Heterotopic Ossification in High-Energy Wartime Extremity Injuries: Prevalence and Risk Factors

2009 ◽  
Vol 91 (5) ◽  
pp. 1084-1091 ◽  
Author(s):  
Jonathan Agner Forsberg ◽  
Joseph M Pepek ◽  
Scott Wagner ◽  
Kevin Wilson ◽  
James Flint ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heterotopic Ossification ◽  
High Energy ◽  
Extremity Injuries

scholarly journals Heterotopic Ossification following Total Elbow Arthroplasty in a Patient with Parkinson’s Disease: Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Ajay Shah ◽  
Michael Uy ◽  
James R. Yan ◽  
Moin Khan ◽  
Bashar Alolabi
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Literature Review ◽  
Heterotopic Ossification ◽  
High Energy ◽  
Total Elbow Arthroplasty ◽  
Heterotopic Bone ◽  
Elbow Arthroplasty ◽  
Elbow Motion

Introduction. Heterotopic ossification (HO) usually develops following surgery or trauma. Risk factors for HO following elbow fractures include delay to surgery (>7 days), floating fractures, and elbow subluxation. Systemic risk factors for HO include male sex; concurrent cranial, neurological, or abdominal injury; high-energy trauma; previous development of HO; and contralateral fracture. To date, no studies have reported on Parkinson’s disease (PD) as a risk factor for the development of HO. Case Presentation. A 68-year-old female with PD (treated with levodopa-carbidopa) sustained a right closed (OTA type A3) distal humerus fracture and was treated with a total elbow arthroplasty. Postoperatively, development of significant near-ankylosing HO was observed and contributed to significant restriction of elbow motion with activities of daily living. After HO maturation, the osseous growth was excised, and the area irradiated. The patient regained excellent elbow motion with no recurrence of HO. Discussion. A literature review revealed six cases of HO development in PD patients following arthroplasty. Patients with PD have higher serum concentrations of interleukins (IL) and tumor necrosis factor- (TNF-) α. These factors stimulate BMP-2 production which may promote osteogenesis. Levodopa-carbidopa may also influence HO through stimulation of growth hormone and IGF-1. Conclusion. Parkinsonism may promote heterotopic bone growth through the release of osteoinductive factors. HO development may also be mediated by levodopa-carbidopa therapy. Future research should highlight the link between HO and PD and identify if prophylaxis is warranted in PD patients undergoing arthroplasty.

Risk Factors and Outcomes From All-Terrain Vehicle Injuries Compared With Motor Vehicle Collisions in Children

2019 ◽  
Vol 58 (11-12) ◽  
pp. 1255-1261
Author(s):  
Sriram Ramgopal ◽  
Natan Cramer ◽  
Barbara A. Gaines ◽  
Kavitha A. Conti
Keyword(s):  
Risk Factors ◽  
Household Income ◽  
Motor Vehicle ◽  
Multivariable Analysis ◽  
Risk Groups ◽  
Median Household Income ◽  
Motor Vehicle Collisions ◽  
Vehicle Collisions ◽  
Targeted Interventions ◽  
Extremity Injuries

We compared risk factors and outcomes of children injured from all-terrain vehicle (ATV) injuries to those injured from motor vehicle collisions (MVC). We reviewed records of patients ≤18 years of age admitted to a trauma center with ATV- or MVC-related injuries between January 1, 2000, and December 31, 2015. Demographics were compared using logistic regression. Rates of injuries were compared using χ2 tests. Of 6293 patients, 1140 (18%) ATV and 5153 (82%) MVC events were identified. In multivariable analysis (adjusted odds ratio [aOR], 95% confidence interval [CI]), patients with ATV-related injuries occurred more at older age (≥12 years; aOR = 4.29, 95% CI = 3.20-5.77), in rural counties (aOR = 3.72, 95% CI = 2.62-5.28), in regions with lower median household income (aOR = 1.37, 95% CI = 1.03-1.83), and in the spring (aOR = 2.44, 95% CI = 1.87-3.18), and summer (aOR = 2.50, 95% CI = 1.93-3.25) compared with winter. ATV-related injuries occurred less frequently among females (aOR = 0.76, 95% CI = 0.65-0.89). Upper extremity injuries were associated with ATV-related injuries ( P ≤ .001). Findings may facilitate identification of at-risk groups for targeted interventions.

