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Chaosuan Kanchanomai and Vajara Phiphobmongkol

A locking compression plate (LCP) can serve as an external fixation for fractured tibia. However, there is concern about the stability and endurance during partial weight bearing. This study was experimentally evaluated the effects of fracture gap sizes (1, 5, and 10 mm) on the stability and endurance of fractured tibia externally fixed with a 316L-stainless LCP. For stable fractured tibia (1-mm fracture gap), the large contact area of fracture surfaces resulted in nearly similar stiffness to that of intact tibia. The partial weight bearing is therefore possible. Whereas smaller contact area and no contact of fracture surfaces were observed for tibias with 5-mm and 10-mm fracture gaps, respectively. Their stiffnesses were significantly lower than those of intact tibia and tibia with 1-mm fracture gap. Thus, the partial weight bearing should be considered carefully in early phase of treatment. All LCP-tibial models were cyclically loaded beyond 500,000 cycles, that is, approximately 6 months of healing, without any failure of LCP. Thus, the failure of LCP is unlikely a critical issue for the present cases.

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Katie Crockett, Saija A. Kontulainen, Jonathan P. Farthing, Philip D. Chilibeck, Brenna Bath, Adam D.G. Baxter-Jones, and Catherine M. Arnold

Distal radius fractures (DRF) are the most common fractures in women over the age of 50 years ( Edwards et al., 2006 ; Handol, Madhok, & Howe, 2006 ; Mulhall, Ahmed, Khan, & Masterson, 2002 ), with the incidence increasing from 9% at age 50–59 to 38% after age 80 ( Barrett-Conner, Weiss, McHorney

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Sheena S. Philip, Joy C. Macdermid, Saranya Nair, Dave Walton, and Ruby Grewal

Distal radius fracture (DRF) is a common, debilitating injury of the upper extremity with a crude incidence of 175.5/100,000 persons in the United States ( Orces & Martinez, 2010 ). The number of older adults (>50 years) who received treatment for forearm and hand fractures increased by 15.2% in U

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Kelly M. Seevers, Hannah G. Stephenson, and Adam B. Rosen

Key Points ▸ Division I collegiate female soccer player diagnosed with blow-up fracture and concussion. ▸ Blow-up fractures are uncommon in sport. ▸ Treatment varies based on severity of fractures and compounding factors such as a concussion. Between the 2014/2015 and 2018/2019 reporting years, an

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Michael S. Guss, John P. Begly, Austin J. Ramme, David P. Taormina, Michael E. Rettig, and John T. Capo

Major League Baseball (MLB) players are highly skilled athletes that require full function of their hands to perform at the highest level, and are at risk for hook of hamate fractures while swinging the bat, or from direct blunt trauma, such as a fall on an outstretched hand or an errant pitch. 1

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Sravya Vajapey and Timothy L. Miller

Key Points ▸ Vertical fractures of the medial malleolus are rare but inherently unstable fractures due to shear forces created during weightbearing. ▸ These injuries occur most commonly in the presence of a varus hindfoot deformity or as a stress fracture from repetitive overuse or anteromedial

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Takahiro Ogawa, Yuki Sueyoshi, Shintaro Taketomi, and Nobumasa Chijiiwa

Age-related sarcopenia and osteoporosis-related fractures are critical health issues among older adults. In general, many older adults suffer from fractures and spend much time in bed rest, inducing decreased skeletal muscle mass and function deterioration, such as in activities of daily living

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Ian Robertson, Marina Lazarides, and Cody R. Butler

pathology in active populations. 4 , 5 Ineffective or inadequate rehabilitation can lead to detrimental loss of strength and atrophy of supporting muscles, increased pain, and prolonged return to preinjury function. In the appropriate clinical context, it can also lead to malunion of the fracture site and

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Shannon David, Kim Gray, Jeffrey A. Russell, and Chad Starkey

The original and modified Ottawa Ankle Rules (OARs) were developed as clinical decision rules for use in emergency departments. However, the OARs have not been evaluated as an acute clinical evaluation tool.


To evaluate the measures of diagnostic accuracy of the OARs in the acute setting.


The OARs were applied to all appropriate ankle injuries at 2 colleges (athletics and club sports) and 21 high schools. The outcomes of OARs, diagnosis, and decision for referral were collected by the athletic trainers (ATs) at each of the locations. Contingency tables were created for evaluations completed within 1 h for which radiographs were obtained. From these data the sensitivity, specificity, positive and negative likelihood ratios, and positive and negative predictive values were calculated.


The OARs met the criteria for radiographs in 100 of the 124 cases, of which 38 were actually referred for imaging. Based on radiographic findings in an acute setting, the OARs (n = 38) had a high sensitivity (.88) and are good predictors to rule out the presence of a fracture. Low specificity (0.00) results led to a high number of false positives and low positive predictive values (.18).


When applied during the first hour after injury the OARs significantly overestimate the need for radiographs. However, a negative finding rules out the need to obtain radiographs. It appears the AT’s decision making based on the totality of the examination findings is the best filter in determining referral for radiographs.

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Federico Jose Villalba and Melina Soledad Martínez

third most common musculoskeletal condition presenting to primary care physicians, physiotherapists, and athletic trainers worldwide. 1 For all injuries of the shoulder girdle, the global incidence of sternoclavicular (SC) injuries are less than 1%, and only 6% of those are fracture-dislocations 2 (i