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Sporting injuries

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 Sports. Rugby American Football Ice Hockey Soccer. Impact Sports.

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Sporting injuries

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  1. Sporting injuries David Hargreaves Consultant Hand, Wrist and Elbow Surgeon Southampton

  2. Sporting Injuries • Leisure Time • Sports Interest • Sports Industry • UK Sporting legacy • Soccer • America`s Cup

  3. Impact Sports • Rugby • American Football • Ice Hockey • Soccer

  4. Impact Sports • Tackle Elbow : • Biceps Tendon Rupture • MCL Rupture

  5. Impact - Wrists • Distal Radius Fracture • Scaphoid fracture • Sc-Lunate Lig Rupture

  6. Impact - Hands • 5th most common Rugby injury • Thumb : • UCL rupture • CMC: Bennetts Fracture

  7. Scaphoid Fractures • FOOSH • Wrist Extension Injury • Ball hitting hand • Punch Injury

  8. 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

  9. 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

  10. Factors affecting Union • Delay in Treatment • Displacement (>1mm) • Smoking

  11. Handle Sports • Racquet vs Hand Ball vs Hand

  12. Ball vs Hand • Mallett Finger • PIP dislocation: ?Fracture ?Central slip • Crush : Phalangeal / MC fracture • Wrist : Scaphoid / ScLun Lig

  13. Racquet Type Injuries • Elbow • Tendonitis • Chronic MCL • PostMed Impingement

  14. Racquet • Wrist Injury • Tendonitis • FCR • ECU • Ligament • TFCC tear • CMC 4 &5

  15. Racquet • Hook of Hamate • Golf • Tennis • Mechanism : • Direct Trauma • ?

  16. Hook of Hamate • Clinical signs: • Tenderness • Resisted LF flexion in ulnar deviation • Ulnar nerve irritation

  17. Treatment • Non Op • Operation: • Excise • Fixation

  18. Fighting Sports • Boxing • Martial Arts • Judo

  19. Fighting: • Elbow : • Hypertrophic osteophytosis • Impingement • Instability • PLRI • MCL

  20. Punch • Wrist : • Scaphoid • CMC Subluxation • Sagittal Band tears

  21. Loading Sports • Sudden : • Weight Lifting • Chronic : • Cycling

  22. Biceps Tendon Rupture • Avulsion from Bicipital tub. • Clinical Signs : • Bruising • Hook Test • Popeye sign

  23. Biceps Treatments • Non Op Rx: • Fatigability • Supn & Flexion • Muscle cramp • Not an option for most Sportsmen

  24. 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

  25. Late Repair • Reattachment : • Tight Biceps • <60deg • Graft : • Hamstring • Allograft : Achilles • Transfer • Brachialis insertion

  26. Biceps Tendonitis • Diff Diag: Bursitis • Degeneration • Partial Avulsion • PRP • Reattachment

  27. Conclusions • Diagnosis: -over investigate • Prognosis: -don’t underestimate • Communication: -Rehab team

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