Teres major injuries are rare and are generally treated conservatively, except in high-performance athletes. This report describes a case of traumatic rupture of the teres major at its myotendinous junction in a professional gymnast. The patient underwent surgical treatment 10 days after the injury. Six months post-surgery, the patient achieved complete recovery of the range of motion and strength, returning to the pre-injury performance level, guided by physiotherapy rehabilitation. This is the first documented case in the literature of surgical treatment of this injury in a professional gymnast. The main lesson from this case is that early surgical repair in elite athletes can result in excellent functional outcomes and allow return to sport at the pre-injury performance level.

BACKGROUND: The Achilles tendon is the strongest tendon in humans and is frequently injured, especially in the physically active young to middle-aged population. An increasing frequency of Achilles tendon ruptures (ATR) has been reported in several studies. However, there is no international consensus regarding possible non-operative (N-OP) or operative (surgical) treatment (OP).
OBJECTIVE: The aim of this article is to semi-quantitatively compare both treatment options for ATR by analyzing the results reported in the literature.
METHODS: For this purpose, relevant categories were identified, and the literature was then evaluated in a PubMed analysis. Ten meta-analyses and two cost analyses were included. The data was extracted according to the categories and evaluated comparatively.
RESULTS: OP and N‑OP for acute ATR can lead to equally good restitution of clinical function if early functional rehabilitation is applied. The lower re-rupture rate is an advantage of OP, whereas the lower general complications speak in favor of N‑OP. The minimally invasive or percutaneous surgical technique (M-OP) appears to be advantageous over the open surgical technique (O-OP), although studies show an increased rate of lesions of the sural nerve.
CONCLUSIONS: There is no consensus regarding the superiority of OP or N‑OP for acute ATR, as several studies conducted since the introduction of early mobilization protocols have shown similar results for these two interventions. Results and complications of M‑OP and O‑OP are also comparable. Considering the available data on the various surgical procedures, the authors prefer the M‑OP technique with adequate sural nerve protection for repair of acute ATR, combined with an early mobilization protocol.
UNASSIGNED: HINTERGRUND: Die Achillessehne ist die stärkste Sehne des Menschen und wird häufig verletzt, vor allem bei der körperlich aktiven Bevölkerung im jungen bis mittleren Alter. In mehreren Studien wird über eine zunehmende Häufigkeit von Achillessehnenrupturen (ASR) berichtet. Hinsichtlich der möglichen nichtoperativen (N-OP) oder operativen Therapie (OP) besteht jedoch international kein Konsens. ZIEL: Das Ziel dieses Artikels ist es, beide Behandlungsoptionen für ASR durch Analyse der in der Literatur beschriebenen Ergebnisse semiquantitativ miteinander zu vergleichen.
METHODS: Zu diesem Zweck wurden relevante Kategorien identifiziert, und die Literatur wurde daraufhin in Rahmen einer PubMed-Analyse ausgewertet. Es wurden 10 Metaanalysen und 2 Kostenanalysen eingeschlossen. Die Daten wurden bezüglich der Kategorien extrahiert und vergleichend ausgewertet.
UNASSIGNED: Die OP und N‑OP der akuten ASR kann zu einer gleichwertig guten Restitution der klinischen Funktion führen, wenn eine frühfunktionelle Rehabilitation angewendet wird. Die geringere Rerupturrate ist ein Vorteil der OP, wohingegen die geringeren allgemeinen Komplikationen für die N‑OP sprechen. Die minimal-invasive oder perkutane Operationstechnik (M-OP) erscheint gegenüber der offenen Operationstechnik (O-OP) vorteilhaft, obwohl die Studien eine erhöhte Läsionsrate des N. suralis zeigen.
CONCLUSIONS: Es besteht kein Konsens bezüglich einer Überlegenheit der OP oder N‑OP bei akuter ASR, da mehrere Studien, die seit der Einführung der Frühmobilisierungsprotokolle durchgeführt wurden, ähnliche Ergebnisse für diese beiden Interventionen ergeben haben. Ergebnisse und Komplikationen zwischen M‑OP und O‑OP sind ebenfalls vergleichbar. In Anbetracht der Datenlage über die verschiedenen chirurgischen Verfahren bevorzugen die Autoren die M‑OP-Technik mit adäquater Protektion des N. suralis zur Reparatur einer akuten ASR, kombiniert mit einem Frühmobilisierungsprotokoll.

