Physician Sportsmed
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Physician Sportsmed · Feb 2011
Multicenter Study Comparative Study Clinical TrialEffectiveness and safety of diclofenac epolamine topical patch 1.3% for the treatment of acute pain due to back strain: an open-label, uncontrolled study.
The diclofenac epolamine topical patch 1.3% (DETP) is indicated for topical treatment of acute pain due to minor strains, sprains, and contusions. This exploratory, multicenter, open-label study evaluated effectiveness and safety of DETP in patients with acute pain due to back strain. ⋯ In this exploratory study, patients experienced well-tolerated relief for acute pain due to back strain, with ≥ 85% of patients and their investigators expressing satisfaction with DETP treatment.
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Physician Sportsmed · Feb 2011
ReviewAcromioclavicular joint injuries: anatomy, diagnosis, and treatment.
Acromioclavicular (AC) joint injuries are common in athletic populations and account for 40% to 50% of shoulder injuries in many contact sports, including lacrosse, hockey, rugby and football. The AC joint is stabilized by static and dynamic restraints, including the coracoclavicular (CC) ligaments. Knowledge of these supporting structures is important when identifying injury and directing treatment. ⋯ Treatment options for AC injuries continue to expand, and include arthroscopic-assisted anatomic reconstruction of the CC ligaments. The purpose of this article is to review the anatomy, diagnostic methods, and treatment options for AC joint injuries. In addition, the authors' preferred reconstruction technique and outcomes are presented.
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Physician Sportsmed · Feb 2011
Comparative StudyHip pain referral patterns in patients with labral tears: analysis based on intra-articular anesthetic injections, hip arthroscopy, and a new pain "circle" diagram.
Fluoroscopically guided intra-articular (FGIA) anesthetic hip joint injections have been used to determine whether the hip joint is the source of a patient's hip pain. However, there have been no reports documenting the efficacy of their use for defining the pain referral patterns (PRPs) of patients with labral tears. The aim of this study was to determine the PRPs of patients with labral tears and evaluate a new pain "circle" diagram (PCD) developed for this analysis. ⋯ The most common locations of pain were the central groin and the lateral peritrochanteric area. The least common were the ischial tuberosity and the anterior thigh, which are 2 areas often associated with osteoarthritis of the hip. The use of the PCD combined with an FGIA anesthetic injection may help physicians reconcile the expectations of those patients with labral tears who believe that hip arthroscopy will treat their multiple areas of "hip" pain.
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Fractures of the proximal humerus occur frequently, and are primarily insufficiency fractures that occur in the elderly. Thorough clinical evaluation is essential in identifying associated neurovascular injury, which warrants emergent surgical referral. Good quality radiographs remain a necessary diagnostic tool in the evaluation of proximal humerus injuries. ⋯ Significantly displaced proximal humerus fractures are typically treated with surgical reduction and internal fixation. Complex fractures in the elderly and fracture dislocations are indications for humeral head prosthetic replacement. Proximal humerus fractures are strongly associated with decreased bone mineral density and future fracture risk, and should prompt a referral for medical management of osteoporosis.
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Physician Sportsmed · Feb 2011
ReviewExercise and osteoporosis-related fractures: perspectives and recommendations of the sports and exercise scientist.
Osteoporosis-related fractures represent a major health concern, particularly in elderly populations. Direct and indirect costs (amounting to nearly $17 billion in 2005), increased morbidity, and loss of independence place substantial burden on the health care system. Observational studies have shown that a physically active lifestyle is associated with a 30% to 50% decrease in vertebral or hip fractures, and a recent meta-analysis that determined the effects of exercise on fracture incidence further confirmed these results. ⋯ More sophisticated protocols are required to impact bone strength. Corresponding state-of-the-art protocols have focused on periodized high-impact/high-intensity resistance protocols performed at least twice per week. In the frail elderly, high-frequency/high-cycle number exercise programs with low-to-moderate strain intensity may also positively affect bone strength.