Comparison of Previously Injured Body Regions in Elite Freestyle and Greco-Roman Wrestlers

The aim of this study was to compare the injured body regions that elite Freestyle and Greco-Roman wrestlers suffered from and to determine the importance of injuries. 41 Freestyle and 51 Greco-Roman wrestlers, who were practicing in Turkish National Wrestling Team camps, participated in this study. ‘Chi Square’ and student t tests were used in statistical analyses. When examined injury status and body regions distribution between Freestyle and Greco-Roman wrestlers, significant difference was found in head and trunk injuries according to wrestling styles (p<0.05). No difference was found in upper/lower extremities and lesion/scrape and friction burns status of the wrestlers according to wrestling style (p>0.05). There was significant difference in trunk and upper extremity injuries with respect to weight category (p<0.05 and p<0.001). Significant difference was also found in nose injuries according to wrestling styles (p<0.05). When examined wrestling style and upper extremity injuries according to the number of injuries, there was found significant difference between two styles in muscle injuries, finger and wrist injuries (p<0.05). The difference between toe injuries in respect to the wrestling style was statistically significant (p<0.05). Results: Greco-Roman wrestlers experienced more injuries in trunk, head and nose compared to Freestyle wrestlers. Trunk, lower and upper extremity injuries varied depending on weight categories. Neck, back, lumbar and chest injuries were more common in Greco-Roman wrestlers. Freestyle wrestlers were more vulnerable to muscle injuries while Greco-Roman wrestlers were more vulnerable to finger and wrist injuries. It is recommended to improve some abilities excellently such as aerobic power, strength, balance and neuro-motor coordination in wrestling. Techniques should be taught well to the wrestlers, most risky extremities for injury have to be applied extra training and these extremities should be protected from injuries by several tapes, bandages or gears during exercise. Freestyle wrestlers ought to be more careful in diving move. Using ear protector in addition to preventive measures can be recommended during training in order to prevent temporal bone fractures and swellings.

Hand and wrist injuries among collegiate athletes vary with athlete division

Background The rates, severity and consequences of hand and wrist injuries sustained by National Collegiate Athletic Association athletes are not well characterized. This study describes the epidemiology of hand and wrist injuries among collegiate athletes competing in different divisions. Methods The National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) was accessed from 2004 to 2015 for the following sports: baseball, basketball, football, ice hockey, lacrosse, soccer, wrestling, field hockey, gymnastics, softball and volleyball. The data were used to identify all hand and wrist injuries, the specific injury diagnosis, mean time loss of activity following injury, and need for surgery following injury. These were then stratified by gender. Descriptive statistics were performed to examine the association between sports, event type and division. Student's t test was used to calculate p-values for independent variables. Chi-Square test was used to calculate odds ratio. P < 0.05 was considered significant. Results 103,098 hand and wrist injuries were reported in in the studied NCAA sports from 2004 to 2015. Male athletes sustained 72,423 injuries (6.01/10,000 athlete exposure) and female athletes sustained 30,675 injuries (4.13/10,000 athlete exposure). Division I athletes sustained significantly more injuries compared to divisions II and III. Overall, 3.78% of hand and wrist injuries required surgical intervention. A significantly higher percentage of division I athletes (both male and female) underwent surgical intervention compared to divisions II and III. The mean time lost due to hand and wrist injury was 7.14 days for all athletes. Division I athletes missed the fewest days due to injury at 6.29 days though this was not significant. Conclusions Hand and wrist injuries are common among collegiate athletes. Division I athletes sustain higher rates of injuries and higher surgical intervention rates, while tending to miss fewer days due to injury. Improved characterization of divisional differences in hand and wrist injuries can assist injury management and prevention.

Carpometacarpal Dislocation with Third Metacarpal Fracture

Case Presentation: A 17-year-old male presented to the emergency department (ED) due to trauma to the right hand and wrist after punching a locker at school. He had significant soft tissue swelling. Radiographs demonstrated intra-articular metacarpal fractures with associated carpometacarpal dislocations. The dislocation was reduced bedside in the ED and ultimately underwent closed reduction surgical management with orthopedic surgery. Discussion: Metacarpal fractures result from high-force impact injuries and account for 30-40% of all hand injuries. The most common sites of second through fifth metacarpal fractures are at the neck and the shaft, with the majority involving the fifth metacarpal neck (commonly coined “boxer’s fractures”). Carpometacarpal (CMC) dislocations are a rare injury associated with high-force impact trauma to the wrist. These injuries account for as little as 1% of all acute hand and wrist injuries. Carpometacarpal dislocations are often difficult to diagnose on physical examination due to significant soft tissue swelling, and they can easily be missed on anterior-posterior views of the hand. Lateral and oblique plain radiograph views are essential in the diagnosis as they are more likely to show dislocations. Despite appropriate plain radiographic views, subtle CMC dislocations may be difficult to discern dependent on the level of dislocation or subluxation and overlapping of joints. These injuries are rare due to otherwise highly stable ligamentous and muscular attachments within the wrist. Because of these attachments, dislocations are often associated with concomitant metacarpal fractures.

Magnetic Resonance Arthrography of the Wrist: The Impact on Operative Management of Wrist Injuries

Background There is no consensus on the utility of arthrography in the evaluation of wrist injuries. This study evaluates ordering trends of different types of magnetic resonance imaging (MRI) of the wrist and compares rates of surgery following these imaging modalities. Methods A national claims-based database was used to identify patients who underwent MRI within 90 days of a first-instance diagnosis of wrist injury from 2010 to 2018. The utilization of MRI without intravenous (IV) contrast, MRI with IV contrast, and MRI with arthrogram was investigated. The instances of operative procedures of the wrist within 1 year of MRI study were recorded. Patient demographics, comorbidities, type of operative procedure, and ordering physician specialty were obtained. Logistic regression analysis was used to evaluate the utilization of MRI and subsequent 1-year operative intervention rates as well as association of patient-related factors. Results Magnetic resonance arthrography use was associated with higher rates of subsequent operative treatment. Surgeons were more likely to order an arthrogram at the time of MRI. Younger patients were more likely to undergo MRI-based advanced imaging. Conclusion Surgeons may perceive MRA of the wrist to play an important role in operative decision-making following wrist injury. Level of Evidence This is a Level III, retrospective cohort study.