Effects on gait kinematics, pedobarography, functional and subjective results after isolated chopart injury.

BACKGROUND: This study analysed changes in gait and pedobarography and subjective and functional outcomes after isolated Chopart joint injury. METHODS: The results of 14 patients were reviewed. Kinematic 3D gait analysis, comparative bilateral electromyography (EMG) and pedobarography were performed. RESULTS: On the injured side, the 3D gait analysis showed a significantly increased internal rotation and decreased external rotation of the hip and significantly decreased adduction and decreased range of motion (ROM) for the ankle. On the healthy side, the pedobarography revealed a significantly increased mean force in the forefoot, an increased peak maximum force and an increased maximum pressure in the metatarsal. When standing, significantly more weight was placed on the healthy side. The EMG measurements showed no significant differences between the healthy and injured legs. CONCLUSIONS: After isolated Chopart injuries, significant changes in gait and pedobarography can be seen over the long term.

The Impact of the SARS-COVID-19 Lockdowns on the Subjectively Perceived Performance Level of Amateur Athletes after Returning to the Gyms.

Since December 2019, few issues have garnered as much global attention as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-19). The imposed lockdowns in 2020/21, which led to the closure of all gyms, barred people from participating in their favourite sports activities. This study explores athletes' self-evaluations of their performance levels upon return to training facilities post-reopening. Data were collected in May 2021, after the end of the second lockdown, using a national online questionnaire. The study recorded 20 demographic and training-specific parameters to discern the factors influencing self-perceived performance upon resuming gym activities after the 2020/2021 lockdown. A total of 1378 respondents participated in the study. Of the total number of participants, 27.5% (365) reported regaining 100% of their original performance level after reopening their studios, a proportion that comprised 212 males, 150 females, and 3 individuals of unspecified gender. Additionally, 35.7% (474) estimated their performance level to be up to 75%, followed by 30% (398) recording their performance level at 50%, and a minority of 6.8% (90) determining their performance level to be up to 25%. Exercise intensity prior to lockdown, training experience, sex, and concurrent practice of another sport significantly influenced the athletes' self-assessment of their current fitness levels (p > 0.001, p > 0.001, p > 0.001, and 0.006, respectively). We need to understand the factors that shape self-perception, especially in case of another lockdown, in order to provide preventive assistance concerning mental and physical well-being. Positive influences on self-perception include prior athletic experience, intensive training before the lockdown, and continued participation in sports throughout the lockdown. Younger age is also favourable, but this may not necessarily reflect the benefits of youth; rather, it could indicate the current lack of accessible online sports activities for older individuals. Women, however, might have a less favourable perception of their own athletic performance.

Shoulder pathologies in CrossFit: a magnetic resonance imaging study of 51 cases.

BACKGROUND: Recent scientific work shows that the most common injuries in CrossFit© occur in the shoulder joint. This paper aims to provide a review of shoulder pathologies in a young CrossFit© cohort via MRI and clinical examination. METHODS: A survey was conducted in 13 CrossFit "boxes" in Germany, in which athletes with recurrent shoulder pain could report for a clinical examination and MRI diagnostic. Fifty-one CrossFit athletes with chronic shoulder pain agreed to participate in the study and were then examined physically and by MRI. RESULTS: Fifty-one active CrossFit athletes aged 21-45 years (mean 33.7 years, 35 male and 16 female) were recruited. The most frequently detected pathologies were partial lesions of the supraspinatus tendon (N.=25; 49%) and labral lesions (N.=11; 21.6%). The findings also identified partial lesions of the subscapularis tendon (N.=9; 17.6%), pulley lesions (N.=9; 17.6%), and partial lesions of the infraspinatus muscle (N.=2; 3.9%). CONCLUSIONS: These data demonstrate the need for a specific focus on particular shoulder injuries in CrossFit. Knowledge about the type of shoulder pathologies caused by CrossFit training allows for training-specific adaptations with regard to prevention, as well as a more targeted, sport-specific therapy. This study is the first in the literature to present on structural changes in the shoulders of active CrossFit athletes.

[Traumatic spinal cord injuries in sports: a 22-year analysis performed by a specialized trauma centre]. / Traumatische Rückenmarkverletzungen im Sport ­ eine Analyse eines spezialisierten Traumazentrums von 22 Jahren.

