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European Journal of Sport Science Jul 2017Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the... (Review)
Review
Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the effect of preventive measures on the incidence of injuries in volleyball. This study aimed to review systematically the scientific evidence on the incidence, prevalence, aetiology and preventive measures of volleyball injuries. To this end, a highly sensitive search strategy was built based on two groups of keywords (and their synonyms). Two electronic databases were searched, namely Medline (biomedical literature) via Pubmed, and SPORTDiscus (sports and sports medicine literature) via EBSCOhost. The results showed that ankle, knee and shoulder injuries are the most common injuries sustained while playing volleyball. Results are presented separately for acute and overuse injuries, as well as for contact and non-contact injuries. Measures to prevent musculoskeletal injuries, anterior knee injuries and ankle injuries were identified in the scientific literature. These preventive measures were found to have a significant effect on decreasing the occurrence of volleyball injuries (for instance on ankle injuries with a reduction from 0.9 to 0.5 injuries per 1000 player hours). Our systematic review showed that musculoskeletal injuries are common among volleyball players, while effective preventive measures remain scarce. Further epidemiological studies should focus on other specific injuries besides knee and ankle injuries, and should also report their prevalence and not only the incidence. Additionally, high-quality studies on the aetiology and prevention of shoulder injuries are lacking and should be a focus of future studies.
Topics: Ankle Injuries; Athletic Injuries; Cumulative Trauma Disorders; Humans; Incidence; Knee Injuries; Prevalence; Risk Factors; Shoulder Injuries; Volleyball
PubMed: 28391750
DOI: 10.1080/17461391.2017.1306114 -
Journal of Orthopaedic Trauma May 2019We aimed to produce comprehensive guidelines and recommendations that can be utilized by orthopaedic practices as well as other specialties to improve the management of... (Review)
Review
PURPOSE
We aimed to produce comprehensive guidelines and recommendations that can be utilized by orthopaedic practices as well as other specialties to improve the management of acute pain following musculoskeletal injury.
METHODS
A panel of 15 members with expertise in orthopaedic trauma, pain management, or both was convened to review the literature and develop recommendations on acute musculoskeletal pain management. The methods described by the Grading of Recommendations Assessment, Development, and Evaluation Working Group were applied to each recommendation. The guideline was submitted to the Orthopaedic Trauma Association (OTA) for review and was approved on October 16, 2018.
RESULTS
We present evidence-based best practice recommendations and pain medication recommendations with the hope that they can be utilized by orthopaedic practices as well as other specialties to improve the management of acute pain following musculoskeletal injury. Recommendations are presented regarding pain management, cognitive strategies, physical strategies, strategies for patients on long term opioids at presentation, and system implementation strategies. We recommend the use of multimodal analgesia, prescribing the lowest effective immediate-release opioid for the shortest period possible, and considering regional anesthesia. We also recommend connecting patients to psychosocial interventions as indicated and considering anxiety reduction strategies such as aromatherapy. Finally, we also recommend physical strategies including ice, elevation, and transcutaneous electrical stimulation. Prescribing for patients on long term opioids at presentation should be limited to one prescriber. Both pain and sedation should be assessed regularly for inpatients with short, validated tools. Finally, the group supports querying the relevant regional and state prescription drug monitoring program, development of clinical decision support, opioid education efforts for prescribers and patients, and implementing a department or organization pain medication prescribing strategy or policy.
CONCLUSIONS
Balancing comfort and patient safety following acute musculoskeletal injury is possible when utilizing a true multimodal approach including cognitive, physical, and pharmaceutical strategies. In this guideline, we attempt to provide practical, evidence-based guidance for clinicians in both the operative and non-operative settings to address acute pain from musculoskeletal injury. We also organized and graded the evidence to both support recommendations and identify gap areas for future research.
Topics: Humans; Musculoskeletal Pain; Musculoskeletal System; Pain Management; Practice Guidelines as Topic; Wounds and Injuries
PubMed: 30681429
DOI: 10.1097/BOT.0000000000001430 -
The Journal of the American Academy of... Jun 2020Increasing numbers of people are participating in the sport of rock climbing, and its growth is expected to continue with the sport's Olympic debut in 2020. Extreme... (Review)
Review
Increasing numbers of people are participating in the sport of rock climbing, and its growth is expected to continue with the sport's Olympic debut in 2020. Extreme loading of the upper extremities, contorted positioning of the lower extremities, rockfall, and falling from height create an elevated and diverse injury potential that is affected by experience level and quantity of participation. Injuries vary from acute traumatic injuries to chronic overuse injuries. Unique sport-specific injuries to the flexor tendon pulley system exist, but the remaining musculoskeletal system is not exempt from injury. Orthopaedic evaluation and surgery is frequently required. Understanding the sport of rock climbing and its injury patterns, treatments, and prevention is necessary to diagnose, manage, and counsel the rock-climbing athlete.
