Clinics in sports medicine
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As the COVID-19 (Coronavirus disease 2019) pandemic continues, the paradigm of treatment continues to rapidly evolve, especially for sports medicine surgeons, because treatment before the pandemic was considered predominantly elective. This article provides subjective and objective data on the changes implicated by the COVID-19 pandemic with regard to the interactions and practices of sports medicine surgeons. This perspective also considers the potential impact on the patients and athletes treated by sports medicine surgeons. This article discusses the impact of the COVID-19 pandemic on sports medicine and provides thoughts on how the landscape of the field may continue to change.
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Tendinopathies in the hand and wrist are common in athletes. This article reviews some of the common hand and wrist conditions, such as trigger digits, first dorsal compartment tendonitis, and extensor carpi ulnaris tendonitis. In addition, it reviews less commonly seen tendon conditions of the flexor carpi radialis and ulnaris, intersection syndrome, and extensor pollicis entrapment conditions. Diagnosis, nonoperative and operative treatment, and postoperative recommendations and return to play are also discussed.
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This article examines the most common problematic hand and wrist injuries in the pediatric athlete. Hand and wrist injuries in the growing skeleton pose a different diagnostic and therapeutic challenge than in the mature skeleton. ⋯ Although remodeling can correct for even moderate deformities if sufficient growth potential exists, remodeling cannot return the child to normal anatomy in many cases. Remodeling depends on intact periosteum, a nearby growing physis, and competent ligaments to direct remodeling via Hueter-Volkmann and Wolff's laws.
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Thumb metacarpophalangeal collateral ligament injuries are common in athletes and occur via forced abduction or hyperextension. Management primarily depends on the grade of ligamentous injury and the presence of a Stener lesion or large avulsion fracture. Surgeons should consider the athlete's position, hand dominance, duration of season remaining, and goals. ⋯ Chronic collateral ligament injuries are effectively treated with ligament reconstruction. Numerous surgical techniques have been described without 1 showing superiority. Postoperative rehabilitation protocols vary based on repair quality and sports-specific considerations.
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Review
Fibular Collateral Ligament/ Posterolateral Corner Injury: When to Repair, Reconstruct, or Both.
The posterolateral corner (PLC) of the knee was regarded as the "dark side" of the knee because of limited understanding of its anatomy and biomechanics and because of poor outcomes after injuries to PLC structures. These injuries rarely occur in isolation, with 28% reported as isolated PLC injuries. ⋯ Several techniques for reconstruction of the PLC have been described, and all are reported to improve outcomes. Biomechanically validated anatomic reconstructions are preferred because they restore native knee kinematics and improve clinical outcomes without over-constraining the knee.