Simple Sprain Research Articles

Sporting foot and ankle injuries in older athletes

Sporting foot and ankle injuries in older athletes are scarcely documented, however, they can play a key role in ending one's professional career. The term ‘older athlete’ itself comprises a large amount of age groups depending on various factors, mainly depending on the type of sport. Ankle inversion/injuries sprains are by far the most common with the anterior talofibular ligament being most frequent to tear about 75%, these injuries can range from a simple sprain, to more serious conditions which require accurate diagnosis and early treatment to ensure a full and expedient return to sports. Syndesmosis injury count for 1–18% of injuries following an ankle sprain. Deltoid ligament tear in combination with lateral ligament complex may need acute surgery; peroneal tendon injury and retinaculum tear are found mainly to affect the peroneus longus tendon in this group. Overuse chronic pathologies and arthritis are the leading cause of damage in this athlete group. The orthopaedic surgeon needs to be aware of the more subtle presentations of significant injuries and use appropriate imaging to make the diagnosis and treat the athlete appropriately to enable them in maintaining a professional/semi-professional career as long as possible, this review explores this topic into detail.

Correlation Between Muscle Strength Asymmetry and Its Impact on Functional Scores after Ankle Sprain Rehabilitation

Category: Sports; Ankle Introduction/Purpose: Ankle sprain is one of the most common sports-related injuries. Treatment of these lesions can be performed conservatively with satisfactory results in up to 80% of cases. The main goals of rehabilitation are the recovery of mobility, strength and balance; but there is no consensus on decision make criteria to return to sport. It is known that the time elapsed from trauma may be insufficient reference and may induce early return, while the individual still does not have symmetric parameters of mobility, strength and proprioception. Purpose: To assess the proportionality of muscle strength between the healthy and rehabilitated sides 16 weeks after ankle sprain related to physical activity and to correlate with its impact on function scores. Methods: 131 individuals, from 18 to 64 years old, were evaluated after rehabilitation of simple sprain. Physical examination was performed with anterior drawer test, measurement of leg circumference by perimetry and by the method of figure in '8'; determination of active and passive range of motion using goniometer; muscle strength conference with hand held dynamometer and finally with the application of function scores. Equality test between two proportions, T-student test, Chi-square test and Pearson correlation were used to determine the significance between the values and correlations found. Results: We identified an average age of 36.1 (+- 2.5) years, 56 (42.70%) women and 75 (57.30%) men. 19.8% of sprains were severe. Limb volume and range of motion evaluations did not show significant differences. The anterior drawer remained positive in 19.1% of the individuals with the highest proportion in severe sprains (36.6%). Force asymmetry for flexion (52.7%), extension (50.4%), eversion (46.6%) and inversion (56.5%) movements above the 10% limit were observed. Impact on function scores showed a moderate correlation (0.59) with the proportionality of ankle extension forces. Conclusion: Individuals adequately rehabilitated after an ankle sprain and considered able to return to sports may present changes anterior drawer test and asymmetries in lower limb muscle strength impacting performance on function scores.

Effect of exercises with a designed device on the strength of the ankle joint ligaments for athletes injured with minor sprains

The purpose of this paper is to preparing exercises with a device designed to rehabilitate the strength of the ankle joint ligaments, and identifying the effect of exercise with a device designed to strengthen the ankle joint ligaments for athletes injured with minor sprains. The two researchers used the experimental method by designing the experimental group with a pre-and post-test in order to suit the problem in order to reach results that achieve the objectives of the research and its imposition. The research community was identified for athletes with minor sprains in the ankle joint in Baghdad Governorate, where the first injury was on 30/10/2020 and the injuries were at different times, which started from this date and the first injury occurred in the player during the exercise, and the injury was determined after the diagnosis by Doctor The specialist, when conducting a clinical examination and magnetic resonance imaging, it was found that they had a simple sprain in the ankle joint, which does not exceed a period of one to three days.

