BACKGROUND:Trauma remains one of the leading causes of morbidity and mortality worldwide. Generally, the incidence of traumatic injuries is disproportionately high in males. However, trauma in females is underreported.AIM:To study the epidemiology and outcome of different mechanisms and types of traumatic injuries in women.METHODS:We conducted a traditional narrative review using PubMed, MEDLINE and EMBASE, searching for English-language publications for gender-specific trauma between January 1993 and January 2013 using key words "trauma", "gender", "female" and "women".RESULTS:Among 1150 retrieved articles, 71 articles were relevant over 20 years. Although it is an important public health problem, traumatic injuries among females remain under-reported.CONCLUSION:There is a need for further research and evaluation of the exact burden of traumatic injuries among females together with the implementation of effective community based preventive programs.

Introduction: The number of girls and women participating in all levels of soccer has risen greatly in recent years. Rationale for the study: The injury risk is high in soccer, but little is known about the mechanisms by which these injuries occur. Objective: To describe the types of injuries and the mechanisms sustained by teenage girls playing soccer. Design: A descriptive study was done. Method: An injury observation sheet was used to collect data over one week of interregional schools tournament that took place in August 2003, Rustenburg, North West province. For all injuries the following information was documented: type of injury, site of injury, mechanism of injury, cause of injury, part of field, time of ball in play and player position. The teenage girls playing soccer who participated in the USSASSA summer ball games tournament were used. The verbal player informed consent form which provided information on the rights of participants was also drawn and handed to all participants to familiarize themselves with contents prior to a game. Results: Main findings in this study were that the ligament sprains accounted for the highest number (57%) of total injuries sustained by the teenage girls playing soccer. Contusions were the less common type of injury that affected teenage girls. Tackling was the mechanism responsible for most injuries (49%). Strikers were the players’ positions associated with all types of injuries sustained in this study, 72% of strains, 56 %of strains and 45% of total contusions. Goal keepers were not affected by any of the lower limb injuries in this study. Conclusion: Injuries sustained by teenage girls are minor in nature. Sprains and strains are the most common injuries affecting ankles and knees. Injury prevention program can have beneficial results if implemented at developmental stage of their carriers. / Dissertation (MPhyst (Sports Medicine))--University of Pretoria, 2007. / Physiotherapy / MPhyst / unrestricted

Introduction: Despite the unique act of actively using the head as part of the game in soccer, insufficient attention is paid to its potential harmful effects. There is an increased concern regarding head trauma in soccer and its impact both in the short- and long-term. Only a few studies have examined the ability of head protection to mitigate head trauma, and opinions differ regarding its effectiveness. Objective: The purpose of this project was to investigate the injury mechanisms behind concussions in soccer and its short- and long-term effect. Furthermore, the project aimed to evaluate the ability of head protection to protect against head impacts in soccer. Methods: Two finite element models of THUMS version 4.02 pedestrians were used to simulate head collisions between two players, with the aim of mimic an aerial duel in soccer. Different impact angles and impact points were simulated, after which worst case scenarios were selected for further evaluation with head protection. The kinematics of the head and the strains of the brain tissue were used to evaluate the head's response to impacts and to evaluate the effectiveness of head protection. Results: The study showed that the maximum strain of the brain tissue as well as the kinematics of the head were sensitive to the point of impact, while the angle of impact did not show any significant influence. Head protection showed a good ability to reduce the kinematics of the head and the strain of the brain tissue. A thicker head protector had an increased ability to reduce the max values and a low friction head protector had the capacity to further reduce the max values in certain types of impacts. Conclusion: Head protection showed promising ability to reduce head kinematics and the maximum strain of the brain tissue. / Introduktion: Trots den unika handlingen av att aktivt använda huvudet som en del av spelet i fotboll, ägnas otillräcklig uppmärksamhet åt dess potentiella skadliga effekter. Det finns en ökad oro kring huvudtrauman inom fotboll och dess påverkan både på kort och lång sikt. Endast ett fåtal studier har undersökt huvudskydds förmåga att mildra huvudtrauman och olika åsikter råder angående dess effektivitet. Syfte: Syftet med detta projekt var att undersöka skademekanismerna bakom hjärnskakningar inom fotboll samt dess kort- och långsiktiga påverkan. Vidare ämnade projektet till att utvärdera ett huvudskydds förmåga att skydda vid huvudislag inom fotboll.  Metoder: Två finita element modeller av THUMS version 4.02 fotgängarmodell användes för att simulera huvudkollisioner mellan två spelare, i syfte att imitera en luftduell i fotboll. Olika islagsvinklar och islagspunkter simulerades varpå värsta scenarier valdes för vidare utvärdering med huvudskydd. Huvudets kinematik samt töjningar av hjärnvävnaden användes för utvärdering av huvudets respons på islag samt för att undersöka huvudskydds effektivitet.  Resultat: Studien visade att den maximala töjningen av hjärnvävnaden samt kinematiken av huvudet var känslig för islagspunkt medan islagsvinkeln inte visade på någon signifikant inverkan. Huvudskydd visade på god förmåga att reducera huvudets kinematik och töjningen av hjärnvävnaden. Ett tjockare huvudskydd hade en ökad förmåga att reducera maxvärdenaoch ett huvudskydd med låg friktion hade kapaciteten att reducera maxvärdena ytterligare vid vissa typer av islag.. Slutsats: Huvudskydd visade på lovande förmåga att reducera huvudets kinematik och den maximala töjningen av hjärnvävnaden.

