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Tibial tubercle avulsion fractures, though rare, pose a significant challenge in pediatric orthopedics, particularly in athletic adolescents. For nondisplaced fractures, conservative treatment involves the use of braces or casts, while displaced fractures necessitate operative intervention, often through screw fixation. Concomitant soft tissue injuries should also be identified and addressed operatively to ensure complete repair of the extensor mechanism. This paper introduces a method for open reduction and internal fixation (ORIF) of tibial tubercle fractures with suture anchor repair of the distal patellar tendon avulsion. Two case examples of 14-year-old males with displaced fractures undergoing this procedure are presented. After standard screw fixation of the displaced fragment was performed, a single suture anchor was placed into the tibia and an onlay tension slide technique was utilized to secure the distal patellar tendon avulsion. Both patients underwent immobilization and protected weightbearing for four weeks with physical therapy initiated at six weeks. At four months postoperatively, both patients had returned to competitive sports without issue. The described technique may represent a reliable and reproducible method for addressing the distal patellar tendon avulsion component of tibial tubercle fractures. Its biomechanical advantages contribute to the complete repair of the extensor mechanism, enabling a successful return to competitive athletics without hardware complications.

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Clavicle fractures combined with sternoclavicular joint dislocations are very rare injuries that need to be addressed quickly and treated effectively due to the altered biomechanics of the shoulder girdle as well as to the potential damages to the surrounding "noble" anatomical structures. A diagnostic and therapeutic algorithm for such injuries has not yet been established. Computer Tomography with 3D reconstruction should be the diagnostic gold standard. In case of a highly displaced fracture and/or dislocation in an active patient, surgical treatment is advised in order to obtain proper bone and joint healing with satisfactory functional outcomes as well as to protect the surrounding anatomical structures from potential damages. We present the case of an 18-year-old male, skeletally mature patient, who had a fall while snowboarding. Subsequently he was diagnosed with a very uncommon combination of a displaced medial clavicle fracture and complete posterior Sterno-Clavicular dislocation with 111° rotation of the sternoclavicular fragment. We opted for surgery, decided to use "off-label" a 2.5 V-plate Ulna plate long (Medartis®) and to associate this procedure with a Sterno-Clavicular arthrodesis with tape-augmentation to stabilize the SC joint; this treatment strategy resulted in a good clinical outcome without any remaining instability and satisfactory ROM. We collected this case to describe this seldom combination, to show our treatment strategy and to advocate the creation of a standardized diagnostic and therapeutic algorithm. X-rays, Computer Tomography images and intraoperative photos are presented.

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Bone-tendon junctions are prone for acute trauma due to its structural weakness, especially in premature males. For the lower limb, the most eminent area is the tibial tubercle apophysis. Osgood Schlatter disease (OSD) due to repetitive trauma or epiphyseal fractures due to one trauma is well described in literature and known in pediatric practice. Traumatic distal patella tendon ruptures on the other hand are a typical injury of the knee extensor mechanism of mature patients in the fourth decade. Here, the very rare condition of fracture of the tibial tubercle apophysis with simultaneous rupture of the distal patellar tendon of a 15 year old soccer player with previous history of OSD is presented including a review of the recent literature.

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Purpose: To compile and analyze the top 50 most frequently cited articles published in the Knee Surgery, Sports Traumatology, Arthroscopy journal. Methods: Guidelines set by the Preferred Reporting Items for Systematic Reviews were used as the foundation for data collection and analysis. Scopus database was used to acquire the metric analyzed in the study. Once collected, the data was exported to an excel sheet in order to be organized, sorted, and analyzed in accordance with the metrics of interest. Results: The United States was the most contributory nation with 14 publications, followed by Sweden with13 publications and Germany with eight publications. The most contributory institution was Umeå University in Vasterbottens, Sweden (8) followed by National Institute for Working Life in Stockholm, Sweden (7) and The University of Pittsburgh (5). Most publications were either Level II (19) or Level III (19) in terms of Level of Evidence. There was only one publication that was classified as a Level I paper. Conclusion: The Journal of Knee Surgery, Sports Traumatology, and Arthroscopy has published very influential research papers as noted by the number of citations amassed by its most popular articles. KSSTA's top cited publications hail largely from major European and United States institutions and are composed of high-quality reports of mostly Level 2 and Level 3 evidence classifications. Level of Evidence: 3.

