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    Epidemiology and associated injury risk factors in figure skating: A systematic review
    (Elsevier BV, 2025-07)
    Natasha T. Schmidt
    ;
    Dina C. Janse van Rensburg
    ;
    Marlene Schoeman
    ;
    BESOMI MOLINA, MANUELA  
    ;
    Audrey Jansen van Rensburg
      1Scopus© Citations 4
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    The Presence of Associated Injuries in Pediatric Radial Neck Fractures: A Systematic Review of the Literature and Meta-Analysis of Pooled Individual Patient Data
    (MDPI AG, 2025-02-27)
    Lisette C. Langenberg
    ;
    Joyce L. Benner
    ;
    Nazira Bernal Bader  
    ;
    Christiaan J. A. van Bergen
    ;
    Joost W. Colaris
    <jats:p>Background: Pediatric radial neck fractures (pRNFs) can occur in isolation or in association with concomitant injuries. It is unknown whether the presence of associated injuries should influence the choice of treatment. The aim of this study is to assess the incidence of associated injuries in pRNF and their correlation with fracture angulation (Judet grade) or the patient’s age (under or over ten years of age). Methods: A systematic literature review was performed following PRISMA-IPD guidelines, including case series on pRNF with a minimum of five cases of children until 16 years of age. The quality assessment included a risk of bias analysis and evaluation using the MINORS criteria. Individual patient data on age, Judet classification and associated injuries were extracted from the included studies and pooled for the meta-analysis. The correlation between the presence of associated injury and the patient’s age or Judet classification was depicted in two forest plots. Results: A total of 20 articles published sufficient individual patient data (n = 371) on associated injuries. All but one were retrospective case series. Fifteen articles had MINORS scores of 8 or higher. The incidence of associated injuries was 33% (123 of 371 cases). Almost half of the associated injuries included an olecranon fracture (61/123). There was no correlation between Judet classification (p = 0.243) and incidence nor between patient age and the incidence of associated injuries (p = 0.694). Conclusions: Surgeons should be aware of potential associated injuries in over a third of pRNF cases, regardless of the patient’s age or fracture angulation. Deduction of the trauma mechanism may be a more useful tool for assessing the potential presence of associated injuries than the most frequently used fracture classification or the patient’s age. More research is needed regarding the requirements for enhanced diagnostic imaging, specific treatment or follow-up adaptations in children with pRNFs and associated injuries.</jats:p>
      4Scopus© Citations 1
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    Variations in management of A3 and A4 cervical spine fractures as designated by the AO Spine Subaxial Injury Classification System
    (2022)
    Barry Ting Sheen Kweh
    ;
    Jin Wee Tee
    ;
    Sander Muijs
    ;
    F. Cumhur Oner
    ;
    Klaus John Schnake
    <jats:sec> <jats:title>OBJECTIVE</jats:title> <jats:p>Optimal management of A3 and A4 cervical spine fractures, as defined by the AO Spine Subaxial Injury Classification System, remains controversial. The objectives of this study were to determine whether significant management variations exist with respect to 1) fracture location across the upper, middle, and lower subaxial cervical spine and 2) geographic region, experience, or specialty.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>A survey was internationally distributed to 272 AO Spine members across six geographic regions (North America, South America, Europe, Africa, Asia, and the Middle East). Participants’ management of A3 and A4 subaxial cervical fractures across cervical regions was assessed in four clinical scenarios. Key characteristics considered in the vignettes included degree of neurological deficit, pain severity, cervical spine stability, presence of comorbidities, and fitness for surgery. Respondents were also directly asked about their preferences for operative management and misalignment acceptance across the subaxial cervical spine.