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[PMID]: 23217656 [Au] Autor: Patel H; Celenza A; Watters T [Ad] Dirección: Emergency Consultant, Rockingham Kwinana Hospital, Australia. hiten.patel@health.wa.gov.au [Ti] Título: Effect of nurse initiated X-rays of the lower limb on patient transit time through the emergency department. [So] Fuente: Australas Emerg Nurs J;15(4):229-34, 2012 Nov. [Is] ISSN: 1574-6267 [Cp] País de publicación: Netherlands [La] Idioma: eng [Ab] Resumen: OBJECTIVE: To compare outcomes of nurse initiated X-rays (NIX) with emergency physician (EP) initiated X-rays (EPIX) of isolated lower limb injuries in patient transit time (from triage to discharge) through the emergency department (ED). METHOD: A prospective, interventional study using a historical control group. Data were collected at each contact point from triage (including time of EP's initial assessment of patient, X-ray request and review, patient disposition decision and discharge time). Initially, data were collected as patients proceeded through the ED having X-rays requested after EP assessment. Following nurse education on use of pre-validated foot, ankle and knee X-ray decision instruments, similar data were collected following nurse X-ray request. Time differences between the two groups were compared. RESULTS: A total of 206 patients were enrolled, with 105 having EPIX and 101 NIX. Group characteristics were not significantly different. Fractures were identified in 26.7% of EPIX compared to 34.7% of NIX (p=0.300). Despite an observed reduction in the mean transit time (172.9minutes (min) for EPIX to 158.6min for NIX) this did not achieve statistical significance (p=0.230). There were significant differences in times from triage to initial assessment by EP (mean 57.6min EPIX, 93.4min NIX, p<0.001) (median 45.0min in EPIX, 78.0min in NIX group, p<0.001) which delayed transit time in the NIX group. CONCLUSION: Although NIX reduced patient transit times, this did not reach statistical significance. In an ED with substantial access block, this suggests that corresponding systems changes are required to improve ED flow. [Mh] Términos MeSH primario: Eficiencia Organizacional Enfermería de Urgencia Servicio de Urgencia en Hospital/organización & administración Traumatismos de la Pierna/radiografía Enfermeras Practicantes/organización & administración Evaluación de Resultado (Atención de Salud)/estadística & datos numéricos [Mh] Términos MeSH secundario: Adulto Competencia Clínica/normas Femenino Humanos Traumatismos de la Pierna/enfermería Masculino Cuerpo Médico de Hospitales Enfermeras Practicantes/normas Rol de la Enfermera Personal de Enfermería en Hospital/normas Guías de Práctica Clínica como Asunto Estudios Prospectivos Factores de Tiempo Triaje [Pt] Tipo de publicación: COMPARATIVE STUDY; JOURNAL ARTICLE [Em] Mes de ingreso: 1305 [Sb] Subgrupo de revista: IM; N [Da] Fecha de ingreso para procesamiento: 121210 [St] Status: MEDLINE

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[PMID]: 23074997 [Au] Autor: Henningsen MH; Jaeger P; Hilsted KL; Dahl JB [Ad] Dirección: Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, Copenhagen, Denmark. [Ti] Título: Prevalence of saphenous nerve injury after adductor-canal-blockade in patients receiving total knee arthroplasty. [So] Fuente: Acta Anaesthesiol Scand;57(1):112-7, 2013 Jan. [Is] ISSN: 1399-6576 [Cp] País de publicación: England [La] Idioma: eng [Ab] Resumen: BACKGROUND: Adductor-canal-blockade is a new technique for pain relief after knee surgery. This block could cause nerve injury and the aim of this follow-up study was to determine the prevalence of saphenous nerve injury in patients receiving adductor-canal-blockade for pain treatment after total knee arthroplasty. METHODS: All patients included in two former studies of adductor-canal-blockade following total knee arthroplasty were invited to participate in this follow-up study 3-6 months after surgery. We examined the cutaneous area on the medial aspect of the lower leg (medial crural branch of the saphenous nerve), as well as the anterior, posterior, lateral and infrapatellar part of the affected and contralateral lower leg. Sensory function was tested with pinprick (sharp and blunt needle), temperature discrimination (cold disinfectant swabs) and light brush. RESULTS: We included 97 patients. None of the patients [0-5.3% (99% confidence interval)] had sensory changes related to temperature