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Gotlieb RJ, Sorenson TJ, Borad V, Schubert W. Children in Boxing and Martial Arts Should Be Better Guarded From Facial Injuries. Craniomaxillofac Trauma Reconstr 2022; 15:104-110. [PMID: 35633771 PMCID: PMC9133516 DOI: 10.1177/19433875211016666] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVE Childhood participation in boxing and martial arts has increased over the past decade, and these activities are well-known causes of traumatic injury. We hypothesized that the face is frequently injured in the setting of pediatric boxing and martial arts trauma in the United States and that there are identifiable injury patterns. METHODS We performed a cross-sectional study of consecutive pediatric patients in the National Electronic Injury Surveillance System (NEISS) from January 1, 2010 to December 31, 2019. Patients were included in our study if they were younger than 18 years of age and evaluated in the emergency department (ED) after boxing or martial arts trauma. Primary outcome was facial injury. Other variables of interest include age, sex, ED disposition, type and location of injury. Descriptive and univariate statistics of the primary outcome were computed with these variables. RESULTS There were 4,978 total pediatric patients injured due to boxing and martial arts trauma reported by NEISS-participating EDs during the study period, and 264 patients experienced injury to the face (264/4978; 5.3%). Over 20% (n = 60) of reported facial injuries were fractures; the most fractured structure was the nose (42/60; 70), orbit (11/60; 18.3%), and mandible (6/60; 10%). Almost 20% (11/60%) of pediatric facial fractures due to boxing and martial arts trauma involved fighting a family member or friend, and a punch was the most common mode of fracture (42/58; 72.4%). CONCLUSIONS Facial injuries comprise about 5% of injuries after boxing and martial arts trauma and 22% of these facial injuries are fractures. If children choose to participate, parents, coaches, trainers, officials, and community leaders should make the greatest effort possible to minimize risk, including the mandatory use of head and face protective gear and elimination of training fighting, or "sparring."
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Affiliation(s)
| | | | - Vedant Borad
- Division of Plastic Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Warren Schubert
- Division of Plastic Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
- Department of Plastic and Hand Surgery, Regions Hospital, Saint Paul, MN, USA
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Abstract
Study Design Retrospective descriptive observational study. Purpose Skiing and snowboarding offers valuable opportunities for outdoor physical activity throughout the cold winter months, but these activities can result in substantial personally injury. This study aimed to analyze trends in skiing and snowboarding-related facial trauma epidemiology. Methods The National Electronic Injury Surveillance System (NEISS) was queried for facial trauma related to skiing and snowboarding treated in United States (US) emergency departments between 2010 and 2019. These data and weighted estimates were used to analyze patient demographics, injury location, and etiology. Results A total of 361 skiing or snowboarding-related facial injuries were recorded. Lacerations were most common injury (165/361; 45.7%), and facial fractures occurred in 21.6% (78/261) of patients. The most common facial fracture locations are the nose (38/78; 48.7%), orbit (17/78; 21.8%), and mandible (15/78; 19.2%). Pediatric patients accounted for 52% (187/361) of these injuries and had higher rates of lacerations (51.9% vs 39.1%, P < 0.05) and hospital admission (4.8% vs 1.15%, P < 0.05) than adults. Adults had a higher rate of facial fracture (30% vs 13.9%, P < 0.001) than children. Conclusions Skiing and snowboarding-related facial trauma is relatively uncommon in the US. In general, these injuries are largely decreasing, but facial fractures still occur not infrequently during these activities. Based on our data, we strongly urge helmet manufacturers to increase the availability of recreational snowsport helmets that include nose, orbit, and mandible protections, which could help to prevent many of these injuries.