Topics: Accidental Falls; Athletic Injuries; Chronic Disease; Cumulative Trauma Disorders; Humans; Mountaineering; Musculoskeletal System
PubMed: 32015250
DOI: 10.5435/JAAOS-D-19-00575 -
Sports Health 2017The medial head of the gastrocnemius is the third most commonly strained muscle in elite athletes after the biceps femoris and rectus femoris. The differential diagnosis... (Review)
Review
CONTEXT
The medial head of the gastrocnemius is the third most commonly strained muscle in elite athletes after the biceps femoris and rectus femoris. The differential diagnosis of posterior calf injury includes musculoskeletal and nonmusculoskeletal causes. Classically, delineation of these injuries from one another relied primarily on historical features and physical examination findings. The utilization of musculoskeletal ultrasound (sonography) has augmented the diagnosis of these injuries by providing dynamic, real-time confirmation.
EVIDENCE ACQUISITION
A review of PubMed, OVID, and MD Consult prior to January 2016 was performed using search terms, including s oleus ultrasound, gastrocnemius ultrasound, and tennis leg. The references of the pertinent articles were further reviewed for other relevant sources.
STUDY DESIGN
Clinical review.
LEVEL OF EVIDENCE
Level 4.
RESULTS
There have been few reviews to date of calf injuries and the use of sonography in their diagnosis. Prompt diagnosis utilizing ultrasound allows the clinician to focus management on gastrocnemius injury if present. Two-thirds of calf injuries occur at the junction of the fascia between the medial head of the gastrocnemius and the soleus. Injuries to the lateral head of the gastrocnemius occur in up to 14% of patients in some case series, but injury may occur anywhere from the proximal origin to the mid-belly to the fascial junction with the soleus. Numerous injuries to the posterior compartment can mimic gastrocnemius strain, and musculoskeletal ultrasound can aide in their diagnosis by incorporating real-time imaging into the grading of the injury and visual confirmation of physical examination findings.
CONCLUSION
Acute injury to the posterior compartment of the lower extremity can represent a diagnostic challenge. Medial gastrocnemius strain represents the most common injury of the posterior compartment of the lower extremity. Ultrasound is a useful tool to assist the clinician in determining the specific cause of calf injury, estimate the severity of the injury, and monitor progress of healing. The vast majority of calf injuries can be diagnosed and managed without any additional imaging. Serial diagnostic ultrasound of an injured area allows for direct monitoring of tissue healing and may allow the clinician to more confidently assess response to treatment and help guide return-to-play decisions.
Topics: Athletic Injuries; Humans; Leg Injuries; Muscle, Skeletal; Sprains and Strains; Ultrasonography
PubMed: 28661826
DOI: 10.1177/1941738117696019 -
Emergency Medicine Clinics of North... May 2021Geriatric trauma patients will continue to increase in prevalence as the population ages, and many specific considerations need to be made to provide appropriate care to... (Review)
Review
Geriatric trauma patients will continue to increase in prevalence as the population ages, and many specific considerations need to be made to provide appropriate care to these patients. This article outlines common presentations of trauma in geriatric patients, with consideration to baseline physiologic function and patterns of injury that may be more prevalent in geriatric populations. Additionally, the article explores specific evidence-based management practices, the significance of trauma team and geriatrician involvement, and disposition decisions.
Topics: Accidental Falls; Aged; Aging; Cardiovascular Diseases; Comorbidity; Frailty; Geriatricians; Health Services Accessibility; Humans; Lung Diseases; Musculoskeletal Diseases; Neurocognitive Disorders; Pain Management; Patient Discharge; Trauma Centers; Vital Signs; Wounds and Injuries
PubMed: 33863458
DOI: 10.1016/j.emc.2021.01.002 -
Lancet (London, England) Oct 2014Improvements in the control of haemorrhage after trauma have resulted in the survival of many people who would otherwise have died from the initial loss of blood.... (Review)
Review
Improvements in the control of haemorrhage after trauma have resulted in the survival of many people who would otherwise have died from the initial loss of blood. However, the danger is not over once bleeding has been arrested and blood pressure restored. Two-thirds of patients who die following major trauma now do so as a result of causes other than exsanguination. Trauma evokes a systemic reaction that includes an acute, non-specific, immune response associated, paradoxically, with reduced resistance to infection. The result is damage to multiple organs caused by the initial cascade of inflammation aggravated by subsequent sepsis to which the body has become susceptible. This Series examines the biological mechanisms and clinical implications of the cascade of events caused by large-scale trauma that leads to multiorgan failure and death, despite the stemming of blood loss. Furthermore, the stark and robust epidemiological finding--namely, that age has a profound influence on the chances of surviving trauma irrespective of the nature and severity of the injury--will be explored. Advances in our understanding of the inflammatory response to trauma, the impact of ageing on this response, and how this information has led to new and emerging treatments aimed at combating immune dysregulation and reduced immunity after injury will also be discussed.
