Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.057
Filtrar
1.
Sports Health ; 12(3): 225-233, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32271136

RESUMO

CONTEXT: The prescription of opioids after elective surgical procedures has been a contributing factor to the current opioid epidemic in North America. OBJECTIVE: To examine the opioid prescribing practices and rates of opioid consumption among patients undergoing common sports medicine procedures. DATA SOURCES: A systematic review of the electronic databases EMBASE, MEDLINE, and PubMed was performed from database inception to December 2018. STUDY SELECTION: Two investigators independently identified all studies reporting on postoperative opioid prescribing practices and consumption after arthroscopic shoulder, knee, or hip surgery. A total of 119 studies were reviewed, with 8 meeting eligibility criteria. STUDY DESIGN: Systematic review. LEVEL OF EVIDENCE: Level 4. DATA EXTRACTION: The quantity of opioids prescribed and used were converted to milligram morphine equivalents (MMEs) for standardized reporting. The quality of each eligible study was evaluated using the Methodological Index for Non-Randomized Studies. RESULTS: A total of 8 studies including 816 patients with a mean age of 43.8 years were eligible for inclusion. A mean of 610, 197, and 613 MMEs were prescribed to patients after arthroscopic procedures of the shoulder, knee, and hip, respectively. At final follow-up, 31%, 34%, and 64% of the prescribed opioids provided after shoulder, knee, and hip arthroscopy, respectively, still remained. The majority of patients (64%) were unaware of the appropriate disposal methods for surplus medication. Patients undergoing arthroscopic rotator cuff repair had the highest opioid consumption (471 MMEs), with 1 in 4 patients receiving a refill. CONCLUSION: Opioids are being overprescribed for arthroscopic procedures of the shoulder, knee, and hip, with more than one-third of prescribed opioids remaining postoperatively. The majority of patients are unaware of the appropriate disposal techniques for surplus opioids. Appropriate risk stratification tools and evidence-based recommendations regarding pain management strategies after arthroscopic procedures are needed to help curb the growing opioid crisis.


Assuntos
Analgésicos Opioides/uso terapêutico , Traumatismos em Atletas/cirurgia , Dor Pós-Operatória/tratamento farmacológico , Padrões de Prática Médica , Uso Excessivo de Medicamentos Prescritos , Artroscopia/efeitos adversos , Lesões do Quadril/cirurgia , Humanos , Traumatismos do Joelho/cirurgia , Manejo da Dor/métodos , Lesões do Ombro/cirurgia
2.
Orthop Clin North Am ; 51(2): 227-233, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32138860

RESUMO

Ulnar abutment (ulnocarpal impaction) syndrome may be a source of ulnar-sided wrist pain in the athlete. This condition results from excessive load transfer across the triangular fibrocartilage complex and ulnocarpal joints with characteristic degenerative changes. It frequently occurs in patients with either static or dynamic ulnar positive variance. Treatment is tailored to the athlete and their sporting demands. Surgical treatment focuses on addressing ulnar variance to unload the ulnocarpal joint, with multiple surgical options, including the metaphyseal closing wedge osteotomy achieving this goal. This review focuses on the presentation, biomechanics, and treatment options for ulnar abutment syndrome in the athlete.


Assuntos
Artralgia/terapia , Traumatismos em Atletas/terapia , Mau Alinhamento Ósseo/terapia , Ulna/lesões , Traumatismos do Punho/terapia , Artralgia/complicações , Artralgia/cirurgia , Traumatismos em Atletas/complicações , Traumatismos em Atletas/cirurgia , Mau Alinhamento Ósseo/complicações , Mau Alinhamento Ósseo/cirurgia , Humanos , Osteotomia , Ulna/cirurgia , Traumatismos do Punho/complicações , Traumatismos do Punho/cirurgia
3.
Einstein (Sao Paulo) ; 18: eRC4778, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31994610

RESUMO

This is a case report of a previously healthy athlete who did not use oral anticoagulant, suffered a rupture of the distal biceps brachii tendon, and evolved with arm compartment syndrome. An emergency fasciotomy and the repair of the tendon were performed. After surgery the patient had a good recovery of the paresthesia and sensibility. This complication is rare and, when reported, is usually associated with patients who use anticoagulant therapy. Due to growth of rupture of distal biceps tendon cases, physicians should be aware that this complication must be treated as an emergency.


