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S.P.O.R.R.T.-A Comprehensive Approach to the Assessment and Non-Operative Management of Overuse Knee Conditions in Youth Athletes. s.p.o.r.r.t.:青少年运动员过度使用性膝关节状况的综合评估与非手术治疗。
IF 4.1 2区 医学 Q1 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-11-24 DOI: 10.1007/s12178-023-09874-8
Jacob Davis, Bridget Doyle, Haruki Ishii, Neeru Jayanthi

Purpose of review: The evaluation of a young athlete with an overuse injury to the knee involves a comprehensive approach. There are a number of elements to consider including assessments of skeletal maturity (biologic maturation), workload (training load + competition load), sport specialization status, and biomechanics. The type of injury and treatment, as well as future prognosis, may be influenced by these and other factors.

Recent findings: Calculating the percentage of predicted adult height (PPAH) is a valuable tool in assessing overuse injury patterns and diagnoses in youth athletes. Modifiable and non-modifiable overuse injury risk factors require monitoring from clinicians as young athletes mature and develop over time. Training and rehabilitation programs should be adapted to account for these. In this manuscript, we seek to introduce a novel, comprehensive approach: S.P.O.R.R.T. (Skeletal Maturity, Prior Injury Risk, One Sport Specialization, Rehabilitation, Return to Play, Training Recommendations) (Fig. 1). Overuse, non-traumatic injuries to the knee in youth athletes will be presented in a case-based and evidence-based model to provide a framework for a comprehensive approach to the assessment and treatment of youth athletes with overuse injuries.

回顾的目的:评估一个年轻的运动员与过度使用性损伤的膝盖涉及一个全面的方法。有许多因素需要考虑,包括骨骼成熟度(生物成熟度)、工作量(训练负荷+比赛负荷)、运动专业化状态和生物力学的评估。损伤的类型和治疗,以及未来的预后,可能受到这些因素和其他因素的影响。最近的研究发现:计算预测成人身高百分比(PPAH)是评估青少年运动员过度使用损伤模式和诊断的一个有价值的工具。随着年轻运动员的成熟和发展,可改变和不可改变的过度使用损伤风险因素需要临床医生的监测。训练和康复计划应该适应这些。在本文中,我们试图介绍一种新颖的综合方法:S.P.O.R.R.T.(骨骼成熟度,先前损伤风险,一项运动专业化,康复,恢复比赛,训练建议)(图1)。青少年运动员过度使用,非创伤性膝盖损伤将以案例为基础和基于证据的模型提出,为评估和治疗青少年运动员过度使用损伤的综合方法提供框架。
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引用次数: 0
Return to Play After Femoroacetabular Impingement. 股骨髋臼撞击后重返赛场。
IF 4.1 2区 医学 Q1 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-10-10 DOI: 10.1007/s12178-023-09871-x
Nicolò Zanchi, Marc R Safran, Paul Herickhoff

Purpose of review: Femoroacetabular impingement (FAI) is a pathomechanical process whereby abnormal contact between proximal femur and acetabulum at end range of hip motion induces chondrolabral lesions within the hip joint. Surgery followed by a rehabilitation program or physical therapy with possible addition of an intra-articular corticosteroid injection are the two predominant treatments. The majority of authors recognize that a well-designed rehabilitation protocol is essential to achieve good outcomes with both nonoperative and surgical treatment. However, there is little evidence about what is the best rehabilitation protocol and most of the literature available is based on expert level opinion. This current review investigates the recent literature on nonoperative and postoperative rehabilitation protocol and return to play in FAI patients and describes our approach.

Recent findings: Historically, rehabilitation protocols for treatment of FAI as well as return to play protocols were based on experts' opinion and low-level evidence studies. In order to improve standardization of protocols and to allow a better comparison in between different protocols, different authors have created standardized rehabilitation protocols with consensus building methods comparing them with other treatment options in high-level evidence trials (FASHIoN trial, etc.). Despite the excellent results reported after nonoperative and post-surgical rehabilitation, and the high RTP rate after FAI treatment, there is a significant variability in between protocols. Further high-level evidence studies are necessary in order to establish a gold standard in rehabilitation and RTP protocols.

