This study tested the hypothesis that interfragmentary axial movement of transverse diaphyseal osteotomies would result in improved fracture healing compared to interfragmentary shear movement. Ten skeletally mature merino sheep underwent a middiaphyseal osteotomy of the right tibia, stabilized by external fixation with an interfragmentary gap of 3 mm. A custom made external fixator allowed either pure axial ( n = 5) or pure shear movement ( n = 5 ) of 1.5 mm amplitude during locomotion by the animals. The movement of the osteotomy gap was monitored weekly in two sheep by an extensometer temporarily attached to the fixator. After 8 weeks the sheep were killed, and healing of the osteotomies was evaluated by radiography, biomechanical testing, and undecalcified histology. Shear movement considerably delayed the healing of diaphyseal osteotomies. Bridging of the osteotomy fragments occurred in all osteotomies in the axial group (lOO%), while in the shear group only three osteotomies (60%) were partially bridged. Peripheral callus formation in the shear group was reduced by 36% compared to the axial group (p < 0.05). In the axial group bone formation was considerably larger at the peripheral callus and in between the osteotomy gaps but not in the intramedullary area. The larger peripheral callus and excess in bone tissue at the level of the gap resulted in a more than three times larger mechanical rigidity for the axial than for the shear group (p < 0.05). In summary, fixation that allows excessive shear movement significantly delayed the healing of diaphyseal osteotomies compared to healing under axial movement of the same magnitude.
AimWe aimed to systematically analyse the videos of acute injuries in professional men’s football and describe typical injury patterns.MethodsInjuries were registered with the German statutory accident insurance for professional athletes as part of occupational accident reporting. Following each season (2014–2017), video footage of the two highest divisions in German male football was searched for moderate and severe acute match injuries. Two raters then independently assessed the injuries for: game situation, player and opponent behaviour, referee decision, and injury mechanisms.ResultsThe total data set included 7493 acute injuries. Of these, 857 (11%) were moderate or severe match injuries. The video search yielded 345 (40%) clearly identifiable injuries and of those 170 (49%) were contact injuries. We describe nine typical injury patterns: one each for head and shoulder injuries, two for thigh and ankle, and three for knee injuries. The nine patterns are called: (1) Head-to-head injury. (2) Collision-and-fall shoulder injury. (3) Sprinter’s thigh injury. (4) Perturbation-and-strain thigh injury. (5) Tackle knee injury. (6) Tackle-and-twist knee injury. (7) Non-contact knee injury. (8) Attacked ankle injury. (9) Collision-and-twist ankle injury. Thigh injuries occurred primarily in non-contact situations (44/81), mostly while the player was sprinting (23/44). Knee injuries were often caused by direct external impact (49/84)—mainly suffered by the tackler during a tackle (17/49).ConclusionThe nine common injury patterns in football differed substantially in their mechanisms and causes.
The aim of this study was to investigate the effect of a moderate soft tissue trauma to the course of fracture healing in a standardized animal model. Thirty‐eight Wistar rats were randomly divided into a fracture group (F, n = 19) and a group with a fracture and a soft tissue trauma (F + STT, n = 19). The fracture and the soft tissue trauma were created using an impact device with a standardized energy. All fractures were stabilized by two Kirschner wires. Three rats were measured for blood flow and sacrificed at days 1, 3, 7, and 14, and seven rats at day 28, from both groups. A three‐point bending test was performed on the healed tibia after 28 days. During the first 24 h there was a reduction in blood flow, which was more pronounced in the F + STT group than in the F group. From histological sections, the shape of the callus formation, as well as the tissue distribution of newly formed bone, fibrous cartilage and fibrous connective tissue were determined. Distinctly more periosteal new bone formed and a larger callus formed at days 3 and 7 in group F compared to group F + STT. However, by days 14 and 28, the ossification and overall callus size no longer showed differences between the two groups. A fast recovery of blood flow and callus formation took place in the F + STT group, which led to similar histological and biomechanical results in fracture healing observed after 28 days between the two groups. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 24:1178–1185, 2006
AimWe aimed to identify patterns and mechanisms of injury situations in men’s professional handball by means of video match analysis.MethodsModerate and severe injuries (absence of >7 days) sustained in competition in one of six seasons (2010 to 2013 and 2014 to 2017) in men’s professional handball were prospectively analysed with a newly developed standardised observation form. Season 2013 to 2014 was excluded because of missing video material.Results580 injuries were identified: 298 (51.4%) contact injuries, 151 (26.0%) indirect contact injuries and 131 (22.6%) non-contact injuries. Head (87.5%), hand (83.8%), shoulder (70.2%) and ankle (62.9%) injuries were mainly sustained during direct contact. Typical contact injuries included collision with an opponent’s upper extremity or torso, and ankle injuries mainly consisted of foot-to-foot collisions. A large proportion (41.7%) of knee injuries were caused by indirect contact, whereas thigh injuries mainly occurred (56.4%) through non-contact mechanism. Wing (56.9%) and pivot (58.4%) players had the highest proportion of contact injuries, whereas backcourt players had a high proportion of indirect contact injuries (31.5%) and goalkeepers of non-contact injuries (48.9%). The injury proportion of foul play was 28.4%. Most injuries occurred in the central zone between the 6-metre and 9-metre lines (26.1%) and during the last 10 min of each match half (OR 1.71, p=0.016).ConclusionsIn men’s professional handball in a league setting, contact — but not foul play — was the most common mechanism associated with moderate and severe injuries. Head, hand, shoulder and ankle injury were mainly sustained during direct contact.
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