Management Of Sports Injuries Research Articles

Conservative management of sports injuries

Thomas E. Hyde and Marianne S. Gengenbach. Conservative management of sports injuries. 2nd edition. Jones & Bartlett, Ontario, Canada. 2007. Paperback. 1172 pages. £55.00 Conservative management of...

Growth factor delivery methods in the management of sports injuries: the state of play

In recent years there have been rapid developments in the use of growth factors for accelerated healing of injury. Growth factors have been used in maxillo-facial and plastic surgery with...

Sports injuries of the knee: surgical approaches

The Journal of Bone and Joint Surgery. British volumeVol. 89-B, No. 11 Book ReviewsFree AccessSports injuries of the knee: surgical approaches Edited by P. T. Simonian, B. J. Cole and B. R. Bach Jr Pp. 240. New York: Thieme, 2006. ISBN: 3-13-140291-1. € 129.95.D. BickerstaffD. BickerstaffSearch for more papers by this authorPublished Online:1 Nov 2007https://doi.org/10.1302/0301-620X.89B11.20311AboutSectionsPDF/EPUB ToolsDownload CitationsTrack CitationsPermissionsAdd to Favourites ShareShare onFacebookTwitterLinked InRedditEmail The three editing authors have sought to bring together leading sports injury surgeons, each to write a chapter on a defined subject. The intention is to produce a book which covers the breadth of arthroscopic and reconstructive knee surgery and sports-related injuries. Each author describes the surgical technique that is used to address a particular injury and the problems that might be encountered.It was perhaps disappointing to see that of the 53 authors used, 51 were from the USA. Whilst it is understood that the USA are certainly leaders in sports injury management, to provide an international flavour, one might consider that the breadth of sports injury experience emanating from Europe and Australasia may have made more of an impact.The chapters are organised to deal with various pathologies including those of the meniscus, articular surface, ligamentous rupture and finally patellofemoral problems, tendon injuries and fractures around the knee. There is, therefore, a huge amount of information to be imparted to the reader and all encapsulated within 200 pages.Although the remit of the book is to describe surgical approaches, many of the chapters begin with patient presentation, the indications for surgery and contraindications, some diagnostic tests and the timing of surgery. Other chapters more specifically deal only with the surgical approach. Some chapters are really lists of the presenting pathology. When one comes to the actual description of the surgical approach, we are given one particular surgeon’s view of how the operation is performed, or “how I do it”.During training in orthopaedics and attendance at specialist fellowships in sports medicine, the trainee is exposed to a variety of surgical procedures which mould his own approach to the problem. In this book, the reader is given only one author’s surgical style which, for someone with very little experience in sports surgery, may give them a false view of the diversity of options. For someone with much experience in sports surgery, one is left disappointed that other aspects of surgical management have been omitted.The presentation is good with excellent line drawings and full colour surgical photographs, but the book seems to fall between two stools. It tries to impart too much knowledge in too brief a format. Whilst knowledge of the pathology is vital, I believe it should be imparted in full or not at all. Nothing can replace the apprenticeship of a specialist fellowship, attending skills courses where there are many instructors. The depth of knowledge needed to formulate one’s own surgical approach to deal with a particular problem cannot be imparted by such a narrow overview as provided by this book.FiguresReferencesRelatedDetails Vol. 89-B, No. 11 Metrics Downloaded 61 times History Published online 1 November 2007 Published in print 1 November 2007 InformationCopyright © 2007, The British Editorial Society of Bone and Joint Surgery: All rights reservedPDF download

Prise en charge du traumatisme sportif

Aims To analyse the best management of sports injuries. Current knowledge and points of views During past years knowledge concerning physical activity in the prevention and treatment of a number of diseases has dramatically increased. Unfortunately, during sports practice, injuries are frequent (specific or not), acute injuries or overuse syndrome. Definition of injury must be always clearly defined. After diagnostic, the patient will be globally treated. The impact is not only physiologic, but also psychologic and sociologic. The medical staff must take account these three dimensions, to perform the best treatment for a quick and totally return to sports practice, and to avoid the relapse, always frightening moment for the sportsman himself, and his entourage.

Sports medicine training in Canadian paediatric residency programs: Are we doing enough?

