scholarly journals Mandibular Condylar Fracture in a Professional Soccer Goalkeeper: How to Achieve Early Return-to-Play—A Case Report

2021 ◽  
Vol 6 ◽  
pp. 247275122110225
Author(s):  
Ryo Sasaki ◽  
Kohei Tominaga ◽  
Toshihiro Okamoto
Keyword(s):  
Case Report ◽  
Maxillofacial Surgery ◽  
Mouth Opening ◽  
Skin Incision ◽  
Return To Play ◽  
Reference Case ◽  
Professional Soccer ◽  
Early Return ◽  
Lower Canine ◽  
Condylar Fractures

Sport-related mandibular fracture is a common injury in the field of maxillofacial surgery. However, the treatment of mandibular condylar fractures in professional soccer goalkeepers is rarely reported. A 32-year-old male professional soccer goalkeeper was referred for malocclusion after collision with an opponent player during a game. The patient’s mandible was displaced between the left lower lateral incisor and left lower canine. Computed tomography showed right condylar base fracture with medial displacement and left para-symphysis fracture. Internal fixation using retromandibular anterior trans-parotid approach via 25-mm skin incision immediately below the earlobe and intraoral vestibular approach were performed under general anesthesia 2 days after the injury. The patient was discharged without complications 3 days after surgery, with mandibular protrusion and diduction exercises with limitation of mouth opening. Soft diet and limitation of mouth opening was performed for 4 weeks after surgery. To achieve early return-to-play, rehabilitation based on Fowell and Earls’ return-to-play guidelines following facial fractures was started, with moderate exercise 5 days after surgery, and progressively full exercise without contact 8 days after surgery. He started normal team training with individualized jaw-guard 4 weeks after surgery. His body weight decreased by 2.2 Kg 1 week after surgery, gradually recovered, and became normal 4 weeks after surgery. The patient returned to a game 2 months after surgery. This case report can be a reference case in condylar fractures of professional soccer players, as the available scientific literature is limited with regard to return-to-play after maxillofacial fracture in professional athletes.

scholarly journals CLINICAL AND RADIOLOGICAL OUTCOMES OF MANDIBULAR CONDYLAR FRACTURES AFTER CONSERVATIVE TREATMENT

2021 ◽  
Vol 71 (2) ◽  
pp. 667-71
Author(s):  
Humaira Sarwar ◽  
Irfan Shah ◽  
Ali Akhtar Khan ◽  
Adnan Babar ◽  
Saad Mehmood ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Conservative Management ◽  
Maxillofacial Surgery ◽  
Radiological Finding ◽  
Mouth Opening ◽  
Armed Forces ◽  
P Value ◽  
Oral And Maxillofacial Surgery ◽  
Condylar Fractures

Objective: To assess the clinical as well as radiological outcomes of the conservative management of mandibular condyle fractures. Study Design: Cross-sectional comparative study. Place and Duration of Study: Department of Oral and Maxillofacial Surgery (OMFS), Armed Forces Institute of Dentistry (AFID), Rawalpindi, from Feb 2018 to Aug 2019. Methodology: A total of 60 patients diagnosed as isolated mandible trauma with unilateral condyle fractures were studied. All patients were assessed radiologically on orthopantomogram (OPG) before the start of treatment. They were assessed clinically for maximum mouth opening (MMO), occlusion, pain and masticatory satisfaction before the start of treatment and after conservative management. Conservative Management includes soft diet only or maxillomandibular fixation (MMF) followed by active physical therapy. After 6 months of follow up, pre-treatment and post-treatment clinical parameters and radiological finding were compared. Results: Sixty patients were managed conservatively, among them 37 (62%) were male and 23 (38%) were female with age range of 21-53 years. There was statistically significant decrease in pain (p-value 0.002) and improvement in mastication (pvalue 0.079) before and after the conservative treatment of mandibular condylar fractures. Overall 46 (77%) patients treated with conservative management were satisfied with their mastication and 40 (67%) patients had mild pain on mastication. All the patients showed satisfactory occlusion and had no occlusal discrepancy on last follow up visit. Maximum mouth opening improved from 32.38 ± 4.54 to 40.90 ± 1.75 after treatment. The mean of preoperative ramus length difference of both sides of the mandible was 4.23 ± 2.3 mm............