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Affiliation(s)
- Thomas J. Sorenson
- Medical School, University of Minnesota, Minneapolis, MN, USA,Thomas J. Sorenson, BS, Medical School, University of Minnesota, Minneapolis, MN, USA.
| | - Vedant Borad
- Division of Plastic Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Warren Schubert
- Division of Plastic Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA,Department of Plastic and Hand Surgery, Regions Hospital, Saint Paul, Minneapolis, MN, USA,Warren Schubert, MD, Department of Plastic and Hand Surgery, Regions Hospital, Mail Stop 11503 B, 640 Jackson Street, Saint Paul, Minneapolis, MN 55101, USA.
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Zhou JJ, Shah NV, Scheer RC, Newman JM, Hariri OK, Tretiakov M, Koehler SM, Hesham K, Aibinder WR, Chapman CR. Trends and epidemiology of radial head subluxation in the United States from 2004 to 2018. Eur J Orthop Surg Traumatol 2021; 32:1137-1144. [PMID: 34363491 DOI: 10.1007/s00590-021-03089-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/26/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Increased body mass may predispose children to a greater risk for radial head subluxation (RHS). Recent studies in the literature have reported a plateau in obesity prevalence among infants and toddlers. This study sought to examine recent epidemiological trends in RHS incidence from 2004 to 2018 using the National Electronic Injury Surveillance System database to determine how obesity patterns may affect RHS incidence. METHODS The National Electronic Injury Surveillance System (NEISS) database was queried for patients 6 years of age or younger presenting with radial head subluxation between January 1, 2004 and December 31, 2018. Patient demographics, mechanisms of injury, and location of injury were recorded. RESULTS An estimated total 253,578 children 6 years or younger were treated for RHS with 14,204 (95% CI = 8124-20,284) in 2004 to 21,408 (95% CI = 12,882-29,934) in 2018. The overall annual rate of RHS per 10,000 children ≤ 6 years was 6.03 (95% CI = 4.85-7.58). The annual rate of RHS per 10,000 children ≤ 6 years increased (m = 0.200, ß = 0.802, p < 0.001) from 5.18 (95% CI 2.96-7.39) in 2004 to 7.69 (95% CI = 4.63-10.75) in 2018. The most common mechanism associated with RHS was falls (39.4%) with 103,466 (95% CI 74,806-132,125) cases. Pulls accounted for the second most common mechanism of injury, accounting for 90,146 (95% CI 68,274-112,018) cases or 36.2%. Yearly RHS incidence was compared to obesity prevalence for ages 2-5 children provided by the National Health and Nutritional Examination Survey (NHANES) surveys. Changes in obesity prevalence may visually reflect RHS incidence trends, but no causality between obesity prevalence and RHS incidence could be confirmed. CONCLUSION This study corroborated previous findings that falls and arm pulling contribute to the vast majority of RHS cases. The nonsignificant rise in RHS cases may reflect a possible plateau in obesity prevalence of children aged 2-5 years in recent years. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Jack J Zhou
- Department of Orthopedic Surgery and Rehabilitation Medicine, Downstate Medical Center, State University of New York (SUNY, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
| | - Neil V Shah
- Department of Orthopedic Surgery and Rehabilitation Medicine, Downstate Medical Center, State University of New York (SUNY, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA.
