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Liu CX, Zhang ZZ, Wang JS, Luo XY, Liu TY, Ma YF, Deng XH, Zhou YF, Xu DZ, Li WP, Wang P, Song B. Optimal fibular tunnel direction for anterior talofibular ligament reconstruction: 45 degrees outperforms 30 and 60 degrees. Knee Surg Sports Traumatol Arthrosc 2023; 31:4546-4550. [PMID: 37308663 DOI: 10.1007/s00167-023-07452-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 05/02/2023] [Indexed: 06/14/2023]
Abstract
PURPOSE There is currently no consensus on the optimal drilling direction of the fibular bone tunnel for anterior talofibular ligament (ATFL) reconstruction, and few studies have investigated the potential injury to the peroneus longus and brevis tendons and the possibility of fibular fractures during the drilling process. The aim of this study was to assess the potential risk of drilling the tunnel from different directions and determine the most appropriate tunnel direction. The hypothesis was that drilling the tunnel in the 45-degree direction would be the safest and most suitable for the fibular tunnel. METHODS Forty-eight fibular tunnels were drilled on fresh ankle specimens using a K-wire guide and a 5.0 mm hollow drill. Three tunnel orientations were created, parallel to the sagittal plane of the long axis of the fibula and angled 30°, 45°, and 60° to the coronal plane. The length of the fibular tunnel and the distances from the outlet of the K-wire to the peroneus longus and brevis tendons were measured. The occurrence of a fibula fracture was also observed. RESULTS The lengths of the bone tunnels in the three groups were 32.9 ± 6.1 mm (30°), 27.2 ± 4.4 mm (45°) and 23.6 ± 4.0 mm (60°). The length of the tunnel drilled at 30° was the longest when compared with that of the tunnels drilled at 45° and 60° (all p values < 0.05). The distances from the outlet of the K-wire to the peroneus longus tendon were 3.0 ± 3.8 mm (30°), 3.8 ± 3.2 mm (45°) and 5.3 ± 1.8 mm (60°), and the distances to the peroneus brevis tendon were 4.2 ± 4.0 mm (30°), 6.1 ± 3.8 mm (45°), 7.9 ± 3.5 mm (60°). In terms of protecting the peroneus longus and brevis tendons, drilling in the 60° direction was better than drilling in the 30° and 45° directions (all p values < 0.05). The risk of injury to the peroneal longus and brevis tendons was 62.5% (30°), 31.3% (45°), and 0% (60°). Although no fibular fractures were observed in any of the three directions, drilling the bone tunnel in the 60° direction disrupted the lateral cortex of the fibula. CONCLUSION This study shows that drilling the tunnel in the 45° direction is less likely to cause injury to the peroneus longus and brevis tendons, while ensuring that the tunnel has a sufficient length and avoiding fracturing the distal fibula. Drilling a fibular bone tunnel in a 45° direction is safer and recommended for ATFL reconstruction.
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Affiliation(s)
- Cheng-Xiao Liu
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, No. 107 on Yanjiang Road West, Guangzhou, 510120, Guangdong, China
| | - Zheng-Zheng Zhang
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, No. 107 on Yanjiang Road West, Guangzhou, 510120, Guangdong, China
| | - Jing-Song Wang
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, No. 107 on Yanjiang Road West, Guangzhou, 510120, Guangdong, China
| | - Xi-Yuan Luo
- Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Tian-Yu Liu
- Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yu-Fan Ma
- Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xing-Hao Deng
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, No. 107 on Yanjiang Road West, Guangzhou, 510120, Guangdong, China
| | - Yun-Feng Zhou
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, No. 107 on Yanjiang Road West, Guangzhou, 510120, Guangdong, China
| | - Da-Zheng Xu
- Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Wei-Ping Li
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, No. 107 on Yanjiang Road West, Guangzhou, 510120, Guangdong, China
| | - Peng Wang
- Department of Orthopedics, Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, China.
| | - Bin Song
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, No. 107 on Yanjiang Road West, Guangzhou, 510120, Guangdong, China.