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>In total, 155 (57.0%) participants completed the survey. Pooled analysis demonstrated that surgeons were more likely to offer operative intervention for both A3 (p &lt; 0.001) and A4 (p &lt; 0.001) fractures located at the cervicothoracic junction compared with fractures at the upper or middle subaxial cervical regions. There were no significant variations in management for junctional incomplete (p = 0.116) or complete (p = 0.342) burst fractures between geographic regions. Surgeons with more than 10 years of experience were more likely to operatively manage A3 (p &lt; 0.001) and A4 (p &lt; 0.001) fractures than their younger counterparts. Neurosurgeons were more likely to offer surgical stabilization of A3 (p &lt; 0.001) and A4 (p &lt; 0.001) fractures than their orthopedic colleagues. Clinicians from both specialties agreed regarding their preference for fixation of lower junctional A3 (p = 0.866) and A4 (p = 0.368) fractures. Overall, surgical fixation was recommended more often for A4 than A3 fractures in all four scenarios (p &lt; 0.001).</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>The subaxial cervical spine should not be considered a single unified entity. Both A3 and A4 fracture subtypes were more likely to be surgically managed at the cervicothoracic junction than the upper or middle subaxial cervical regions. The authors also determined that treatment strategies for A3 and A4 subaxial cervical spine fractures varied significantly, with the latter demonstrating a greater likelihood of operative management. These findings should be reflected in future subaxial cervical spine trauma algorithms.</jats:p> </jats:sec>
      17Scopus© Citations 3
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    Scopus© Citations 6  5
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      29
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    Evidence-Based Treatment Algorithm for Freiberg Disease
    (2023)
    Ichiro Yoshimura
    ;
    Masato Takao
    ;
    WAGNER HITSCHFFELD, EMILIO  
    ;
    Sjoerd Stufkens
    ;
    Jari Dahmen
    <jats:p> Freiberg disease is a type of osteonecrosis of the metatarsal head that predominantly occurs in young females and adolescents, although it may occur at any age. The pathophysiology is multifactorial and may involve trauma, altered foot biomechanics, systemic disorders, and arterial insufficiency. The most typical location is the second metatarsal head, but Freiberg disease may also occur in other lesser toes. Nonoperative treatment is best applied in the early stage of the disease; if this is ineffective, surgical treatment is recommended. Currently available surgical procedures include debridement, osteotomy, osteochondral grafting, microfracture, interposition arthroplasty, implant arthroplasty, and metatarsal shortening arthroplasty. In this article, we propose a treatment algorithm for Freiberg disease based on the current literature and expert opinion. </jats:p>
    Scopus© Citations 9  1
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      7Scopus© Citations 8
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    Frequency of Injury and Illness in the Final 4 Weeks before a Trail Running Competition
    (2021)
    Rubén Gajardo-Burgos
    ;
    Manuel Monrroy-Uarac
    ;
    René Mauricio Barría-Pailaquilén
    ;
    Yessenia Norambuena-Noches
    ;
    Dina Christa Janse van Rensburg
    <jats:p>We aimed to (i) determine self-reported injury and illness frequency in trail runners 4 weeks preceding competition; (ii) compare athletes with and without injury/illness by sex, age, body mass index (BMI) and competition distance; (iii) describe mechanism of injury, anatomical region (injury)/organ system (illness) involved, consequences of injury on preparation and self-perception of injury severity; (iv) compare anatomical region (injury) and organ system (illness) by sex. A total of 654 trail runners (age 36.2, IQR 30.6–43.0; 36.9% females) participated in this retrospective cross-sectional study by completing a self-reported questionnaire. Injury and illness frequency rates were 31.3% (n = 205, CI:27.7–35.0%) and 22.3% (n = 146, CI:19.1–25.7%), respectively. No significant difference was found between injured vs. non-injured or ill vs. non-ill study participants by sex, age, BMI and competition distance. Regarding injuries, gradual onset (41.6%) and knee (33.2%) were the most indicated mechanism and anatomical region of injury. At least 85.4% of trail runners changed their training following injury and 79% indicated that their injury would affect their competition performance. Regarding illness, the respiratory tract was the most frequent organ system involved (82.9%). Male and female participants reported similar proportions of anatomical regions (injury) and organ systems (illness) affected. These results could help to generate education strategies and appropriate medical support before and during these competitions.</jats:p>
      4Scopus© Citations 13
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      13Scopus© Citations 7
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      10Scopus© Citations 7