OBJECTIVES: To determine the rate and type of injuries occurring to registered professional kickboxers in Victoria, Australia over a 16 year period. METHODS: Data describing all fight outcomes and injuries sustained during competition for the period August 1985 to August 2001 were obtained from the Victorian Professional Boxing and Combat Sports Board. RESULTS: A total of 382 injuries were recorded from 3481 fight participations, at an injury rate of 109.7 injuries per 1000 fight participations. The most common body region injured was the head/neck/face (52.5%), followed by the lower extremities (39.8%). Specifically, injuries to the lower leg (23.3%), the face (19.4%), and intracranial injury (17.2%) were the most common. Over 64% of the injuries were superficial bruising or lacerations. CONCLUSION: The nature of kickboxing, whereby kicking the opponent is the prime movement and the head a prime target, is reflected in the distributions of body regions most commonly injured by participants. Further research into injury patterns in different styles of kickboxing and the mechanism of injury occurrence is required. Exposure adjusted prospective studies are needed to monitor injury rates over time. (+info)
(18/169) Use of tissue adhesives in sport? A new application in international ice hockey.
In the tough, competitive environment of international ice hockey, it is vital that a player who sustains a minor facial laceration is returned to play as soon as possible. A method of wound closure that is fast to apply, water resistant, and effective was sought. Dermabond, a cyanoacrylate tissue adhesive, was selected for use during the 2002 International Ice Hockey Federation World Championships for the closure of selected facial wounds. The wounds were all closed using prescribed aseptic techniques. The results are presented and discussed. The tissue adhesive met the criteria set out. (+info)
(19/169) Topical adrenaline and cocaine gel for anaesthetising children's lacerations. An audit of acceptability and safety.
OBJECTIVES: (1) To assess the acceptability of a gel solution of adrenaline (epinephrine) (1 in 2000) and cocaine (5%) for anaesthetising children's facial lacerations to the child, parent, and operator. (2) To assess the safety of the current protocol. SETTING: The emergency unit of a large university hospital. METHODS: All patients who were treated with topical adrenaline and cocaine (topAC) gel over a six month period were entered into a prospective audit (n = 75). Patient details, the nature and cause of the injury, and any treatment carried out were all recorded. The acceptability to children over 3 years of age, was assessed by the use of the Wong Baker face scale, in which 0 represents "no hurt" and 5 represents "hurts worst". The acceptability to both the parent and the operator was assessed by the use of a 0 to 9 Likert scale, where 0 represented "very acceptable" and 9 represented "not at all" acceptable. RESULTS: (1) Children aged 3 years or older graded their pain during the procedure as having a mean value of 1.17 on the Wong Baker (0 to 5) scale. Parents graded acceptability on the Likert scale (0 to 9) with a mean score of 1.13. Operators using the same grading system, recorded a mean score of 1.75. (2) No toxic side effects were seen but the protocol was updated in line with evidence. CONCLUSIONS: Topical adrenaline and cocaine is an effective anaesthetic for suturing children's facial lacerations and is acceptable to child, parent, and operator alike. (+info)
(20/169) Effectiveness of rugby headgear in preventing soft tissue injuries to the head: a case-control and video cohort study.
OBJECTIVE: To determine if headgear use by rugby players was associated with a reduced risk of head or facial laceration, abrasion, or fracture. METHODS: An emergency department based case-control study in South Wales, UK, with cases being rugby players treated for superficial head and facial injuries and controls being their matched opponents during the game. A review of videos of the 41 games in the 1999 Rugby World Cup was also carried out to compare with the case-control study. Odds ratios (OR) and 95% confidence intervals (95% CI) were used to measure association between exposure (headgear wearing) and outcome (head and facial injuries). RESULTS: In the case-control study, 164 pairs were analysed, with headgear worn by 12.8% of cases and 21.3% of controls. Headgear use was associated with substantial but non-significant reductions in superficial head (OR = 0.43, 95% CI 0.13 to 1.19) and facial (OR = 0.57, 95% CI 0.21 to 1.46) injuries. The video study followed 547 players over 41 games, during which there were 47 bleeding injuries to the head. Headgear use significantly reduced the risk of bleeding head injury in forwards (OR = 0.14, 95% CI 0.01 to 0.99, p = 0.02), but not in backs. There was also a higher risk of facial injury among forwards, but this was not significant. CONCLUSIONS: The combined results suggest that headgear can prevent certain types of superficial head injuries in players at all levels of the game, but the evidence is strongest for superficial head injury in elite forwards. A randomised controlled trial would be the best way to study this further. (+info)
(21/169) Epidemiology study of facial injuries during a 13 month of trauma registry in Tehran.
