Objectives: To assess the incidence, type and location of injuries sustained during the Portuguese rugby union sevens circuit. To investigate the influence of players’ training loads on injury risk. Methods: A prospective cohort study recording time-loss injuries was conducted with all teams competing in the Portuguese national rugby sevens circuit (eight from the top-tier and seven from the second-tier). Main outcome measures included: incidence rate, anatomical location, type, injury incident and severity. Data were also collected regarding players’ training loads. Fisher's exact test was used to estimate the relative risk of suffering an injury during the sevens season and training sevens during the fifteens season. Results: A total of 27 injuries were recorded corresponding to an incidence rate of 133.9 injuries per 1000 player match-hours. The average severity was 22.22 days. Contact events preceded 81.5% of injuries. Most injuries occurred in the lower limb (66.7%) and were joint/ligament or muscle/tendon injuries (85.1%). The association between injuries and lower volume of training during the sevens season was identified for the second-tier (p=0.021). For the same level, an inverse relation between training hours and injury severity was also found (p=0.008). Top-tier players training sevens and fifteens simultaneously during the year presented a significant increase of injury risk (relative risk=3.2; p=0.011). Conclusions: Injury incidence in our study is similar to that reported for international sevens, although severity is lower. An association between training loads and the occurrence of injuries was found for both tiers, although with differential results, thus reinforcing the need to customize players’ preparation. Further studies at non-elite competitions are needed to gather significant data to accurately formulate future injury prevention protocols or recommend modifications to game laws or competition formats, aiming at players’ welfare.

There is evidence that nerve flaps are superior to nerve grafts for bridging long nerve defects. Moreover, arterialized neurovenous flaps (ANVFs) have multiple potential advantages over traditional nerve flaps in this context. This paper describes a case of reconstruction of a long defect of the ulnar artery and nerve with an arterialized neurovenous free flap and presents a literature review on this subject. A 16-year-old boy sustained a stab wound injury to the medial aspect of the distal third of his right forearm. The patient was initially observed and treated at another institution where the patient was diagnosed with a flexor carpis ulnaris muscle and an ulnar artery section. The artery was ligated and the muscle was sutured. Four months later, the patient was referred to our institution with complaints of ulnar nerve damage, as well as hand pain and cold intolerance. Physical examination and ancillary tests supported the diagnosis of ulnar artery and nerve complete section. Surgery revealed an 8 cm hiatus of the ulnar artery and a 5 cm defect of the ulnar nerve. These gaps were bridged with a flow through ANVF containing the sural nerve and the lesser saphenous vein. The postoperative course was uneventful. Two years postoperatively, the patient had regained normal trophism and M5 strength in all previously paralyzed muscles according to the Medical Research Council Scale. Thermography revealed good perfusion in the right ulnar angiosome. The ANVF may be an expedite, safe and efficient option to reconstruct a long ulnar nerve and artery defect.

PURPOSE: To track the regeneration process of lateral gastrocnemius due to a muscle laceration in rats, and to treatment with plateletrich plasma (PRP). METHODS: Ultrasound (40 MHz) images were used for measuring pennation angle (PA), muscle thickness (MT) and mean pixel intensity, along with claudication scores, of treated (PRPG) and non-treated (NTG) groups of rats. RESULTS: NTG showed a PA increase for the non-injured leg (p<0.05) and a tendency of MT to increase, whereas for PRPG there were no differences. There was a progressive reduction of the claudication score for the PRPG group throughout the entire period, with an immediate difference after seven days (p<0.05), whereas the NTG had a significant reduction only at day 28 (p<0.05). CONCLUSION: It was observed a compensatory hypertrophic response due to the overload condition imposed to healthy leg for NTG that did not occur in PRPG, suggesting an accelerated repair process of the injured leg due to treatment, anticipating its use.