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Introduction Anterior cruciate ligament (ACL) reconstruction techniques continue to evolve and the need to address the more anatomical femoral tunnel placement of the graft is critical, and in our study, we assessed the placement of femoral tunnel via transportal and retrograde drilling techniques. Material and methods Sixty patients where n=31 for retrograde, n=29 for transportal were assessed via CT knee for the femoral tunnel aperture on the intercondylar ridge via high low and deep shallow direction ratio and interpreted accordingly. Results In our study, the femoral tunnel done via transportal method (n=29) has a deep shallow ratio range of 22%-47% and mean of 31.9±6.5, and graft is anatomical in 79%. The femoral tunnel done via the retrograde method (n=31) has a deep shallow depth ratio range of 11%-41% with a mean of 27.5±6.5 and graft is anatomical in 77% of the study group and the p-value means the ratio is 0.01 (significant). The femoral tunnel done via transportal method (n=29) has a high low ratio range of 19%-45% and mean of 32.9±6.3 and graft is anatomical in 72%. The femoral tunnel done via the retrograde method (n=31) has a deep shallow depth ratio range of 20%-38% with a mean of 33.9±4.1 and graft is anatomical in 94% of the study group with a p-value mean ratio being 0.51 (insignificant). Conclusion Watch out for the femoral tunnel placement in a deep shallow direction while going for standard transportal technique and high low direction while performing retrograde technique.

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INTRODUCTION: Rupture of the plantar fascia is a rare condition. It can also occur spontaneously and with no history of disease of the plantar fascia, above all in athletes. This review aims to systematically analyze all cases described in the literature regarding the rupture of the plantar fascia, evaluating incidence, risk factors, and treatments, considering which procedures show the best outcomes and the highest success rate. MATERIALS AND METHODS: A systematic review of PubMed, Google Scholar, and Cochrane review computerized databases was performed, focusing on articles about cases of rupture of the plantar fascia; 18 studies fulfilled all the criteria and were analyzed. There were no randomized controlled trials. RESULTS: A total of 155 patients (157 foot) were included in this systematic review. Considering all the studies included, 12 patients had a spontaneous rupture, 138 patients had a diagnosis of plantar fasciitis, and 130 patients were treated with local injections of corticosteroid before the rupture. Only 2 cases of bilateral rupture were reported. In all, 15 studies reported conservative treatment, with a total of 154 patients (156 feet) included. Operative treatment was reported in 3 studies, with 3 patients (3 feet) treated. CONCLUSIONS: Ruptures of the plantar fascia are very rare in asymptomatic patients and more common in patients treated with injection of steroids in the plantar fascia. Conservative treatment, although not standardized in the literature, led to good outcomes in most cases. Chronic ruptures of the fascia should be considered for operative treatment. LEVELS OF EVIDENCE: Level III.

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PURPOSE: Content validity is the most important property of PROMs. The COSMIN initiative has published guidelines for evaluating the content validity of PROMs, but they have only sparsely been applied to relevant PROMs for musculoskeletal conditions. The aim of this study was to use the COSMIN Risk of Bias checklist to evaluate the content validity of five PROMs, that are highly relevant in musculoskeletal research and used by the arthroscopic surgery community: the modified Harris' Hip Score (mHHS), the Copenhagen Hip and Groin Outcome Score (HAGOS), the International Knee Documentation Committee Subjective Knee evaluation Form (IKDC-SKF), the Knee injury and Osteoarthritis Outcome Score (KOOS) and the Knee Numeric-Entity Evaluation Score ACL (KNEES-ACL). METHODS: The development articles for the five PROMs were identified through searches in PubMed and SCOPUS. A literature search was performed to identify additional studies assessing content validity of the PROMs. Additional information, necessary for the assessments, was obtained from the PROM developers after direct request. To evaluate the quality of the development studies and rate the content validity, the COSMIN Risk of Bias checklist was applied to all studies. RESULTS: All five development studies were identified. Three subsequent content validity studies were identified, all evaluating KOOS and one also IKDC. One content validity study was of inadequate quality and excluded from further analysis. The development of mHHS, IKDC-SKF, and KOOS was rated inadequate and possess insufficient content validity for their target populations. Due to the irrelevance of multiple items, KOOS was in particular inappropriate to evaluate patients with an ACL injury. The development of HAGOS was also rated inadequate, although the insufficiency aspects can be regarded as minor. KNEES-ACL possessed sufficient content validity. CONCLUSION: Out of five PROMs, only KNEES-ACL possessed sufficient content validity. Particularly, KOOS should not be used as an outcome for patients with an ACL injury. There is an urgent need for condition-specific PROMs for musculoskeletal conditions, developed with adequate methods. LEVEL OF EVIDENCE: III.

