Injuries Associated With Standing Electric Scooter Use

Importance

Since September 2017, standing electric scooters have proliferated rapidly as an inexpensive, easy mode of transportation. Although there are regulations for safe riding established by both electric scooter companies and local governments, public common use practices and the incidence and types of injuries associated with these standing electric scooters are unknown.

Objective

To characterize injuries associated with standing electric scooter use, the clinical outcomes of injured patients, and common use practices in the first US metropolitan area to experience adoption of this technology.

Design, Setting, and Participants

This study of a case series used retrospective cohort medical record review of all patients presenting with injuries associated with standing electric scooter use between September 1, 2017, and August 31, 2018, at 2 urban emergency departments associated with an academic medical center in Southern California. All electric scooter riders at selected public intersections in the community surrounding the 2 hospitals were also observed during a 7-hour observation period in September 2018.

Main Outcomes and Measures

Incidence and characteristics of injuries and observation of riders' common use practices.

Results

Two hundred forty-nine patients (145 [58.2%] male; mean [SD] age, 33.7 [15.3] years) presented to the emergency department with injuries associated with standing electric scooter use during the study period. Two hundred twenty-eight (91.6%) were injured as riders and 21 (8.4%) as nonriders. Twenty-seven patients were younger than 18 years (10.8%). Ten riders (4.4%) were documented as having worn a helmet, and 12 patients (4.8%) had either a blood alcohol level greater than 0.05% or were perceived to be intoxicated by a physician. Frequent injuries included fractures (79 [31.7%]), head injury (100 [40.2%]), and contusions, sprains, and lacerations without fracture or head injury (69 [27.7%]). The majority of patients (234 [94.0%]) were discharged home from the emergency department; of the 15 admitted patients, 2 had severe injuries and were admitted to the intensive care unit. Among 193 observed electric scooter riders in the local community in September 2018, 182 (94.3%) were not wearing a helmet.

Conclusions and Relevance

Injuries associated with standing electric scooter use are a new phenomenon and vary in severity. In this study, helmet use was low and a significant subset of injuries occurred in patients younger than 18 years, the minimum age permitted by private scooter company regulations. These findings may inform public policy regarding standing electric scooter use.

The Football Association medical research programme: an audit of injuries in academy youth football

OBJECTIVES

To undertake a prospective epidemiological study of the injuries sustained in English youth academy football over two competitive seasons.

METHODS

Player injuries were annotated by medical staff at 38 English football club youth academies. A specific injury audit questionnaire was used together with a weekly return form that documented each club's current injury status.

RESULTS

A total of 3805 injuries were reported over two complete seasons (June to May) with an average injury rate of 0.40 per player per season. The mean (SD) number of days absent for each injury was 21.9 (33.63), with an average of 2.31 (3.66) games missed per injury. The total amount of time absent through injury equated to about 6% of the player's development time. Players in the higher age groups (17-19 years) were more likely to receive an injury than those in the younger age groups (9-16 years). Injury incidence varied throughout the season, with training injuries peaking in January (p<0.05) and competition injuries peaking in October (p<0.05). Competition injuries accounted for 50.4% of the total, with 36% of these occurring in the last third of each half. Strains (31%) and sprains (20%) were the main injury types, predominantly affecting the lower limb, with a similar proportion of injuries affecting the thigh (19%), ankle (19%), and knee (18%). Growth related conditions, including Sever's disease and Osgood-Schlatter's disease, accounted for 5% of total injuries, peaking in the under 13 age group for Osgood-Schlatter's disease and the under 11 age group for Sever's disease. The rate of re-injury of exactly the same anatomical structure was 3%.

CONCLUSIONS

Footballers are at high risk of injury and there is a need to investigate ways of reducing this risk. Injury incidence at academy level is approximately half that of the professional game. Academy players probably have much less exposure to injury than their full time counterparts. Areas that warrant further attention include the link between musculoskeletal development and the onset of youth related conditions such as Sever's disease and Osgood-Schlatter's disease, the significant number of non-contact injuries that occur in academy football, and the increased rates of injury during preseason training and after the mid season break. This study has highlighted the nature and severity of injuries that occur at academy level, and the third part of the audit process now needs to be undertaken: the implementation of strategies to reduce the number of injuries encountered at this level.

Bruises in infants and toddlers: those who don't cruise rarely bruise. Puget Sound Pediatric Research Network

OBJECTIVES

To determine the frequency and location of bruises in normal infants and toddlers, and to determine the relationship of age and developmental stage to bruising.

