Littérature scientifique sur le sujet « Traumatologie – Football »

On October 15, 2016, experts met at Clínica CEMTRO in Madrid, Spain, under the patronage of the Spanish Society for Sports Traumatology (SETRADE), the Spanish Society of Sports Medicine (SEMED), the Spanish Association of Medical Services for Football Clubs (AEMEF), the Spanish Association of Medical Services for Basketball Clubs (AEMB), F.C. Barcelona, and Clínica CEMTRO. The purpose was to consider the most appropriate clinical management and treatment of tendinopathies in sports, based on proven scientific data described in the medical literature as well as on each expert’s experience. Prior to the meeting, each expert received a questionnaire regarding clinical management and treatment of tendinopathies in sports. The present consensus document summarizes the answers to the questionnaire and the resulting discussion and consensus regarding current concepts on tendinopathies in sports.

AbstractIntroductionRisk assessment is a vital step in the disaster-preparedness continuum as it is the foundation of subsequent phases, including mitigation, response, and recovery.Hypothesis/ProblemTo develop a risk assessment tool geared specifically towards the Union of European Football Associations (UEFA) Euro 2012.MethodsIn partnership with the Donetsk National Medical University, Donetsk Research and Development Institute of Traumatology and Orthopedics, Donetsk Regional Public Health Administration, and the Ministry of Emergency of Ukraine, a table-based tool was created, which, based on historical evidence, identifies relevant potential threats, evaluates their impacts and likelihoods on graded scales based on previous available data, identifies potential mitigating shortcomings, and recommends further mitigation measures.ResultsThis risk assessment tool has been applied in the vulnerability-assessment-phase of the UEFA Euro 2012. Twenty-three sub-types of potential hazards were identified and analyzed. Ten specific hazards were recognized as likely to very likely to occur, including natural disasters, bombing and blast events, road traffic collisions, and disorderly conduct. Preventative measures, such as increased stadium security and zero tolerance for impaired driving, were recommended. Mitigating factors were suggested, including clear, incident-specific preparedness plans and enhanced inter-agency communication.ConclusionThis hazard risk assessment tool is a simple aid in vulnerability assessment, essential for disaster preparedness and response, and may be applied broadly to future international events.WongEG, RazekT, LuhovyA, MogilevkinaI, PrudnikovY, KlimovitskiyF, YutovetsY, KhwajaKA, DeckelbaumDL. Preparing for Euro 2012: developing a hazard risk assessment. Prehosp Disaster Med. 2015;30(2):1-6.

Introduction: Injuries from the athlete’s hand are frequent. We present 2 clinical cases: Stener injury and traumatic dislocation of the metacarpophalangeal joint of the thumb. The “skier’s thumb” is an injury to the ulnar collateral ligament of the metacarpophalangeal joint of the thumb produced by abduction and hyperextension of the thumb. Dorsal dislocation of the thumb metacarpophalangeal joint (MCP) in children is a rare entity. There are three types of dislocation: incomplete, simple and complete complete complex. Methods: Presentation of 2 clinical cases of injuries of the athlete’s hand: Stener injury and traumatic dislocation of the metacarpophalangeal joint of the thumb. Retrospective descriptive method with reports of clinical cases based on patients’ electronic clinical processes. Results: CASE 1: Male 11 years old, put into service urgency by hand trauma during football match. He had pain and swelling at the ulnar rim of the joint of the first metacarpal-phalangeal joint. Radiogram unchanged. Coping with clinical suspicion was carried out ray under stress (radial deviation) showed that this instability of the joint. Ultrasonography confirmed complete rupture of the ulnar side of the attachment with the aponeurosis interposition of the adductor - stener lesion. Surgery decided. Focus through internal and distal reinsertion. 