller skating injuries between 2002 and 2021 were identified, and patient demographics, types of injury, and year of injury were compared between skating types.

Results

A total of 1,656,746 skating-related injuries were estimated nationally: 24% (403,791) for ice skating, 24% (400,172) for inline skating, and 52% (852,783) for roller skating. While the incidence of ice-skating- and roller-skating-related injuries decreased by 34.4% (from 22,490 in 2002-2004 to 14,758 in 2019-2021) and 29.6% (from 42,452 in 2002-2004 to 31,980 in 2019-2021), respectively, injuries related to inline skating decreased comparatively more, by 75.8% over the study period (from 48,097 in 2002-2004 to 11,662 in 2019-2021). Injuries occurred predominantly to the head/face/neck for ice skating (n = 139,501; 34.5% of injuries), whereas injuries occurred predominantly in the shoulder/arm/elbow/wrist for inline skating (n = 212,088, 53.0% of injuries) and roller skating (n = 425,216, 49.9% of injuries). Fracture was the most common injury type for all 3 skating types (n = 614,853, 37.1% of injuries), and the majority of fractures occurred in the upper extremity (shoulder/arm/elbow/wrist) for all 3 skating types (n = 59,624, 60.0% [ice skating]; n = 69,197, 41.2% [inline skating], and n = 237,099, 68.2% [roller skating]). Lower extremity (leg/knee/ankle) fractures were more common among ice skating (n = 28,019, 28.2%) and roller skating (n = 82,094, 23.6%) injuries compared with inline skating (n = 21,391, 12.7%).

Conclusion

In the current study, we found that fractures were the most common type of injury regardless of skating type but that the location of the injury/fracture varied by skating type.

Occupational hand trauma - Mechanism of injury and transient risk factors in Jerusalem

INTRODUCTION

Although prevalent, and variable geographically, there is little information on the incidence and risk factors for occupation hand trauma in our health care system. This pilot study was designed to determine the optimal data collection methods for transient risk factors locally METHODS: All adult patients with occupational hand trauma treated at an emergency department (ED) during a three-month period were interviewed, either in person or by phone, using a case crossover designed questionnaire, regarding occupation and exposure to potential transient risk factor.

RESULTS

Of 206 patients treated with occupational trauma during the study period, 94 had trauma distal to the elbow (46%). Patient compliance was high - 89% of the patients consented to phone interviews and 83% completed in-person ED interviews. In the 75 patients which participated in the study, several risk factors were found to be significant, including machine maintenance and being distracted, including by a cellular phone. We found lack of job experience, limited training on the job site and reports of previous injuries in these workplaces to be prevelent.

DISCUSSION

The risk factors implicated in this study are similar to those reported in previous studies at other locations and are modifiable although this is the first report linking cellular phone use and occupation trauma. This finding should be further examined in a larger group and according to occupational categories. Compliance with the study was high, in person or with phone interviews, making these options viable for further studies. Several minor changes to the questionnaire were suggested although it did conform with the case-crossover study design. According to this study, standard preventive measures may be lacking in Jerusalem and should be implemented more uniformly, including specific workplace safety plans and education and taking into consideration the risk factors documented here.

Short-Term Outcomes of Enhanced Recovery after Surgery (ERAS) for Ankle Fracture Patients: A Single-Center Retrospective Cohort Study

OBJECTIVE

Enhanced recovery after surgery (ERAS) has been successfully adopted for the improvement of medical quality and efficacy in many diseases, but the effect thereof for ankle fracture patients can vary. The aim of the present study was to explore the short-term postoperative outcomes of ERAS among ankle fracture patients.

METHODS

The present study was a retrospective cohort study conducted between January 2019 and May 2019. One hundred and sixty ankle fracture participations (58 males and 102 females, aged 41.71 ± 14.51 years) were included. The participants treated with open reduction and internal fixation were divided into two groups (non-ERAS vs. ERAS) depending on whether ERAS was applied. Postoperative outcomes included American Orthopedic Foot and Ankle Society (AOFAS) score, length of stay (LOS), hospital cost, complications, and consumption of opioids. To assess the association between the groups and outcomes, generalized estimating equation (GEE) modeling and multivariable linear regression analysis were performed.

