Impact of Previous Ankle Injuries on Professional Footballers' Preseason Functional Ankle Assessment

Introduction

Football is the most popular sport and is widely played around the globe, with approximately 400 million players in 208 countries. Lower extremity injuries showed the highest incidence, with ankle injuries being the most prevalent after hip and knee injuries. The purpose of this study was to describe the characteristics of the players who reported previous ankle injuries during pre-competition medical assessment (PCMA) during the 2022 seasons of the Malaysian professional club. In addition, the study also investigated the effect of previous injuries on current ankle function.

Materials and methods

This was a retrospective cross-sectional study using secondary data from the preseason PCMA data from a professional club that competed in Malaysia. The ankle range of motion, anterior drawer test, and functional ankle assessments including the Biodex athlete single leg stability test and ankle joint muscle strength were performed during the PCMA.

Results

A total of 45 footballers reported previous history of ankle injuries to the left (n=9), right (n=20), or both ankles (n=16). Footballers with prior ankle injuries exhibited significantly less ankle inversion (p = 0.008) and a larger proportion of positive ADT tests in the injured ankle (x2(1, N=90) =7.76, p=0.005) compared to the non-injured side. there was no significant difference in other ankle range of motion, ankle stability index, or ankle muscular strength between previously injured and uninjured ankles.

Conclusions

During preseason screening, half of the footballers in this study reported previous history of ankle injury, putting them at risk of having future ankle injuries. Aside from inversion and the anterior drawer test, no significant differences in range of motion, stability index, or muscle strength were discovered. However, as injury causation is multifactorial, preventive measures should be taken to reduce the risk of injury.

Does primary urethral realignment improve the outcome of pediatric pelvic fracture urethral injury? A randomized controlled trial

OBJECTIVE

To assess the efficacy of primary urethral realignment in the prevention of urethral stenosis and in simplifying delayed urethroplasty after complete pelvic fracture urethral injury in male children.

METHODS

This randomized comparative trial included 40 boys <18 years with complete pelvic fracture urethral injury. The initial management was a primary urethral realignment in 20 boys and suprapubic cystostomy alone in the remaining 20 boys. The boys who underwent primary urethral realignment were assessed regarding the development of urethral stenosis. Boys who needed to be delayed urethroplasty in the two groups were compared regarding urethral defect length, intraoperative details, postoperative outcomes, number of procedures, and time to achieve normal voiding.

RESULTS

Although 14 (70%) patients were able to void after primary urethral realignment, all of them developed urethral stenosis and needed delayed urethroplasty. No statistically significant difference between the two groups was found regarding urethral defect length, intraoperative details, and postoperative outcomes. Patients in the primary urethral realignment group underwent significantly more procedures (p < 0.001) and took a significantly longer time to achieve normal voiding (p = 0.002).

CONCLUSION

Primary urethral realignment is neither able to prevent urethral stenosis nor effective in simplifying later urethroplasty after complete pelvic fracture urethral injury in male children. It exposes the patients to more surgical procedures and a prolonged clinical course.

Pulmonary complications in diabetes mellitus

Diabetes mellitus is a chronic debilitating and devastating disease, which affects various organs including lungs. The incidence and prevalence of diabetes mellitus and its complications is increasing day by day. Many studies have reported different pulmonary complications in diabetic patients. Chronic hyperglycemia causes non-enzymatic glycation of the chest wall and bronchial tree collagen protein that leads to fibrous tissue formation. Due to increased protein catabolism, there is decreased respiratory muscle strength. Neuropathy of phrenic nerve may cause diaphragmatic paralysis. So, the diabetes mellitus causes reduced ventilatory function. The disease also causes thickening of the basal lamina by glycation and reduces the gas diffusing capacity. It also causes glycation of immunoglobulin and increases the chance of acute and chronic pulmonary infections that causes fibrosis of lung parenchyma and consequently reduces the lung mechanics. Hyperglycemia causes local biochemical changes in the lungs and reduces the antioxidant defense of the lungs. The consequence of the local oxidative stress reduces the lung volumes, elastic recoil of the lungs and also causes reduced bronchodilatation. So, diabetes mellitus plays a significant role in development of pulmonary complication and like other organs lungs are the target organ in diabetes mellitus.

Upper abdominal mass with diagnostic dilemma

A 32 years old gentleman presented with a lump occupying the epigastric, left hypochondriac and umbilical region for the last 3 months which gradually increased in size & dull aching pain. He also complained of low grade fever and early satiety. On examination, he had a lump on upper abdomen which was irregular, firm, mildly tender, lobulated surface, restricted mobility, dull on percussion. USG examination of HBS revealed hepatomegaly and SOL in liver. CT abdomen revealed soft tissue mass in left upper abdomen. FNA revealed cells of mesenchymal origin. Per operatively a large lobulated, myxomatous highly vascular mass arising from the fundal part of the stomach was found and removed. Histopathology report comments about two differential diagnosis-leiomyosarcoma and gastrointestinal stromal tumour. CD117 immunostaining confirmed it was gastrointestinal stromal tumor (GIST). Post operatively patient was treated by Imatinib and is now under regular follow up.