Owing to the lack of trained professionals in amputee care, the pediatrician is often required to assist in the care of children with limb deficiencies. An overview of the causes and epidemiology of ...limb deficiency is provided, as well as an evaluation and diagnostic workup. Important considerations for surgical interventions are discussed and an introduction to prosthetic prescribing and care of the amputee is described. Common overuse syndromes and mental health issues are also reviewed. Finally, resources for funding of prosthetic devices, as well as support and education for clinicians and families are provided.
Career-related injuries and disorders in professional musicians are prevalent across all their respective instruments and fields. They often endure long hours of intensive practice that demand high ...levels of precision, dexterity, and flexibility of their head, neck, hands, and upper extremities. Unlike the average patient, musicians are sensitive to even mild symptoms and deficits that can interfere with performance, which can potentially be career-threatening. Increasing attention to the care of musicians motivated performing arts medicine to tailor the practice to their individual and unique needs. Plastic surgeons are at the forefront of this practice; however, there are very limited reviews discussing plastic surgery management of the common injuries and disorders in musicians. This article reviews the most relevant literature of the past several decades regarding treatment modalities of the most common conditions endured by professional instrumentalists, with an emphasis on surgical considerations in the field of plastic surgery. A thorough literature search was performed for articles that encompass the interface between plastic surgery and musicians. We examined disorders of the head, ears, eyes, nose, throat, hands, and upper extremities including stress velopharyngeal incompetence, disruption of the embouchure, nerve entrapments, arthritis, traumatic injuries, focal dystonia, Linburg–Comstock syndrome, and overuse disorder. Overall, the goal of this review is to provide a summary of the existing and successful procedures performed to address prevalent musician conditions.
To identify risk factors associated with overuse injuries in cyclists.
Systematic review.
Data sources: Medline, CINAHL, EMBASE, SPORTDiscus, and the Cochrane Library were systematically searched. ...Reference checking and citation tracking of included articles were undertaken. Grey literature searches and a review of key publications by known experts in the industry were conducted.
Eligibility criteria for selecting studies: Studies evaluating the association between specific measures of the bike, the cyclist's body and load characteristics, and overuse pain or injury in cycling.
Of the 3596 studies yielded in the search, 18 studies were included in the review with only 3 of these studies deemed to have a low risk of bias. The best evidence synthesis showed moderate evidence of a relationship between load and symptoms, as well as moderate evidence of no relationship between cycling overuse injury or pain and many measures traditionally used in bike fitting. Conflicting evidence of a relationship exists between seat height and symptoms.
Cycling is popular on a world scale for transport and exercise with cyclists experiencing a high prevalence of overuse pain and injury. Many theories exist as to the cause of these symptoms, however there are limited high quality studies of risk factors for overuse injuries. This review highlights that there is no strong evidence relating any measure of the bike, body or load to cycling overuse pain or injury.
ZusammenfassungStressverletzungen des Knochens im Kindes- und Jugendalter stellen die Folge eines Missverhältnisses von körperlicher Belastung auf das wachsende muskuloskeletale System und dessen ...intrinsischer Belastbarkeit dar. Insbesondere sportlich sehr aktive Kinder sind betroffen. Durch überproportionale Belastung eines gesunden Knochens treten die klassischen Stressverletzungen hauptsächlich im Bereich des Unterschenkels, des Mittelfußes und der unteren LWS auf. Auch im Bereich der Wachstumsfugen können Überlastungssyndrome vorkommen und ggf. zu Wachstumsfugenstörungen führen. Die Anamnese weist meist einen seit Längerem bestehenden Belastungsschmerz ohne Trauma auf. Im Rahmen der Differenzialdiagnose muss zunächst aufgrund der seltenen Entität überhaupt an die Stressverletzungen gedacht werden. Eine Röntgenuntersuchung kann erste Hinweise auf eine Stressreaktion zeigen. Hier muss bei auffälliger Periostreaktion auch ein malignes Geschehen in Betracht gezogen werden. Eine MRT-Untersuchung ist dann wegweisend; selten müssen Biopsien erwogen werden. Die Therapie der Stressverletzungen ist konservativ. Rezidiven sollte über Belastungssteuerung entgegengewirkt werden.
We systematically searched medical publication databases for articles in English on upper extremity overuse syndrome in musicians. We focused on non-specific pain disorders, including diagnostic ...definitions, epidemiology, pathophysiology, risk factors, symptoms, treatment, and prevention. We included 42 out of 156 identified articles. The point prevalence of playing-related musculoskeletal disorders ranges from 37% to 47% in musicians with the hand and wrist among the most commonly affected areas, and the lifetime prevalence is reported as high as 89%. Leading symptoms are pain, weakness, stiffness, and loss of control. Intense repetitive use during practice, or before an audition or concert, recent changes in conductors or teachers, psychological stress, the effort of holding a weighty instrument, wrong technique, and joint laxity have all been identified as risk factors. The need for prevention is highlighted. Today’s therapy is mostly based on individual rehabilitation programmes rather than on long-term rest. However, treatment remains predominantly based on beliefs rather than on evidence. The entire subject needs intensive future research.
