Sportverletzung Sportschaden : Organ der Gesellschaft für Orthopädisch-Traumatologische Sportmedizin
-
Sportverletz Sportschaden · Dec 1996
[Weber fibular ligament-plasty with plantar tendon with Segesser modification].
Ankle joint injuries are one of the most frequently diagnosed sports injuries. In our clinic we observed between 1981-92 18% ankle joint injuries in 11.350 patients. The acute injury was generally handled conservatively by functional treatment with a special shoe; only comminute injuries like fractures, luxations or tendon injuries would lead to the decision to perform surgery. The ratio of acutely performed surgery compared to late surgery was decreasing: 1981 1:3, compared to 1992 1:50. Reconstructive surgery of the lateral ligament complex is indicated under the following conditions: patient suffering from recurrent trauma and feeling of instability and/ or in case of comminuted overuse injuries caused by instability like the entrapment of the tibial nerve in the tarsal tunnel, achilodynia caused by instability of the rearfoot or luxation of the peroneal tendons. Reconstruction of the lateral ligaments of the ankle should be done anatomically, operations with effect of tenodesis should be avoided. ⋯ 443 (76%) out of 584 operated patients were followed at least one year after OP. Working ability: 19% (group 1)/25% (group 2) of the patients after two weeks, 31/42% after 2-4 weeks and 79/88% after 4-6 weeks. Full sports activity to previous sport 8/17% after 4-6 weeks, 26/38% after 6-8 weeks, 65/70% after 8-12 weeks. The group 2 achieved full sports activity and working ability on average two weeks before the patients of group one. Personal evaluation: 88/90% felt their ankle joint to be more stable postoperatively, 10/9% as stable as before and 2/1% described it as less stable. Clinical evaluation: The modified Benedetto score showed in 76/81% very good results, in 9/7% good and 13/8% bad results. In conclusion the described reconstruction of the fibular ligaments without damaging the active stabilizing muscles is a valid technique. The reconstruction of the calcaneofibular ligament improved the long term results of surgery. The functional postoperative rehabilitation (special shoe and night brace) does shorten the time for the patients working ability as well as the return to full sports activity. The long term results on the other hand appeared to be similar for both groups. The advantage of our technique using the plantaris tendon as a graft. The use of autograft material having the same tensile strength as the original ligaments anatomically reconstructed. Surgery with tenodesis effects should be abandoned. The good results occurring while performing late surgery leave the chance for primary conservative treatment of lateral ligament injuries.
-
Sportverletz Sportschaden · Jun 1996
[Densitometric studies of the tensile strength of the proximal femur].
The prognostic assessment of the fracture resistance of the proximal femur is of great importance to the age related increasing incidence of femur neck fractures. This is particularly important in sport for the elderly. The statistical relationship between the osteodensitometrically determined bone density and the risk of a femur neck fracture has been shown in epidemiological studies, whereby the determination of bone density at the proximal femur has provided the most precise predictive results. ⋯ Quite different forces with considerably greater amplitudes can occur in falls. These may also be absorbed by different structures such as muscle tissue, and, therefore not act directly upon the femur neck. Despite these limitations the determination of bone density appears to permit the individual estimation of fracture risk of the femur neck.
-
Sportverletz Sportschaden · Jun 1995
Case Reports[Bilateral apophyseal rupture of the tibial tuberosity in the athlete].
The fracture through the apophysis underlining the tibial tuberosity remains an infrequent traumatic lesion. The simultaneous bilateral occurrence of this injury is rare. A 16-year old athlete suffered an Ogden type 1B fracture on the left and a type 1B injury combined with a Salter II lesion on the right side during the acceleration phase of a high jump. ⋯ Hardware removal was performed after 12 weeks. Full range of motion and return to athletic activity was obtained 20 weeks after the injury. A modification of the Ogden classification is suggested.
-
Frequency and mechanisms of injuries in field hockey are evaluated in a retrospective study of 322 players. Each athlete sustains 0.6 (female) respectively 1.0 (male) injuries per season on the average, mostly minor lesions. ⋯ The risk during match exceeds the risk during practice by a factor of 10.36% are typical field hockey injuries as they are caused by ball or stick. 62% of the lesions are related to the lower limb, 19% to the upper limb (mainly hand and fingers), and 19% to head and trunk. The data allow to draw conclusions concerning preventive measures.