scholarly journals A Current Concepts Review of Clavicle Injuries in Ice Hockey From Sternoclavicular to Acromioclavicular Joint

2020 ◽  
Vol 8 (9) ◽  
pp. 232596712095141
Author(s):  
Eugene S. Jang ◽  
Caroline N. Park ◽  
William N. Levine ◽  
Charles A. Popkin
Keyword(s):  
Upper Extremity ◽  
Acromioclavicular Joint ◽  
Significant Proportion ◽  
Sternoclavicular Joint ◽  
Ice Hockey ◽  
Return To Play ◽  
Joint Injuries ◽  
Joint Dislocations ◽  
Hockey Players ◽  
Clavicle Fractures

Clavicle injuries are common in ice hockey, and a number of high-profile fractures and dislocations have occurred in elite hockey players in recent years. Acromioclavicular joint injuries, clavicle fractures, and sternoclavicular joint injuries are some of the most frequent hockey-related injuries treated by orthopaedic surgeons, and familiarity with the management of these injuries and sport-specific considerations for treatment and recovery are critical. Injuries involving the clavicle can sometimes be life-threatening, and subtle findings on physical examination and radiographic studies can have profound implications for treatment. The recent literature pertinent to the diagnosis and treatment of clavicle-related injuries in ice hockey players was reviewed and compiled into a clinical commentary. For ice hockey players, the upper extremity was traditionally considered a relatively well-protected area. However, given the evolution of the game and its protective equipment, the upper extremity now accounts for the majority of youth ice hockey injuries, of which clavicle injuries comprise a significant proportion. Acromioclavicular joint injuries are the most common injury in this population, followed closely by clavicle fractures. Sternoclavicular joint injuries are rare but can be associated with serious complications. The treatment of these injuries often differs between athletes and the general population, and surgical indications continue to evolve in both groups. Although the evidence regarding clavicle injuries is ever-increasing and the treatment of these injuries remains controversial, clavicle injuries are increasingly common in ice hockey players. Rule and equipment changes, most notably the increased use of flexible boards and glass, have been shown to significantly decrease the risk of clavicle injuries. We also recommend compulsory use of shoulder pads, even at a recreational level, as well as continued enforcement and evolution of rules aimed at reducing the rate of clavicle injuries. Future research should focus on equipment design changes directed toward clavicle injury prevention, standardized return-to-play protocols, and studies weighing the risks and benefits of nonoperative management of controversial injuries, such as type III acromioclavicular joint dislocations and diaphyseal clavicle fractures.

Epidemiology of Upper Extremity Injuries in NCAA Men’s and Women’s Ice Hockey

2018 ◽  
Vol 46 (10) ◽  
pp. 2521-2529 ◽  
Author(s):  
Patricia R. Melvin ◽  
Spenser Souza ◽  
R. Nelson Mead ◽  
Christopher Smith ◽  
Mary K. Mulcahey
Keyword(s):  
Upper Extremity ◽  
Acromioclavicular Joint ◽  
Injury Rate ◽  
Injury Surveillance ◽  
Ice Hockey ◽  
Surveillance Program ◽  
Time Loss ◽  
Injury Rates ◽  
Men And Women ◽  
Hockey Players

Background: Ice hockey is a physically demanding sport where athletes are susceptible to a variety of injuries. Several studies reported the overall injury rates in ice hockey; however, there is a paucity of information on upper extremity (UE) injuries among collegiate ice hockey players. Purpose: To describe the epidemiology of UE injuries among collegiate male and female ice hockey players with NCAA (National Collegiate Athletic Association) injury surveillance data from 2004-2005 to 2013-2014. Study Design: Descriptive epidemiology study. Methods: Data were obtained from the NCAA Injury Surveillance Program for all UE injuries sustained during the academic years 2004-2005 to 2013-2014. Injury rates, rate ratios (RRs), and injury proportion ratios were reported with 95% CIs. Results: During the 10 years studied, the overall rate of UE injuries for men was higher than that for women (236 vs 125 injuries per 100,000 athlete-exposures [AEs]; RR, 1.89; 95% CI, 1.67-2.15). UE injuries sustained during either pre- or postseason were approximately 3 times higher for men than for women (preseason: 149 vs 53 per 100,000 AEs; RR, 2.83; 95% CI, 1.69-4.74; postseason: 143 vs 49 per 100,000 AEs; RR, 2.91; 95% CI, 1.33-6.38). The overall injury rate was highest during the regular season (men: 257 per 100,000 AEs; 95% CI, 242-272; women: 143 per 100,000 AEs; 95% CI, 126-160). Additionally, the injury rate for men and women was higher during competition than practice (men: 733 vs 83 per 100,000 AEs; 95% CI, 687-780 and 75-92; women: 303 vs 64 per 100,000 AEs; 95% CI, 259-348 and 52-76). The most common injury observed was acromioclavicular joint sprain (men, 29.1%; women, 13.8%). For both groups, acromioclavicular joint injuries accounted for most non–time loss, moderate time loss (2-13 days), and severe time loss (≥14 days) injuries. Conclusion: Men and women sustained a significant number of UE injuries playing collegiate ice hockey during the period studied, with acromioclavicular joint sprain being the most common UE injury and the one that most frequently led to significant time loss. These data may provide insight for future injury prevention and guide improvements in training.

