Injury
-
Randomized Controlled Trial
Effects of medical training therapy on injury rehabilitation and sports-specific performance in elite rock climbers: A randomized controlled trial.
Medical training therapy (MTT) is an advanced, individualized rehabilitation approach that integrates multiple methods to improve physical function. It is widely applied to rehabilitate sports injuries. This randomized study evaluated MTT's effects on physical injury rehabilitation, mental function, and athletic performance in elite rock climbers. ⋯ MTT is an ideal method for the rehabilitation of injuries in elite rock climbers and for facilitating their early return to sport. It addresses the majority of athletes' physical injuries and reduces the concentration of injuries in high-risk areas. Additionally, it specifically improves athletes' performance in specialized tests to alleviate the symptom of anxiety.
-
Multicenter Study
Low-grade infections in nonunion of the femur and tibia without clinical suspicion of infection - Incidence, microbiology, treatment, and outcome.
Treatment algorithms for fracture nonunion depend on the presence or absence of bacterial infection. However, it is often impossible to identify infection preoperatively. While some infections may present with clinical signs of infection, low-grade infections lack infection signs and have a clinical presentation similar to aseptic nonunion. ⋯ Our findings suggest that unexpected low-grade infection is frequently associated with nonunion. While expected and confirmed infected nonunion differs significantly from aseptic nonunion, low-grade infected nonunion is very similar to aseptic nonunion, except for intraoperative bacterial detection. In addition to antibiotic therapy, surgical nonunion revision with implant exchange and debridement appears to be highly effective in achieving consolidation of low-grade infected nonunion.
-
Multicenter Study
Self-directed violence and unclear intent presentation within a major trauma system. A multisite analysis.
Determining trauma as an act of Self-directed violence (SDV) or from high risk or unclear behaviours is challenging for trauma clinicians and may be affected by patient sex and mechanism of injury. The aim of this study was to examine the differences in characteristics and outcomes between those who have intentionally directed violence towards themselves with those of unclear intent, within a regional trauma system. ⋯ Previous mental health co-morbidity was associated with self-directed violence in our cohort. Yet the determinants of intent for over half of the patients were unclear. Trauma clinicians should actively enquire regarding intent of injury and escalate to clinical psychology or psychiatry teams as indicated. Those with mental health comorbidities, previous depression and older women may all have an increased risk where intent is unclear and warrants further investigation. Understanding the predictors and characteristics of unclear intent and high-risk behaviours are key to implementation of public health strategies around prevention of self-directed violence and suicide.
-
Multicenter Study
Psychological health status after major trauma across different levels of trauma care: A multicentre secondary analysis.
Concentration of trauma care in trauma network has resulted in different trauma populations across designated levels of trauma care. ⋯ Major trauma patients admitted to a level I trauma centre have more depressive, anxious, and post-traumatic stress symptoms than when admitted to a non-level I trauma centre. These symptoms differed across trauma regions, indicating populations differences. Level of trauma care and trauma region are important when analysing psychological health status.
-
Multicenter Study
Paediatric falls: An analysis of patterns of injury and associated mortality in urban India.
Falls are some of the most common childhood injuries. However, for vulnerable children in low- and middle-income countries (LMICs) such as India, mortality from a fall is nearly three times that of high-income countries. Despite fall being a leading cause of paediatric injury, detailed data from LMICs remain sparse. This study aims to assess fall-related patterns of injury and mortality in children in urban India. ⋯ The majority of paediatric patients admitted to urban hospitals in India after a fall were between the ages of two-to-five years, with isolated TBI and male sex associated with greater mortality. These findings have the potential to aid age-specific fall prevention strategies and resource allocation towards targeted initiatives to improve access to care, and consequently, mortality from fall in urban India.