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Background: A treatment algorithm and screening examination have been developed to guide patient management and prospectively determine potential for highly active individuals to succeed with nonoperative care after anterior cruciate ligament rupture.

Objective: To prospectively characterize and classify the entire population of highly active individuals over a 10-year period and provide final outcomes for individuals who elected nonoperative care.

Methods: Inclusion criteria included presentation within 7 months of the index injury and an International Knee Documentation Committee level I or II activity level before injury. Concomitant injury, unresolved impairments, and a screening examination were used as criteria to guide management and classify individuals as noncopers (poor potential) or potential copers (good potential) for nonoperative care.

Results: A total of 832 highly active patients with subacute anterior cruciate ligament tears were seen over the 10-year period; 315 had concomitant injuries, 87 had unresolved impairments, and 85 did not participate in the classification algorithm. The remaining 345 patients (216 men, 129 women) participated in the screening examination a mean of 6 weeks after the index injury. There were 199 subjects classified as noncopers and 146 as potential copers. Sixty-three of 88 potential copers successfully returned to preinjury activities without surgery, with 25 of these patients not undergoing anterior cruciate ligament reconstruction at the time of follow-up.

Conclusion: The classification algorithm is an effective tool for prospectively identifying individuals early after anterior cruciate ligament injury who want to pursue nonoperative care or must delay surgical intervention and have good potential to do so.



NAVIGATION


         

 

Background:

Skimboarding is a beachside water sport that is enjoying increasing popularity among both dedicated enthusiasts and casual beachgoers. Although many consider this sport to be similar to its “sister” sport, surfing, the technique, the environment in which it is performed, and the skills required differ dramatically from that of surfing. Moreover, the pattern of injuries seen in skimboarders differs substantially from those sustained while surfing.


Hypothesis:

A better understanding of the injuries encountered in this sport will allow improved participant education and facilitate the implementation of preventative measures.


Study Design:

Descriptive epidemiology study.


Methods:

A case series was generated by performing a single retrospective chart review of skimboarding injuries referred for orthopaedic evaluation over a 2-year period at 2 medical treatment facilities, one on the East Coast and one on the West Coast of the United States; demographic data, injury type, and treatments rendered were documented.


Results:

Sixty-one patients were identified and analyzed. Average patient age was 19.1 years. Fractures represented 93.4% of all acute injuries. The most common sites of injury were the ankle (41%) and wrist (36%). Rotation about a planted lower extremity was the most common mechanism of injury (30/61, 49%), followed by falls onto an outstretched hand (26/61, 43%).


Conclusion:

Fractures of the ankle and wrist comprise a high proportion of skimboarding injuries. Knowledge of potential hazards associated with this sport should be made available to participants. To decrease the risk of orthopaedic injury, the use of protective equipment or instruction in proper techniques of the activity may be warranted.




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