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Metzger GA, Minneci PM, Gehred A, Day A, Klingele KE. Creatine supplementation in the pediatric and adolescent athlete-- A literature review. J Orthop 2023; 38:73-78. [PMID: 37008451 PMCID: PMC10063391 DOI: 10.1016/j.jor.2023.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/21/2023] [Indexed: 04/03/2023] Open
Abstract
Background An increase in intra-muscular creatine through supplementation has been proposed as a strategy for improving muscle performance and recovery, with studies showing some benefit for adult athletes who rely on short, explosive movements. We reviewed and summarized the current literature on creatine supplementation in a pediatric and adolescent population. Methods The databases PubMed and EMBASE were queried to identity articles related to the use of creatine supplementation in a healthy pediatric and adolescent population according to the guidelines established by PRISMA. The abstracts of all articles were reviewed to determine relevancy, with those meeting the pre-defined criteria included in the final review. Results A combined total of 9393 articles were identified. Following application of filters and review of abstracts, 13 articles were found to meet criteria and were included in the final review. There was a total of 268 subjects across all studies, with mean age ranging from 11.5 to 18.2 years. More than 75% of the studies were randomized-controlled trials, and 85% involved either soccer players or swimmers. The overall quality of the studies was poor, and there were no consistent findings regarding creatine supplementation and improvements in athletic performance. No studies were designed to address the topic of safety. Conclusions There is a gap in the study of the safety and efficacy of creatine supplementation in adolescents. Additional studies are needed to evaluate the effects of alterations in muscle composition on the growth, development, and performance of the developing athlete. Orthopedic providers should counsel their pediatric and adolescent patients on the current limitations in trying to assess the true risk and benefit of creatine supplementation for the aspiring athlete. Level of evidence Review, III.
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Affiliation(s)
- Gregory A. Metzger
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Peter M. Minneci
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Alison Gehred
- Nationwide Children's Hospital Library, Columbus, OH, USA
| | - Alexis Day
- Department of Orthopedic Surgery, Nationwide Children's Hospital, Columbus, OH, USA
| | - Kevin E. Klingele
- Department of Orthopedic Surgery, Nationwide Children's Hospital, Columbus, OH, USA
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2
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Verhagen E, Vriend I, Gouttebarge V, Kemler E, de Wit J, Zomerdijk D, Nauta J. Effectiveness of a warm-up programme to reduce injuries in youth volleyball players: a quasi-experiment. Br J Sports Med 2023; 57:464-470. [PMID: 36801807 DOI: 10.1136/bjsports-2022-105425] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 02/19/2023]
Abstract
OBJECTIVES To establish the effectiveness of the 'VolleyVeilig' programme on reducing injury rate, injury burden and injury severity in youth volleyball players. METHODS We conducted a quasi-experimental prospective study over one season of youth volleyball. After randomisation by competition region, we instructed 31 control teams (236 children, average age 12.58±1.66) to use their usual warm-up routine. The 'VolleyVeilig' programme was provided to 35 intervention teams (282 children, average age 12.90±1.59). This programme had to be used during each warm-up before training sessions and matches. We sent a weekly survey to all coaches, collecting data on each player's volleyball exposure and injuries sustained. Multilevel analyses estimated differences in injury rates and burden between both groups, and we used non-parametric bootstrapping to compare the differences in injury numbers and injury severity. RESULTS We found an overall reduction in injury rates of 30% for intervention teams (HR 0.72; 95% CI 0.39 to 1.33). Detailed analyses revealed differences for acute (HR 0.58; 95% CI 0.34 to 0.97) and upper extremity injuries (HR 0.41; 95% CI 0.20 to 0.83). Compared with control teams, the intervention teams had a relative injury burden of 0.39 (95% CI 0.30 to 0.52) and a relative injury severity of 0.49 (95% CI 0.03 to 0.95). Only 44% of teams fully adhered to the intervention. CONCLUSION We established that the 'VolleyVeilig' programme was associated with reduced acute and upper extremity injury rates and lower injury burden and severity in youth volleyball players. While we advise implementation of the programme, programme updates to improve adherence are needed.