To assess sports medicine teaching in Canadian paediatric residency programs and recent paediatric graduates' comfort level with sports medicine. Recent paediatric graduates were surveyed about the amount of sports medicine training they had received during residency, as well as their comfort level in diagnosing and managing common sports medicine problems. Paediatric residency program directors were surveyed about the sports medicine content in their programs. Survey response rates for recent graduates and program directors were 52.6% and 81.3%, respectively. Of the recent graduates who responded, 84.7% had 5 h or less of formal sports medicine teaching during residency and 94.9% had no formal clinical rotation in sports medicine. The vast majority of respondents (84.2%) were less than comfortable with their musculoskeletal anatomy knowledge; only 15.8% were comfortable. There were no significant differences between general paediatricians and subspecialists in their reported comfort level with diagnosis (P=0.938) and management (P=0.967) of sports injuries. No program provided more than 5 h of formal teaching in sports medicine, and only one program has a core sports medicine rotation. None of the responding program directors felt that new paediatricians are even somewhat prepared to provide adequate medical care for athletes, and 61.5% felt that a curriculum in sports medicine was necessary. Canadian paediatric residents had limited exposure to sports medicine, and many recent graduates were uncomfortable with their skills in sports medicine. Canadian paediatric residency programs should include a curriculum in sports medicine to adequately prepare future paediatricians to care for young athletes.

The S-Quattro in the management of sports injuries of the fingers

Intra-articular phalangeal fractures of the small joints of the hand are difficult sports injuries to manage. The Stockport Serpentine Spring System, abbreviated to S-Quattro was developed by the senior author as an external fixator to treat these fractures. We present the largest series of patients with sports injuries treated with the S-Quattro. Twenty patients with these fractures were treated over a three-year period. The injured joint was distracted after inserting two pins percutaneously into normal phalangeal bone. Two serpentine springs were then inserted between the pins applying distraction to the fracture site. The fixation devices were removed in clinic between 4 and 6 weeks. Objective analysis revealed an average arc of movement of the affected joint of 94 degrees at an average follow-up of 14 months. The mean DASH score was 5 indicating mild impairment. All of the patients were satisfied with the results and the radiographic appearances were satisfactory. The S-Quattro is a versatile system that permits some movement of the injured joint while maintaining reduction. It is relatively free of complications with good results. We advocate the routine use of the S-Quattro in view of its inherent simplicity and the good results it produces with these difficult sports injuries.

Conference call.

The RCN paediatric emergency care group is holding a conference on May 24 in Leeds. Topics include international disaster response, fever management, sports injury management and mental health assessment. For details, contact janet.youd@cht.nhs.uk.

A review of the initial management of soft tissue sports injuries

Summary Soft tissue injuries comprise the majority of sports injuries. Nursing plays a key role in the initial management of these, which has traditionally adhered to the standard initial intervention of rest, ice, compression and elevation, acronym RICE. Although this is generally accepted to be the gold standard of initial management, closer scrutiny reveals inconsistencies in practice during the implementation of the four elements that this comprises, with potential detrimental effects to the patient. This paper reviews the literature to ascertain the optimum management to produce best patient outcomes in light of immediate and subsequent pathophysiology of sports injury. Additionally, suggestions for further study will be made within the recommendations for practice.

스쿼시 선수들의 스포츠 상해 요인과 처치방법 실태에 대한 연령 집단별 분석

스쿼시 선수들의 스포츠 상해 요인과 처치방법 실태에 대한 연령 집단별 분석

Transdermal approaches to pain in sports injury management.

There is much lore about training room treatments for common overuse and traumatic musculoskeletal injuries. This review looks at the evidence behind many of the common transdermal treatments that are purported to reduce pain and inflammation and improve function. These include cryotherapy, laser treatments, electrical stimulation, ultrasound and phonophoresis, extracorporeal shock wave therapy, and iontophoresis. In addition, there are numerous over the counter sports creams and prescribed topical treatments that are routinely used. With the pressure to treat athletes safely and efficiently, sports practitioners must rely on well-proven evidence to build the most effective treatment plans.

An audit of sports injuries in children attending an Accident & Emergency department.