Successful return to play following adductor longus proximal tendon rupture in professional soccer without re-injury at 12 months: A case report

2018 ◽  
Vol 31 (3) ◽  
pp. 583-587 ◽  
Author(s):  
Ömer B. Gözübüyük ◽  
Maarten H. Moen ◽  
Mehmet Akman ◽  
Ioakim Ipseftel ◽  
Agah Karakuzu
Keyword(s):  
Case Report ◽  
Tendon Rupture ◽  
Return To Play ◽  
Professional Soccer ◽  
Adductor Longus

Long-term Complications of Isolated and Combined Condylar Fractures: A Retrospective Study

2021 ◽  
pp. 194338752110267
Author(s):  
Margaux Nys ◽  
Tim Van Cleemput ◽  
Jakob Titiaan Dormaar ◽  
Constantinus Politis
Keyword(s):  
Conservative Treatment ◽  
Initial Treatment ◽  
Late Onset ◽  
Maxillofacial Surgery ◽  
Mouth Opening ◽  
Secondary Treatment ◽  
Condylar Fracture ◽  
Mandibular Body ◽  
Condylar Fractures

Study Design: Fractures of the mandibular condyle are a common injury in maxillofacial trauma. Both conservative treatment (i.e., analgesic therapy and soft diet) and intermaxillary fixation (IMF) or open reduction internal fixation (ORIF) have satisfactory and functional outcomes, though severe late-onset complications have been reported. Objective: We compared the long-term complications of patients with condylar fractures treated conservatively, with IMF, or with combined ORIF and IMF. Methods: We retrospectively analyzed all patients diagnosed with unilateral or bilateral condylar fracture, isolated or combined with a fracture of the mandibular body, admitted to the Department of Maxillofacial Surgery at UZ Leuven between January 2013 and January 2020. We collected data on age, gender, side of condylar fracture, presence of associated fracture of the mandibular body, referrals, initial treatment, long-term complications and secondary treatment. Long-term complications were defined as sequelae still present 6 weeks after initial treatment. Results: Among 192 patients, 68.8% had unilateral and 31.2% bilateral condylar fractures; an associated fracture of the mandibular body was seen in 45.8%, 31% received conservative treatment, 51% IMF only, and 18% combined ORIF and IMF. Forty-eight percent of all patients suffered from 1 or more long-term complications, most frequently malocclusion (24%), reduced mouth opening (15.1%), nerve disturbances (13.5%), pain (8.9%), and facial asymmetry (2.6%). Surgery as a secondary treatment was necessary in 25% of all cases. Conclusions: The presence of bilateral condylar fractures or associated fracture of the mandibular body is a risk factor for developing long-term complications. Most patients with long-term complications were initially treated with combined ORIF and IMF, but long-term complications after initial conservative or IMF treatment were treated with secondary surgery.

Neuro-Optometric Rehabilitation Accelerates Post-Concussion Syndrome Recovery in a Professional Athlete – A Case Report Presenting a New Paradigm

2017 ◽  
pp. 167-178
Keyword(s):  
Case Report ◽  
Brain Injury ◽  
Medical Staff ◽  
Clinical Findings ◽  
Return To Play ◽  
Top Down ◽  
Post Concussion Syndrome ◽  
Persistent Symptoms ◽  
Professional Soccer ◽  
Medicine Physician

Background: Optometrists are becoming increasingly instrumental in the care of brain injured patients. Within the profession of optometry, a segment of optometrists has become highly trained and skilled in rehabilitation of vision dysfunctions and therefore is integral in the interdisciplinary management of a patient’s overall recovery from acquired brain injury. No system provides more neurosensory input to the brain than vision. Therefore, optometry has an obligation to and is best prepared to provide this area of care referred to as neuro-optometric rehabilitation. Case Report: A professional soccer player suffered a head injury during competition. He was diagnosed with a mild traumatic brain injury (concussion) and was unable to obtain complete resolution of symptoms despite current standard return-to-play protocol administered by the team medical staff. Symptoms included intermittent blurred vision during movement, mild photophobia, and feeling somewhat “not present”. The team medical staff included a sports medicine physician, head athletic trainer/physical therapist, and a neuropsychologist. Neurooptometric consultation was requested for the athlete by the team physician to determine if vision dysfunction was contributing to the athlete’s persistent symptoms. He was diagnosed with vision dysfunctions presumably associated with the concussion and neurooptometric rehabilitation was prescribed. Conclusion: The clinical findings and treatment in a case of post-concussion syndrome involving associated vision dysfunctions are described. Neuro-optometric rehabilitation utilizing a unique paradigm remediated the vision dysfunctions of the athlete and eliminated his post-concussion symptoms. This in turn facilitated his return-to-play process. The paradigm applied began with passive, inputbased, bottom-up therapy accompanied by gradual introduction of active, output-based, top-down techniques. In recent years, this author has found this paradigm to be more effective than a top-down approach when non-oculomotor based vision dysfunctions are included in the post-concussion patient clinical findings.