INTRODUCTION: There is not much data on traumatic spinal cord injuries sustained during sports in Germany. This study aims to present the frequency of traumatic spinal cord injuries with neurological involvement within various sports over the past 22 years. METHODS: This study is a retrospective evaluation of traumatic spinal cord injuries (tSCI) in sports sustained in the past 22 years. The study was performed by a German level 1 trauma centre with a department for spinal cord injuries. The files of inpatients treated in the years 1998 to 2020 were evaluated with regard to patients' histories and traumatic spinal cord injuries. In addition, injury location and gender distribution were recorded. RESULTS: A total of 1630 patients with traumatic spinal cord injuries with neurological involvement were recorded. Of the 1630 patients, N=116 (7.1%) had had sports accidents. The age of this subpopulation was significantly younger at 41 years (p=0.05) than the age of the total group of tSCI at 50 years. A more detailed analysis of the sports injuries showed that in descending order equestrian sports (N=22), winter (N=18), air (N=16), motor sports (N=16) and cycling (N=15) were the most common causal factors for these particularly serious spinal injuries. As regards the distribution of the location of the spinal cord injury with a view to the type of sports practiced, a significant result was shown in aerial sports, with patients from this group mainly having had lumbar spine injuries (p <0.01), and in diving with cervical spine injuries (p=0). Gender distribution in the individual sports shows a significant difference in equestrian sports (male < female, p <0.01) as well as a significant difference in air sports (male > female, p = 0.05) and cycling (male > female, p=0.07). CONCLUSION: In summary, equestrian sports is the most common cause of spinal cord injuries with neurological involvement in the sports sector with a higher proportion of female participants, although the proportion of female patients is smaller compared with male patients in the section of traumatic spinal cord injuries. Winter (N=18), air (N=16), motor sports (N=15) and cycling (N=15) come next in descending order.Patients with traumatic spinal cord injuries caused by sports accidents are significantly younger than the entirety of patients with traumatic spinal cord injuries.

Popular Gym Fitness Sport: An Analysis of 1387 Recreational Athletes Regarding Prone to Pain Exercises and the Corresponding Localisations.

BACKGROUND: Recreational fitness sports are popular worldwide and rank first among organised sports. This study aims to bridge a knowledge gap by examining which exercises are most prone to causing pain symptoms, as a possible precursor for injury, and analysing the body regions that are most frequently affected. METHODS: Using an online questionnaire, 20 demographic and training-specific items and 49 sport-specific exercises were recorded. Frequent exercises as well as the incidence and distribution of pain symptoms that the athletes experienced during or in relation to their training were evaluated. RESULTS: The study assessed common exercises and documented the frequency and distribution of pain symptoms experienced by athletes during or in relation to their training. A total of 1387 respondents were included in this study. Of these, 732 (53.1%) experienced pain during their fitness training, with 333 (24.2%) being female and 397 (22.3%) being male. The method of creating a training plan showed a significant influence (p < 0.001): athletes who devised their own plans reported pain or instability more frequently than those in the comparison groups. Guided exercises on machines resulted in the lowest frequency of pain (11.54%), while exercises with free weights were associated with the highest pain rate among respondents (19.94%). Specifically, exercises such as the back squat, deadlift, bench press, and triceps dips were identified as the exercises most commonly associated with pain. The most frequently reported pain region was the shoulder, followed by the lower back and knees. CONCLUSION: The findings reveal a significant number of unreported pain symptoms. The disparity between rigorous training volumes and the absence of professional care frequently leads to injuries and pain. It is incumbent upon sports medicine to investigate the root causes of these complaints (pain or instability) to implement preventive measures against potential injuries.

[Fatal necrotizing fasciitis with clostridium perfringens infection following resection of soft tissue sarcoma of the thigh]. / Letaler Verlauf einer fulminanten nekrotisierenden Fasziitis und Clostridium-perfringens-Infektion nach Resektion eines Weichteil-Sarkoms.

We present the case of a 57-year-old male patient with a fatal outcome after resection of a soft tissue sarcoma of the lateral thigh. A polymicrobial surgical site infection with Staphylococcus lugdunensis and Clostridium perfringens caused fulminant necrotising fasciitis with an additional gas gangrene. The patient suffered a severe sepsis with consecutive haemolysis and multiorgan failure. The authors recapitulate the deadly progress of a rarely reported complication after oncological resection. The therapeutic approach and surgical interventions are discussed based on the current literature.

An Evaluation of 7279 Sports Injuries from a Level 1 Trauma Center with a Focus on Gender Differences.

PURPOSE: Hardly any other topic is as current as the gender-conscious medical treatment of every individual. Similarly, in sports, there are crucial differences that should be considered in order to treat everyone appropriately, with the aim to prevent injuries according to their needs. The objective of this study is to show that the differences between biological males and females are so significant that they require both specific injury prevention and therapy programs. METHODS: This study is a retrospective analysis of letters from a department of orthopedics and trauma surgery between the years 2000 and 2015. RESULTS: The analysis of 20,567 inpatient and outpatient letters of a level 1 trauma center in Germany revealed that 5455 patients suffered 7279 injuries; 1475 of the patients were female and suffered 2035 injuries, and 3890 patients were male and suffered 5244 injuries. CONCLUSION: The results show the differences between males and females with regard to sport-specific injuries, pointing out the sex differences in the sport-specific area in relation to the body region.