ABSTRACT Introduction There are many drawbacks in sports, one of the main problems being injuries. Objective This work aimed to study the effect of prolonged basketball practice and associated sports injuries on electrophysiological indicators about the functional state of the neuromuscular apparatus in specialized athletes. Methods A study was conducted in which 14 basketball players participated voluntarily: 7 basketball players aged 17 to 23 years with first category sports qualifications, relatively healthy, with a history of knee and ankle injuries, and seven non-athletes with no history of injuries. Psychophysiological and electrophysiological methods were used for the study, designed to diagnose strength and endurance, measure rhythmic dynamics in hand movements, evaluate the mobility of neural processes, and the functional state of the central nervous system and processes in the central nervous system. Results It was established that regular sports training leads to morphological and functional changes in the neuromuscular system. Conclusion Due to repeated injuries, basketball players experience a decrease in the conduction velocity of the electrical pulse in the neural fiber pathway and in the level of reflex excitability in the neuronal motor ensemble of the lumbosacral segments of the spinal cord that innervate the bilateral muscles of the lower limbs; a weakening of the nervous system resistance, mobility of the nervous processes, deterioration of the functional state of the central nervous system and analyzers was noted. Evidence level II; Therapeutic studies - outcomes research.

ABSTRACT Introduction: secondary forms of lymphedema may occur as consequence of tumors, surgeries, radiotherapy, trauma and infections. Degloving injuries are severe and infrequent forms of trauma, with avulsion at the level of muscular fascia, and consequent injury of the lymphatic system. Objective: to evaluate the alterations in lymphatic circulation in patients being victims of circumferential degloving injuries in the lower limbs, using lymphoscintigraphic. Patients and Methods: retrospective analysis of the cases treated in the period from 2010 to 2016. Segmental, circumferential and unilateral injuries with involvement of the lower limbs were included. Lymphoscintigraphy was performed after a minimum interval of 12 months after the end of treatment. The non-injured lower limb was used as control. The Kleinhans Semiquantitative Index (KSI) was used for the semiquantitative evaluation of the lymphoscintigraphic findings. Results: eighteen patients were evaluated, six of whom were female and 12 were male. The mean age was 28.11 years. The average vertical extension of the circumferential traumatized segment was 29.33cm. The injured area presented variations of 5 to 15% of the body surface, with an average of 8.95%. Lymphoscintigraphy was performed after an average interval of 22.55 months. Alterations were observed on the traumatized limb (TL) in 13 patients. All control limbs (CL) were normal. The mean KSI observed in TL was 8.32, while in CL, the average value was 0.58 (p<0.001). Conclusion: patients with circumferential degloving injuries in the lower limbs present compromised lymphatic circulation and high probability to develop lymphedema.

In this report, we present a case of myositis ossificans traumatica (MOT) of the medial pterygoid muscle that had developed after mandibular block anesthesia administered for endodontic treatment of the lower right second molar, demonstrating typical features of this condition. MOT should be considered as a differential diagnosis when there is severe limitation of jaw opening and an associated trauma. Panoramic radiographs and axial and coronal computed tomography (CT) scans can effectively delineate the calcified mass. Other imaging studies that may be helpful include magnetic resonance imaging (MRI), bone scans, and ultrasound. As shown in our case, calcified masses were found in the right mandibular angle, which severely limited jaw opening. Some earlier reported cases of MOT were treated by extraoral surgical approaches with complete removal of the evolving muscle. The aim of this case report is to present only the diagnostic imaging aspects of myositis ossificans traumatica.

Ankle sprains are highly prevalent in the population, and not all of them require medical treatment. It is generally agreed that both the individual and health professionals do not always base their decision on evidence, with a negative impact on the evolution of these injuries, which may evolve to chronicity. The involvement of various professionals in rehabilitation, with different approaches, justifies the standardisation of protocols for action. Goals: This study aims to: 1) identify the acronyms of the protocols of action for the management of soft tissue injuries of the ankle joint and, 2) analyse the evidence of the acronyms. Methods: Integrative Literature Review guided by the research question: "Which interventions are recommended in protocols for the management of acute soft tissue injuries in adults and elderly people?", according to the protocol and eligibility criteria. The search took place between October and December 2020, in the EBSCO, B-On, ISI, SCOPUS and JBI platforms. Results: (The 11 studies in the bibliographic sample are heterogeneous in terms of objectives and type of article, making it possible to answer the research question. The following acronyms/protocols were identified: RICE; PRICE; POLICE; MEAT and PEACE and LOVE. Conclusions: There is no evidence on the effectiveness of these protocols for the management of soft tissue injuries of the ankle joint.&nbsp; Good practices such as ice application, limb elevation and Optimal Loading are recommended because progressive loading is more likely to restore collagen strength and morphological characteristics.