scholarly journals Mandibulektomi segmental dengan rekonstruksi cangkok tulang fibula non-vaskularisasi pada pasien ameloblastoma tipe folikulerSegmental mandibulectomy with non-vascularised fibular bone graft reconstruction in follicular ameloblastoma patient

2021 ◽  
Vol 32 (3) ◽  
pp. 143
Author(s):  
Rumartha Putri Swari ◽  
Arfan Badeges ◽  
Vera Julia
Keyword(s):  
Case Report ◽  
Bone Graft ◽  
Maxillofacial Surgery ◽  
Mouth Opening ◽  
Neck Region ◽  
Oral And Maxillofacial Surgery ◽  
Severe Problem ◽  
Fibula Graft ◽  
Segmental Mandibulectomy ◽  
Graft Reconstruction

Pendahuluan: Ameloblastoma adalah tumor invasif lokal dengan insidensi kekambuhan yang tinggi jika tidak dieksisi sepenuhnya. Mandibulektomi segmental sebagai pilihan tatalaksana yang dapat menyebabkan deformitas dan asimetri pada wajah, serta masalah pengunyahan. Pemulihan defek setelah reseksi mandibula menimbulkan masalah yang cukup berat. Tujuan laporan kasus ini untuk melaporkan hasil rekontruksi menggunakan cangkok tulang non-vaskularisasi mandibulektomi segmental pada pasien dengan ameloblastoma mandibula. Laporan kasus: Pria berusia 33 tahun datang ke Poliklinik Rawat Jalan Bagian Bedah Mulut dan Maksilofasial RS Persahabatan dengan keluhan utama pembengkakan mandibula yang perlahan bertambah dan tidak nyeri sejak enam tahun lalu. Pemeriksaan ekstra oral tampak asimetri wajah, bukaan mulut tidak ada limitasi, tidak teraba pembesaran kelenjar getah bening regio leher. Pemeriksaan intraoral didapatkan adanya benjolan regio mandibula kiri dengan batas tegas, konsistensi padat, permukaan tampak trauma oklusi gigi antagonis, immobile, dan terdapat nyeri tekan. Gambaran radiologis menunjukan lesi radiolusen multilokuler menyerupai honeycomb pada corpus mandibula kiri meluas ke regio ramus mandibula kiri. Pemeriksaan biopsi menunjukkan hasil ameloblastoma tipe folikuler pada mandibula kiri dan dilakukan mandibulektomi segmental dengan rekonstruksi cangkok tulang fibula non-vaskularisasi. Sembilan bulan setelah operasi, cangkok tulang non-vaskularisasi tidak menunjukkan komplikasi intraoral dengan bekas luka submandibular ekstraoral baik. Simpulan: Cangkok tulang fibula non-vaskular dapat dipertimbangkan sebagai salah satu pilihan untuk rekonstruksi setelah mandibulektomi segmental pada pasien ameloblastoma.Kata kunci: Mandibulektomi segmental, cangkok fibula non-vaskularisasi, ameloblastoma folikuler. ABSTRACTIntroduction: Ameloblastoma is a locally invasive tumour with a high incidence of recurrence if not completely excised. Segmental mandibulectomy as a treatment option that can cause facial deformities and asymmetry and mastication problem. Recovery of the defect after mandibular resection presents a severe problem. This case report was aimed to report the results of reconstruction using a segmental non-vascularised mandibulectomy bone graft in a patient with mandibular ameloblastoma. Case report: A 33-year-old male came to the Outpatient Polyclinic of the Oral and Maxillofacial Surgery Division of Persahabatan General Hospital with the chief complaint of mandibular inflammation, which was slowly increasing yet painless since six years prior. Extraoral examination showed facial asymmetry, no limitation in mouth opening, no palpable enlargement of lymph nodes in the neck region. Intraoral examination revealed a lump in the left mandibular region with firm borders, solid consistency. The surface appears to be traumatic occlusion of the antagonist tooth, immobile, and tenderness was found. Radiological features showed a multilocular, honeycomb-like radiolucent lesion on the left mandibular body extending into the left mandibular ramus region. A biopsy showed follicular ameloblastoma in the left mandible, and a segmental mandibulectomy was performed with non-vascular fibular bone graft reconstruction. Nine months after surgery, non-vascular bone grafts showed no intraoral complications with either extraoral submandibular scar. Conclusion: Non-vascular fibular bone graft can be considered an option for reconstruction after segmental mandibulectomy in ameloblastoma patients. Keywords: Segmental mandibulectomy, non-vascularised fibula graft, follicular ameloblastoma.

