Caine Dennis, Purcell Laura, Maffulli Nicola
Department of Kinesiology and Public Health Education, University of North Dakota, Grand Forks, ND, USA.
Department of Pediatrics, David Braley Sport Medicine and Rehabilitation Centre, McMaster University, Hamilton, ON, Canada.
BMC Sports Sci Med Rehabil. 2014 Jun 10;6:22. doi: 10.1186/2052-1847-6-22. eCollection 2014.
The increased participation of children and adolescents in organized sports worldwide is a welcome trend given evidence of lower physical fitness and increased prevalence of overweight in this population. However, the increased sports activity of children from an early age and continued through the years of growth, against a background of their unique vulnerability to injury, gives rise to concern about the risk and severity of injury. Three types of injury-anterior cruciate ligament (ACL) injury, concussion, and physeal injury - are considered potentially serious given their frequency, potential for adverse long-term health outcomes, and escalating healthcare costs. Concussion is probably the hottest topic in sports injury currently with voracious media coverage and exploding research interest. Given the negative cognitive effects of concussion, it has the potential to have a great impact on children and adolescents during their formative years and potentially impair school achievement and, if concussion management is not managed appropriately, there can be long term negative impact on cognitive development and ability to resume sports participation. Sudden and gradual onset physeal injury is a unique injury to the pediatric population which can adversely affect growth if not managed correctly. Although data are lacking, the frequency of stress-related physeal injury appears to be increasing. If mismanaged, physeal injuries can also lead to long-term complications which could negatively affect ability to participate in sports. Management of ACL injuries is an area of controversy and if not managed appropriately, can affect long-term growth and recovery as well as the ability to participate in sports. This article considers the young athlete's vulnerability to injury, with special reference to ACL injury, concussion, and physeal injury, and reviews current research on epidemiology, diagnosis, treatment, and prevention of these injury types. This article is intended as an overview of these injury types for medical students, healthcare professionals and researchers.
鉴于儿童和青少年群体中身体素质下降和超重患病率上升的证据，全球范围内儿童和青少年更多地参与有组织的体育运动是一个值得欢迎的趋势。然而，儿童从幼年开始并在成长过程中持续增加体育活动，而他们又特别容易受伤，这引发了人们对受伤风险和严重程度的担忧。前交叉韧带（ACL）损伤、脑震荡和骨骺损伤这三种损伤，因其发生频率、长期不良健康后果的可能性以及不断攀升的医疗费用，被认为可能较为严重。脑震荡可能是目前运动损伤领域最热门的话题，受到媒体的大量报道，研究兴趣也在激增。鉴于脑震荡对认知有负面影响，它有可能在儿童和青少年的成长阶段产生重大影响，可能损害学业成绩，如果脑震荡管理不当，还可能对认知发展以及恢复运动参与的能力产生长期负面影响。突发性和渐进性骨骺损伤是儿科人群特有的损伤，如果处理不当会对生长产生不利影响。虽然缺乏相关数据，但与压力相关的骨骺损伤的发生率似乎在上升。如果处理不当，骨骺损伤也可能导致长期并发症，对参与运动的能力产生负面影响。ACL损伤的管理存在争议，如果处理不当，会影响长期生长和恢复以及参与运动的能力。本文探讨了年轻运动员易受伤的情况，特别提及ACL损伤、脑震荡和骨骺损伤，并综述了目前关于这些损伤类型的流行病学、诊断、治疗和预防的研究。本文旨在为医学生、医疗保健专业人员和研究人员提供这些损伤类型的概述。