综述目的:股骨髋臼撞击(FAI)是一种病理力学过程,在髋关节运动结束时,股骨近端和髋臼之间的异常接触会导致髋关节内软骨实验室病变。手术后的康复计划或可能添加关节内皮质类固醇注射的物理治疗是两种主要的治疗方法。大多数作者认识到,精心设计的康复方案对于非手术和手术治疗取得良好效果至关重要。然而,几乎没有证据表明什么是最佳的康复方案,大多数可用的文献都是基于专家级的意见。这篇综述调查了最近关于FAI患者非手术和术后康复方案和重返赛场的文献,并描述了我们的方法。最近的发现:从历史上看,FAI的康复治疗方案以及重返赛场方案都是基于专家的意见和低水平的证据研究。为了改进协议的标准化并允许不同协议之间更好的比较,不同的作者创建了标准化的康复方案,并将其与高水平证据试验(FASHIoN试验等)中的其他治疗方案进行了比较。尽管在非手术和术后康复后报告了良好的结果,并且FAI治疗后的RTP率很高,但方案之间存在显著差异。为了建立康复和RTP协议的黄金标准,有必要进行进一步的高水平证据研究。
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引用次数: 0
The Impact of Spine Pathology on Posterior Ligamentous Complex Structure and Function. 脊柱病理学对后韧带复合体结构和功能的影响。
IF 4.1 2区 医学 Q1 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-10-23 DOI: 10.1007/s12178-023-09873-9
Bradley Anderson, Bahar Shahidi

Purpose of review: Spinal ligament is an important component of the spinal column in mitigating biomechanical stress. Particularly the posterior ligamentous complex, which is composed of the ligamentum flavum, interspinous, and supraspinous ligaments. However, research characterizing the biomechanics and role of ligament health in spinal pathology and clinical context are scarce. This article provides a comprehensive review of the implications of spinal pathology on the structure, function, and biomechanical properties of the posterior ligamentous complex.

Recent findings: Current research characterizing biomechanical properties of the posterior ligamentous complex is primarily composed of cadaveric studies and finite element modeling, and more recently incorporating patient-specific anatomy into finite element models. The ultimate goal of current research is to understand the relative contributions of these ligamentous structures in healthy and pathological spine, and whether preserving ligaments may play an important role in spinal surgical techniques. At baseline, posterior ligamentous complex structures account for 30-40% of spinal stability, which is highly dependent on the intrinsic biomechanical properties of each ligament. Biomechanics vary widely with pathology and following rigid surgical fixation techniques and are generally maladaptive. Often secondary to morphological changes in the setting of spinal pathology, but morphological changes in ligament may also serve as a primary pathology. Biomechanical maladaptations of the spinal ligament adversely influence overall spinal column integrity and ultimately predispose to increased risk for surgical failure and poor clinical outcomes. Future research is needed, particularly in living subjects, to better characterize adaptations in ligaments that can provide targets for improved treatment of spinal pathology.

综述目的:脊柱韧带是脊柱减轻生物力学应力的重要组成部分。特别是后韧带复合体,它由黄韧带、棘间韧带和棘上韧带组成。然而,关于生物力学以及韧带健康在脊柱病理学和临床中的作用的研究却很少。本文对脊柱病理学对后韧带复合体的结构、功能和生物力学特性的影响进行了全面的综述。最近的发现:目前表征后韧带复合体生物力学特性的研究主要包括尸体研究和有限元建模,最近将患者特定解剖结构纳入有限元模型。目前研究的最终目标是了解这些韧带结构在健康和病理性脊柱中的相对贡献,以及保留韧带是否在脊柱外科技术中发挥重要作用。在基线时,后韧带复杂结构占脊柱稳定性的30-40%,这在很大程度上取决于每个韧带的内在生物力学特性。生物力学随着病理学和随后的刚性手术固定技术的不同而有很大差异,并且通常是不适应的。通常继发于脊柱病理学中的形态学变化,但韧带的形态学变化也可能是主要病理学。脊柱韧带的生物力学不适应会对脊柱的整体完整性产生不利影响,并最终导致手术失败和不良临床结果的风险增加。未来需要进行研究,特别是在活体受试者中,以更好地描述韧带的适应,从而为改善脊柱病理学的治疗提供靶点。
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引用次数: 0
Physeal Sparing Approaches for MPFL Reconstruction. 用于 MPFL 重建的骨膜疏松方法。
IF 4.1 2区 医学 Q1 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-12-11 DOI: 10.1007/s12178-023-09864-w
Tyler J Stavinoha, Kevin G Shea