Adolescent medial epicondyle trash lesion clinic radiological evaluation and treatment

<p class="abstract">Elbow injures in children accounts for 10% of all fractures, ranges from simple sprain to elbow fracture dislocation. Ligamentous injury accounts for 2-3% only and are mostly sports related seen in overhead athletes. Trash lesions (the radiological appearances seemed harmless) around the elbow are reported in children under 10 years which are high energy trauma with initial normal looking X-rays. These are osteochondral or physical injures presenting with soft tissue swelling without any fractures. A high index of suspicion, early additional imaging such as MRI, CT scan, ultrasound examination and aggressive surgical care are usually necessary for prompt diagnosis and successful treatment of these injuries before complications arise. We presented a case of an elbow injury in a 15 year old girl, following a fall on her outstretched hand with initial normal findings in her X-rays. 3 months following the injury she had persisting pain and instability with ulnar nerve impingement symptoms. Her elbow CT scan, nerve conduction study confirmed the avulsion fracture of medial epicondyle with ulnar nerve neuritis and cubital tunnel syndrome. Valgus stress test proved the extent of additional medial instability. Medial epicondyle avulsion fractures are always challenging for fixation. The retracting UCL forces prevents healing and were prone for failure with non-operative splinting once instability is defined. Attempted fixation can also result in failure of fixation. Our case study highlights the possibility of such trash lesion in adolescent and also the modified technique of ulnar collateral ligament (UCL) reconstruction in a cost effective manner.</p>

Initial Evaluation by a Non-Surgeon Provider Does Not Delay the Surgical Care of Pediatric Forearm and Elbow Trauma in a Walk-In Orthopaedic Clinic.

IntroductionWalk-in and after-hours clinics are being increasingly utilized in orthopedics and are especially beneficial for patients with simple sprains, fractures, or overuse injuries that might otherwise require an emergency room visit. To meet the increased patient load, additional staffing often is required, which might include a family medicine physician, nurse practitioner, or physician assistant. Few studies have evaluated the performance of these non-surgeon providers in an orthopedic clinical setting. This study compared the time to definitive care of pediatric patients with forearm and elbow injuries between non-surgeon providers in a walk-in clinic, orthopedic surgeons in a walk-in clinic, and a pediatric orthopedic surgeon in a regular clinic.MethodsChildren who had closed reduction and fixation of an elbow or forearm injury from January 2010 to December 2017 were identified. The patients were divided into groups: patients initially evaluated in a walk-in clinic by a non-surgeon provider; patients initially evaluated in a walk-in clinic by an orthopedic surgeon; and patients initially seen by a fellowship-trained, pediatric orthopedic surgeon in a regular clinic (control group). Neither type of provider (non-surgeon or surgeon) in the walk-in clinics definitively treated any injury but rather transferred care of the patient to a pediatric orthopedic surgeon. The number of clinic visits until surgery, the number of providers seen, the days before evaluation by a pediatric orthopedic surgeon, and the number of days before definitive surgical treatment were documented.ResultsOf the 162 patients identified, 36 (22%) were initially seen by an orthopedic surgeon and 62 (38%) by a non-surgeon provider in a walk-in clinic. The remaining 64 (40%) (control group) were initially seen in a regular office visit by a pediatric orthopedic surgeon. There were no significant differences noted for patients treated by orthopedic surgeon and non-surgeon providers in days before a referral visit to the pediatric orthopedic surgeon (3.7 vs. 3.9, respectively; p = 0.63) or days to surgery for definitive treatment (5.2 vs. 4.8, respectively; p = 0.62). The average number of providers seen (1.58 vs. 1.63, respectively; p = 0.69) and average number of clinic visits before surgery (2.08 vs. 2.06, respectively; p = 0.76) also were similar when comparing the two groups. The control group had significantly fewer days from evaluation to surgical treatment than the surgeon walk-in group (3.3 days vs. 5.2 days, p < 0.05) and the non-surgeon walk-in group (3.3 days vs. 4.8 days, p < 0.05).ConclusionThere was no difference in the number of days to transfer patient care to a pediatric orthopedic surgeon between non-surgeon providers and orthopedic surgeons in the walk-in clinic. However, there was a one-day delay reaching definitive treatment when initial evaluation occurred in a walk-in clinic, regardless of whether the patient was initially seen by a surgeon or non-surgeon, when compared to an initial evaluation by a pediatric orthopedic surgeon.