DESIGN

Cross-sectional survey.

SETTING

Community primary care pediatric offices.

SUBJECTS

Children younger than 36 months attending well-child care visits.

METHODS

Prospective data collection of demographics, developmental stage, and presence and location of bruises. Any medical condition that causes bruises as well as known or suspected abuse was also recorded. A chi2 test or Fisher exact test was used to determine the significance of differences.

MAIN OUTCOME MEASURES

Presence and location of bruises as related to age and developmental stage.

RESULTS

Bruises were found in 203 (20.9%) of 973 children who had no known medical cause for bruising and in whom abuse was not suspected. Only 2 (0.6%) of 366 children who were younger than 6 months and 8 (1.7%) of 473 children younger than 9 months had any bruises. Bruises were noted in only 11 (2.2%) of 511 children who were not yet walking with support (cruising). However, 17.8% of cruisers and 51.9% of walkers had bruises (P<.001). Mean bruise frequency ranged from 1.3 bruises per injured child among precruisers (range, 1-2 bruises) to 2.4 per injured child among walkers (range, 1-11). The most frequent site of bruises was over the anterior tibia and knee. Bruises on the forehead and upper leg were common among walkers, but bruises on the face and trunk were rare, and bruises on the hands and buttocks were not observed at any age. There were no differences in bruise frequency by sex. African American children were observed to have bruises much less frequently than white children (P<.007).

CONCLUSIONS

Bruises are rare in normal infants and precruisers and become common among cruisers and walkers. Bruises in infants younger than 9 months and who are not yet beginning to ambulate should lead to consideration of abuse or illness as causative. Bruises in toddlers that are located in atypical areas, such as the trunk, hands, or buttocks, should prompt similar concerns.

Incidence of injury in indoor soccer

All injuries occurring over a 7-week period at a local indoor soccer arena were documented for analysis of incidence rates. All injury rates were calculated per 100 player-hours. The overall injury rates for male and female players were similar, 5.04 and 5.03, respectively. The lowest injury rate was found among the 19- to 24-year-old athletes and the highest injury rate was found among the oldest age group (> or = 25 years). Collision with another player was the most common activity at the time of injury, accounting for 31% of all injuries. The most common injury types were sprains and muscle contusions, both occurring at a rate of 1.1 injuries per 100 player-hours. Male players suffered a significantly higher rate of ankle ligament injuries compared with female players (1.24 versus 0.43, P < 0.05), while female players suffered a significantly higher rate of knee ligament injuries (0.87 versus 0.29, P < 0.01). Goalkeepers had injury rates (4.2) similar to players in nongoalkeeper positions (4.5).

Injuries in women's professional soccer

OBJECTIVE

The injury data from the first two seasons of the Women's United Soccer Association (WUSA) were analysed to determine the injury incidence, anatomic location of injuries, and relation of player position.

METHODS

Injury data on 202 players from eight teams during the first two seasons of the WUSA were prospectively collected and analysed.

RESULTS

A total of 173 injuries occurred in 110 players with an overall injury incidence rate of 1.93 injuries per 1000 player hours. The incidence of injury during practice and games was 1.17 and 12.63 per 1000 player hours, respectively. Of the injuries 82% were acute and 16% were chronic. Most of the injuries (60%) were located in the lower extremities. Strains (30.7%), sprains (19.1%), contusions (16.2%), and fractures (11.6%) were the most common diagnoses and the knee (31.8%) and head (10.9%) were the most common sites of injury. Anterior cruciate ligament (ACL) injuries accounted for 4.6% of all injuries and the incidence of ACL tears was 0.09 per 1000 player hours (practice 0.04, game 0.90). Midfielders suffered the most injuries (p<0.007).

CONCLUSION

We conclude that the injury incidence in the WUSA is lower than the 6.2 injuries per 1000 player hours found in the corresponding male professional league (Major League Soccer); however, knee injuries predominate even in these elite female athletes.

A six year prospective study of the incidence and causes of head and neck injuries in international football

OBJECTIVE

To identify those risk factors that have the greatest impact on the incidence of head and neck injuries in international football.

METHOD

A case-control study of players sustaining head and neck injuries during 20 FIFA tournaments (men and women) from 1998 to 2004. Video recordings of incidents were used to identify a range of parameters associated with the incidents. Team physicians provided medical reports describing the nature of each injury. chi2 tests (p< or =0.01) and 95% confidence intervals were used to assess differences in distribution and incidence of injury, respectively.

