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Shoulder acromioclavicular (AC) separation glenohumeral dislocation Elbow olecrannon bursitis

Upper Extremity. Shoulder acromioclavicular (AC) separation glenohumeral dislocation Elbow olecrannon bursitis. Upper Extremity. Wrist distal radius fracture scaphoid (navicular) fracture ECU (tendon) subluxation/dislocation DRUJ (ligament) sprain. Upper Extremity. Hand

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Shoulder acromioclavicular (AC) separation glenohumeral dislocation Elbow olecrannon bursitis

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  1. Upper Extremity • Shoulder • acromioclavicular (AC) separation • glenohumeral dislocation • Elbow • olecrannon bursitis

  2. Upper Extremity • Wrist • distal radius fracture • scaphoid (navicular) fracture • ECU (tendon) subluxation/dislocation • DRUJ (ligament) sprain

  3. Upper Extremity • Hand • ulnar collateral (thumb ligament) sprain • phalanx (finger) fracture

  4. Lower Extremity • Abdomen/Groin/Hip • athletic pubalgia • adductor (groin) strain • iliopsoas/rectus (hip flexor) strain

  5. Lower Extremity • Knee • MCL sprain • ACL sprain • quadriceps contusion

  6. Lower Extremity • Ankle • malleolar bursitis • distal fibula fracture • syndesmosis/lateral ligamentsprain

  7. Lower Extremity • Foot • contusion/fracture • calcaneal bursitis

  8. Catastrophic Injuries • Traumatic Brain Injury • (Concussion) • Cervical Spine Fracture/Dislocation • (± spinal cord injury) • Eye Injuries

  9. Catastrophic Injuries • Upper Airway • (larynx, hyoid, soft tissues) • Commotio Cordis • (chest blow) • Subarachnoid Hemorrhage • (neck blow) • Spleen Rupture • Neck Laceration

  10. Concussion Concussion may be caused by a direct blow to the head, face, neck or elsewhere on the body that results in an impulsive force transmitted to the head causing a rapid onset of short-lived impairment of neurologic function that resolves spontaneously.

  11. Concussion Symptoms: unaware of situation, confusion, amnesia, loss of consciousness, headache dizziness, nausea, loss of balance, flashing lights, ear ringing, double vision, sleepiness, feeling dazed

  12. Concussion Signs: altered mental status, poor coordination, seizure, slow to answer, poor concentration, nausea, vomiting, vacant stare, slurred speech, personality changes, inappropriate emotions, abnormal behavior

  13. Concussion • repeated concussions cause cumulative damage increased severity with each incident • initial concussion  chance of a 2ndconcussion is 4x greater

  14. Simple Concussion • Progressively resolves without complication over 7-10 days: • all concussions mandate evaluation by physician • limit training & competition while symptomatic • able to resume sport without further problems • managed by certified athletic trainers working under medical supervision • formal neuropsychological testing unnecessary?

  15. Complex Concussion • Specific features, persistent symptoms or recurrence with exertion: • prolonged loss of consciousness (>1 minute) • multiple concussions over time • repeated concussions with less impact force • neuropsychological testing helpful • multidisciplinary management • (experienced sports medicine physician, sports neurologist or neurosurgeon, neuropsychologist)

  16. Concussion Management A player with ANY symptoms or signs: • should not be allowed to return to play in the current game or practice • should not be left alone- regular monitoring for deterioration is essential • should be medically evaluated following the injury

  17. Concussion Management Return to play must follow a medically supervised stepwise process: • monitored by a medical doctor • player should never return to play while symptomatic “When in doubt, sit them out!”

  18. Concussion Management • physical andcognitive rest • monitoring of: • symptoms • neurocognitive function • postural stability • neuropsychological testing (?) • graded exertion protocol

  19. Concussion Management • Return to Play Protocol • 1. No activity, complete rest • 2. Light aerobic activity (walking, stationary cycling) • 3. Sports specific training- skating. • 4. Non-contact training drills • 5. Full-contact training after medical clearance • 6. Return to competition • * Proceed to the next level only if asymptomatic • * Any symptoms or signs: drop back to the previous level & attempt progression again after 24 hours

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