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Affiliation(s)
- Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Ingrid Vriend
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Vincent Gouttebarge
- Section Sports Medicine, University of Pretoria, Pretoria, South Africa.,Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Musculoskeletal Health, Sports, Amsterdam, The Netherlands
| | - Ellen Kemler
- Dutch Consumer Safety Institute (VeligheidNL), Amsterdam, The Netherlands
| | | | - Daniel Zomerdijk
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Joske Nauta
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
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3
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Turati M, Boerci L, Piatti M, Zanchi N, Zatti G, Accadbled F, Bigoni M. Updates on etiopathogenesis of musculoskeletal injuries in adolescent athletes. Minerva Pediatr (Torino) 2023; 75:133-135. [PMID: 33107275 DOI: 10.23736/s2724-5276.20.05944-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- Marco Turati
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy - .,Hospital Couple Enfant, Grenoble, France - .,Department of Orthopedics, San Gerardo Hospital, University of Milano-Bicocca, Monza, Monza-Brianza, Italy - .,School of Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy - .,Department of Pediatric Orthopedic Surgery, Couple Enfant Hospital, Grenoble Alpes University, Grenoble, France -
| | - Linda Boerci
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
| | - Massimiliano Piatti
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy.,Department of Orthopedics, San Gerardo Hospital, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
| | - Nicolò Zanchi
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
| | - Giovanni Zatti
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy.,Department of Orthopedics, San Gerardo Hospital, University of Milano-Bicocca, Monza, Monza-Brianza, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
| | - Franck Accadbled
- Department of Orthopedics, Children's Hospital, Centre Hospitalier Universitaire (CHU), Toulouse, France
| | - Marco Bigoni
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy.,Department of Orthopedics, San Gerardo Hospital, University of Milano-Bicocca, Monza, Monza-Brianza, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
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Hu C, Du Z, Tao M, Song Y. Effects of Different Hamstring Eccentric Exercise Programs on Preventing Lower Extremity Injuries: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2057. [PMID: 36767424 PMCID: PMC9916392 DOI: 10.3390/ijerph20032057] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
This systematic review and meta-analysis aims to investigate the effects and differences of various hamstring eccentric training protocols for the prevention of lower limb injuries, and we further propose a more refined hamstring eccentric training protocol for the prevention of lower limb injuries. A literature search for the effects of hamstring eccentric training on lower extremity sports injuries was conducted using the PubMed, Web of Science, and EMBASE databases, and the literature was searched covering the period from the date of the database's creation to 20 August 2022. A meta-analysis of the included literature was performed using R.4.21 for lower extremity injuries, injuries in various parts of the lower extremity, and subgroup analysis for exercise frequency, exercise cycle, and exercise population. A total of 23 randomized controlled trial (RCT) studies were found to be included in the meta-analysis, and 15 of these trials, totaling 14,721 patients, were determined to be included in the overall lower extremity injury prevention effect. The analysis showed that the implementation of a hamstring eccentric training program reduced lower extremity injuries by 28%, and it resulted in a 46% decrease in hamstring injury rate and a 34% decrease in knee injury rate. The subgroup analysis revealed that the frequency of exercise was most significant in the twice-a-week exercise group, that the exercise program was most effective in preventing injuries in the 21-30-week exercise period, and that the program was most effective in preventing injuries in elite athletes and amateur adult athletic populations, compared with adolescents.
