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Clin J Sport Med ; 30(2): 102-107, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32073473


OBJECTIVE: To investigate CrossFit-related injuries presenting to a pediatric sports medicine clinic. DESIGN: Retrospective review of pediatric CrossFit-related injuries from between January 1, 2003, and June 31, 2016. SETTING: Pediatric sports medicine clinic at a tertiary-level academic medical center. PATIENTS: Patients with injury related to CrossFit participation. INDEPENDENT VARIABLES: Sex, age, injury site, diagnosis, diagnostic imaging, and treatment. MAIN OUTCOME MEASURES: Annual CrossFit-related injury proportion (%) over time. RESULTS: One hundred fifteen medical identified (N = 55 female; mean age, 25.2 ± 10.4 years). Proportion of CrossFit-related injuries presenting to clinic relative to overall clinic volume consistently increased over time (Pearson r = 0.825; P = 0.022). Injury location included head (0.08%), trunk/spine (25.2%), upper extremity (27.0%), and lower extremity (47.0%). Common injured joints included knee (27%), spine (24.3%), and shoulder (16.5%). Nearly half of patients had a single diagnostic imaging (49.6%; 57 of 115). Most common diagnostics included magnetic resonance imaging (60.0%; 69 of 115), plain radiographs (51.3%; 59 of 115), ultrasound (10.4%; 12 of 115), and computerized tomographic scan (9.6%; 11 of 115). Most commonly prescribed treatments included physical/occupational therapy (38.3%; 44 of 115), activity modification (19.1%; 22 of 115), crutches/brace/splinting/compression sleeve (13.0%; 15 of 115), and non-steroidal anti-inflammatory medications (10.4%; 12 of 115). CONCLUSIONS: CrossFit-related injury proportion presenting to a pediatric sports medicine clinic increased over time. A notable proportion of injuries occurred to the trunk and spine. Advanced imaging was obtained in approximately half of these youth athletes. Further research in youth CrossFit athletes is required surrounding mechanism of injury to prevent future injury in this mode of training for youth athletes.

Traumatismos em Atletas/diagnóstico por imagem , Condicionamento Físico Humano/efeitos adversos , Condicionamento Físico Humano/métodos , Adulto , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/terapia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Estados Unidos/epidemiologia , Adulto Jovem
Clin J Sport Med ; 30(3): 251-256, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31842052


OBJECTIVE: To examine CrossFit-related injuries based on sex and age. DESIGN: Retrospective case series. SETTING: A tertiary-level pediatric sports medicine clinic. PARTICIPANTS: CrossFit athletes. MAIN OUTCOME MEASURES: CrossFit-related injuries by sex (males vs females) and age groups (≤19 years vs >19 years) using a χ analysis with P = 0.05, odds ratio (OR), and 95% confidence interval (95% CI). RESULTS: Among injured CrossFit athletes, female athletes sustained lower extremity injuries more frequently than male athletes (P = 0.011; OR, 2.65; 95% CI, 1.25-5.65). In observed CrossFit injuries, shoulder injuries were more frequently observed in male athletes compared with female athletes (P = 0.049; OR, 2.79; 95% CI, 0.98-7.95). Additionally, a greater proportion of CrossFit athletes aged 19 years and younger suffered trunk/spine injuries than those older than 19 years (P = 0.027; OR, 2.61; 95% CI, 1.10-6.21) in injured CrossFit athletes. CONCLUSIONS: The current results indicated sex- and age-specific susceptibility to CrossFit-related injuries based on body parts and diagnoses. The presented information may be useful to develop a safer exercise program, especially for pediatric and adolescent CrossFit participants.

Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/etiologia , Condicionamento Físico Humano/efeitos adversos , Condicionamento Físico Humano/métodos , Adolescente , Adulto , Fatores Etários , Índice de Massa Corporal , Feminino , Treinamento Intervalado de Alta Intensidade/efeitos adversos , Lesões do Quadril/diagnóstico , Lesões do Quadril/etiologia , Humanos , Articulações/lesões , Traumatismos do Joelho/diagnóstico , Traumatismos do Joelho/etiologia , Masculino , Ossos Pélvicos/lesões , Exercício Pliométrico/efeitos adversos , Estudos Retrospectivos , Fatores Sexuais , Lesões do Ombro/diagnóstico , Lesões do Ombro/etiologia , Traumatismos da Coluna Vertebral/diagnóstico , Traumatismos da Coluna Vertebral/etiologia , Levantamento de Peso/lesões , Adulto Jovem
Phys Sportsmed ; 47(4): 441-447, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31109214