Assuntos
Traumatismos do Braço/complicações , Síndromes Compartimentais/etiologia , Traumatismos dos Tendões/complicações , Idoso , Traumatismos do Braço/cirurgia , Traumatismos em Atletas/complicações , Traumatismos em Atletas/cirurgia , Síndromes Compartimentais/cirurgia , Articulação do Cotovelo/lesões , Articulação do Cotovelo/cirurgia , Fasciotomia/métodos , Humanos , Masculino , Ruptura , Traumatismos dos Tendões/cirurgia , Resultado do Tratamento
4.
Clin Sports Med ; 39(1): 185-196, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31767105

RESUMO

Meniscal injuries in athletes present a challenging problem. Surgeons must balance the needs of the healing meniscus with the desire of the athlete to return to play as quickly as possible. Evidence-based rehabilitation protocols are important for ensuring a successful meniscal repair and preventing athletes from returning to play prematurely. Ultimately, however, the return to play determination requires a shared decision-making approach between the physician, the athlete, and the providers involved in the athlete's rehabilitation process. This decision considers not only the athlete's ability to meet return-to-play criteria but also their season-specific and career goals.


Assuntos
Traumatismos em Atletas/cirurgia , Volta ao Esporte , Lesões do Menisco Tibial/cirurgia , Artroscopia/métodos , Traumatismos em Atletas/reabilitação , Desempenho Atlético , Humanos , Meniscectomia/métodos , Lesões do Menisco Tibial/reabilitação
5.
Clin Sports Med ; 39(1): 197-209, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31767106

RESUMO

Older athletes consist of a relatively healthier population with a high desire for return to sport despite knee injury. A meniscal tear is a common injury that has lasting impacts on joint function and activity level. Lower extremity loading from sporting activity in conjunction with degenerative meniscal changes increases the risk of meniscal tear in older athletes. Optimal treatment of degenerative meniscal tears is often debated with varying studies reporting the benefits of strictly nonoperative treatment or the value of surgery. Postoperative rehabilitation is crucial to enhance the possibility of return to sport.


Assuntos
Traumatismos em Atletas/cirurgia , Lesões do Menisco Tibial/cirurgia , Artroscopia/métodos , Traumatismos em Atletas/diagnóstico , Tomada de Decisão Clínica , Humanos , Articulação do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/diagnóstico , Cuidados Pós-Operatórios , Lesões do Menisco Tibial/diagnóstico
6.
Curr Sports Med Rep ; 18(11): 416-420, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702723

RESUMO

Hamstring muscle injuries (HMI) are common among athletes. HMI can take many months to years to resolve. Often, athletes do not report complete resolution with typical conservative therapy. We present several cases of athletes who presented with chronic hamstring injuries that resolved immediately after being treated with an ultrasound-guided fascial hydrodissection procedure. Following the procedure and graded rehabilitation protocol, athletes reported resolution of pain and tightness in addition to increased performance and a quicker return to play.