Purpose of review: To update and concepts for pediatric physeal-sparing patellofemoral stabilization surgery.

Recent findings: Recent studies have demonstrated positive results in patellofemoral stabilization in pediatric populations with physeal-sparing techniques that limit the potential for physeal damage. Comprehensive analysis remains limited by population and technique heterogeneity. Physeal-sparing patellofemoral stabilization, most significantly through physeal-sparing reconstruction of the medial patellofemoral ligament complex remains a viable option for pediatric patients with recurrent patellofemoral instability.

综述目的更新小儿趾骨分离髌骨稳定手术的内容和概念:最近的研究表明,在小儿群体中采用保护趾骨的髌骨稳定手术效果良好,这种技术限制了趾骨损伤的可能性。全面分析仍然受到人群和技术异质性的限制。对于复发性髌骨不稳的儿科患者来说,最主要的方法是通过髌骨内侧韧带复合体的保骺重建来实现髌骨稳定,这仍然是一个可行的选择。
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引用次数: 0
Sulcus-Deepening Trochleoplasty for High-Grade Trochlear Dysplasia: Demystifying the Procedure-a Review of the Current Literature. Sulcus加深Trochlear高级别发育不良的Trohlear切除术:揭开过程的神秘面纱——当前文献综述。
IF 4.1 2区 医学 Q1 ORTHOPEDICS Pub Date : 2023-11-01 Epub Date: 2023-09-12 DOI: 10.1007/s12178-023-09868-6
Magdalena Tarchala, Sarah Kerslake, Laurie A Hiemstra

Purpose of review: The most common and biomechanically influential pathoanatomic risk factor for recurrent patellofemoral instability is trochlear dysplasia. Sulcus-deepening trochleoplasty is a procedure developed to address high-grade trochlear dysplasia in the setting of patellofemoral instability. The purpose of this paper is to outline the current classification and surgical management of trochlear dysplasia as well as to review the current literature on the clinical outcomes and complications of sulcus-deepening trochleoplasty.

Recent findings: This review outlines the most recent literature reporting evidence behind the decision-making to perform a trochleoplasty in the setting of patellofemoral instability and high-grade trochlear dysplasia. Critical parameters include grade of trochlear dysplasia, severity of symptoms, pertinent physical examination findings, surgical techniques, modifications for skeletally immature patients, and considerations for the revision setting. Historic studies have elicited concerns regarding high reported complication rates for trochleoplasty; however, recent studies consistently report good clinical outcomes and acceptable complication rates, similar to those of other patellar stabilizing procedures. The addition of a trochleoplasty in patients with high-grade dysplasia results in a lower re-dislocation rate, significant improvements in patient-reported outcome measures (PROMs) as well as high levels of patient satisfaction and return to sport. The use of sulcus-deepening trochleoplasty for the treatment of high-grade dysplasia and recurrent patellofemoral instability is a well-established technique with good outcomes and an acceptable complication profile. In patients with high-grade dysplasia, trochleoplasty results in lower re-dislocation rates, high patient satisfaction scores, and good clinical and functional outcomes. An understanding of trochleoplasty and its indications should be in the armamentarium of surgeons treating patellofemoral instability.

