Search Results (186)

Background: Midfacial fractures are common outcomes of facial trauma. While younger individuals typically sustain these injuries through high-energy events like assaults and traffic or sports accidents, elderly patients increasingly present with fractures from low-energy mechanisms, primarily falls. Purpose: The aim of this study was to analyze age- and gender-specific patterns in midfacial fractures over a 10-year period, with emphasis on elderly individuals and low-energy trauma. Methods: A retrospective review was performed of proven midfacial fractures between 2013 and 2022 at the Department of Oral and Maxillofacial Surgery (University of Pécs, Hungary). The patients were stratified by age (<65 vs. ≥65 years) and gender. The variables included the injury mechanism, fracture localization, the dental status, hospitalization, and the presence of associated injuries. Bivariate analyses were performed, and the significance level was set to p < 0.05. Results: A total of 957 radiologically confirmed midfacial fracture cases were evaluated, of whom 344 (35.9%) were ≥65 years old. In the elderly group, females had a 19-fold higher risk for midfacial trauma than younger females (OR: 19.1, 95%CI: 9.30–39.21). In the older group, a fall was significantly the most frequent injury mechanism (OR: 14.5; 95%CI: 9.9–21.3), responsible for 89.5% of the cases, while hospitalization (OR: 0.36; 95%CI: 0.23–0.56) was less characteristic. Most of the fractures occurred in the zygomatic bone, in the zygomaticomaxillary complex, or in the anterior wall of the maxilla. Associated injuries in the elderly group included mostly lower limb injuries—particularly pertrochanteric femoral fractures in females—and upper limb injuries, with a slight male dominance. Conclusions: Low-energy falls are the primary cause of midfacial fractures in elderly patients, particularly in women. Tailored prevention and management strategies are essential for improving the outcomes in this growing demographic group. Full article

Background/Objectives: Traumatic brain injury is one of the leading causes of death and disability. When traumatic brain injury is repeated over time, it can lead to the development of Chronic Traumatic Encephalopathy, a chronic neurodegenerative disease commonly observed in individuals who engage in contact sports or military personnel involved in activities with a high risk of repeated head trauma. At autopsy, the examination of the brain reveals regional atrophy, corresponding to high concentrations of glutamate receptors. Microscopically, the primary findings are the deposition of neurofibrillary tangles and neuropil threads. The aim of this study is to highlight the clinical and histopathological characteristics of Chronic Traumatic Encephalopathy, providing diagnostic support to forensic pathologists. Additionally, it seeks to aid in the differential diagnosis of similar conditions. Methods: A review of literature was conducted following the PRISMA criteria. Of 274 articles, 7 were selected. Results: According to these papers, most patients were male and exhibited neurological symptoms and neuropsychiatric impairments, and a proportion of them committed suicide or had aggressive behavior. Conclusions: Chronic Traumatic Encephalopathy remains largely underdiagnosed during life. The definitive diagnosis of Chronic Traumatic Encephalopathy is established post-mortem through the identification of pathognomonic tauopathy lesions. Early and accurate antemortem recognition, particularly in at-risk individuals, is highly valuable for its differentiation from other neurodegenerative conditions, thereby enabling appropriate clinical management and potential interventions. Full article

Background/Objectives: Participation in sports activities is one of the risk factors for traumatic dental injuries. Nevertheless, little data are available in the literature on such problems in persons with disabilities. This study aims to evaluate the prevalence and severity of traumatic dental injuries in athletes with intellectual disabilities and other coexisting chronic diseases, as well as the use of mouthguards and the level of treatment of injuries in this population. Methods: The research was carried out in seven special needs schools. Two calibrated dentists performed dental examinations in 100 subjects practicing sports, aged 8–30 years (study group), and in 128 individuals, aged 8–25 years, who do not perform systematic physical activity (control group). Statistica Software v.10 was used for statistical analysis, with the level of statistical significance at p ≤ 0.05. Results: The majority of individuals had one tooth affected by traumatic injury in the study and control individuals, with the results amounting to 14% and 5%, respectively; the difference between both groups was statistically significant (p = 0.02). Only one athlete used a mouthguard during training and competitions. Restorative treatment of traumatically damaged teeth was performed in six athletes (37%) out of the total sixteen subjects affected by dental injuries from the study group and in two (15%) out of thirteen participants from the controls. Conclusions: This study reveals that dentists should be professionally prepared to meet the special needs of the population with disabilities and chronic disorders to minimize the burden of dental trauma. There is an urgent need for preventive programs for special needs athletes, their parents/caregivers, and trainers concerning the use of mouthguards. Full article

