oxford american handbook of sports medicine apr 2010

About the Oxford American Handbooks in Medicine The Oxford American Handbooks are fl exi-covered pocket clinical books, providing practical guidance in quick reference, note form.. Oxfor

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About the Oxford American Handbooks in Medicine

The Oxford American Handbooks are fl exi-covered pocket clinical books, providing practical guidance in quick reference, note form Titles cover major medical specialties or cross-specialty topics and are aimed at stu-dents, residents, internists, family physicians, and practicing physicians within specifi c disciplines

Their reputation is built on including the best clinical information, plemented by hints, tips, and advice from the authors Each one is carefully reviewed by senior subject experts, residents, and students to ensure that content refl ects the reality of day-to-day medical practice

com-Key series features

Written in short chunks, each topic is covered in a two-page spread

•

to enable readers to fi nd information quickly They are also perfect for test preparation and gaining a quick overview of a subject without scanning through unnecessary pages

Content is evidence based and complemented by the expertise and

•

judgment of experienced authors

The Handbooks provide a humanistic approach to medicine—it’s more

•

than just treatment by numbers

A “friend in your pocket,” the Handbooks offer honest, reliable

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Oxford American Handbook of Sports Medicine

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Oxford American Handbook of Clinical Medicine

Oxford American Handbook of Anesthesiology

Oxford American Handbook of Clinical Dentistry

Oxford American Handbook of Clinical Diagnosis

Oxford American Handbook of Clinical Pharmacy

Oxford American Handbook of Critical Care

Oxford American Handbook of Emergency Medicine

Oxford American Handbook of Geriatric Medicine

Oxford American Handbook of Nephrology and HypertensionOxford American Handbook of Obstetrics and GynecologyOxford American Handbook of Oncology

Oxford American Handbook of Otolaryngology

Oxford American Handbook of Pediatrics

Oxford American Handbook of Physical Medicine and RehabilitationOxford American Handbook of Psychiatry

Oxford American Handbook of Pulmonary Medicine

Oxford American Handbook of Rheumatology

Oxford American Handbook of Surgery

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Oxford American Handbook of

Sports

Medicine

Edited by

Jeffrey R Bytomski

Head Medical Team Physician

Associate Professor and Director

Primary Care Sports Medicine FellowshipDuke University Medical Center

Durham, North Carolina

Claude T Moorman, III

Associate Professor

Head Team Physician and DirectorDuke Sports Medicine

Duke University Medical Center

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Oxford University Press, Inc publishes works that further

Oxford University’s objective of excellence

in research, scholarship and education

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Published by Oxford University Press Inc

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Oxford is a registered trade mark of Oxford University Press

First published 2010

stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise,

without the prior permission of Oxford University Press,

Library of Congress Cataloging-in-Publication Data

Oxford American handbook of sports medicine / edited by Jeffrey R Bytomski, Claude T Moorman with Domhnall MacAuley.

p ; cm — (Oxford American handbooks)

Adapted from: Oxford handbook of sport and exercise medicine / edited by Domhnall MacAuley 2007.

Includes bibliographical references and index.

ISBN 978–0–19–537219–9

1 Sports medicine—Handbooks, manuals, etc I Bytomski, Jeffrey R II Moorman, Claude T III MacAuley, Domhnall IV Title: Handbook of sports medicine

V Series: Oxford American handbooks [DNLM: 1 Sports Medicine—Handbooks

2 Athletic Injuries—Handbooks QT 29 O97 2010]

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This material is not intended to be, and should not be considered,

a substitute for medical or other professional advice Treatment for

the conditions described in this material is highly dependent on the vidual circumstances And, while this material is designed to offer accurate information with respect to the subject matter covered and to be current

indi-as of the time it windi-as written, research and knowledge about medical and health issues is constantly evolving and dose schedules for medications are being revised continua lly, with new side effects recognized and accounted for regularly Readers must therefore always check the product informa-tion and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulation Oxford University Press and the authors make no representations or warranties to readers, express

or implied, as to the accuracy or completeness of this material, including without limitation that they make no representation or warranties as to the accuracy or effi cacy of the drug dosages mentioned in the material The authors and the publishers do not accept, and expressly disclaim, any responsibility for any liability, loss or risk that may be claimed or incurred

as a consequence of the use and/or application of any of the contents of this material