or light brush corresponding to the medial crural branch of the saphenous nerve, but 10 patients could not discriminate between blunt and sharp stimulation with a needle. In the infrapatellar area of the operated knee, 76 patients could not discriminate between blunt and sharp stimulation with a needle, 81 patients could not discriminate between cold and warmth, and 82 patients displayed an altered sensation to light brush. CONCLUSION: We found no indications of saphenous nerve injury caused by the adductor-canal-blockade at the mid-thigh level. However, 84% of the patients had signs of injury to the infrapatellar branch of the saphenous nerve in the operated leg. Such findings are well-known complications to the surgical procedure. [Mh] Términos MeSH primario: Artroplastia de Reemplazo de Rodilla/efectos adversos Bloqueo Nervioso/efectos adversos Traumatismos de los Nervios Periféricos/epidemiología [Mh] Términos MeSH secundario: Anciano Anciano de 80 o más Años Femenino Estudios de Seguimiento Lateralidad Funcional/fisiología Humanos Pierna/inervación Masculino Mediana Edad Manejo del Dolor Dimensión del Dolor/métodos Estimulación Física Sensación Piel/inervación Sensación Térmica Resultado del Tratamiento [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mes de ingreso: 1305 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 121210 [St] Status: MEDLINE [do] DOI: 10.1111/j.1399-6576.2012.02792.x

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[PMID]: 22841615 [Au] Autor: Gros T; Viel E; Ripart J; Delire V; Eledjam JJ; Sebbane M [Ad] Dirección: Département d'anesthésie-réanimation, clinique mutualiste Beausoleil, 34000 Montpellier, France. [Ti] Título: [Prehospital analgesia with femoral nerve block following lower extremity injury. A 107 cases survey]. [Ti] Título: Bloc fémoral en analgésie préhospitalière pour traumatisme du membre inférieur. Enquête de pratique observationnelle sur 107 cas.. [So] Fuente: Ann Fr Anesth Reanim;31(11):846-9, 2012 Nov. [Is] ISSN: 1769-6623 [Cp] País de publicación: France [La] Idioma: fre [Ab] Resumen: OBJECTIVE: Femoral Nerve Block (FNB) has been proposed for femoral fracture analgesia in a prehospital setting. METHODS: Descriptive case-series survey. All suspected femoral fractures that were managed by our extrahospital service and had a femoral block were prospectively included. The physician was free to choose any block technique (paravascular femoral block [BFPV], nerve stimulation femoral block [BFNS], or fascia iliaca block [BFI]), as well as local anesthetic mixture and volume. Pain was assessed using a simplified verbal scale (0-4) before (T0), 10minutes after block (T1), and at hospital arrival (T2). Demographic values, actual trauma diagnosis, the technique used, the local anesthetic mixture and volume, incidents and complications were recorded. RESULTS: One hundred and seven blocks were included. Eighty-six percent of the blocks were performed by an anesthesiologist, although they represent 50% of the prehospital physician staff. Pain on the simplified verbal scale (EVS) decreased from T0 to both T1 and T2 for the whole population and also in each technique subgroup (eight BFPV, 36 BFNS, and 63 BFI). Two BFI blocks required a re-injection to be successful. Ten blocks failed (eight BFI, and two BFNS). Among those 10 failed blocks, two were first wrongly quoted as successful and two successful BFNS blocks appeared inadequate with regard to the trauma location outside the femoral dermatoma. No complication was observed. CONCLUSION: Prehospital FNB appeared to be efficacious in routine practice. Teaching FNB to non-anesthesiologist physicians is challenging. [Mh] Términos MeSH primario: Analgesia/métodos Fracturas del Fémur/complicaciones Bloqueo Nervioso/utilización Dolor/etiología Dolor/prevención & control [Mh] Términos MeSH secundario: Adolescente Adulto Anciano Recolección de Datos Servicios Médicos de Urgencia Femenino Nervio Femoral Humanos Traumatismos de la Pierna Masculino Mediana Edad Estudios Prospectivos Adulto Joven [Pt] Tipo de publicación: ENGLISH ABSTRACT; JOURNAL ARTICLE [Em] Mes de ingreso: 1305 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 121116 [St] Status: MEDLINE