Assuntos
Traumatismos em Atletas/cirurgia , Dissecação/métodos , Músculos Isquiossurais/lesões , Traumatismos da Perna/cirurgia , Lesões dos Tecidos Moles/cirurgia , Adolescente , Adulto , Atletas , Feminino , Humanos , Masculino , Ultrassonografia
7.
Am J Case Rep ; 20: 1500-1504, 2019 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-31604906

RESUMO

BACKGROUND Unilateral double-level Achilles tendon tear is a rare presentation that has not been previously reported in the English literature. Diagnosis and management of these cases are challenging, and outcomes are not well described in the literature. CASE REPORT A 46-year-old man presented to us with ankle pain following a football sports injury. Clinical examination and ultrasound scan showed unilateral Achilles tendon double-level partial tears that were managed conservatively. The patient presented again with another trauma and progression to full-thickness tear, managed operatively with open Achilles tendon repair technique. CONCLUSIONS Management of these cases is complex and challenging. In the literature, both operative and non-operative management have been described. However, the recent literature shows no major difference between these 2 methods of treatment. Our case was quite unique, so we decided to use the open repair technique. Awareness about this rare presentation and the need for further research is necessary for proper management of such cases.


Assuntos
Tendão do Calcâneo/lesões , Tendão do Calcâneo/cirurgia , Tendão do Calcâneo/diagnóstico por imagem , Traumatismos em Atletas/diagnóstico por imagem , Traumatismos em Atletas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Ruptura/diagnóstico por imagem , Ruptura/cirurgia , Tendinopatia/diagnóstico por imagem , Ultrassonografia
8.
Sports Health ; 11(6): 520-527, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31584340

RESUMO

CONTEXT: Superior labral anterior-posterior (SLAP) lesions often result in significant sporting limitations for athletes. Return to sport is a significant outcome that often needs to be considered by athletes undergoing the procedure. OBJECTIVE: To evaluate return to sport among individuals undergoing arthroscopic SLAP repair. DATA SOURCES: Four databases (MEDLINE, EMBASE, PubMed, and Cochrane) were searched from database inception through January 29, 2018. STUDY SELECTION: English-language articles reporting on return-to-activity rates after arthroscopic SLAP repairs were included. STUDY DESIGN: Systematic review. LEVEL OF EVIDENCE: Level 4. DATA EXTRACTION: Data including patient demographics, surgical procedure, and return to activity were extracted. The methodological quality of included studies was evaluated using the Methodological Index for Non-Randomized Studies (MINORS) tool. RESULTS: Of 1938 screened abstracts, 22 articles involving a total of 944 patients undergoing arthroscopic SLAP repair met inclusion criteria. Of the total included patients, 270 were identified as overhead athletes, with 146 pitchers. Across all patients, 69.6% (657/944 patients) of individuals undergoing arthroscopic SLAP repair returned to sport. There was a 69.0% (562/815 patients) return to previous level of play, with a mean time to return to sport of 8.9 ± 2.4 months (range, 6.0-11.7 months). The return-to-sport rate for pitchers compared with the return-to-activity rate for nonpitchers, encompassing return to work and return to sport, was 57.5% (84/146 patients) and 87.1% (572/657 patients), respectively, after arthroscopic SLAP repair. CONCLUSION: Arthroscopic SLAP repair is associated with a fair return to sport, with 69.6% of individuals undergoing arthroscopic SLAP repair returning to sport. SLAP repair in pitchers has significantly decreased return to sport in comparison with nonpitching athletes. Athletes on average return to sport within 9 months postoperatively.


Assuntos
Artroscopia/métodos , Traumatismos em Atletas/cirurgia , Volta ao Esporte , Articulação do Ombro/lesões , Articulação do Ombro/cirurgia , Artroscopia/efeitos adversos , Artroscopia/reabilitação , Beisebol/lesões , Humanos , Complicações Pós-Operatórias , Recuperação de Função Fisiológica , Reoperação
9.
BMJ Case Rep ; 12(9)2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31494581

RESUMO

A 27-year-old elite-level professional cyclist presented to the emergency department with a 6-hour history of chest pain and vomiting after prematurely aborting a competitive event. ECG demonstrated anterior ST segment elevation myocardial infarction, and blood tests revealed a grossly elevated high-sensitivity troponin T. Emergent coronary angiography confirmed the presence of a thrombus in the mid-left anterior descending artery with possible spontaneous coronary artery dissection. The patient recovered well following balloon angioplasty and thrombus aspiration, despite delayed recognition, invasive investigation and intervention.