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a safe return to sports while aggressively treating the problem in the least amount of time With extensive media coverage of elite athletes, every athlete from children to the average “weekend warrior” expect the same level of care given to their sports elite fi gures The sports medicine team is stretched on a daily basis to provide cutting-edge care while maintaining a full schedule.The purpose of this Handbook is to have a reliable source readily available

to those who are on the frontlines of sports medicine care It is meant to be

a reference as care providers travel from the offi ce, to the training room, to the sideline, and around the world Our aim for this text is to bridge the gap between comprehensive knowledge and quick access at the point of care by multiple levels of providers This book is adapted from the original British version and has the advantage of knowledge collected from many experts around the globe We have provided some practical chapters on procedures and radiology as well as exposure to many of the techniques used in the evolving world of sports psychology The scope of the text ranges from discussion of event coverage and preparticipation exams to both acute and chronic treatment of common medical and orthopedic problems in athletes

We hope you gain the knowledge and insight needed to take care of your athletes at the highest level, wherever your travels take you

Acknowledgments

This Handbook has only come together through the time, effort, and

sacri-fi ce of many individuals, not unlike the sports medicine team caring for its athletes at the highest level The authors did a wonderful job of reviewing the previous text while updating and molding the new chapters to their current version The clinical experience and knowledge of Dr Moorman was without equal in assuring a quality text in the orthopedic chapters Also, Andrea Seils at Oxford University Press has been instrumental in making this publication a high-quality Handbook I would also like to thank all of the families of the contributors for their sacrifi ce in allowing the contributors to take time away from their schedules to make this a fi ne Handbook

And fi nally, I would like to thank Shanda, Jarek, Trevor, and Alexandra for their patience and sacrifi ce as I spent time away from them in preparing the Handbook you have in front of you

Jeffrey R Bytomski

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Symbols and abbreviations xxxi

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Advanced cardiac life support 10

Automated external defi brillators 16

Major emergencies in sport 18

The unconscious athlete 19

Sports injury in children 50

Traumatic brain injury (TBI) 54

Glasgow Coma Scale (GCS) 55

Management of traumatic brain injury 56

Traumatic intracerebral hematomas and

contusion 59

Subdural hematoma 60

Epidural hematoma 61

Traumatic subarachnoid hemorrhage 62

Diffuse cerebral swelling 63

Head injury advice card 64

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Sports concussion 66

Acute concussion management 68

The SCAT2 (Sport Concussion Assessment

Headaches and sport 84

Epilepsy and sports 88

Fractures 90

Eye injuries 91

Boxing and head injury 92

Paradoxical vocal cord motion (PVCM) or

vocal cord dysfunction (VCD) 94

Acute traumatic causes 114

Nonoperative management of shoulder

dislocation 117

Rehabilitation 118

Acromioclavicular joint sprains and

dislocations 120

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xiiiDETAILED CONTENTS

Sternoclavicular joint sprains and

dislocations 121

Glenoid labrum tears 122

Biceps tendon rupture 124

Fractures of the shoulder 125

Chronic overuse disorders 126

Medial epicondylosis (golfer’s elbow) 143

Medial epicondylar apophysitis 144

Ulnar collateral ligament injury 145

Osteochondritis dissecans and

osteochondrosis 146

Lateral epicondylosis (tennis elbow) 148

Posterolateral rotatory instability 150

Acute injuries 152

Chronic elbow injuries 156

Epidemiology 164

Wrist biomechanics 166

Fracture of the distal radius 168

Fracture of the scaphoid 170

Fracture of the hamate 172

Fracture of the pisiform 173

Fracture of the fi fth metacarpal neck (boxer’s

fracture) 174

Fracture–dislocation of the fi rst metacarpal base

(Bennett’s or Rolando’s fracture) 176

Phalangeal shaft fractures 177

Dislocation of the carpal bones 178

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Dislocation of the metacarpophalangeal (MCP)

