Orthopedic Clinics of North America Volume 47, Issue 4, Pages A1-A10, 645-828 (October 2016)


    • Tibial Stress Fractures in Athletes

      Review Article
    • Pages 733-741
    • John J. Feldman, Eric N. Bowman, Barry B. Phillips, John C. Weinlein
    • Tibial stress fractures are common in the athlete. There are various causes of these fractures, the most common being a sudden increase in training intensity. Most of these injuries are treated conservatively; however, some may require operative intervention. Intervention is mostly dictated by location of the fracture and failure of conservative treatment. There are several surgical options available to the treating surgeon, each with advantages and disadvantages. The physician must understand the nature of the fracture and the likelihood for it to heal in a timely manner in order to best treat these fractures in this patient subset.

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  1. Pediatrics

    • Pediatric Elbow and Wrist Pathology Related to Sports Participation

      Review Article
    • Pages 743-748
    • Matthew D. Ellington, Eric W. Edmonds
    • Pediatric overuse injuries are becoming more prevalent in today’s society with more children competitively playing year-round sports at a younger age. The importance of prompt diagnosis and treatment is paramount to the treatment for these injuries, second only to rest and activity modification. This article will focus on overuse injuries of the upper extremity, specifically: little league elbow, elbow osteochondritis dissecans, and gymnast wrist. It will also discuss the pathophysiology, diagnosis, imaging, and treatment of each of these entities.

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    • Shoulder Injuries in Pediatric Athletes

      Review Article
    • Pages 749-762
    • James E. Moyer, Jennifer M. Brey
    • Shoulder injuries in pediatric athletes are typically caused by acute or overuse injuries. The developing structures of the shoulder lead to injury patterns that are distinct from those of adult athletes. Overuse injuries often affect the physeal structures of the proximal humerus and can lead to pain and loss of sports participation. Shoulder instability is common in pediatric athletes, and recurrence is also a concern in this population. Fractures of the proximal humerus and clavicle are typically treated with conservative management, but there is a trend toward surgical intervention.

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    • Pediatric Knee Osteochondritis Dissecans Lesions

      Review Article
    • Pages 763-775
    • Aristides I. Cruz Jr., Kevin G. Shea, Theodore J. Ganley
    • Osteochondritis dissecans (OCD) can cause knee pain and dysfunction in children. The etiology of OCD remains unclear; theories on causes include inflammation, ischemia, ossification abnormalities, genetic factors, and repetitive microtrauma. Most OCD lesions in skeletally immature patients will heal with nonoperative treatment. The success of nonoperative treatment decreases once patients reach skeletal maturity. The goals of surgical treatment include maintenance of articular cartilage congruity, rigid fixation of unstable fragments, and repair of osteochondral defects with cells or tissues that can adequately replace lost or deficient cartilage. Unsalvageable OCD lesions can be treated with various surgical techniques.

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    • Anterior Cruciate Ligament Injuries in Children and Adolescents

      Review Article
    • Pages 777-788
    • Peter D. Fabricant, Mininder S. Kocher
    • Dramatic increases in youth competitive athletic activity, early sport specialization, and year-round training and competition, along with increased awareness of anterior cruciate ligament (ACL) injuries in children, have led to a commensurate increase in the frequency of ACL tears in the skeletally immature. Recent understanding of the risks of nonoperative treatment and surgical delay have supported a trend toward early operative treatment. This article discusses treatment strategies for ACL injuries in children and adolescents, and offers our preferred treatment strategy for skeletally immature youth athletes with ACL tears.

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  2. Upper Extremity

    • Ulnar-Sided Wrist Pain in the Athlete

      Review Article
    • Pages 789-798
    • Chance J. Henderson, Ky M. Kobayashi
    • Ulnar-sided wrist pain can be a challenging entity for the hand surgeon and even more so in the athletic population. The authors present 8 causes of ulnar-sided wrist pain in an athlete (hook of hamate fracture, pisiform fracture, hypothenar hammer syndrome, triangular fibrocartilage complex injuries, ulnocarpal impaction syndrome, lunotriquetral ligament tears, extensor carpi ulnaris tendinitis, subluxation of extensor carpi ulnaris) and their associated imaging and treatment options.

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    • Thumb Ligament Injuries in the Athlete

      Review Article
    • Pages 799-807
    • F. Patterson Owings, James H. Calandruccio, Benjamin M. Mauck
    • Hand injuries account for up to 15% of sports injuries and are common in contact sports and in sports with a high risk of falling. Appropriate management requires knowledge of the type of injury, demands of the sport and position, competitive level of the athlete, future athletic demands and expectations, and the role of rehabilitation and protective splints for return to play. Management of the athlete requires aggressive and expedient diagnostic intervention and treatment. This article describes ligamentous injuries to the thumb, including thumb carpometacarpal dislocations, thumb metacarpophalangeal dislocations, collateral ligament injuries and interphalangeal dislocations, their evaluation, treatment and outcomes.

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  3. Foot and Ankle

    • Foot and Ankle Stress Fractures in Athletes

      Review Article
    • Pages 809-822
    • Michael C. Greaser
    • The incidence of stress fractures in the general athletic population is less than 1%, but may be as high as 15% in runners. Stress fractures of the foot and ankle account for almost half of bone stress injuries in athletes. These injuries occur because of repetitive submaximal stresses on the bone resulting in microfractures, which may coalesce to form complete fractures. Advanced imaging such as MRI and triple-phase bone scans is used to evaluate patients with suspected stress fracture. Low-risk stress fractures are typically treated with rest and protected weight bearing. High-stress fractures more often require surgical treatment.

Autor / Fonte:Orthopedic Clinics of North America Volume 47, Issue 4, Pages A1-A10, 645-828 (October 2016)
Link: http://www.sciencedirect.com/science/journal/00305898/47/4