scholarly journals REASSESSMENT OF PAINFUL SHOULDERS AMONG BASEBALL PLAYERS AFTER CONSERVATIVE TREATMENT

2012 ◽  
Vol 47 (2) ◽  
pp. 228-234
Author(s):  
Alberto Naoki Miyazaki ◽  
Marcelo Fregoneze ◽  
Pedro Doneux Santos ◽  
Luciana Andrade da Silva ◽  
Guilherme do Val Sella ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Baseball Players

scholarly journals Outcome of Asymptomatic Osteochondritis Dissecans of the Capitellum in Adolescent Baseball Players

2017 ◽  
Vol 5 (3_suppl3) ◽  
pp. 2325967117S0012
Author(s):  
Tetsuya Matsuura ◽  
Toshiyuki Iwame ◽  
Naoto Suzue ◽  
Koichi Sairyo
Keyword(s):  
Conservative Treatment ◽  
Osteochondritis Dissecans ◽  
Early Stage ◽  
Stage I ◽  
Stage Ii ◽  
Radiological Outcome ◽  
Loose Bodies ◽  
Baseball Players ◽  
Complete Repair

Objectives: Osteochondritis dissecans (OCD) of the capitellum is a well-recognized cause of elbow pain and disability in adolescent baseball players. OCD is classified into three different stages based on AP radiographs of the elbow in 45°flexion. Stage I was characterized by radiolucent areas. In stage II, nondisplaced fragments were present. Loose bodies and sclerotic change indicated stage III. Matsuura et al performed the conservative treatment on 101 patients with stage I or II lesions. Conservative treatment consisted of discontinuation of heavy use of the elbow for at least 6 months. Of 101 patients, 84 were diagnosed as stage I, with a mean age of 11.3 years and 17 were in stage II, with a mean age of 13.9 years. Of the 84 patients in stage I, healing was observed in 90.5%. In stage II, the incidence of healing decreased to 52.9%. Mean period required for healing was 14.9 months in stage I and 12.3 months in stage II. These results suggest that conservative treatment is recommended for the early stage lesions. However, little is known about the outcome of conservative treatment for asymptomatic OCD patients. The purpose of this study was to investigate 2year follow-up outcome of asymptomatic OCD in adolescent baseball players. Methods: We retrospectively reviewed 33 baseball players aged 9-12 years (mean, 11.3 years) with asymptomatic OCD. There were 23 stage I lesions and 10 stage II lesions. We recommended the conservative treatment including stop throwing to all the players. Sixteen players (48.5%) agreed to our advice. The remaining 17 players did not follow the authors’ advice. Twelve players (36.4%) changed position or throwing side and 5 players (15.1%) did not change throwing level. Two years later, subjects were evaluated clinically and radiographically. Radiological outcome was divided into 3 types, complete repair, incomplete repair, and failure. Results: Stop throwing produced complete repair in 93.7%, incomplete repair in 6.3%, and none of the failure. Changing position or throwing side produced complete repair in 41.7%, incomplete repair in 25%, and failure in 33.3%. Not changing throwing level produced complete repair in 20%, none of incomplete repair, and failure in 80% ( Table 1 ). Players with complete or incomplete repair had not any symptom at the follow-up. On the other hand, all the players with failure had symptom such as pain and/or catching. Six of 8 players (75%) with symptom needed operation. [Table: see text] Conclusion: Even in the asymptomatic early stage OCD, it is desirable to stop throwing until the healing is observed.

scholarly journals Return to Play Following Nonoperative Treatment of Partial Ulnar Collateral Ligament Injuries in Professional Baseball Players: A Critically Appraised Topic

2019 ◽  
Vol 28 (6) ◽  
pp. 660-664
Author(s):  
Nicole Cascia ◽  
Tim L. Uhl ◽  
Carolyn M. Hettrich
Keyword(s):  
Conservative Treatment ◽  
Conservative Management ◽  
Ulnar Collateral Ligament ◽  
Nonoperative Treatment ◽  
Return To Play ◽  
Current Evidence ◽  
Professional Baseball ◽  
Inclusion Criteria ◽  
Collateral Ligament ◽  
Baseball Players

Clinical Scenario: Ulnar collateral ligament (UCL) injuries are highly prevalent in professional baseball players with the success of operative management being well known in the literature. Return to play (RTP) rates following nonoperative management of partial UCL injuries in professional baseball players are not well established in the literature. With a UCL tear being a potential career-ending injury, it is imperative that the best treatment option is provided to these throwing athletes. There is an increase in the incidence of UCL surgical rates and a lack of general agreement on nonoperative treatment of partial UCL injuries as reported by the American Shoulder and Elbow Surgeons in 2017. There is also a lack of clarity on when to initiate rehabilitation, which may be due to the limited amount of studies reporting success of RTP rates and time to RTP following conservative interventions of partial UCL injuries. Evidence on the RTP rates seen following conservative management of partial UCL tears injuries can help guide health care providers in deciding on the best treatment option for professional baseball athletes who desire to return to their athletic careers. These rates of RTP will add valuable objective input when determining if conservative management is the best choice. To determine the current evidence, inclusion criteria for the literature search consisted of RTP rates following conservative treatment in professional baseball players between inception and 2018. Clinical Question: Is there evidence for successful RTP rates in professional baseball players following conservative treatment of a UCL injury? Summary of Key Findings: Three retrospective studies met the inclusion criteria and were included. Of those, 2 reported RTP rates following a nonoperative rehabilitation program of a UCL injury, whereas 1 reported RTP rates after injection therapy in subjects who attempted a trial of conservative treatment. All 3 studies considered location and grade of UCL tear. Successful RTP rates (66%–100%) were reported in professional baseball players following nonoperative treatment of partial UCL injuries. Clinical Bottom Line: Current evidence supports high success with RTP rates up to 100% after nonoperative treatment of grade 1 UCL injuries in professional baseball players and between 66% and 94% for a grade 2 and above. Strength of Recommendation: There is level C evidence for high RTP rates following nonoperative treatment of partial UCL injuries in professional baseball players.