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Choosing the most adequate PROM for a study is a non-trivial process. The aim of this study was to provide a catalogue with analyses of content and construct validity of PROMs relevant to research in sports science, including all published local translations. The most commonly used PROMs in sports research were selected from a PubMed search "patient reported outcome measures sports", identifying 439 articles and 194 different PROMs. Articles describing development of the 61 selected PROMs were assessed for content validity, and all articles regarding construct validity of each PROM and all published translations (in total 622 articles) were analyzed. A catalogue with assessments of the 61 PROMs was produced. The majority were of inferior validity, with few exceptions. The most common reason for this was that the PROM had not been developed by methods that ensure high content validity. Another major reason for inferior validity was that construct validity had not been secured by adequate statistical methods. In conclusion, this catalogue provides a tool for researchers to facilitate choosing the most valid PROM for studies in sports research. Furthermore, it shows for popular PROMs where further validation is needed, and for fields in musculoskeletal medicine where valid PROMs are lacking. It is suggested that a targeted effort is made to develop valid PROMs for major conditions in musculoskeletal research. The current method is easier to practice compared with assessment after COSMIN guidelines.

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Deviations from adequate use and reporting of PROMs may be problematic and misleading. The aim of this study was to investigate the extent of such problems in randomized clinical trials (RCTs). RCTs involving sports medicine research that used PROMs as primary outcomes were identified in 13 preselected journals. The articles were reviewed for nine potential problems related to how the PROM was used and how the data had been reported. The potential problems were as follows: aggregating subscale scores; combining patient-reported scores with physical, clinical, or para-clinical measures; using a PROM to diagnose or evaluate the individual patient; using a PROM for one leg or arm; selectively excluding domains or items; constructing a PROM for the specific occasion; mixing PROM formats (ie, digital, paper, telephone, e-mail, in person); ambiguous instructions for how the PROM should be completed; and recall bias. As covariates, we registered journal impact factor, year of publication, and existence of a registered protocol. In 29 (53.7%) of 54 identified RCTs, at least one potential problem was identified, the most common being aggregation of domain scores. This was not different with a published protocol or dependent on journal rankings, except for exclusion of domains, which was most common in high-ranking journals. Aggregation of domain scores was significantly less common in recently published articles compared with older articles (P = .03). Potential problematic use of PROMs and reporting of PROM data are common in RCTs, also in high-ranking journals, but less so in more recent articles.

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Results by patient-reported outcome measures (PROMs) from randomized controlled trials (RCTs) in musculoskeletal research often influence healthcare strategies. We aimed to evaluate to which extent these RCTs use adequate PROMs, and how this influences the results and conclusions. We identified RCTs of sports research relevance with PROMs as primary outcomes published in 13 preselected journals between January 1, 2008, and November 1, 2019; all journals regularly publish results from musculoskeletal research. Five journals have a high impact factor (>15), and eight with lower impact factors are widely read journals. It was assessed whether the RCTs had used PROMs with high content validity and whether the most adequate PROMs were used (ie, the most well developed and well validated for the patients enrolled in the study). We registered journal impact factor, year of publication, existence of a registered protocol, and whether the study showed significant difference between interventions. A total of 54 RCTs with 56 primary outcomes comprising 26 different PROMs were identified. For 13 RCTs (24%), a protocol was not published. In only 24 of RCTs (44%), the most appropriate PROM had been used as primary outcome, independent of a registered protocol, ranking of the journal, and year of publication. In seven cases, PROMs were used to evaluate a condition that they had not been developed for. RCTs that used the most adequate PROM showed significantly more often (46%) difference in outcomes in contrast to RCTs that used inadequate PROMs (22%) (P = 0.0483). In conclusion, in the majority of RCTs, the most adequate PROM had not been used. Studies, in which the most adequate PROM had been used as outcome, were significantly more likely to show significant difference between interventions. The extent to which protocols were not available was surprisingly high. Journals should request that adequate PROMs are used in RCTs, and if this is not the case that it is discussed how it might influence the results and conclusions. Likewise, it should be requested that a protocol is published or registered.

