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PubMed1980

Skiing lacerations. Preventability by the use of ski brakes.

Analysis of all ski injuries recorded at Vail, Colo, during the 1973-1974 season showed that 178 injuries occurred in which the skier was lacerated by his own ski. This represented approximately one out of every ten ski injuries--a ratio that remained constant during the six seasons from 1972 through 1978. Frequently these lacerations occurred about the head and face and were cosmetically serious in nature. It is believed that such injuries are largely preventable. The use of ski brakes as an alternative to runaway straps could appreciably lower the incidence of these injuries.

Arm Injuries↗
PubMedDate not supplied

Advances in peripheral nerve repair in emergency surgery of the hand.

The development of microsurgical techniques has changed the surgical treatment of severe hand injuries over the last 25 years. Not only has the repair of vessels by microvascular surgery brought new possibilities of treatment, but the results in repair or peripheral nerves have been improved by the use of new microsurgical techniques, such as perineural suture and interfascicular nerve grafts. The use of vascularized nerve grafts in multiple digit amputations has been a further new idea in emergency hand surgery. The operative treatment of lesions of the brachial plexus has become possible. Nevertheless, the traditional secondary operations such as tendon and muscle transfers are necessary in order to reach an optimal functional reconstruction following nerve injuries.

Adolescent↗
PubMed2004

Superior labrum, anterior-posterior lesions and biceps injuries: diagnostic and treatment considerations.

Proximal biceps tendon rupture, biceps tendinitis, and medical biceps subluxation are injuries that occur alone and in association with other pathologic conditions of the shoulder. The literature describes various strategies for imaging and treating these biceps tendon complex injuries but offers no clear consensus on a gold-standard approach. The keys to successful treatment are an accurate diagnosis, identification of associated pathologic conditions, and assessment of functional limitations of the injury.

Arm Injuries↗
PubMed1999

Painful conditions around the elbow.

This article discusses the origin and histology of conditions causing pain around the elbow as well as possible treatments. Specific conditions examined include epicondylitis and medial, posterior, and anterior musculotendinous injuries.

Algorithms↗
PubMed2004

The effectiveness of standard care, early intervention, and occupational management in Workers' Compensation claims: part 2.

STUDY DESIGN: A prospective cohort. OBJECTIVES: To compare the effectiveness of standard care, early intervention treatment, and occupational management in the management of Workers' Compensation injury claims. SUMMARY OF BACKGROUND DATA: The current management of occupational back pain and work-related upper extremity disorders with either standard care or early intervention treatment appears to be ineffective. METHODS: A prospective cohort looked at the effect of one company with access to standard care (primary care) changing to occupational management (worksite encouragement to resume activity and work as soon as safely possible) and then to early intervention treatment (offsite work hardening). This information was then compared with the control company with access to early intervention treatment, which later changed to a combined occupational management/early intervention treatment approach. Survival analysis was used to attempt to explain differences in time to injury claim closure. RESULTS: Occupational management resulted in lower injury claim incidence, duration, and costs than early intervention treatment. Only the covariate of enhanced physical therapist (work hardening) involvement (2001 hazard rate ratio 17.41, 95% confidence interval 3.72-41.51 and 2002 hazard rate ratio 6.22, 95% confidence interval 2.51-15.40) was associated with delayed time to injury claim closure when the company had access to early intervention treatment. Only the covariate of serious injury was associated with delayed time to injury claim closure in the company when it had access to occupational management (hazard rate ratio 1.67, 95% confidence interval 1.05-27.20). CONCLUSIONS: It is recommended that an occupational management approach, in comparison to early intervention treatment and standard care, be considered for management of occupational injuries.

Absenteeism↗
PubMed2006

Evaluation and treatment of medial ulnar collateral ligament injuries in the throwing athlete.

Medial ulnar collateral ligament (UCL) injuries are common and are seen most frequently in baseball pitchers. Appropriate recognition, treatment, and rehabilitation are necessary to ensure the best chance for return to preinjury levels of participation. Participation in competitive sports may be disrupted for 6 months to 1 year when treated optimally. Abstinence from play may be prolonged when treatment is delayed or if conservative treatment fails; this delay carries significant consequences to the professional, collegiate, and high school athlete. The orthopedic literature is replete with recommendations for the care of these athletes. These recommendations are generally based on retrospective reviews. The purposes of this paper are 3-fold: to provide background knowledge on this injury, to synthesize the current knowledge on the diagnosis, treatment, and rehabilitation of athletes with medial UCL injuries, and lastly, to provide a treatment algorithm for athletes with UCL injuries.

Arm Injuries↗
PubMed2005

Rugby injuries.