The Effectiveness of a Training Package Prepared to Teach First Aid Skills to Individuals with Intellectual and Additional Disabilities

This study aimed to evaluate the effectiveness of a training package, which was applied through direct teaching method and included digital storytelling, a first aid manikin and live modeling, in teaching basic first aid skills necessary for cuts, sprains and bee stings to individuals with intellectual and additional disabilities. Three middle school students with multiple developmental disabilities whose ages ranged from 12 to 15 participated in the study. The first aid skills for simple cuts, sprains and bee stings were taught in a small group format. A multiple probe design across behaviors with probe conditions, one of the single-subject designs, was employed in the study. The independent variable of the study was training package and the dependent variables of the study were the participants’ level of acquisition of the target skills (Cut, sprain and bee sting). The results of the study revealed that the package was effective in teaching simple first aid skills to the participants, and they maintained those skills for 1, 3 and 4 weeks after the completion of training. The participants were also able to generalize the skills to other first aid tools, settings and practitioners. Social validity findings showed that the participants enjoyed the classes in which digital storytelling was used. Also, they expressed their desire to have them in other courses.

The Diagnostic Challenge of Ankle Injuries in the Emergency Department

An ankle injury is a very common musculoskeletal problem that can be easily misdiagnosed. About 15% to 20% of these injuries result in fractures, whereas the rest can range from a simple sprain to more complicated injuries, including tears to ligaments and the interosseous membrane. Ankle injuries that are not properly assessed may result in a lifetime of joint instability, pain, and problems with ambulation.

Valgus instability of the elbow: acute and chronic form.

There has been an increase in thrower-specific elbow injuries in recent years. High valgus stresses during the late cocking and acceleration phases of throwing need to be compensated by the flexor pronator muscles as these can exceed the tensile strength of the medial collateral ligament complex. Prevention of injuries is the priority, with a focus on strengthening, reducing throwing frequency, decreasing force, and promoting a technique. The spectrum of thrower injuries ranges from a simple sprain to complete failure of the valgus stabilizing factors. The medial collateral ligament can stretch, leading to posteromedial impingement and radiocapitellar compression forces. This in turn can result in arthrosis and the formation of osteophytes. Ligament failure may eventually occur, making it impossible for the athlete to continue their throwing activities. The outcome of conservative treatment with strengthening, improvement of technique, and relative rest is often disappointing. Direct repair may no longer be possible in these acute-on-chronic injuries and a reconstruction with a tendon graft may be necessary.

Irreducible Dislocations of the Proximal Interphalangeal Joint: Algorithm for Open Reduction and Soft-tissue Repair.

The "jammed finger" is among the most common hand injuries and may include simple sprains, dislocations, fractures, and fracture-dislocations. In contrast, irreducible dislocations of the proximal interphalangeal joint are rare injuries. However, they must not be overlooked in the primary assessment, because persistent subluxation may lead to joint contracture, severely compromising hand function. Irreducible dislocations are challenging injuries with interposed soft tissues, preventing closed reduction. Thorough preoperative diagnosis and soft-tissue imaging guide the approach to open reduction and repair of injured periarticular structures. We introduce a systematic algorithm with considerations on classification and management of irreducible proximal interphalangeal joint dislocations. The algorithm is useful for the primary assessment and for hand surgeons responsible for open reduction and rehabilitation.

Dentistry with Ergonomics

Dental professionals of all the specialties are often amongst the groups suffering from musculoskeletal disorders because of prolonged working hours with awkward positioning. Adding to it are the vibratory equipments and miniature instruments. The disorders ranges from simple sprain to carpel tunnel syndrome. Thus the only way is to prevent by encorporating principles of ergonomics to avoid illness and injuries thereby resulting in prolonged efficient work outcome.

