Epidemiology and traumatology of injuries in soccer.

A prospective investigation of soccer injuries among 123 players participating at various competition levels was undertaken in a Danish soccer club. The injury incidence during games was highest at division level (18.5/1000 hours) and lowest at series level (11.9/1000 hours), whereas the distribution of the incidences during practice was reversed. The youth section (16 to 18 years) had incidences that could be compared to the highest senior level. The lower extremity was involved in 84% of the injuries, including 34% of overuse injuries. Ankle sprains were most common (36%) and equally found at all levels, whereas half of all overuse injuries were seen among division players. Contact injuries during tackling occurred most often in lower series and youths (45%). Players participating at high levels had only 30% of the injuries during tackling and 54% during running. More than half of 20 knee injuries were caused by tackling. Thirty-five percent of injured players were absent from soccer for more than 1 month; 28% had complaints 12 months after the end of the season with knee injuries the most serious. The study shows that the injury incidence, the pattern of injury, and the traumatology varied between players participating at different levels of soccer competition.

The Lauge Hansen classification of malleolar fractures.

A total of 488 fractures of the ankle are described and classified into types and stages according to Lauge Hansen (1942). The classification was partly based on operative findings. The type division was: supination-eversion fractures 57.4 per cent, supination fractures 20.1 per cent, pronation and pronation-eversion fractures 20.1 per cent and pronation-dorsiflexion fractures 0.4 per cent. A small percentage of the fractures (1.2) could not be fitted into this system, and two-thirds of these were found to have an isolated fracture of the posterior tibial margin. This fracture seems to be a special type of ankle fracture. It was found that the stage 2 injury in pronation and pronation-eversion fractures is not fully explained by Lauge Hansen. The classification of Lauge Hansen gives a very exact description of ankle fractures. This is very important for the operative treatment and also indispensable for the evaluation of the results of various methods of treatment.

Ankle fractures. Supination-eversion fractures stage II. Primary and late results of operative and non-operative treatment.

Sixty-nine patients with stage II supination-eversion fractures of the ankle, 34 treated by operation and 35 treated conservatively, were seen at follow-up after 3-10 years. There was no statistically significant differnce between the results of the two methods. However, larger series and perhaps a longer observation time are probably needed to decide whether the displacement of the lateral malleolus as a result of non-operative treatment affords the same possibility of unhindered ankle function as union of the lateral malleolus in the anatomical position obtained by operation.

Ankle fractures: supination-eversion fractures of stage IV. Primary and late results of operative and non-operative treatment.

Supination-eversion fractures of stage IV, 60 treated operatively and 29 non-operatively, were seen at follow-up after 3-10 years. This disclosed a statistically significant difference between the results of the two methods. Operation which attempted to re-establish the anatomical position was apparently the better method in the presence of more than minimal displacement or a suspicion of deltoid ligament rupture.

An epidemiologic and traumatologic study of injuries in handball.

To identify the risk factors of injuries in handball, 221 players were followed during one indoor season. The injury incidence was 4.6/1000 playing hours and 11.4/1000 game hours. The upper extremity was involved in 41% of the injuries including 21% finger sprains. Ankle sprains were the most common injury (33%), and overuse injuries accounted for 18%. The risk of reinjury was 32%. Contact with opponent players during running or shooting caused 31% of the injuries. Errors during grasping the ball were the reason for most of the finger injuries. Forty percent of the injuries was treated by the players themselves. After the injury 73% were absent from handball for more than 1 week. Forty-one percent of the injured players had complaints 6 months after the end of the season. The study shows that injuries in handball are serious and cause extensive consequences for the players. In most of the injuries both intrinsic and extrinsic factors were involved, and prophylactic intervention in these cases demands changes in more fields.

Sports injuries in adolescents' ball games: soccer, handball and basketball.

In a prospective study of 302 adolescent players in three ball games (soccer, handball and basketball), 119 incurred injuries. The injury incidence (number of injuries per 1000 playing hours) was 5.6 in soccer, 4.1 in handball and 3.0 in basketball. Ankle sprains accounted for 25 per cent of the injuries, finger sprains 32 per cent, strains in the thigh and leg 10 per cent, and tendinitis/apophysitis 12 per cent. The most serious injuries were four fractures, one anterior cruciate ligament rupture, and two meniscus lesions. The most serious injuries, with the longest rehabilitation period, occurred in soccer. In soccer, many injuries occurred during tackling and contact with an opposing player, while the injuries in handball and basketball were often caused by ball contact and running.

