Body fatness and increased injury rates in high school football linemen.

OBJECTIVE: To determine whether associations exist between body fatness and injury rates in high school football linemen. DESIGN: Prospective, injury surveillance study during a 2-week preseason and 10-week regular season. SETTING: 10 public high schools in Texas. PARTICIPANTS: Two hundred fifteen varsity and junior varsity high school football linemen. MAIN OUTCOME MEASURES: Injury rates (injuries per 1000 hours of playing time) for groups of players above a given body fat level and at or below a given body fat level. Rates were computed as the number of injuries per group divided by the group's aggregate playing time (practice + game time). The null hypothesis was that there is no difference in injury rates between players above a given level of body fat and those at or below that level of body fat. Body fat was determined from chest, abdomen, and thigh skinfold measurements using standard conversion equations. Body mass index (BMI) (kg/m2) was also calculated for each player. RESULTS: The overall injury rate was 5.66 injuries per 1000 hours of playing time. Percent body fat ranged from 9.3% to 40.2%. BMI ranged from 19.9 to 46.6 kg/m2. Sixty-seven players sustained 86 injuries, the most common of which were ankle sprains and medial collateral ligament sprains. No difference in overall injury rates between higher and lower fat groups was seen at any body fat level. Players in higher body fat groups, however, had significantly greater lower extremity injury rates than did players in lower fat groups between 18% and 27% body fat and again 32% to 33%, but not at intermediate levels or >33%. Players in higher BMI groups had significantly greater lower extremity injury rates than did players in lower BMI groups throughout the range from 24 to 36 kg/m2, except at 34 kg/m2. CONCLUSION: Both higher body fatness and BMI were associated with increased rates of lower extremity injury among high school football linemen. BMI appears to be associated more consistently with increased lower extremity injury rates than is body fat.

Market research guides an RN recruitment/retention campaign.

A 600-bed metropolitan hospital reduced agency nurse fees by $2.5 million a year by using market research to determine and produce the most effective advertising messages and media for its nurse recruitment/retention marketing effort.

Results of treatment using the Hoffmann external fixator for fractures of the tibial diaphysis.

External fixation via the Hoffmann apparatus was employed as primary treatment in 19 patients and as secondary treatment in eight patients. These were severe fractures: almost all were open, comminution was present in 66%, 50% were classified as Grade III, and 50% had other orthopedic injuries. The majority of patients had delayed unions. Overall, three nonunions (13%) resulted, yet the malunion rate was 39%. Forty-five per cent of patients required a bone graft for eventual union. Fifty per cent had drainage from their pin tracts yet only two required debridement and all eventually resolved. Almost one half of the patients had neurologic impairment, primarily because of severe compartment syndromes (all in open fractures, all treated with fasciotomies) and four major vascular injuries. The most common neurologic sequela was footdrop, found in eight patients. The Hoffmann fixator is valuable, but only in severe injuries, as complications do occur which might be avoided with simpler methods of treatment.