scholarly journals Acromioclavicular Joint Injuries in Professional Ice Hockey Players: Epidemiologic and MRI Findings and Association With Return to Play

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096447
Author(s):  
Lawrence M. White ◽  
Jonathan Ehmann ◽  
Robert R. Bleakney ◽  
Anthony M. Griffin ◽  
John Theodoropoulos
Keyword(s):  
Acromioclavicular Joint ◽  
Ice Hockey ◽  
Return To Play ◽  
Low Grade ◽  
Mri Findings ◽  
Grade 5 ◽  
Significant Difference ◽  
Hockey Players ◽  
Mri Scans ◽  
Grade 3

Background: Acromioclavicular joint (ACJ) injuries are common in ice hockey players and are traditionally evaluated with conventional radiography, which has recognized limitations in the accurate characterization of the spectrum of soft tissue injuries and severity/grade of injury sustained. Purpose: To evaluate the epidemiologic, clinical, and magnetic resonance imaging (MRI) findings in professional ice hockey players who have sustained acute ACJ injuries. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review was performed of professional National Hockey League (NHL) players referred for MRI evaluation of acute ACJ injuries. All MRI scans were assessed for status of the ACJ, ligamentous stabilizers, and surrounding musculature. MRI-based overall grade of ACJ injury (modified Rockwood grade 1-6) was assigned to each case. Data regarding mechanism of injury, player handedness, clinical features, and return to play were evaluated. Results: Overall, 24 MRI examinations of acute ACJ injuries (23 patients; mean age, 24 years) were reviewed. We found that 50% of injuries were sustained during the first period of play, and in 75% of cases, injuries involved the same side as player shooting handedness. Analysis of MRI scans revealed 29% (7/24) grade 1 ACJ injuries, 46% (11/24) grade 2 injuries, 21% (5/24) grade 3 injuries, and 4% (1/24) grade 5 injuries. Trapezius muscle strains were seen in 79% and deltoid muscle strain in 50% of cases. Nonoperative management was used for 23 injuries; 1 patient (grade 5 injury) underwent acute reconstructive surgery. All players successfully returned to professional NHL competition. Excluding cases with additional injuries or surgery (n = 3) or convalescence extending into the offseason (n = 3), we found that the mean return to play was 21.4 days (7.2 games missed). No statistically significant difference was observed in return to play between nonoperatively treated grade 3 injuries (mean, 28.3 days) and grade 1 or 2 injuries (mean, 20.1 days). However, grade 3 injuries were associated with a greater number of NHL scheduled games missed (mean, 12.7) compared with lower grade injuries (mean, 6.1) ( P = .027). Conclusion: The spectrum of pathology and grading of acute ACJ injuries sustained in professional ice hockey can be accurately assessed with MRI; the majority of injuries observed in this study were low grade (grades 1 and 2). Although grade 3 injuries were associated with a greater number of games missed, similar return-to-play results were observed between nonoperatively treated grade 3 and grade 1 or 2 ACJ injuries.