[Femoral neck stress fracture in a young runner - a rare but severe injury]. / Laterale Schenkelhalsstressfraktur eines 29-jährigen Marathonläufers ­ eine seltene und risikobehaftete Überlastungsfraktur des Sportlers.

A 29-year-old athlete suffered from vague hip pain during the preparation for a marathon competition. During the competition, severe pain forced him to drop out after 29 kilometres. He underwent conventional x-rays immediately, which showed a displaced lateral fracture of the femoral neck. The fracture was immediately treated with a dynamic hip screw. A few days later, the patient was discharged. He returned to sport upon completion of treatment. Vague hip pain after exercise may be an indicator for a rare stress fracture of the femoral neck and should be taken into consideration in athletes. Delayed diagnostic investigation and treatment reduce return-to-sport rates and outcomes.

An Analysis of Sport-Specific Pain Symptoms through Inter-Individual Training Differences in CrossFit.

BACKGROUND: CrossFit is one of the fastest growing "high-intensity functional training" methods in recent years. Due to the very demanding motion sequences and high loads, it was initially assumed that there was an extremely high risk of injury. However, studies have shown that injury rates are given between 0.74-3.3 per 1000 h of training, which is not higher than in other individual sports such as weightlifting. The purpose of the study was to estimate the type of pain symptoms that are directly related to CrossFit, to estimate the frequency of injuries that occur within a population of recreational CrossFit athletes, and, finally, to identify the factors influencing the frequency of pain during CrossFit training. METHODS: A total of 414 active CrossFit athletes completed an online survey inclusive of 29 items focusing on individual physical characteristics and training behavior, as well as simultaneous or previously practiced sports. RESULTS: There was a significantly higher proportion of knee pain in athletes who had previously or simultaneously played another sport (p = 0.014). The duration, intensity, or type of personal training plan developed, along with personal information such as age, gender, or BMI, had no significant influence on the pain data. We could not find any significant variance between the groups that we formed based on the differently stated one-repetition max (RMs). There were differences in athletes who stated that they did specific accessory exercises for small muscle groups. Above all, athletes performing exercises for the hamstrings and the gluteus medius indicated fewer pain symptoms for the sacro-iliac joint (SIJ)/iliac and lower back locations. CONCLUSIONS: It is important not to see CrossFit as a single type of sport. When treating a CrossFit athlete, care should be taken to address inter-individual differences. This underlines the significant differences of this study between the individual athletes with regard to the ability to master certain skills or their previous sporting experience. The mere fact of mastering certain exercises seems to lead to significantly more pain in certain regions. In addition, there seems to be a connection between the previous or simultaneous participation in other sports and the indication of pain in the knee region.

Bilateral Proximal Humerus Fracture - a Rare Combination with a High Complication Rate after Surgery. / Die beidseitige proximale Humerusfraktur ­ eine seltene Kombination mit hoher Komplikationsrate nach operativer Versorgung.

INTRODUCTION: Bilateral acute proximal humerus fractures are rare. There are no data available about these bilateral injuries. The aim of the study was to analyse bilateral proximal humerus fractures retrospectively in terms of incidence, complications and revisions. METHODS: All bilateral proximal humerus fractures were evaluated retrospectively using the institution's database, with the focus on cause of the injury, fracture severity and the clinical course compared to published information on monolateral proximal humerus fractures. Bilateral posterior dislocation fractures were excluded, because these fractures are a separate entity. RESULTS: Between 2005 and 2016, n = 17 patients were primarily treated within our hospital for an acute proximal humerus fracture on both sides (n = 12 female, n = 5 male, average age: 68 years; overall 34 proximal humerus fractures). The general trauma mechanism was a fall on both arms (82% [18% polytrauma]). There were 65% displaced 3-/4-part proximal humerus fractures. Angle-stable plate osteosynthesis was performed predominantly (64%), followed by fracture prosthesis (18%; tension wiring: 3%; non-operatively: 15%). Overall, n = 10 patients (59%) or n = 18 (53%) proximal humerus fractures developed a complication, primarily with loss of reduction or implant loosening (44%). In n = 14 (78%) of the complications further operations were necessary. Alcohol abuse was increasingly found in 29% of the cases within the bilateral patient cohort compared to patients with monolateral fractures. CONCLUSION: Bilateral proximal humerus fractures are mainly associated with comminuted displaced fractures and a higher complication rate in comparison to monolateral fractures after surgical treatment.