Sports hernia is a non-anatomic, non-diagnostic term that has been attributed to many different causes of groin pain. » Sports hernia is better described as pain localized anatomically to the inguinal region of an athlete without an actual hernia.» Nonoperative management including core stability while avoiding extreme hip range of motion should be attempted for at least 2 months prior to any operative intervention.» Associated pathology such as femoroacetabular impingement or adductor tear should be addressed. » If a sports hernia is not responsive to rehabilitation, referral to a general surgeon is appropriate.
Low back pain (LBP) is the most prevalent musculoskeletal complaint among professional and amateur golfers; however, associated radiological changes in golf-related LBP have not been examined in the literature. We suspect that Modic Type 1 changes in the lumbar spine are linked to golf-related LBP. In this retrospective case series, four middle-aged golfers (one professional and three high-level amateurs) presented to our clinic with LBP. Inflammation of the right side of endplates in the lumbar spine was suspected based on Modic Type 1 changes detected by magnetic resonance imaging (MRI) in each patient. All four cases were diagnosed with right-sided endplate inflammation and administered intradiscal steroid injections with a non-steroidal anti-inflammatory drug (NSAID). Treatment swiftly alleviated LBP and diminished Modic Type 1 changes on follow-up MRI 3–6 months later in all four patients. We suggest that Modic Type 1 changes play a significant role in the diagnosis and treatment of golf-related LBP.
Ligamentous Lisfranc injuries are characterized by disruption between the articulation of the medial cuneiform and base of the second metatarsal. Ligamentous injuries can be either subtle or obvious and can also occur with tarsometatarsal subluxations or dislocations. These injuries typically happen in athletic activity and are also seen lower-energy falls. Conventional use of transarticular screws to repair Lisfranc ligament injuries has provided good outcomes; however, the screws are also believed to decrease the natural physiological movement of the Lisfranc joint. As treatment options for ligamentous Lisfranc injuries move away from transarticular screws and toward bridge plating and motion-preserving fixation techniques, the goal of stable fixation is still important for optimizing long-term results. This article will focus on the technique of using a suture button device, and also introduce the technique of Lisfranc InternalBrace fixation. The internal brace technique allows for less bone loss from drilling, allows for collagen ingrowth, and can be used in conjunction with bridge plating techniques.
Level of Evidence: Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence.
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