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Sports Injuries in the Military, An Issue of Clinics in Sports Medicine, E-Book

Sports Injuries in the Military, An Issue of Clinics in Sports Medicine, E-Book

Brett D. Owens

(2015)

Abstract

This issue of Clinics in Sports Medicine focuses on athletic injuries in the military population. The young, active individuals participate in a wide range of athletic and military activities that results in high injury rates as well as extreme performance demands. Military sports medicine physicians have provided many advances in the care of athletic injuries in the past and continue to pursue this today.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Sports Injuries in theMilitary\r i
Copyright\r ii
Contributors iii
Contents vii
Clinics In Sports Medicine\r xi
Foreword xiii
Preface\r xv
Dedication xvii
The Burden and Management of Sports-Related Musculoskeletal Injuries and Conditions Within the US Military 573
Key points 573
Introduction 573
Musculoskeletal injuries related to sports and physical training 574
Deployment-related musculoskeletal injuries and conditions 575
Musculoskeletal injuries and conditions commonly seen in sports medicine clinics 577
Injuries to the Knee 577
Injuries to the Ankle 579
Injuries to the Shoulder 579
Injuries to the Hand, Wrist, and Elbow 580
Other Overuse Injuries and Chronic Conditions 581
Degenerative Joint Disease in Military Populations 582
Applying the sports medicine model in the military setting 583
Summary 585
References 585
Lower Extremity Stress Fractures in the Military 591
Key points 591
Introduction 591
The burden and pathogenesis of stress fracture injuries in physically active populations 592
Incidence and Impact 592
Modifiable Risk Factors 592
Nonmodifiable Risk Factors 595
Pathogenesis 596
Assessment and diagnosis of stress fracture injuries 596
Clinical Evaluation 596
Imaging 597
Treatment of common high-risk stress fractures 597
Femoral Neck 597
Femoral Shaft 598
Tibia 600
Patella 601
Treatment of common low-risk stress fractures 602
Calcaneus 602
Tarsal Navicular 603
Metatarsals 604
Miscellaneous Stress Fractures 606
The prevention of lower extremity stress fractures 606
Primary Injury Prevention 607
Secondary Injury Prevention 608
Summary 608
References 609
Seven Steps for Developing and Implementing a Preventive Training Program 615
Key points 616
Establish administrative support 617
Develop an interdisciplinary implementation team 619
Identify logistical barriers and solutions 620
Time 620
Personnel 620
Environment 620
Organization 620
Develop an evidence-based and context-appropriate PTP 622
Train the trainers and users 622
Fidelity control 625
Exit strategy 625
Summary 630
References 631
ACL Injury and Posttraumatic Osteoarthritis 633
Key points 633
Osteoarthritis burden 633
PTOA definition 634
ACL injury and PTOA 634
Cause of PTOA after ACL tear 636
Paradigm shift in the study of OA 636
Knowledge gaps in PTOA 637
Early Diagnosis Knowledge Gaps 637
Radiographs 637
Advanced imaging 637
Surrogate markers 638
Treatment Knowledge Gaps 639
Summary 639
References 639
Meniscal Repair and Transplantation in the Military Active-duty Population 641
Key points 641
Introduction 641
Anatomy and biomechanics 642
Meniscal tears 642
Repair indications 642
Repair techniques 644
Enhancement 648
Rehabilitation 648
Authors’ preferred technique 649
Meniscal transplantation 650
References 650
Intra-articular Hip Disorders in the Military Population 655
Key points 655
Introduction 655
Anatomy 656
Pathophysiology 657
Developmental Dysplasia 657
Femoroacetabular Impingement 657
Pincer 658
Cam 659
Evaluation of the hip 660
History 660
Physical Examination 660
Imaging 661
Cross-sectional imaging 662
Intra-articular injection 664
Management of intra-articular hip disorders 664
Nonoperative Management 664
Hip Arthroscopy 664
Technique 665
Labral tears 666
Cartilage damage 666
FAI 666
Rehabilitation 668
Summary 669
References 669
Management of Chronic Lateral Ankle Instability in Military Service Members 675
Key points 675
Introduction and epidemiology 675
Anatomy and cause 676
Risk factors for chronic lateral ankle instability 677
Clinical presentation 678
Physical examination 679
Stress testing 680
Functional versus mechanical instability 681
Radiography 682
Nonoperative management 682
Operative management 684
Role of Ankle Arthroscopy 685
Our Preferred Treatment of Primary Lateral Ligamentous Reconstruction 685
Concomitant Procedures 686
Postoperative Management 688
Summary 688
References 689
Chronic Exertional Compartment Syndrome of the Leg in the Military 693
Key points 693
Introduction 693
Epidemiology and risk factors 694
Clinical presentation and diagnosis 695
Nonsurgical treatment 697
Surgical treatment 698
Perioperative complications and revision surgery 701
Summary 702
References 702
Shoulder Instability in the Military 707
Key points 707
Introduction 707
Patient evaluation 708
Associated lesions of shoulder instability 709
Bankart Lesion 709
Bony Bankart/Glenoid bone loss 709
Imaging modalities for measurement of bone loss 710
Arthroscopic quantification of bone loss 711
ALPSA Lesion 712
Hill-Sachs Lesion 712
HAGL 713
GLAD Lesion 714
Treatment 714
Initial Treatment 714
Surgical Treatment 714
Arthroscopic surgical management 714
Patient Set Up and Preoperative Considerations 715
Surgical Technique 715
Surgical Treatment of Significant Bone Loss 715
Postoperative Care 716
Summary 716
References 716
Surgical Management of Acromioclavicular Dislocations 721
Key points 721
Introduction 721
Epidemiology 721
Pertinent Anatomy 721
Classification 722
The “Optimal Technique” 722
Indications and Contraindications 724
Surgical technique or procedure 724
Preoperative Planning 724
Preparation and Patient Positioning 726
Surgical Approach 726
Surgical Procedure 728
Postoperative care 729
Complications and management 731
Outcomes 731
Summary 733
References 734
Pectoralis Major Injuries 739
Key points 739
Introduction 739
Anatomy 739
Muscle Architecture 739
Tendon Configuration 740
Innervation 741
Biomechanics 741
Injury epidemiology 741
Classification 742
Diagnosis 742
Physical Examination 743
Plain Radiographs 744
Ultrasonography 745
Magnetic Resonance Imaging 745
Treatment options 746
Nonoperative Management 746
Operative Management 747
Surgical Techniques 747
Surgical Timing 749
Rehabilitation 750
Complications 750
Outcomes 751
Military Studies 751
Delayed Reconstruction 752
The Authors’ Preferred Technique 752
Summary 753
References 753
Snapping Scapula Syndrome in the Military 757
Key points 757
Introduction: nature of the problem 757
Indications/Contraindications 760
Surgical technique/procedure 760
Complications and management 764
Postoperative care 764
Outcomes 765
Summary 765
References 765
Index 767