Prospective research on musculoskeletal disorders in office workers (PROMO): study protocol.
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BACKGROUND: This article describes the background and study design of the PROMO study (Prospective Research on Musculoskeletal disorders in Office workers). Few longitudinal studies have been performed to investigate the risk factors responsible for the incidence of hand, arm, shoulder and neck symptoms among office workers, given the observation that a large group of office workers might be at risk worldwide. Therefore, the PROMO study was designed. The main aim is to quantify the contribution of exposure to occupational computer use to the incidence of hand, arm, shoulder and neck symptoms. The results of this study might lead to more effective and/or cost-efficient preventive interventions among office workers. METHODS/DESIGN: A prospective cohort study is conducted, with a follow-up of 24 months. In total, 1821 participants filled out the first questionnaire (response rate of 74%). Data on exposure and outcome is collected using web-based self-reports. Outcome assessment takes place every three months during the follow-up period. Data on computer use are collected at baseline and continuously during follow-up using a software program. DISCUSSION: The advantages of the PROMO study include the long follow-up period, the repeated measurement of both exposure and outcome, and the objective measurement of the duration of computer use. In the PROMO study, hypotheses stemming from lab-based and field-based research will be investigated. (+info)
Differences in the risk associated with head injury for pediatric ice skaters, roller skaters, and in-line skaters.
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OBJECTIVE: The goals were to describe the epidemiologic features of pediatric skating-related injuries sustained from 1993 to 2003 and to compare ice skating-related injuries with roller skating--and in-line skating-related injuries. METHODS: An analysis of pediatric skating-related injury data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission was performed. RESULTS: An estimated 1 235 467 pediatric skating participants presented to hospital emergency departments with injuries between 1993 and 2003. These children had a mean age of 10.9 years (SD: 3.2 years; range: 1-18 years), and 50.0% were male. The most common mechanism of injury was a fall (83.1%). Ice skaters sustained a greater proportion of head injuries (13.3%), compared with roller skaters (4.4%) and in-line skaters (5.0%). Ice skaters also experienced a greater proportion of concussions (4.3%), compared with roller skaters (0.6%) and in-line skaters (0.8%). The proportion of facial injuries among ice skaters was greater than the proportions among roller skaters and in-line skaters. The majority of roller skating-and in-line skating-related injuries were upper-extremity fractures (53.9% and 59.7%, respectively). Children < or = 6 years of age experienced a greater proportion of head and facial injuries than did older children in each skating activity. CONCLUSIONS: The epidemiologic features of pediatric ice skating-related injuries differ from those of roller skating--and in-line skating-related injuries. Children should wear helmets during all recreational skating activities, especially ice skating, because of the risk of serious head injuries. Wrist guards should be worn to protect against the common upper-extremity fractures sustained during skating. (+info)
Lateral impact injuries with side airbag deployments--a descriptive study.
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The present study was designed to provide descriptive data on side impact injuries in vehicles equipped with side airbags using the United States National Automotive Sampling System (NASS). The database was queried with the constraint that all vehicles must adhere to the Federal Motor Vehicle Safety Standards FMVSS 214, injured occupants be in the front outboard seats with no rollovers or ejections, and side impacts airbags be deployed in lateral crashes. Out of the 7812 crashes in the 1997-2004 weighted NASS files, AIS > or = 2 level injuries occurred to 5071 occupants. There were 3828 cases of torso-only airbags, 955 cases of torso-head bag combination, and 288 inflatable tubular structure/curtain systems. Side airbags were not attributed to be the cause of head or chest injury to any occupant at this level of severity. The predominance of torso-only airbags followed by torso-head airbag combination reflected vehicle model years and changing technology. Head and chest injuries were coupled for the vast majority of occupants with injuries to more than one body region. Comparing literature data for side impacts without side airbag deployments, the presence of a side airbag decreased AIS=2 head, chest, and extremity injuries when examining raw data incidence rates. Although this is the first study to adopt strict inclusion-exclusion criteria for side crashes with side airbag deployments, future studies are needed to assess side airbag efficacy using datasets such as matched-pair occupants in side impacts. (+info)
Proximal biceps rupture: management of an unusual injury in an arm wrestler.
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Arm wrestling may cause unusual injuries, which may require operative repair in the sporting individual. Injury to the proximal biceps as a consequence of arm wrestling has not been reported previously. The diagnosis and treatment of a 36-year-old man who sustained a proximal biceps rupture while arm wrestling and his operative management are described. (+info)
Safety and effectiveness of intravenous regional anesthesia (Bier block) for outpatient management of forearm trauma.