Sagittal band rupture (boxer’s knuckle) 185

Ulnar collateral ligament injuries of the thumb

MCP joint (skier’s thumb) 186

Other collateral ligament injuries 188

Carpal tunnel syndrome 189

Ulnar nerve compression 190

Other nerve injury syndromes 190

De Quervain’s tenosynovitis 191

Other tendinopathies 192

Ganglion 193

Impaction syndromes 193

Radial epiphysitis (gymnast’s wrist) 194

Triangular fi brocartilage complex (TFCC)

Acute spinal injury 211

Acute injuries of the back in sports 212

Management of musculoligamentous injuries

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xvDETAILED CONTENTS

Examination of the hip 226

Special tests 232

Femur: acute injury 233

Growth plate injury 234

Femoral neck stress fracture 236

Trochanteric bursitis 238

Iliotibial band friction syndrome 239

Thigh contusion 240

Myositis ossifi cans 242

Osteoarthritis (OA) of the hip 244

Obturator nerve entrapment 261

Dislocation and subluxation of the hip joint 262

Femoroacetabular impingement (FAI) 263

Stress fractures of the pubic rami 264

Calcifi c tendinopathy of the hip 264

Acetabular labral tears 265

Ischial (ischiogluteal) bursitis 265

Sacroiliac joint (SIJ) disorders 266

Diagnosis of knee injuries 281

Medial collateral ligament (MCL) 282

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Rehabilitation after medial collateral ligament

sprain 284

Lateral collateral ligament (LCL) 289

Anterior cruciate ligament (ACL) 290

Posterior cruciate ligament (PCL) 292

Meniscal injuries 293

Articular cartilage injury 294

Anterior knee pain 295

Juvenile osteochondritis dissecans 303

Bipartite patella and patellofemoral pain

syndrome 304

Discoid lateral meniscus 305

Examination of the ankle 308

Special tests 311

Functional tests 311

Persistent painful ankle 312

Acute ankle sprain 314

Rehabilitation after ankle sprain (grade 2) 316 Medial ligament injuries 318

Syndesmosis sprain 318

Fractures 318

Lateral ankle pain 320

Medial ankle pain 322

Anterior ankle pain 324

Posterior ankle pain 325

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xviiDETAILED CONTENTS

Shin splints 326

Achilles tendinopathy 328

Achilles tendon rupture 329

Retrocalcaneal bursitis 330

Chronic exertional leg pain 330

Anterior compartment syndrome 331

Posterior compartment syndrome 332

Popliteal artery entrapment 333

Fracture of the calcaneus 336

Fracture of the metatarsal bones 337

Lisfranc fracture: dislocations 338

Fat pad contusion 338

Midtarsal joint sprains 339

Stress fractures of the calcaneus 348

Stress fractures of the navicular 349

Stress fractures of the metatarsals 350

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Sever’s disease (traction apophysitis

Ingrown toenails (onychocryptosis) 361

Physiology in exercise

What happens when we exercise? 364

Basic principles of training 365

Fitness deterioration with aging 366

Overtraining syndrome 368

Pulmonary issues

Exercise-induced bronchospasm 370

Hematology

Iron defi ciency anemia 376

Sickle cell anemia 378

Food and exercise 386

Recovery after exercise 390

Environmental concerns

Exercise and the environment 392

Exercise at altitude 400

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xixDETAILED CONTENTS

Preparticipation screening 406

Sudden cardiac death in athletes 408

Cardiovascular abnormalities in the setting of

athletic participation 410

Hypertrophic cardiomyopathy 413

Other congenital defects 414

Congenital coronary artery anomalies 417

Coronary artery anomalies 433

Coronary artery disease 434

Commotio cordis 435

The athlete’s heart 435

Evaluation of the symptomatic athlete 436

Classifi cation of sports 437

Automated external defi brillators 438

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Diarrhea (“runner’s trots”) 447