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To use an inadequate patient reported outcome measure (PROM) or use a PROM in an inappropriate way potentially influences the quality of measurement. The objectives of this study were to define potential inadequate uses of PROMs in sports research studies and estimate how often they occur. A consensus group consisting of medical researchers, statisticians, and psychometricians identified and defined potentially irregular applications of PROMs. Occurrence of these in 349 consecutive articles in sports medicine in which PROMs were used as primary outcomes was reviewed. In all, 14 different potential problems were defined, and one or several occurred in 172 of the articles (49%). These were as follows: using a PROM that was developed for a different patient group (100 cases), using two or more PROMs with identical questions (94), aggregation of domain sum scores (82), combinations of subjective and objective measures (27), using a PROM to diagnose or evaluate the individual patient (7), using a PROM for a single limb (3), recall bias (3), exclusion of domains or items (3), construction of a PROM for a specific occasion (2), categorization of the scale (2), and mixing different versions of a PROM (1). Adaption of scale scores (e. g., to percentage) when results are reported (144) carries a risk of miscalculation and distorted impression of results. Data related to uncertainty about completing the PROM and the handling of missing data were not provided in the manuscripts. In conclusion, potential problems in the use and reporting of PROMs are common in sports research, and this can influence the validity of reported results.

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PURPOSE: The European Society for Sports traumatology, Knee surgery and Arthroscopy (ESSKA) identified the need to develop a core curriculum for clinical specialists that work within the interest areas of ESSKA. A research-based approach was used to define a set of core competencies which could be used to map all of their educational activities, resources and development priorities. This paper describes the aims, development, results and implications of this competency-based core curriculum for orthopaedic conditions relevant to ESSKA members. METHODS: A Core Curriculum Working Group, with leaders and other experts representing the main specialist areas within ESSKA, reviewed existing curricula and the literature in their own specialist areas. Applying expert group methodology, they iteratively developed a draft list of 285 core competencies for Orthopedic specialists within 6 specialist areas of Knee, Shoulder, Foot/Ankle, Hip, Elbow/Forearm and Sports/Exercise. All ESSKA members were then asked to comment and rate the importance of these competencies, and the Working Group used these findings to critically review and refine the curriculum. RESULTS: The expert groups defined 56 competencies related to 10 Knee pathologies; 67 related to 15 Shoulder pathologies; 45 related to 9 Foot/Ankle pathologies; 41 related to 6 Hip pathologies; and 34 related to 12 Elbow/Forearm pathologies and 42 related to 8 Sports/Exercise pathologies. Survey respondent mean ratings were at least 'Important' for all competencies, and the Working Group used these results to separate the competencies into three levels of importance. CONCLUSION: A competency-based core curriculum for Orthopedic specialists was achieved through a systematic and scholarly approach, involving both expert opinion and engagement of the wider ESSKA membership, identifying 285 treatment competencies in 6 specialist areas. It is now being used to guide educational and strategic development for ESSKA and should also be of interest to the wider orthopedic and sports medicine communities.

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BACKGROUND: There is a growing interest in the use of artificial turf surfaces in rugby. In particular, artificial surfaces may be an useful means of increasing participation in the sport by allowing greater usage of a given pitch, especially in regions where natural turf pitches are difficult to maintain. METHODS: The incidence of site, nature, cause, and severity of training and match injuries was prospectively recorded in two professional teams (one equipped with World Rugby certified third generation artificial turf and the other with natural grass over the 2014-2015 season). RESULTS: A total of 23,840 minutes of exposure was displayed for the whole sample, 1,440 minutes during matches and 22,400 during training sessions. We recorded 37 (48%) traumatic injuries and 39 (52%) overuse injuries. For traumatic injuries, we did not find significant differences in the overall risk injury between grass and artificial turf considering match exposure and training sessions. For overuse injuries, there were significant differences in the overall risk injury between grass and artificial turf considering match exposure (p=0.03) and training sessions (p=0.02). CONCLUSION: In elite Italian rugby players, artificial turf seems to be safe in regards to traumatic injury while it seems to be a risk factor for overuse injuries. LEVEL OF EVIDENCE: II.

