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Osteochondral injuries. Clinical findings.

Osteochondral injuries are common, mainly affecting a young, active population. Failure to recognize these injuries can lead to long-term disability. A heightened awareness and understanding of the common mechanisms of injury will lead to early diagnosis and rapid recovery. This, along with improved treatment modalities, will keep any long-term disability to a minimum.

Adolescent↗

Arthroscopic excision of type II capitellar fractures.

Type II capitellar fractures are uncommon. The current treatment recommendation for these fractures is open excision. The major complication of open excision is loss of motion. Two cases of the previously unreported technique of arthroscopic excision are presented with a review of the literature. Arthroscopic excision of displaced type II capitellar fractures is a safe, effective technique that causes minimal soft tissue trauma, allows thorough inspection of the joint for additional occult injuries, and optimizes postoperative range of motion.

Adult↗

Wringer washer injuries in children.

Injuries resulting from wringer washers are still fairly common around the world. Manufacturers' data regarding wringer washers are reported. The literature is reviewed, and 104 new pediatric cases seen between 1970 and 1980 at one pediatric institution are presented. These patients suffered a wide variety of injuries ranging from simple skin abrasions to loss of limbs. Skeletal, nerve, and tendon injuries were encountered. The recommended management stresses the importance of elevation and close observation with no emphasis on compression dressing.

Accidents, Home↗

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↗

Disability days in major league baseball.

We have examined the injury experience in Major League Baseball as reflected by the disabled list, based on data presented by American Specialty Companies in their publications, to examine any changes in injury rates over the past 11 years. It is reasonable to expect that improvements in training and conditioning, diagnostic methods, and surgical treatment over the last 11 years would have reduced injuries and resulted in fewer players on the disabled list. Yet, such does not appear to be the case. There is no evidence that the number of injuries in Major League Baseball has declined over the last decade; on the contrary, it appears that both the number of players and player days on the disabled list have increased. Team membership, injury location, and position do not appear to be related to the increase. Nor does it appear that the increase in injuries is a result of more sensitive diagnostic tests allowing the diagnoses of previously unrecognized injuries. Whatever the reason, it is significant that publicly available data, when viewed over an 11-year period, reveal a gradual and consistent increase in reported injuries--suggesting a problem that deserves attention.

Absenteeism↗

Rehabilitation and splinting of common upper extremity injuries in athletes.

Treatment of athletes and the injuries they sustain can be both challenging and rewarding. Each individual case requires a careful examination of the physical symptoms and the process leading up to the injury. From this, one attempts to determine the appropriate course of treatment aimed at minimizing lost time from sports and to develop preventive strategies to promote healing and prevent future injury. Open communication between the athlete and his or her physician, therapist, trainer, and coach facilitates the most innovative and effective treatment strategies, enabling the best possible result following an athletic injury to the upper extremity.

Athletic Injuries↗