RESULTS

In total, 248 head and neck injuries were recorded of which 163 were identified and analysed on video sequences. The commonest injuries were contusions (53%), lacerations (20%), and concussions (11%). The incidence of all head and neck injuries was 12.5/1000 player hours (men 12.8, women 11.5) and 3.7 for lost-time injuries (men 3.5, women 4.1). The commonest causes of injury involved aerial challenges (55%) and the use of the upper extremity (33%) or head (30%). The unfair use of the upper extremity was significantly more likely to cause an injury than any other player action. Only one injury (a neck muscle strain) occurred as a result of heading the ball throughout the 20 tournaments equivalent to 0.05 injuries/1000 player hours.

CONCLUSIONS

Players' actions most likely to cause a head or neck injury were the use of the upper extremity or the head but in the majority of cases these challenges were deemed to be fair and within the laws of the game.

The prevalence and distribution of bruising in babies

AIM

To obtain a prevalence rate and determine the distribution of accidental bruising in babies.

METHODS

177 babies aged 6-12 months were examined naked to look for bruises. They were seen in health visitor hearing test clinics and child health surveillance clinics. The site, size, shape, and colour of bruises were recorded on a skin map, and the parent's explanation noted. Any other injury was recorded. Data collection included the baby's age, mobility and weight, demographic details, and health visitor concerns.

RESULTS

Twenty two babies had bruises, giving a prevalence rate of 12%. There was a total of 32 bruises, 15 babies had one bruise. All bruises were found on the front of the body and were located over bony prominences. Twenty five of the bruises were on the face and head, and seven were on the shin. The babies with bruises on the shin were mobile. There was a highly significant increase in bruises with increase in mobility.

CONCLUSIONS

The study has produced a prevalence and distribution of bruising in babies and sets a baseline from which to work when assessing bruises. It also tested out the methodology, which could be used in further research, particularly of younger babies. Clinicians need to assess a baby's level of development when considering whether a bruise is accidental.

Incidence of injury in Texas girls' high school basketball

We studied the incidence of injury in girl's varsity basketball to characterize injury demographics in high school athletics. We defined a reportable injury as one that occurred during organized practice or competition, resulted in either missed practice or game time, required physician consultation, or involved the head or face. We prospectively evaluated the athletes on team rosters during the 1993 to 1994 season from 100 randomly selected Class 4A and 5A Texas public high schools that employed full-time certified athletic trainers. The 890 student athletes from 80 schools ranged in age from 14 to 18 years. Four hundred thirty-six injuries were reported for a rate of 0.49 per athlete per season. Injury risk, calculated on the basis of exposure time, was 0.4% per hour per athlete. Although game time accounted for only 12.5% of exposure time, it represented one half of the total injuries. Sprains and strains (56%) were the most common injuries, followed by contusions (15%) and dental injuries (14%). Injuries to the ankle (31%) and knee (19%) were by far the most common. There were 34 severe injuries defined as requiring surgery or hospitalization, for a rate of 0.038 per athlete per season. Knee injuries were by far the most likely to require surgeries, and ACL injuries accounted for 69% of the severe knee injuries.

Epidemiology of childhood injuries. II. Sex differences in injury rates

The development of sex differences in children's injury rates was explored by analyzing data from 197,516 consumer product-related injuries reported in 1978. The results indicated that sex differences in injury rates appear within the first year of life for most types of injuries. Burns, ingestions, and poisonings were important exceptions. The sex differences were not completely explained by differences in exposure to risk. Sex differences in behavior begin to appear at the same age as the differences in injury rates and correlate with injury type. Injury prevention efforts should take these developmental differences into account and focus attention on the high-risk child.