Gastroesophageal refl ux disease (GERD, or

Effects of exercise on immunity 458

Why are athletes prone to infection? 459

Upper respiratory infections (URIs) 460

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xxiDETAILED CONTENTS

Problems related to skin trauma 494

Problems related to environmental

exposure 498

Fungal infections 502

Bacterial infections 506

Viral infections 510

Common causes of dermatitis 514

Description of terms in dermatology 516

Gender and performance 520

Manipulation of the menstrual cycle 532

Female athlete triad 534

Pregnancy and exercise 536

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Dietary ergogenic aids 554

Wrist and hand 630

Head and spine 636

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xxiiiDETAILED CONTENTS

Emotional control and sports performance 658

Anxiety, arousal, and stress and sports

performance 660

Self-confi dence and sports performance 662

Commitment and sports performance 664

Attentional focus and sports performance 666

Injury and sports 668

Team physician defi nition 672

The qualifi cations of a team physician 673

The medical kit 674

Basic medical equipment 676

Essential drugs and medications 678

Security and insurance issues 680

The return home 699

Professional and ethical considerations 700

Organizing a major sporting event 702

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xxvDETAILED CONTENTS

Auricular hematoma aspiration/incision

(“caulifl ower ear”) 756

Abscess incision and drainage 760

Ingrown toenail removal 762

Subungal hematoma drainage 765

Epistaxis control 766

Tooth avulsion management 767

Common joint reductions 768

Casting, splinting, and taping 770

Offi ce spirometry 774

Treadmill testing 778

Index 783

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List of color plates

Plate 1 Severe infl ammatory acne on the upper back

Plate 2 Condyloma acuminata, also known as genital warts, in an otherwise healthy individual

Plate 3 Characteristic domed, pearly papules in molluscum contagiosum.Plate 4 Punched-out ulcerations on an erythematous base in

herpes simplex virus 2 (HSV-2) infection

Plate 5 Positive Tzanck prep Notice the multinucleated giant cells.Plate 6 Varicella zoster virus (VZV) infection, commonly known

as chickenpox

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Contributors

Kenton L Anderson, MD

Resident Physician

Division of Emergency Medicine

David Berkoff, MD

Assistant Professor of Surgery

Division of Emergency Medicine

Blake Boggess, DO

Assistant Professor

Department of Family Medicine

Division of Sports Medicine

Jeffrey R Bytomski, DO

Head Medical Team Physician

Associate Clinical Professor and

Director

Primary Care Sports Medicine

Fellowship

Albert Cook, MD

Sports Medicine Fellow

Stephanie Diamantis, MD

ResidentDepartment of DermatologyUniversity of North Carolina at Chapel Hill

Chapel Hill, North Carolina

Mark Easley, MD

Assistant ProfessorDepartment of SurgeryDivision of Orthopedic SurgeryDuke University Medical CenterDurham, North Carolina

Brett Fritsch, MD

Sports Medicine FellowDuke University Medical CenterDurham, North Carolina

William Garrett, MD, PhD

Professor, Department of SurgeryDivision of Orthopedic SurgeryDuke University Medical CenterDurham, North Carolina

John Hedge, DO

Primary Care Sports MedicinePiedmont Family Practice

at Tega CayFort Mill, South Carolina

Luke Hoagland, MD

Resident PhysicianDepartment of RadiologyHarvard UniversityBoston, Massachusetts

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Stacy Kennedy, MD

Rheumatology Fellow

Kevin Krasinski, MD

Duke Sports Medicine

Joe T Minchew, MD

Orthopedic Spine Surgery

North Carolina Orthopedic

Associates

Claude T Moorman, III, MD

Associate Professor

Head Team Physician

and Director

Kerry Mullenix, PT, LAT, ATC

Physical Therapist

Sports Medicine

Gregg Nicandri, MD

Nicholas Potter, DPT, ATC,

LAT

Physical Therapist

Airron Richardson, MD

Clinical AssociateDepartment of SurgeryDivision of Emergency MedicineDuke University Medical CenterDurham, North Carolina

