TreatmentTreatment depends on the type of fracture. Typically, a wrist fracture requires immobilization in a cast or splint for 4-12 weeks depending on the fractured bone. Commonly, it is necessary to apply a splint for a few days until the swelling decreases prior to applying a cast. Ice and elevation of the wrist will help reduce the swelling. In addition, anti-inflammatory or other pain medications may be prescribed for pain control. If the bones are crooked, the sports medicine physician may attempt to straighten them prior to applying a splint. If there is significant separation, angulation (crooked appearance), or inadequate healing of the fracture after casting, surgery may be required.
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Return To PlayReturn to play should be overseen by a sports medicine physician to ensure safe and timely return to sport. Follow-up appointments typically include repeat x-rays to assess for bony healing. Most physicians will determine readiness to return to play based on the return of full strength, pain-free full range of motion and the ability to protect the wrist during activity. This takes varying amounts of time, but is usually about 6-8 weeks. Rehabilitation may be needed after casting to assist with stretching and strengthening the wrist to help it return to normal.
From a clinical perspective, creatine supplementation has been found to potentially offer health benefits with minimal adverse effects in younger populations. Hayashi et al. [81] found improvements in pediatric patients with systemic lupus erythematosus and reported no adverse changes in laboratory parameters of hematology, kidney function, liver function or inflammatory markers after 12 weeks of creatine supplementation. Tarnopolsky et al. [82] reported significant improvements in fat-free mass and hand grip strength in 30 pediatric patients with Duchenne muscular dystrophy following 4 months of creatine supplementation. Importantly, the creatine supplementation protocol appeared to be well tolerated and did not adversely affect laboratory markers of kidney function, oxidative stress, and bone health [81,82,83]. In addition, Sakellaris et al. [83] reported significant improvements in traumatic brain injury-related outcomes in children and adolescents who received oral creatine supplementation (0.4 g/kg/day) for 6 months. These neurological benefits may have potential applications for young athletes participating in collision sports, which pose underlying risks of concussions or sub-concussive impacts. Further, several of these clinical trials implemented strict clinical surveillance measures, including continual monitoring of laboratory markers of kidney health, inflammation, and liver function; none of which were negatively impacted by the respective creatine supplementation interventions. These findings support the hypothesis of creatine supplementation likely being safe for children and adolescents. However, perhaps the strongest supporting evidence for the safety of creatine is the recent classification of creatine as generally recognized as safe (GRAS) by the United States Food and Drug Administration (FDA) in late 2020 ( ). Ultimately, this classification indicates that the currently available scientific data pertaining to the safety of creatine, is sufficient and has been agreed upon by a consensus of qualified experts, thereby determining creatine to be safe under the conditions of its intended use ( ). Even though infants and young children are excluded from GRAS, this would still apply to older children and adolescent populations.
Canine Sports Medicine and Rehabilitation 2nd Edition PDF offers a thoroughly revised and updated new edition of this gold standard reference for all aspects of sports medicine and rehabilitation, encompassing basic science and integrated veterinary and physical therapy approaches.
Appealing to a broad readership, this book will be of interest to both laboratory research scientists and clinicians, including orthopedists, sports physicians, physiatrists, and regenerative medicine experts.
Scott Rodeo is a clinician-scientist at the Hospital for Special Surgery (HSS), with appointments in the Department of Orthopedics and the Research Department. He is a Professor of Orthopedic Surgery at Weill Cornell Medical College and Co-Chief Emeritus of the Sports Medicine Service at the Hospital for Special Surgery. He serves as Vice Chair of Orthopaedic Research and Director of the HSS Center for Regenerative Medicine. He specializes in sports medicine injuries of the knee, shoulder, ankle and elbow and performs arthritis surgery on the knee and shoulder, including joint replacement surgery. Rodeo serves as Head Team Physician for the New York Giants Football Team. . 2ff7e9595c
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