Australian snowboard injury data base study. A four-year prospective study

Information on the rate and spectrum of snowboarding injuries is limited. This 4-year prospective study at 3 major Australian ski resorts assesses incidence and patterns of snowboarding injuries, particularly in relation to skill level and footwear. Ski injury data were collected for the same period. In a predominantly male study population (men:women, 3:1), 276 snowboarding injuries were reported; 58% occurred in novices. Fifty-seven percent of injuries were in the lower limbs, 30% in the upper limbs. The most common injuries were sprains (53%), fractures (24%), and contusions (12%). Comparing skiers' versus snowboarders' injuries, snowboarders had 2.4 times as many fractures, particularly to the upper limbs (21% versus 35% of upper limb injuries), fewer knee injuries (23% versus 44% of lower limb injuries), but more ankle injuries (23% versus 6% of lower limb injuries). Ankle injuries were more common with soft-shell boots, worn most by intermediate and advanced riders. Knee injuries and distal tibial fractures were more common with hard-shell boots, worn most by novices. Overall, novices had more upper limb fractures and knee injuries; intermediate and advanced riders had more ankle injuries. Falls were the principal mode of injury. To prevent injury, beginners should use "hybrid" or soft-shell boots and take lessons.

Prevalence and location of bone bruises associated with anterior cruciate ligament injury and implications for mechanism of injury: a systematic review

BACKGROUND

Bone bruising is commonly observed on magnetic resonance imaging (MRI) after non-contact anterior cruciate ligament (ACL) injury.

OBJECTIVES

The primary objective of this study was to determine if the location and prevalence of tibial and femoral bone bruises after ACL injury can be explained by specific injury mechanism(s). The secondary objective was to determine whether the bone-bruise literature supports sex-specific injury mechanism(s). We hypothesized that most studies would report bone bruising in the lateral femoral condyle (LFC) and on the posterior lateral tibial plateau (LTP).

METHODS

MEDLINE, PubMed, and SCOPUS were searched for studies that reported bone bruise prevalence and location in ACL-injured subjects. Sex differences in bone-bruise patterns were assessed. Time from injury to imaging was assessed to account for confounding effects on bone-bruise size and location.

RESULTS

Thirty-eight studies met the inclusion/exclusion criteria. Anterior-posterior location of bone bruises within the tibiofemoral compartment was assessed in 11 studies. Only five of these studies reported bone-bruise locations on both the tibia and the femur. The most common bone-bruise combination in all five studies was on the LFC and the posterior LTP. Sex differences were only assessed in three studies, and only one reported significantly greater prevalence of LTP bruising in females.

CONCLUSION

Bone-bruise patterns in the current literature support a valgus-driven ACL injury mechanism; however, more studies should report the specific locations of tibial and femoral bone bruises. There is insufficient evidence in the literature to determine whether there are sex-specific bone-bruise patterns in ACL-injured subjects.

Mechanisms of foot and ankle injuries in soccer

BACKGROUND

Although player-to-player contact is a risk factor in the majority of soccer injuries, the mechanisms leading to these injuries have not been analyzed.

PURPOSE

To assess the relationships between foot/ankle injuries and foul play and tackle type, and to identify the position of the foot and ankle at the time of injury.

STUDY DESIGN

Prospective cohort study.

METHODS

Team physicians prospectively recorded each injury in four world soccer competitions, and the videotaped incident leading to the injury was retrospectively analyzed.

RESULTS

Of 76 foot and ankle injuries (52 contusions, 20 sprains, 4 fractures), direct contact occurred between players in 72. Significantly more injuries involved a tackle from the side and a lateral or medial tackle force. The injured limb was weightbearing in 41 and nonweightbearing in 35 of the incidents. Significantly more injuries resulted in time lost from soccer when the limb was weightbearing. The most common foot and ankle positions at the time of injury were pronated/neutral in the sagittal plane for weightbearing limbs, and plantar flexed/neutral in the coronal plane for nonweightbearing limbs. The most common foot and ankle rotations at the time of injury were external (23) and eversion (28).

CONCLUSIONS

The majority of injuries were caused by tackles involving lateral or medial forces that created a corresponding eversion or inversion rotation of the foot or ankle. The weightbearing status of the injured limb was a significant risk factor.

Injury and death as a result of seizures

The literature contains little information regarding the incidence of injury or death in the general population caused by seizures. We prospectively surveyed all patient visits to the four emergency departments serving adults in the Halifax-Dartmouth metropolitan area (adult population 260,935) from September 1, 1990 to August 31, 1991 to identify patients treated as a result of a seizure. The medical examiner's records were also surveyed for deaths related to seizures. We identified 560 patient visits precipitated by seizures of all types and etiologies except those secondary to acute trauma. Injuries or deaths occurred during 84 of 560 seizures (15%). Sixty-three patients incurred 89 injuries during 77 seizures (some patients had more than one injury, and some patients had injuries on more than one occasion). The incidence of seizures resulting in injury was 29.5 in 100,000 population. The most common injuries were head contusions and head lacerations. Most injuries were minor and required little or no treatment. Deaths occurred during seven seizures (1.2%). The incidence of death as a complication of seizures was 2.68 in 100,000 population. Deaths were not restricted to patients with epilepsy. We conclude that the incidence of seizures causing injury or death in the general population was 32.2 in 100,000 population and that 15% of seizures brought to medical attention resulted in injury or death. Most injuries were minor but seven patients died during seizures, indicating that seizures remain a life-threatening event.

