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Introduction: Intramuscular myxomas are rare, benign mesenchymal tumors which commonly arise in muscle of the upper limb, pelvis, abdominal tissue, spine, or facial muscle. There are few case reports of intramuscular myxomas, and none of these describe intramuscular myxoma as a cause of compressive neuropathy. Case Report: We describe the case of a 67-year-old woman who presented to us with a 1-year history of progressive enlargement of a painless right elbow mass. She gradually developed increasing numbness and tingling in her right small finger, which was worse at night. She underwent cubital tunnel release with concurrent right elbow mass excision of the flexor carpi ulnaris muscle. Histology showed intramuscular myxoma. Postoperatively, she had a complete resolution of her symptoms with a good functional outcome. Conclusion: This is the first known case of intramuscular myxoma within the flexor carpi ulnaris causing compressive neuropathy of the ulnar nerve at the elbow.
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BACKGROUND: The prevalence of adolescent athletes who specialize in sports has increased in recent years. Substantial literature on youth sports has linked early sport specialization to negative consequences, such as burnout and injury. However, empirical evidence directly comparing burnout rates in sport specialization versus sport sampling is very limited. PURPOSE: To conduct a systematic review and meta-analysis to evaluate psychological burnout in adolescent athletes who sport specialize compared with adolescent athletes who sport sample. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: A systematic review was performed through use of the PubMed, SportDiscus, PsychInfo, and CINAHL databases (between inception and May 2019) according to PRISMA-IPD (Preferred Reporting Items for Systematic Reviews and Meta-Analyses of individual participant data) guidelines. Results from the 3 measures of the Athlete Burnout Questionnaire and athlete specialization status were recorded and analyzed. An athlete was determined to be a "sport specializer" if he or she met the following 3 criteria: (1) athletic participation limited to 1 sport, (2) which is competed in > 8 months in 1 year, and (3) to the exclusion of all other sports. RESULTS: Of 3578 studies, 8 met criteria for final meta-analysis, which included 1429 athletes (mean age, 15.59 years; range, 12.5-17.2 years). Of these, 1371 (95.9%) were sport specializers, whereas 58 (4.1%) were sport samplers. A total of 1422 (99.5%) athletes completed the Athlete Burnout Questionnaire. Athletes who specialized reported higher levels of burnout than athletes who did not specialize. Specializers had a greater sense of reduced accomplishment (difference of means [â³], 0.87; 95% CI, 0.67-1.08; P < .01). Specializers also reported greater exhaustion (â³, 0.46; 95% CI, 0.24-0.68; P < .01) and sport devaluation (â³, 0.41; 95% CI, 0.22-0.60; P < .01) than athletes who were samplers. CONCLUSION: Adolescent sport specialization was associated with greater levels of burnout in all 3 aspects (reduced sense of accomplishment, sport devaluation, and exhaustion) compared with sport sampling.
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BACKGROUND: The prevalence of youth athletes specializing in 1 sport has been increasing over the past decade. Subsequently, the rate of youth athlete injury has also been increasing. It is possible that an association exists between youth specialization and sports injury rate. PURPOSE: To determine if sport sampling is associated with a lower sports injury rate in youths compared with youths who specialize in 1 sport. STUDY DESIGN: Systematic review and meta-analysis. METHODS: A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed, Embase, and the Cochrane library. Inclusion criteria included studies written in the English language, studies with athletes between 7 and 18 years of age, studies that report injury rates, and studies that specify if athletes were sport samplers or specialized in a sport. Data relevant to this study, including injuries and patient characteristics, were extracted and statistically analyzed. RESULTS: The initial search identified 324 studies, 6 of which met inclusion criteria. From these 6 studies, the total participant number was 5736. Of those, 2451 (42.7%) were "sport samplers," 1628 (28.4%) were "sport specializers," and 1657 (28.9%) were considered "others" (ie, could not be classified as true samplers or true specializers). The average age of all the athletes was 14.6 years (range, 7-18 years). Sport specializers had a significantly higher injury risk than the sport samplers (RR, 1.37; 95% CI, 1.19-1.57; P < .0001). There was a higher risk of injury in the "others" group when compared with the "sport sampler" group (RR, 1.21; 95% CI, 1.14-1.29; P < .0001). There was a higher risk of injury in the "sport specializer" group over the "others" group (RR, 1.09; 95% CI, 1.04-1.14; P < .005). CONCLUSION: Sport sampling is associated with a decreased risk of sports injury in youth athletes when compared with those who specialize in 1 sport. Injury rates increase as a youth athlete becomes increasingly specialized. Youth athletes would benefit substantially from participating in sport sampling.