Background: Trauma-related injuries are among the most common reasons for paediatric hospital presentations and represent a substantial component of orthopaedic care. Their management poses unique challenges due to ongoing skeletal development in children. While most reported fractures occur at home or during sports, prior studies have primarily used data from urban European populations, limiting the relevance of their findings for rural and regional settings. Urban-centred research often informs public healthcare guidelines, treatment algorithms, and infrastructure planning, introducing a bias when findings are generalised outside of metropolitan populations. This study addresses that gap by analysing fracture data from two rural trauma centres in New South Wales, Australia. This study assesses paediatric fractures resulting from severe injury mechanisms in rural areas, identifying common fracture types, underlying mechanisms, and treatment approaches to highlight differences in demographics. These findings aim to cast a light on healthcare challenges that regional areas face and to improve the overall cultural safety of children who live and grow up outside of the metropolitan trauma networks. Methods: We analysed data from two major rural referral hospitals in New South Wales (NSW) for paediatric injuries presenting between 1 January 2018 and 31 December 2022. This study included 150 patients presenting with fractures following severe mechanisms of injury, triaged into Australasian Triage Scale (ATS) categories 1 and 2 upon initial presentation. Results: A total of 150 severe fractures were identified, primarily affecting the upper and lower limbs. Males presented more frequently than females, and children aged 10–14 years old were most commonly affected. High-energy trauma from motorcycle (dirt bike) accidents was the leading mechanism of injury among all patients, and accounted for >50% of injuries among 10–14-year-old patients. The most common fractures sustained in these events were upper limb fractures, notably of the clavicle (n = 26, 17.3%) and combined radius/ulna fractures (n = 26, 17.3%). Conclusions: Paediatric trauma in regional Australia presents a unique and under-reported challenge, with high-energy injuries frequently linked to unregulated underage dirt bike use. Unlike urban centres where low-energy mechanisms dominate, rural areas require targeted prevention strategies. While most cases were appropriately managed locally, some were transferred to tertiary centres. These findings lay the groundwork for multi-centre research, and support the need for region-specific policy reform in the form of improved formal injury surveillance, injury prevention initiatives, and the regulation of under-aged off-road vehicular usage. Full article

Background: Although the difficulty level of figure skating programs has increased in the last two decades, particularly at the junior level, trends in performance have not been reported. This retrospective observational study investigated performance development trends among the top five junior figure skaters competing at international levels in both the ladies’ and men’s singles disciplines from 2005 to 2020. Data from 160 junior single ladies and 160 junior single men were analyzed. The focus was on the progression of technical elements—particularly jumps—and their potential correlation with injury risk. It was hypothesized that younger athletes are increasingly performing jumps with more revolutions, thereby enhancing overall competition standards. Materials and Methods: Using data from the Junior World Championships and Junior Grand Prix Finals, linear regression analysis and one-way ANOVA were conducted to track the frequency of double, triple, and quadruple jumps, as well as trends in age development among athletes in the singles categories from 2005 to 2020. Results: The results indicate a significant increase in the execution of higher-revolution jumps among junior athletes. Between 2005 and 2012, the frequency of double jumps declined across all events, with the most pronounced reductions observed in the Ladies’ Junior World Championships (Δ = 0.216, p = 0.004, d = 1.64) and the Men’s Junior World Championships (Δ = 0.500, p = 0.001, d = 1.82). From 2005 to 2011, the frequencies of triple and quadruple jumps increased, while double jumps remained stable or showed only slight increases. Triple jumps showed slight downward trends (e.g., R² = 0.0202 at the Men’s Junior World Championships). Although still rare, the frequency of quadruple jumps has shown a consistent upward trend across multiple competitions. Between 2000 and 2009, all four events exhibited declining age trends, with decreases ranging from −0.029 to −0.078 years of age per year. In the subsequent decade (2010–2020), when averaged across all events, the observed difference slope (Δ = 0.014) indicated a continued decline in athlete age. Conclusions: In summary, increases in more difficult jumps were found, with simultaneous decreases in less difficult jumps. As jump complexity rises, a parallel increase in sport-specific injury incidence can be anticipated, highlighting the need for proactive strategies for injury prevention and athlete well-being. Full article