Topics: Age Factors; Endocrine System; Hemostasis; Humans; Immunity, Innate; Neutrophils; Sex Factors; Systemic Inflammatory Response Syndrome; Wounds and Injuries
PubMed: 25390327
DOI: 10.1016/S0140-6736(14)60687-5 -
Bulletin of the Hospital For Joint... Sep 2018While yoga has been widely studied for its benefits to many health conditions, little research has been performed on the nature of musculoskeletal injuries occurring... (Review)
Review
While yoga has been widely studied for its benefits to many health conditions, little research has been performed on the nature of musculoskeletal injuries occurring during yoga practice. Yoga is considered to be generally safe, however, injury can occur in nearly any part of the body-especially the neck, shoulders, lumbar spine, hamstrings, and knees. As broad interest in yoga grows, so will the number of patients presenting with yoga-related injuries. In this literature review, the prevalence, types of injuries, forms of yoga related with injury, specific poses (asanas) associated with injury, and preventive measures are discussed in order to familiarize practitioners with yoga-related injuries.
Topics: Humans; Musculoskeletal System; Risk Factors; Wounds and Injuries; Yoga
PubMed: 31513523
DOI: No ID Found -
Pediatric Clinics of North America Feb 2020The management of pediatric orthopedic trauma continues to evolve rapidly. Whereas the strong healing potential of pediatric patients often allows for the nonoperative... (Review)
Review
The management of pediatric orthopedic trauma continues to evolve rapidly. Whereas the strong healing potential of pediatric patients often allows for the nonoperative treatment of most conditions, many injuries require urgent operative treatment to ensure that patients may return to all activities without disability. Some injuries may require additional follow-up and interventions, as complications such as growth arrests or deformity may occur. This article summarizes the most common fractures and orthopedic injuries of the pediatric patient. The keys to diagnosis, acute management, nonoperative and operative treatments, and complications are discussed. The detection and management of nonaccidental trauma are also examined.
Topics: Child; Child Abuse; Fractures, Bone; Humans; Musculoskeletal System; Wounds and Injuries
PubMed: 31779827
DOI: 10.1016/j.pcl.2019.09.010 -
Seminars in Ultrasound, CT, and MR Aug 2018The use of point-of-care ultrasound in trauma is widespread. Focused Assessment with Sonography for Trauma examination is a prototypical bedside examination used by the... (Review)
Review
The use of point-of-care ultrasound in trauma is widespread. Focused Assessment with Sonography for Trauma examination is a prototypical bedside examination used by the treating provider to quickly determine need for intervention and appropriate patient disposition. The role of bedside ultrasound in trauma, however, has expanded beyond the Focused Assessment with Sonography for Trauma examination. Advancements in diagnostics include contrast-enhanced ultrasound, thoracic, and musculoskeletal applications. Ultrasound is also an important tool for trauma providers for procedural guidance including vascular access and regional anesthesia. Its portability, affordability, and versatility have made ultrasound an invaluable tool in trauma management in resource-limited settings. In this review, we discuss these applications and the supporting evidence for point-of-care ultrasound in trauma.
Topics: Humans; Point-of-Care Systems; Ultrasonography; Wounds and Injuries
PubMed: 30070230
DOI: 10.1053/j.sult.2018.03.007 -
Methods in Molecular Biology (Clifton,... 2016Volumetric muscle loss (VML) injury is prevalent in severe extremity trauma and is an emerging focus area among orthopedic and regenerative medicine fields. VML injuries...
Volumetric muscle loss (VML) injury is prevalent in severe extremity trauma and is an emerging focus area among orthopedic and regenerative medicine fields. VML injuries are the result of an abrupt, frank loss of tissue and therefore of different etiology from other standard rodent injury models to include eccentric contraction, ischemia reperfusion, crush, and freeze injury. The current focus of many VML-related research efforts is to regenerate the lost muscle tissue and thereby improve muscle strength. Herein, we describe a VML model in the anterior compartment of the hindlimb that is permissible to repeated neuromuscular strength assessments and is validated in mouse, rat, and pig.
Topics: Animals; Mice; Models, Animal; Muscle Contraction; Muscle Strength; Muscle, Skeletal; Organ Size; Rats; Swine; Wounds and Injuries
PubMed: 27492162
DOI: 10.1007/978-1-4939-3810-0_2