Figure 5 - available via license: CC BY-NC
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Coronal and sagittal MRI images of the wrist. Note: The orange arrow and white triangle show increased signal, consistent with dorsal ulnotriquetral ligament injury.
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Liana J Tedesco,1 Hasani W Swindell,1 Forrest L Anderson,1 Eugene Jang,1 Tony T Wong,2 Jonathan K Kazam,2 R Kumar Kadiyala,3 Charles A Popkin1 1Center for Shoulder, Elbow and Sports Medicine, Columbia University Medical Center, New York, NY, USA; 2Department of Radiology, New York Presbyterian Hospital, New York, NY, USA; 3Department of Orthopedic...
Context in source publication
Context 1
... Though little data have been published regarding "hockey wrist", the diagnostic and treatment options are quite like those of TFCC tears. Advanced imaging may be necessary to identify the injury ( Figure 5). As such, initial management consists of immobilization, often with a removable wrist splint. ...
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... A very important part of the case is that despite the daily performance load on the upper limb and compensating for the supination deficit, there was no development of degenerative or traumatic changes in his shoulder or wrist joint. Holding the hockey stick with the upper hand in palmar flexion of the wrist and pronation can lead to overloading the triangular fibrocartilage complex and its injuries [39]. In the case of fixed pronation and inability to change the wrist position to supination, we can assume increased stress on these structures. ...
Background and Objectives: Proximal radioulnar synostosis (PRUS) is the most frequent congenital forearm disorder, although the prevalence in the general population is rare with a few hundred cases reported. Pfeiffer, Poland, Holt–Oram, and other serious congenital syndromes contain this abnormality. Non-syndromic cases with isolated PRUS very often exhibit as SMAD6, NOG genes variants, or sex chromosome aneuploidy. A subgroup of patients with haematological abnormalities presents with HOXA11 or MECOM genes variants. Case report: We present a non-syndromic adult elite ice-hockey player with unilateral proximal radioulnar synostosis of the left forearm. In early childhood he was able to handle the hockey stick only as a right-handed player and the diagnosis was set later at the age of 8 years due to lack of supination. Cleary–Omer Type III PRUS was found on x-ray with radial head hypoplasia and mild osteophytic degenerative changes of humeroulnar joint. Since the condition had minimal impact on sports activities, surgical intervention was not considered. The player continued his ice-hockey career at the top level and joined a national team for top tournaments. Upper extremity function assessment with questionnaires and physical testing resulted in minimal impairment. The most compromised tool was the Failla score with 10 points from a total of 15. Genetic testing with Sanger sequencing revealed no significant pathogenic variant in SMAD6, NOG, and GDP5 genes. No potentially pathogenic copy number variants were detected by array-based comparative genomic hybridization. Conclusions: In the reported case, the ability of an athlete to deal with an anatomic variant limiting the forearm supination is demonstrated. Nowadays, a comprehensive approach to rule out more complex musculoskeletal impairment and family burden is made possible by evolving genetics.
... The literature on hand and wrist injuries in ice hockey is limited. 2,18,25,31 Finger contusions and wrist sprains were reported in an epidemiology study of men's and women's collegiate hockey players. 25 Another study found that hand, wrist, and elbow injuries comprised roughly 14% of hockey-related visits to the emergency department. ...
Background: Ice hockey referees and linesmen are at risk for musculoskeletal injuries because of the lack of protective equipment and contact with players, sticks, pucks, the ice surface and boards.
Purpose: To quantify and analyze injuries reported by officials of the International Ice Hockey Federation (IIHF).
Study Design: Descriptive epidemiology study.
Methods: A 61-question survey tool was designed by an interdisciplinary team to evaluate musculoskeletal injuries experienced by ice hockey officials. This survey was administered to 600 active IIHF referees and linesmen. Only completed survey responses were included in the statistical analysis. Continuous variables were analyzed using unpaired t-tests, while categorical data were assessed utilizing chi-square tests.