OBJECTIVES: The purpose of this chapter is to review critically the existing studies on the epidemiology of pediatric rugby injuries and discuss suggestions for injury prevention and further research. DATA SOURCES: Data were sourced from the sports medicine and science literature mainly since 1990, and from a prospective injury surveillance project in rugby undertaken by the University of New South Wales (UNSW) in Sydney during 2002. Literature searches were performed using Medline and SportsDiscus. MAIN RESULTS: Reported injury rates were between 7 and 18 injuries per 1,000 hours played, with the rate of injuries resulting in loss of playing or training time measured at 6.5-10.6 per 1,000 hours played. Injury rates increased with age and level of qualification. Head injury and concussion accounted for 10-40% of all injuries. In the UNSW study, concussion accounted for 25% of injuries resulting in loss of playing or training time in the under 13 year age group. Upper and lower extremity injuries were equally apportioned, with musculoskeletal injuries being the main type of injury. Fractures were observed in the upper extremity and ankle, and joint/ligament injuries affected the shoulder, knee and ankle. The tackle was associated with around 50% of all injuries. The scrum produced fewer injuries, but is historically associated with spinal cord injury. CONCLUSIONS: Rugby is a contact sport with injury risks related to physical contact, primarily in the tackle. Most injuries affect the musculoskeletal system, with the exception of concussion. Spinal cord injury is rare, but catastrophic. Research is required to understand better injury risks and to reduce the incidence of shoulder, knee and ankle joint injuries, concussion and spinal injury.

Adolescent↗
PubMed2005

Peripheral nervous system injuries in sport and recreation: a systematic review.

Many sports are associated with a variety of peripheral nervous system (PNS) injuries specific to that sport. A systematic review of sport-specific PNS injuries has not been attempted previously, and will assist in the understanding of morbidities and mortality associated with particular sporting activities, either professional or amateur. A systematic review of the literature using PubMed (1965-2003) was performed examining all known sports and a range of possible PNS injuries attributable to that sport. Numerous sporting activities (53) were found to have associated PNS injuries. The sports most commonly reported with injuries were football, hockey, soccer, baseball and winter activities. There are a number of sporting activities with injuries unique to the individual sport. This review should be of assistance for the neurologist, neurosurgeon, orthopaedic surgeon, physiatrist, sports medicine doctor, athletic trainer and general physician in contact with athletes possessing neurological injuries.

Arm Injuries↗
PubMed2006

Golf injuries: a review of the literature.

Golf is one of a few activities that people of all ages and skill level can play. Injury as with all sports can occur. The low back is the most common injury sustained whilst playing golf, and the dynamic action of the golf swing is a major contributing factor to injury. The golf swing is a complex movement that utilises the whole body in a coordinated fashion and when repeated frequently can result in injury. Injury can be overuse or traumatic in nature. Overuse injuries predominate in the professional golfer, and amateur golfer injury tends to occur secondary to an incorrect golf swing. Upper limb injuries are also common due to their role in linking the fast moving golf club with the power-generating torso. Fortunately, injury from a club or ball strike is rare. More common are the overuse injuries associated with the back, neck and shoulder. Most golf injury data have been collected retrospectively and further epidemiological study of a prospective nature is required to determine injury incidence and factor relating to the onset of injury.

Arm Injuries↗
PubMed2000

Rehabilitation of the burned upper extremity.

With the advancement in medical technology and more effective life-sustaining measures, the rehabilitation therapist is faced with the immense task of effectively restoring functional ROM, strength, and mobility and producing a cosmetic result acceptable to the patient. Rehabilitation therapists have a very significant role to play in achieving these goals. The patients and their families come to rely very heavily on the therapists for advice, support, and information both in the acute phase of burn management and, potentially, for years to follow. A concerted team approach is necessary for a satisfactory functional outcome following burn injury.

Arm Injuries↗
PubMed2002

Upper limb vascular trauma in the Asir region of Saudi Arabia.

Upper limb vascular trauma is associated with major morbidity and mortality, but little is known about its incidence or nature in the Asir region of southern Saudi Arabia. During the five and a half-year period from May 1996 to December 2001, 27 patients were admitted to Asir Central Hospital (ACH), Abha, Saudi Arabia with upper limb vascular injury. The patients were 21 males and 6 females with a mean age of 27+/-12.6 years. Although penetrating trauma was more frequent than blunt trauma (59%), road traffic accident (RTA) was the most common single mechanism of trauma (33%). The brachial artery was the most frequently affected artery and interposition vein grafting was the most commonly employed type of vascular repair. Fifty-two percent of the patients had associated orthopedic injury and 60% had associated nerve injury. One patient underwent delayed above-elbow amputation and two patients died from other associated injuries. Vascular repair was successful in 24 out of the 26 patients in whom it was attempted (92%). However, the functional outcome of the limbs depended on the presence of associated nerve injury.

Adolescent↗
PubMed1990

Upper limb injuries in elite rock climbers.

Rockclimbing is now a popular sport and its standards have undergone a revolution in the past 10 years. Improvements in protection techniques and the quality of climbing equipment mean that the old problems of broken bones have been replaced by a new set of soft tissue problems. These include the impingement syndrome at the shoulder, lateral and medial epicondylitis and brachialis tendinitis at the elbow, and fixed flexion deformity and A2 pulley injury of the fingers.

Arm Injuries↗
PubMed1988

Tendon transfers for brachial plexus injury.

Brachial plexus injuries result in severe functional deficits in the upper limb. The authors review a group of 74 patients with brachial plexus injuries who underwent 160 tendon transfer operations, as well as 94 additional procedures, in an attempt to augment lost function. Following evaluation of functional recovery, 58 percent of the patients were rated Good, 34 percent Improved, and 8 percent Unimproved. The authors conclude that significant benefit can be obtained by peripheral reconstruction and tendon transfers in patients with brachial plexus injuries.

Arm Injuries↗