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1.  Rectus abdominis overuse injury in a tennis athlete treated with traumeel 
Summary
Background:
Rectus abdominis injuries are common in tennis players at all levels of competition. Traumeel® injection can be used for treatment of muscle strains and hematomas.
Case Report:
A 21-year-old female tennis athlete was injured on the non-dominant rectus abdominis during the cocking phase of the service motion. She suffered from pain and tenderness. One week later, during a serve, she experienced severe pain on the contralateral side of her abdomen. Conservative treatment was performed by the team physician with rest, ice therapy and analgesics for 20 days, but she had recurrent injuries. The ultrasonography and MRI showed hematoma of the rectus abdominis muscle. She was treated with 2 injections of Traumeel® on the 2nd, 4th, 6th post-traumatic day and received 1 injection on the 10th post-traumatic day. She also modified her serve technique. On the fourth post-treatment week the athlete had pain-free function and both the MRI appearance and the size of rectus abdominal muscle were normal. She returned to her sport activities. There is no recurrence of her injury 2 years later.
Conclusions:
Rectus abdominis hematoma must be diagnosed early. Traumeel® injections are effective, safe and well-tolerated for the treatment of overuse injury of the rectus abdominis following strain.
doi:10.12659/AJCR.882235
PMCID: PMC3616070  PMID: 23569472
rectus abdominis; overuse injury; Traumeel® injection
2.  Isolated thumb carpometacarpal joint dislocation: a case report and review of the literature 
Background
Isolated thumb carpometacarpal dislocation is a rare injury pattern and the optimal treatment option is still controversial.
Case Description
We present a 27-year-old basketball player who underwent an isolated dorsal dislocation of the thumb carpometacarpal joint after a fall. The dislocation was successfully reduced by closed means but the joint was found to be grossly unstable. Due to inherent instability, repair of the ruptured dorsoradial ligament and joint capsule was performed.
The ligament was detached from its proximal insertion into trapezium and subsequently stabilized via suture anchors. The torn capsule was repaired in an end-to-end fashion and immobilization of the joint was applied for 6 weeks.
Results
At 3-year follow up evaluation the patient was pain free and returned to his previous level of activity. No restriction of carpometacrpal movements or residual instability was noticed. Radiographic examination showed normal joint alignment and no signs of subluxation or early osteoarthritis.
Conclusion
Surgical stabilization of the dorsal capsuloligamentous complex may be considered the selected treatment option in isolated carpometacarpal joint dislocations, that remain unstable after closed reduction in young and high demand patients.
Level of Clinical Evidence: Level IV
doi:10.1186/1749-799X-5-16
PMCID: PMC2841114  PMID: 20219137
3.  Bilateral rectus femoris intramuscular haematoma following simultaneous quadriceps strain in an athlete: a case report 
Introduction
Bilateral rectus femoris haematoma following a simultaneous strain of the quadriceps muscles is a very rare condition.
Case presentation
We report the case of a 21-year-old Greek Caucasian female rowing athlete who was injured on both thighs. She complained of pain and inability to walk. Physical examination revealed tenderness over the thighs and restriction of knee movement. The result of a roentgenogram was normal, and there was no evidence of fracture or patella displacement. Magnetic resonance imaging revealed haematoma formation in both the rectus femoris muscles. The diameters of the left and right haematomas within the muscles were 6 cm and 5 cm, respectively. Therapeutic approaches included compression bandages, ice application, rest, elevation, and administration of muscle relaxant drugs. Active stretching and isometric exercises were performed after three days. The patient was able to walk using crutches two days after the initiation of treatment. On the seventh day, she had regained her full ability to walk without crutches. Non-steroidal anti-inflammatory drugs were administered on the fifth day and continued for one week. Six weeks later, she had pain-free function and the result of magnetic resonance imaging was normal. She was able to resume her training programme and two weeks later, she returned to her previous sport activities and competitions.
Conclusion
There are references in the literature regarding the occurrence of unilateral quadriceps haematomas following strain and bilateral quadriceps tendon rupture in athletes. Simultaneous bilateral rectus femoris haematomas after a muscle strain is a rare condition. It must be diagnosed early. The three phases of treatment are rest, knee mobilization, and restoration of quadriceps function.
doi:10.1186/1752-1947-4-56
PMCID: PMC2830982  PMID: 20167096
4.  Closed subtalar dislocation with non-displaced fractures of talus and navicular: a case report and review of the literature 
Cases Journal  2009;2:8793.
Closed subtalar dislocations associated with talus and navicular fractures are rare injuries. We report on a case of a 43-year-old builder man with medial subtalar dislocation that was further complicated by minimally displaced talar and navicular fractures. Successful closed reduction under general anesthesia was followed by non-weight bearing and ankle immobilization with a below-knee cast for 6 ;weeks. At 3 years post-injury, the subtalar joint was stable, the foot and ankle mobility was in normal limits and the patient could still work as a builder. However, he complained for occasionally mild pain due to the development of post-traumatic arthritis in subtalar and ankle joints. Our search in literature revealed that conservative treatment of all the successfully reduced and minimally displaced subtalar fracture-dislocations has given superior results compared to surgical management. However, even in cases with no or slight fracture displacement, avascular necrosis of the talus or arthritis of the surrounding joints can compromise the final functional outcome.
doi:10.4076/1757-1626-2-8793
PMCID: PMC2769472  PMID: 19918402

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