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OBJECTIVE AND METHOD: Using an online questionnaire, the injuries of 649 acrobats on horseback were recorded (636 female, 13 male, average age 20.8 years, average sports time 12.1 years). 64% of the athletes practised their sport in the upper and 34% in the lower performance classes. RESULTS: 62.7% of the athletes hurt themselves on vaulting at least once during their sports time. Most injuries occured at the lower limbs (57.5%), particularly on foot (31.2%) and knee (22.2%). At the upper limbs (26.1%), injuries were most often registered at hands (8.4%) and shoulders (6.0%). 16.4% of the athletes hurt themselves on trunk, head or neck. Main causes of injury were jumping off the horse and unfortunately landing (44%) or falling off the horse (36%). Ruptures most commonly occured (34%), followed by fractures (20%). Athletes were out of action because of their injury for 11.3 weeks on average. 42% of the respondents complained about chronic afflictions (knee 30.4%, trunk 17.9%). CONCLUSIONS: Prevention includes fall training, regular physical examinations and training of the trainers. Other measures are controversial (head protection) or still need to be improved (backprotectors).

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Our hypothesis is that there are no difference in the injury incidence on artificial turf and natural grass. During the 2011/2012 season, we recorded injuries which occurred to two Italian stadiums equipped with third-generation artificial turf during 36 games (391 players). Data were compared with the injuries which occurred in the same season in two stadiums equipped with natural grass (372 players). We recorded 43 injuries during the playing time (16.7 per 1000 h). About 23 (18.1 per 1000 h) injuries occurred on artificial turf, while 20 (15.2 per 1000 h) on the natural grass with no statistical differences P > 0.05. We recorded 10 (7.87 per 1000 h) contact and 13 (10.23 per 1000 h) non-contact injuries on artificial turf, while 5 (3.8 per 1000 h) contact and 15 (11.4 per 1000 h) non-contact injuries on natural grass P > 0.05. The overall relative risk was 1.15; 95% CI: 0.64-2.07). Our study demonstrates a substantial equivalence in injury risk on natural grass and artificial turf in elite professional soccer athletes during official matches.

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Muscle injuries are recognized to be among the most frequent injuries occurring in the sporting and athletic population, and they account for more than 30% of all injuries in professional soccer players. Despite their considerable frequency and impact, there is still a lack of uniformity in the categorization, description and grading of muscle injuries. Dozens of systems based on clinical signs, ultrasound imaging (US) appearance or magnetic resonance imaging (MRI) findings have been proposed over the years. Most of them are three-grade systems that take into account pain, ROM limitation, swelling and hematoma, hypoechoic or hyperintense areas on US or MRI, and muscle gap or tendon involvement; however, they still lack evidence-based prognostic value. Recently, new comprehensive classification systems have been proposed, with the aim of developing uniform muscle injury terminology and giving each severity grade prognostic value. The systems that combine detailed MRI and US features with the clinical presentation, such as the Munich Muscle Injury Classification, the ISMuLT classification, and the British Athletic Classification, if used extensively, could improve the diagnosis, prognosis and management of muscle injuries.

