RESUMEN
Increasing numbers of people are playing golf. Golf is a unique sport in that the ability to participate at a high level is not limited by age. In addition, participants tend to play more rather than less as they grow older. Injuries can occur at any point during the golf swing, from takeaway through follow-through. Upper extremity injuries can affect the hands, elbow, and shoulder and are usually a result of the golf swing at impact. Injuries are also common in the lower back as well as the lower extremities. Most injuries are the result of overuse and poor swing mechanics. When treating golfers, it is important to have a good understanding of the biomechanics and forces of the golf swing to diagnose and manage the vast spectrum of injuries incurred in this sport.
Asunto(s)
Traumatismos en Atletas/etiología , Traumatismos de la Espalda/etiología , Lesiones de Codo , Golf/lesiones , Lesiones del Hombro/etiología , Traumatismos de la Muñeca/etiología , Traumatismos del Tobillo/epidemiología , Traumatismos del Tobillo/etiología , Traumatismos del Tobillo/terapia , Traumatismos en Atletas/epidemiología , Traumatismos en Atletas/terapia , Traumatismos de la Espalda/epidemiología , Traumatismos de la Espalda/terapia , Fenómenos Biomecánicos , Golf/fisiología , Cadera/fisiología , Lesiones de la Cadera/epidemiología , Lesiones de la Cadera/etiología , Lesiones de la Cadera/terapia , Humanos , Rodilla/fisiología , Traumatismos de la Rodilla/epidemiología , Traumatismos de la Rodilla/etiología , Traumatismos de la Rodilla/terapia , Escápula/fisiología , Hombro/fisiología , Lesiones del Hombro/epidemiología , Lesiones del Hombro/terapia , Torso/fisiología , Traumatismos de la Muñeca/epidemiología , Traumatismos de la Muñeca/terapiaRESUMEN
The technique of osteochondral allograft (OCA) transplantation has been used to treat a wide spectrum of cartilage deficiencies in the knee. Its use has been supported by basic science and clinical studies that show it is a safe and effective treatment option. What sets fresh OCA transplantation apart from other cartilage procedures in the knee, is the ability to treat large defects with mature hyaline cartilage. Studies looking at transplantation of fresh OCAs in the general population have shown reliable pain relief and return to activities of daily living. Reports of cartilage injuries in athletes have risen over the years and more research is needed in evaluating the successfulness of OCA transplantation in the athletic population.
Asunto(s)
Trasplante Óseo , Cartílago Hialino/trasplante , Articulación de la Rodilla/cirugía , Trasplante Óseo/rehabilitación , Cartílago Articular/diagnóstico por imagen , Cartílago Articular/lesiones , Cartílago Articular/cirugía , Fémur/cirugía , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Imagen por Resonancia Magnética , Trasplante Homólogo/rehabilitaciónRESUMEN
Basal joint arthritis leads to thumb metacarpophalangeal (MCP) hyperextension that may prevent physiologic pinch. Various techniques have been used to address this hyperextension, but most are technically challenging, time-consuming, and not supported by long-term follow-up results. Furthermore, few groups have reported subjective, patient-based outcomes after such procedures. In a retrospective study, we evaluated a cohort of 14 patients who underwent a novel technique of thumb MCP capsulodesis in conjunction with basal joint arthroplasty. A mean of 4.74 years after surgery, subjective outcome measures (Disabilities of the Arm, Shoulder, and Hand questionnaire; visual analog scale for pain; patient satisfaction) and objective outcome measures (range of motion, grip and pinch strengths) all reflected excellent function. The described technique for MCP capsulodesis is an attractive adjunct to basal joint arthroplasty, but further prospective studies are needed to establish specific operative indications.
Asunto(s)
Artritis/cirugía , Artroplastia/métodos , Inestabilidad de la Articulación/cirugía , Articulación Metacarpofalángica/cirugía , Placa Palmar/cirugía , Pulgar/cirugía , Anciano , Anciano de 80 o más Años , Artritis/complicaciones , Femenino , Humanos , Inestabilidad de la Articulación/etiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The elbow is a complex joint consisting of 3 separate but important articulations: the ulnohumeral, radiohumeral, and proximal radioulnar joints. The elbow assists in positioning the hand in space through 2 important motions, flexion-extension and pronation-supination. Although the elbow is not a weightbearing joint, it is subjected to significant loads, especially in overhead and throwing athletes. An accurate knowledge of the anatomy and physiology of the elbow joint is critical for conducting a focused physical examination and arriving at an accurate diagnosis. The goal of this article is to review general and focused physical examination of the elbow in a systematic manner based on medial, lateral, anterior, and posterior aspects.
Asunto(s)
Articulación del Codo/fisiología , Codo/fisiología , Examen Físico/normas , Fenómenos Biomecánicos , Codo/anatomía & histología , Codo/fisiopatología , Articulación del Codo/anatomía & histología , Articulación del Codo/fisiopatología , Humanos , Artropatías/diagnóstico , Examen Físico/métodos , Rango del Movimiento Articular , Codo de Tenista/diagnósticoRESUMEN
Advanced stages of basal joint arthritis are sometimes characterized by an adduction deformity of the first metacarpal and a hyperextension deformity of the unstable metacarpophalangeal (MCP) joint. Stabilizing the MCP joint in these patients is critical to ensure a pain-free repair and efficient pinch mechanism. This study presents the anatomic basis for a novel capsulodesis technique using the volar plate that can be incorporated into any reconstructive basal joint procedure when clinically indicated. Eleven normal cadavers were dissected to expose the volar plate. The dimensions of the volar plate, relationship of the sesamoid bones to the oblique pulley, and the distance from the sesamoids to the base of the proximal phalanx were compared between specimens. The radial border of the volar plate measured 8.5 ± 1.3 mm, ulnar border 8.8 ± 1.0 mm, proximal border 7.5 ± 1.0 mm, and distal border 7.8 ± 0.6 mm. The distance between the ulnar sesamoid bone and the oblique pulley measured 12.1 ± 1.1 mm and from the radial sesamoid to the oblique pulley measured 16.6 ± 0.2 mm. The distance between the sesamoids and the base of the phalanx measured 2.2 ± 0.2 mm. The anatomic studies provide a foundation on which the surgeon can understand the complex nature of the MCP joint. This study describes a novel technique for MCP capsulodesis of the thumb in which volar plate flaps are imbricated to provide stability to the MCP joint, obviating the need for suture anchors and tendon grafts.
Asunto(s)
Artrodesis/métodos , Deformidades Adquiridas de la Articulación/cirugía , Inestabilidad de la Articulación/cirugía , Articulación Metacarpofalángica/cirugía , Osteoartritis/cirugía , Placa Palmar/cirugía , Pulgar , Artroplastia/métodos , Artroplastia/rehabilitación , Cadáver , Humanos , Articulación Metacarpofalángica/patología , Placa Palmar/patologíaRESUMEN
Pitchers are prone to elbow injuries because of high and repetitive valgus stresses on the elbow. The anterior bundle of the medial ulnar collateral ligament (MCL) of the elbow is the primary restraint and is often attenuated with time, leading to functional incompetence and ultimate failure. Pitchers with a history of medial elbow pain, reduced velocity, and loss of command may have an MCL injury in evolution. Physical examination and imaging can confirm the diagnosis. Treatment begins with rest and activity modification. All medial elbow pain is not MCL injury. Surgery is considered only for talented athletes who wish to return to competitive play and may include elite scholastic and other collegiates and professionals. The technique for MCL reconstruction was first described in 1986. Many variations have been offered since then, which can result in predictable outcomes, allowing many to return to the same level of competitive play.