Assuntos
Angioplastia Coronária com Balão , Traumatismos em Atletas/fisiopatologia , Trombose Coronária/fisiopatologia , Infarto do Miocárdio/fisiopatologia , Adulto , Traumatismos em Atletas/sangue , Traumatismos em Atletas/cirurgia , Ciclismo , Dor no Peito , Angiografia Coronária , Trombose Coronária/sangue , Trombose Coronária/cirurgia , Eletrocardiografia , Humanos , Infarto do Miocárdio/sangue , Infarto do Miocárdio/cirurgia , Resultado do Tratamento , Troponina T/sangue
10.
Gait Posture ; 74: 87-93, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31491565

RESUMO

BACKGROUND: Partial meniscectomy dramatically increases the risk for post-traumatic, tibiofemoral osteoarthritis after anterior cruciate ligament reconstruction (ACLR). Concomitant medial meniscus surgery influences walking biomechanics (e.g., medial tibiofemoral joint loading) early after ACLR; whether medial meniscus surgery continues to influence walking biomechanics two years after ACLR is unknown. RESEARCH QUESTION: Does medial meniscus treatment at the time of ACLR influence walking biomechanics two years after surgery? METHODS: This is a secondary analysis of prospectively collected data from a clinical trial (NCT01773317). Fifty-six athletes (age 24 ±â€¯8 years) with operative reports, two-year biomechanical analyses, and no second injury prior to two-year testing participated after primary ACLR. Participants were classified by concomitant medial meniscal status: no medial meniscus involvement (n = 36), partial medial meniscectomy (n = 9), and medial meniscus repair (n = 11). Participants underwent biomechanical analyses during over-ground walking including surface electromyography; a validated musculoskeletal model estimated medial compartment tibiofemoral contact forces. Gait variables were analyzed using 3 × 2 ANOVAs with group (medial meniscus treatment) and limb (involved versus uninvolved) comparisons. RESULTS: There was a main effect of group (p = .039) for peak knee flexion angle (PKFA). Participants after partial medial meniscectomy walked with clinically meaningfully smaller PKFAs in both the involved and uninvolved limbs compared to the no medial meniscus involvement group (group mean difference [95%CI]; involved: -4.9°[-8.7°, -1.0°], p = .015; uninvolved: -3.9°[-7.6°, -0.3°], p = .035) and medial meniscus repair group (involved: -5.2°[-9.9°, -0.6°], p = .029; uninvolved: -4.7°[-9.0°, -0.3°], p = .038). The partial medial meniscectomy group walked with higher involved versus uninvolved limb medial tibiofemoral contact forces (0.45 body weights, 95% CI: -0.01, 0.91 BW, p = 0.053) and truncated sagittal plane knee excursions, which were not present in the other two groups. SIGNIFICANCE: Aberrant gait biomechanics may concentrate high forces in the antero-medial tibiofemoral cartilage among patients two years after ACLR plus partial medial meniscectomy, perhaps explaining the higher osteoarthritis rates and offering an opportunity for targeted interventions. LEVEL OF EVIDENCE: Level III.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Traumatismos em Atletas/cirurgia , Meniscectomia/métodos , Meniscos Tibiais/cirurgia , Caminhada/fisiologia , Adolescente , Adulto , Lesões do Ligamento Cruzado Anterior/fisiopatologia , Lesões do Ligamento Cruzado Anterior/cirurgia , Atletas , Traumatismos em Atletas/fisiopatologia , Fenômenos Biomecânicos , Feminino , Marcha/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/prevenção & controle , Estudos Prospectivos , Adulto Jovem
11.
J Sci Med Sport ; 22(12): 1309-1313, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31515168