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PURPOSE: The study aimed to compare two methods of open surgical treatment for midportion Achilles tendinopathy in sportsmen. A novel technique consisting in transferring some soleus fibres into the degenerated tendon to improve its vascularization and longitudinal tenotomies are evaluated and compared. METHODS: From 2006 to 2011, fifty-two competitive and noncompetitive athletes affected by midportion Achilles tendinopathy were surgically treated and prospectively evaluated at 6 months and at a final 4-year mean follow-up. Twenty patients had longitudinal tenotomies, and thirty-two had soleus fibres transfer. Clinical outcome was evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) score and the Victorian Institute of Sports Assessment-Achilles (VISA-A) score. Time to return to walk and to run and tendon thickening were also recorded. RESULTS: Patients in the soleus transfer group had a higher increase in AOFAS and VISA-A score at 6 months and at the mean 4-year final follow-up (by 5.4 points, 95 % CI 2.9-7.9, p < 0.001 and by 5.7 points, 95 % CI 2.5-8.9, p = 0.001, for AOFAS and VISA, respectively). They also needed less time to return to run: 98.9 ± 17.4 days compared to 122.2 ± 26.3 days for the longitudinal tenotomies group (p = 0.0019). The soleus transfer group had a greater prevalence of tendon thickening (59.4 % compared to 30.0 % in the longitudinal tenotomies group, p = 0.037). CONCLUSIONS: Open surgery for midportion Achilles tendinopathy is safe and effective in medium term. Despite similar outcomes in postoperative functional scores, soleus transfer allows a faster recovery but has a higher incidence of tendon thickening. These results should suggest the use of the soleus graft technique in high-level athletes. LEVEL OF EVIDENCE: Prospective comparative study, Level II.

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PURPOSE: Our hypothesis was that the Achilles tendon healing process after surgical treatment would be promoted by PRP with a faster return to sports activities. METHODS: Thirty patients with Achilles tendon rupture and surgically treated with a combined mini-open and percutaneous technique were prospectively enroled in the study. Patients were alternately case-by-case assigned to Group A (control group; 15 patients) or Group B (study group; 15 patients). In Group B, PRP was locally infiltrated both during surgery and 14 days after surgery. Patients in both groups were followed up at 1, 3, 6 and 24 months post-operatively via physical examination, VAS, FAOS and VISA-A scales; ultrasonography (US) and MRI were also conducted at one and 6 months; at the 6-month follow-up, isokinetic and jumping capacity tests were also performed. RESULTS: The VAS, FAOS and VISA-A scale showed no difference between the two groups at 1, 3, 6 and 24 months post-operatively. Isokinetic evaluation showed no differences at both angular speeds. Jumping evaluation showed no difference at 6 months. Also US evaluation showed no differences. MRI data analysis before administration of gadolinium did not reveal significant differences between the two groups. Moreover, after intravenous injection of gadolinium, patients in Group B showed signal enhancement in 30 % of patients compared to 80 % in Group A at 6 months, as indirect evidence of better tendon remodelling (P < 0.05). CONCLUSIONS: A substantial equivalence in structural and functional results in Achilles tendon ruptures surgically treated with and without addition of PRP is shown by present study. Clinical results, morphological features and jumping capability were similar in both groups. The addition of PRP to the surgical treatment of Achilles tendon rupture does not appear to offer superior clinical and functional results. LEVEL OF EVIDENCE: IV.

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INTRODUCCIËN: La confluencia de factores que provocan la fricción del patín sobre ciertas áreas de los pies de patinadores durante sus entrenamientos ocasiona lesiones nodulares. OBJETIVO: Explorar y describir características imagenológicas de estas excrecencias circunscritas que se presentan en los pies de patinadores como consecuencia del sobreuso deportivo. MÉTODOS: Se realizó estudio transversal y descriptivo en 100 jóvenes masculinos no deportistas (controles) y en los 15 integrantes de la Preselección Cubana de Patinaje de carrera en abril de 2009 (10 varones y 5 hembras), todos con más de diez años de práctica deportiva sistemática. Se les realizó examen ecográfico diagnóstico en el Instituto de Medicina Deportiva para evaluar el estado de las estructuras articulares y periarticulares de esta región y los datos se procesaron mediante estadística descriptiva. RESULTADOS: Se verificaron distorsiones ecográficas en el 100 por ciento de los deportistas evaluados caracterizadas fundamentalmente por: engrosamiento dérmico circunscrito (100 por ciento), tendinitis (33,3 por ciento) y exostosis bursata (20 por ciento); manifestaciones todas incluidas en una afección que los autores identificaron como el pie del patinador cuya expresión clínica externa lo constituye la presencia de nódulos de localización retrocalcánea, región dorsal y/o medial del pie. CONCLUSIONES: El pie del patinador puede constituir una entidad nosológica que tiene sustento imagenológico y que se relaciona con la fricción directa y sistemática del patín, propia de este deporte y que no solo afecta la piel de los pies de los patinadores sino que puede interferir con el entrenamiento o competencia por la asociación con otras lesiones(AU)