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5
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Dagi AF, Parry GJ, Labow BI, Taghinia AH. Trends in Pediatric Head and Facial Trauma During the COVID-19 Pandemic. J Craniofac Surg 2023; 34:e1-e6. [PMID: 35864579 PMCID: PMC9793995 DOI: 10.1097/scs.0000000000008776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 04/11/2022] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION The effect of physical-distancing policies and school closures on pediatric health has been a topic of major concern in the United States during the coronavirus disease 2019 (COVID-19) pandemic. The objective of this study was to assess the immediate impact of these public policies on patterns of head and facial trauma in the pediatric population. MATERIALS AND METHOD The Pediatric Health Information System (PHIS) was queried to identify patient encounters at 46 children's hospitals across the United States in 2016-2020. Encounters were included if resultant in ICD-10 diagnosis for head or facial trauma in a child under 18 between April 1 and June 30 in 2020 (first COVID-19 school closures) and during the same period in the previous 4 years (for comparison). RESULTS A total of 170,832 patient encounters for pediatric head and facial trauma were recorded during the study period, including 28,030 (16.4%) in 2020 and 142,802 (83.6%) in 2016-2019. Patient encounters declined significantly in 2020 among children of all age groups relative to previous years. Relative reductions were greatest in children aged 11 to 17 (middle/high school) and 6 to 10 (elementary school), at -34.6% (95% confidence interval: -23.6%, -44%; P <0.001) and -27.7% (95% confidence interval: -18.4%, -36%; P <0.001). Variation in relative reductions by race/ethnicity, sex, and rural/urban status were not statistically significant. CONCLUSIONS Physical-distancing policies and school closures at the start of the COVID-19 pandemic correlated with significant reductions in pediatric head and facial trauma patient encounters. As in-person activities resume, reductions in head and facial trauma during the pandemic may indicate a range of possible preventable injuries in the future.
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6
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Carpenter CM, Cooper SB, Wilson PL, Miller SM, Wyatt CW, Johnson BL, Shea KG, Ellis HB. An Activity Scale for All Youth Athletes? Clinical Considerations for the HSS Pedi-FABS. Orthop J Sports Med 2022; 10:23259671221143534. [PMID: 36582933 PMCID: PMC9793053 DOI: 10.1177/23259671221143534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/16/2022] [Indexed: 12/24/2022] Open
Abstract
Background The Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS) has demonstrated normally distributed scores in children aged 10 to 18 years. It has been used to evaluate knee injuries; however, there is limited information regarding its use in evaluating other injury types. Purpose To (1) assess the validity and utility of HSS Pedi-FABS in youth athletes with injuries to different parts of the body and (2) evaluate the association between the HSS Pedi-FABS and the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Global Health 7 (PGH), as well as PROMIS-Pain Interference (PGH-PI) and PROMIS-Fatigue (PGH-F) components. Study Design Cohort study (diagnosis); Level of evidence, 3. Methods The authors performed a retrospective review of youth athletes aged 10 to 18 years who completed the HSS Pedi-FABS as part of their previsit intake questionnaire between April 2016 and July 2020. HSS Pedi-FABS score distributions were compared and evaluated for ceiling effects in cohorts determined by demographic, injury characteristic, and sports participation variables; a ceiling effect was determined to be present if >15% of respondents received the highest possible score. HSS Pedi-FABS scores were analyzed for a correlation with PGH, PGH-PI, and PGH-F components. Results Included were 2274 patients (mean age, 14.6 ± 2.1 years; 53.0% female) participating in 21 distinct primary sports for 9.6 ± 7.9 hours per week. The mean HSS Pedi-FABS scores by injury group were as follows: elbow (22.7 ± 6.7), shoulder (21.0 ± 8.7), ankle (20.2 ± 8.8), knee (19.5 ± 9.1), and hip (15.4 ± 10.4) (P < .001). Broad distribution was seen in each cohort, with no floor or ceiling effects. The HSS Pedi-FABS score correlated with patient-reported hours per week (r = 0.33), days per week (r = 0.33), and years of participation (r = 0.21) (P < .001 for all). All 3 PROMIS components correlated with HSS Pedi-FABS: PGH (r = 0.28), PGH-PI (r = -0.11), and PGH-F (r = -0.15) (P < .001). Conclusion Study findings indicated that the HSS Pedi-FABS is a valid tool for measuring physical activity level in most injured youth athletes, not just those with knee injuries. The correlation of HSS Pedi-FABS with the PGH suggests a positive relationship of childhood physical activity with general health.
