Page 99 - Hospital Authority Convention 2018

Masterclasses

M5.1 Orthopaedic Sports Injuries Revisit 16:15 Convention Hall A

Common Sports Injuries of the Knee and the Shoulder: The Facts and the Myths
Wong YB
Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital, Hong Kong
Knee and the shoulder injuries are common sports-related injuries and have been the subject debate and research for HOSPITAL AUTHORITY CONVENTION 2018
decades. It is our purpose to examine the current evidence from a scientific point of view, and establish the facts about these
common conditions.

We are going to clarify some myths about the anterior cruciate ligament (ACL) that it ACL is usually torn due to direct impact
in sports; ACL injury occurs more often in men; all complete ACL tears require surgery; ACL reconstruction is only performed
on complete tears; the bone-patellar tendon-bone (BPTB) is the strongest graft; ACL reconstruction surgery requires a long
hospital stay and long rehabilitation period; and re-injury rates are high.

We are also going to discuss the predisposing factors for patellar dislocation, the myths that patients may grow out of it, or
get trained out of it; there is no need to seek medical help and remain largely asymptomatic; surgery is rarely necessary but
rather straightforward if needed, yet with unpredictable results.

For shoulder injuries, we will revisit the mechanism of dislocation and elucidating the myths that there is no need to go to
hospital for reduction; surgery is never necessary for first time dislocators; and surgery is straight forward and easy.

On rotator cuff tears, we will go through the common mechanism of injury, and address the various myths on investigation,
diagnosis, pre-operative exercise, injections, surgery, and rehabilitation. Finally, we hope to differentiate facts from fiction by
carefully examining available evidence. Monday, 7 May 2018

M5.2 Orthopaedic Sports Injuries Revisit 16:15 Convention Hall A

Ankle Sprain is Common but Not Always Simple
Chan KB
Department of Orthopaedics and Traumatology, Tuen Mun Hospital, Hong Kong

Ankle sprain is a general term to describe injury around the ankle ligaments, most commonly on lateral side of the ankle
resulted in lateral ligaments injury or tear. It usually results from inversion injury in which the lateral ligaments are injured.

It is the most common injury in young athletes. Epidemiological studies from the US had estimated incidence rate of ankle
sprain in general population to be between 5 to 7 sprains per 1,000 person-years. Local data from Accident and Emergency
Department, Tuen Mun Hospital had shown that there were about 1,500 consultations in 2017. The incidence was about 2 to
3 sprains per 1,000 person-years.

There are several possible risks factors, athlete, basketball or football players are prone to injury especially after jump when
they landed on other’s feet resulted in inversion injury. Others might have underlying predisposing factors such as varus
hindfoot in which they are also prone to repeated ankle sprain. Gender, height, weight and BMI also had no conclusive
evidence on increasing incidence of ankle sprain. Research team from South Korea found that wearing high heel shoes can
put your ankle at risk. Journal of Foot and Ankle Surgery also reported that increasing incidence in high-heel related injury,
7,000 in 2002, 14,000 in 2012.
Ankle sprain carries a major impact on the healthcare cost and in the US, two billion dollars was spent on treatment of sprain.
In addition to financial cost, these injuries are also associated with significant time lost to injury, delayed return to duty and
long-term disability in up to 60% of patients. Research had been shown that chronic ankle instability in around 15-20 % of
patients even if they were properly treated. Surgical intervention might be needed in those patients.
In fact, not every ankle sprain is simple and the same. There are other conditions look alike but requires different treatment
modalities. Those conditions will be highlighted, and principles of management will be discussed briefly.

97