Posttraumatic Deep Vein Thrombosis in Collegiate Athletes: An Exploration Clinical Case Series.

BACKGROUND: Although athletes are typically at low risk for developing venous thromboembolism (VTE), injured and noninjured athletes alike can be exposed to many acquired risk factors, including intense training, dehydration, trauma, immobilization, oral contraceptive use, and long-distance travel. Additionally, the risk of developing VTE might be increased by unidentified genetic clotting disorders. Due to the potential for fatal outcomes, knowledge of VTE pathoetiology and recognition of deep vein thrombosis (DVT) presentation should be an inherent part of the evaluation process for all who attend to athletes, regardless of age and apparent risk profile. OBJECTIVE: To present an exploration clinical case series consisting of 2 otherwise healthy, college-aged female athletes who, despite their ages and relative low risk profiles, experienced DVTs after lower extremity trauma. Each case will be discussed relative to known clinical prediction rules (CPRs) and published evidence. CONCLUSIONS: Collectively, both cases reinforce the need for the attending clinicians to perform a thorough history and pay attention to subtle clinical findings, regardless of the relatively low risk in college-aged athletes. Although the Wells' CPRs for DVT can be used as a diagnostic guideline in the general population, it might not fully address the risks inherent in a young, otherwise healthy athletic population. We propose a risk-screening tool that is based on and modified from our experiences with these 2 patients and the known prediction rules and positive probability influences.

Nonsurgical Management of an Anterior Cruciate Ligament-Deficient Knee in a Women's Soccer Player: A Validation Clinical Case Report.

BACKGROUND: A collegiate women's soccer player sustained an isolated anterior cruciate ligament (ACL) tear and expressed a desire to continue her season without surgical intervention. DESIGN: Case report. INTERVENTION(S): Using the results of a randomized controlled trial and published clinical guidelines, the clinicians classified the patient as an ACL-deficient coper. The patient completed her soccer season without incident, consistent with the findings of the established clinical guidelines. However, 6 months later, she sustained a meniscal tear, which was not unexpected given that 22% of ACL-deficient copers in the randomized controlled trial incurred a meniscal tear within 24 months of ACL injury. CONCLUSION: The external evidence was helpful in making informed clinical decisions regarding patient care.