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Affiliation(s)
- Connor M. Carpenter
- Center for Excellence in Sports Medicine, Scottish Rite for
Children, Frisco, Texas, USA.,Texas A&M University School of Medicine, Bryan, Texas,
USA.,Connor M. Carpenter, BBA, Center for Excellence in Sports
Medicine, Scottish Rite for Children, 5700 Dallas Pkwy, Frisco, TX 75034, USA
() (Twitter: @CMCarpenter25)
| | - Savannah B. Cooper
- Center for Excellence in Sports Medicine, Scottish Rite for
Children, Frisco, Texas, USA
| | - Philip L. Wilson
- Center for Excellence in Sports Medicine, Scottish Rite for
Children, Frisco, Texas, USA.,Department of Orthopaedic Surgery, University of Texas Southwestern
Medical Center, Dallas, Texas, USA
| | - Shane M. Miller
- Center for Excellence in Sports Medicine, Scottish Rite for
Children, Frisco, Texas, USA.,Department of Orthopaedic Surgery, University of Texas Southwestern
Medical Center, Dallas, Texas, USA
| | - Charles W. Wyatt
- Center for Excellence in Sports Medicine, Scottish Rite for
Children, Frisco, Texas, USA
| | - Benjamin L. Johnson
- Center for Excellence in Sports Medicine, Scottish Rite for
Children, Frisco, Texas, USA
| | - Kevin G. Shea
- Department of Orthopaedic Surgery, Stanford University School of
Medicine, Stanford, California, USA
| | - Henry B. Ellis
- Center for Excellence in Sports Medicine, Scottish Rite for
Children, Frisco, Texas, USA.,Department of Orthopaedic Surgery, University of Texas Southwestern
Medical Center, Dallas, Texas, USA
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7
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Emre Taçyıldız A, Çekmen B, Uzun A, Cevher Çiftçi T, Berkay Uzuncu H, Serdar S, Üçer M. A retrospective analysis of spinal and cranial injury patterns caused by a fall from a tree in the Karabük province. INTERDISCIPLINARY NEUROSURGERY 2022. [DOI: 10.1016/j.inat.2022.101628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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8
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Mendonça LDM, Schuermans J, Denolf S, Napier C, Bittencourt NF, Romanuk A, Tak I, Thorborg K, Bizzini M, Ramponi C, Paterson C, Hägglund M, Malisoux L, Al Attar WSA, Samukawa M, Esteve E, Bakare U, Constantinou M, Schneiders A, Cavallieri Gomes A, Florentz D, Ozer Kaya D, Indra Lesmana S, Harøy J, Kuparinen V, Philips N, Jenkins W, Wezenbeek E, Witvrouw E. Sports injury prevention programmes from the sports physical therapist's perspective: An international expert Delphi approach. Phys Ther Sport 2022; 55:146-154. [DOI: 10.1016/j.ptsp.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 10/18/2022]
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Sudo Y, Kubo K, Shinohara T, Nakagawa K. Effectiveness of a Warm-up Program with Dynamic Stretching in Preventing Sports Injuries. EXERCISE MEDICINE 2022. [DOI: 10.26644/em.2022.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: This study aimed to conduct a warm-up (W-up) program incorporating movement preparation (MP) and clarify its effect on sports injury prevention.Methods: The subjects of the study were 55 first- to third-year students (age: 15.9 ± 1.0 years, height: 168.5 ± 5.2 cm, weight: 57.4 ± 5.3 kg) belonging to a high school boys' soccer team. The first two months were the control period (CP), and the next two months were the intervention period (IP). The CP was a conventional W-up and the IP was a W-up with MP. The effects of each W-up were compared in terms of the incidence of sports injuries and disabilities during both periods and the incidence of sports injuries and disabilities by cause. Other measurements were compared for a total of seven items, including flexibility, balance, and performance.Results: During the IP, the incidence of sports injuries during practice and the incidence of non-contact sports injuries were reduced, whereas flexibility, balance, and performance improved.Conclusions: W-up incorporating MP showed improvement in flexibility and related balance, which may have led to the reduction of sports injuries.
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de Sire A, Marotta N, Lippi L, Scaturro D, Farì G, Liccardi A, Moggio L, Letizia Mauro G, Ammendolia A, Invernizzi M. Pharmacological Treatment for Acute Traumatic Musculoskeletal Pain in Athletes. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57111208. [PMID: 34833426 PMCID: PMC8618079 DOI: 10.3390/medicina57111208] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 12/14/2022]
Abstract
Pain management is a crucial issue for athletes who train and compete at the highest performance levels. There are still evidence gaps for the use of analgesics for sports injuries despite the growing interest in training and competition settings. However, high-quality research is needed to determine the most appropriate and optimal timing and formulations in non-steroidal anti-inflammatory drug and opioid management, particularly given the strictness of anti-doping regulations. Indeed, the role of pharmacological therapy in reducing acute traumatic pain in athletes should still be addressed to minimize the timing of return to sport. Therefore, the aim of this comprehensive review was to summarize the current evidence about pain management in the setting of acute injury in elite athletes, providing the most informed strategy for pain relief and performance recovery.