Effect of Upper Extremity Strength Training on Puck Speed in Collegiate Ice Hockey Players

1998 ◽  
Vol 30 (Supplement) ◽  
pp. 35 ◽  
Author(s):  
W T Pan ◽  
D C Campbell ◽  
J G Richards ◽  
A R Bartolozzi ◽  
M G Ciccotti ◽  
...  
Keyword(s):  
Strength Training ◽  
Upper Extremity ◽  
Ice Hockey ◽  
Hockey Players

Return to play after an initial or recurrent concussion in a prospective study of physician-observed junior ice hockey concussions: implications for return to play after a concussion

2010 ◽  
Vol 29 (5) ◽  
pp. E5 ◽  
Author(s):  
Paul Sean Echlin ◽  
Charles H. Tator ◽  
Michael D. Cusimano ◽  
Robert C. Cantu ◽  
Jack E. Taunton ◽  
...  
Keyword(s):  
Clinical Evaluation ◽  
Consensus Statement ◽  
Assessment Tool ◽  
Ice Hockey ◽  
Return To Play ◽  
Cognitive Test ◽  
Time Interval ◽  
Test Results ◽  
Hockey Players ◽  
The Mean

Object The authors investigated return-to-play duration for initial and recurrent concussion in the same season in 2 teams of junior (16–21-year-old) ice hockey players during a regular season. Methods The authors conducted a prospective cohort study during 1 junior regular season (2009–2010) of 67 male fourth-tier ice hockey players (mean age 18.2 ± 1.2 years [SD], range 16–21 years) from 2 teams. Prior to the start of the season, every player underwent baseline assessments that were determined using the Sideline Concussion Assessment Tool 2 (SCAT2) and the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). The study protocol also required players who entered the study during the season to complete a baseline SCAT2 and ImPACT. If the protocol was not followed, the postinjury test results of a player without true baseline test results were compared with previously established age- and sex-matched group normative levels. Each game was directly observed by a physician and at least 1 neutral nonphysician observer. Players suspected of suffering a concussion were evaluated by the physician during the game. If a concussion was diagnosed, the player underwent clinical evaluation at the physician's office within 24 hours. The return-to-play decision was based on clinical evaluation guided by the Zurich return-to-play protocol (contained in the consensus statement of international expert opinion at the 3rd International Conference on Concussion in Sport held in Zurich, November 2008). This clinical evaluation and return-to-play protocol was augmented by the 2 tests (SCAT2 and ImPACT) also recommended by the Zurich consensus statement, for which baseline values had been obtained. Results Seventeen players sustained a physician-observed or self-reported, physician-diagnosed concussion during a physician-observed ice hockey game. The mean clinical return-to-play duration (in 15 cases) was 12.8 ± 7.02 days (median 10 days, range 7–29 days); the mean number of physician office visits by players who suffered a concussion (15 cases) was 2.1 ± 1.29 (median 1.5 visits). Five of the 17 players who sustained a concussion also suffered a recurrent or second concussion. One of the 5 individuals who suffered a repeat concussion sustained his initial concussion in a regular season game that was not observed by a physician, and as a result this single case was not included in the total of 21 concussions. This initial concussion of the player was identified during baseline testing 2 days after the injury and was subsequently medically diagnosed and treated. The mean interval between the first and second concussions in these 5 players was 78.6 ± 39.8 days (median 82 days), and the mean time between the return-to-play date of the first and second concussions was 61.8 ± 39.7 days (median 60 days). Conclusions The mean rates of return to play for single and recurrent concussions were higher than rates cited in recent studies involving sport concussions. The time interval between the first and second concussions was also greater than previously cited. This difference may be the result of the methodology of direct independent physician observation, diagnosis, and adherence to the Zurich return-to-play protocol.

The value of computerised neurocognitive testing at medical clearance to return to play following a sport-related concussion in youth ice hockey players

2017 ◽  
Vol 51 (11) ◽  
pp. A58.3-A59
Author(s):  
Amanda M Black ◽  
Brian L Brooks ◽  
Regan S McLeod ◽  
Luz Palacios-Derflingher ◽  
Kathryn J Schneider ◽  
...  
Keyword(s):  
Ice Hockey ◽  
Return To Play ◽  
Neurocognitive Testing ◽  
Medical Clearance ◽  
Hockey Players

scholarly journals Canadian Minor Hockey Participants’ Knowledge about Concussion

2009 ◽  
Vol 36 (03) ◽  
pp. 315-320 ◽  
Author(s):  
Michael D. Cusimano ◽  
Mary L. Chipman ◽  
Richard Volpe ◽  
Peter Donnelly
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Physical Therapy ◽  
Ice Hockey ◽  
Return To Play ◽  
Educational Strategies ◽  
Greater Toronto Area ◽  
Minor League ◽  
Hockey Players ◽  
The Usa