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Gajardo-Burgos R, Valdebenito-Tejos C, Gálvez-García G, Bascour-Sandoval C. Pain and Psychological Readiness to Return to Sport in Elite Volleyball Players: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2492. [PMID: 36767858 PMCID: PMC9915367 DOI: 10.3390/ijerph20032492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 06/18/2023]
Abstract
UNLABELLED Pain is modulated by multiple factors. A relevant psychological process peculiar to athletes and which could be associated with pain is Psychological Readiness to Return to Sport (PRRS). The analysis of this association in competition context is particularly important. OBJECTIVE To determine the correlation between the PRRS and pain intensity in elite volleyball players during their participation in a continental sporting event. METHODS A cross-sectional study was conducted. Data from 107 male volleyball players (23.50 ± 4.08 years of age) participating in the South American Volleyball Championship were used. The athletes answered a self-report questionnaire on the day the championship began regarding their history of injuries in the previous six months. The athletes who declared injuries were asked about the current pain intensity using the Pain Numeric Rating Scale (NRS) and Psychological Readiness to Return to Sport using the Injury-Psychological Readiness to Return to Sport scale (I-PRRS). RESULTS 43.93% (n = 47) of the athletes (23.70 ± 3.54 years) reported an injury in the six months prior to the championship. They presented a median on the NRS of three (interquartile range (IQR), 2-5), and 54 (IQR, 46-58) on the I-PRRS. The Spearman's Rho correlation test showed an inversely and moderate correlation (rs = -0.36; p = 0.011; CI: -0.64--0.08) between pain intensity and PRRS. CONCLUSIONS In male elite volleyball players who participate in a Continental Championship in South America, higher levels of PRRS was correlated to lower pain intensity.
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Affiliation(s)
- Rubén Gajardo-Burgos
- Instituto de Aparato Locomotor y Rehabilitación, Facultad de Medicina, Universidad Austral de Chile, Valdivia 5090000, Chile
- Programa de Magister en Terapia Física, Mención Musculoesquelética, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco 4780000, Chile
| | - Camila Valdebenito-Tejos
- Dirección de Desarrollo Estudiantil, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco 4780000, Chile
| | - Germán Gálvez-García
- Departamento de Psicología, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco 4780000, Chile
- Departamento de Psicología Básica, Psicobiología y Metodología de las Ciencias del Comportamiento, Facultad de Psicología, Campus Ciudad Jardín, Universidad de Salamanca, 37005 Salamanca, Spain
| | - Claudio Bascour-Sandoval
- Programa de Magister en Terapia Física, Mención Musculoesquelética, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco 4780000, Chile
- Departamento de Ciencias de la Rehabilitación, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco 4780000, Chile
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Yokoe T, Tajima T, Yamaguchi N, Nagasawa M, Morita Y, Chosa E. The Results of Orthopaedic Medical Examinations in Adolescent Amateur Weightlifters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13947. [PMID: 36360830 PMCID: PMC9657830 DOI: 10.3390/ijerph192113947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Few studies have reported injuries and physical characteristics in adolescent weightlifters. The purpose of this study was to report the results of orthopaedic medical examinations in adolescent amateur weightlifters that were performed cross-sectionally from 2012 to 2019. The orthopaedic medical examination included physical examinations, generalized joint laxity, muscle and joint tightness, static alignment, muscle volume of the lower extremities, and medial longitudinal arch of the foot (the height from the tip of the navicular tubercle to the ground surface). A questionnaire survey regarding pain in the spine and lower extremities was also performed. A total of 99 adolescent weightlifters were included (male/female, 71/28; mean age, 16.2 ± 0.2 years). A total of 9.1% had received orthopaedic treatments, with spine injuries being the most prevalent. Of those who had not received orthopaedic treatments, 31.1% had pain in the spine or lower extremities (for >4 weeks). There were no significant gender differences in the incidence of pain or positive findings of physical examinations. Female weightlifters had a more reduced dorsiflexion of the ankle joint than male weightlifters (p = 0.02). Male weightlifters had a lower flexibility of the quadriceps than female weightlifters. The results of orthopaedic medical examinations in this study may help clinicians and young weightlifters to prevent injuries in competitive weightlifting.
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Affiliation(s)
- Takuji Yokoe
- Correspondence: ; Tel.: +81-985-85-0986; Fax: +81-985-84-2931
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