Technische Neuerungen (z. B. Werkstoff Carbon, Scheibenbremsen, Stosdampfer, Schaltgetriebe) und ein verandertes Freizeitverhalten haben in der letzten Dekade zu erheblichen Veranderungen im Radsport gefuhrt. Wahrend der ambitionierte Freizeitfahrer noch vor wenigen Jahrzehnten primar am Erholungswert in der Natur beim Radfahren interessiert war, dominieren bei mittlerweile zahlreichen Freizeitsportler aller Altersklassen Leistungsanspruch und der Wunsch nach permanenter Selbstoptimierung. Gleichzeitig haben sich die Hersteller dem unterschiedlichen Anforderungsprofil ihrer Kunden angepasst: Neben den beiden traditionellen extremen Radformen, dem Rennrad und dem Mountainbike, existiert mittlerweile eine Vielzahl von Zwischen- und Ausfuhrungsstufen: Trekking, Cyclocross, Gravel, Fullsuspension, Singletrail, Hardtail, Downhill, Fatbike etc. Fur Radbegeisterte, die aufgrund individueller Leistungseinschrankungen nicht mehr in der Lage sind, ihrem Anspruch nachzukommen, wurden vor wenigen Jahren elektrogetriebene Rader (E-Bikes, Pedelecs) auf den Markt gebracht. Diese erfreuen sich zunehmender Beliebtheit, fuhren jedoch zu einem Anstieg an Unfallen und Verletzungen. Der vorliegende Beitrag fasst die wesentlichen sportmedizinisch relevanten Auswirkungen dieser Entwicklungen zusammen.

[Current trends and injuries in cycling: faster, further, e-bike?]

The objective of this systematic review is to investigate changes in the epidemiology of major trauma presentations during the implementation of movement restriction measures to manage the first wave of the SARS-CoV-2 (COVID-19) pandemic.A systematic search in six databases, as well as a search of grey literature was performed from January 2020 to August 2021. Estimates were pooled using random-effects meta-analysis. The certainty of evidence was rated according to the GRADE approach. The review is reported using both PRISMA guideline and the MOOSE checklist.In total, 35 studies involving 36,987 patients were included. The number of major trauma admissions overall decreased during social movement restrictions (-24%; p < 0.01; 95% CI [-0.31; -0.17]). A pooled analysis reported no evidence of a change in the severity of trauma admissions (OR:1.17; 95%CI [0.77, 1.79], I2 = 77%). There was no evidence for a change in mortality during the COVID-19 period (OR:0.94, 95%CI [0.80,1.11], I2 = 53%). There was a statistically significant reduction in motor vehicle trauma (OR:0.70; 95%CI [0.61, 0.81], I2 = 91%) and a statistically significant increase in admissions due to firearms and gunshot wounds (OR:1.34; 95%CI [1.11, 1.61], I2 = 73%) and suicide attempts and self-harm (OR:1.41; 95%CI [1.05, 1.89], I2 = 39%).Although evidence continues to emerge, this systematic review reports some decrease in absolute major trauma volume with unchanged severity and mortality during the first wave of COVID-19 movement restriction policies. Current evidence does not support the reallocation of highly specialised trauma professionals and trauma resources. Registration PROSPERO ID CRD42020224827. 

/pdf/the-epidemiology-of-major-trauma-during-the-first-wave-of-3nu0t4pf.pdf

The Epidemiology of Major Trauma During the First Wave of COVID-19 Movement Restriction Policies: A Systematic Review and Meta-analysis of Observational Studies

Aim To investigate the epidemiology of traumatic spinal cord injury (TSCI) in New Zealand over a 10-year period. Methods Ambispective data of all new patients admitted to New Zealand's two spinal rehabilitation units between January 2007 and December 2016 (n=929) were collated. Variables assessed included age at injury, gender, ethnicity, date of injury, aetiology, length of hospital stay, injury level, neurological status on discharge and discharge destination. Results The incidence of TSCI averaged 22 (95% CI 21-24) per million, increasing 6% a year. The average incidence for Māori (29 per million people (95% CI 25-34)) was 1.8 times higher than New Zealand European (16 per million people (95% CI 15-18)), and show an increase of 14% a year. The median age of TSCI increased from 43 to 48 years. Overall, falls (32%), transport (32%) and sports (22%) were the most common causes of TSCI. Cervical TSCI (54%) were most common, particularly in older adults (70% over 75 years) and Māori (61%) and Pacific Island (72%) patients. Surgical rates remained stable (77%) but length of stay in hospital decreased over the study period. Conclusions The demographic of TSCI is changing in New Zealand. The median age of patients is increasing, as is the incidence, particularly for women, older adults and Māori patients.

Epidemiology of traumatic spinal cord injury in New Zealand (2007-2016).