Risk Factors for the Development of Heterotopic Ossification in Operatively Treated Terrible Triad Injuries

2020 ◽  
Vol 29 (4) ◽  
pp. e146
Author(s):  
Jennifer Tangtiphaiboontana ◽  
Julie Agel ◽  
Daphne Beingessner ◽  
Jonah Hébert-Davies
Keyword(s):  
Risk Factors ◽  
Heterotopic Ossification ◽  
Terrible Triad

Incidence and risk factors for heterotopic ossification following periprosthetic joint infection of the hip

2019 ◽  
Vol 139 (9) ◽  
pp. 1307-1314 ◽  
Author(s):  
Thomas Rosteius ◽  
Valentin Rausch ◽  
Simon Pätzholz ◽  
Sebastian Lotzien ◽  
Hinnerk Baecker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heterotopic Ossification ◽  
Periprosthetic Joint Infection ◽  
Joint Infection

scholarly journals The Potential Therapeutic Value of Medicinal Plants in the Management of Metabolic Disorders

Molecules ◽  
2020 ◽  
Vol 25 (11) ◽  
pp. 2669 ◽  
Author(s):  
Trevor T. Nyakudya ◽  
Thulani Tshabalala ◽  
Rachael Dangarembizi ◽  
Kennedy H. Erlwanger ◽  
Ashwell R. Ndhlala
Keyword(s):  
Risk Factors ◽  
Medicinal Plants ◽  
South African ◽  
Health Benefits ◽  
Well Being ◽  
High Energy ◽  
Biologically Active ◽  
Potential Health ◽  
Increased Risk ◽  
The Impact

Metabolic syndrome (MetS) is a prevalent, multifactorial and complex disease that is associated with an increased risk of developing diabetes and other major cardiovascular complications. The rise in the global prevalence of MetS has been attributed to genetic, epigenetic, and environmental factors. The adoption of sedentary lifestyles that are characterized by low physical activity and the consumption of high-energy diets contributes to MetS development. Current management criteria for MetS risk factors involve changes in lifestyle and the use of pharmacological agents that target specific biochemical pathways involved in the metabolism of nutrients. Pharmaceutical drugs are usually expensive and are associated with several undesirable side effects. Alternative management strategies of MetS risk factors involve the use of medicinal plants that are considered to have multiple therapeutic targets and are easily accessible. Medicinal plants contain several different biologically active compounds that provide health benefits. The impact of phytochemicals present in local medicinal plants on sustainable health and well-being of individuals has been studied for many years and found to involve a plethora of complex biochemical, metabolic, and physiological mechanisms. While some of these phytochemicals are the basis of mainstream prescribed drugs (e.g., metformin, reserpine, quinine, and salicin), there is a need to identify more medicinal plants that can be used for the management of components of MetS and to describe their possible mechanisms of action. In this review, we assess the potential health benefits of South African ethnomedicinal plants in protecting against the development of health outcomes associated with MetS. We aim to provide the state of the current knowledge on the use of medicinal plants and their therapeutically important phytochemicals by discussing the current trends, with critical examples from recent primary references of how medicinal plants are being used in South African rural and urban communities.

scholarly journals The Development of Heterotopic Ossification Following Ankle Fracture Syndesmotic Screw Fixation

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0044
Author(s):  
Benjamin R. Williams ◽  
Paul M. Lafferty
Keyword(s):  
Risk Factors ◽  
Heterotopic Ossification ◽  
Ankle Fracture ◽  
Screw Fixation ◽  
Low Energy ◽  
Ankle Fractures ◽  
Factors Associated ◽  
Syndesmotic Screw ◽  
The Mean

