Australian Football (AF) is a popular sport in Australia, with females now representing one-third of participants. Despite this, the injury profiles of females versus males in largely unknown. The current study investigated fractures, dislocations and tendon ruptures in females versus males presenting to emergency departments (ED) with an AF injury. All patients, regardless of age, presenting to one of 10 EDs in Victoria, Australia, with an AF injury were included. Data were prospectively collected over a 10-month period, coinciding with a complete AF season. Data were extracted from patient medical records regarding injury-type, body-part injured and treatments required. Female and male data were compared with chi-squared tests. Of the 1635 patients presenting with an AF injury, 595 (36.0%) had a fracture, dislocation or tendon rupture, of whom 85 (14.3%) were female and the average age was 20.5 years (SD 8.0). Fractures accounted for most injuries (n=478, 80.3% of patients had a fracture), followed by dislocations (n=118, 19.8%) and tendon ruptures (n=14, 2.4%). Upper limb fractures were more common than lower limb fractures (71.1% v 11.5% of fractures). Females were more likely to fracture their hands or fingers than males (45.7% v 34.3%). Males were more likely to fracture ribs (5.4% v 0%). Most fractures (91.2%) were managed in the ED, with the remainder being admitted for surgery (GAMP/ORIF). Males were more likely to be admitted for surgery than females (11.2% v 5.9%). Regarding dislocations (n=118), females were more likely to dislocate the patella (36.8% v 8.1% of dislocations). Only males sustained a tendon rupture (n=14): finger extensor or flexor (57.1%), achilles tendon (28.6%) and patella tendon (14.3%). Orthopaedic AF injuries are common presentations to EDs in Victoria, though few require specialist orthopaedic intervention. Injury profiles differed between genders suggesting that gender specific injury prevention and management might be required.
Subject-specific finite element models (FEMs) allow for a variety of biomechanical conditions to be tested in a highly repeatable manner. Accuracy of FEMs is improved by mapping density using quantitative computed tomography (QCT) and choosing a constitutive relationship relating density and mechanical properties of bone. Although QCT-derived FEMs have become common practice in contemporary computational studies of whole bones, many density-modulus relationships used at the whole bone level were derived using mechanical loading of small trabecular or cortical bone cores. These cores were mechanically loaded to derive an apparent modulus, which is related to each core's mean apparent or ash density. This study used these relationships and either elemental or nodal material mapping strategies to elucidate optimal methods for scapular QCT-FEMs. Six cadaveric scapulae (3 male; 3 female; mean age: 68±10 years) were loaded within a micro-CT in a custom CT-compatible hexapod robot Pre- and post-loaded scans were acquired (spatial resolution = 33.5 µm) and DVC was used to quantify experimental full-field displacements (BoneDVC, Insigneo) (Figure 1).. Experimental reaction forces applied to the scapulae were measured using a 6-DOF load cell. FEMs were derived from corresponding QCT scans of each cadaver bone. These models were mapped with one of fifteen density-modulus relationships and elemental or nodal material mapping strategies. DVC-derived BCs were imposed on the QCT-FEMs using local displacement measurements obtained from the DVC algorithm. Comparisons between the empirical and computational models were performed using resultant reaction loads and full-field displacements (Figure 2).Introduction
Methods
In revision hip surgery, Type IIIB femurs have presented the greatest historical challenge to achieving stable fixation and osseous integration. This study evaluated the intermediate term outcome of a modular, tapered, distal fixation revision femoral component used in a consecutive revision hip series with special attention to its performance in the defective Type IIIB femur. Between February 2002 and January 2005, 51 consecutive revision hip arthroplasties were performed using modular, tapered, distal fixation femoral components. The femoral defects at the time of revision surgery were classified using a system previously described by Paprosky. The most recent radiographs were reviewed and clinic notes examined to assess femoral component stability.Purpose
Methods