Objective: To describe the evaluation, management and recovery time of hallux sesamoid fractures in young athletes.Methods: A retrospective chart review was performed in a large academic teaching institution over a 5-year period (1/1/2010-12/31/2014). All patients with a sesamoid injury were initially included. Excluded were those patients who: 1) did not receive the diagnosis of hallux sesamoid fracture, had a history of prior foot surgery, or had medical records inadequate for analysis, 2) had missing or unclear diagnostic imaging, 3) were age >21 years, or 4) did not report sports participation. Descriptive statistics were employed to analyze the data.Results: Fifty-eight patients (51 females and 7 males) with a mean age of 15.4 years (range: 9-21) were identified with a total of 59 sesamoid fractures. Dancing (37.9%), running (13.8%), and gymnastics (13.8%) were the most common sports reported among these patients. A greater number of fractures were classified as repetitive stress injuries (83.1%), rather than acute traumatic injuries (16.9%). Fractures were treated conservatively in the majority of cases (89.8%), and only six fractures (10.2%) were treated surgically. Most patients (84.7%) were able to return to sports and activities. The average time from diagnosis/start of treatment to pain-free state/cleared to return to sport was 161.4 days.Conclusion: Diagnosis of sesamoid fractures can be challenging, but overall most patients do well with conservative treatment and are able to return to sports and activities. Providers should keep sesamoid fracture in the differential when evaluating patients with pain in the area around the base of the first toe, especially in dancers, gymnasts, and runners. Understanding that the recovery from a sesamoid fracture can be a prolonged process may help patients develop realistic expectations.

Dança/lesões , Traumatismos do Pé/terapia , Fraturas Ósseas/terapia , Ginástica/lesões , Hallux/lesões , Corrida/lesões , Ossos Sesamoides/lesões , Adolescente , Atletas , Criança , Feminino , Traumatismos do Pé/diagnóstico , Traumatismos do Pé/cirurgia , Fraturas Ósseas/diagnóstico , Fraturas Ósseas/cirurgia , Hallux/cirurgia , Humanos , Masculino , Procedimentos Ortopédicos , Estudos Retrospectivos , Ossos Sesamoides/cirurgia
Clin Orthop Relat Res ; 477(5): 1086-1098, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30531425


BACKGROUND: Hip microinstability has gained attention recently as a potential cause of hip pain. Currently there is a lack of evidence-based objective diagnostic criteria surrounding this diagnosis. Previous studies have shown translation of the femoral head during extreme hip positions. However, reliable assessment of femoral head translation is lacking. QUESTIONS/PURPOSES: (1) How precise is musculoskeletal ultrasound for measuring anterior femoral head translation during the hip anterior apprehension test? (2) What is the intra- and interrater reliability of dynamic ultrasonography in assessing anterior femoral head translation? METHODS: We recruited 10 study participants (20 hips) between the ages of 22 and 50 years with no history of hip pain or functional limitations. Test-retest methodology was used. Seven females and three males were enrolled. The mean age of study participants was 27 years (SD 8.7 years); mean body mass index was 22.6 kg/m (SD 2.2 kg/m). All study participants underwent dynamic hip ultrasonography by three different physicians 1 week apart. Each hip was visualized in two neutral positions (neutral and neutral with the contralateral hip flexed [NF]) and two dynamic positions, which sought to replicate the apprehension test, although notably study participants had no known hip pathology and therefore no apprehension. The first maintained the hip in extension and external rotation off to the side of the examination table (EER1), and the second held the hip off of the bottom of the examination table (EER2). One hundred twenty ultrasound scans (480 images) were performed. Mean and SD were calculated using absolute values of the difference in ultrasound measurements (mm) between positions NF and EER1 and NF and EER2 calculated for each physician as well as an average of all three physicians. Intraclass correlation coefficient (ICC) analysis was used to examine intra- and interrater reliability. RESULTS: The mean absolute difference for NF and EER1 was 0.84 mm (SD 0.93 mm) and for NF and EER2 0.62 mm (SD 0.40 mm) on Study Day 1. Similarly, on Study Day 2, the mean absolute difference for NF and EER1 position was 0.90 mm (SD 0.74 mm) and for NF and EER2 1.03 mm (SD 1.18 mm). Cumulative values of ICC analysis indicated excellent intrarater reliability in all four positions: neutral 0.794 (95% confidence interval [CI], 0.494-0.918), NF 0.927 (95% CI, 0.814-0.971), EER1 0.929 (95% CI, 0.825-0.972), and EER2 0.945 (95% CI, 0.864-0.978). Similarly, interrater ICC analysis cumulative values were excellent for NF, EER1, and EER2 and fair to good for the neutral position: neutral 0.725 (95% CI, 0.526-0.846), NF 0.846 (95% CI, 0.741-0.913), EER1 0.812 (95% CI, 0.674-0.895), and EER2 0.794 (95% CI, 0.652-0.884). CONCLUSIONS: This study offers the first ultrasound protocol of which we are aware for measuring anterior femoral head translation. Hip dynamic ultrasound may assist in providing precise objective clinical-based diagnostic evidence when evaluating complex hip pain and suspected microinstability. Musculoskeletal ultrasound is a reliable office-based method of measuring anterior femoral head translation that can be utilized by physicians with varying experience levels. Future studies are needed to investigate ultrasound anterior femoral head translation taking into account sex, prior hip surgery, hip osseous morphology, and ligamentous laxity. LEVEL OF EVIDENCE: Level III, diagnostic study.

Fêmur/diagnóstico por imagem , Articulação do Quadril/diagnóstico por imagem , Quadril/diagnóstico por imagem , Instabilidade Articular/diagnóstico por imagem , Ultrassonografia/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem