Micheli / Purcell The Adolescent Athlete

A Practical Approach
1. Auflage 2010
ISBN: 978-0-387-49825-6
Verlag: Springer US
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 445 Seiten, eBook

Good health should be a goal of all children and adolescents, as well as the parents and guardians who care for them. Regular physical activity is part of achieving this goal. Sports can provide manifold benefits, including fitness, motor skill development, teamwork, and of course, fun. As with any pursuit that provides such benefits, however, there are risks involved, p- ticularly for growing athletes. Physicians and other health professionals caring for active children should be able to provide appropriate care and advice for sport and fitness related medical issues. This book is written as a practical guide for those of us who provide care for young athletes. The focus ison musculoskeletal injuries that occur in this unique population, as well as conditions that may present as a musculosk- etal injury, but may have more serious consequences. The first section of the book focuses on rehabilitation and diagnostic imaging of musculoskeletal conditions in adolescents. The secondsection organized according to a- tomical region addresses specificinjuries that adolescents may sustain as a result of sport/activity participation. Each of these body part specific ch- ters begins with a review of the relevant anatomy, followed by details of clinical evaluation. Specific injuries, such as acute and chronic injuries, are described in detail, including the management/treatment of each condition.

Zielgruppe

Professional/practitioner

Autoren/Hrsg.

Micheli, Lyle J.

Purcell, Laura

Inhaltsverzeichnis

Rehabilitation and Diagnosis.- Principles of Rehabilitation.- Diagnostic Imaging.- Anatomic Regions.- Traumatic Head Injuries.- Cervical and Thoracic Spine Injuries.- Lumbar Spine Injuries.- Thoracoabdominal Injuries.- Adolescent Shoulder Injuries.- Elbow and Forearm Injuries.- Injuries to the Wrist, Hand, and Fingers.- Pelvic, Hip, and Thigh Injuries.- Knee Injuries.- Lower Leg Injuries.- Foot and Ankle Injuries.

Leseproben

"Section II Anatomic Regions (p. 60-63)

3 Traumatic Head Injuries

Laura Purcell

Head injuries are common among children, and they result in a significant number of visits to emergency departments and physicians offices each year. In children 15yr old and under, the estimated incidence of traumatic brain injury is 180 per 100,000children per year, totaling more than 1 million injuries annually in the United States and accounting for more than 10% of all visits to emergency departments (1). A recent study conducted in emergency departments in Canada demonstrated that 3% of all sport-related injuries were head injuries (2). The majority of sport-related head injuries occurred in individuals less than 20yr of age. Head injuries represented 2.8% of all sport injuries in children less than 10yr old, 3.7% in 10-14yr olds, and 4.20/0 in 15-19yr olds (2). Head injuries as a result of sport participation include minor injuries such as contusions, lacerations, and superficial hematomas, as well as more serious injuries, including concussions, skull fractures, and intracranial hemorrhages. Head injuries can occur in both organized sports, such as football, hockey, basketball, and soccer, as well as recreational activities, including biking, skiing, skateboarding, and rollerblading.

Anatomy

The brain is enclosed in the bony skull or cranium (Figure 3.1 A). Below the skull, there are three layers of meninges between the skull and the brain. The meninges, or mater, include the outer dura mater, enclosing the venous sinuses; the arachnoid mater, which bridges the sulci on the cortical surface of the brain; and the pia mater, which is a delicate vascular membrane lining the cerebral cortex.

There are three potential meningeal spaces: the epidural space between the cranium and the dura; the subdural space between the dura and arachnoid; and the subarachnoid space between the arachnoid and pia, which contains cerebrospinal fluid. The brain consists of right and left cerebral hemispheres, which are divided into lobes corresponding to the overlying cranial bones: frontal, parietal, occipital, and temporal (Figure 3.1 B). The cerebral cortex consists of gyri (folds) and sulci (grooves).

Posterior and inferior to the cerebral cortex are the cerebellum and the brainstem, consisting of the medulla oblongata, pons, and midbrain. Clinical Evaluation The athletes level of consciousness should guide management priorities (3,4). In an unconscious athlete, a cervical spine injury should be assumed, and appropriate immobilization of the cervical spine should be immediately instituted to protect against potential catastrophic spinal injury (4-6). Management then proceeds through the ABCs (airway, breathing, and circulation) (3-6). A patent airway must be established and protected.

If the patient is unable to protect the airway, or if there are signs of neurological deterioration, such as posturing or pupillary abnormalities, the athlete should be intubated and hyperventilated (4-7). If the airway is patent, adequate ventilation must be ensured. Circulation should be monitored and supported as necessary. The athlete should be transported on a spinal board by ambulance to the nearest trauma center as quickly as possible (Table 3.1) (3-7)."

Über Autor(innen)

Lyle J. Micheli, MD, one of the world’s foremost authorities on sports medicine, is an associate clinical professor of orthopaedic surgery at Harvard Medical School and director and co-founder of the Sports Medicine Division at Children’s Hospital Boston, which is internationally recognized for clinical care and research in pediatric and adolescent sports medicine. Noted as an active clinician and teacher, Dr. Micheli presents at the AAOS, ACSM, and NATA. He has written more than 100 book chapters (contributor to Cole & Malek, Articular Cartilage Lesions) and has co-edited several titles, including the Oxford Textbook of Sports Medicine, 2/e (Oxford, 1998, ISBN 0192627171) and The Sports Medicine Bible for Young Athletes (SourceBooks, 2001, ISBN 1570717109). Dr. Micheli serves on the editorial and advisory boards of more than 20 journals, including Spine and the Clinical Journal of Sport Medicine, and he has published more than 200 articles.

Laura Purcell, MD, received her medical doctorate from McMaster University, one of the world’s leading evidence-based practice centers, and completed her pediatric residency at Dalhousie University (Nova Scotia) and a sport medicine fellowship at Fowler Kennedy Sport Medicine Clinic (Ontario). She is currently a primary care sport medicine physician at Fowler Kennedy and an emergency department consultant at the Children’s Hospital of Western Ontario. Dr. Purcell is chair of the Pediatric Sport and Exercise Medicine Committee of the Canadian Academy of Sport Medicine and president of the Pediatric Sport and Exercise Medicine Section of the Canadian Pediatric Society. She has contributed to several publications, including Paediatrics & Child Health, Pediatric Emergency Care, and Paediatric Child Health. An active educator, Dr. Purcell has been invited to speak at symposiums held by the Canadian Paediatric Society and the Canadian Academy of Sport Medicine/Ontario Medical Association.