综述目的:复发性髌股关节不稳定的最常见和生物力学影响的病理解剖危险因素是滑车发育不良。Sulcus加深滑车成形术是一种在髌股关节不稳定的情况下为解决高级别滑车发育不良而开发的手术。本文的目的是概述目前滑车发育不良的分类和手术治疗,并回顾目前关于沟加深滑车成形术的临床结果和并发症的文献。最近的发现:这篇综述概述了在髌股关节不稳定和高级别滑车发育不良的情况下决定进行滑车成形术背后的最新文献报告证据。关键参数包括滑车发育不良的分级、症状的严重程度、相关的体检结果、手术技术、骨骼发育不成熟患者的改良以及翻修设置的考虑因素。历史研究引起了人们对滑车成形术并发症发生率高的担忧;然而,最近的研究一致报告了良好的临床结果和可接受的并发症发生率,类似于其他髌骨稳定手术。在高度发育不良患者中增加滑车成形术可降低再脱位率,显著改善患者报告的预后指标(PROM),并提高患者满意度和重返运动。使用脑沟加深滑车成形术治疗高度发育不良和复发性髌股关节不稳定是一项公认的技术,具有良好的疗效和可接受的并发症。在高度发育不良患者中,滑车成形术可降低再脱位率,提高患者满意度,并取得良好的临床和功能结果。对滑车成形术及其适应症的理解应纳入治疗髌股关节不稳定的外科医生的装备中。
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引用次数: 0
Racial and Ethnic Disparities in the Management of Diabetic Feet. 糖尿病足治疗中的种族和民族差异。
IF 4.1 2区 医学 Q1 ORTHOPEDICS Pub Date : 2023-11-01 Epub Date: 2023-09-21 DOI: 10.1007/s12178-023-09867-7
Elizabeth O Clayton, Confidence Njoku-Austin, Devon M Scott, Jarrett D Cain, MaCalus V Hogan

Purpose of review: Diabetes mellitus is a chronic medical condition affecting many individuals worldwide and leads to billions of dollars spent within the healthcare system for its treatment and complications. Complications from diabetes include diabetic foot conditions that can have a devasting impact on quality of life. Diabetic foot ulcers and amputations occur in minority individuals at an increased rate compared to Caucasian individuals. This review provides an update examining the racial and ethnic disparities in the management of diabetic foot conditions and the differences in rates of amputation.

Recent findings: Current research continues to show a disparity as it relates to diabetic foot management. There are novel treatment options for diabetic foot ulcers that are currently being explored. However, there continues to be a lack in racial diversity in new treatment studies conducted in the USA. Individuals from racial and ethnic minority groups have diabetes at higher rates compared to Caucasian individuals, and are also more likely to develop diabetic foot ulcers and receive amputations. Over the last few years, more efforts have been made to improve health disparities. However, there needs to be an improvement in increasing racial diversity when investigating new therapies for diabetic foot ulcers.

综述目的:糖尿病是一种影响全球许多人的慢性疾病,导致医疗系统内花费数十亿美元用于治疗和并发症。糖尿病的并发症包括糖尿病足,这可能会对生活质量产生毁灭性影响。糖尿病足溃疡和截肢发生在少数民族人群中,与高加索人群相比,发生率增加。这篇综述提供了最新的研究糖尿病足疾病管理中的种族和民族差异以及截肢率的差异。最近的发现:目前的研究继续显示出与糖尿病足管理相关的差异。目前正在探索糖尿病足溃疡的新治疗方案。然而,在美国进行的新的治疗研究中,仍然缺乏种族多样性。与高加索人相比,来自种族和少数民族群体的人患糖尿病的比率更高,也更有可能患上糖尿病足溃疡并接受截肢手术。在过去几年中,为改善健康差距作出了更多努力。然而,在研究糖尿病足溃疡的新疗法时,需要在增加种族多样性方面有所改进。
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引用次数: 0
Turf Toe Injuries in the Athlete: an Updated Review of Treatment Options, Rehabilitation Protocols, and Return-to-Play Outcomes. 运动员草皮脚趾损伤:治疗方案、康复方案和重返赛场结果的最新综述。
IF 4.1 2区 医学 Q1 ORTHOPEDICS Pub Date : 2023-11-01 Epub Date: 2023-10-03 DOI: 10.1007/s12178-023-09870-y
Arjun Gupta, Priya K Singh, Amy L Xu, Rachel S Bronheim, Claire M McDaniel, Amiethab A Aiyer