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[PMID]: 23075803 [Au] Autor: Chow DH; Suen PK; Fu LH; Cheung WH; Leung KS; Wong MW; Qin L [Ad] Dirección: Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. [Ti] Título: Extracorporeal shockwave therapy for treatment of delayed tendon-bone insertion healing in a rabbit model: a dose-response study. [So] Fuente: Am J Sports Med;40(12):2862-71, 2012 Dec. [Is] ISSN: 1552-3365 [Cp] País de publicación: United States [La] Idioma: eng [Ab] Resumen: BACKGROUND: Tendon-bone insertion (TBI) consists of both hard and soft tissues. TBI injury with delayed repair is not uncommon. High-dose extracorporeal shockwave (ESW) is effective for treating nonunion fracture, whereas low-dose ESW is used for tendinopathy therapy. The dosing effect of ESW on delayed TBI healing is lacking. HYPOTHESIS: Low-dose ESW might have a healing enhancement effect comparable to that of high-dose ESW in treating delayed TBI healing. STUDY DESIGN: Controlled laboratory study. METHODS: Partial patellectomy was adopted to create a delayed TBI healing model by shielding the healing interface between tendon and bone. Ninety-six female New Zealand White rabbits with unilateral delayed TBI healing at the knee joint were divided into 3 groups: controls, low-dose ESW (LD-ESW; 0.06 mJ/mm(2), 4 Hz, 1500 impulses), and high-dose ESW (HD-ESW; 0.43 mJ/mm(2), 4 Hz, 1500 impulses). The TBI shielding was removed at week 4 after partial patellectomy, followed by treatment with control or ESW at week 6. The rabbits were euthanized at week 8 and week 12 for radiological, microarchitectural, histological, and mechanical assessments of healing tissues. RESULTS: Radiologically, both the LD-ESW group and the HD-ESW group showed larger new bone area than the controls at week 8 and week 12. Microarchitectural measurements showed that the LD-ESW and HD-ESW groups had larger new bone volume than the controls at week 12. Histological assessments confirmed osteogenesis enhancement. Both the LD-ESW and HD-ESW groups showed significantly higher failure load at the TBI healing complex than the control group at week 12. No significant difference was detected between the 2 ESW treatment groups at week 8 or week 12. CONCLUSION: Extracorporeal shockwave, a unique noninvasive physical modality, had similar effects between the low and high dose for treating delayed TBI healing. CLINICAL RELEVANCE: Low-dose ESW for TBI delayed healing might be more desirable and have better compliance in clinical applications. [Mh] Términos MeSH primario: Ondas de Choque de Alta Energía/uso terapéutico Articulaciones/patología Traumatismos de la Pierna/terapia Transferencia de Tendón Cicatrización de Heridas [Mh] Términos MeSH secundario: Animales Femenino Traumatismos de la Pierna/patología Traumatismos de la Pierna/radiografía Conejos [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mes de ingreso: 1305 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 121129 [St] Status: MEDLINE [do] DOI: 10.1177/0363546512461596

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[PMID]: 22878257 [Au] Autor: van Beijsterveldt AM; van de Port IG; Krist MR; Schmikli SL; Stubbe JH; Frederiks JE; Backx FJ [Ad] Dirección: Department of Rehabilitation, Nursing Science and Sports, University Medical Centre Utrecht, Utrecht, The Netherlands. a.m.c.beijsterveldt@umcutrecht.nl [Ti] Título: Effectiveness of an injury prevention programme for adult male amateur soccer players: a cluster-randomised controlled trial. [So] Fuente: Br J Sports Med;46(16):1114-8, 2012 Dec. [Is] ISSN: 1473-0480 [Cp] País de publicación: England [La] Idioma: eng [Ab] Resumen: BACKGROUND: The incidence rate of soccer injuries is among the highest in sports, particularly for adult male soccer players. PURPOSE: To investigate the effect of the 'The11' injury prevention programme on injury incidence and injury severity in adult male amateur soccer players. STUDY DESIGN: Cluster-randomised controlled trial. METHODS: Teams from two high-level amateur soccer competitions were randomly assigned to an intervention (n=11 teams, 223 players) or control group (n=12 teams, 233 players). The intervention group was instructed to perform The11 in each practice session during one soccer season. The11 focuses on core stability, eccentric training of thigh muscles, proprioceptive training, dynamic stabilisation and plyometrics with straight leg alignment. All participants of the control group continued their practice sessions as usual. RESULTS: In total, 427 injuries were recorded, affecting 274 of 456 players (60.1%). Compliance with the intervention programme was good (team compliance=73%, player compliance=71%). Contrary