RESUMO

OBJECTIVES: The risk of a subsequent anterior cruciate ligament (ACL) sprain is greater in high school aged female athletes with prior history of ACL reconstruction (ACLR) than in age-matched controls. The risk of a subsequent ACL injury in female collegiate athletes with prior ACLR is unknown. The primary purpose of this study was to determine the relative risk of a subsequent ACL injury in female collegiate athletes with prior ACLR when compared to age-matched controls. The secondary purpose of this study was to evaluate the ability of jump and hop tests to discriminate ACL injury risk. DESIGN: Prospective cohort. METHODS: Three hundred and sixty female collegiate athletes (mean age 19.3 ±â€¯1.4 years) representing the following sports: volleyball, soccer, and basketball were recruited. Subjects reported prior history of ACLR and standing long jump (SLJ) and single-leg hop (SLH) scores were collected during the preseason. Noncontact time-loss ACL and lower quadrant (i.e., low back and lower extremities) injuries were tracked by university athletic trainers. RESULTS: Female collegiate athletes with a prior history of ACLR were 6 times (RR = 6.8 [95% CI: 1.4, 32.9] p-value = 0.007) more likely to experience an ACL injury than controls. Suboptimal performance on a battery of tests (SLJ ≤ 79% height, (B) SLH ≤ 69% height) was associated with a greater risk of lower quadrant injury (RR = 1.6 [95% CI: 1.1, 2.4] p-value = 0.028); however performance on these tests was not associated with ACL injury. CONCLUSIONS: Female collegiate athletes should be screened for history of ACLR.


Assuntos
Lesões do Ligamento Cruzado Anterior/diagnóstico , Reconstrução do Ligamento Cruzado Anterior , Traumatismos em Atletas/diagnóstico , Adolescente , Lesões do Ligamento Cruzado Anterior/cirurgia , Atletas , Traumatismos em Atletas/cirurgia , Basquetebol/lesões , Teste de Esforço , Feminino , Humanos , Traumatismos do Joelho , Estudos Prospectivos , Recidiva , Fatores de Risco , Futebol/lesões , Voleibol/lesões , Adulto Jovem
13.
Unfallchirurg ; 122(11): 901-904, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31407025

RESUMO

Based on a case study, the injury pattern and surgical procedure for traumatic dislocation of the posterior tibial tendon is presented. A 32-year-old ice hockey player suffered a direct impact from a puck at the dorsomedial aspect of the inner ankle. In the course of the injury a ganglion developed due to recurrent dislocation of the posterior tibial tendon. Intraoperatively, a distracted retinaculum and a flattened retromalleolar sulcus were present. An open wedge osteotomy and suture anchor refixation of the retinaculum were performed. This procedure is described in the context of a review of the literature.


Assuntos
Traumatismos do Tornozelo/cirurgia , Luxações Articulares/cirurgia , Traumatismos dos Tendões/cirurgia , Adulto , Traumatismos do Tornozelo/diagnóstico por imagem , Traumatismos do Tornozelo/etiologia , Traumatismos em Atletas/complicações , Traumatismos em Atletas/cirurgia , Hóquei/lesões , Humanos , Luxações Articulares/diagnóstico por imagem , Luxações Articulares/etiologia , Masculino , Osteotomia , Âncoras de Sutura , Traumatismos dos Tendões/diagnóstico por imagem , Traumatismos dos Tendões/etiologia
14.
BMJ Case Rep ; 12(8)2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31466954

RESUMO

A 10-year-old girl presented to the emergency department having sustained a fall onto an outstretched left hand while playing soccer. Clinical and radiographical assessment identified a Salter-Harris I distal ulna fracture, as well as a buckle fracture of the distal radius. The injury was closed, and she had no neurovascular deficits on examination. She was brought to the operating theatre the following morning for closed reduction under general anaesthesia. Image intensification was used to confirm anatomical reduction, and an above-elbow moulded plaster-of-paris cast was applied. Follow-up clinical assessment at 6 weeks confirmed healing of the fracture, and she proceeded to make a full recovery. This case describes the anatomy and physiology of such rare injuries and outlines treatment principles and potential pitfalls based on best available evidence.


