Showing papers by "Nicola Maffulli published in 1995"

Common Skeletal Injuries in Young Athletes

Abstract: The increasing frequency of injury in young athletes over the last 2 decades reflects the increases in sports participation of children of a young age. Physical injury is an inherent risk in sports participation at any age. In general, the factors causing sports injuries can be grouped in 2 separate broad categories: extrinsic and intrinsic factors. However, the great majority of injuries which are sustained are minor and self-limiting, suggesting that children and youth sports are safe. However, a increasing number of children undergo treatment because of the effects that injuries may have on their developing bodies. A child’s skeletal system shows pronounced adaptive changes to intensive sports training. Sports injuries affect both growing bone and soft tissues, and could result in damage of the growth mechanisms with subsequent life-lasting damage. Adolescents are particularly vulnerable to injuries, at least partially due to an imbalance in strength and flexibility. During growth there are significant changes in the biomechanical properties of bone. In young athletes, as bone stiffness increases and resistance to impact diminishes, sudden overload may cause bones to bow or buckle. Epiphyseal injuries occur at the epiphyseal growth plates. They are usually due to shearing and avulsion forces, although compression also plays a significant role. Given the remarkable healing potential of bone in youngsters, fractures that initially united with some deformity can completely remodel and appear totally normal in later life. As the risk of injuries sustained by young athletes can be significant, it is essential that training programmes take into account their physical and psychological immaturity, so that the growing athlete can adjust to their own body changes.

Ultrasonographic appearance of external callus in long-bone fractures.

Abstract: High-resolution real-time ultrasound (US) scanning was used to monitor serially 24 patients with an acute long-bone fracture and three patients with humeral non-union, looking at the fracture site over a period of 12 months following the fracture. In both these groups, we found that US gave important information about the soft tissues surrounding the fracture site, and indicated callus formation at an early stage. US was more sensitive than conventional radiography at showing the early phases of organization of the callus, and its progression to bridging new bone formation. US also clearly showed a disorganized echopattern at the fracture site of the patients with non-union.

Muscular strength after callotasis limb lengthening.

Abstract: Seven patients (average age, 9.2 years; range, 7.6-10.6 years) underwent callotasis lengthening of a congenital short femur. The isometric voluntary contraction strength of the knee extensor muscles was measured for each leg immediately before and at 6-month intervals for 2 years, starting from 2 months after the fixator was removed. The normal side was always stronger, even when strength was standardized for an anthropometric estimate of the thigh muscle and bone cross-sectional areas. The increase in strength was correlated with the increase in limb size, both in the normal and in the lengthened limb. Although leg length discrepancy was equalized by the end of the procedure, the functional characteristics of the lengthened limb remained impaired for a significant time

Traumatic dislocation of the lateral sesamoid of the great toe: nonoperative management

Abstract: A case of traumatic dislocation of the lateral sesamoid of flexor hallucis brevis tendon associated with metatarsal neck fractures due to a crush injury is reported. This patient was treated nonoperatively by elevation, application of plaster, and then free mobilisation. The patient has now fully recovered and remains completely asymptomatic despite residual sesamoid dislocation 1 year after the injury. The nonoperative management of this injury has not, to our knowledge, been reported previously.

Quasi-synchronous patellar tendon rupture.

Abstract: The case of a 66-year-old male who suffered from rupture of both patellar tendons within a few minutes of each other is reported. The patient was not suffering from any underlying medical problems, and made an uneventful recovery following surgical repair.

Osteoid osteoma of the clavicle.

Abstract: We describe a case of osteoid osteoma of the clavicle in an Olympic free-style wrestler who presented to us with persistent and increasingly, elevated pain in his right shoulder. Originally a persistent injury was considered to be causing the pain, however, the correct diagnosis was made three months after the onset of the symptoms. Even in sportsman where muscle pain is commonplace, non-traumatic conditions should be considered in the presence of persistent and increasingly elevated pain that is not relieved by rest and physiotherapy.

Achilles Tendon Rupture

Abstract: The Achilles tendon (AT) is the largest tendon in the human body, but it is also the one that frequently undergoes a complete subcutaneous tear. Men are more frequently affected than women, in particular between 30–40 years old. An AT tear is usually the end result of an asymptomatic process of failed heling typical of tendinopathy. The diagnosis of acute tear of the AT is clinical, based on careful history taking and detailed clinical examination. Operative management of acute AT ruptures provides lower re-rupture rate, early functional treatment, less calf atrophy, and better functional results, in particular in athletes. Minimally invasive Achilles tendon repair provides many advantages and should be considered in young and active patients. Simple parameters as single-legged concentric strengthening, range of motion, and calf circumference can be used to predict the ability to return to activity. On the basis of current evidence-based studies, the routine use of PRP to improve tendon AT healing is not recommended.

Color atlas and text of sports medicine in childhood and adolescence

Abstract: Children in sport - questions and controversies, Mafulli foot injuries, Taylor upper limb injuries, Aldridge lower limb injuries, King exercise physiology of children, Sharp nutrition, Mirkin pre-participation sports examination - musculo-skeletal system, Thabit and Micheli exercise in children with chronic conditions, Helms stress and the young athlete - a physiological perspective, Levita gynaecological issues for the young female athlete, Patrizio muscle strength and training in children, Jones laboratory testing in young athletes, Armstrong field testing in young athletes, Conconi the role of accident and emergency in paediatric sports emergencies, Gavalas.