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At least 1,747 records · Page 97Linked to original sources
PubMedDate not supplied

Achilles tendon injuries.

As the number of persons who participate in athletic activity into their later years has increased, so has the incidence of overuse injuries to the Achilles tendon. The etiology of these problems is multifactorial and includes biomechanical factors and training errors. Use of a histopathologic scheme for classification of these injuries facilitates a logical approach to treatment. Conservative care is a mainstay of treatment for inflammatory conditions. Satisfactory outcomes may be obtained with either nonoperative or operative treatment of acute ruptures, although surgically treated patients appear to recover better functional capacity. Treatment of neglected injuries to the Achilles tendon continues to be a challenging problem.

Achilles Tendon↗
PubMed1999

Partial-thickness tears of the rotator cuff: evaluation and management.

The approach to management of a partial-thickness rotator cuff tear is best made with the understanding that this is not a singular condition. Rather, partial tears represent the common outcome of a variety of insults to the rotator cuff. Degenerative changes due to aging, anatomic impingement, and trauma may all be etiologic agents. Overhead athletes may develop tears due to repetitive microtrauma or internal impingement. Outlet radiographs and magnetic resonance imaging are recommended for routine preoperative evaluation. A nonoperative treatment program for rotator cuff strengthening and stretching is appropriate as initial treatment; modification of activities and anti-inflammatory medication are often used as well. Operative management may be considered when nonoperative treatment fails. Arthroscopic evaluation is required to determine the true extent of the cuff lesion. Arthroscopic subacromial decompression is recommended when outlet impingement is present. Rotator cuff debridement or formal cuff repair is dependent on the size of the cuff defect and the age and activity level of the patient. The importance of recognizing the different causes of partial-thickness rotator cuff tears is emphasized in this review of pathogenesis, clinical diagnosis, imaging, and treatment.

Acromion↗
PubMedDate not supplied

Medial elbow problems in the overhead-throwing athlete.

The elbow is subjected to enormous valgus stresses during the throwing motion, which places the overhead-throwing athlete at considerable risk for injury. Injuries involving the structures of the medial elbow occur in distinct patterns. Although acute injuries of the medial elbow can occur, the majority are overuse injuries as a result of the repetitive forces imparted to the elbow by throwing. Injury to the ulnar collateral ligament complex results in valgus instability. Valgus extension overload leads to diffuse osseous changes within the elbow joint and secondary posteromedial impingement. Overuse of the flexor-pronator musculature may result in medial epicondylitis and occasional muscle tears and ruptures. Ulnar neuropathy is a common finding that may be due to a variety of factors, including traction, friction, and compression of the ulnar nerve. Advances in nonoperative and operative treatment regimens specific to each injury pattern have resulted in the restoration of elbow function and the successful return of most injured overhead athletes to competitive activities. With further insight into the relevant anatomy, biomechanics, and pathophysiology involved in overhead activities and their associated injuries, significant contributions can continue to be made toward prevention and treatment of these injuries.

Athletic Injuries↗
PubMedDate not supplied

Chronic exertional compartment syndrome.

Chronic exertional compartment syndrome is an often overlooked and uncommon cause of pain in the extremities of individuals who engage in repetitive physical activity. A thorough history, a careful physical examination, and compartment pressure testing are essential to establish the diagnosis. Catheter measurements can provide useful information on baseline resting compartment pressures as well as compartment pressures after exercise or trauma. Patients with chronic exertional compartment syndrome usually do not respond to nonsurgical therapy other than completely ceasing the activities that cause the symptoms. Surgical intervention entails fasciotomies of the involved compartments. Although obtaining accurate compartment pressure measurements can be difficult and fascial releases must be done carefully, patients typically have satisfactory functional results and are able to return to their usual physical activities after fasciotomy.

Angiography↗
PubMedDate not supplied

Shoulder and elbow injuries in the skeletally immature athlete.

The intensity of training and competition among young athletes can place them at increased risk of acute and chronic injuries, which occur in patterns unique to the skeletally immature athlete. Prompt recognition and treatment of these injuries are critical to prevent long-term functional disability and deformity. Children and adolescents participating in recreational and organized sports are particularly susceptible to a broad spectrum of shoulder and elbow injuries involving both osseous and soft-tissue structures. Understanding the relevant functional anatomy, biomechanics of throwing, and pathophysiology of injury can help the clinician manage common acute traumatic injuries, some of which may result in chronic problems. Over-use injuries occur more frequently than do acute, traumatic injuries, and early recognition, coupled with appropriate treatment or prevention, can help restore and maintain normal shoulder and elbow function.

Adolescent↗
PubMed2006

The hallucal sesamoid complex.

The hallucal sesamoids are vitally important to normal weight bearing and foot mechanics. The sesamoid complex of the hallux normally transmits up to 50% of body weight and during push-off can transmit loads >300%. These high stresses may lead to both acute and chronic pathologies of the hallucal sesamoids. Sesamoidal problems may occur in the weekend warrior or the elite-level athlete. Thus, patients with sesamoid pathology may present to a general orthopaedic surgeon, sports medicine physician, foot and ankle specialist, or podiatrist. Physical examination, radiographs, and other specialized studies assist with the classification of sesamoid pathology. Initial treatment almost always involves an accommodative orthosis, but surgical intervention may be necessary in recalcitrant cases. Surgical options for managing problems of the hallucal sesamoid complex include curettage, bone grafting, shaving, internal fixation, and partial or complete excision.

Cumulative Trauma Disorders↗
PubMed1987

Epidemiological aspects of "repetition strain injury" in Telecom Australia.

An epidemic of "repetition strain injury" ("RSI") in Telecom Australia is described. In the years 1981-1985, there have been 3976 reports of "RSI". The occupation that was most affected was that of telephonist, with 1886 reports and a rate of 343 per 1000 keyboard staff members over five years; among other occupations that were affected were clerical workers (1421 reports; rate, 284 per 1000 keyboard staff members); telegraphists (17 reports; rate, 34 per 1000 staff members); and process workers (235 reports; rate, 116 per 1000 staff members). Women accounted for 3330 (83%) of all reports; in the telephonist group, 27% of female and 20% of male staff members were affected (P less than 0.001); for women, younger staff members were more affected. There was a significant difference among states in the prevalence of "RSI" in telephonists. There was a high morbidity, and 644 (16%) subjects were affected for more than 26 weeks; the cost-effectiveness of treatment and rehabilitation varied appreciably among state administrations. The costs of the epidemic exceed $15 million, including $1.8 million in medical costs. Reasons for the rise and decline of the epidemic are discussed.

Australia↗