RESULTS

The average follow-up periods of the participations were 24 months postoperatively. No significant differences were detected between the non-ERAS group and ERAS group with respect to the demographic of patients in terms of gender, age, Danis-Weber classification of fracture, dislocation of ankle joint, and comorbidity (P > 0.05). Significant differences in terms of a higher AOFAS score were found in the ERAS group compared with the non-ERAS group (6.73, 95% CI, 5.10-8.37, p < 0.001) at 3 months postoperatively (PO3M) and (4.73, 95% CI, 3.02-6.45, p < 0.001) at 6 months postoperatively (PO6M). However, similar AOFAS scores were found at 12 months postoperatively (PO12M) (0.28, 95% CI, -0.32 to 0.89, P > 0.05) and at 24 months postoperatively (PO24M) (0.56, 95% CI, -0.07 to 1.19, P > 0.05). Additionally, the GEE analysis and group-by-time interaction of AOFAS score revealed that the ERAS protocol could facilitate faster recovery for ankle fracture patients, with higher PO3M and PO6M (both P < 0.05). At the same time, significant differences in terms of a shorter length of stay (-3.19, 95% CI, -4.33 to -2.04, P < 0.01) and less hospital cost (-6501.81, 95% CI, -10955.21 to -2048.42, P < 0.01) were found in the ERAS group compared with the non-ERAS group.

CONCLUSION

By reducing LOS and hospital cost, the ERAS protocol might improve the medical quality and efficacy. The present study can provide a realistic evaluation and comparison of the ERAS protocol among ankle fracture patients, and ultimately guide clinical decision making.

Factors associated with texting and walking performance in children with ADHD: The role of age, environment, and symptom severity

BACKGROUND

Children with ADHD show deficits in executive function, as well as motor symptoms such as difficulties in gross and fine motor skills and gait stability. Texting while walking is becoming increasingly common and is a significant health risk among people of all ages.

RESEARCH QUESTION

The objective of this work was to compare texting and walking performance between children with ADHD and controls and between two environments (indoors and outdoors), and evaluate the role of age and symptom severity in dual-task performance.

METHODS

Nineteen children with ADHD and 30 healthy children walked across an indoors corridor and an outdoors street, with and without texting on a mobile phone. Walking and texting performance were measured using inertial measurement units and a custom-made mobile app.

RESULTS

No between-group differences were found in texting or walking performance. Walking and texting were similar across environments. In both groups, older children had smaller dual-task performance deficits for both gait and texting speed. Children with ADHD who had more severe symptoms of hyperactivity had larger dual task costs for gait speed outdoors (r = 0.69, p = 0.002), and those with more motor symptoms typed faster under dual-task conditions indoors (r = 0.6, p = 0.007) but were less accurate (r = - 0.60, p = 0.009).

SIGNIFICANCE

Children with ADHD do not demonstrate deficits in dual-task performance of a texting and walking task indoors or outdoors. The relationship of age, hyperactivity and motor symptoms with texting and walking performance supports a more personalized approach for examination of dual-task performance in children with ADHD.

Prefrontal Cortex Brain Activation During Texting and Walking: A Functional Near-Infrared Spectroscopy Feasibility Study

Texting while walking is an increasingly common, potentially dangerous task but its functional brain correlates have yet to be reported. Therefore, we evaluated prefrontal cortex (PFC) activation patterns during single- and dual-task texting and walking in healthy adults. Thirteen participants (29–49 years) walked under single- and dual-task conditions involving mobile phone texting or a serial-7s subtraction task, while measuring PFC activation (functional near-infrared spectroscopy) and behavioral task performance (inertial sensors, mobile application). Head lowering during texting increased PFC activation. Texting further increased PFC activation, and decreased gait performance similarly to serial-7 subtraction. Our results support the key role of executive control in texting while walking.