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Affiliation(s)
- Alessandro de Sire
- Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (N.M.); (L.M.); (A.A.)
- Correspondence: ; Tel.: +39-0961712819
| | - Nicola Marotta
- Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (N.M.); (L.M.); (A.A.)
| | - Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.L.); (M.I.)
| | - Dalila Scaturro
- Physical and Rehabilitative Medicine, Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90100 Palermo, Italy; (D.S.); (G.L.M.)
| | - Giacomo Farì
- Motor and Sports Sciences, Department of Sciences and Biological and Environmental Technologies, Salento University, 73100 Lecce, Italy;
| | - Alfonso Liccardi
- Department of Biomedical Sciences for Health, University of Milan, 20122 Milan, Italy;
| | - Lucrezia Moggio
- Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (N.M.); (L.M.); (A.A.)
| | - Giulia Letizia Mauro
- Physical and Rehabilitative Medicine, Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90100 Palermo, Italy; (D.S.); (G.L.M.)
| | - Antonio Ammendolia
- Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (N.M.); (L.M.); (A.A.)
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.L.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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Tokumaru T, Eifuku R, Sai K, Kurata H, Hata M, Tomioka J. Pediatric blunt abdominal trauma with horizontal duodenal injury in school baseball: A case report. Medicine (Baltimore) 2021; 100:e24089. [PMID: 33466171 PMCID: PMC10545394 DOI: 10.1097/md.0000000000024089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/13/2020] [Accepted: 12/08/2020] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Pediatric sports injuries, including those from baseball, most often are musculoskeletal injuries and rarely include blunt abdominal injuries. Duodenal injury is rare and often associated with other organ injuries. Because it has a relatively high mortality, early recognition and timely treatment are needed. Here, we report a case of successful treatment of a pediatric patient with duodenal injury incurred in the context of school baseball. PATIENT CONCERNS A 13-year-old boy suffered blunt abdominal trauma and a right-hand injury caused by beating his abdomen strongly with his own right knuckle after he performed a diving catch during a baseball game. On the following day, the abdominal pain had worsened. DIAGNOSES Computed tomography led to a suspicion of injury to the horizontal part of the duodenum. INTERVENTIONS The duodenal injuries were repaired by simple closure. On the 10th post-operative day, an abscess formed in the retroperitoneal cavity because of an occult pancreatic injury. Ultrasound-guided percutaneous drainage of the cavity was performed. OUTCOMES The post-operative course of the abscess drainage was uneventful. The patient was discharged from our hospital on day 72 after admission and was in good health at the 9-month follow-up. LESSONS Regardless of the type of injury, we must assess the life-threatening conditions that can be expected based on the mechanism of the injury. In duodenal injuries, it is critical to perform surgical procedures and post-operative management based on the assumption of injuries to other organs.
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12
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Thiebat G, Spreafico A, Mazzoni S, Ravasio G, de Girolamo L, Schoenhuber H. Incidence of injuries in young soccer players: epidemiological study in an Italian elite club. J Sports Med Phys Fitness 2020; 61:80-86. [PMID: 32936570 DOI: 10.23736/s0022-4707.20.11157-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Football is the most popular sport in the world, increasingly played by the youngsters. However, little epidemiological data exists regarding injuries in young players. The aim of this study was to describe the most common types and sites of injury among the different classes of a single professional football club. METHODS The present perspective study covered a three-season period, including 679 children divided in 9 age classes. All the athletes were managed by the same staff and for each injury, onset date, date of return to training, anatomic site and type of injury were recorded. RESULTS The mean age of the population was 12.7 years old (Range 7.4-16.9). A total 975 injuries were recorded without significant differences among seasons (P=0.682). The most affected classes were U17 and U16, while the lowest rate of injury was in U11. The most common injury in U9 and U10 affected foot and ankle, while in all the other classes thigh was the most frequently site involved. Focusing on the type of injury, the most common cause was traumatic (40.9%), followed by muscular diseases. The mean value of absence from soccer was 19.7 days (±1.2). The highest rate of injuries occurred in September and August. In January and February, injuries were more frequent during competitions, whereas in the other months the rate was inverted. CONCLUSIONS This study highlights that preseason and the final phase of the season are more at risk of injury and the type of injury differs between classes.