Participatory action research (PAR) has been increasingly used in sport for development research due to its potential to challenge hegemonic forms of knowledge production within sport contexts. Drawing on the youth and feminist action literature, we explore the methodological and ethical challenges of conducting participatory research as young academic researchers collaborating with young coaches as community collaborators. This article calls for greater transparency in how researchers conduct YPAR, whether it is youth-centred or youth-led, and underscores the utility of a feminist lens and trauma- and violence-informed framework in grounding critical reflexivity throughout the research process. These contributions aim to advance ethically grounded, trauma-informed action research projects with young people in sport and physical activity settings. Full article

Introduction: Rotational ankle instability (RAI), involving combined medial and lateral ligament insufficiency, is an increasingly recognized clinical entity. While open surgery has traditionally been the mainstay for treating deltoid ligament injuries, recent developments in arthroscopic techniques offer a minimally invasive alternative. This systematic review aimed to evaluate the current evidence on the arthroscopic management of medial and rotational ankle instability, focusing on surgical techniques, clinical outcomes, and complications. Methods: A systematic literature search was conducted following PRISMA guidelines using the PubMed, Scopus, and Web of Science databases. The search strategy included the following terms: ((rotation instability) OR (deltoid) OR (medial ankle instability)) AND (ankle arthrosc*). Eligible studies included adult patients undergoing arthroscopic repair of medial ankle instability with a mean 26.4 months follow-up and reported clinical outcomes. Ten studies met the inclusion criteria, encompassing 336 patients and 346 ankles. Results: The mean patient age was 32.6 ± 5.0 years, with 80.6% being male. MRI was the primary diagnostic tool across most studies. Ankle sprains were the most common cause of instability. Lateral ligament insufficiency was frequently associated with medial injuries, reported in all studies evaluating this parameter. All patients underwent prior conservative treatment (mean duration: 5.6 months). Surgical management involved all-inside arthroscopic repair using knotless suture anchors. Additional procedures were performed in 90% of studies, including osteophyte resection (33.3%) and microfracture (22.2%). The mean follow-up period was 26.4 months. The mean postoperative AOFAS score was 95.3, with return to sport generally achieved between 3 and 5 months. Complications were minimal, primarily consisting of superficial wound issues and transient nerve irritation; no major complications or revision surgeries were reported. Discussion: Arthroscopic management of medial and rotational ankle instability is associated with excellent functional outcomes, low complication rates, and early return to sport. Compared to open procedures, arthroscopic techniques offer advantages including reduced soft tissue trauma, fewer wound complications, and the ability to address concomitant intra-articular lesions in a single session. Although technically demanding, this approach is particularly beneficial in athletic populations. However, high-quality prospective studies are still needed to validate these findings and establish long-term comparative outcomes with open reconstruction techniques. Full article