4 weeks immobilization period, followed by a return to activities of daily living. At the last visit, at 6 months after the operation there was no residual instability. CASE 2: Seven-year-old boy put into service urgency for thumb injury in hyperextension during football match. The objective examination shows hyperextension deformity of MCF. The radiological study confirmed complete MCF dorsal joint dislocation diagnosis of the thumb joint. A closed reduction procedure under sedation, by McLaughlin corset technique. Immobilization was performed for two weeks. At six weeks he was asymptomatic, with normal mobilities, symmetrical grip and clamp strength without instability or radiographic changes. Discussion/Conclusion: Lesion of the ulnar side ligament is a possible diagnosis of the pediatric age, even without associated withdrawal. Proper clinical observation and x-rays provide supplemented by ultrasound, often all the information necessary for diagnosis and therapeutic decision. The low frequency relevance of pediatric Stener injuries can damage your diagnosis of the emergency situation. In this clinical case, it is possible to detect this damage. The dislocations dorsal joint MCP thumb are more frequent than flying, lesional mechanism involving the traumatic hyperextension of it. The diagnosis is based on clinical information supplemented by radiography, which allows the differentiation between complete and incomplete dislocations. A complete dislocation can not be reduced by maneuvering bloodless injury is complex and requires surgical treatment. The reduction technique involves MCF hyperextension and replacement of the base of the phalanx. Other gestures should be avoided, and axial traction, risk of joint injury structures, cartilage growth or conversion of a simple dislocation into complex, to determine the need for surgical intervention. After reducing the stability of the collateral ligaments should be evaluated, often directly damaged by trauma or inappropriate gestures reducing the reduction of multiple attempts. Lateral instability may benefit from surgical correction. References STENER, B.: “Displacement of the ruptured ulnar collateral ligament of the metacarpo-phalangeal joint of the thumb”. A clinical and anatomical study. J. Bone Jt. Surg. 44-B: 869, 1962. STENER, B.: “Hyperextension injuries to the metacarpophalangeal joint of the thumb. Rupture of ligaments, fracture of sesamoid bones, rupture of flexor pollicis brevis. An anatomical and clinic study”. Acta Chir. Scand. 125: 275, 1963. COONRAD, R.W., GOLDNER, J.L.: “A study of the pathological findings and treatment in soft-tissue injury of the thumb metacarpophalangeal joint”. J. Bone Jt Surg. 59- A: 439, 1968. PARIKH, M., NAHIGIAN, S., FROIMSON, A.: “Gamekeeper’s thumb”. Plast. Reconstr, Surg. 58:24, 1976. STENER, B.: “Entorses récents de la métacarpophalangienne du pource”, en Traité de chirurgie de la main de Tubiana R. Tomo II, pág. 779. París, Masson, 1984. KAPLAN, E.B.: “The pathology and treatment of radial subluxation of the thumb with ulnar displacement of the head of the first metacarpal”. J. Bone Jt Surg. 43-A: 541, 1961. YAMANAKA, K., YOSHIDA, K., INOVE, A., MIYAGI, T.: “Locking of the metacarpophalangeal joint of the thurnb”. J. Bone Jt Surg. 67-A: 782, 1985. NAVES, J., SALVADOR, A., PUIG, M.: “Traumatología del deporte”. Pág. 251. Salvat, Barcelona, 1986, SMITH, R.J.: “Post-traumatic instability of the metacarpophalangeal joint of the thumb”. J. bone Jt Surg. 59-A: 14-21, 1977. Kasuaki M. Dorsal dislocations of the second to fifth carpometacarpal joints: a case report. Hand Surg 2008; 13(2): 129-132. Laforgia R, Specchiulli F, Mariani A. Dorsal dislocation of the fifth carpometacarpal joint. Hand Surg Am 1990; 15: 463-465. Gangloff D, Mansat P, Gaston A, Apredoaei C, Rongières M. Carpometacarpal dislocation of the fifth finger: descriptive study of 31 cases. Chir Main 2007; 26(4-5): 206-213. Epub 2007 Jul 16. Eichhorn-Sens J, Katzer A, Meenen NM, Rueger JM. Carpometacarpal dislocation injuries. Handchir, Mikrochir, Plast Chir 2001; 33(3): 189. Yoshida R, Shah MA, Patterson RM, Buford WL Jr, Knighten J, Viegas SF. Anatomy and pathomechanics of ring and small finger carpometacarpal joint injuries. J Hand Surg Am 2003; 28(6): 1035-1043.