UNASSIGNED: To evaluate the stress distribution of calculated standardized force on maxillary and mandibular jaw bones with proclined maxillary anterior teeth with and without the use of a mouthguard.
UNASSIGNED: It\'s a finite element analysis (FEA) study. Maxillary and mandibular jaw models with and without mouthguard (4 mm) were created using a cone-beam computed tomography (CBCT) scan of a 13-year-old male patient with proclined maxillary anterior teeth. Calculated standardized forces were applied on the maxillary central incisors in the horizontal direction of the created model. The von Mises stresses (MPa) were analyzed on the maxillary and mandibular jaw.
UNASSIGNED: Higher von Mises stresses were analyzed in the maxillary and mandibular jaw model without a mouthguard compared to the model with a mouthguard. Forces were more evenly distributed in the maxillary and mandibular jaw models with a mouthguard.
UNASSIGNED: A mouthguard can be used to reduce and evenly distribute the stress on the maxillary and mandibular jaw with proclined maxillary anterior teeth when exposed to real-life situation forces.
UNASSIGNED: The force of injury is influenced by the size of the object or the velocity at which the athlete hits the object/individual. There is a need to evaluate the force at which the individual athlete hits the object/surface based on average height, weight, and velocity/performance at that particular age. As the age of the athlete\'s advances, there is a change in the height, weight as well as performance. This factor will influence the impact and severity of the trauma caused during sports activities. So, these parameters should be considered while designing the mouthguard for its better effectiveness.
UNASSIGNED: Doiphode AR, Kalaskar R. Stress Distribution Pattern of a Calculated Standardized Force on Maxillary and Mandibular Jaws with Proclined Maxillary Anterior Teeth with and without the Use of Mouthguard: A 3D Finite Element Analysis. Int J Clin Pediatr Dent 2024;17(S-1):S61-S66.

BACKGROUND: Anterior cruciate ligament (ACL) injuries are common, particularly among athletes, and often result in knee instability and decreased functionality. Arthroscopic ACL reconstruction is the standard treatment, typically using a patellar tendon bone graft (PTBG) or hamstring tendon graft (HTG). The central quadriceps tendon graft (QTG) has been proposed as a superior alternative due to its structural properties.
METHODS: This study involved patients undergoing ACL reconstruction using the central quadriceps tendon graft. Functional outcomes were assessed using the Tegner Lysholm knee score were assessed at preoperative and postoperative intervals of two weeks, three months, and six months. Statistical analysis compared these scores over time.
RESULTS: Among the subjects, 90.6% were male and 9.4% were female. Injuries primarily resulted from sports activities and road traffic accidents (46.9% each). Right-side injuries were more prevalent (65.6%). The mean time from injury to surgery was 9.37 months. The mean graft size was 8.75 mm, and the mean tourniquet time was 105.94 minutes. Preoperative tests showed positive results for anterior drawer, Lachman, and pivot shift tests in most patients, which were negative postoperatively. Significant improvements in knee flexion and Lysholm knee scores were observed. Preoperative knee flexion ranged from 0-100° to 0-120°, improving to 0-120° to 0-130° six months postoperatively. The mean Lysholm knee score improved from 47.06 preoperatively to 93.16 at six months. Excellent outcomes were seen in 78.1% of the patients, with 21.9% achieving good outcomes.
CONCLUSIONS: The central quadriceps tendon graft is an effective option for ACL reconstruction, offering excellent functional outcomes and low complication rates. It shows promise as a better alternative to traditional graft types, although further research is necessary to confirm these findings.

