Nature of Injury in sports

Question 1

how many sports injuries occur each year in GB?

Answer 1

20 million

Question 2

which site is most susceptible for sports injuries?

Answer 2

lower leg, upper limb and head/neck

Question 3

what are traumatic sports injuries?

Answer 3

-fractures and dislocations
-major muscle ligament tendon injuries
-head and spinal injuries
-chest and abdominal injuries

Question 4

what are the classifications of bony injuries?

Answer 4

-transverse
-oblique
-spiral
-comminuted
-avulsion (piece of bone attached to tendon or ligament is torn away)

Question 5

what are the clinical features of bony injury?

Answer 5

-pain
-tenderness
-localised bruising
-swelling
-deformity
-restriction of movement

Question 6

what is the management for bony injuries

Answer 6

-anatomical functional realignment
-may need reduction
-plaster cast or surgical stabilisation

Question 7

what is acute compartment syndrome?

Answer 7

-occurs in a fracture where there is a resultant soft tissue damage as well
secondary swelling in a muscle compartment with non distensible fascial sheath
severe pain on movement and numbness
treated by fasciotomy

Question 7

what sites are at risk of growth plate fractures?

Answer 7

wrist, elbow, distal femur, tibia, fibula

Question 8

which sites are susceptible to damage of articular cartilage?

Answer 8

talus, femoral condyles, patella and humerus

Question 9

what is a dislocation?

Answer 9

trauma produces complete dissociation of the articulating surfaces

Question 10

what is subluxation?

Answer 10

some contact of articulating surfaces remains

Question 11

what are treatments to dislocation or subluxation?

Answer 11

-reduction
-muscle relaxants
-protect to allow soft tissue to heal
-early protected mobilisation
-rebuild muscle strength

Question 12

what are grade 1 ligament injuries?

Answer 12

fibres stretched but normal range on stressing

Question 13

what are grade 2 ligament injuries?

Answer 13

more fibres involved, laxity on stressing but definite end point

Question 14

what are grade 3 injuries to ligaments?

Answer 14

complete tear, excessive laxity and no end point may be pain free as nerve fibres torn

Question 15

what is the management for grade 1 and 2 ligament injuries?

Answer 15

-promote tissue healing
-prevent joint stiffness
-protect against further damage
-strengthen muscle to provide additional joint stability
-protection may allow earlier return to sport

Question 16

what is the treatment for a grade 3 ligament injury?

Answer 16

conservative, medial collateral of knee or lateral collateral of ankle
surgical (direct repair or reconstruction)

Question 17

when are tears and strains common?

Answer 17

-when demands exceed muscles capacity
-most common if it crosses 2 joints
-commonly hamstring, quadriceps and gastrocnemius
-common during sudden acceleration/deceleration

Question 17

what is grade 1 classification of a muscle injury?

Answer 17

few fibres, localised pain and no loss of strength

Question 17

grade 2 muscle injury?

Answer 17

significant no of fibres, swelling, pain on contraction, reduced strength and limitation of movement

Question 18

grade 3 muscle injury?

Answer 18

complete tear, most common at musculotendinous junctions

Question 19

how does quadriceps rupture?

Answer 19

direct impact against contracted muscle or sign vigorous contraction

Question 20

what is myositis ossificans?

Answer 20

occurs when haematoma calcifies
most common in severe contusions
suspected if resolution is slow
diagnosed on x ray after 14 days
slow recovery

Question 21

what do normal tendons consist of?

Answer 21

tight parallel bundles of collagen fibres

Question 22

what is involved in injuries to the tendons?

Answer 22

generally occur at point of least blood supply rupture may be complete or partial and usually occurs without warning achilles and supraspinatus are most common

Question 23

what are bursas?

Answer 23

small fluid filled sacs usually situated between a tendon and a bone role is to reduce friction present in hips, knees, feet, shoulders and elbows

Question 24

what are the complications associated with bone injuries?

Answer 24

-infection -acute compartment syndrome -DVT/pulmonary embolism -delayed union/non union -malunion

Question 25

what is delayed union?

Answer 25

prolonged healing of a fracture

Question 26

what is a non union?

Answer 26

failure of a fracture to heal

Question 27

what is malunion?

Answer 27

-fractured bone does not heal properly -may be due to bone being twisted, shorter or bent -bones improperly aligned when immobilised, cast too early, not seeking medical attention after break -common and painful

Question 28

what are the 5 R's of ortho?

Answer 28

-resusciate -reduce -radiograph -restrict -rehabilitate

Question 29

who are more susceptible to chronic overuse injury?

Answer 29

females

Question 30

what does the pill reduce?

Answer 30

-risk of tendon damage and ACL rupture

Question 31

what can impact sports injuries?

Answer 31

-menstrual cycle -pill -menopause -diabetes

Question 32

what is bursitis?

Answer 32

fluid filled sac around joints, stops structures from getting irritated from skin movement. can get infected and usually presents in people who work on their knees

Question 33

how is s a soft tissue injury managed?

Answer 33

POLICE protection optimal loading ice compression elevation

Question 34

what happens if patients rest too much?

Answer 34

risk of loss of bone density and strength

Question 35

what is the treatment for tendon rupture?

Answer 35

-brace and crutches -ice reduce swelling -compression strapping to reduce swelling -elevation needed

Question 36

what is the treatment for fracture?

Answer 36

-advanced trauma life support -stop bleeding -reduce bone and put it in splint -X-RAY/CT -fix bone -rehabilities

Question 37

how do we manage chronic injury?

Answer 37

remove the cause introduce preventative measures extend rehabilitation

Question 38

what is tendonosis?

Answer 38

chronic changes that develop due to multiple tendonitis, increased type 3 collagen, separation of collagen fibres over expression of VEGF, tendons feel hard and thick can look dull and brown rather than white

Question 39

what is the treatment for tendonosis?

Answer 39

-remove cause -improve health and nutrition -introduce preventative measures -discuss extended rehab

Question 40

what are tendons made up of?

Answer 40

collagen (mainly type I) and elastin embedded in proteoglycan water matrix

Question 41

how is an ACL injury managed?

Answer 41

Protection – you may be offered a knee brace. Optimal Loading – you may be given crutches to reduce the amount of weight put on the injured joint. This can help control pain and swelling. Ice – the regular application of ice packs can reduce pain and swelling. Compression – you may be given an elastic compression bandage to reduce swelling. Elevation – this will help reduce swelling. Try to keep your knee above the height of your hip. ACL reconstruction

Question 42

how is an Achilles ligament injury managed?