| | - Ryan C Scheer
- Department of Orthopedic Surgery and Rehabilitation Medicine, Downstate Medical Center, State University of New York (SUNY, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
| | - Jared M Newman
- Department of Orthopedic Surgery and Rehabilitation Medicine, Downstate Medical Center, State University of New York (SUNY, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
| | - Omar K Hariri
- Department of Orthopedic Surgery and Rehabilitation Medicine, Downstate Medical Center, State University of New York (SUNY, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
| | - Mikhail Tretiakov
- Department of Orthopedic Surgery and Rehabilitation Medicine, Downstate Medical Center, State University of New York (SUNY, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
| | - Steven M Koehler
- Department of Orthopedic Surgery and Rehabilitation Medicine, Downstate Medical Center, State University of New York (SUNY, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
| | - Khalid Hesham
- Department of Orthopedic Surgery and Rehabilitation Medicine, Downstate Medical Center, State University of New York (SUNY, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
| | - William R Aibinder
- Department of Orthopedic Surgery and Rehabilitation Medicine, Downstate Medical Center, State University of New York (SUNY, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
| | - Christopher R Chapman
- Department of Orthopedic Surgery and Rehabilitation Medicine, Downstate Medical Center, State University of New York (SUNY, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
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Sorenson TJ, Mohr WJ, Mahajan AY. Pediatric Hand Burns Requiring Emergency Care in the United States. J Burn Care Res 2021; 44:704-708. [PMID: 34297093 DOI: 10.1093/jbcr/irab144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Indexed: 11/12/2022]
Abstract
PURPOSE Hand and finger burns represent a relatively common occurrence in children, and serious injuries may require surgical intervention to prevent long-term disability. This study examines the epidemiological characteristics of pediatric patients presenting for emergency care of hand and finger burns within the United States (US). METHODS We report a cross-sectional study of patients reported to the National Electronic Injury Surveillance System (NEISS) from January 1, 2010 to December 31, 2019. Patients were included in our study if they were younger than 18 years old and evaluated for an isolated hand or finger burn. United States census data from the same period were utilized for determining epidemiological estimates of injury incidence. RESULTS During the 10-year study period, an estimated 300,245 pediatric hand and finger burns were treated in 778,497,380 person-years: an incidence rate of 38.6 burns per 100,000 person years. Most treated burns occurred in the 1- to 2-year age group (28.3%) with an approximate 50% reduction in incidence for each 1-year age stratum until stabilizing at 6 years. Most burns occurred in white children (58%), but Black children had a higher incidence than white children when corrected for US population (45.15 burns versus 21.45 burns per 100,000 person-years). The most common etiology was a stove or oven (1595/10420; 15%). CONCLUSIONS Pediatric hand and finger burns occurred most frequently in young children from the oven and/or stove. We urge that parents be assertively counseled about potential burn risks to their young children's hands and fingers, especially once they reach ambulatory age.
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Affiliation(s)
- Thomas J Sorenson
- Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - William J Mohr
- Department of Critical Care and Burn Surgery, Regions Hospital, Saint Paul, Minnesota, USA
| | - Ashish Y Mahajan
- Department of Plastic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Plastic Surgery, Regions Hospital, Saint Paul, Minnesota, USA
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Abstract
BACKGROUND There are little demographic data on finger dislocation injuries. This study examines the epidemiological characteristics of patients presenting for emergency care of finger dislocations within the United States. METHODS The National Electronic Injury Surveillance System was queried for finger dislocation injuries treated in US emergency departments between 2004 and 2008. Weighted estimates, in conjunction with Census data, were used to analyze patient demographics, injury locales, and incidence rates within and between, demographic groups. RESULTS During the 5-year study period, an estimated 166 561 finger dislocations were treated in 1 499 222 917 person-years: an incidence rate of 11.11 per 100 000 person-years. Males were predominantly affected (78.7%) at an incidence rate of 17.8 per 100 000. The rate in females was 4.65 per 100 000 person-years. Most dislocations occurred in the 15- to 19-year age group (38.6 dislocations per 100 000 person-years). Among racial groups, blacks (16.8) were affected more than whites (7.72) or patients characterized as "other" (4.90). In terms of injury venue, 35.9% of cases took place at a sporting or recreational facility. In addition, 44.7% of sports-related dislocations occurred while playing either basketball or football. CONCLUSIONS In the United States, finger dislocations appear to occur most often in black males 15 to 19 years of age and among sports participants, particularly basketball and football players.
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Affiliation(s)
- Elan Golan
- Maimonides Medical Center, Brooklyn, NY, USA,Elan Golan, Department of Orthopaedics, Maimonides Medical Center, 927, 49th Street, Brooklyn, NY 11219, USA.
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