Football Traumatology (eBook)

Foreword 5
Preface 7
Contents 9
Contributors 13
Section I Generel Concepts 21
Epidemiology and Risk Factor 22
Aspects of Biomechanics 30
Training Methods 42
Evaluation of Whole Physical Condition 52
Biochemical and Haematological Parameters in Football Players 62
Prevention of Football Injuries 72
Organisation of a Professional Team’s Medical Staff and the Physician’s Role 86
Injuries in Women’s Football 94
Referee Lesions 108
Future Treatments for Football Injuries 120
Section II Secific Injuries 130
Maxillo-Facial Traumatology 132
Upper Extremity Injuries 142
Shoulder Dislocation 146
Back Problems 162
Muscle Strains 172
Tendon Injuries 184
Groin Pain 202
Meniscal Lesions 216
Anterior Cruciate Ligament Injuries 224
Anteromedial Knee Instability 236
Medial-Side Injury of the Knee 250
Posterior Cruciate Ligament Injuries 264
Articular Cartilage Lesions in Football Players 274
Patellofemoral Problems 282
Footballer’s Arthritic Knee 294
Leg Fractures 306
Malleolar Fractures 316
Ankle Ligaments Injuries 326
Osteochondral Ankle Defects 338
Chronic Footballer’s Ankle 352
Foot Problems 372
Stress Fractures 384
Rehabilitation after Football Injuries 394
Return to Play 408
Protective Equipment 420
Subject Index 436

Shoulder Dislocation (P. 127)

RAUL ZINI

Introduction

The game of football presents a multiple variety of traumas that, due to the characteristics of the game itself, commonly concern the lower limbs and to a lesser extent the upper limbs.Volpi [1] reported various case studies that published very high percentages of traumas to the lower limbs with respect to the upper limbs in professional football players [2.5].

More recently,Morgan and Oberlander [6] reported 77%, and an epidemiological study by the Committee on Sports Medicine and Fitness of the American Academy of Paediatrics [7] confirmed percentage values of lower-limb injuries between 61% and 80% in comparison to 2.3.7.7% for upper limbs. Within this percentage, those involving the shoulder were between 1.8% and 2.6%. Another epidemiological study carried out on 50 Asian football matches by Yoon et al. [8] reported 5.4% of shoulder injuries.

Junge et al. [9] examined the main football injury cases in the 4-year period from 1998 to 2001 reporting shoulder injuries between 2% and 13%. Therefore, the shoulder is not frequently injured in football even though recently published documentation shows an increase in the trend, above all for the most traumatic injuries, such as fractures and dislocations.

In fact, the evolution of the game of football in recent years with a notable increase in speed, choice of tactical solutions such as pressing and marking, and the everincreasing recourse to tactical fouls, augmented the number of legal and illegal physical contacts, with a subsequent increase in trauma caused by falling on the ground.

Shoulder dislocation is one of the most frequent possibilities in the field of pathological trauma in the upper limbs of football players and, certainly, in light of the most recent suggestions in the literature, offers inspiration for a plethora of debates on prognosis and treatment.

Pathogenesis and Clinical Aspects

Gleno-humeral dislocation occurs when the upper part of the humerus is forced past its normally permitted limits, following traumas of varying extents and characteristics, the humeral head can be pushed against the acromion edge, which works as a fulcrum, and if the bone does not break, causes the dislocation of the humeral epiphysis from the joint cavity. There are five varieties of scapular-humeral dislocations: subglenoid, subcoracoid, subclavicular, subspinatus, or posterior, erected.

The most common are the anterior subcoracoid dislocations, which will be the focus of attention here. Trauma mechanisms that most frequently determine a gleno-humeral dislocation in footballers are due to a double strain of abduction and external rotation, which act violently on the humerus.

On occasion, it can be a mechanism of extreme retropositioning with the arm abducted or simply, in more violent traumas, only extreme abduction, in other cases, not uncommon, the trauma is purely indirect due to a fall on the palm of the hand or the elbow of an abducted arm with the resulting force along the diaphysis of the humerus.