Purpose of review: First metatarsophalangeal joint sprains or turf toe (TT) injuries occur secondary to forceful hyperextension of the great toe. TT injuries are common among athletes, especially those participating in football, soccer, basketball, dancing, and wrestling. This review summarizes the current treatment modalities, rehabilitation protocols, and return-to-play criteria, as well as performance outcomes of patients who have sustained TT injuries.

Recent findings: Less than 2% of TT injuries require surgery, but those that do are typically grade III injuries with damage to the MTP joint, evidence of bony injury, or severe instability. Rehabilitation protocols following non-operative management consist of 3 phases lasting up to 10 weeks, whereas protocols following operative management consist of 4 phases lasting up 20 weeks. Athletes with low-grade injuries typically achieve their prior level of performance. However, among athletes with higher grade injuries, treated both non-operatively and operatively, about 70% are expected to maintain their level of performance. The treatment protocol, return-to-play criteria, and overall performance outcomes for TT injuries depend on the severity and classification of the initial sprain. For grade I injuries, players may return to play once they experience minimal to no pain with normal weightbearing, traditionally after 3-5 days. For grade II injuries, or partial tears, players typically lose 2-4 weeks of play and may need additional support with taping when returning to play. For grade III injuries, or complete disruption of the plantar plate, athletes lose 4-6 weeks or more depending upon treatment strategy.

综述目的:第一跖趾关节扭伤或草皮趾(TT)损伤继发于大脚趾用力过伸。TT损伤在运动员中很常见,尤其是那些参加足球、足球、篮球、舞蹈和摔跤的运动员。这篇综述总结了目前的治疗模式、康复方案、重返赛场标准以及TT损伤患者的表现结果。最近的研究结果:不到2%的TT损伤需要手术,但需要手术的通常是III级损伤,伴有MTP关节损伤、骨损伤或严重不稳定。非手术治疗后的康复方案包括3个阶段,持续时间长达10周,而手术治疗后方案包括4个阶段,长达20周。轻度受伤的运动员通常能达到他们之前的水平。然而,在非手术和手术治疗的高级别损伤运动员中,预计约70%的人能保持他们的表现水平。TT损伤的治疗方案、重返赛场标准和整体表现结果取决于初始扭伤的严重程度和分类。对于一级损伤,球员在正常负重的情况下,通常在3-5天后,一旦疼痛最小或没有疼痛,就可以重返赛场。对于二级损伤或部分撕裂,球员通常会输掉2-4周的比赛,在重返赛场时可能需要额外的胶带支撑。对于III级损伤或足底板完全断裂,运动员会根据治疗策略损失4-6周或更长时间。
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引用次数: 0
Soft Tissue Lengthening for Flexion Dislocation of Patella. 软组织延长术治疗髌骨屈折脱位。
IF 4.1 2区 医学 Q1 ORTHOPEDICS Pub Date : 2023-11-01 Epub Date: 2023-09-04 DOI: 10.1007/s12178-023-09865-9
Clark Yin, Betina B Hinckel

Purpose of review: Obligatory dislocation of the patella (also known as habitual dislocation) is a rare subset of patellofemoral instability in which the patella dislocates every time the knee is flexed. The problem arises due to contracture of the quadriceps muscles. Soft tissue lengthening procedures such as quadriceps tendon lengthening are the mainstay of treatment, in contrast to medial patellofemoral reconstruction (MPFL-R) for the more common recurrent lateral patellar dislocation. The current review explores the existing literature surrounding the pathophysiology and treatment strategies for this unique cause of knee instability.