Assuntos
Traumatismos em Atletas/diagnóstico por imagem , Fraturas do Rádio/diagnóstico por imagem , Fraturas Salter-Harris/diagnóstico por imagem , Fraturas da Ulna/diagnóstico por imagem , Traumatismos em Atletas/cirurgia , Criança , Redução Fechada , Feminino , Humanos , Radiografia , Fraturas do Rádio/cirurgia , Fraturas Salter-Harris/cirurgia , Resultado do Tratamento , Fraturas da Ulna/cirurgia
15.
Acta Orthop Belg ; 85(2): 169-181, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31315007

RESUMO

The authors present a 10-year review of the postoperative bilateral release of the adductor brevis and gracilis muscles combined with a bilateral abdominal myo-fascio-plasty according to Nesovic for groin pain in competitive athletes. We present the 10 years results of 33 patients operated on between April 2002 and May 2006 diagnosed with a "sports hernia". The injury was treated with a bilateral abdominal procedure according to Nesovic combined with a bilateral adductor release after unsuccessful conservative treatment of at least 2 months. There were 32 male patients between 18 and 43 years and one female patient aged 25 years with a mean age of 28.8 at time of surgery. All procedures were bilateral. Patients were seen in the postoperative clinic and a questionnaire was collected after 2 years and 10 years. Within 16 weeks, 30 patients (90,9 %) returned to the same or a higher level of sports activities. 10 years after surgery 31 patients (93,9%) remained free of pain. 1 patient has minor pain after training (VAS 0-1) and only 1 patient still experiences pain (VAS ≥ 5) after heavy work. 13 patients (39,3%) are still performing sports today, and 19 of 20 patients (95%, 57% of total cohort) were pain free to the end of their sporting careers. The bilateral Nesovic procedure with bilateral adductor release has a high success rate for the competitive athlete with chronic groin pain. It also is a procedure that gave most athletes suffering from a certain type of groin pain a solution till the end of their sporting careers.


Assuntos
Atletas , Traumatismos em Atletas/cirurgia , Músculo Grácil/cirurgia , Dor Musculoesquelética/cirurgia , Volta ao Esporte , Adolescente , Adulto , Feminino , Virilha/cirurgia , Humanos , Masculino , Resultado do Tratamento , Adulto Jovem
16.
Int J Low Extrem Wounds ; 18(3): 336-338, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31322020

RESUMO

Soft tissue loss in the lower leg presents a challenge for reconstructive surgeons. When a defect is large, free flap transfer provides a well-established method, but local flaps are more convenient for small to moderately sized soft tissue defects. When a defect is very small, even local flaps are too invasive, leave additional scar, and cause bulky flaps. We present our case aiming to underline the usefulness of percutaneous aponeurotomy and lipofilling in a small lower leg defect with several advantages.


Assuntos
Aponeurose/cirurgia , Cicatriz , Traumatismos da Perna/cirurgia , Procedimentos Cirúrgicos Reconstrutivos , Lesões dos Tecidos Moles/cirurgia , Gordura Subcutânea/transplante , Traumatismos em Atletas/cirurgia , Cicatriz/etiologia , Cicatriz/cirurgia , Desbridamento/métodos , Humanos , Masculino , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Reoperação/métodos , Esqui , Resultado do Tratamento , Cicatrização , Adulto Jovem
17.
Orthopedics ; 42(4): e370-e375, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31323109

RESUMO

Cervical spine injuries in elite athletes can have detrimental consequences, which makes return to play for professional athletes after cervical spine injury controversial. Although most athletes can return to sport under some circumstances, such as single-level anterior cervical diskectomy and fusion for cervical disk herniation, return to play after cervical disk arthroplasty and multilevel fusion for cervical disk herniation remains controversial. Allowing athletes to return to play after a finding of cervical stenosis and in the incidence of pseudarthrosis remains unclear. This review provides a systematic framework to guide return-to-play decision-making in common cervical conditions in elite athletes. [Orthopedics. 2019; 42(4):e370-e375.].