L'objectif de cette thèse était double : i) objectiver les effets de la réathlétisation sur le contrôle neuromoteur de footballeurs de haut-niveau; ii) développer un modèle théorique prédictif de la survenue de blessure chez l'athlète sain. Le modèle expérimental du countermovement-jump (CMJ) a été utilisé pour tester les hypothèses spécifiques à chacune des 5 études réalisées. Les paramètres cinétiques, cinématiques et électromyographiques (EMG) du CMJ étaient calculés au moyen de plateforme de force, caméra rapide et électrodes de surface, respectivement. Trois pathologies des membres inférieurs ont été considérées: rupture du ligament croisé antérieur du genou, chondropathie de genou et lésions musculaires de la cuisse. Dans une 1ère étude, les résultats ont montré que les paramètres biomécaniques et EMG du CMJ de la jambe blessée et de la jambe non blessée étaient altérés dans tous les groupes pathologiques. Le programme SSR (specific sport rehabilitation) de trois semaines a permis d'améliorer significativement ces paramètres caractéristiques du contrôle neuromoteur. Dans une 2ème étude, le niveau de récupération fonctionnelle des footballeurs a été évalué par le biais de deux méthodes: la méthode LSI (limb symmetry index) et la méthode Norm-Values. Les résultats ont montré que la méthode Norm-Values était la plus discriminante. Dans une 3ème étude, la comparaison inter-groupes des paramètres biomécaniques et EMG a permis de mettre en évidence une « signature neuromotrice » spécifique à chaque pathologie. Dans une 4ème étude, les résultats ont montré que la superposition d'une tâche de prise d'information visuelle (tâche secondaire) avait un effet bénéfique sur les paramètres du CMJ (tâche primaire), probablement dû à une « défocalisation » de l'attention des athlètes blessés vers la tâche secondaire. Enfin, dans une dernière étude, le suivi longitudinal de joueurs sains au cours d'une saison a été réalisé avec pour objectif de développer un modèle théorique prédictif de blessure. Ce modèle, basé sur une méthode de machine learning a permis de mettre en évidence des tendances (non significatives) à la survenue de blessures en fonction des caractéristiques neuromotrices des joueurs. Globalement, l'ensemble de ces résultats contribue à l'amélioration des connaissances et des pratiques dans le domaine de la réathlétisation
This thesis had two principal objectives: i), to provide an objective analysis of the impact of sport-specific-rehab (SSR) on the neuromotor control of high-level soccer players ; ii) to develop a theoretical model that could predict the likelihood of injury in healthy athletes. The experimental countermovement jump (CMJ) model was employed to test the specific hypotheses associated with each of the five studies. The kinetic, kinematic and electromyographic (EMG) parameters of the CMJ were calculate using a force platform, a high-speed camera and surface electrodes, respectively. Three pathologies of the lower-limb were considered: anterior cruciate ligament rupture of the knee, knee chondropathy and muscular lesions of the thigh. The initial study demonstrated that the biomechanical and electromyographic parameters of the CMJ of the injured leg and the non-injured leg were altered in all pathological groups. The three-week SSR programme led to a notable improvement in these parameters, which are indicative of neuromotor control. In a second study, the level of functional recovery of the soccer players was evaluated using two methods: the LSI (limb symmetry index) and the Norm-Values method. The findings indicated that the Norm-Values method was the most effective in discriminating between the groups. In a third study, an intergroup comparison of biomechanical and EMG parameters revealed the existence of a 'neuromotor signature' specific to each pathology. In a fourth study, the results demonstrated that superimposing a visual information-gathering task (secondary task) had a beneficial effect on CMJ parameters (primary task). This was likely due to the injured athletes' attention being defocused towards the secondary task. In a final study, healthy players were monitored over the course of a season with the objective of developing a theoretical predictive model of injury. This model, based on a machine learning method, revealed non-significant trends in the occurrence of injuries as a function of the neuromotor characteristics of the players. Overall, these results contribute to advancing knowledge and practices in the field of rehabilitation