Recent findings: Flexion dislocation of the knee often presents in children when they begin to walk. It is also termed obligatory or habitual because the patella dislocates laterally with each flexion and extension cycle of the knee. In contrast to other forms of patellar dislocation, the displacement is painless in obligatory dislocation. Likewise, the underlying biomechanical cause of this issue is related to contracture of tissues lateral to the patella rather than disruption of medial soft tissues as seen in recurrent/traumatic dislocation or subluxation of the patella. A number of procedures have been described for management of obligatory dislocation of the patella, with the general consensus that a combination of procedures including release/lengthening of the proximal lateral soft tissues as a critical component for a successful outcome. Soft tissue release/lengthening has been performed for over 50 years to treat obligatory dislocation of the patella. This procedure must be used in combination with other proximal and distal reconstructive with careful intraoperative assessment of knee flexion and patellar tracking for satisfactory outcomes. Further research using standardized outcome measures is needed to identify the optimal step-wise approach in treatment of obligatory patellar dislocation.

综述目的:髌骨斜性脱位(也称为习惯性脱位)是髌股不稳定的一种罕见亚型,每次膝盖弯曲时髌骨都会脱位。这个问题是由于股四头肌挛缩引起的。软组织延长术,如股四头肌腱延长术是治疗的主要方法,而内侧髌股重建术(MPFL-R)治疗更常见的复发性外侧髌骨脱位。目前的综述探讨了现有的关于膝关节不稳定这一独特原因的病理生理学和治疗策略的文献。最近的研究结果:儿童在开始走路时经常出现膝关节屈曲脱位。它也被称为强制性的或习惯性的,因为髌骨在膝盖的每个屈曲和伸展周期都会发生侧向脱位。与其他形式的髌骨脱位相比,强制性脱位的移位是无痛的。同样,这个问题的潜在生物力学原因与髌骨外侧组织的挛缩有关,而不是髌骨复发/创伤性脱位或半脱位中内侧软组织的破坏。已经描述了许多治疗髌骨强制性脱位的手术,普遍认为,包括释放/延长近侧软组织在内的多种手术组合是成功治疗的关键组成部分。软组织松解/延长治疗髌骨强制性脱位已有50多年的历史。该手术必须与其他近端和远端重建结合使用,并在术中仔细评估膝关节屈曲和髌骨追踪,以获得满意的结果。需要使用标准化结果测量进行进一步研究,以确定治疗强制性髌骨脱位的最佳分步方法。
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引用次数: 0
Non-operative Management and Outcomes of Femoroacetabular Impingement Syndrome. 股骨髋臼撞击综合征的非手术治疗和结果。
IF 4.1 2区 医学 Q1 ORTHOPEDICS Pub Date : 2023-11-01 Epub Date: 2023-08-31 DOI: 10.1007/s12178-023-09863-x
Rosa M Pasculli, Elizabeth A Callahan, James Wu, Niam Edralin, William A Berrigan

Purpose: To serve as a guide for non-operative physicians in the management of femoroacetabular impingement syndrome and provide an algorithm as to when to refer patients for potential surgical management.

Recent findings: Supervised physical therapy programs that focus on active strengthening and core strengthening are more effective than unsupervised, passive, and non-core-focused programs. There is promising evidence for the use of intra-articular hyaluronic acid and PRP as adjunct treatment options. Recent systematic reviews and meta-analyses have found that in young active patients, hip arthroscopy demonstrates improved short-term outcomes over physical therapy. The decision for the management of FAIS is complex and should be specific to each patient. Consideration of the patient's age, timing to return to sport, longevity of treatment, hip morphology, and degree of cartilage degeneration is required to make an informed decision in the treatment of these patients.

