Sports medicine presentation

Please follow add the answers to the powerpoint I have attached below. the one titled “ankle fractures in snowboarding”. the references you are using are all listed on the last slide. I also attached the rubric and examples of how I expect it to turn out. be sure that the presentation is no longer than 5 points. When you send back the presentation please be sure it is on my original slides that I have attached. I have each slide titled to what is expected to go on that slide. you can use the examples I provide as a guide not as a reference! thank you and please reach out if you have any questions.

ANKLE FRACTURES IN
SNOWBOARDING
BY: AHMAD ALFOROOKH
PREVALENCE
MECHANISM OF INJURY
FRACTURE SEVERITY
MECHANISM OF INJURY
CLASSIFICATION OF INJURY
CONSERVATIVE TREATMENT
SURGICAL TREATMENT
RECOMMENDED TREATMENT FOR AN ATHLETE
REFERENCES
•
Kramer, Irene Fleur, et al. “Snowboarders’ Ankle.” BMJ Case Reports, U.S. National Library of Medicine, 29 Oct. 2014,
www.ncbi.nlm.nih.gov/pmc/articles/PMC4216907/.
•
Boon AJ, Smith J, Zobitz ME, Amrami KM. Snowboarder’s talus fracture. Mechanism of injury. Am J Sports Med. 2001 MayJun;29(3):333-8. doi: 10.1177/03635465010290031401. PMID: 11394605.
•
Perera A, Baker JF, Lui DF, Stephens MM. The management and outcome of lateral process fracture of the talus. Foot Ankle Surg. 2010
Mar;16(1):15-20. doi: 10.1016/j.fas.2009.03.004. Epub 2009 May 1. PMID: 20152749.
•
Physiopedia. (n.d.). Snowboarder’s Ankle. Retrieved from https://www.physio-pedia.com/Snowboarder%27s_Ankle
•
Young CC, Niedfeldt MW. Snowboarding injuries. Am Fam Physician. 1999 Jan 1;59(1):131-6, 141. Erratum in: 2000 Jan 1;61(1):50.
Erratum in: Am Fam Physician 1999 Aug;60(2):404. Erratum in: Am Fam Physician 1999 Feb 15;59(4):786. PMID: 9917579.
•
Mammoth Orthopedic Institute. (n.d.). Lateral Process Fracture of the Talus AKA Snowboarder Fracture. Retrieved from
https://www.mammothortho.com/lateral-process-fracture-of-the-talus-aka-snowboarder-fracture.html
ANKLE FRACTURES IN
SNOWBOARDING
BY:
PREVALENCE
MECHANISM OF INJURY
FRACTURE SEVERITY
MECHANISM OF INJURY
CLASSIFICATION OF INJURY
CONSERVATIVE TREATMENT
SURGICAL TREATMENT
RECOMMENDED TREATMENT FOR AN ATHLETE
REFERENCES
•
Kramer, Irene Fleur, et al. “Snowboarders’ Ankle.” BMJ Case Reports, U.S. National Library of Medicine, 29 Oct. 2014,
www.ncbi.nlm.nih.gov/pmc/articles/PMC4216907/.
•
Boon AJ, Smith J, Zobitz ME, Amrami KM. Snowboarder’s talus fracture. Mechanism of injury. Am J Sports Med. 2001 MayJun;29(3):333-8. doi: 10.1177/03635465010290031401. PMID: 11394605.
•
Perera A, Baker JF, Lui DF, Stephens MM. The management and outcome of lateral process fracture of the talus. Foot Ankle Surg. 2010
Mar;16(1):15-20. doi: 10.1016/j.fas.2009.03.004. Epub 2009 May 1. PMID: 20152749.
•
Physiopedia. (n.d.). Snowboarder’s Ankle. Retrieved from https://www.physio-pedia.com/Snowboarder%27s_Ankle
•
Young CC, Niedfeldt MW. Snowboarding injuries. Am Fam Physician. 1999 Jan 1;59(1):131-6, 141. Erratum in: 2000 Jan 1;61(1):50.
Erratum in: Am Fam Physician 1999 Aug;60(2):404. Erratum in: Am Fam Physician 1999 Feb 15;59(4):786. PMID: 9917579.
•
Mammoth Orthopedic Institute. (n.d.). Lateral Process Fracture of the Talus AKA Snowboarder Fracture. Retrieved from
https://www.mammothortho.com/lateral-process-fracture-of-the-talus-aka-snowboarder-fracture.html
Athletic Injury Care PowerPoint Presentation
Describe the common motions performed while participating in the sport and why the lower extremity
injury assigned is common in the sport. Review both conservative and surgical treatment for the injury,
and describe the proposed treatment that is recommended or required for an athlete. Include
recommended rehabilitation required, including any bracing, strapping, casting, shoe modification,
and/or custom orthotic device that would be beneficial for the athlete during or after conservative care
or for recovery during the post-operative care if surgery is required. Pictures of such devices should be
included.
Remember to include references either on each slide, or in a summary slide of your references at the
end of the presentation. Each group will be allotted 5 minutes of time to present and highlight the key
points.