Craig Rineer, MD

Hand FellowDivision of Orthopedic SurgeryDuke University Medical CenterDurham, North Carolina

Jamie Robbins, PhD

Associate ProfessorDepartment of Human Performance and Sport SciencesWinston-Salem State UniversityWinston-Salem, North Carolina

Jeffrey Roberts, MD

Clinical AssociateDepartment of Family MedicineDuke University Medical CenterDurham, North Carolina

David Ruch, MD

Professor, Department

of SurgeryDivision of Orthopedic SurgeryDuke University Medical CenterDurham, North Carolina

Michael Sampson, DO

Associate Professor, Family Medicine/Sports MedicineDirector, Primary Care Skills/Family Medicine ClerkshipPhiladelphia College of Osteopathic MedicineSuwanee, Georgia

Deborah Squire, MD

Assistant ProfessorDepartment of PediatricsDuke University Medical CenterDurham, North Carolina

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Harry Stafford, MD

Clinical Associate

Department of Family Medicine

John Sundy, MD, PhD

Associate Professor

Department of Medicine

Division of Pulmonary Medicine

Paul Tawney, MD

Assistant Professor

Department of Surgery

Division of Orthopedic Surgery

Dean Taylor, MD

Professor, Department of SurgeryDivision of Orthopedic SurgeryDuke University Medical CenterDurham, North Carolina

Alison Toth, MD

Assistant ProfessorDepartment of SurgeryDivision of Orthopedic SurgeryDuke University Medical CenterDurham, North Carolina

Priscilla Tu, DO

Sports Medicine FellowDuke Sports MedicineDurham, North Carolina

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ACOG American College of Obstetricians and Gynecologists

ADLs activities of daily living

AED automated external defi brillator

AITFL anteroinferior tibiofi bular ligament

AS ankylosing spondylitis; aortic stenosis

ASIS anterior superior iliac crest

ATFL anterior talofi bular ligament

AVPU alert, verbal, pain, unresponsive

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BP blood pressure

CAQ certifi cate of added qualifi cation

ECG electrocardiogram

ECRB extensor carpi radialis brevis

ECRL extensor carpi radialis longus

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xxxiiiSYMBOLS AND ABBREVIATIONS

EMG electromyography

EPO erythropoetin

GFR glomerular fi ltration rate

IBD infl ammatory bowel disease

ICD implantable cardioverter defi brillator

IGF-1 insulin-like growth factor 1

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IM intramuscular

ITBFS iliotibial band friction syndrome

MJ megajoules

MRSA methicillin-resistant Staphylococcus aureus

NATA National Athletic Trainers’ AssociationNCAA National Collegiate Athletic AssociationNSAIDs nonsteroidal anti-infl ammatory drugs

PaO2 partial pressure of arterial oxygen

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xxxvSYMBOLS AND ABBREVIATIONS

PEA pulseless electrical activity

PLRI posterolateral rotary instability

PRICE protect, rest, ice, compression, elevation

PSIS posterior superior iliac crest

PTFL posterior talofi bular ligament

SARA sexually acquired reactive arthritis

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SCD sudden cardiac death

SSRI selective serotonin reuptake inhibitor

TENS transcutaneous electrical nerve stimulationTFCC triangular fi brocartilage complex

ULCL ulnar lateral collateral ligament

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Acute care and

sports injury

Sports fi rst aid 2

Basic life support 4

Resuscitation of children 8

Advanced cardiac life support 10

Automated external defi brillators 16

Major emergencies in sport 18

The unconscious athlete 19

Choking 20

Management of shock and bleeding 22

Injury management 24

General management plan for acute sports injuries 26

Management of acute soft tissue injury 28

Care of wounds 32

Nonsteroidal anti-infl ammatory drugs (NSAIDs) 36

Strains and sprains 40

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Tiêu đề	Oxford American Handbook of Sports Medicine
Trường học	Oxford University
Chuyên ngành	Sports Medicine
Thể loại	handbook
Năm xuất bản	2010