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攀石导致肘部脱位的中-长期功能结果和重返运动情况:一项临床回顾性队列研究。

Mid- to long-term functional outcome and return to sport after elbow dislocation in bouldering: a clinical retrospective cohort study.

机构信息

Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany.

Clinic of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

出版信息

Arch Orthop Trauma Surg. 2024 Jul;144(7):3145-3151. doi: 10.1007/s00402-024-05397-0. Epub 2024 Jun 13.

Abstract

INTRODUCTION

Traumatic elbow dislocations are among the most common injuries in sport climbing. They occur most frequently in bouldering (a climbing discipline with strong upward trend often performed indoors) due to the typical low-height backward fall into crashpads. There is still no data about the functional outcome and return to sport of this typical bouldering injury.

MATERIALS AND METHODS

All Patients with elbow dislocations due to a bouldering associated fall between 2011 and 2020 were identified retrospectively in our level I trauma centre. Trauma mechanisms, injury types and therapies were obtained. Follow-up was performed with an online questionnaire including sports-related effects, return to sport and the Elbow Self-Assessment Score (ESAS).

RESULTS

30 patients with elbow dislocations after bouldering accidents were identified. In 22 (73.3%) patients the injury was a simple dislocation. The questionnaire was completed by 20 patients. The leading mechanism was a low-height fall into crashpads. Surgical procedures were performed in every second patient. 18 patients (90%) reported return to bouldering after 4.7 ± 2.1 months. 12 patients (66.7%) regained their pre-injury level. Mid-/Long-term follow-up (mean 105 ± 37.5 months) showed excellent results in ESAS score (97.2 ± 3.9 points). Persistent limited range of motion or instability was reported by only 3 patients (15%).

CONCLUSION

Most athletes are able to return to bouldering but only two thirds regain their pre-injury performance level in this demanding upper-extremity sport. The unique low-height trauma mechanism may create a false sense of security. Specific awareness and safety features should be placed for climbing athletes to reduce elbow injuries.

摘要

简介

运动性肘脱位是攀岩运动中最常见的损伤之一。由于典型的高向低向后坠落至软垫,它们在抱石(一种具有强烈向上趋势的攀岩运动,通常在室内进行)中最为常见。对于这种典型的抱石损伤,其功能结果和重返运动的情况仍缺乏数据。

材料与方法

我们在一级创伤中心回顾性地确定了 2011 年至 2020 年间因抱石相关坠落而发生肘脱位的所有患者。获取了创伤机制、损伤类型和治疗方法。通过在线问卷进行随访,包括与运动相关的影响、重返运动和肘部自我评估评分(ESAS)。

结果

确定了 30 例因抱石事故发生肘脱位的患者。22 例(73.3%)患者的损伤为单纯脱位。20 例患者完成了问卷。主要机制是低高度坠落至软垫。每例患者中均有一半患者接受了手术。18 例(90%)患者在 4.7±2.1 个月后报告重返抱石。12 例(66.7%)患者恢复了受伤前的水平。中/长期随访(平均 105±37.5 个月)显示 ESAS 评分结果优异(97.2±3.9 分)。仅 3 例(15%)患者报告存在持续的活动度受限或不稳定。

结论

大多数运动员能够重返抱石运动,但在这项高难度上肢运动中,只有三分之二的运动员能够恢复到受伤前的运动水平。独特的低高度创伤机制可能会产生一种虚假的安全感。应针对攀岩运动员采取特定的意识和安全措施,以减少肘部损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7256/11319378/e2088d87d734/402_2024_5397_Fig1_HTML.jpg

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