Background: Hamstring strain injury remains persistently high in sports, highlighting the need for additional investigation of its predisposing variables. Despite hamstring injury being well investigated, there’s a lack of studies on changes in echo intensity and shear wave elastography of hamstrings among athletes with a history of injury, which could be considered modifiable risk variables. Objectives: To examine echo intensity and shear wave elastography characteristics of previously injured hamstrings among athletes, assessing the differences between the injured leg and controls. Methods: This systematic review will focus on studies reporting echo intensity and shear wave elastography characteristics of athletes with a history of hamstring strain injury compared to a control group. The search strategy will locate studies written in English from 1990 to 2023 using four electronic databases: PubMed, EBSCO (CINAHL and Medline), Science Direct, and Web of Science. Studies reporting measures using imaging other than ultrasound and where no diagnosis of hamstring strain has been made will be excluded. Two independent reviewers will screen and critically appraise the studies using the McMasters Critical Review Form. Two reviewers will independently extract relevant data and present a descriptive synthesis. A meta-analysis will be conducted when two or more studies provide data for the same outcome measure. Expected Results This review can better understand hamstring maladaptation to injury. Utilizing echo-intensity and shear wave elastography as objective outcome measures can inform clinical practice toward developing an effective rehabilitation program for injury prevention.
Wounds and Injuries ; Sports ; Rehabilitation

The development of microsurgical techniques has also increased the success rate of replantation surgery. This paper reports the results of limb replantation performed on a lower extremity amputation that was associated with crush amputation and an ipsilateral comminuted fracture in and elderly patient. A 68-year-old female presented with a right distal tibia amputation due to a traffic accident. At that time, with a comminuted fracture in the distal femoral condyle, simple wound repair was recommended, but the caregivers strongly wanted replantation. Three years after surgery, normal walking was possible without a cane and the patient was satisfied with the function and aesthetics. What used to be contraindicated in limb replantation in the past are now indications due to the development of microsurgical techniques, surgical experience, and postoperative rehabilitation treatment. If the patient is willing to be treated, good results in contraindications can be obtained.
Accidents, Traffic ; Aged ; Amputation ; Canes ; Caregivers ; Esthetics ; Extremities ; Female ; Fractures, Comminuted ; Humans ; Leg ; Lower Extremity ; Rehabilitation ; Replantation ; Tibia ; Walking ; Wounds and Injuries

A 49-year-old female patient suffered a suspicious scalding burn in her right hand and forearm during a seizure, and visited the clinic 16 hours after injury without appropriate initial treatment. The wound was covered with multiple bullae, was cold and pale, and the extension and flexion functions were decreased. The intrafascial pressure was measured as 19~95 mmHg (mean 46.9), confirming compartment syndrome. The pressure was improved following fasciotomy to 23~32 mmHg (mean 27); escharectomy, split thickness skin grafting and partial ostectomy was then performed, and an abdominal flap operation was conducted. The patient underwent a delayed procedure 14 days after the operation, and on the 18th day, subcutaneous fat and fascia tissues from the subcutaneous layer were removed from the skin; after sculpturing, split thickness skin grafting was performed. On the 21st day after flap separation, stump revisions were performed. The patient is currently undergoing rehabilitation; the metacarpophalangeal joint exhibits a normal range of motion, and the proximal interphalangeal joint has a range of motion of 30~45°. The abdominal flap operation was performed for soft tissue defects in the extensor tendon and bone exposure. Thus, various long-term processes were avoided, and by implementing a short operation time and low-cost surgery, relatively quick rehabilitation treatment could be initiated.
Burns* ; Compartment Syndromes ; Fascia ; Female ; Fingers* ; Forearm ; Hand ; Humans ; Joints ; Metacarpophalangeal Joint ; Middle Aged ; Range of Motion, Articular ; Reference Values ; Rehabilitation ; Seizures ; Skin ; Skin Transplantation ; Subcutaneous Fat ; Tendons ; Wounds and Injuries