Very distal vein bypass in patients with thromboangiitis obliterans

VASA ◽  
2017 ◽  
Vol 46 (4) ◽  
pp. 304-309 ◽  
Author(s):  
Achim Neufang ◽  
Carolina Vargas-Gomez ◽  
Patrick Ewald ◽  
Nicolaos Vitolianos ◽  
Tolga Coskun ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Vein Graft ◽  
Duplex Ultrasound ◽  
Critical Limb Ischaemia ◽  
Thromboangiitis Obliterans ◽  
Surgical Revascularization ◽  
Autologous Vein ◽  
Therapeutic Concept ◽  
Autologous Vein Graft ◽  
Vein Bypass

Abstract. Background: Surgical revascularization for chronic critical limb ischaemia in patients with thromboangiitis obliterans (TAO) still remains controversial. Generally, besides cessation of smoking, conservative treatment supported by intravenous administration of vasoactive agents is regarded as the treatment of choice, in combination with local wound therapy or minor amputation. Patients and methods: In four male patients (42-47 years) surgical revascularization was chosen as therapy for established gangrene or non-healing ulceration after unsuccessful conservative treatment and cessation of smoking. Angiography was able to identify a suitable distal arterial segment for the bypass which was revascularized by means of an autologous vein graft. Grafts were followed with repetitive duplex ultrasound. Revision of the bypass graft was initiated if indicated by pathological duplex findings. Results: In all cases a bypass could be constructed with either the ipsilateral greater saphenous vein or arm veins. A distal origin configuration was possible in three cases with popliteo-pedal or cruro-pedal bypasses. In the fourth case the distal superficial femoral artery was used for inflow. Two early graft thromboses underwent successful revision. During follow-up, duplex ultrasound identified graft stenoses in three bypasses which were successfully treated with endovascular techniques. All grafts are patent with complete resolution of ischaemic symptoms after 46, 42, 32, and 29 months. The patients remained non-smokers and returned to a professional life. Conclusions: Surgical therapy with distal vein bypass for persistent ischaemic symptoms after definitive cessation of smoking seems feasible in selected cases with TAO and a suitable distal artery. Close follow-ups of the patients with duplex ultrasound are necessary to identify developing vein graft stenoses. Angioplasty seems to be an important part of the long-term therapeutic concept.

Penetrating atherosclerotic ulcer aneurysm of the innominate artery

VASA ◽  
2009 ◽  
Vol 38 (3) ◽  
pp. 263-266 ◽  
Author(s):  
Yuan ◽  
Tager
Keyword(s):  
Conservative Treatment ◽  
Thoracic Aorta ◽  
Open Surgery ◽  
Innominate Artery ◽  
Ruptured Aneurysm ◽  
Descending Thoracic Aorta ◽  
Penetrating Atherosclerotic Ulcer ◽  
Descending Aorta

Penetrating atherosclerotic ulcer of the aorta is uncommon, and usually develops in the descending thoracic aorta. Rarely this condition involves the branch vessels of the aorta. We report a case of ruptured aneurysm of the innominate artery resulting from penetrating atherosclerotic ulcer. Open surgery was the treatment of choice for the ruptured aneurysm, while conservative treatment was recommended for the associated penetrating atherosclerotic ulcers of the descending aorta.

Lymphedema and lipedema - an overview of conservative treatment

VASA ◽  
2011 ◽  
Vol 40 (4) ◽  
pp. 271-279 ◽  
Author(s):  
Wagner
Keyword(s):  
Conservative Treatment ◽  
General Practitioners ◽  
Subcutaneous Tissue ◽  
Compression Therapy ◽  
Compression Stocking ◽  
Lymph Drainage ◽  
Intensive Phase ◽  
Manual Lymph Drainage ◽  
Causal Therapy

Lymphedema and lipedema are chronic progressive disorders for which no causal therapy exists so far. Many general practitioners will rarely see these disorders with the consequence that diagnosis is often delayed. The pathophysiological basis is edematization of the tissues. Lymphedema involves an impairment of lymph drainage with resultant fluid build-up. Lipedema arises from an orthostatic predisposition to edema in pathologically increased subcutaneous tissue. Treatment includes complex physical decongestion by manual lymph drainage and absolutely uncompromising compression therapy whether it is by bandage in the intensive phase to reduce edema or with a flat knit compression stocking to maintain volume.

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