Assuntos
Atletas , Traumatismos em Atletas/cirurgia , Vértebras Cervicais/cirurgia , Degeneração do Disco Intervertebral/cirurgia , Deslocamento do Disco Intervertebral/cirurgia , Recuperação de Função Fisiológica/fisiologia , Volta ao Esporte , Traumatismos da Coluna Vertebral/cirurgia , Discotomia , Humanos , Fusão Vertebral
19.
Hand Clin ; 35(3): 365-371, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31178093

RESUMO

Most minimally displaced scaphoid fractures and all displaced scaphoid fractures in elite athletes are treated with early fixation to maximally expedite the return to full function. Computed tomographic (CT) scans are recommended in all scaphoid fractures to facilitate a complete understanding of fracture anatomy and to allow for optimal screw placement. Screw placement is important to maximize healing capacity of the fracture and allow for return to sport. Postoperative CT scans can be helpful to evaluate the extent of healing and may allow patients to return to play sooner.


Assuntos
Traumatismos em Atletas/cirurgia , Fraturas Ósseas/cirurgia , Osso Escafoide/cirurgia , Parafusos Ósseos , Tomada de Decisão Clínica , Confidencialidade , Fixação Interna de Fraturas , Consolidação da Fratura , Fraturas Ósseas/diagnóstico por imagem , Fraturas de Estresse/cirurgia , Health Insurance Portability and Accountability Act , Humanos , Imagem por Ressonância Magnética , Cuidados Pós-Operatórios , Radiografia , Volta ao Esporte , Osso Escafoide/diagnóstico por imagem , Osso Escafoide/lesões , Estados Unidos
20.
Clin J Sport Med ; 29(4): 276-280, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31241528

RESUMO

OBJECTIVE: The incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) after pediatric knee arthroscopy is unknown. The purpose of this study was to determine the incidence of venous thromboembolism (VTE) after knee arthroscopy in the pediatric and adolescent population in a high-volume center. DESIGN: Retrospective cohort study. SETTING: Tertiary care children's hospital. PATIENTS: All patients who underwent arthroscopy of the knee for a sports-related injury by 2 surgeons were reviewed. Chief complaint, past medical/surgical history, medications, procedure performed, intraoperative findings, intraoperative complications, and postoperative recovery were reviewed. The incidences of postoperative VTE within 30 days after the procedure were reviewed. RESULTS: Seven hundred forty-six (358 male and 388 female patients) knee arthroscopies performed from September 2011 to October 2016 by 2 pediatric orthopedic surgeons specializing in sports-related injuries were included. The average age was 15.2 ± 2.72 years. Five patients were suspected to have either DVT or PE postoperatively (0.67%). The overall incidence of symptomatic confirmed VTE after knee arthroscopic procedures was 0.27% (one DVT after a partial lateral meniscectomy and one PE after fixation of an osteochondral lesion). CONCLUSIONS: The incidence of VTE after pediatric sports medicine knee arthroscopies is low, 0.27%. Patients who present with calf swelling or pain, chest pain, or shortness of breath after arthroscopic surgery should be examined closely. LEVEL OF EVIDENCE: Level III.


Assuntos
Artroscopia/efeitos adversos , Articulação do Joelho/cirurgia , Complicações Pós-Operatórias/epidemiologia , Embolia Pulmonar/etiologia , Trombose Venosa/etiologia , Adolescente , Traumatismos em Atletas/cirurgia , Feminino , Humanos , Incidência , Masculino , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA