[Iron deficiency and anemia in junior women's competitive sport]. / Carence martiale et anémie dans le sport de compétition junior féminin.

An iron deficient athlete is likely to develop iron deficiency anemia, a pathology that may lead to a decrease in performance. If adult athletes, women and men, are aware of the need for regular monitoring, young people under 18 are not necessarily aware of the risks associated with competitive sports practice in the presence of anemia. Even if the guidelines are well known and described, a lack of regular monitoring is found for the aforementioned age group. In junior female athletes practicing basketball, a significant rate of iron deficiency or even iron deficiency anemia was found during annual analyses. The authors wish to emphasize the importance of regular medical and laboratory follow-up for younger athletes who often no longer have a pediatrician and no attending physician.

Un sportif carencé en fer risque de développer une anémie ferriprive qui peut être à l'origine d'une diminution des performances. Les sportifs adultes, femmes et hommes, ont conscience de la nécessité d'un suivi régulier mais cette connaissance des risques liés à l'anémie dans la pratique sportive n'est pas forcément présente chez les jeunes de moins de 18 ans. Même si les lignes de conduite sont décrites et connues, on observe un manque de suivi régulier dans la tranche d'âge précitée. Chez les basketteuses féminines juniors, un taux de carence martiale significatif, voire une anémie ferriprive, a été retrouvé lors des analyses annuelles. Les auteurs souhaitent mettre ce problème en évidence et souligner l'importance d'un suivi médical et biologique régulier pour les sportifs en devenir qui n'ont souvent plus de médecin pédiatre et pas encore de médecin traitant.

Hinge plate technique for osteosynthesis of comminuted proximal humeral fractures.

BACKGROUND: Several surgical techniques of osteosynthesis have been described for treatment of proximal humeral fractures. There is evidence that the quality of reduction improves the clinical outcome and decreases the number of complications. Reduction of the medial calcar is tricky when standard manoeuvres are performed. We have therefore augmented our standard surgical technique with a low-profile medial hinge plate which aims at better reconstructing the medial metaphysis without extensile soft tissue dissection in combination with proximal humerus locked plating. OBJECTIVE: Evaluate the radiological and clinical outcome after application of an augmented fixation with a low-profile medial hinge plate. We questioned: (i) The quality of reduction, (ii) The rate of complications, (iii) The clinical function in terms of the Oxford Shoulder Score (OSS). METHODS: A retrospective single-centre case series. Between 2016 and 2019, patients who had undergone open reduction and osteosynthesis by an anatomical locking plate associated with a 2.0 mm locking compression plate used as a hinge to support the medial metaphysis. Thirty-four patients, with an average age of 64 years had a clinical and/or radiological average follow-up of 36 months. RESULTS: The preoperative imaging identified three fractures in two parts, 19 fractures in three parts and 12 fractures in four parts. Seven cases with fracture-dislocation were identified, one head-split fracture, and 14 cases with a metaphyseal head extension of less than 8 mm. After comparing head-shaft displacement, cranialisation of the greater tuberosity as well as head-shaft alignment in the preoperative and postoperative radiographs, overall anatomical or near-anatomical fracture reduction was achieved in 27 of the patients. Only two cases presented postoperative complications. The two cases were complicated with nonunion without screw perforation requiring surgical intervention by re-osteosynthesis. The clinical outcome assessed by the OSS showed an average of 45/48. The age of the group with anatomical or near anatomical reduction and the group with at least one parameter of malreduction was significantly different, 65 and 74 years respectively (p<0.05). No significant differences were found when comparing the sex, surgical time, time to operation or the number of fracture parts. CONCLUSION: The technique described provides a surgical treatment option with lower complication rates and a quality of reduction consistent with the current literature as well as a satisfactory clinical outcome.