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Pediatric Sports Injuries: Upper Extremity Injuries
John Gregg, MD, was clinical assistant professor and senior surgeon at the Children’s Hospital of Philadelphia. Here, he discusses how pediatric sports medicine injuries of the upper extremities differ from those of adults … and how these injuries are diagnosed and treated. With the aid of more than 60 illustrations, Dr. Gregg covers several types of sports and how they can result in pediatric sports medicine injuries of the upper extremities. For example, humeral shaft spiral fractures and repetitive microtrauma may be caused by the throwing action. Osgood-Schlatter’s type syndrome is a characteristic of so-called little league shoulder, and its presenting complaints and examination are described. The author provides a mnemonic for understanding little league elbow and another, RICE (rest, ice, compression, elevation) for its treatment. The lecture continues with swimmer’s shoulder and how it manifests with destabilization of the humeral head on the glenoid followed by supraspinatus tendonitis. Treatment is by rest and by reduced inflammation. He discusses the causes and treatment of suprascapular nerve palsy and how the trapezius and sternocleidomastoid muscles may be injured by a direct blow from, say, a hockey stick. Shoulder dislocations occur mostly in football or rugby and may lead to Bankart lesion or Hill-Sachs fracture, in which case orthopedic surgical repair is needed. Dr. Gregg discusses the vulnerable age bracket for developing gymnast wrist and its treatment, as well as the consequences of nontreatment such as ulnar carpal impingement syndrome. The lecture concludes with a description of spondylolysis and spondylolisthesis and how these occur mainly in rowers and equestrians. Therapy involves avoiding the offending activities and fitting the patient with an antilordotic lumbosacral orthosis. |
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