Category: Ankle, Trauma Introduction/Purpose: Syndesmotic fixation with screws is commonly used for ankle fractures with syndesmotic disruption. Few studies have reported the development of heterotopic ossification (HO) within the syndesmosis following ankle injuries, which may lead to abnormal joint kinematics and even joint synostosis. However, there is little data on the prevalence and on the risk factors associated with the development of HO. The purpose of this study is to determine the (1) prevalence and (2) risk factors associated with the development of HO within the distal tibiofibular syndesmosis following ankle fractures requiring syndesmotic fixation. We hypothesized that screws within the syndesmosis articulation and broken screws would be associated with a higher incidence of HO than extraarticular and intact screws, respectively. Methods: A retrospective review was conducted for patients who sustained an ankle fracture with syndesmotic disruption. Inclusion criteria: age between 18 and 65 years old, a closed ankle fracture treated operatively with syndesmotic screw fixation. Exclusion criteria: additional lower extremity injury, history of prior ankle fracture, lack of radiographic follow-up and fixation other than 1 or 2 syndesmosis screws. Medical records were reviewed for: age, sex, high or low energy injury mechanism, smoking status, diabetes, BMI, perioperative complications, and further procedures. Fractures were classified by Lauge-Hansen and Weber systems. Immediate postoperative radiographs were reviewed for the number of syndesmotic screws, whether screws were intraarticular or extraarticular and the number of cortices each screw crossed. Final postoperative radiographs were reviewed for retention or screw removal and the presence of HO. The presence of HO was defined as new or increased bone formation within the syndesmosis compared to immediate postoperative radiographs. Results: Included were 264 patients, mean radiographic follow-up of 10.5+/-10.2 months. The mean age was 39.2+/-12.6 years (38.7% female) with a mean BMI of 32.1+/-7.8. Current smokers made up 39.4% of patients and 10.6% were diabetic. The mean time to fracture fixation was 12.6+/-3.2 days and 198 patients (75%) had a low energy injury. There was no significant difference in HO formation for demographics, injury mechanism or time to fixation. Overall, HO developed in 160 patients (60.6%). There was no difference, additionally for fracture pattern, number screws or fixation construct (Table 1). HO developed in 92% of broken, 75% of loose and 44% of intact screws (P<0.001). Screws were removed in 107 patients (40.5%) with no difference in HO formation compared to patients with intact screws. Conclusion: Heterotopic ossification is commonplace following screw fixation for syndesmotic injuries with a prevalence of 60.6%. Broken screws and loosened screws are a significant risk factor for the development of HO. However, no other risk factors in this study were found to be associated with the development of HO, including intraarticular syndesmotic screw placement. Patients should be counseled on the prevalence although further research is needed to determine the effect on ankle motion and progression of post-traumatic osteoarthritis.

scholarly journals Risk factors for lower extremity injuries in young badminton players

2018 ◽  
Vol 28 (2) ◽  
pp. 28939
Author(s):  
Ang Lin Kang ◽  
Vinodhkumar Ramalingam
Keyword(s):  
Risk Factors ◽  
Lower Extremity ◽  
Limb Length Discrepancy ◽  
Ankle Injuries ◽  
Case Group ◽  
Lower Limb Injuries ◽  
Lower Extremity Injuries ◽  
Younger Age ◽  
Limb Injuries ◽  
Extremity Injuries

AIMS: Based on the limited evidence available about the intrinsic factors causing lower extremity injuries among Malaysian badminton players, this study was aimed to determine the relationship of demographic and physical characteristics to lower extremity injuries in young badminton players.METHODS: A cross-sectional study included badminton players between 14 and 24 years of age, categorized into case and control groups. Participants diagnosed with lower limb injuries were designated as cases, and those with no reported injuries were designated as controls. Personal information including demographic data, level of athlete and injury history was collected using a questionnaire. Independent t-test was used to analyze the differences between intrinsic characteristics in cases and controls. Pearson's χ2 was applied to evaluate the association between risk factors and general lower limb injuries, knee injuries and ankle injuries, with 95% confidence interval (CI). A p value of ≤0.05 was considered significant.RESULTS: A total of 106 young badminton players (83 males, 23 females) were recruited, of whom 42 participants were allocated as the case group, and 64 participants were allocated as the control group. A total of 60 lower extremity injuries were reported among the 42 players of the case group. The overall mean age of the sample was 18.7±5 years (minimum 14 years and maximum 24 years). Mean age of the participants in the case group was 16.92±2.99 years. The most common injuries reported were ankle joint injuries, followed by knee and hip injuries. Participants of the younger age group (14-19 years old) were found to have a higher risk for lower extremity injures compared to those of the older age group (20-24 years old) (odds ratio [OR], 3.39; 95%CI, 1.15-10.01; p=0.023). Increased true limb length discrepancy was identified among the participants with lower extremity injuries (OR, 4.57, 95%CI, 1.2-17.24; p=0.016) and this discrepancy was strongly associated with ankle injuries (OR, 7.25; 95%CI, 1.85-28.57; p=0.002). There was no significant relationship between lower extremity injuries and gender, limb dominance or Q-angle.CONCLUSIONS: Lower extremity injuries in young badminton players were predominantly located in ankle and knee joints. Younger age and increase in true limb length discrepancy were identified as risk factors for lower extremity injuries in the study sample.