Submit the presentations to your DSL who will upload files into google drive before the presentation
date so that it will be available to the faculty and for you to review for examination.
Sport Topics:
1. Turf toe in Football
2. Posterior impingement syndrome in Dance
3. Anterior impingement syndrome in Soccer
4. Achilles tendon ruptures in Basketball
5. Open fractures in MMA
6. Plantar fasciitis/fasciosis in Baseball
7. Stress fractures in Track and Field
8. Sesamoiditis in Gymnastics
9. Jones fractures in Tennis
10. IT band syndrome in Ironman
11. Ankle fractures in Snowboarding
12. Ankle sprains in Volleyball
Presentations will be graded as follows:
Mechanism of Injury
(MOI)
Sport
Treatment
Treatment of athlete
Presentation Skills
2
Complete and through
explanation of all
possible MOIs
All common motions of
sport described and
relates this to MOIs
Complete and through
explanation of
conservative and
surgical treatments
Preferred treatment for
various situations
outlined, supported by
research
Students speak
confidently, are audible,
and/or have engaging
presentation.
1
Missing some possible
MOIs for particular
injury
Missing some common
motions of sport and
their relation to MOI
Incomplete or
inaccurate explanation
of conservative and
surgical treatments
Vague treatment plan
given
0
Ineffective discussion of
MOI
Students are able to
speak fairly confidently.
May be difficult to
understand/hear. May
be unable to effectively
engage audience.
Students are not
confident while
presenting, are
inaudible and/or do not
seem to engage
audience.
Students will lose points if:
Presentation not within time limit of 5 minutes (-1):
_______
References not cited (-1):
_______
Total (10): _______
Ineffective discussion or
common motions in
assigned sport
Ineffective discussion of
conservative/surgical
treatments
Ineffective discussion
on treatment of athlete
Ankle Fractures in Snowboarding
1
Prevalence
• Fracture of the lateral process of the talus
•
Referred to as “Snowboarder’s Fracture/Ankle”
•
15% of all ankle injuries and 34% of all ankle fractures
•
Easily missed with 48% being diagnosed late
•
Misdiagnosis can result in long-term morbidity
2
Mechanism of Injury
• Dorsiflexion of the ankle with inversion of the hindfoot
• Landing from aerial maneuver or jump
• Ankle fractures are more common when wearing soft shell boots and
carry twice the risk of injury compared to hard shell boots
3
Severity of Fracture
• Type of treatment depends on the lateral process fracture grade as
classified by Hawkins
Type I
Simple fracture
NWB short leg cast for 6wks
Type IA
Less than 2mm
displaced
NWB short leg cast for 6wks
Type IB
More the 2mm
displaced
ORIF
Type II
Comminuted
fracture
ORIF
Type III
Chip Fracture
NWB short leg cast for 6wks
4
Conservative Treatments
•
Manual Reduction
•
Immobilization
•
RICE
•
Pain Management
•
Physical Therapy
5
Surgical Treatments
Open Reduction Internal Fixation
• Fracture fragment excision
•
6
History and Physical Exam
HPI: 29-year-old female presents to the ER with left ankle pain
after falling off of her snowboard three hours ago
Vascular & Neuro: Intact
Derm: Distinct swelling and ecchymosis around the lateral
malleolus at the level of the anterior talofibular ligament (ATFL).
No external lesions.
MSK: Tenderness on palpation around the ATFL. Limited ROM due
to pain. No deformities noted. (-) Anterior Drawer Test.
7
Assessment
•
Radiographs showed possible
fracture line on the Anteroposterior
View but not on the Lateral View
•
CT Scan shows comminuted intraarticular fracture of the lateral
process of the talus
8
Plan
•
ORIF with a k-wire and 2.4mm lag
screws
•
NWB short leg cast for 4wks followed
by WB short leg cast for another 4 wks
9
Follow-Up
•
Follow-up CT scan 2 months postoperatively
10
References
Author links open overlay panelA. Perera FRCS, et al. “The Management and Outcome of Lateral Process Fracture of the Talus.” Foot and Ankle Surgery,
Elsevier, 1 May 2009, www.sciencedirect.com/science/article/abs/pii/S1268773109000344?via%3Dihub.
Caracchini, Giuseppe, et al. “Talar Fractures: Radiological and CT Evaluation and Classification Systems.” Acta Bio-Medica : Atenei Parmensis, U.S.
National Library of Medicine, 19 Jan. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6179081/.
Dunn, K A. “What Are the Health Hazards of Snowboarding?” The Western Journal of Medicine, U.S. National Library of Medicine, Feb. 2001,
www.ncbi.nlm.nih.gov/pmc/articles/PMC1071277/.
KM;, Boon AJ;Smith J;Zobitz ME;Amrami. “Snowboarder’s Talus Fracture. Mechanism of Injury.” The American Journal of Sports Medicine, U.S. National
Library of Medicine, pubmed.ncbi.nlm.nih.gov/11394605/. Accessed 30 Oct. 2023.
Kramer, Irene Fleur, et al. “Snowboarders’ Ankle.” BMJ Case Reports, U.S. National Library of Medicine, 29 Oct. 2014,
www.ncbi.nlm.nih.gov/pmc/articles/PMC4216907/#R8.