Sports Injuries Morimoto, Yusuke
Journal of Nihon University Medical Association,
2021/04/01, Volume:
80, Issue:
2
Journal Article
Peer reviewed
Open access
The world of sports injuries includes traumatic injuries and overuse syndrome.Typical traumatic injuries are sprains (ligament injuries), including ankle sprains and anterior cruciate ligament(ACL) ...knee injuries. If primary treatment of sprains is not performed properly, secondary injury caused by jointinstability often occurs, which can lead to osteoarthritis.Examples of overuse syndrome include tennis elbow and jumper’s knee. Overuse syndrome involves the inflammation of the surrounding enthesis. Improper treatment of such cases can lead to chronic enthesopathy.What is important in treating sports injuries is not only evaluating and treating the condition itself but alsomaintaining the overall physical stature of the athlete. Such care must involve both the treatment of the conditionand the prevention of recurrence.The knowledge acquired in sports medicine, including treatment methods and strategies for improving physicalfunction, can be widely applied in general medical care. This is the significance of sports orthopedics.
Background
Tendinosis in the common extensor tendon and accompanying ligament, bone, and plica abnormalities can be observed on magnetic resonance imaging (MRI).
Purpose
To determine whether there is ...a difference between accompanying abnormalities according to the degree of common extensor tendon injury
Material and Methods
Patients who underwent 1.5-T MRI tests with a prediagnosis of lateral overuse syndrome were retrospectively reviewed, and 56 patients who had an injury in the common extensor tendon (CET) were included. The degree of tendon and ligament injury, muscle signal change, bone marrow signal change, presence of joint effusion, and morphological features in the presence of plica were evaluated via MRI examinations of the elbow.
Results
Overall, 32, 16, and eight patients had mild, moderate, and severe CET damage, respectively. As the severity of CET damage increased, the presence of joint effusion, and the presence and degree of damage to the lateral ulnar collateral ligament (LUCL) and radial collateral ligament (RCL) increased. The radiohumeral (RH) plica area was significantly larger in the group with mild CET damage. There was no statistically significant correlation between the severity of CET damage and the end of RH plica with a blind-end, coverage of one-third or more of the radius, its signal, thickness, and presence of olecranon fold.
Conclusion
As the severity of CET injury increases, damage to the LUCL, RCL, and the presence of effusion in the joint increases. RH plica should be evaluated in terms of concomitant pathology in patients with mild CET injuries on MRI.
Deep fascia has long been considered a source of pain, secondary to nerve pain receptors becoming enmeshed within the pathological changes to which fascia are subject. Densification and fibrosis are ...among such changes. They can modify the mechanical properties of deep fasciae and damage the function of underlying muscles or organs. Distinguishing between these two different changes in fascia, and understanding the connective tissue matrix within fascia, together with the mechanical forces involved, will make it possible to assign more specific treatment modalities to relieve chronic pain syndromes. This review provides an overall description of deep fasciae and the mechanical properties in order to identify the various alterations that can lead to pain. Diet, exercise, and overuse syndromes are able to modify the viscosity of loose connective tissue within fascia, causing densification, an alteration that is easily reversible. Trauma, surgery, diabetes, and aging alter the fibrous layers of fasciae, leading to fascial fibrosis.
Le poignet microtraumatique du sportif Coustet, Baptiste
Revue du rhumatisme (Ed. française : 1993),
March 2023, 2023-03-00, Volume:
90, Issue:
2
Journal Article
Les douleurs du poignet sont un symptôme fréquent touchant les pratiquants de sports de raquettes, golf, gymnastique, cyclisme dans lesquels l’utilisation des mains est importante. Les douleurs du ...poignet du sportif peuvent être causées par un traumatisme aigu ou des microtraumatismes chroniques avec répétition de contraintes sur les tendons, ligaments et les structures articulaires. Dans cet article, nous décrirons les mécanismes menant aux lésions microtraumatiques du poignet, les lésions spécifiques du versant ulnaire et radial avec les diagnostics différentiels, les examens d’imagerie et les principes de traitement.
Wrist pain is a common symptom affecting athletes in racket sports, golf, gymnastics, cycling where there is frequent use of the hands. Wrist pain in athletes can be related to acute trauma or chronic overuse with repetitive stresses to tendons, ligaments, and the joint structures. In the present article, we discuss mechanisms of overuse wrist injury, sport-specific ulnar-sided and radial-sided wrist injuries with differential diagnosis, imaging and principles of treatment.
: The immature skeleton in a pediatric population exposed to frequent physical activity might be extremely prone to injuries, with possible consequences later in adulthood. The main aim of this study ...is to present specific morphometric parameters and magnetic resonance imaging (MRI) morphological changes of the knee and patella in a physically active pediatric population. Additionally, we wanted to investigate the morphological risk factors for patellar instability.
The study included the MRI findings of 193 physically active pediatric patients with knee pain. The participants underwent sports activities for 5 to 8 h per week. Two divisions were performed: by age and by patellar type. We evaluated three age groups: group 1 (age 11-14), group 2 (age 15-17), and group 3 (age 18-21 years). In addition, participants were divided by the patellar type (according to Wiberg) into three groups. The following morphometric parameters were calculated: lateral trochlear inclination (LTI), the tibial tubercle-trochlear groove distance (TT-TG), trochlear facet asymmetry (TFA), Insall-Salvati index, modified Insall-Salvati index, Caton-Deschamps index, articular overlap, morphology ratio and contact surface ratio.
We found a statistically significant association between patellar type groups in LTI (
< 0.001), TFA (
< 0.001), Insal-Salvati (
= 0.001) index, and Caton-Deschamps index (
= 0.018). According to age groups, we found statistical significance in the Caton-Deschamps index (
= 0.039). The most frequent knee injury parameter, according to Wiberg, in physically active pediatric patients was patella type 2 in boys and type 3 in girls.
The MRI morphometric parameters observed in our study might be factors of prediction of knee injury in physically active children. In addition, it might be very useful in sports programs to improve the biomechanics of the knee in order to reduce the injury rate in sports-active children.
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