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Best Practices on Radiology Department Workflow: Tips from the Impact of the COVID-19 Lockdown on an Italian University Hospital

Abstract Introduction The effect of lockdown on the incidence of fractures and severe injuries has been widely studied, whereas studies regarding muscle, tendon, and ligament injuries have not received as much attention. The aim of the study was to investigate the effect of the lockdown and later regional regulations due to the COVID pandemic on the incidence of muscle, tendon, and ligament injuries and related surgical procedures. Materials and methods This study focuses on the working-age population in the catchment areas of three major Finnish hospitals. Patients were divided into three age groups 18–34, 35–50 and 51–65 years of age. Suitable injuries were retrieved from the data using appropriate ICD-10 codes and procedure codes. The monthly incidence rate ratio (IRR), with 95% confidence intervals (CI), were compared between the year 2020 and the reference years 2017–2019. Results Upper and lower extremity injury ED visits decreased by 15.7 and 8.2%. For upper extremity injuries, a decrease in incidence was observed for all three age groups in March (IRR 0.52, CI 0.33–0.80), (IRR 0.53, CI 0.31–0.91), (IRR 0.60, CI 0.38–0.95), respectively. An increase in 18–34 years of age group was detected in June (IRR 1.49, CI 1.05–2.13). Lower extremity injuries decreased in 18–34 years of age group in March (IRR 0.62, CI 0.43–0.90) and April (IRR 0.60, CI 0.42–0.87). A decrease on the incidence of surgeries was observed in April for the 35–50 (IRR 0.53, CI 0.29–0.97) and 51–65 years of age groups (IRR 0.58, CI 0.34–0.98). Conclusions The nationwide lockdown in spring 2020 led to a notable decrease in the incidence of emergency department visits and the surgical treatment of muscle, tendon, and ligament injuries in Finland. 

/pdf/effect-of-national-covid-19-lockdown-on-the-incidence-of-2ziiz68c.pdf

Effect of national COVID-19 lockdown on the incidence of muscle, tendon and ligament injuries and related surgical procedures in the working-aged Finnish population

AIM Current policy direction seeks to promote participation in both recreational and active transport cycling. We evaluate cycling-related injuries resulting in hospital admission across the Midland Region of New Zealand to establish injury trends. METHOD A retrospective review of anonymised prospectively-collected trauma registry data from 1 June 2012 to 31 July 2016 in the Midland Region. Cases include patients hospitalised with cycling-related injuries. RESULTS Nine hundred and ninety-eight cyclists were admitted to hospital (2012-2016). Admission volumes increased approximately 16.8% per year, major trauma by 11.9% and non-major trauma by 17.8%. Overall, 66.7% of admissions were for people aged over 20 years and 73.4% were for males. The participation-adjusted annual injury rate was 78.4 per 100,000. This masked considerable variation by gender, age group and injury severity. CONCLUSION Hospital admission volumes and rates are rising with underlying variation in patient demography, place and severity of injury. Current policy direction to grow cycling participation based on the health, environmental and economic benefits is ahead of the implementation of safer cycling infrastructure, creating a timing lag. From a regional hospital-based trauma service perspective, this timing lag needs due consideration if the full benefits of increasing participation are to be realised.

Cycling-related injuries and cycling promotion: a trauma service perspective.

AIM: To assess the effects of the community lockdown phases on trauma-related admissions to Midland region hospitals over the period 15 February to 10 July 2020, and to compare volume variation with the same period in the previous three years METHODS: A retrospective, descriptive study of prospectively collected data from the Midland Trauma Registry in New Zealand RESULTS: There was a 36 7% (p< 00001) reduction in injury admissions during Alert Level 4 ('Lockdown') compared with the same period in 2017, 2018 and 2019 This was in the context of volume increases during the pre-lockdown period (17 8%, p< 00001) and a 'rebound' as restrictions eased There was an increase in injuries occurring at home (28 3%, p< 00001) and on footpaths (37 9%, p=0 00076), while there was a decline in events on roads (33 0%, p=0 017), at schools (75 0%, p< 00001) and in sports areas (79 7%, p< 00001) Falls remained the dominant mechanism of injury in 2020, contributing 39 9% of all hospitalisations CONCLUSIONS: The reduction in hospital admissions during alert levels 4 and 3 was short lived, with a rebound evident when restrictions eased Hospital resources have been strained because this rebound coincided with a planned 'catch up' on healthcare that was delayed during the higher community restriction levels Alternate abstract:The reduction in trauma hospital admissions during alert levels 4 and 3 was short lived, with a 'rebound' evident when restrictions eased across the Midland region Hospital resources have been strained as this rebound coincided with a planned 'catch up' on healthcare delayed during the higher community restriction levels

Neerja Singh

Papers

Cycling-related injuries and cycling promotion: a trauma service perspective.

Admission to hospital for injury during COVID-19 alert level restrictions