Der Unfallchirurg
-
Intra-articular tibial plateau fractures can present a surgical challenge due to complex injury patterns and compromised soft tissue. The treatment goal is to spare the soft tissue and an anatomical reconstruction of the tibial articular surface. Depending on the course of the fracture, a fracture-specific access strategy is recommended to provide correct positioning of the plate osteosynthesis. ⋯ If necessary, osteotomy of the femoral epicondyles can improve joint access for reduction control. Injuries to the posterior columns should be anatomically reconstructed and biomechanically correctly addressed via posterior approaches. Bony posterior cruciate ligament tears can be refixed via a minimally invasive posteromedial approach.
-
Muscle injuries are common in professional sports, especially in football. Recent epidemiological studies showed that muscle injuries account for more than 30% of professional football injuries (1.8-2.2/1000 h exposure); however, even though there are significant differences within a European comparison, a single professional football team diagnosed on average 12 muscle injuries per season, corresponding to more than 300 availability days lost. ⋯ The authors present a model of gradual progression for the treatment of muscular injuries and their rehabilitation. Due to the time-pressured nature of the professional sports environment, often promoted by coaches and media, this model could help lead players to recover as quickly as possible and return to competitive sports without relapse or sequel injury. This model integrates the player into the treatment plan. The progression sequences in the rehabilitation should be made clear to players and other parties involved, which are crucial for optimal healing. Even if absolute certainty cannot be achieved, i.e. the occurrence of re-injury or secondary injury, this model attempts to minimize the level of risk involved for the returning athlete. Since it is hardly possible to act strictly in line with more conservative guidelines due to the particular circumstances of the professional sport environment, the experiences of the authors are presented in the sense of best practice in order to support future decision-making processes.
-
Many publications about the treatment and return to play after severe football injuries are available from the scientific literature, particularly about injuries requiring surgery. In contrast, less severe football injuries, such as muscle strains, ankle sprains and contusions, are less well addressed in the literature although these represent the most frequent type of injury. Additionally, such reports often have a low level of evidence and guidelines on treatment and the return to play process are very rare. ⋯ To achieve the aim of stay and play on the field, the medical team should be highly knowledgeable in interdisciplinary football medicine, prevention strategies, first aid on the field, clinical and manual diagnostics, tissue regeneration, symptomatic and conservative treatment as well as in return to play decision-making. No consensus exists on stay and play procedures neither on the practical level nor on the scientific level regarding injury definition, the diagnostic and treatment options and stay and play criteria. Therefore, this article presents the first steps for assessing stay and play strategies after minor injuries to standardize and improve practical routine, education and scientific research.
-
The warm-up and injury prevention program FIFA 11+ was developed to reduce injuries in recreational and amateur level football. Despite systematic education it is uncertain what amount of knowledge is passed down to the lower recreational level football players and what exercises are implemented in the daily routine. This study presents the summarized experiences of German coaches about the implementation of exercises on the football pitch. ⋯ The prevention program FIFA 11+ is seen by coaches in recreational and amateur football as an effective tool to prevent injury. Implementation on the football pitch is regular but not as frequent as the evidence-based recommendations in the training concept.
-
The number of scientific studies about acupuncture has increased significantly during recent years. Acupuncture can be used as an evidence-based adjunct therapy for a variety of indications in professional football. ⋯ Besides knee, shoulder, spinal, elbow and postoperative pain, scientific meta-analyses also point towards the effectiveness of acupuncture in ankle sprains, allergic rhinoconjunctivitis and nausea. Dry needling is an emerging option for treatment of myofascial trigger points and could potentially result in improved prevention of muscular injuries and enhancement of muscular performance.