Kramer, Irene Fleur, et al. “Snowboarders’ Ankle.” BMJ Case Reports, U.S. National Library of Medicine, 29 Oct. 2014,
www.ncbi.nlm.nih.gov/pmc/articles/PMC4216907/.
Luger, Nancy M., et al. “Talus Fractures in Snowboarders: A Case Series.” MDPI, Multidisciplinary Digital Publishing Institute, 26 May 2022,
www.mdpi.com/2673-4036/2/2/12.
11
Ankle Fractures
In Snowboarding
Motions in Snowboarding
● Snowboarders ride with both feet fixed by non-releasable bindings to a board
● Stand perpendicular to the long axis of their boards
● Snowboarders twists from forward to backward planes instead of side to side like skiers
do
● Gliding lets the snowboarder move around gentle hills on the mountain with one foot
strapped in and the free foot resting on the board.
● Snowboarders “skid” the board on the snow in zig-zag pattern (creates frictional
resistance with the snow).
○ Snowboard edge tilted and the exposed base of the board “plows” into the snow
head on
● Purely carved turn usually done by experienced snowboarders
○ snowboard is pointing in the same direction as its velocity
● 4 basic movements:
○ The more you tilt your board the more you engage
your edge through the turn.
○ By flexing one ankle and extending the other,
you create a twist on the snowboard.
○ Pivot is the rotation of the snowboard and it
helps the board skid through the turn.
○ Keeping your weight centered over the front foot
controls pressure over the board
Mechanism of Injury
Snowboarder’s fracture
● High energy trauma
● Dorsiflexion and inversion in combination with an axial load
○ a possible role of eversion (fixed pronated foot)
○ external rotation at the tibia
○ usually the forcing of ankle into dorsiflexion and inversion occurs during a
landing from an aerial maneuver or a jump, especially when the landing has
been over-rotated
● The talar head laterally shifts. The lateral process of the talus compresses against
the calcaneus and the lateral malleolus
● High incidence in snowboarders due to the use of soft boots which results in more
flexibility around the ankle joint leading to higher risk of foot and ankle injuries
● Movement and the positioning of the ankle joint at the time of injury appear to be
more important than the type of footwear being used
● Commonly misdiagnosed as a lateral ankle sprain
Management According to Hawkins’ Classification
Hawkins’ classification:
I. Simple fractures: extending from the talofibular articular surface to the posterior talocalcaneal
articular surface of the subtalar joint.
II. Comminuted fractures: involving both the articular surfaces and the entire lateral process.
III. Chip fractures: arising from the anterior and inferior portion of the
posterior articular process involving only the subtalar joint and not extending
into the talofibular articulation.
Treatment:
Conservative
● Implicated if fracture is non-displaced/minimally displaced ( 2 mm) fracture:
● Patient can bear right away if only excision/debridement was performed
● With ORIF, 1 week NWB in splint post-op
● Continue to be NWB for 4-6 weeks in short leg cast and crutches
● When healed bony fragments, patient can carefully transition to weightbearing. Will do figure
8 taping method for 6-12 weeks or gauntlet ankle brace
● Patient will also be referred to physical therapy. Ankle ROM and strengthening begin when
healing signs are seen on the x-ray.
● Return to sport in approximately 6 months
References
Snowboarder’s Ankle. (n.d.). Physiopedia. https://www.physio-pedia.com/Snowboarder%27s_Ankle
A. (n.d.). Lateral Process Fracture of the Talus Snowboarder’s Fracture | Diagnosis & Treatment | Mammoth Lakes, CA. Lateral
Process Fracture of the Talus Snowboarder’s Fracture | Diagnosis & Treatment | Mammoth Lakes, CA.
https://www.mammothortho.com/lateral-process-fracture-of-the-talus-aka-snowboarder-fracture.html
Barbosa N (2021) Occult Talar Fractures in Young Athletes Case Report and Literature Review. Clin Res Foot Ankle 9: 322.
https://www.omicsonline.org/open-access-pdfs/occult-talar-fractures-in-young-athletes-case-report-and-literature-review.pdf
Majeed, H., & McBride, D. J. (2018). Talar process fractures: An overview and update of the literature. EFORT Open
Reviews, 3(3), 85-92. Retrieved Sep 7, 2023, from https://doi.org/10.1302/2058-5241.3.170040
YOUNG, C. C., & NIEDFELDT, M. W. (n.d.). Snowboarding Injuries. Snowboarding Injuries | AAFP.
https://www.aafp.org/pubs/afp/issues/1999/0101/p131.html
Snowboarders Ankle | News | OneWelbeck Orthopaedics. (n.d.). Snowboarders Ankle | News | OneWelbeck Orthopaedics.
https://onewelbeck.com/news/snowboarder-s-ankle-a-commonly-mis-diagnosed-injury/#list-item-2
O’Brien, K. (2021, July 1). Beginner’s Guide to Snowboarding. PSIA-AASI. https://www.thesnowpros.org/take-alesson/beginners-guide-to-snowboarding/