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Shoulder acromioclavicular (AC) separation glenohumeral dislocation Elbow olecrannon bursitis - PowerPoint PPT Presentation


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Upper Extremity. Shoulder acromioclavicular (AC) separation glenohumeral dislocation Elbow olecrannon bursitis. Upper Extremity. Wrist distal radius fracture scaphoid (navicular) fracture ECU (tendon) subluxation/dislocation DRUJ (ligament) sprain. Upper Extremity. Hand

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Presentation Transcript

Upper Extremity

  • Shoulder

    • acromioclavicular (AC) separation

    • glenohumeral dislocation

  • Elbow

    • olecrannon bursitis


Upper Extremity

  • Wrist

    • distal radius fracture

    • scaphoid (navicular) fracture

    • ECU (tendon) subluxation/dislocation

    • DRUJ (ligament)

      sprain


Upper Extremity

  • Hand

    • ulnar collateral (thumb ligament) sprain

    • phalanx (finger)

      fracture


Lower Extremity

  • Abdomen/Groin/Hip

    • athletic pubalgia

    • adductor (groin) strain

    • iliopsoas/rectus

      (hip flexor) strain


Lower Extremity

  • Knee

    • MCL sprain

    • ACL sprain

    • quadriceps contusion


Lower Extremity

  • Ankle

    • malleolar bursitis

    • distal fibula fracture

    • syndesmosis/lateral ligamentsprain


Lower Extremity

  • Foot

    • contusion/fracture

    • calcaneal bursitis


Catastrophic Injuries

  • Traumatic Brain Injury

  • (Concussion)

  • Cervical Spine Fracture/Dislocation

  • (± spinal cord injury)

  • Eye Injuries


Catastrophic Injuries

  • Upper Airway

  • (larynx, hyoid, soft tissues)

  • Commotio Cordis

    • (chest blow)

  • Subarachnoid Hemorrhage

    • (neck blow)

  • Spleen Rupture

  • Neck Laceration


  • Concussion

    Concussion may be caused by a direct blow to the head, face, neck or elsewhere on the body that results in an impulsive force transmitted to the head causing a rapid onset of short-lived impairment of neurologic function that resolves spontaneously.


    Concussion

    Symptoms: unaware of situation, confusion, amnesia, loss of consciousness, headache dizziness, nausea, loss of balance, flashing lights, ear ringing, double vision, sleepiness, feeling dazed


    Concussion

    Signs: altered mental status, poor coordination, seizure, slow to answer, poor concentration, nausea, vomiting, vacant stare, slurred speech, personality changes, inappropriate emotions, abnormal behavior


    Concussion

    • repeated concussions cause cumulative damage increased severity with each incident

    • initial concussion  chance of a 2ndconcussion is 4x greater


    Simple Concussion

    • Progressively resolves without complication over 7-10 days:

      • all concussions mandate evaluation by physician

      • limit training & competition while symptomatic

      • able to resume sport without further problems

      • managed by certified athletic trainers working under medical supervision

      • formal neuropsychological testing unnecessary?


    Complex Concussion

    • Specific features, persistent symptoms or recurrence with exertion:

      • prolonged loss of consciousness (>1 minute)

      • multiple concussions over time

      • repeated concussions with less impact force

      • neuropsychological testing helpful

      • multidisciplinary management

        • (experienced sports medicine physician, sports neurologist or neurosurgeon, neuropsychologist)


    Concussion Management

    A player with ANY symptoms or signs:

    • should not be allowed to return to play in the current game or practice

    • should not be left alone- regular monitoring for deterioration is essential

    • should be medically evaluated following the injury


    Concussion Management

    Return to play must follow a medically supervised stepwise process:

    • monitored by a medical doctor

    • player should never return to play while symptomatic

    “When in doubt, sit them out!”


    Concussion Management

    • physical andcognitive rest

    • monitoring of:

      • symptoms

      • neurocognitive function

      • postural stability

      • neuropsychological testing (?)

    • graded exertion protocol


    Concussion Management

    • Return to Play Protocol

    • 1. No activity, complete rest

    • 2. Light aerobic activity (walking, stationary cycling)

    • 3. Sports specific training- skating.

    • 4. Non-contact training drills

    • 5. Full-contact training after medical clearance

    • 6. Return to competition

      • * Proceed to the next level only if asymptomatic

      • * Any symptoms or signs: drop back to the previous level & attempt progression again after 24 hours


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