Multiligamentous Knee Injuries: Acute Management, Associated Injuries, and Anticipated Return to Activity.

Multiligamentous knee injuries (MLKIs) are devastating injuries. The energy and severity of these injuries encompass a wide range from low-energy single-joint mechanisms to high-energy polytrauma settings. Currently, there is no consensus on surgical treatment approach, surgical timing, or the return to preinjury activity levels after injury. There does appear to be a difference in the rate of return to activity and level of activity based on whether the injury was sustained during sport, in a trauma setting, or while on active military duty. The purpose of this descriptive review was to summarize current concepts related to (1) the acute management of MLKIs; (2) the effect of concomitant neurovascular, meniscal, and chondral injury on MLKI outcomes; (3) the effect of surgical versus nonsurgical treatment of MLKI on outcomes; and (4) rates and predictors of return to sport, work, and active military service after an MLKI.

Proximal Fifth Metatarsal Fractures in Athletes: Management of Acute and Chronic Conditions.

Proximal fifth metatarsal fractures are common in the athlete and can be a source of significant, temporary disability and missed playing time. The pattern of fracture can vary, and the type of fracture leads to a significantly different prognosis and treatment. Jones fractures of the fifth metatarsal are particularly common and difficult to treat in the athlete, can have recurrence and refracture, and require expertise to heal. Intramedullary screw fixation is currently the preferred method of fixation. Most other (non-Jones fractures and os vesalianum) proximal fifth metatarsal fractures can be treated successfully without surgery.