to the hypothesis, injury incidences were almost equal between the two study groups: 9.6 per 1000 sports hours (8.4-11.0) for the intervention group and 9.7 (8.5-11.1) for the control group. No significant differences were found in injury severity, but a significant difference was observed in the location of the injuries: players in the intervention group sustained significantly less knee injuries. CONCLUSIONS: This study did not find significant differences in the overall injury incidence or injury severity between the intervention and control group of adult male soccer players. More research is recommended, focusing on injury aetiology and risk factors in adult male amateur soccer players. [Mh] Términos MeSH primario: Terapia por Ejercicio/métodos Traumatismos de la Pierna/prevención & control Fútbol/lesiones [Mh] Términos MeSH secundario: Adolescente Adulto Traumatismos en Atletas/prevención & control Análisis por Conglomerados Humanos Masculino Cooperación del Paciente Análisis de Regresión Resultado del Tratamiento Adulto Joven [Pt] Tipo de publicación: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mes de ingreso: 1305 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 121126 [St] Status: MEDLINE [do] DOI: 10.1136/bjsports-2012-091277

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[PMID]: 22892416 [Au] Autor: Gribble PA; Hertel J; Plisky P [Ad] Dirección: University of Toledo, Toledo, OH 42606, USA. phillip.gribble@utoledo.edu [Ti] Título: Using the Star Excursion Balance Test to assess dynamic postural-control deficits and outcomes in lower extremity injury: a literature and systematic review. [So] Fuente: J Athl Train;47(3):339-57, 2012. [Is] ISSN: 1938-162X [Cp] País de publicación: United States [La] Idioma: eng [Ab] Resumen: CONTEXT: A dynamic postural-control task that has gained notoriety in the clinical and research settings is the Star Excursion Balance Test (SEBT). Researchers have suggested that, with appropriate instruction and practice by the individual and normalization of the reaching distances, the SEBT can be used to provide objective measures to differentiate deficits and improvements in dynamic postural-control related to lower extremity injury and induced fatigue, and it has the potential to predict lower extremity injury. However, no one has reviewed this body of literature to determine the usefulness of the SEBT in clinical applications. OBJECTIVE: To provide a narrative review of the SEBT and its implementation and the known contributions to task performance and to systematically review the associated literature to address the SEBT's usefulness as a clinical tool for the quantification of dynamic postural-control deficits from lower extremity impairment. Data Sources: Databases used to locate peer-reviewed articles published from 1980 and 2010 included Derwent Innovations Index, BIOSIS Previews, Journal Citation Reports, and MEDLINE. STUDY SELECTION: The criteria for article selection were (1) The study was original research. (2) The study was written in English. (3) The SEBT was used as a measurement tool. DATA EXTRACTION: Specific data extracted from the articles included the ability of the SEBT to differentiate pathologic conditions of the lower extremity, the effects of external influences and interventions, and outcomes from exercise intervention and to predict lower extremity injury. DATA SYNTHESIS: More than a decade of research findings has established a comprehensive portfolio of validity for the SEBT, and it should be considered a highly representative, noninstrumented dynamic balance test for physically active individuals. The SEBT has been shown to be a reliable measure and has validity as a dynamic test to predict risk of lower extremity injury, to identify dynamic balance deficits in patients with a variety of lower extremity conditions, and to be responsive to training programs in both healthy people and people with injuries to the lower extremity. Clinicians and researchers should be confident in employing the SEBT as a lower extremity functional test. [Mh] Términos MeSH primario: Extremidad Inferior/lesiones Balance Postural [Mh] Términos MeSH secundario: Ligamento Cruzado Anterior/lesiones Reconstrucción del Ligamento Cruzado Anterior Biomecánica Femenino Humanos Traumatismos de la Pierna/fisiopatología Extremidad Inferior/fisiopatología Masculino Síndrome de Dolor Patelofemoral Factores Sexuales [Pt] Tipo de publicación: JOURNAL ARTICLE; REVIEW [Em] Mes de ingreso: 1302 [Cu] Fecha actualización por clase: 130502 [Lr] Fecha última revisión: 130502 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 120815 [St] Status: MEDLINE [do] DOI: 10.4085/1062-6050-47.3.08

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[PMID]: 22892412 [Au] Autor: Wikstrom EA [Ad] Dirección: Department of Kinesiology and the Center for Biomedical Engineering Science, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA. ewikstrom@uncc.edu [Ti] Título: Validity and reliability of Nintendo Wii Fit balance scores. [So] Fuente: J Athl Train;47(3):306-13, 2012. [Is] ISSN: 1938-162X [Cp] País de publicación: United States [La] Idioma: eng [Ab] Resumen: CONTEXT: Interactive gaming systems have the potential to help rehabilitate patients with musculoskeletal conditions. The Nintendo Wii Balance Board, which is part of the Wii Fit game, could be an effective tool to monitor progress during rehabilitation because the board and game can provide objective measures of balance. However, the validity and reliability of Wii Fit balance scores remain unknown. OBJECTIVE: To determine the concurrent validity of balance scores produced by the Wii Fit game and the intrasession and intersession reliability of Wii Fit balance scores. DESIGN: Descriptive laboratory study. SETTING: Sports medicine research laboratory. Patients or Other Participants: Forty-five recreationally active participants (age = 27.0 ± 9.8 years, height = 170.9 ± 9.2 cm, mass = 72.4 ± 11.8 kg) with a heterogeneous history of lower extremity injury. Intervention(s): Participants completed a single-limb-stance task on a force plate and the Star Excursion Balance Test (SEBT) during the first test session. Twelve Wii Fit balance activities were completed during 2 test sessions separated by 1 week. Main Outcome Measure(s): Postural sway in the anteroposterior (AP) and mediolateral (ML) directions and the AP, ML, and resultant center-of-pressure (COP) excursions were calculated from the single-limb stance. The normalized reach distance was recorded for the anterior, posteromedial, and posterolateral directions of the SEBT. Wii Fit balance scores that the game software generated also were recorded. RESULTS: All 96 of the calculated correlation coefficients among Wii Fit activity outcomes and established balance outcomes were interpreted as poor (r < 0.50). Intrasession reliability for Wii Fit balance activity scores ranged from good (intraclass correlation coefficient [ICC] = 0.80) to poor (ICC = 0.39), with 8 activities having poor intrasession reliability. Similarly, 11 of the 12 Wii Fit balance activity scores demonstrated poor intersession reliability, with scores ranging from fair (ICC = 0.74) to poor (ICC = 0.29). CONCLUSIONS: Wii Fit balance activity scores had poor concurrent validity relative to COP outcomes and SEBT reach distances. In addition, the included Wii Fit balance activity scores generally had poor intrasession and intersession reliability. [Mh] Términos MeSH primario: Ejercicio Balance Postural Juegos de Video [Mh] Términos MeSH secundario: Adolescente Adulto Humanos Traumatismos de la Pierna/rehabilitación Mediana Edad Reproducibilidad de Resultados Adulto Joven [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mes de ingreso: 1302 [Cu] Fecha actualización por clase: 130502 [Lr] Fecha última revisión: 130502 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 120815 [St] Status: MEDLINE [do] DOI: 10.4085/1062-6050-47.3.16

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[PMID]: 22842236 [Au] Autor: Smeets K; Jacobs P; Hertogs R; Luyckx JP; Innocenti B; Corten K; Ekstrand J; Bellemans J [Ad] Dirección: Department of Orthopaedic Surgery, UZ Pellenberg, K.U. Leuven, Leuven, Belgium. kristofsmeets@yahoo.com [Ti] Título: Torsional injuries of the lower limb: an analysis of the frictional torque between different types of football turf and the shoe outsole. [So] Fuente: Br J Sports Med;46(15):1078-83, 2012 Dec. [Is] ISSN: 1473-0480 [Cp] País de publicación: England [La] Idioma: eng [Ab] Resumen: BACKGROUND: Football turf is increasingly used in European soccer competition. Little is known on the rotational torque that players experience on these fields. High rotational torques between the shoe outsole and the sports surface has been correlated with torsional injuries of the lower limb and knee. PURPOSE: To evaluate the effect of six parameters that could influence the