Cases reported "Athletic Injuries"

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1/49. Complete rotational burst fracture of the third lumbar vertebra managed by posterior surgery. A case report.

    STUDY DESIGN: Case report of a young man with rotational burst fracture of the third lumbar vertebra, treated by posterior surgery. OBJECTIVES: To describe the management of a rotational burst fracture of the third lumbar vertebra by posterior surgery consisting of reduction, decompression, fusion, and transpedicular instrumentation. SUMMARY OF BACKGROUND DATA: Surgery is the generally recommended means of managing lumbar burst fractures with neurologic deficit. Some surgeons recommend anterior decompression, fusion, and instrumentation. Posterior surgery with decompression through laminectomy, spongioplasty of the vertebral body, interbody fusion of damaged discs, posterolateral fusion, and transpedicular fixation is also a safe and successful management technique. The combined approach consists of posterior decompression, fusion, transpedicular fixation, and anterior fusion using pelvic autografts. The optimum method of management remains in question. METHOD: An 18-year-old man with complete rotational burst fracture of the third lumbar vertebra was treated by posterior surgery. This surgery consisted of reduction, laminectomy, decompression, structure of dural sac tears, spongioplasty of the vertebral body, interbody fusion of both damaged discs, and the implantation of a transpedicular Socon fixator (Aesculap, Tuttlingen, germany), including a transverse connector. The case was documented by radiographs and computed tomography scans before surgery and after fixator removal 19 months after surgery. RESULTS: The patient healed solidly with no instrumentation failure. The neurologic deficit Frankel Grade B improved to Frankel Grade D. CONCLUSION: Surgery to manage lumbar burst fracture must include reduction, decompression, restoration and fusion of anterior and posterior elements by using autologous pelvic spongious autografts, and anterior or posterior instrumentation. Posterior surgery including suturing of dural sac tears, fusion of damaged structures, and transpedicular fixation is successful in young patients and patients with good bone quality.
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2/49. Fracture of the sternum--an unusual case.

    Stress fracture of the sternum is a rare injury and can occur in young athletes due to repeated stress and in elderly with osteoporotic bones or other pathological conditions under normal stress. A case of a 14-year-old boy is reported who sustained fracture of the sternum without any history of significant trauma when he simply tried to lift his whole body over his arms and felt pain in front of the chest.
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3/49. Kite-flying: a unique but dangerous mode of electrical injury in children.

    A retrospective study was conducted to evaluate the cause of a sudden rise in number of pediatric admissions with electrical injuries at our centre during the year 1998. In evaluating the cause, six out of twelve admissions were found to be related to kite-flying which is a popular sport during the months of June, July, August and September. In two out of six cases current travelled directly through the string of the kite. In two others, flame burns occured following ignition of clothing. Another patient had contact with wire through a metal rod. In the last case, arcing pulled the hand of the patient leading to direct contact with wire. The average burns size was approximately 31% body surface area (BSA), with all patients having burns over the palmar aspect of at least one hand. No patient required amputation for the injuries. In this article, attention has been focussed on the various modes of electrical injuries associated with kite-flying and some measures have been advised to avoid such accidents.
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4/49. Traumatic intracerebral venous thrombosis associated with an abnormal golf swing.

    OBJECTIVES: To describe the occurrence of cerebral venous thrombosis in a 40-year-old man whose cerebral event was induced by a poor golf swing, to review the literature on possible mechanisms producing venous thrombosis, and to compare this case with the literature. BACKGROUND: headache is the most frequent symptom in patients with cerebral venous thrombosis. However, patients presenting with a headache due to cerebral venous thrombosis are uncommon. The known risk factors for thrombosis include both acquired and genetic factors. When the interaction of these two groups occurs, the magnitude of this interaction is thought to produce a dynamic state that can favor thrombosis. Our case report illustrates that moderate levels of anticardiolipin antibodies together with the mild trauma of a golf swing can induce a cerebral venous thrombosis. This case also suggests that although headache is rarely due to cerebral venous thrombosis, it should be excluded by good medical acumen and testing. RESULTS: Minor trauma induced by a poor golf swing was chronologically related to the development of a progressive cerebral venous thrombosis. The patient had none of the risk factors associated with a predisposition to venous thrombosis: hypercoagulable state, concurrent infection, pregnancy/puerperium, collagen vascular disorder, malignancy, migraine, false-positive VDRL, previous deep vein thrombosis, renal disease, factor v Leiden, or a hematological disorder. There was no anatomical abnormality that would predispose the patient to a cerebral venous thrombosis. The only laboratory abnormality was a moderate anticardiolipin antibody level (25 GPL). The patient was placed on warfarin sodium therapy and is currently without clinical sequela from the venous thrombotic event. CONCLUSIONS: Under certain circumstances, minor trauma can induce cerebral venous thrombosis. A review of the literature indicates that cerebral venous thrombosis in the presence of anticardiolipin antibodies and in the absence of systemic lupus erythematosus is a rare event. Previously, only major traumatic events have been reported to be associated with cerebral venous thromboses. The chronological development of cerebral venous thrombosis after a faulty golf swing strongly indicates that given a background of moderate levels of anticardiolipin antibodies, even minor trauma can induce a venous thrombotic event.
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5/49. Refracture of proximal fifth metatarsal (Jones) fracture after intramedullary screw fixation in athletes.