BACKGROUND: Upper extremity soft tissue defects with complete circumferential involvement are not common. Coupled with the unique anatomy of the upper extremity, the underlying etiology of such circumferential soft tissue defects represent additional reconstructive challenges that require treatment to be tailored to both the patient and the wound. The aim of this study is to review the various options for soft tissue reconstruction of complete circumferential defects in the upper extremity. METHODS: A literature review of PubMed and MEDLINE up to December 2016 was performed. The current study focuses on forearm and arm defects from the level at or proximal to the wrist and were assessed based on Tajima's classification (J Trauma 1974). Data reviewed for analysis included patient demographics, causality, defect size, reconstructive technique(s) employed, and postoperative follow-up and functional outcomes (when available). RESULTS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 14 unique articles were identified for a total of 50 patients (mean=28.1 years). Underlying etiologies varied from extensive thermal or electrical burns to high impact trauma leading to degloving or avulsion, crush injuries, or even occur iatrogenically after tumor extirpation or extensive debridement. Treatment options ranged from the application of negative pressure wound dressings to the opposite end of the spectrum in hand transplantation. CONCLUSIONS: With the evolution of reconstructive techniques over time, the extent of functional and aesthetic rehabilitation of these complex upper extremity injuries has also improved. The proposed management algorithm comprehensively addresses the inherent challenges associated with these complex cases.
Arm ; Bandages ; Burns ; Classification ; Debridement ; Demography ; Follow-Up Studies ; Forearm ; Hand Transplantation ; Humans ; Reconstructive Surgical Procedures ; Rehabilitation ; Soft Tissue Injuries ; Upper Extremity* ; Wounds and Injuries ; Wrist

PURPOSETo evaluate the return to work (RTW) rate, time and predictors among trauma patients using survival analysis.

METHODSThis cohort study was conducted with a three-month follow-up on 300 trauma patients hospitalized in Shahid Beheshti Hospital, Kashan, Iran in 2014. The data were collected through conducting interviews and referring to patients' medical records during their hospital stay and follow-up information at one & three months after discharge from hospital. Final analysis was conducted on the data retrieved from 273 patients. Data were analyzed by chi-square test, Mann-Whitney U test and survival analysis method.

RESULTSThe rate of RTW at the end of the first and the third follow-up months was respectively 21.6% and 61.2%. Survival analysis showed that the RTW time (Time between admission to first return to work) was significantly longer among patients with illiteracy, drug abuse, hospitalization history in the intensive care unit, low socioeconomic status, non-insurance coverage, longer hospital stay, multiple and severe injuries as well as severe disability.

CONCLUSIONOur findings indicated that trauma has profound effects on the rate and time of RTW. Besides disability, many personal and clinical factors can affect the outcome of RTW.

Adult ; Cohort Studies ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Proportional Hazards Models ; Return to Work ; statistics & numerical data ; Social Class ; Survival Analysis ; Wounds and Injuries ; rehabilitation

Gunshot injuries are always known to cause severe morbidity and mortality when head and neck are involved. They vary in morbidity, which can occur in civilian surroundings. The wound largely depends on the type of weapon, mass and velocity of the bullet, and the distance from where it has been shot. Close-range gunshot wounds in the head and neck region can result in devastating aesthetic and functional impairment. The complexity in facial skeletal anatomy cause multiple medical and surgical challenges to an operating surgeon, demanding elaborate soft and hard tissue reconstruction. Here we presented the successful management of three patients shot by short-range pistol with basic life support measures, wound management, reconstruction and rehabilitation.
Adolescent ; Adult ; Child ; Facial Injuries ; rehabilitation ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Wounds, Gunshot ; rehabilitation ; surgery

The purpose of this study was to investigate implant-supported restoration as a technique for restoring missing teeth in patients with aplastic anemia. Recurrent bleeding from wound sites leads to persistent release of iron in the tissue. Excessive iron in tissue is related to clinical findings, including fibrosis, poor wound healing, and high level of angiogenesis, which are possible etiological factors of reduced osseointegration. A 44-year-old female patient with aplastic anemia was treated with multiple endosseous implants throughout the mandible and in the posterior region of the maxilla. After 14 implants were placed, radiological and clinical parameters were assessed during the follow-up period. Marginal bone did not change significantly during the follow-up period. The fine trabecular bone in intimate contact and enclosing the implant fixture was sufficient for successful osseointegration. None of the 14 implants were associated with compilations during the seven-year experimental period. This study suggests that dental implant procedures are a safe and reliable treatment option for restoration of missing dentition in patients with aplastic anemia.
Adult ; Anemia, Aplastic* ; Dental Implants* ; Dentition ; Female ; Fibrosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Iron ; Mandible ; Maxilla ; Osseointegration ; Rehabilitation* ; Tooth ; Wound Healing ; Wounds and Injuries