A retrospective study of dento-alveolar injuries of children in Ankara, Turkey

Information concerning age and sex distribution, etiology, types, place and extent of trauma as well as seasonal variations, time difference between traumatic injury and seeking of dental care and number of traumatic injuries was recorded retrospectively from 150 patients. The study comprised 91 boys and 59 girls representing 246 dental injuries and 332 injured teeth (72 primary and 260 permanent teeth). The most common injuries were uncomplicated crown fracture (23.57%), subluxation (15.85%), avulsion (10.16%), lateral luxation (9.75%), complicated crown fracture and intrusion (8.4% and 8.94%, respectively). The occurrence of uncomplicated crown fractures was significantly higher (P<0.05) in the 10-12 years age group than other age groups. Lateral luxation and intrusion were significantly higher in the 1-6 and 7-9 years age groups (P<0.05, respectively).

Recent skin injuries in normal children

OBJECTIVE

The objective of our study was to collect data on the totality of recent skin injuries in normal children and adolescents, and to determine the relationship between the number of injuries, the age of the child, and the time of year in a temperate climate.

METHODS

The participants in this study were children and adolescents seen successively for a reason other than trauma over a period of 1 year, by the first author (J.L.), in a university medical center in Québec City, Canada. The total body surface, with the exception of the anal-genital area, was examined systematically. The characteristics and location of all recent injuries (bruises, abrasions, scratches, cuts, burns, etc) were recorded. Scars from old injuries were ignored. The statistical method used for comparison was the Fisher's exact test.

RESULTS

Two thousand forty examinations were done on 1467 youngsters from 0 to 17 years of age. Nine hundred thirty-one examinations were done on boys and 1109 on girls. The majority of children 9 months and older (76.6%) had at least 1 recent skin injury, without a significant difference between the sexes. Seventeen percent of the total sample of children had at least 5 injuries, whereas 4% had 10 or more, <1% had 15 or more, and 0.2% had 20 or more. The sites involved were mostly the lower limbs. Less than 2% of the total sample of children had injuries to the thorax, abdomen, pelvis, or buttocks, and <1% to the chin, ears, or neck. The majority of injuries observed were bruises, regardless of the time of year. There were, however, more skin injuries during the summer and the proportion of abrasions was higher at this time of the year. The 0- to 8-month age group was unique from all points of view. Skin injuries were rare in this age group (11.4%); they did not vary with the season, and they were mainly on the head and the face. Their injuries were mostly scratches. Bruises were found in only 1.2% of this group.

CONCLUSIONS

The majority of normal children (after the age of 9 months) and adolescents, who do not consult for trauma, had 1 or more recent skin injuries. These injuries, mostly bruises, are more prevalent in the summer in a region with a temperate climate and can be present on all parts of the body, although they are most frequently observed on the limbs, especially on the shins and knees. Even if there are no recognizable marks on the skin, physicians must pay particular attention to children who have injuries with other unusual characteristics (uncommon location, >/=15 injuries, bruises in a child <9 months of age, numerous injuries elsewhere than the lower limbs, numerous injuries in the cold seasons in a temperate climate, injuries other than bruises, abrasions or scratches) because they could be a sign of a bleeding disorder or physical abuse.bruising, child abuse, accidental injury.

134 battered children: a medical and psychological study

A controlled investigation of 134 battered children showed that nearly half had serious injuries and 21 died. Sixty-five had been battered more than once, 20 had permanent neurological sequelae, a quarter were low birth weight babies, and 10 had serious congenital defects. Twenty-three had been previously admitted to hospital with failure to thrive and the overlap with physical neglect was considerable. Mortality and morbidity among their siblings was also high. Difficulties with the child were attributable to interaction with neurotic mothers.The risk of battering diminishes after a child's second birthday. The establishment of specialized hospital teams to tackle the overall problem is suggested as a method of improving management. Prevention may lie in educating mothers in the basic physical and psychological requirements of children and overcoming their reluctance to avail themselves of medical care.