Introduction: Combat sport athletes are exposed to repetitive head impacts yet also develop distinct performance-related brain adaptations. Electroencephalography (EEG) provides millisecond-level insight into both processes; however, findings are dispersed across decades of heterogeneous studies. This mechanistic review consolidates and interprets EEG evidence to elucidate how participation in combat sports shapes brain function and to identify research gaps that impede clinical translation. Methods: A structured search was conducted in March 2025 across PubMed/MEDLINE, Scopus, Cochrane Library, ResearchGate, Google Scholar, and related databases for English-language clinical studies published between January 1980 and March 2025. Eligible studies recorded raw resting or task-related EEG in athletes engaged in boxing, wrestling, judo, karate, taekwondo, kickboxing, or mixed martial arts. Titles, abstracts, and full texts were independently screened by two reviewers. Twenty-three studies, encompassing approximately 650 combat sport athletes and 430 controls, met the inclusion criteria and were included in the qualitative synthesis. Results: Early visual EEG and perfusion studies linked prolonged competitive exposure in professional boxers to focal hypoperfusion and low-frequency slowing. More recent quantitative studies refined these findings: across boxing, wrestling, and kickboxing cohorts, chronic participation was associated with reduced alpha and theta power, excess slow-wave activity, and disrupted small-world network topology—alterations that often preceded cognitive or structural impairments. In contrast, elite athletes in karate, fencing, and kickboxing consistently demonstrated neural efficiency patterns, including elevated resting alpha power, reduced task-related event-related desynchronization (ERD), and streamlined cortico-muscular coupling during cognitive and motor tasks. Acute bouts elicited transient increases in frontal–occipital delta and high beta power proportional to head impact count and cortisol elevation, while brief judo chokes triggered short-lived slow-wave bursts without lasting dysfunction. Methodological heterogeneity—including variations in channel count (1 to 64), reference schemes, and frequency band definitions—limited cross-study comparability. Conclusions: EEG effectively captures both the adverse effects of repetitive head trauma and the cortical adaptations associated with high-level combat sport training, underscoring its potential as a rapid, portable tool for brain monitoring. Standardizing acquisition protocols, integrating EEG into longitudinal multimodal studies, and establishing sex- and age-specific normative data are essential for translating these insights into practical applications in concussion management, performance monitoring, and regulatory policy. Full article

Background: Musculoskeletal injuries are frequent in handball players due to the high-impact nature of the sport. Accurate diagnosis and tailored treatment are essential for recovery. Magnetic resonance imaging (MRI) has become the gold standard for evaluating complex sports-related injuries. This case report aims to assess the role of MRI in diagnosing trauma in professional handball players and the effectiveness of individualized treatment approaches. Methods: Four male members of the “Politehnica” Timișoara first team who sustained match- or training-related injuries between January 2023 and December 2024 underwent an 1.5 T MRI. Individualized conservative protocols included rest, NSAIDs, physiotherapy, and graded kinesitherapy. Results: The first case involved a right back with a knee hematoma and a vastus lateralis tear. Conservative treatment led to recovery. The second case was a left back with peripheral neuropathy caused by hamstring avulsion at the ischial tuberosity. Conservative therapy alleviated symptoms. The third case involved a left winger with adductor muscle tears, which recovered with conservative management. The fourth case, a goalkeeper, had a type III navicular fracture misdiagnosed on radiography, correctly identified via MRI and treated conservatively. Conclusions: MRI is invaluable in diagnosing handball-related injuries, enabling accurate assessments and effective individualized treatment, resulting in early recovery. Full article

Purpose: Pickleball, the fastest-growing sport in the United States, has seen a rapid increase in participation across all age groups, particularly among older adults. However, the sport introduces specific risks for ocular injuries due to the unique dynamics of gameplay and the physical properties of the pickleball. This study aims to explore the mechanisms of pickleball-related eye injuries, utilizing finite element modeling (FEM) to simulate ocular trauma and better understand injury mechanisms. Methods: A multi-modal approach was employed to investigate pickleball-related ocular injuries. Finite element modeling (FEM) was used to simulate blunt trauma to the eye caused by a pickleball. The FEM incorporated detailed anatomical models of the periorbital structures, cornea, sclera, and vitreous body, using hyperelastic material properties derived from experimental data. The simulations evaluated various impact scenarios, including changes in ball velocity, angle of impact, and material stiffness, to determine the stress distribution, peak strain, and deformation in ocular structures. The FEM outputs were correlated with clinical findings to validate the injury mechanisms. Results: The FE analysis revealed that the rigid, hard-plastic construction of a pickleball results in concentrated stress and strain transfer to ocular structures upon impact. At velocities exceeding 30 mph, simulations showed significant corneal deformation, with peak stresses localized at the limbus and anterior sclera. Moreover, our results show a significant stress applied to lens zonules (as high as 0.35 MPa), leading to potential lens dislocation. Posterior segment deformation was also observed, with high strain levels in the retina and vitreous, consistent with clinical observations of retinal tears and vitreous hemorrhage. Validation against reported injuries confirmed the model’s accuracy in predicting both mild injuries (e.g., corneal abrasions) and severe outcomes (e.g., hyphema, globe rupture). Conclusions: Finite element analysis provides critical insights into the biomechanical mechanisms underlying pickleball-related ocular injuries. The findings underscore the need for preventive measures, particularly among older adults, who exhibit age-related vulnerabilities. Education on the importance of wearing protective eyewear and optimizing game rules to minimize high-risk scenarios, such as close-range volleys, is essential. Further refinement of the FEM, including parametric studies and integration of protective eyewear, can guide the development of safety standards and reduce the socio-economic burden of these injuries. Full article