Abstract:Background and Objectives:In Canada and the USA, ice hockey is a cause of traumatic brain injury. Post-concussive symptoms are the most important feature of the diagnosis of concussion in sports and it is recommended that athletes not return to play while still symptomatic. Lack of knowledge of concussions could therefore be one of the main detriments to concussion prevention in hockey. The purpose of this research is to describe what minor league hockey players, coaches, parents and trainers know about concussion and its management.Methods:A questionnaire to assess concussion knowledge and return to play guidelines was developed and administered to players at different competitive levels (n = 267), coaches, trainers and parents (total adults n = 142) from the Greater Toronto Area.Results:Although a majority of adults and players could identify mechanisms responsible for concussion, about one-quarter of adults and about a quarter to a half of children could not recall any symptoms or recalled only one symptom of a concussion. A significant number of players and some adults did not know what a concussion was or how it occurred. Almost half of the players and a fifth of the adults incorrectly stated that concussion was treated with medication or physical therapy. Nearly one quarter of all players did not know if an athlete experiencing symptoms of concussion should continue playing.Conclusions:This study demonstrated that a significant number of people held misconceptions about concussion in hockey which could lead to serious health consequences and creates a need for better preventive and educational strategies.

scholarly journals Epidemiology of Acromioclavicular Joint Injuries in Professional Baseball

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0041
Author(s):  
Prem Ramkumar ◽  
Salvatore Frangiamore ◽  
Grant Jones ◽  
Lonnie Soloff ◽  
Keshia Pollack ◽  
...  
Keyword(s):  
Acromioclavicular Joint ◽  
Return To Play ◽  
Professional Baseball ◽  
Shoulder Injuries ◽  
Ac Joint ◽  
Joint Injuries ◽  
Acute Injuries ◽  
Chronic Injuries ◽  
The Impact ◽  
Ac Joint Injuries

Objectives: Shoulder injuries account for a large portion of all recorded injures in professional baseball. Much is known about other shoulder pathologies in the overhead athlete, but the incidence and impact of acromioclavicular (AC) joint injuries in this population is unknown. The purpose of this study was to examine the incidence, rates, and characteristics of AC joint injuries in professional baseball, and determine the impact on time missed. Methods: The Major League Baseball Health and Injury Tracking System (HITS) was used to compile records of all major and minor league player from 2011-2017 with documented AC joint injuries. These injuries were classified as acute (sprain or separation) or chronic (AC joint arthritis or distal clavicular osteolysis), and associated data included laterality, date of injury, player position, activity, mechanism of injury, length of return to play (RTP), and need for surgical intervention. Results: A total of 312 AC joint injuries (183 MiLB, 129 MLB; range 39-60 per year) were recorded (acute n=201, 64.4%; chronic n=111, 35.6%). A total of 81% of acute injuries resulted in time missed with an average RTP of 22.8 days whereas 59% of chronic injuries resulted in days missed with an average RTP of 32.2 days (p<0.001). Acute injuries occurred most commonly in outfielders (42.7%), followed by infielders (27.3%). Chronic injuries were seen in higher proportions among pitchers and catchers (45.5-56.4% chronic injuries). Acute AC injuries occurred most often while playing defense (n=100; 49.8%) in the infield or outfield (n=138; 68.7%), with 63.2% the result of a contact injury. Chronic AC joint injuries were most commonly with throwing or pitching (n=48; 43.2%) and non-contact injuries (n=79; 71.2%). Conclusion: Acute AC joint injuries are contact injuries occurring most commonly among infielders and outfielders that result in more than 3 weeks missed before return to play whereas chronic AC joint injuries occur more commonly in pitchers and catchers from repetitive overhead activity. Knowledge of these data can better guide expectation management in this elite population to better elucidate the prevalence of two common injury patterns in the acromioclavicular joint.

scholarly journals The unicortical sternoclavicular joint reconstruction using synthetic graft

2018 ◽  
Vol 12 (2) ◽  
pp. 144-147
Author(s):  
Mohamed A Imam ◽  
Saqib Javed ◽  
Ian Trail ◽  
Puneet Monga
Keyword(s):  
Sternoclavicular Joint ◽  
Synthetic Graft ◽  
Joint Reconstruction ◽  
Joint Injuries ◽  
Reproducible Technique ◽  
Joint Dislocations ◽  
Shoulder Complex

Sternoclavicular joint injuries represent 5% of all injuries to the shoulder complex. We report a safe and reproducible technique for reconstruction of anterior sternoclavicular joint dislocations, employing a synthetic graft using a unicortical technique with minimal dissection anterior to the joint.

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