rotational torque between the shoe outsole and the latest generation football turf. STUDY DESIGN: Controlled laboratory study. METHODS: A testing apparatus was constructed to measure the peak torque generated during a controlled rotation of the foot. Six parameters that could potentially influence the frictional forces, were considered: (1) the sports surface, (2) the shoe outsole cleat design, (3) the weather conditions, (4) the weight, (5) the presence of an impact and (6) the direction of rotation. RESULTS: The football turf without infill showed significantly lower frictional torques than natural grass whereas a football turf with sand/rubber infill had significantly higher torques. Blades were associated with significantly higher torques than studs on natural grass and on one football turf with sand/rubber infill. Dry weather was associated with higher torques only for the football turf without infill. The torque increased linearly and significantly with an increasing vertical load. The rotational torque increased significantly following an impact. Torques on external rotational movements were significantly higher with blades. CONCLUSIONS: Important differences in rotational torques are found and could be seen as potential risk factors for torsional injuries of the lower limb. [Mh] Términos MeSH primario: Traumatismos de la Pierna/etiología Zapatos Fútbol/lesiones Equipo Deportivo Anomalía Torsional/fisiopatología [Mh] Términos MeSH secundario: Peso Corporal/fisiología Diseño de Equipo Femenino Pisos y Cubiertas de Piso Fricción Humanos Traumatismos de la Pierna/fisiopatología Traumatismos de la Pierna/prevención & control Masculino Torque Anomalía Torsional/etiología [Pt] Tipo de publicación: JOURNAL ARTICLE [Em] Mes de ingreso: 1304 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 121113 [St] Status: MEDLINE [do] DOI: 10.1136/bjsports-2012-090938

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[PMID]: 23157505 [Au] Autor: Weng X; Li X; Ning J; Zhu F; Zhang L [Ad] Dirección: Department of Plastic Surgery, First Affiliated Hospital, Anhui Medical University, Hefei , Anhui , PR China. wsy_wxj@yahoo.com [Ti] Título: Experience of 56 patients using a retrograde sural neurovascular flap to repair lower limb tissue defects. [So] Fuente: J Plast Surg Hand Surg;46(6):434-7, 2012 Dec. [Is] ISSN: 2000-6764 [Cp] País de publicación: Sweden [La] Idioma: eng [Ab] Resumen: This study was made to investigate the clinical effects of repairing lower limb defects with an improved retrograde sural nerve flap. From November 1996 to September 2010, a total of 56 patients with soft-tissue defects of the lower limb received improved retrograde sural neurocutaneous flap repair. There were 21 women and 35 men ranging in age from 12-73 years (average age 45.9). Eight patients had dorsal foot defects, five patients had foot bottom defects, four patients had heel defects, six patients had defects around the ankle, and 15 patients had defects below the lower third of the leg. Of these, 10 patients had exposed wounds and six cases had exposed tendons. The size of the surgical repair was between ∼6 cm × 5 cm and ∼25 cm × 9 cm. Four patients retained the donor's sural neurovascular flap and normal sural nerve function, and 10 patients retained the retrograde sural neurovascular flap with a thin layer of muscle. All grafted flaps survived in all 56 patients. Patient follow-up lasted between 3 months and 3 years. The shape and function of their lower limbs were satisfactory. Two-point discrimination detection in the donor area and nerve-control area revealed that the sensory function recovered well in the four patients with retained nerves. The partial necrosis of the distal flap in two patients healed successfully after dressing, and no other adverse reactions or complications were observed. Through clinical treatment of the 56 patients, good experience was accumulated. The operation methods made the flap blood supply more abundant, improved the survival rate, and retained the sensory function of the donor site of the lower limb flap. This reduced the damage to the donor site and made the operation safer. [Mh] Términos MeSH primario: Procedimientos Quirúrgicos Reconstructivos/métodos Traumatismos de los Tejidos Blandos/cirugía Nervio Sural/trasplante Colgajos Quirúrgicos/irrigación sanguínea Colgajos Quirúrgicos/inervación [Mh] Términos MeSH secundario: Adolescente Adulto Anciano Niño Estudios de Cohortes Femenino Estudios de Seguimiento Úlcera del Pie/diagnóstico Úlcera del Pie/cirugía Rechazo de Injerto Supervivencia de Injerto Humanos Puntaje de Gravedad del Traumatismo Traumatismos de la Pierna/cirugía Masculino Microcirugia/métodos Mediana Edad Estudios Retrospectivos Medición de Riesgo Traumatismos de los Tejidos Blandos/diagnóstico Nervio Sural/cirugía Resultado del Tratamiento Cicatrización de Heridas/fisiología Adulto Joven [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mes de ingreso: 1304 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 121119 [St] Status: MEDLINE [do] DOI: 10.3109/2000656X.2012.722093