To assess the incidence of attendance, type of injury, sport involved and management of sports injuries in children attending an Accident & Emergency (A&E) department. Children, aged between 5-16 years, presenting with an injury related to sport, were studied over a period of three months. 1858 children attended the A&E department during the three month period. 238 (12.8%) were classified as sports injuries. Boys (71%) were injured more frequently than girls (29%). Injury rates in boys peaked at 14 years whereas in girls a peak occurred earlier at 12 years. Football was the most common sport implicated in injuries (39%). Rollerblading (14%), Rugby (8%), Basketball (7%) and Physical Education at school (7%) were the next most frequently involved sports. Soft tissue injuries dominated (61%). The upper limb was the most common anatomical area injured (46%). Other injuries involved the lower limb (36%), head and neck (15%) and the trunk (3%). Injuries to the wrist were the most frequent presentation accounting for 30 fractures and 30 soft tissue injuries (25%). The majority of children were discharged from the A&E department after treatment (71%). 26% were reviewed at out-patient clinics and 3% required hospital admission. No children were referred for physiotherapy. Children participate in sport and can be injured. The majority of sports injuries presenting to an A&E department appear to be of a minor nature and could be managed with simple first aid techniques by parents, teachers and coaches at the scene or by attending primary care in the first instance. Supervision of children, participation in organised sport and the use of protection devices may help to prevent serious injury.

IMAGING OF SPORTS INJURIES IN CHILDREN AND ADOLESCENTS

Imaging plays an important role in the diagnosis and management of sports injuries of childhood and adolescence. The injuries discussed are typical of those seen in the skeletally immature athlete. Imaging specialists must be able to apply the full range of imaging modalities when evaluating the injured young athlete.

Sports Injuries: Emergency Assessment and Field-side Care

1. Anthony Luke, MD* 2. Lyle Micheli, MD† 1. 2. *Fellow, Division of Sports Medicine, Harvard University, Children’s Hospital, Boston, MA. 3. 4. †Director, Division of Sports Medicine, Associate Clinical Professor of Orthopaedic Surgery, Harvard University, Children’s Hospital, Boston, MA. After completing this article, readers should be able to: 1. Describe the steps for assessing a fallen athlete. 2. List the requirements for clearing an athlete to return to play. 3. Describe the procedure for handling a suspected cervical injury. 4. Delineate the procedure for handling a child or adolescent who has a concussion or transient neurologic deficit. 5. List the primary factors to consider when dealing with heat-related illnesses. 6. Describe the appropriate procedure for handling a suspected significant eye injury. Sports injuries are very common in the pediatric population; approximately one third of injuries from all causes in children are sports-related. Primary care physicians are becoming more involved in sports medicine both in the office and on the sidelines of athletic events. This article is designed to provide a practical guide to increase knowledge and facilitate management of urgent and emergent problems in pediatric sports medicine. Fortunately, most sports injuries are nonemergent musculoskeletal injuries, but certain problems must be addressed immediately. The initial on-site approach to an injured athlete as well as management of neck injuries in children, head injuries, heat-related illnesses, and ophthalmologic problems receive particular emphasis in this article. Any physician who assumes the role of team doctor should be knowledgeable and prepared for the acute management of these injuries. Recommendations for their prevention also are offered. A sports physician should work to improve awareness of sports injury prevention through counseling and promoting interventions that help reduce injuries. For more detailed, definitive management of sports injuries in a tertiary care setting, the reader is directed to the Suggested Reading. Management of the athlete who has collapsed begins before the injury occurs with proper preparation. Depending on the location and level of the event, resources may be limited. At the very least, it is imperative that the physician has quick access to a …

A one-year review of maxillofacial sports injuries treated at an accident and emergency department