Functional evaluation of volar plate advancement arthroplasty in fracture dislocation of proximal interphalangeal joint

Introduction: Injuries of the proximal interphalangeal joint ranging from simple sprain to fracture dislocation, are most common injuries of the hand labelled as jammed finger. The management of these injuries are difficult and challenging to hand surgeon with potential long term sequelae of residual pain and stiffness. So our aim is to evaluate the result of volar plate advancement arthroplasty in these injuries. Materials and Methods: This is a retrospective study conducts between 2013 to 2017. In our study 10 cases (8 male and 2 female with average age 26.9y) of fracture dislocation of PIP joint with average 5.3 weeks after injury, operated by advancement of volar plate arthroplasty (in 3 case as a primary and in 7 cases as a secondary reconstructive procedure) with inclusive criteria of unstable joint and > 40% involvement of volar surface of middle phalanx. Results: The average follow up was 20.9 months with preoperative ROM was 15.70. The ROM improved to 910 in fresh and 720 in late cases . The result of over- all study shows good result with functional gain in range of movement. Discussion: The surgeon must choose an appropriate treatment based on fracture pattern, joint stability , duration. Stability of the joint is paramount in determining the appropriate treatment, which should aim to facilitate early mobilisation and restoration of function. Conclusion: volar plate arthroplasty gives stable joint and functional range of motion.

Posterior hip instability relocation testing: a resident’s case report

Background: Micro-instability (non-radiographic clinical instability) continues to gain recognition as a problem at the hip. Although most research has been directed to anterior hip instability, posterior hip instability (PHI) has also garnered attention. PHI is under recognized, difficult to identify, and confused with other hip pathologies such as a simple sprain or strain. A novel clinical test is introduced that may have helped identify PHI in this patient. Additionally, a conservative rehabilitation approach emphasizing stabilization exercises is described.Case Description: A 29-year-old female presented with complaints of posterior lateral and anterior hip pain of 1.5 years duration. Upon initiating an aggressive stretching program, her pain worsened. Examination revealed limited and painful hip flexion, and positive anterior impingement testing for femoroacetabular impingement. Both tests were significantly less painful with more motion when retested with manual repositioning of the femoral head from posterior to anterior, referred to as posterior relocation testing. The patient was instructed to discontinue stretching. A stabilization plan was established including strengthening of the deep external rotators with trunk and lower quarter neuromuscular re-education.Outcome: The patient completed 12 appointments over 2.5 months. At discharge, the patient reported improvements with pain and function. The Lower Extremity Functional Scale improved from 64/80 to 77/80 and Oswestry Disability Questionnaire improved from 8 to 0%.Discussion: PHI may have contributed to this patient’s symptoms. The posterior relocation test may assist clinicians with identification of PHI, thus directing treatment toward stabilization and neuromuscular control rather than interventions designed to increase mobility.Level of Evidence: 4

Lateral instability of the upper ankle joint

Because of their frequency, ankle sprains are of major clinical and economic importance. The simple sprain with uneventful healing has to be distinguished from the potentially complicated sprain which is at risk of transition to chronic ankle instability. Conservative treatment is indicated for the acute, simple ankle sprain without accompanying injuries and also in cases of chronic instability. If conservative treatment fails, good results can be achieved by anatomic ligament reconstruction of the lateral ankle ligaments. Arthroscopic techniques offer the advantage of joint inspection and addressing intra-articular pathologies in combination with ligament repair. Accompanying pathologies must be adequately addressed during ligament repair to avoid persistent ankle discomfort. If syndesmotic insufficiency and tibiofibular instability are suspected, the objective should be early diagnosis with MRI and surgical repair.

Management of sports injuries of the foot and ankle: an update.

Sporting injuries around the ankle vary from simple sprains that will resolve spontaneously within a few days to severe injuries which may never fully recover and may threaten the career of a professional athlete. Some of these injuries can be easily overlooked altogether or misdiagnosed with potentially devastating effects on future performance. In this review article, we cover some of the common and important sporting injuries involving the ankle including updates on their management and outcomes. Cite this article: Bone Joint J 2016;98-B:874-83.