INTRODUCTION: The convergence of factors leading to skate friction on some areas of skater's feet during trainings provoke nodular injuries. OBJECTIVES: To explore and to describe the imaging features of these circumscribed excrecences present in the skater's feet as consequence of sports overuse. METHODS: A cross-sectional and descriptive study was conducted in 100 young no-sportsmen (controls) and in the 15 members of the Cuban Pre-Selection of speed Skating in April, 2009 (10 boys and 5 girls), all of them with more than 10 years of systematic sports practice. Then underwent a diagnostic echographic examination in the Institute of Sports Medicine to assess the condition of articular and periarticular structures of this area and data were processed by descriptive statistics. RESULTS: There were demonstrated echographic distortions in 100 percent of assessed sportsmen, mainly due to: circumscribed dermic thickening (100 percent), tendonitis (33,3 percent) and exostosis bursata (20 percent), manifestations included in an affection identified by authors as skater foot whose external clinical expression is the presence of retrocalcaneal nodules, dorsal and/or foot medial region. CONCLUSIONS: The skater's foot may be a disease entity with an imaging support and is related to direct and systematic friction of skate, characteristic of this sport and that not only involve the teeth's skin but it may to interfere with treatment or competence due to its association with other injuries(AU)

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INTRODUCCIËN: La confluencia de factores que provocan la fricción del patín sobre ciertas áreas de los pies de patinadores durante sus entrenamientos ocasiona lesiones nodulares. OBJETIVO: Explorar y describir características imagenológicas de estas excrecencias circunscritas que se presentan en los pies de patinadores como consecuencia del sobreuso deportivo. MÉTODOS: Se realizó estudio transversal y descriptivo en 100 jóvenes masculinos no deportistas (controles) y en los 15 integrantes de la Preselección Cubana de Patinaje de carrera en abril de 2009 (10 varones y 5 hembras), todos con más de diez años de práctica deportiva sistemática. Se les realizó examen ecográfico diagnóstico en el Instituto de Medicina Deportiva para evaluar el estado de las estructuras articulares y periarticulares de esta región y los datos se procesaron mediante estadística descriptiva. RESULTADOS: Se verificaron distorsiones ecográficas en el 100 por ciento de los deportistas evaluados caracterizadas fundamentalmente por: engrosamiento dérmico circunscrito (100 por ciento), tendinitis (33,3 por ciento) y exostosis bursata (20 por ciento); manifestaciones todas incluidas en una afección que los autores identificaron como el pie del patinador cuya expresión clínica externa lo constituye la presencia de nódulos de localización retrocalcánea, región dorsal y/o medial del pie. CONCLUSIONES: El pie del patinador puede constituir una entidad nosológica que tiene sustento imagenológico y que se relaciona con la fricción directa y sistemática del patín, propia de este deporte y que no solo afecta la piel de los pies de los patinadores sino que puede interferir con el entrenamiento o competencia por la asociación con otras lesiones

INTRODUCTION: The convergence of factors leading to skate friction on some areas of skater's feet during trainings provoke nodular injuries. OBJECTIVES: To explore and to describe the imaging features of these circumscribed excrecences present in the skater's feet as consequence of sports overuse. METHODS: A cross-sectional and descriptive study was conducted in 100 young no-sportsmen (controls) and in the 15 members of the Cuban Pre-Selection of speed Skating in April, 2009 (10 boys and 5 girls), all of them with more than 10 years of systematic sports practice. Then underwent a diagnostic echographic examination in the Institute of Sports Medicine to assess the condition of articular and periarticular structures of this area and data were processed by descriptive statistics. RESULTS: There were demonstrated echographic distortions in 100 percent of assessed sportsmen, mainly due to: circumscribed dermic thickening (100 percent), tendonitis (33,3 percent) and exostosis bursata (20 percent), manifestations included in an affection identified by authors as skater foot whose external clinical expression is the presence of retrocalcaneal nodules, dorsal and/or foot medial region. CONCLUSIONS: The skater's foot may be a disease entity with an imaging support and is related to direct and systematic friction of skate, characteristic of this sport and that not only involve the teeth's skin but it may to interfere with treatment or competence due to its association with other injuries

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