Clinics in sports medicine
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A review of the literature shows that 3% to 9% of all athletic injuries occur to the hand or wrist. Also, hand and wrist injuries are more common in pubescent and adolescent athletes than adults. Although knee and shoulder injuries are more common athletic injuries, an injury to the hand or wrist significantly can impair the athlete's ability to throw or catch a ball, or swing a bat or racquet. ⋯ Displaced fractures of the hook of the hamate, trapezial ridge fractures, and comminuted pisiform fractures are managed best by early excision to promote uncomplicated recovery and early return to sport. For most athletes, return to competition can be expedited safely with the use of padded gloves and custom playing splints or casts. The sports medicine physician always must put the athlete's safety first when deciding the appropriate time for return to competition.
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Elbow dislocations can result in extensive injury to the supporting structures of the elbow joint. Principles of treatment include prompt reduction of the dislocation and treatment of associated fractures. ⋯ When stability is compromised, as with many complex dislocations, further stabilization with ligament repair, reconstruction, and fracture fixation also can lead to satisfactory results. The prognosis following complex dislocations is more guarded in the athlete, and depends on anatomic restoration and initiation of early motion.
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Valgus instability of the elbow in athletes is uncommon among athletes in general, but has a higher incidence in individuals who throw repetitively. When valgus overload injury results in disabling symptoms for the athlete, surgical reconstruction of the anterior band of the ulnar collateral ligament may be indicated. This procedure has been successful in getting athletes back to premorbid levels of competition. The authors provide a comprehensive review of valgus instability of the elbow and offer their preferred method of treatment.