Bone contusions of the knee: increased lesion detection with fast spin-echo MR imaging with spectroscopic fat saturation

PURPOSE

To demonstrate that T2-weighted fast spin-echo (FSE) imaging with spectroscopic fat saturation (FS-FSE) increases the conspicuity between normal marrow and bone contusions in posttraumatic knees.

MATERIALS AND METHODS

Seventy-six magnetic resonance (MR) studies of the knee were prospectively evaluated in 73 consecutive patients with knee pain. Conspicuity of regions of microtrabecular trauma (bone contusions) was evaluated with conventional T2-weighted imaging in the sagittal plane, T2-weighted FSE imaging in the coronal plane, T2-weighted FS-FSE imaging in the sagittal plane, and conventional T1-weighted imaging in the sagittal plane.

RESULTS

Twenty-six foci of bone contusion were identified in 21 knees with the FS-FSE technique. Only 16 foci were demonstrated with conventional T2-weighted imaging. Six of the sites of bone contusion were not demonstrated with the FSE technique alone (without fat saturation). Four of the bone contusions were not seen on T1-weighted images; these sites of bone contusion were substantially more conspicuous on the FS-FSE images. In addition, FS-FSE imaging was more sensitive in demonstrating the extent of microtrabecular trauma.

CONCLUSION

T2-weighted FS-FSE imaging is a sensitive and rapid method of identifying and assessing the extent of microtrabecular trauma about the knee.

Selective validation of the WHO Bleeding Scale in patients with chronic immune thrombocytopenia

OBJECTIVE

To evaluate the World Health Organization's (WHO) Bleeding Scale in two studies of eltrombopag in adults with chronic immune thrombocytopenia (ITP).

RESEARCH DESIGN AND METHODS

Validated scales assessing bleeding in adults with ITP are lacking. Data from two long-term, phase 3 clinical trials (RAISE: NCT00370331; EXTEND: NCT00351468) that assessed eltrombopag in adults with chronic ITP were analyzed to evaluate the performance of the WHO Bleeding Scale.

RESULTS

In RAISE, effect size (0.71), standardized response (0.75), and responsiveness statistics (0.57) were moderate for bleeding and bruising assessments. In EXTEND, effect size (0.62) and responsiveness statistics (0.59) were moderate; the standardized response statistic was 0.487. Intraclass correlation for test-retest reliability was 0.75 in RAISE and 0.71 in EXTEND. A positive correlation was observed between the WHO Bleeding Scale and the ITP Bleeding Scale. Bleeding scores and quality-of-life measures were inversely correlated (p < 0.05 for all). Minimal important differences for the WHO Bleeding Scale were 0.33-0.40 at baseline and last on-treatment assessment in both studies.

LIMITATIONS

The majority of bleeding in these studies was mild to moderate, so this analysis cannot provide strong evidence of the validity of the WHO Bleeding Scale in patients with more severe bleeding. Potential limitations to the WHO Bleeding Scale itself include dependence on clinician interpretation of patient recall, inability to distinguish among bleeding events occurring at different anatomical sites, and an inherent assumption of linear increases in severity of bleeding across the response categories.

CONCLUSIONS

These findings suggest potential usefulness of the WHO Bleeding Scale in adult patients with chronic ITP for standardizing grading of bleeding across research studies and in clinical practice.

Ice hockey injuries in Finland. A prospective epidemiologic study

In this prospective study of ice hockey injuries in Finland we have investigated the incidence of injury at two playing levels and the causal factors, mechanisms, types, and consequences of the injuries. Seven Finnish ice hockey teams were observed during the 1988 to 1989 season. There were a total of 189 injuries. There were 134 injuries in 4 teams of the highest level, the Finnish National League, and 55 injuries in 3 teams of the second highest level, Division I. The incidence of injuries during games was 66 per 1000 player-game hours in the National League and 36 per 1000 player-game hours in Division I. As for severity, 10 (5%) injuries were classified as major. Of all injuries, 15 (8%) were fractures and 34 (18%) were to the head or face. The most severe injuries were tears of a knee ligament or fractures of an upper extremity. Ongoing surveillance and an exact reporting system are needed for establishing the trends in the number and severity of the injuries.