Consumption of Foods With Higher Energy Intake Rates is Associated With Greater Energy Intake, Adiposity, and Cardiovascular Risk Factors in Adults

2020 ◽  
Author(s):  
Pey Sze Teo ◽  
Rob M van Dam ◽  
Clare Whitton ◽  
Linda Wei Lin Tan ◽  
Ciarán G Forde
Keyword(s):  
Risk Factors ◽  
Body Composition ◽  
Energy Density ◽  
Energy Intake ◽  
Disease Risk ◽  
Asian Population ◽  
High Energy ◽  
High Energy Density ◽  
Intake Rate ◽  
Eating Rate

ABSTRACT Background Both high energy density and fast eating rates contribute to excess energy intakes. The energy intake rate (EIR; kcal/min) combines both the energy density (kcal/g) and eating rate (g/min) of a food to quantify the typical rate at which calories of different foods are ingested. Objectives We describe the EIRs of diets in a multi-ethnic Asian population, and examine relationships between the consumption of high-EIR foods and total energy intake, body composition, and cardio-metabolic risk factors. Methods Diet and lifestyle data from the Singapore Multi-Ethnic Cohort 2 (n = 7011; 21–75 y), were collected through interviewer-administrated questionnaires. The EIR for each of the 269 foods was calculated as the product of its eating rate and energy density. Multivariable models were used to examine associations between the relative consumption of foods with higher and lower EIRs and energy intake, body composition, and cardio-metabolic risks, after adjusting for age, sex, ethnicity, education level, physical activity, smoking status, and alcohol drinking status. Results Individuals with higher daily energy intakes and with obesity consumed a significantly larger percentage of their energy from high-EIR foods, with a smaller relative intake of lower-EIR foods. Individuals with raised serum cholesterol also consumed a significantly higher proportion of high-EIR foods, whereas those without hypertension consumed a larger percentage of energy intake from low-EIR foods. Individuals classified as having a “very high” dietary EIR had a significantly 1.3 kg higher body weight (95% CI, 0.2–1.5; P = 0.013), 0.4 kg/m2 higher BMI (95% CI, 0.03–0.8; P = 0.037), and 1.2 cm larger waist circumference (95% CI, 0.2–2.2; P = 0.010), and were more likely to have abdominal overweight (OR, 1.3; 95% CI, 1.1–1.5; P &lt; 0.001) than those with a “low” dietary EIR. Conclusions Comparing foods by their EIRs summarizes the combined impact of energy density and eating rate, and may identify foods and dietary patterns that are associated with obesogenic eating styles and higher diet-related cardiovascular disease risk in an Asian population.

scholarly journals Incidence and Risk Factors of Upper Extremity Injuries in Young Adult Men: A Nationwide Registry-Based Study of 128,714 Conscripts

2019 ◽  
Vol 185 (3-4) ◽  
pp. e487-e494
Author(s):  
Harri Pihlajamäki ◽  
Arttu Silvennoinen ◽  
Paavo-Ilari Kuikka ◽  
Tiina Luukkaala ◽  
Heikki Kröger ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Incidence Rate ◽  
Upper Extremity ◽  
Body Mass ◽  
Shoulder Joint ◽  
Military Service ◽  
Young Men ◽  
Joint Dislocation ◽  
Extremity Injuries

Abstract Introduction Injuries are the major cause of morbidity and loss of active training days in military populations. Previous investigations have mainly focused on lower extremities. This study evaluated the incidence, diagnosis, and risk factors of upper extremity injuries requiring hospitalization in a large cohort of Finnish conscripts during a 5-year period. Materials and Methods A total of 128,714 male military conscripts, who served 6–12 months in compulsory military service, were studied. Injury hospitalization data were obtained from the National Hospital Discharge Register. The main outcome variables were hospitalization due to any injuries to the upper extremity and hospitalization due to traumatic shoulder dislocation. Background variables for risk factor analysis included length of military service, age, body height and weight, body mass index, and physical fitness. Results Overall person-based incidence rate for hospitalization due to upper extremity injury was 743 (95% confidence interval [CI]: 697–791) per 100,000 conscripts per year. Shoulder joint dislocation was the most common injury: incidence rate of 103 (95% CI: 86–122) per 100,000 conscripts per year. Trend during follow-up years 1998–2002 was decreasing concerning on any upper extremity injuries (odd ratios [OR] 0.90; 95% CI: 0.86–0.95, P &lt; 0.001). Body mass index &gt; 25 increased a risk for any injuries of the upper extremity (OR 1.29; CI 95%: 1.10–1.51) and, especially, for shoulder joint dislocation (OR 1.88; CI 95%: 1.26–2.80). Conclusions Overweight young men were at greater risk for upper extremity injuries. The incidence rate of traumatic shoulder joint dislocation was considerably higher than reported previously. In conclusion, preventive measures such as reducing the body weight of overweight young men should play an important role in reducing the incidence of upper extremity injuries.

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