Injury Profile among Elite Youth Male Football Players in a German Academy.

Studies that report injuries in elite youth football players are scarce. So far, no such studies have been reported in Germany. The aim of this study is to descriptively and statistically report the incidence of injuries that resulted in time-loss ≥ 4 days in the TSG Hoffenheim football academy by 138 male players aged between 12 and 19 years during one season. A total of 109 injuries were sustained by 76 players: 6.9 injuries occurred per 1000 hours of matches (95% CI, 5.0-9.6) and 0.7 injuries per 1000 hours of training (95% CI, 0.5-0.9) with a ratio of 9.8. Some 66% of all injuries occurred during matches. Injuries involved the lower limb (81%), upper limb (9%), head & neck (5%) and trunk injuries (5%). 21 (19%) of all injuries were regarded as severe and resulted in time-loss > 28 days. U16-U19 teams sustained more injuries (74, 68%) than U12-U15 (35, 32%) (P= 0.032). The most frequent diagnosis was thigh strain (22%). Time-loss ranged from 4-339 days (SD: 40, Average: 23). Many injuries were a result of strain. Available injury prevention programs should be adhered to more strictly. Dedicated epidemiological studies are needed to optimize focused injury prevention programs.

Fixation of Unstable Femoral Juvenile Osteochondritis Dissecans Lesions with Bioabsorbable Pins-Clinical and Radiographic Outcomes.

Juvenile Osteochondritis Dissecans (JOCD) is a common reason for knee pain among children. The aim of this case study was to report on clinical and radiographic outcomes after fixation of an osteochondral fragment with bioabsorbable pins in children with open growth plates. We hypothesized that surgical treatment with this technique will result in good function, high rates of radiographic healing and high return to sport rates. A total of 13 knees in 12 patients (6 male, 6 female) with a median of 13 years (11, 17) were evaluated retrospectively at a minimum clinical follow-up of 24 months. Inclusion criteria were defined as open growth plates and an unstable osteochondral lesion grade III or IV. The clinical outcome was evaluated utilizing three standardized patient-reported outcome scores (Tegner Activity Scale [TAS], Knee Injury and Osteoarthritis Outcome Score [KOOS], Lysholm Score). All patients underwent magnetic resonance imaging 15 months (3, 34) after surgical treatment and defect healing was evaluated utilizing a modified version of the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. Due to the small sample size, the data was reported descriptively. The interobserver variability was calculated with the Spearman rank correlation coefficient. Comparisons were made with Wilcoxon sign rank test (or sign test). At final follow-up the median KOOS Score was 98% (79.2%, 100%) and the median Lysholm Score was 94 (69, 100) points. The Tegner Activity Scale was 7 (4, 10) points preoperatively and 7 (4,10) points postoperatively (p = 0.5). Complete bony ingrowth occurred in 9 knees (69%), complete cartilage defect repair in 10 knees (77%) and integration to the border zone was found in 11 knees (85%) 15 (3, 34) months following surgical treatment. Fixation of osteochondral fragments with bioabsorbable pins resulted in good functional and radiographic outcomes, a high return to sport- and a low complication rate among children with open growth plates.

Variation of the glenohumeral and scapulothoracic motion in progressive severity of glenohumeral osteoarthritis.