A stethoscope for the knee: Investigating joint acoustical emissions as novel biomarkers for wearable joint health assessment

Each year, millions of Americans endure knee injuries, ranging from simple sprains to ligament tears requiring surgical intervention. Our team is investigating wearable rehabilitation assessment technologies for patients recovering from knee injuries based on the measurement and analysis of the acoustical emissions from the knees. Using miniature electret microphones combined with piezoelectric sensors placed on the surface of the skin at the knee, we measure the sounds from the joint as subjects perform basic flexion/extension exercises and standardized sit-to-stand protocols. We then analyze the consistency of the knee acoustical emissions in the context of the activity, and the angle of the joint, to quantify the health of the joint. We have found, in early pilot studies, promising results differentiating the healthy versus injured knee, and longitudinal changes progressing from acute injury and recovery following rehabilitation. We have also determined that, in healthy subjects, the pattern of acoustic emissions is consistent within several repetitions of a movement, and for multiple recordings throughout the day (r > 0.88). Knee acoustic emissions combined with angle measurements provide promising in-depth information regarding joint health and exciting new opportunities for personalized rehabilitation protocols following injury.

Is a Simple Spinal Sprain From Whiplash Injury Really That Simple?

The answer of course is a resounding NO. I want to educate you on what a spinal sprain is and WHY is it critical that you get under the care of a doctor who understands how to test for, document, and effectively treat the spinal ligament injuries. Unless you think a life or chronic pain, or poor health is ideal for you, a loved one or anyone else that you may know, we really hope you take this to heart. First you need to understand that a spinal sprain is an injury to the ligaments, which are the tough straps that hold the spinal motion units (2 or more vertebra) together. This is what they look like (Figure 1):

Operative and Nonoperative Treatment of Acromioclavicular Dislocation: A Critical Analysis Review.

Acromioclavicular joint injury is a common contact sports-related injury in the upper extremity1. These injuries range from a simple sprain of the acromioclavicular ligament to a complete dislocation (complete separation) of the joint, which involves disruption of the acromioclavicular and coracoclavicular ligaments and varying degrees of injury to the deltoid and trapezius muscles and fascia. Rockwood et al.2 classified acromioclavicular joint injuries on the basis of the number of ligaments involved, the severity of injury, radiographic findings (including the position of the clavicle relative to the acromion), and reducibility of the acromioclavicular joint with shoulder shrugging (Table I). The Upper Extremity Committee of ISAKOS (International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine) recently proposed a subclassification of the original Rockwood type-III dislocation into …

Tug-of-War Injuries: A Case Report and Review of the Literature.

We report a case of a 10-year-old boy presenting with radial nerve palsy due to injury during a tug-of-war game. Patient was managed nonoperatively and regained radial nerve function. Tug-of-war is a globally popular noncontact sport. Injuries during this game are inevitable and may range from simple sprains to life and limb threatening trauma. Combined hip and knee injuries and soft-tissue injuries involving the back are most frequent. Most injuries occur when tug-of-war was played in an informal setting and where the tug-of-war International Federation rules were less likely to be followed. Measures should be taken to increase the awareness about these safety rules and prevention of consequent injuries. Sports physicians, pediatricians, orthopedic surgeons, general physicians, and athletic trainers should be aware of potential injuries resulting from this game while caring for these athletes, so as to be well prepared for apt management of the injuries associated with TOW.

Epidemiology of Spinal Injuries in Sports

Supraphysiological stresses placed on the spine during sporting activity can lead to various spinal injuries, ranging from a simple sprain or strain of the musculoligamentous structures surrounding the spine to a cervical fracture dislocation with complete spinal cord injury. Collision sports, such as football, are responsible for the vast majority of catastrophic spinal injuries. Gymnastics and other sports that require repetitive hyperextension at the waist have been associated with isthmic spondylolysis. This article reviews the epidemiology of spinal injuries associated with various sports, with a specific focus on spinal cord injury.

A 'Three-Way' Ankle Splint for Acute Ankle Injury

Acute ankle injuries are among the most commonly seen sports-related injuries in primary care. Many of these are simple lateral sprains, for which immobilization is typically not appropriate because it tends to prolong rehabilitation. However, immobilization is often indicated for more severe ankle injuries. These are usually accompanied by a large amount of edema, which precludes immediate casting. In such cases, a "three-way" ankle splint will provide excellent interim immobilization.