We report a case of Brown-Sequard syndrome (BSS) caused by an accidental stab injury of the cervical spine that shows clear magnetic resonance imaging (MRI) findings and clinical presentation. A 42-year-old woman was brought into the emergency department after a stab injury on the right side of the posterior neck from a knife that was lying in a fruit basket after slipping. The patient complained of hemiparesis of the right-side extremities, and ipsilateral hypoesthesia and contralateral sensory loss of pain and temperature were also found on neurological examination. MRI showed a signal change of the C6-7 cord level and the tract of the stab wound through the posterior neck. Irrigation and primary closure of the laceration was performed under the impression of BSS. The neurologic deficit was improved with rehabilitation therapy.
Adult ; Brown-Sequard Syndrome* ; Cervical Vertebrae ; Deception ; Emergency Service, Hospital ; Extremities ; Female ; Fruit ; Humans ; Hypesthesia ; Lacerations ; Magnetic Resonance Imaging ; Neck ; Neurologic Examination ; Neurologic Manifestations ; Paresis ; Rehabilitation ; Spinal Cord Injuries ; Spine* ; Wounds, Stab

PURPOSE: Many burn patients are troubled with pain and paresthesia from healed wounds. Extracorporeal Shock Wave Therapy (ESWT) in various musculoskeletal disease and wounds is reported that it reduces the pain and promotes regenerating of tendon and healing of the wound. Therefore we investigated the effect of ESWT on the scar pain of burn patients. METHODS: On February 2014, three patients admitted to the department of rehabilitation medicine of Hangang Sacred Heart Hospital Burn Center underwent ESWT. One low-energy ESWT (0.05~0.12 mJ/mm2) a week was provided to them for 3 weeks in total. Numerical rating scale (NRS), Nirschl pain phase system, 70-point scoring system, Roles and Maudsley score were evaluated before ESWT, after first and third ESWT. RESULTS: In all three patients, the NRS score was decreased and total scores of Nirschl pain phase system and 70-point scoring system were improved after ESWT compared to before ESWT. Roles and Maudsley scores was poor in all three patients at before ESWT but was acceptable in two patients and good in one patient after third ESWT. CONCLUSION: Extracorporeal shockwave therapy (ESWT) is non-invasive, feasible and effective modality on the scar pain of burn patients.
Burn Units ; Burns* ; Cicatrix* ; Heart ; Humans ; Musculoskeletal Diseases ; Paresthesia ; Rehabilitation ; Shock* ; Tendons ; Wounds and Injuries

PURPOSE: The purpose of this study is to evaluate the outcome of treatment for patients with Type IIIb open tibial fractures. MATERIALS AND METHODS: This study targeted 35 adult patients for whom follow-up was possible over one year after undergoing surgical treatment. There were 29 males and six females with an average age of 45 years. RESULTS: Fracture location was proximal in 10 cases, midshaft in 13 cases, and the distal part of the tibia in 12 cases. An average of 10 days was observed for definitive fixation with soft tissue coverage of the injury. The mean time to radiographic union was 27 weeks. Sixteen cases (45.7%) of complications were observed. Three cases of superficial infection, two cases of deep infection, four cases of partial flap necrosis, three cases of mal-alignment, three cases of joint stiffness, and one case of hardware breakage were observed. The mean lower extremity functional scale score was 68.5 and the factors influencing the clinical results were severity of open wound (p=0.000) and occurrence of complications (p=0.000) according to results of multiple regression analysis. CONCLUSION: In treatment of Type IIIb open tibial fractures, good clinical results can be expected provided that complications are prevented through proper reduction, firm fixation, early soft tissue reconstruction, and early rehabilitation.
Adult ; Female ; Follow-Up Studies ; Fractures, Open ; Humans ; Joints ; Lower Extremity ; Male ; Necrosis ; Negative-Pressure Wound Therapy ; Rehabilitation ; Soft Tissue Injuries ; Tibia ; Tibial Fractures* ; Wounds and Injuries