INTRODUCTION: The aim of this study is to investigate the variation of the glenohumeral and scapulothoracic motion in progressive severity of glenohumeral osteoarthritis using a 3-D-motion analysis. Moreover, the variation of the Constant Score is evaluated. HYPOTHESIS: The hypothesis is that the motion of the scapulothoracic joint may partly compensate for the loss of the glenohumeral joint movement in patients with increasing severity of glenohumeral osteoarthritis. MATERIAL AND METHODS: A total of 21 patients with primary osteoarthritis of the glenohumeral joint were clinically examined, divided in three groups (SP1-SP3) according to size of their caudal osteophyte. The contribution of the scapulothoracic (acromioclavicular and sternoclavicular) joint to the total arm (humerothoracical) elevation in sagittal and frontal plane was measured with 3D motion analysis and the Constant Score was evaluated. DISCUSSION: In sagittal plane elevation (anteversion) the contribution of the scapulothoracic joint to the total elevation was while arm raising 32.7% (SD 8.0%) in Group SP1, 36.6% (SD 11.0%) in Group SP2 and 49.6% (SD 9.0%) in Group SP3 (p=0.002). The contribution of the scapulothoracic joint to the total elevation while arm lowering was 31.4% (SD 9.0%) in Group SP1, 39.0% (SD 13.0%) in Group SP2 and 49.7% (SD 12.0%) in Group SP3 (p=0.043). In frontal plane elevation (abduction) the contribution of the scapulothoracic joint was while arm raising 33.7% (SD 8.0%) in Group SP1, 34.0% (SD 10.0%) in Group SP2 and 42.3% (SD 9.0%) in Group SP3 (p=0.071). While arm lowering the contribution of the scapulothoracic joint was 30.8% (SD 10.0%) in Group SP1, 36.3% (SD 12.0%) in Group SP2 and 44.8% (SD 8.0%) in Group SP3 (p=0.022). The group SP1 achieved a Constant Score of 78.00 (SD 9.823) points. The group SP2 achieved a Constant Score of 53.57 (SD 13.92) and the group SP3 38.64 (SD 10.40). There is a significant difference between the three groups (p<0.001). Increasing severity of glenohumeral osteoarthritis leads to a reduced motion of the glenohumeral joint. Instead the magnitude of the scapulothoracic motion increases. LEVEL OF PROOF: V, Case Series.

No Pain, No Gain? Prevalence, Location, Context, and Coping Strategies with Regard to Pain Among Young German Elite Basketball Players.

Pain among young athletes requires special attention given that symptoms occur during the ongoing development of the conditional, and in particular, the motor capacities, and while the musculoskeletal system is in a continuous process of growth. The purpose of this study was to evaluate prevalence, location, context, and coping strategies regarding pain among young athletes. We chose survey data of young elite athletes from the highest level national basketball leagues in Germany, as this meant that health implications may be observed earlier and in a more pronounced manner. The German 'Adolescents' and Children's Health in Elite Basketball study' (ACHE study), a quantitative survey, was conducted between April and June 2016. Analyses were based on elite basketball players between 13 and 19 years of age from 46 German teams (n = 182). Constant, and to some extent severe pain, was part of daily life of young elite basketball players: eight out of ten players in the highest German leagues suffered from pain at the time of the survey. Knee, leg, and back pain occurred most frequently. For most players, occasional or frequent consumption of analgesics was the norm, in some cases these were also taken "prophylactically". The consumption of multiple pharmaceutical substances, especially of cyclooxygenase inhibitors such as ibuprofen and diclofenac, is widespread among adolescent elite basketball players. Physicians involved in treating these athletes should address pain and its management preemptively. Coaches, sporting organizations and parents should be involved in this process from an early stage.

Prevalence and classification of equinus foot in bilateral spastic cerebral palsy.

BACKGROUND: Equinus is a common deformity in children with bilateral spastic cerebral palsy (BSCP). While dynamic equinus usually is treated by conservative therapy, fixed contractures need surgical correction. To choose the appropriate surgical method, it is important to discriminate between isolated gastrocnemius shortening and combined gastrosoleus complex contracture. METHODS: In a retrospective study 938 patients with BSCP were studied. Patients underwent gait analysis and clinical examination. 248 patients (496 limbs) met the inclusion criteria. Data from motion analysis and clinical examination were used to calculate the prevalence and to further classify fixed equinus foot. RESULTS: The prevalence of equinus was 83.3%. During clinical exam 246 (59.6%) limbs showed combined gastrosoleus complex contracture and 167 (40.4%) isolated gastrocnemius contracture. Max. DF at stance and mean DF at initial contact were significantly reduced in combined contracture, while max. ROM was increased (P < 0.05). CONCLUSIONS: Corroborating the results of previous studies, in this study there was a high prevalence of fixed equinus in patients with BSCP. The prevalence of equinus correlated with increasing age. As half of the patients with fixed equinus show a different involvement of gastrocnemius and soleus muscle, we recommend to apply Silfverskiöld's test to discriminate between those two types to choose the appropriate surgical therapy.

What's New in Severe Deformity Correction: The German Perspective.

Foot deformities are found in several neurologic conditions, most typically, but not exclusively, Charcot-Marie-Tooth disease. Posttraumatic deformities and undercorrection or overcorrection of congenital talipes equinovarus are also encountered. A severely deformed foot that cannot fit into normal shoes presents a significant day-to-day challenge to the young and active patient. This article presents some basic principles for evaluating the deformity and a toolkit of procedures to deal with these complex cases.