Emergency Care for Avulsed Teeth and Sports Injuries

Rugby Player with Avulsed Tooth

• Appropriate immediate treatment for a rugby player with an avulsed tooth (a tooth knocked out) involves covering/storing the tooth in gauze.
• Stick the tooth back into the socket without cleaning it.
• Clean the tooth and the socket carefully with water, holding the tooth by the roots.
• Clean out the socket thoroughly with gauze.
• Inject local anesthetic (LA) and adrenaline into the socket.
• If dirty, irrigate with saline or milk or suck the tooth clean under the tongue.
• Debris should not be scraped off the tooth root.
• If the patient is alert, reimplant the tooth and have them bite down on gauze.
• If not alert, store the tooth in milk (preferably skim) and seek immediate dental care within 2 hours of injury.

Weight Training in 12-Year-Olds

• Significant muscle hypertrophy is expected in 12-year-olds participating in weight training.
• Most injuries occur at the growth plates during weight training.
• Weight training significantly benefits injury prevention.
• A strong correlation is observed between strength training and sports-related injuries- higher training severity correlates with higher injury severity.
• Weight training promotes overall health and well-being.

Hip Arthroscopy for Athletes

• The benefits of hip arthroscopy for athletes are low after two years.
• The benefit is evident up to ten years when combined with labral repair and osteoplasty.
• The complication rate of hip arthroscopy is 1-7%.
• Returning to sport after hip arthroscopy 88% return to sport.
• A significant complication (20%) rate is noted if combining procedures are not done.
• Labral tears are definitely correlated with OA.

Immobilization of an Injured Limb and Strength Loss

• Muscle atrophy is observed following limb immobilisation.
• Fast twitch muscle fibres exhibit the most atrophy during the first week.
• Muscle strength starts decreasing 24 hours after the immobilisation.
• Strength loss is more pronounced after a week.
• The second week of immobilisation shows increasing strength loss.
• Muscle loss is similar for all fiber types.

Exertional Headaches

• Potential underlying causes of exertional headaches include aneurysms and raised intracranial pressure.
• Other possible causes include cardiac issues, Arnold-Chiari malformation, and normal pressure hydrocephalus.

Exertional Headaches in Soccer Players

• Appropriate course of action for a soccer player experiencing recent exertional headaches includes taking 25-50mg of Indocid one hour before exercise.
• Sumatriptan should be taken at symptom onset.

Medications Increasing Heat Illness Risk

• Amphetamines, beta-blockers, colchicine, calcium channel blockers and antihistamines increase the risk of heat illness by disrupting sweating.

60-Year-Old with Muscle Pain

• The least likely cause of myopathy (muscle pain) in a 60-year-old is cimetidine.
• Statins may cause myopathy (a condition involving painful and inflammatory muscle disease).
• NSAIDS are another potential cause of myopathy as well as colchicine.

ECG Changes Not Normal in Athletes

• Early repolarization is considered normal in athletes.
• Type I second-degree heartblock (Wenkebach) is not normal.
• Sinus bradycardia below 30bpm is not normal in athletes..
• Junctional escape rhythm isn't normal, and ventricular couplets are also abnormal.

Indications for Radial Head Fracture Surgery

• Indications for surgery in radial head fractures include 25% angulation or 20% involvement of the articular surface if the fracture is undisplaced.
• If a small, undisplaced fracture has occured following an elbow dislocation which is reduced, surgical intervention can also be necessary.

Mechanical Block in Flexion at 100°

• A mechanical block in flexion at 100 degrees, along with a 2 mm displaced fracture, is a potential indication for surgery, depending on additional findings.

Benign Bone Tumor in Children/Adolescents

• Osteochondroma is the most common benign bone tumor in childhood and adolescence.

Quickest Time to Adjust to a Different Time Zone

• Adapting to a different time zone across multiple time zones can take between 6 and 48 hours.

Right-handed Adolescent Tennis Player with Back Pain

• The most likely diagnosis for a right-handed adolescent tennis player with left lower back pain after three weeks is a Pars defect, Pars stress, Paravertebral muscle strain, or facet joint dysfunction.

Snowboarding vs. Skiing Injuries

• Snowboarding injuries disproportionately lead to higher rates of head injuries.
• Ankle sprains & fractures are more common in snowboarders.

Exercise-Associated Muscle Cramps

• Exercise-related muscle cramps are predominantly caused by electrolyte imbalances.

School Children on Snowboarding Trips

• Hard boots, helmets, and wrist guards are all suitable choices for protection while on snowboarding trips.
• Hip guards reduce wrist fractures and shoulder dislocations.
• Elbow pads decrease the risk of common injuries.
• Backbone guards reduce concussion risk as well.

Dancer with Posterior Ankle Pain

• Flexor hallucis longus (FHL) tenosynovitis is the most probable cause of posterior ankle pain with crepitus in dancers.

Tanner Stage

• Determining Tanner stage involves assessing pubic hair distribution across the pubis area and inner thighs.

Stress Fractures in Ballet Dancers

• Base of the second metatarsal is the most common stress fracture in ballet dancers.

Athlete with Vitamin D Level of 25

• If an athlete has a vitamin D level of 25, nothing is abnormal; additional measurement can be taken in 1-2 weeks.
• 3000-5000 IU per day is advised to restore or maintain appropriate levels.
• Sun exposure for 6-7 minutes during midmorning and midafternoon in summer is also recommended, or 7-40 minutes at noon during the winter.
• Daily supplementation with vitamin D (10,000 IU) and subsequent re-evaluation are recommended as well.

Time Zone Adaptation

• Adjusting to a new time zone typically takes approximately one day per hour of time difference.