Muscle sonography is used in rheumatology, neurology, geriatrics, sports medicine and orthopedics. Muscular atrophy with fatty and connective tissue degeneration can be visualized and must be interpreted in conjunction with the sonographic findings of the supplying nerves. Sonography is becoming increasingly more important for the early diagnosis of sarcopenia in rheumatology, geriatrics and osteology. Even if its significance has not yet been conclusively clarified, many publications confirm the high reliability of the method. Sonography can ideally be used in addition to magnetic resonance imaging (MRI) in the diagnostics of myositis as it can speed up the diagnosis, muscle groups that were not imaged by MRI can also be assessed sonographically and all muscle groups can be examined during the course of the procedure. Sonography also helps to make a quick and uncomplicated diagnosis of many sports injuries in addition to MRI and is therefore the basis for a targeted therapeutic approach.
UNASSIGNED: Die Sonographie von Muskeln wird in der Rheumatologie, Neurologie, Geriatrie, Sportmedizin und Orthopädie genutzt. Muskelatrophien mit fettigen und bindegewebigen Degenerationen können dargestellt werden und müssen in Zusammenhang mit den Sonographiebefunden der versorgenden Nerven interpretiert werden. Für die frühe Diagnose einer Sarkopenie gewinnt die Sonographie in der Rheumatologie, Geriatrie und Osteologie immer mehr an Bedeutung. Auch wenn ihr Stellenwert noch nicht abschließend geklärt ist, so belegen viele Publikationen eine hohe Zuverlässigkeit der Methode. Die Sonographie kann in der Diagnostik von Myositiden idealerweise ergänzend zur Magnetresonanztomographie (MRT) eingesetzt werden, da dadurch die Diagnose möglicherweise beschleunigt wird, Muskelgruppen, die nicht in der MRT abgebildet wurden, zusätzlich sonographisch bewertet werden können und alle Muskelgruppen im Verlauf untersucht werden können. Auch bei vielen Sportverletzungen hilft die Sonographie, ergänzend zur MRT, die Diagnose schnell und unkompliziert zu stellen, und ist so die Basis für ein zielführendes therapeutisches Vorgehen.

The objective of this paper is to review how the mental and psychological well-being of the adolescent athlete population may be impacted by sports injuries, specifically the development of their personal identities. To answer this question, we conducted a narrative review using keywords such as \"adolescence,\" \"psychological,\" \"injury,\" and \"sport\" in the PubMed database. When conducting the research, we included sources from the past 15 years in order to gain a more present and accurate analysis of our question, and no countries were excluded from our population. Through our research, we identified risk factors that contribute to the rising psychological stress on adolescents. The return to sport was also found to be primarily affected by implied psychological illnesses such as self-confidence and identity, along with parental and coach guidance through the rehabilitation process. Despite the lack of research, scientists work to pursue additional psychological interventions to ensure the emotional well-being of adolescent athletes. Through this review, we aim to inform athletes, coaches, parents, and pediatricians about psychological issues that they may face as they continue to pursue their respective roles in sports. This study also paves a path for future research concerning potential interventions to prevent such psychological issues and ensure both physical and mental health for young athletes.

OBJECTIVE: To examine the nature and severity of badminton-related ocular injuries in Melbourne, Australia.
METHODS: This is a retrospective chart review. A search of the medical records was conducted for patients presenting to the ED at The Royal Victorian Eye and Ear Hospital, with badminton-related eye injuries from June 2018 to May 2023. Data were extracted, focusing on injury mechanism, patient demographics and treatment outcomes.
RESULTS: In total, 88 patients were included in the study, comprising 64 (73%) men and 24 (27%) women. The mean patient age was 36.13 years. The most common injury was hyphaema (73%), followed by commotio retinae (45%). One patient sustained a penetrating eye injury when a shuttlecock shattered the spectacles he was wearing during play. Medical intervention was required for 90% of patients. The most common interventions were steroid eye drops (80%) and cycloplegic eyedrops (76%). A total of six (7%) patients required surgical management. For those 69 patients followed up at The Royal Victorian Eye and Ear Hospital, 77% of patients had a final best-corrected visual acuity of 6/6 or greater.
CONCLUSIONS: Hyphaema, commotio retinae and traumatic uveitis were the most commonly diagnosed injuries. The majority of patients with badminton-related eye injuries required medical treatment, and some necessitated surgical intervention. To mitigate these risks, there is a pressing need to develop an eye safety policy for Australian badminton players, and players should exercise caution when wearing spectacles during play to prevent potential penetrating eye injuries.