Results: Of the 600 surveys administered, 264 surveys were completed by officials from 45 countries (44% response rate). Of the respondents, 72% were male, and 28% were female, with a mean age of 31.1 ± 5.8 years. Officiating experience averaged 11.4 ± 6.0 years (6.3 ± 4.5 years with the IIHF). A total of 295 injuries were reported by 55% of the officials. Injuries occurred more frequently during games compared with training, and officials who worked year-round had more total injuries than those who took time off (P 1⁄4 .03). The most common injuries involved the wrist and hand (n 1⁄4 64 [22%]), head and face (n 1⁄4 58 [20%]), and the knee (n 1⁄4 47 [16%]). Wrist and hand trauma included 23 fractures. Knee and shoulder injuries were most likely to require surgery compared with other body areas (P < .001); 30 officials underwent surgery because of an acute knee injury (10%). Injury prevention activities were effective at reducing injuries (P 1⁄4 .04).
Conclusion: Most ice hockey officials experienced musculoskeletal injuries during their career. The risk of trauma to the wrist and hand can possibly be reduced via equipment modifications including protective gloves. A greater emphasis should be placed on injury prevention programs and time away from officiating competitions.
Keywords: referees; ice hockey; musculoskeletal injury; injury prevention
... In tennis, wrist injuries most commonly involve the ECU tendon and are associated with the forehand (13). In hockey, common wrist injuries include TFCC tears, hook of hamate fractures, and dorsal ulnotriquetral ligament (DUTL) injuries (14). In golfers, 67% of injuries occur in the leading wrist with the majority at the ulnar side, while 87% of all ulnar-sided injuries happen in the leading wrist (15). ...
... Hockey players are exposed to powerful pronosupination during hockey shots and repetitive load bearing when impacting the ice or surrounding boards (14,25). Continuous contact with the hockey stick end, long hours of shooting practice, and FOOSH injuries compress the hypothenar eminence (19). ...
... Continuous contact with the hockey stick end, long hours of shooting practice, and FOOSH injuries compress the hypothenar eminence (19). Grasping the hand placed more proximal on the hockey stick in wrist flexion, radial deviation, and forearm pronation places the greatest tension on the DUTL (14,26). ...
Ulnar-sided wrist injuries are common in sports that require repeated pronosupination, wrist radial/ulnar deviation, axial loading, and gripping equipment. Common anatomic structures affected include the triangular fibrocartilage complex, extensor carpi ulnaris tendon, distal radioulnar and ulnocarpal joints, and hamate bone. Presenting symptoms include pain with activity, swelling, possible snapping or clicking, and reproduction of symptoms with provocative maneuvers. Imaging may confirm or rule out pathologies, but abnormal findings also may present in asymptomatic athletes. Initial treatment is usually nonoperative with splinting, load management, activity modification, strengthening the components of the kinetic chain of the particular sport, and pain management. Surgery is usually indicated in ulnar-wrist pain pathology such as hook of hamate fractures and required in associated instability. Future research should address specific treatment and rehabilitation protocols, emphasizing the complete kinetic chain along with the injured wrist.
Soccer is a global widespread sport with a high injury rate, mostly to the lower limbs. Even though upper limb injuries are much less common among soccer players, their prevalence has increased in recent years. This is due to several reasons/factors, including new and more aggressive tactics, a rise in the number of younger players with different levels of skeletal maturation, and due to the growth of women’s participation in sports, which is in line with the fast progression in the degree of professionalism in women’s soccer. This review paper aims to (a) describe the most common injuries in the shoulder, arm, and elbow in soccer players and (b) to show the role of different imaging modalities in diagnosing upper extremity injuries that can occur in this sport. Familiarity with these injuries and their mechanisms will lead to a quicker diagnosis and correct reporting of imaging of soccer players.
Dr. Forrest L. Anderson, MD, Curriculum Vitae and Career Timeline. Current Position: New York-Presbyterian Hospital, Columbia University Irving Medical Center Resident Physician Department of Orthopaedic Surgery
New York, NY 10032 Phone: (212) 305-5974 E-mail: fla2102@cumc.columbia.edu
EDUCATION & EXPERIENCE:
2013–2017 Columbia University, College of Physicians and Surgeons MD,
Alpha Omega Alpha Honor Society New York, NY
2007–2011 Columbia University Columbia College BA, Biology, New York, NY
2003–2007 The Bronx High School of Science, New York, NY
2007-2011 Rower, Columbia University Varsity Heavyweight Crew New York Athletic Club Rowing Team
2017 New York City Marathon Finisher, Team Tisch MS
As of Summer, 2022, Fellow at Stanford University Medical School, Orthopedic Surgeon specializing in Sports Medicine Surgery.
The article presents data from modern foreign and domestic scientific sources about the most common injuries when playing hockey, as well as measures to prevent injuries in this sport.
