Sporting injuries David Hargreaves Consultant Hand, Wrist and Elbow Surgeon Southampton.
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Transcript of Sporting injuries David Hargreaves Consultant Hand, Wrist and Elbow Surgeon Southampton.
Sporting Injuries
• Leisure Time • Sports Interest • Sports Industry
• UK Sporting legacy– Soccer– America`s Cup
Impact - Wrists
• Distal Radius Fracture
• Scaphoid fracture
• Sc-Lunate Lig Rupture
QuickTime™ and a decompressor
are needed to see this picture.
Scaphoid Fractures
• FOOSH
• Wrist Extension Injury
• Ball hitting hand
• Punch Injury
QuickTime™ and a decompressor
are needed to see this picture.
Percutaneous Fixation
• Percutaneous screw fixation versus conservative treatment for fractures of the waist of the scaphoid - A Prosp Randomised study
• M. M. McQueen• J Bone Joint Surg Br; Jan 2008:66-71
• Quicker time to union • Earlier return to sport & function. • No stat diff in nonunion
Electro-magnetic Stimulation
• The clinical and radiological outcome of pulsed electromagnetic field treatment for acute scaphoid fractures: A randomised double-blind placebo-controlled multicentre trial
• Hanneman (Maastrich)• Bone Joint J Oct 2012 94-B:1403.
• No significant difference
Ball vs Hand
• Mallett Finger• PIP dislocation: ?Fracture ?Central slip• Crush : Phalangeal / MC fracture• Wrist : Scaphoid / ScLun Lig
Racquet Type Injuries
• Elbow – Tendonitis– Chronic MCL
• PostMed ImpingementQuickTime™ and a
decompressorare needed to see this picture.
Hook of Hamate
• Clinical signs:
– Tenderness
– Resisted LF flexion in ulnar deviation
– Ulnar nerve irritation
Biceps Tendon Rupture
• Avulsion from Bicipital tub.• Clinical Signs :
– Bruising – Hook Test– Popeye sign
Biceps Treatments
• Non Op Rx: – Fatigability – Supn & Flexion– Muscle cramp
– Not an option for most Sportsmen
Acute Surgical Repair
• 2 Incision Technique– Posterior aspect of BT
• 1 Incision Technique– Endobutton / ToggleLoc– Tendon not easily inserted
into bone – Anterior part of BT
Late Repair • Reattachment :
– Tight Biceps– <60deg
• Graft : – Hamstring– Allograft : Achilles
• Transfer – Brachialis insertion