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OBJECTIVE: To assess the safety and effectiveness of intravenous regional anesthesia (Bier block) in the management of forearm injuries (i.e., forearm, wrist or hand) by primary care physicians at a diagnostic and treatment facility. METHODS: A retrospective review was conducted of all patients at a single centre who underwent a Bier block for forearm injuries between September 2000 and March 2005. RESULTS: 1816 Bier blocks were performed on 1804 patients (64% male) during the study period. Patient age ranged from 4-70 (mean 25) years. Wrist fractures requiring reduction were the most common diagnosis. Adverse events were recorded in 9 cases (0.50%, 95% confidence interval 0.23%-0.94%): 1 case of medication error (0.06%); 3 of improper cuff inflation (0.17%); and 5 of inadequate analgesia (0.28%). None of the adverse events resulted in failure to complete the procedure or in serious morbidity or mortality. CONCLUSION: Bier block anesthesia is a safe, effective and reliable technique in an outpatient primary care setting. This technique is a useful modality for physicians who manage acute upper-extremity injuries. (+info)
Acute peg in hole docking in the management of infected non-union of long bones.
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The Ilizarov method has been studied extensively in the management of non-union of long bones. In most cases this involves filling of defects present primarily or after debridement by bone transport. Acute docking over gaps longer than 2 cm has not been adequately studied, however. The purpose of this paper is to report the efficacy of acute peg in hole docking as a bone graft-sparing modality in the management of infected non-union of long bones. (+info)
A review of K-wire related complications in the emergency management of paediatric upper extremity trauma.
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INTRODUCTION: Kirschner wires (K-wires) are immensely versatile in fracture fixation in the paediatric population. Complications associated with the K-wiring procedure vary from minor to a life-threatening. The aim of this study was to analyse the outcome of fracture fixation using K-wires in all types of upper-extremity fractures in children in order to assess the incidence and type of complication critically. PATIENTS AND METHODS: Between September 1999 and September 2001, we retrospectively reviewed a consecutive series of 105 fractures in 103 paediatric trauma cases (below 12 years) treated with K-wires in a university teaching hospital. The case notes and radiographs were reviewed by an independent single assessor. All paediatric, acute, upper-extremity, displaced and unstable fractures were included. All elective procedures using K-wires were excluded. RESULTS: We observed an overall 32.3% complication rate associated with the K-wiring procedure affecting 34 pins (24 patients). Wound-related complications included over-granulation in 13 cases, pin tract infection in 6 cases and hypersensitive scar in 1 case. Neurapraxia was found in 3 patients and axonotmesis in 1 patient. Wire loosening at the time of removal in 14 cases and retrograde wire migration in 4 cases were observed. There were 2 cases of penetrating tendonitis and 1 case of osteomyelitis. There was a higher complication rate in terms of wire loosening and pin tract infection when the K-wires: (i) were left outside the skin compared with those placed under the skin; (ii) stayed longer in the patients; and (iii) did not traverse both cortices. There were more complications in complex operations performed by senior surgeons (P = 0.056). The duration of K-wire stay, associated co-morbidity and anatomical location were statistically insignificant. CONCLUSIONS: Complications are part of operative procedures; an important point to consider is what causes them in order to take preventative measures. We recommend that the risks and complications should be explained to parents during the consenting process to allay their anxiety, irrespective of the fact that most complications are minor and of short duration. (+info)
Work-related physical and psychosocial risk factors for sick leave in patients with neck or upper extremity complaints.
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OBJECTIVES: To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. METHODS: Three hundred and forty two patients with neck or upper extremity complaints completed self-report questionnaires at baseline and after 3 months. Cox regression models were used to investigate the association between work-related risk factors and sick leave (i.e., lost days from work due to neck or upper extremity complaints in 3 months). Effect modification by sick leave at baseline, sex, worrying and musculoskeletal co-morbidity was evaluated by adding product terms to the regression models. RESULTS: In the subgroup of patients who scored high on the pain copying scale "worrying" the hazard ratio of sick leave was 1.32 (95% CI 1.07-1.62) per 10% increase in heavy physical work. The subgroup of patients who were sitting for long periods of time had a reduced risk of sick leave as compared to patients who did not spend a lot of time sitting, again only in patients who scored high on the pain coping scale "worrying" (adjusted HR=0.17, 95%-CI 0.04-0.72). Other work-related risk factors were not significantly related to sick leave. CONCLUSIONS: Heavy physical work increased the risk of sick leave and prolonged sitting reduced the risk of sick leave in a subgroup of patients who worried much about their pain. Additional large longitudinal studies of sufficiently large size among employees with neck or upper extremity complaints are needed to confirm our results. (+info)