    This study details six instances of refracture of clinically and radiographically healed fractures of the base of the fifth metatarsal after intramedullary screw fixation. Four professional football players, one college basketball player, and one recreational athlete underwent intramedullary screw fixation of fifth metatarsal fractures. The athletes were released to full activities an average of 8.5 weeks (range, 5.5 to 12) after fixation, when healing was clinically and radiographically documented. Three football players developed refracture within 1 day of return to full activity. The other three athletes refractured at 2.5, 4, and 4.5 months after return to activity. Two football players underwent repeat fixation with larger screws and returned to play in the same season. The college basketball player underwent bone grafting and returned to play in subsequent seasons. The other three athletes underwent nonoperative management and healed uneventfully over 6 to 8 weeks. On the basis of this series, we recommend that 1) screw fixation using a large-diameter screw should be given careful consideration for patients with large body mass for whom early return to activity is important; 2) functional bracing, shoe modification, or an orthosis should be considered for return to play; 3) if refracture occurs, exchange to a larger screw may allow return to play in the same season; and 4) alternative imaging should be considered to help document complete healing.
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6/49. myasthenia gravis in a collegiate football player.

    A 17-yr-old Division I-AA collegiate offensive lineman developed unilateral ptosis shortly after minor head trauma during a scrimmage. The subsequent temporal profile of the ptosis, a history of a similar event lasting a short period of time 2 yr earlier, and the results of his clinical and electrophysiologic examinations established a diagnosis of very mild, generalized, antibody-negative myasthenia gravis (MG). His desire to continue playing football posed several additional management problems for which there was no published guidance. We started him on alternate-day, high-dose prednisone therapy with potassium and calcium supplementation, and allowed him to partake in conditioning but no contact. Except for residual decreased exercise tolerance, he improved symptomatically and experienced no serious adverse effects from the illness or the treatment during his first season, despite imperfect drug compliance. His MG eventually came under excellent symptomatic control, allowing initiation of a slow taper of the prednisone before his second season. Shortly thereafter, he abruptly stopped the prednisone without seeking medical advice. He continued to experience mild left ptosis and a mild decrease in intense exercise tolerance. He decided to forego his senior season of collegiate football after a bout of severe mechanical low-back pain incurred during spring football practice and limited his athletic activity thereafter to recreational sports.
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7/49. Anterior angulation deformity of the radial head. An unusual lesion occurring in juvenile baseball players.

    Four cases of an unusual angulation deformity of the radial head were seen in juvenile baseball players, with or without associated lesions of osteochondritis in the contiguous capitellum of the humerus and loose-body formation. The established deformity did not show a tendency toward anatomical restitution. In each case, symptoms produced by this deformity were noted to appear in association with athletic activity.
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8/49. Premenarchal athletic injury to the breast bud as the cause for asymmetry: prevention and treatment.

    Some variation in breast size is normal and is common in most women. When this variation becomes large and appreciable asymmetry develops--greater than a one-cup size difference--the asymmetry often disrupts the patient's life. The etiology of most breast asymmetries is unknown; however, current theories on causes include endocrine, iatrogenic, and traumatic injury. The Tulane University Plastic Surgery Service recently evaluated two cases of breast asymmetries that developed after traumatic injury to the breast bud while the body was under increased physical stress. Both girls sustained injuries at approximately 10 to 11 years old (Tanner Stages I-II) while participating in gymnastics.
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9/49. Beware the boogie board: blunt abdominal trauma from bodyboarding.

    Riding waves on a bodyboard (boogie board) at the beach is popular with children. Three teenagers who sustained blunt abdominal trauma during bodyboarding are described. Two suffered lacerated livers, one a lacerated spleen. Serious blunt abdominal injuries from bodyboarding mishaps have not previously been reported. The usual method of riding a bodyboard may place the rider at risk of abdominal trauma.
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10/49. Exact moment of a gastrocnemius muscle strain captured on video.

    A left gastrocnemius strain was sustained by an elite cricket batsman while he was taking off to run. The exact moment of injury, captured by a camera in the middle stump, appears to correspond to the sudden appearance of a deficit in the gastrocnemius muscle, seen through the player's trousers. The strain occurred when the entire body weight was on the left foot with the centre of mass well in front of the leg. The injury probably occurred close to the time when the gastrocnemius complex was moving from an eccentric to an isometric phase.
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