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Affiliation(s)
- Gabriele Thiebat
- Sport Traumatology and Arthroscopic Unit, IRCCS Galeazzi Orthopedic Institute, Milan, Italy -
| | - Andrea Spreafico
- Sport Traumatology and Arthroscopic Unit, IRCCS Galeazzi Orthopedic Institute, Milan, Italy.,University of Milan, Milan, Italy
| | | | - Giovanni Ravasio
- Sport Traumatology and Arthroscopic Unit, IRCCS Galeazzi Orthopedic Institute, Milan, Italy.,AC Milan, Milan, Italy
| | - Laura de Girolamo
- Sport Traumatology and Arthroscopic Unit, IRCCS Galeazzi Orthopedic Institute, Milan, Italy.,Orthopedic Biotechnology Laboratory, IRCCS Galeazzi Orthopedic Institute, Milan, Italy
| | - Herbert Schoenhuber
- Sport Traumatology and Arthroscopic Unit, IRCCS Galeazzi Orthopedic Institute, Milan, Italy
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13
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Return to sport and re-tears after anterior cruciate ligament reconstruction in children and adolescents. Orthop Traumatol Surg Res 2018; 104:S183-S188. [PMID: 30253986 DOI: 10.1016/j.otsr.2018.09.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 09/02/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The primary objective of this study was to determine the time to and level of return to sports after anterior cruciate ligament (ACL) reconstruction in children and adolescents. The secondary objectives were to evaluate the risk of early ACL re-tear after return to sports and the risk of ACL tear in the contralateral knee. HYPOTHESIS The time to return to sports in young patients is considerably longer than in adults. METHODS A prospective multicentre study was conducted at 12 centres specialised in knee ligament surgery, in children and adolescents younger than 18 years, between 1 January 2015 and 31 October 2015. The patients were divided into a paediatric group with open physes and a skeletally mature group with closed physes. We recorded the time to return to sport, the type of sport resumed, and the occurrence of early re-tears on the same side. A poor outcome was defined as a re-tear or an objective IKDC score of C or D. A contralateral ACL tear was not considered a poor outcome. RESULTS Of 278 included patients, 100 had open physes and 178 closed physes. In the open physes group, return to running occurred after 10.4±4.7 months, return to pivoting/contact sport training after 13.1±3.9 months, and return to pivoting/contact sport competitions after 13.8±3.8 months. Of the 100 patients, 80% returned to the same sport and 63.5% to pivoting/contact sport competitions. Re-tears occurred in 9% of patients, after 11.8±4.1 months, and contralateral tears in 6% of patients, after 17.2±4.4 months. In all, 19.4% of patients had a poor outcome, including 10.4% with an IKDC score of C or D and 9% with re-tears. In the group with closed physes, return to running occurred after 8.8±5.1 months, return to pivoting/contact sport training after 11.7±4.7 months, and return to pivoting/contact sport competitions after 12.3±4.2 months. Of the 178 patients, 76.9% returned to the same sport and 55.6% to pivoting/contact sport competitions. The re-tear rate was only 2.8% and the contralateral tear rate 5%. In all, 14.7% of patients had poor outcome, including 11.9% with an IKDC score of C or D and 2.8% with re-tears. No risk factors for re-tears were identified; the quadruple-bundle semitendinosus technique showed a non-significant association with re-tears. CONCLUSION In young children, the return to sport time after ACL reconstruction is considerably longer than 1 year and the return to competitions occurs later and is more difficult. The results of this study indicate that reservations are in order when informing the family about return to sports prospects after ACL reconstruction. The return to pivoting/contact sport competitions should not be allowed until 14 months after surgery in young skeletally immature patients, and the risk of re-injury is high within the first 2 years. LEVEL OF EVIDENCE IV, retrospective study.
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