Acute sports injuries in Oslo: a one-year study

All sport injuries treated at the Emergency Department, Ullevål Hospital in Oslo (OKL) were registered for one year. They accounted for 6.3% of the total number of patients treated at OKL in that period. 4673 patients were seen; 3292 males and 1381 females. The women were younger than the men, 55% were below 20 years of age; 41% of the males (p less than 0.05). Most of the men (64%) were injured in connection with competitive sports, but 52% of the women sustained their injury pursuing recreational sports. Football and skiing accounted for 49% of the total number of injuries. In males football caused most injuries--35%. In females handball accounted for most injuries--18%. Nearly 3/4 of the injuries affected the extremities; the most common injury being the ankle sprain (16%). Almost 1/4 of the patients had a fracture, and 218 patients (4.7%) were admitted to hospital, the rest being treated as outpatients. In all, the sports injuries required 7658 consultations.

Oral trauma in Brazilian patients aged 0-3 years

The aim of the present investigation was to gather data pertaining to dental trauma in 1654 patients aged 0-3 years, attended at the Baby Clinic of the School of Dentistry at Araçatuba-UNESP, Brazil. The prevalence of traumatic injuries was 16.3%. There was greater involvement of boys (62.6%), of children aged 1-2 years (39.9%) and of the maxillary central incisors (86%). Falls were more often the etiology for dental injuries (58.3%). There was a predominance of uncomplicated crown fractures (48.4%).

Injuries in young female players in European team handball

The purpose of this study was to examine the nature, extent and severity of sports injuries in young female players in European team handball and to identify the etiological factors involved in the injuries. Twenty-two teams with 217 players, aged 16-18 years, participated in the study. A very high injury incidence during games was observed, with 40.7 injuries/1000 hours of game. Backplayers had the highest incidence (54.8/1000 hours), which is five times higher than any previously recorded injury incidence in players in European team handball. We found that 92.9% of injuries were traumatic and 7.1% were from overuse. One-hundred and twenty-four of the 211 injuries were traumatic injuries of the lower extremities. Of these 63 (51%) were without contact with an opponent. The study confirmed that European team handball is a sport that has a very high injury rate, especially regarding young female players. Field position and earlier injuries are major risk factors, with an earlier injury being the single highest risk factor and with backplayers having a significantly higher number of injuries than players in other field positions.

Clinical investigation of traumatic injuries in Yeditepe University, Turkey during the last 3 years

The aim of this study was to evaluate etiology, types of traumatic dental injuries, treatment and to determine the incidence of complications according to dental injuries in patients who referred to Yeditepe University, Faculty of Dentistry, Istanbul, Turkey. The study was based on the clinical data of the 161 traumatized teeth in 92 patients. WHO classification slightly modified by Andreasen & Andreasen for dental trauma was used. The causes and localization of trauma, traumatized teeth classification, treatment and complications were evaluated both primary and permanent teeth. The distribution of complications according to diagnosis and treatment of the injured teeth were evaluated. Of 35 (38%) girls and 56 (72%) boys with a mean age 7.6 +/- 3.5 (ranging 1-14.2) participated to study and the mean followed up was 1.72 +/- 1.28 years (ranging 0.10-3.8 years). From the 161 affected teeth, 69 (42.9%) were in primary teeth and 92 (57.1%) in permanent teeth. The highest frequency of trauma occurred in the 6-12 year age group. Overall boys significantly outnumbered girls by approximately 1:1.6. The most common type of injury in the primary and permanent teeth was seen as luxation (38%) and enamel fracture (20%) of the maxillary central incisors, respectively. Falls were the major sources of trauma both the primary (90%) and the permanent teeth (84%). In the primary dentition, the most common type of soft tissue injury is contusion (62.5%) and in the permanent dentition, it is laceration (49%). The most of the treatment choice was determined as examination only and extraction in primary teeth (58 and 24.6%, respectively) while it was applied as restoration and pulpectomy in permanent teeth (31.5 and 18.5%, respectively). Complications were recorded on 37 teeth (23%) with a most common type of necrosis (10.5%) and dental abscess (7.4%). Necrosis was more frequent in luxation whereas dental abscess were in crown fracture with pulpal involvement in both dentitions. The study showed that boys were more prone to dental traumas than girls. Falls were more frequent trauma type with a high complication risk. It reveals that the time of the immediate treatment showed the important predisposing factors that increase the success of treatment and decrease the risk of complication. The correct diagnosis of dental injuries is more important for eliminating the occurrence of complications.