Chaque année en France, on dénombre environ 2000 cas de lésions de la région abdominale lors d'accidents de la route. Ces lésions sont très souvent sévères, mortelles dans 20% des cas, et nécessitent un traitement médical délicat, long et coûteux car il fait appel à la chirurgie dans un cas sur deux. Parmi ces lésions, celles du foie font partie des plus fréquentes mais aussi des plus graves à cause de leur risque hémorragique et sceptique élevé. Une voie d'amélioration de leur prévention passe alors par la conception de systèmes de protection plus efficaces basée sur une connaissance détaillée du comportement de ces structures et des mécanismes lésionnels mis en jeu lors d'un choc. L'objectif de ce travail a donc été de construire un outil numérique de prédiction des lésions hépatiques en situation d'impact. Pour cela, nous avons tout d'abord réalisé une étude expérimentale de compression uniaxiale de foies humains à différentes vitesses pour observer le comportement visco-hyperélastique du foie et comprendre ses modes de rupture tant à l'échelle globale qu'à l'échelle cellulaire. Ensuite, nous avons fixé un cadre théorique adapté à la fois au comportement observé et à la description de l'endommagement et de la rupture. Enfin, nous avons construit un modèle éléments finis intégrant une description fine des sous-structures du foie (parenchyme, capsule et arbres vasculaires), les comportements théoriques déduits de la phase expérimentale, la rupture des différents tissus et la présence de fluide dans les structures vasculaires. / Every year in France, about 2000 cases of abdominal injuries are due to car crashes. These injuries are often severe and 20% of them are lethal. They require long and expensive treatments because half of cases needs surgery. Among abdominal organs, liver is one of the most frequently and severely injured: haemorrhage and infectious risks are real. To improve hepatic injuries prevention, the definition of efficient safety devices should be based on a comprehensive knowledge of these structures behaviour and liver injury mechanisms. Thus the aim of this thesis was to build a predictive tool for hepatic injuries in crash situation. To achieve this point, we performed experimental uniaxial compressions of human livers with various loading speeds. We then observed the visco-hyperelastic behaviour of the liver and its failure modes at the global scale and also at the cells scale. After that, we chose a theoretical framework which was adapted both to the observed behaviour and to the damage and rupture description. We finally built a finite element model which integrate a precise description of liver structures (parenchyma, capsule and vascular trees), the theoretical behaviours deduced from the experimental phase, the failure of the different tissues and the fluid action within the vascular structures. After the model calibration and validation with experimental observations, this FEM makes up the wanted predictive tool for hepatic injuries. This tool can be used both with slow and rapid loading speeds.

La biomécanique des chocs vise à étudier les lésions, établir des limites de tolérance et de proposer des mesures de protections adéquates. La méthode des éléments-finis permet l’étude approfondie des mécanismes de lésions, évitant des problèmes liés à l’expérimentation et d’éthique. La biomécanique de la tête humaine chez l’adulte a pris ce virage très tôt, et des modèles de la tête de l’adulte existent, dont celui développé à l’Université de Strasbourg : le SUFEHM (Strasbourg University Finite Element Head Model). Le présent projet a pour but d’ouvrir cette thématique à la modélisation des traumatismes crâniens du nourrisson. Deux axes de travail ont été conduits successivement pour étudier des situations d’accidents et de maltraitances. Le premier axe consiste à développer un modèle de l’œil du nourrisson pour l’étude des hémorragies rétiniennes. Le deuxième consiste à améliorer le modèle de tête en intégrant d’une part les données de l’imagerie médicale comme l’orientation et la densité des fibres axonales, et d’autre part en validant la formulation du crâne pour prédire les fractures crâniennes. / Impact biomechanics aim at studying injuries, establishing tolerance limit and propose efficient protective systems. The finite-element method permits to study precisely injury mechanisms by avoiding questions linked to experimentation and ethics. For the human adult head biomechanics, this methodology was taken earlier and several stable and validated models exist worldwide, among which one can find the Strasbourg University Finite Element Head Model (SUFEHM). This thesis aims at widening the human head biomechanics by studying infant head trauma. The research work has been conducted in two steps. In the first one, an infant eye numerical model was developed in order to study retinal hemorrhages. The second one consisted in improving the infant head model by integrating medical images data such as axonal fiber density and orientations into the infant brain and by validating the mechanical formulation of the infant skull in order to predict skull fractures.