To assess the aetiology and demand for oral and maxillofacial surgery services associated with sports injuries, a prospective study was undertaken. Data were collected from consecutive patients (with maxillofacial injuries associated with sports) attending the accident and emergency department at the Cardiff Royal Infirmary in the UK during a 12-month period and analysed. Data relating to demography, aetiology, site and extent of injury, treatment and outcome were collected. There were 790 attendances (695M: 85F) arising principally from injuries related to rugby ( n = 206), cycling ( n = 189) and football ( n = 109) but few from recognized contact sports ( n = 26). The principal causes of these injuries were direct bodily contact ( n = 260) and falls ( n = 219). The commonest injury was soft-tissue laceration ( n = 604); 80 patients had dentoalveolar fractures and 64 patients had fractures of the facial skeleton. Injuries were located in the upper- ( n = 257), middle- ( n = 201) and lower third of the face ( n = 124) with 188 lip/intraoral injuries. Repair of lacerations ( n = 600) was the commonest treatment; only 46 fractures required interventive treatment. Follow-up was performed for most of these patients at the Department of Oral and Maxillofacial Surgery at the Dental Hospital ( n = 404) and general medical/dental practitioners ( n = 258). These data highlight the importance of oral and maxillofacial surgery staff in the management of sports injuries in accident and emergency departments. Moreover, they suggest the need for prioritization of rule and legislation changes and the continuing need to improve safety standards to prevent maxillofacial injuries.

Local corticosteroid injection in sport: review of literature and guidelines for treatment.

The risks and benefits of local injection therapy of overuse sports injuries with corticosteroids are reviewed here. Injection of corticosteroid inside the tendon has a deleterious effect on the tendon tissue and should be unanimously condemned. No reliable proof exists of the deleterious effects of peritendinous injections. Too many conclusions in the literature are based on poor scientific evidence and it is just the reiteration of a dogma if all steroid injections are abandoned. The corticosteroids represent an adjuvant treatment in the overall management of sports injuries: basic treatment is 'active' rest and graduated rehabilitation within the limits of pain. With proper indications there are only few and trivial complications that may occur with corticosteroid injections. Guidelines for proper local injection therapy with corticosteroids are given.

Sports Injury Management

Sports Injury Management

The use and practice of body substance precautions in sports physiotherapy

This study examined the use of Universal Precautions in the management of bleeding sports injuries. A survey was used which asked questions on: demographics, hepatitis B vaccination, first aid practices and frequency of blood contact. The national sample consisted of 1800 Australian Physiotherapy Association National Sports Physiotherapy Group members. The response rate was 29.2 per cent. Eighty-five per cent of physiotherapists were exposed to bleeding injuries. The use of rubber gloves in the treatment of bleeding injuries was low (47 per cent using them always/frequently). Only 60 per cent disposed of sharp instruments appropriately. Eighty per cent reported being immunised against hepatitis B. Experience was strongly associated with appropriate first aid practices. The study suggests that physiotherapists in sport are not consistently adhering to Universal Precautions.

Internal fixation of closed tibial fractures for the management of sports injuries.

From 1985 to 1988, 90 closed tibial fractures were prospectively studied to assess the morbidity of such injuries to sports people and how this can be influenced by treatment regimens. All fractures were sustained during rugby or football matches. After random selection, 45 fractures were openly reduced and internally fixed (group A), and 45 fractures were manipulated under general anaesthesia and a long-leg plaster applied (group B). For patients in group A, below-knee plasters were used for 3 to 4 weeks, with immediate weight-bearing when tolerated. A total of 44 (98%) tibiae united clinically and radiologically within 14-18 weeks. Within 4 months of surgery 28 (62%) patients had returned to work and were able to play again by the following season. By 6 months 17 (38%) patients had resumed normal activities. In group B, only 24 (53%) tibiae united in a mean time of 16 weeks (range 12-40 weeks). Six (13%) patients required bone grafting for non-union, and one patient subsequently developed osteomyelitis. Only ten (22%) patients were back to work and playing sport again within 6 months of initial injury. It is concluded that internal fixation of closed tibial fractures as a primary procedure following low velocity sports injuries can be safely performed. It leads to a faster return to normal activities with fewer complications than does conservative treatment in plaster using contemporary methods.

Use of Telethermography in the Management of Sports Injuries

Telethermography can contribute to the diagnostic process in the management of sports injuries by clearly demonstrating thermal alterations in the tissues involved. Although there are no typical images, in general hyperthermic images are found when inflammatory reactions prevail, and hypothermic pictures when compression or degenerative processes are present. Telethermography is not only an aid to diagnosis, it also appears to be an ideal tool in controlling the injury evolution and treatment efficacy. In fact this objective method of evaluation is noninvasive, innocuous and repeatable, and well-related to the clinical and functional status.

Office Management of Sports Injuries and Athletic Problems

Office Management of Sports Injuries and Athletic Problems