Introduction: Para-cycling is a competitive sport governed by the World Body for Cycling, Union Cycliste Internationale (UCI), encompassing various cycling disciplines tailored to athletes with physical or visual impairments. This study aimed to prospectively monitor the incidence of injury and illness in Para cyclists during the 2024 Paralympic season. Methods: This prospective, observational study included ten professional Para cyclists (five male, five female) with impairments ranging from spinal cord-related, neuromuscular, and musculoskeletal conditions to vision impairment. The definitions of an ‘athlete health problem’, ‘injury’, and ‘illnesses’ followed the Para sport translation of the IOC consensus. Injury and illness data were collected weekly using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems V2 (OSTRC-H2), with the addition of subjective markers of well-being and training load, between February 2024 and October 2024. All medical contacts for any injury or illness were logged in line with consensus statement recommendations. Results: The OSTRC-H2 questionnaire had a response rate of 76.5% (±12.2%, range 55–88%) across the 35 weeks. Athletes reported 7.36 (95% CI: 5.41–9.46) health problems per 365 days, with a medical attention rate of 5.56 (95% CI: 3.91–7.36) per 365 days. The overall injury rate was 1.94 per 365 athlete days (95% CI: 1.23–2.93), with a higher incidence in males (2.44, 95% CI: 1.53–3.67) than in females (1.51, 95% CI: 0.68–2.95). Conversely, illness rates were higher in females (5.40, 95% CI: 3.00–8.11) than in males (1.80, 95% CI: 0.60–3.30), with an overall illness rate of 3.60 per 365 days (95% CI: 2.29–5.10). Conclusions: This is the first study to present prospective injury and illness epidemiology rates in Para cyclists in combination with subjective well-being markers. The findings underscore the importance and feasibility of longitudinal health monitoring in Para cyclists, ensuring that both physical and mental health concerns are systematically tracked and addressed. This enables a proactive, multidisciplinary support system to respond effectively to fluctuations in well-being, particularly during periods of injury or illness. Full article

Background and Objectives: The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC-O2) and the Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC-H2) scales are designed to objectively monitor various overuse or acute injuries of professional and non-professional athletes in association with other physical problems that relate to health spheres. The aim of this study was to validate these questionnaires in a population of professional and amateur Italian athletes and to analyze their psychometric properties, in order to verify that both scales have equivalent properties in different linguistic and cultural contexts. Materials and Methods: The Italian versions of the OSTRC-O2 (OSTRC-O2-IT) and the OSTRC-H2 (OSTRC-H2-IT) were administered to 102 professional and non-professional athletes over a period of 3 months, once a week, for each rating scale. The inclusion criteria were: age over 18 years, practicing a sports activity for at least 1 year and having had at least one injury. The internal consistency and reliability of both scales and their correlations with pain and quality of life scales have been analyzed. Results: The psychometric properties of the scales turned out to be very high and statistically significant for both scales proposed to the athletes. A Cronbach’s Alpha of 0.946 and an ICC between 0.705 and 0.746 confirmed the good reliability of the questionnaires. Conclusions: The Italian versions of the OSTRC-O2-IT and OSTRC-H2-IT assessment scales are reliable and valid tools for the monitoring of overload injuries. This study shows that they are easy to understand for the Italian sports population and may be of help to the scientific community to increase precautionary control and prevention measures for overuse injuries in professional and amateur athletes, favoring a safer return to the field. Full article