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[PMID]: 23036399 [Au] Autor: Forman JL; Lopez-Valdes FJ; Pollack K; Heredero-Ordoyo R; Molinero A; Mansilla A; Fildes B; Segui-Gomez M [Ad] Dirección: European Center for Injury Prevention (ECIP) at Universidad de Navarra, Irunlarrea 1 (Ed. Los Castaños), 31080 Pamplona, Navarra, Spain. jlf3m@virginia.edu [Ti] Título: Injuries among powered two-wheeler users in eight European countries: a descriptive analysis of hospital discharge data. [So] Fuente: Accid Anal Prev;49:229-36, 2012 Nov. [Is] ISSN: 1879-2057 [Cp] País de publicación: England [La] Idioma: eng [Ab] Resumen: Powered two-wheelers (PTWs--mopeds, motorcycles, and scooters) remain the most dangerous form of travel on today's roads. This study used hospital discharge data from eight European countries to examine the frequencies and patterns of injury among PTW users (age≥14 years), the predicted incidence of the loss of functional ability, and the mechanisms of the head injuries observed (all in light of increased helmet use). Of 977,557 injured patients discharged in 2004, 12,994 were identified as having been injured in PTW collisions. Lower extremity injuries accounted for 26% (25.6-26.7, 95% C.I.) of the total injuries, followed by upper extremity injuries (20.7%: 20.3-21.2), traumatic brain injuries (TBI) (18.5%: 18-19), and thoracic injuries (8.2%: 7.8-8.5). Approximately 80% of the lower extremity injury cases were expected to exhibit some functional disability one year following discharge (predicted Functional Capacity Index, pFCI-AIS98<100), compared to 47% of the upper extremity injury cases and 24% of the TBI cases. Although it occurred less frequently, patients that were expected to experience some functional limitation from TBI were predicted to fair worse on average (lose more functional ability) than patients expected to have functional limitations from extremity injuries. Cerebral concussion was the most common head injury observed (occurring in 56% of head injury cases), with most concussion cases (78%) exhibiting no other head injury. Among the AIS3+ head injuries that could be mapped to an injury mechanism, 48% of these were associated with a translational-impact mechanism, and 37% were associated with a rotational mechanism. The observation of high rates of expected long-term disability suggests that future efforts aim to mitigate lower and upper extremity injuries among PTW users. Likewise, the high rates of concussion and head injuries associated with a rotational mechanism provide goals for the next phase of PTW user head protection. [Mh] Términos MeSH primario: Accidentes de Tránsito/estadística & datos numéricos Motocicletas Heridas y Traumatismos/epidemiología [Mh] Términos MeSH secundario: Actividades Cotidianas Adolescente Adulto Anciano Anciano de 80 o más Años Algoritmos Traumatismos del Brazo/epidemiología Traumatismos del Brazo/etiología Traumatismos del Brazo/rehabilitación Biomecánica Traumatismos Craneocerebrales/epidemiología Traumatismos Craneocerebrales/etiología Traumatismos Craneocerebrales/prevención & control Traumatismos Craneocerebrales/rehabilitación Europa (Continente)/epidemiología Femenino Dispositivos de Protección de la Cabeza Humanos Puntaje de Gravedad del Traumatismo Traumatismos de la Pierna/epidemiología Traumatismos de la Pierna/etiología Traumatismos de la Pierna/rehabilitación Masculino Mediana Edad Alta del Paciente/estadística & datos numéricos Recuperación de la Función Heridas y Traumatismos/etiología Heridas y Traumatismos/prevención & control Heridas y Traumatismos/rehabilitación Adulto Joven [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mes de ingreso: 1304 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 121005 [St] Status: MEDLINE

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