ABSTRACT
Avulsion fractures of the pelvis and hip region are typical injuries in adolescent athletes. Avulsion sites include the muscle tendon origin or insertion, and treating these injuries surgically or conservatively remains a debated issue. The main goals of this review were to assess and summarize injury types and sites, treatment-related clinical outcomes, and return to sport for adolescent patients with a pelvis avulsion fracture and to provide support for making treatment decisions. The PubMed database was searched in November 2021 to identify all published articles from 2000 to 2021 that reported the outcome and return to sport after conservative or surgical treatment. Eighteen studies with 453 patients were included in this review. The age range was 13.6-16.8 years. The most common injury site the was anterior superior iliac spine (37%), followed by the anterior inferior iliac spine (31%), ischial tuberosity (14%), lesser trochanter (9%), iliac crest (8%), and superior corner of the pubic symphysis (1%). Overall complications were lower in the surgical group compared to the conservative group. The rate of return to pre-injury activity level was greater in patients who underwent surgical treatment (p < 0.05). In conclusion, surgery is preferred for major dislocation and fragment size, providing a better return-to-sport rate and decreasing the risk of complications.
ABSTRACT
BACKGROUND: Sarcopenia is defined as a progressive loss of muscle mass and muscle strength associated to increased adverse events, such as falls and hip fractures. The aim of this systematic review is to analyse diagnosis methods of sarcopenia in patients with hip fracture and evaluate prevention and treatment strategies described in literature. METHODS: Three independent authors performed a systematic review of two electronic medical databases using the following inclusion criteria: Sarcopenia, hip fractures, diagnosis, treatment, and prevention with a minimum average of 6-months follow-up. Any evidence-level studies reporting clinical data and dealing with sarcopenia diagnosis, or the treatment and prevention in hip fracture-affected patients, were considered. RESULTS: A total of 32 articles were found. After the first screening, we selected 19 articles eligible for full-text reading. Ultimately, following full-text reading, and checking of the reference list, seven articles were included. CONCLUSIONS: Sarcopenia diagnosis is challenging, as no standardized diagnostic and therapeutic protocols are present. The development of medical management programs is mandatory for good prevention. To ensure adequate resource provision, care models should be reviewed, and new welfare policies should be adopted in the future.
ABSTRACT
Lateral epicondylitis (LE) of the humerus is a chronic degeneration of wrist extensor tendons at their attachments to the lateral epicondyle of the humerus. There is not a common consensus on a specific therapeutic algorithm, but Extracorporeal Shockwave Therapy (ESWT) is widely used. The purpose of this study is to evaluate the clinical benefits of low dose ESWT in LE-affected patients in short and medium follow-up. Between January 2015 and December 2017, 60 patients (38 male, mean age 52.2 ± 10.1 years, the duration of the disease was 3.6 ± 1.3 months) were clinically evaluated using visual analog scale (VAS) and Patient Rated Tennis Elbow Evaluation Test (PRTEE-I) scores before treatment, at one, three, six and 12 months after treatment. According to the VAS and PRTEE-I scoring systems, all patients achieved an improvement of pain and functional outcome comparing the baseline results with one, six and 12 months values. Low dose ESWT is a safe and effective treatment of LE in the short and middle term. In elderly subjects, patients with a long disease history, or those with occupational and sportive risk factors, a longer persistence of the symptomatology could be observed.
