Musculoskeletal & Orthopaedics

MercyAscot - Paediatric Care Update

At this 1day MercyAscot Education Series workshop Orthopaedic Surgeon Andrew Graydon, General Surgeon James Hamill and ENT Surgeon Melanie Collins covered a range of paediatric topics, including hernias, ENT issue and the challenges of managing paediatric patients.

Concussion

Head injuries sustained during sport can appear quite dramatic and evoke a strong emotional response from athletes, coaches, spectators and the media. This can mean they are difficult to assess and manage. It is important to have a consistent approach to the assessment and management of head injuries to ensure that an accurate diagnosis is made and to allow athletes to safely return to sport and to the workplace. 

After studying this topic, you should be able to:

Shaken baby syndrome

Shaken baby syndrome (SBS) is the leading cause of preventable, traumatic head injury in those under the age of two years. The term SBS is the most commonly used internationally although remains controversial as it indicates one exact cause of injury.

Achilles tendon rupture: diagnosis & treatment

The Achilles tendon attaches the gastrocnemius, the soleus and plantaris muscles to the calcaneus. It is one of the longest and thickest tendons in the body and is a powerful plantar flexor of the foot and ankle.

The two most common pathologies involving the Achilles tendon are tendinopathy and rupture. Patients with tendinopathy typically describe a gradual onset of pain, while ruptures are associated with an acute event.

Rotator cuff: acute injuries

Rotator cuff pathology comprises a wide range of different problems. At one end of the spectrum is a patient with acute rotator impingement. These patients may have an anatomically normal rotator cuff and have symptoms which have been provoked by an acute bout of activity. In this situation the problem will generally settle with a short period of rest.

Patellofemoral pain syndrome

Patellofemoral pain is a common presentation in primary care. It is most commonly seen in those below the age of forty years; however it can affect people of all ages and activity levels. In adolescents the onset of pain can coincide with periods of accelerated growth, while in older patients it often co-exists with degenerative joint changes.

The term ‘patellofemoral syndrome’ is usually reserved to describe the younger patient with an anatomically normal (or near normal) knee.

Shoulder instability

Shoulder instability is a relatively common injury. The incidence of traumatic shoulder instability in the athletic population is approximately two times greater than in the general population, especially amongst those involved in contact or overhead sports. Instability can be due to acute trauma, repetitive microtrauma or related to congenital issues like generalised laxity. 

Knee injuries: acute management

Acute knee injuries are common, especially in sports that involve twisting movements and sudden changes of direction such as netball, football, basketball and skiing.

Shoulder injuries: acute management

Shoulder injuries are common in primary care and can be difficult to correctly diagnose and manage. The shoulder is a mobile joint and vulnerable to injury from sport, falls, and overhead work. Common shoulder injuries include: rotator cuff tendinopathy or tear, rotator cuff impingement, capsular stiffness, glenohumeral instability or dislocation, muscular tears, or acromioclavicular joint (ACJ) sprains. 

Relative energy deficiency (RED-S): recognition & management

The term “female athlete triad” has been used for several decades to describe an association between disordered eating, an irregular menstrual cycle and impaired bone health. While disordered eating and low energy availability clearly has an effect on a woman’s menstrual cycle and bone health, almost every system in the body can also be involved. It can affect metabolic rate, immunity and protein synthesis as well as cardiovascular and psychological health.

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