目的:为非手术医生治疗股骨髋臼撞击综合征提供指导,并提供何时转诊患者进行潜在手术治疗的算法。最近的发现:专注于主动强化和核心强化的有监督的物理治疗项目比无监督、被动和非核心强化的项目更有效。有很好的证据表明关节内透明质酸和PRP作为辅助治疗选择。最近的系统综述和荟萃分析发现,在年轻活跃的患者中,髋关节镜检查显示出比物理治疗改善了短期疗效。FAIS的管理决策是复杂的,应该针对每个患者。在治疗这些患者时,需要考虑患者的年龄、恢复运动的时间、治疗寿命、髋关节形态和软骨退化程度,以做出明智的决定。
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引用次数: 0
Point-of-Care Ultrasound (POCUS) for Sideline Youth Sports Coverage. 护理点超声波(POCUS)用于边线青少年体育报道。
IF 4.1 2区 医学 Q1 ORTHOPEDICS Pub Date : 2023-11-01 Epub Date: 2023-08-11 DOI: 10.1007/s12178-023-09859-7
Jacob C Jones, Cassidy Schultz, Caroline Podvin, David Mikhail, Luke C Radel

Purpose of review: The purpose of this review is to discuss the use of point-of-care ultrasound for sideline youth sports coverage.

Recent findings: Participation in youth sports has been increasing, with trends that athletes are specializing earlier and competing at higher levels at younger ages (NSCH 2019, Fabricant 2013). Point-of-care ultrasound (POCUS) utilizes non-invasive imaging to diagnose and manage various musculoskeletal conditions ranging from traumatic injuries, such as fractures and intramuscular hematomas, to early screening for conditions such as asymptomatic knee lesions. Since it is well-tolerated by children and adolescents and allows for easy accessibility for sideline care, POCUS could provide a strong alternative to other imaging modalities such as x-ray and magnetic resonance imaging (MRI) as both have their limitations. Youth sideline sports coverage could be enhanced with immediate medical attention from ultrasound-trained medical professionals. On the sidelines of a traumatic injury, POCUS expedites patient care with immediate examination of acute injuries. In low resource and hard-to-reach locations such as a rural youth sporting event, it can be key in the triaging of injuries. As a supplement to a physical exam, the risk of a misdiagnosis is reduced, and a long, expensive trip to the hospital for unnecessary imaging studies may be avoided. Ultrasound is a versatile, non-invasive, radiation-free imaging modality that serves as an accessible option for sideline coverage at youth sporting events. Ultrasound is well-tolerated by children and adolescents. It can be used to evaluate, diagnose, and manage a range of musculoskeletal conditions at the sidelines of youth sports.

综述的目的:本综述的目的是讨论护理点超声在青少年副业体育报道中的应用。最近的研究结果:参与青少年体育运动的人数一直在增加,运动员的专业化程度更早,在更年轻的时候参加更高水平的比赛(NSCH 2019,Fabricant 2013)。护理点超声(POCUS)利用非侵入性成像来诊断和管理各种肌肉骨骼疾病,从创伤(如骨折和肌肉内血肿)到无症状膝盖损伤等疾病的早期筛查。由于儿童和青少年对POCUS的耐受性很好,并且可以方便地进行副业护理,因此POCUS可以为其他成像模式(如x射线和磁共振成像(MRI))提供强有力的替代方案,因为两者都有其局限性。受过超声波培训的医疗专业人员可以立即提供医疗服务,从而提高青少年副业运动的覆盖率。在创伤性损伤之外,POCUS通过立即检查急性损伤来加快患者护理。在资源匮乏、难以到达的地方,如农村青年体育赛事,这可能是对伤病进行分类的关键。作为体检的补充,可以降低误诊的风险,并可以避免去医院进行不必要的影像学研究的漫长而昂贵的旅行。超声波是一种多功能、无创、无辐射的成像方式,是青少年体育赛事场边报道的一种可供选择的方式。儿童和青少年对超声波的耐受性很好。它可以用于评估、诊断和管理青少年运动场外的一系列肌肉骨骼状况。
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引用次数: 0
期刊
Current Reviews in Musculoskeletal Medicine
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