Background: Recreational participation in Mixed Martial Arts (MMA) has rapidly increased. Despite consistent evidence of a high injury prevalence in MMA athletes, the neuromuscular implications of regular MMA training remain underexplored. The cervical spine is particularly vulnerable to trauma due to repetitive impacts and high mechanical demands in combat sports. Methods: This case-control study compared cervical spine function and self-reported symptoms between 25 recreational MMA athletes and 25 matched individuals who engaged in general fitness training. Outcome measures included Neck Disability Index (NDI), Post-Concussion Symptom Scale (PCSS), pain and headache reports, cervical range of motion (ROM), proprioception, isometric strength, and endurance. Multivariate logistic regression analysis was used to identify the predictors of group classification. Results: The MMA group exhibited significantly higher values for post-concussion symptoms (p = 0.012), cervical flexor endurance (p = 0.031), and the number of concussions (p = 0.001) but lower flexion ROM (p = 0.031). No significant differences were observed in strength, proprioception, or NDI scores. Logistic regression identified the number of concussions, age, total cervical ROM, and average rotation strength as significant predictors of group membership (model AUC = 0.96; Nagelkerke R² = 0.797). Conclusions: Recreational MMA athletes demonstrated higher rates of concussion-related symptoms and reduced cervical flexion ROM than noncontact exercisers despite no statistically significant differences in strength and proprioception. These findings suggest that cumulative exposure to amateur MMA is associated with alterations in cervical neuromuscular characteristics. These results support the implementation of targeted mobility, endurance, and injury prevention programs in recreational MMA training. Full article

Objectives: This study aims to compare the postoperative clinical outcomes of using non-elastic compression bandages versus elastic bandages after lateral ankle ligament repair. Methods: This retrospective study analyzed a total of 110 patients who underwent repair surgery for chronic lateral ankle ligament injuries. Based on the postoperative bandaging method, patients were divided into two groups: the non-elastic compression bandage group (Group NECB, 55 cases) and the elastic bandage group (Group EB, 55 cases). A comparison was made between the two groups of patients regarding postoperative ankle joint swelling, pain scores (VAS scores), ankle function (AOFAS Ankle–Hindfoot Scale), range of motion of the ankle joint, the incidence of perioperative complications (including subcutaneous ecchymosis, wound seepage, and events requiring loosening of the bandage due to pain), and the status of return to work postoperatively. Results: There were no significant differences between the two groups in terms of early postoperative ankle joint swelling or increased circumference (0.53 ± 1.47 cm vs. 1.08 ± 1.84 cm, p = 0.095) or VAS scores at 1 day (3.84 ± 2.14 vs. 3.63 ± 2.03, p = 0.595), 7 days (2.20 ± 1.89 vs. 1.78 ± 1.67, p = 0.216), 14 days (1.45 ± 1.56 vs. 0.97 ± 1.23, p = 0.075), or 3 months (1.27 ± 1.50 vs. 1.38 ± 1.76, p = 0.744). Both groups demonstrated comparable functional recovery based on AOFAS scores at 3 months (89.89 ± 8.08 vs. 90.05 ± 9.50, p = 0.926), ROM in all measured directions (p > 0.05), and return to work status (p = 0.567). However, the incidence of complications was significantly lower in Group NECB (3.6%) compared to Group EB (30.9%). The reported complications in Group EB were mainly related to postoperative subcutaneous ecchymosis and discomfort requiring bandage loosening. Conclusions: There is no difference between non-elastic compression bandaging with cotton padding and elastic bandaging in postoperative swelling, pain, and functional recovery. However, in reducing the incidence of postoperative skin adverse events, using non-elastic compression bandages with cotton padding proves to be more ideal as a bandaging method after lateral ankle ligament repair. Full article