Severe Pain and Limited Mouth Opening Due to TMJ Chondromatosis: a Case Report

2021 ◽  
Vol 3 (5) ◽  
pp. 1227-1232
Author(s):  
Lucas Maia Nogueira ◽  
Isabela Wolf Grotto ◽  
Samuel de Souza Moraes ◽  
Fabio Ricardo Loureiro Sato ◽  
Érica Cristina Marchiori
Keyword(s):  
Case Report ◽  
Severe Pain ◽  
Mouth Opening ◽  
Limited Mouth Opening

The Effectiveness of a Hinged Elbow Orthosis in Medial Collateral Ligament Injuries: An In Vitro Biomechanical Study

2019 ◽  
Vol 47 (12) ◽  
pp. 2827-2835
Author(s):  
Ranita H.K. Manocha ◽  
James A. Johnson ◽  
Graham J.W. King
Keyword(s):  
Medial Collateral Ligament ◽  
Muscle Activation ◽  
Mechanical Stability ◽  
Biomechanical Study ◽  
Return To Play ◽  
Collateral Ligament ◽  
Valgus Stress ◽  
Active Motion ◽  
Early Return

Background: Medial collateral ligament (MCL) injuries are common after elbow trauma and in overhead throwing athletes. A hinged elbow orthosis (HEO) is often used to protect the elbow from valgus stress early after injury and during early return to play. However, there is minimal evidence regarding the efficacy of these orthoses in controlling instability and their influence on long-term clinical outcomes. Purpose: (1) To quantify the effect of an HEO on elbow stability after simulated MCL injury. (2) To determine whether arm position, forearm rotation, and muscle activation influence the effectiveness of an HEO. Study Design: Controlled laboratory study. Methods: Seven cadaveric upper extremity specimens were tested in a custom simulator that enabled elbow motion via computer-controlled actuators and motors attached to relevant tendons. Specimens were examined in 2 arm positions (dependent, valgus) and 2 forearm positions (pronation, supination) during passive and simulated active elbow flexion while unbraced and then while braced with an HEO. Testing was performed in intact elbows and repeated after simulated MCL injury. An electromagnetic tracking device measured valgus angulation as an indicator of elbow stability. Results: When the arm was dependent, the HEO increased valgus angle with the forearm in pronation (+1.0°± 0.2°, P = .003) and supination (+1.5°± 0.0°, P = .006) during active motion. It had no significant effect on elbow stability during passive motion. In the valgus position, the HEO had no effect on elbow stability during passive or active motion in pronation and supination. With the arm in the valgus position with the HEO, muscle activation reduced instability during pronation (–10.3°± 2.5°, P = .006) but not supination ( P = .61). Conclusion: In this in vitro study, this HEO did not enhance mechanical stability when the arm was in the valgus and dependent positions after MCL injury. Clinical Relevance: After MCL injury, an HEO likely does not provide mechanical elbow stability during rehabilitative exercises or when the elbow is subjected to valgus stress such as occurs during throwing.

scholarly journals A Diagnosis of Maxillary Sinus Fracture with Cone-Beam CT: Case Report and Literature Review

2014 ◽  
Vol 7 (2) ◽  
pp. 85-91 ◽  
Author(s):  
Selmi Yardimci Yilmaz ◽  
Melda Misirlioglu ◽  
Mehmet Zahit Adisen
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Maxillary Sinus ◽  
Cone Beam Ct ◽  
Maxillofacial Surgery ◽  
Maxillofacial Trauma ◽  
Cone Beam ◽  
Maxillofacial Region ◽  
Emergency Center ◽  
Frontal Wall

The purpose of this article is to present the case of maxillofacial trauma patient with maxillary sinus fracture diagnosed with cone-beam computed tomography (CBCT) and to explore the applications of this technique in evaluating the maxillofacial region. A 23-year-old male patient attempted to our clinic who had an injury at midface with complaints of swelling, numbness. The patient was examined before in emergency center but any diagnosis was made about the maxillofacial trauma. The patient re-examined clinically and radiographically. A fracture on the frontal wall of maxillary sinus is determined with the aid of CBCT. The patient consulted with the department of maxillofacial surgery and it is decided that any surgical treatment was not necessary. The emerging technique CBCT would not be the primary choice of imaging maxillofacial trauma. Nevertheless, when advantages considered this imaging procedure could be the modality of choice according to the case.

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