BACKGROUND: Many studies have recently noted a shift in the causative mechanism of facial injuries away from traffic accident to assaults. AIMS: Our study aimed to investigate patterns of facial injuries in trauma patients during 13 months study of trauma patients in six general hospitals in Tehran. MATERIAL AND METHODS: Trauma patients who were hospitalized for more than 24 hours and had sustained injuries within seven days from admission were included in the study. Of the 8000 trauma patients, four hundred (5%) sustained facial injuries. RESULTS: Male to female ratio was 4.5:1. Among them, 53.3% were aged 11-30 years. Traffic accidents were by the far the commonest cause of injury. Motorcyclists who wore a helmet sustained facial fractures less often during traffic accident than those patients who did not wear helmet. Soft tissue injury and facial bone fracture comprised 43.3% and 40.8% of facial injuries, respectively. The majority of Soft tissue injuries (79%) were located extra orally. The mandible and nasal bone were the most commonly fractured facial bones. Victims of assault sustained more severe injuries compared to those involved in falls and traffic accidents. CONCLUSIONS: Use of helmets by motorcyclists and the separation of pedestrians routes from motor vehicles could reduce the number of victims and consequently injuries due to road traffic accidents. For implementation of effective prevention programs for reduction of facial injuries due to assault, it seems to be necessary to conduct studies investigating causes and pattern of injuries resulting in assault. (+info)
(22/169) The Lancaster experience of 2.0 to 2.5 mg/kg intramuscular ketamine for paediatric sedation: 501 cases and analysis.
OBJECTIVES: To report the experience of using intramuscular ketamine 2.0 or 2.5 mg/kg for minor painful procedures in children in a medium sized district general hospital accident and emergency department. To demonstrate the safety and acceptability of ketamine and determine if the incidence of adverse effects is related to dose or other variables. METHODS: Prospective data collection and analysis using Statsdirect and SPSS software. RESULTS: 501 consecutive cases were collected from August 1996 to April 2002. A total of 310 children received 2.0 mg/kg and 191 received 2.5 mg/kg. Twenty six received a second dose. In seven cases oxygen saturation fell below 93%, three of these fell below 90%. There was one case of laryngospasm. Eight cases received airway suctioning, five of these were mouth or lip wounds. Seventeen per cent vomited in recovery or at home for which one child required admission. Muscle hypertonicity was observed in 6.8%, disturbed sleep or nightmares in 2%. The median time to discharge was 85 minutes. Ninety seven per cent of parents' experiences were "the same as" or "better than" expected. No children suffered any lasting or troublesome complications. CONCLUSIONS: 2.0 - 2.5 mg/kg intramuscular ketamine sedation is a safe and acceptable technique when used within a defined protocol. Lower dose ketamine (2 mg/kg) warrants further study in view of potentially less airway complications and quicker discharge times than previously reported. (+info)
(23/169) The management of facial injuries in rugby union.
BACKGROUND: There are as yet no guidelines in rugby union for the management of facial lacerations which account for one-third of total injuries sustained by players. METHOD: We devised a questionnaire to establish the current standards in rugby union clubs in England. The questionnaire covered such issues as inadequate wound cleansing, inappropriate suture material, the use of sterile suture equipment, and advice required for suture removal. RESULTS: We recommend that a dedicated medical room should be available in all clubs, the doctor should always wear gloves, and local anaesthetic and sterile suture packs and instruments should be provided. (+info)
(24/169) Parental perceptions regarding mandatory mouthguard use in competitive youth soccer.
OBJECTIVE: To understand factors that influence parental perceptions regarding mandatory mouthguard use in competitive youth soccer. SETTING AND SUBJECTS: A web based survey of parents whose 8-14 year old children participated in outdoor competitive youth soccer during the fall of 2002. Questions focused on: previous injury, education provided, dentist/physician recommendations, and parental perceptions of mouthguard use. MAIN OUTCOME MEASURE: The outcome variable was parental agreement with the statement "mouthguards should be mandatory for competitive youth soccer". Logistic regression and chi(2) were performed using STATA 8.0. RESULTS: Altogether 120 parents participated. The children had a mean (SD) age of 11.8 (1.5) years and 48% were female; 14% wore mouthguards and 11% suffered orofacial injuries. Nineteen percent of parents reported receiving educational material from the youth soccer organization. Although 92% of parents believed that mouthguards were effective in reducing orofacial injuries, only one half agreed that mouthguards should be mandatory. Thirty percent of respondents reported that their dentist/physician recommended mouthguards for competitive youth soccer. Logistic regression showed that dentist/physician recommendation and parental female gender were independently associated with parental agreement for mandatory mouthguard use (odds ratio 2.9, 95% confidence interval (CI) 1.2 to 7.3; odds ratio 3.0, 95% CI 1.1 to 6.5). CONCLUSIONS: Few athletes wear mouthguards during competitive youth soccer. Health care professionals in this study did not capitalize on the apparent influence they have on parental beliefs regarding mouthguard use. Efforts are needed by both health professionals and soccer organizations to educate parents about orofacial injuries and mouthguard use in competitive youth soccer. (+info)