We aimed to investigate whether there is clinical and MRI evidence of healing of lateral ligaments 6 weeks after acute lateral ankle sprain (LAS). We prospectively enrolled 18 participants (age 32.7 ± 7.5 years) who sustained an acute LAS and underwent conservative treatment. An ankle MRI was acquired up to 48 hours and 6 weeks following the LAS. A partial tear of the anterior talofibular ligament (ATFL) was observed in 10/18 and a complete tear in 8/18 of the patients. The calcaneofibular ligament (CFL) was partially torn in 11/18 and completely torn in 1/18 of the patients. The healing status, intensity, and thickness of the ligaments, Anterior Drawer Test (ADT), and FAOS scale were assessed. A control group (CG) was composed by 17 participants (age 40 ± 13.9 years). Six weeks after the LAS, 89% of the participants presented MRI evidence of ATFL healing. The repaired ATFL was thicker in comparison with the CG (p < .001). The cut-off of 2.5 mm for ATFL thickness in the 6th week maximized sensitivity (62.5%) and specificity (100%). CFL and PTFL presented 94% and 100% of healing signs, respectively. In the 6th week, 11/18 (61%) participants showed mild residual instability and a mean FAOS of 80 ± 11. The MRI revealed signs of the repair process in 89% of ATFL and 94% of CFL tears, 6 weeks after a moderate or severe LAS. The MRI findings were concomitant with enhancements in mechanical ankle stability and function.

Heel pain is a prevalent issue in young athletes, often arising from overuse and increased sporting demands. While Sever\'s Disease is the predominant cause, various other entities, including stress-related injuries and pathologies like tumors and bone lesions, contribute to this condition. The complex hind foot anatomy, encompassing ossicles, physis, and soft tissues, may lead to heel pain. This study aims to provide physicians with a clinically oriented narrative review of adolescent heel pain, supported by illustrative cases. CONCLUSION: This study aims to offer physicians a comprehensive understanding of the concepts surrounding heel pain in adolescents. By presenting clinically relevant information and illustrated cases, it seeks to enhance medical practitioners\' ability to diagnose and manage heel pain effectively in this specific demographic.

BACKGROUND: Ankle sprains are the second most common sports injury after knee injuries, with about 85% of them affecting the lateral ankle ligaments. These injuries are particularly prevalent in sports like basketball and volleyball.
OBJECTIVE: To investigate the effect of Aquatic therapy as an early rehabilitation protocol for elite athletes with acute lateral ankle sprain grade III on back-to-sport time, dynamic balance, pain, Athletic performance, and muscle power compared to land-based exercise training.
METHODS: Thirty elite athletes have ankle sprain grade III with sprain onset from 1 to 7 days, their age ranges from 18-30 years old were recruited. All participants are professional athletes; mainly participating in above-head sports such as volleyball and basketball. The patients were randomly allocated into two treatment groups: Group I (control group): 15 patients received a conventional physical therapy program of structured therapeutic exercise program, manual therapy and land-based exercises, in addition to external support, and Group II (Aquatic therapy group): 15 patients received aquatic training. Visual Analog Scale (VAS) was used to measure the pain intensity, while the dynamic balance was measured by the Star Excursion Balance Test. Athletic performance was measured by HOP Tests (Single, Triple, 6-m, and Cross-over hops) aided by the Agility T-Test (ATT) and Illinois Agility Test (IAT). Muscle power was tested by a Single Leg Press. Finally, back to sports time was recorded for each participant in both groups.
RESULTS: There was a significant interaction effect of Aquatic therapy and time for VAS (p < 0.001), single hop (p < 0.001), triple hop (p < 0.001), cross-over hop (p < 0.001), IAT (p = 0.019) and ATT (p < 0.001) of both affected and nonaffected. There was no significant interaction effect of Aquatic therapy and time for 6-MHT of affected (p = 0.923), and nonaffected (p = 0.140). There was a significant main effect of time for all dependent variables (p < 0.001) except for 6-MHT of affected (p = 0.939), nonaffected (p = 0.109), and IAT (p = 0.099). The Star excursion dynamic balance test (SEBT) and Single leg press revealed a significant difference between groups on affected and non-affected sides (p < 0.001*). Lastly and most importantly the back-to-sport time revealed a significant difference in the return-to-sport time in favor of the Aquatic therapy group who returned faster than the control group (p < 0.001*).
CONCLUSIONS: Aquatic therapy is more effective than traditional protocols regarding early rehabilitation of acute ankle sprain grade III in Elite professional athletes for reducing pain intensity, improving dynamic balance and athletic performance and power and accelerating their return to sports time. Because aquatic therapy produces better outcomes, it is advised to be included in the rehabilitation programs of athletic patients with acute ankle sprains grade III.