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W10 Injury- Road Trauma & Sports (Sports injuries (Anterior cruciate…
W10 Injury- Road Trauma & Sports
Definition
any unintentional or intentional (ie. self-harm or violence) damage to body resulting from acute exposure to thermal, mech, elec, or chem E or frm the absence of such essentials as heat or oxygen
predictable & preventable
like other conds & illnesses, ossur w/ distinct patterns within pops
Injuries are not 'accident's
Injuries are preventable
accidents= events tht are unpredictable & unpreventable
injuries result frm event tht can be predicted & prevented
can include consequences of intentional actions (ie violence)
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Haddon's Mtx
tool for designing strats to control injuries
Pre-event, Event, Post-event
Human, Vehicle/Equipment, Physical Environment, Socioeconomic Environment
Sports injuries
Shoulder dislocation
Sts tht provide stability to the shoulder
Bones: humerus, scapula, clavicle, thorax
Ligs: glenohumeral ligs, coracoacromial arch, coracoclavicular ligs, acromiovicular ligs
Muscles & tendons: rotor cuff muscles, biceps tendon complex, scapulothoracic muscles, superficial muscles
Mech of injury
Strength of ligaments providing anterior shoulder stability is exceeded, the ligs most commonly fail @ glenoid attachment
Lig detachment= Bankart lesion
Signs & symptoms of glenohumeral dislocation
extreme pain
inability to move shoulder
deformity
less pronounced in subluxation
patients describe instability w/:
"dead arm" - paralysis
"stinger" - electric shooting pain
patients are apprehensive w/ abduction & external rotation of injured arm
What imaging should be done before a reduction is attempted?
x-ray
ultrasound
CT
MRI
Management after reduction
physiotherapy for 6 weeks
immobilisation string for comfort
return to norm activities within 6-8 weeks
Concussion
Define
a disturbance in brain function caused by direct/indirect force to the head
Glasgow Coma Scale: what & how it is used in assessment
used to evaluate patient cond/status in the even of an injury
for concussion: GCS <15 - needs emergency management
Signs & symptoms suggesting a patient should be reviewed @ hospital
headache
unsteadiness
confusion
change in personality
deteriorating mental status
loss of consciousness
visible facial injury
blank look
motor incoordination
disorientation
Anterior cruciate ligament (ACL) injury
Function of ACL
ACL prevents anterior mvt of tibia off of the femur, awa hypertension of the knee
by preventing these motions: ACL provides stability to the knee joint & allow for dynamic mvt
Mech of injury of the ACL
ACL is unusually torn as a result of quick deceleration, hyperextension or rotational injury tht usually doesn't involve contact w/ another ind
this injury often occurs following a sudden change in direction: feels a pooping sensation in knee
Factors increasing the risk of ACL injury
females
cutting, pivoting and single leg landings (in sports)
previous torn ACL
direct blow to outside of the leg or knee
age ( common between age 15-45)
3 Tests tht might be done to assess the ACL
Lachman test
Anterior Drawer test
Pivot shift test
TOTAPS: toassess a simulated injury
Talk
Observe
Touch
Active mvt
Passive mvt
Skills
Findings on a clinical assessment of an ACL injury
swelling & inflamed knee
Positive Lachman test (increased anterior translation of tibia)
Positive Anterior Drawer test (tibia moves anteriorly w/o an abrupt, hard endpoint
Positive Pivot Shift test (force created by examiner cause the knee to slip)
Initial management
Protected weight bearing
Rest
Ice
Compression
Elevation
Bracing
Analgesis
Meniscal Injury
Mech of injury
meniscus can be damaged or torn during activities tht put pressure or rotate the knee
sports requiring sudden turns & stops (eg football)
presence of osteoarthritis: higher risk of injuring your knee
degeneration: common to older person
Tests to assess menisci
McMurray test
Imaging tests:
knee x-ray
ultrasound
arthroscopy
MRI
Signs & symptoms
torn meniscus: popping sound around knee joint
pain
swelling of knee
difficulty/inability in knee mvt
the feeling of your knee locking/catching
Initial management of injury
RICE (rest, ice, compression, elevation)
medication: ibuprofen, aspiring or other NSAIDs (non-steroidal anti-inflammatory drug)
physical therapy
surgery
Passive & active interventions
Passive
don't req ind to take any action
work independently of ind behaviour
eg. an airbag deploys automatically on impact
more likely to be successful than active int in preventing unintentional injuries
Active
req action on the part of the ind
eg. using appropriate protective devices while doing jobs w/ an injury risk
eg. putting on safety glasses or helmet