Epidemiology of acute knee injuries: a prospective hospital investigation.

During a 1-year period, data on all acute injuries treated at emergency departments were entered into a registry; of these injuries, 6% involved the knee joint. The patients were followed until a definite diagnosis was established. The rate of anterior cruciate ligament injuries and meniscus tears was, respectively, 0.3 and 0.7 (injuries per 1,000 inhabitants per year). The rate of dislocations of the patellofemoral joints was equal to the rate of anterior cruciate ligament injuries. Ten percent of the cases involved ligament injuries, and isolated ruptures of the anterior cruciate ligaments were twice as common as combined lesions of this ligament. Injuries of both the collateral ligament and the meniscus represented 6% of the cases. In most age groups male patients predominated, but the frequency of anterior cruciate ligament injuries was similar in both sexes, while the frequency of collateral ligament injuries and meniscus tears varied according to both gender and age. Only 27% of the injuries were associated with sports activities, but they were found twice as often among athletes than people injured in nonathletic accidents. Ruptures of the collateral ligament and anterior cruciate ligament were four and seven times more common among athletes, respectively, while athletes sustained fewer meniscus tears than people involved in nonathletic activities. Half of the patients needed further care after primary treatment, and 18% were primarily (65%) or secondarily (35%) admitted to in-patient care. Operative treatment, including arthroscopic examination, was performed in 20% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Inferior tibio-fibular diastasis treated by staple fixation.

This paper concerns the operative treatment of the total syndesmotic rupture of the ankle fractures classified as pronation-eversion fractures, stage III and IV, according to Lauge Hansen in 1942. Stabilization of the syndesmosis by a screw between the fibula and the tibia is well known. However, the method involves a risk of inaccurate positioning of the fibula in the incisura tibiae and of injury of the syndesmosis. A method of staple fixation of the syndesmosis in combination with rigid and anatomic osteosynthesis or the fibular fracture is presented and found suitable for securing the syndesmosis during healing. The followup results, range 3 to 10 years, of 16 ankle fractures treated in this way are promising.

Badminton injuries.

In a one year period, from 1 January 1986 to 31 December 1986, 4303 patients with sports injuries were treated at Aarhus Amtssygehus and Aarhus Kommunehospital. The mean age was 21.6 years (range 7-72 years) and 2830 were men. Two hundred and seventeen badminton injuries occurred in 208 patients (136 men) with a mean age of 29.6 years (range 7-57 years), constituting 4.1 percent of all sport injuries in Aarhus. Joints and ligaments were injured in 58.5 percent of the patients, most frequently located in the lower limb and significantly more often among patients younger than 30 years of age. Muscle injury occurred in 19.8 percent of the patients. This type of injury was significantly more frequent among patients older than 30 years of age. Most injuries were minor. However, 6.8 percent of the patients were hospitalized and 30.9 percent received additional treatment by a physician. As the risk of injury varies with age, attempts to plan training individually and to institute prophylactic measures should be made.

Volleyball injuries presenting in casualty: a prospective study.

During 1986, all sports injuries (n = 5222) were prospectively recorded at the two casualty departments in Arhus, Denmark. Volleyball injuries (n = 278) accounted for 5.3% of all sports injuries. An evaluation of the rehabilitation period and the consequences of the injuries was undertaken by questionnaire three years after the injury. The injury incidence was 1.9 injuries/1000 inhabitants/year. Hand, finger, and ankle sprains were the most frequent injuries. Female players had significantly more hand/finger injuries than male players, who incurred more ankle/foot injuries. Knee (6%) and ankle injuries (31%) were responsible for the longest duration of absence from sports participation. There were relatively few chronic injuries. The study suggests the need to enhance prophylactic measures with regard to blocking and overhand pass techniques, in order to reduce the number and extent of ankle and hand/finger injuries.