Football Traumatology Current Concepts: from Prevention

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Football Traumatology

Current Concepts: from Prevention to Treatment

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Piero Volpi (Ed.)

Football Traumatology

Current Concepts:

from Prevention to Treatment

Foreword by:

Neil P. Thomas Franco Carraro Sergio Campana Giacinto Facchetti

Springer

-

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PIERO VOLPI

Center for Sports Rehabilitation Galeazzi Orthopaedics Institute Milan, Italy

Library of Congress Control Number: 2005937087

ISBN 10 88-470-0418-7 Springer Milan Berlin Heidelberg New York ISBN 13 978-88-470-0418-4 Springer Milan Berlin Heidelberg New York

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Springer is a part of Springer Science+Business Media springer.com

63 Springer-Verlag Italia 2006 - 2nd printing 2006 Printed in Italy

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Cover design: Simona Colombo, Milan, Italy Typesetting: Graphostudio, Milan, Italy

Printing: Grafiche Porpora, Cernusco SIN (MI), Italy

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Foreword

This anthology of Football Traumatology edited by Dr. Piero Volpi comprises the collective experience of many of the leading surgeons in Europe whose practice includes footballers at all levels. By pooling this experience and clearly defining common problems and areas of current interest Professor Volpi has produced a very useful reference source for orthopaedic surgeons, sports physicians and physiotherapists. Future editions may expand on emerging areas in non-surgical fields such as dietary supplements and the effects of psychological factors on both injury itself as well as recovery. Topics in this first edition such as Epidemiology, Training Methods, Prevention, and Future Treatment are welcome adjuncts to the usual subjects and reflect recent areas of research.

Neil P. Thomas President ESSKA 2000 Winchester UK With football becoming ever more relentless and intense, the role of the sports doctor has become in the last few years increasingly important in protecting footballers' health and their physical integrity. It is in this context that Dr. Volpi's in depth and wide ranging work must be viewed. His attention has focused specifically on two important aspects: the fight against doping and the prevention of sports traumas. Together with his scientific experience as a sports clini- cian and traumatologist, Dr. Volpi can also draw on his direct field experience as a football player, which adds considerable value to the editing of the current vol- ume, intended as a service to football. With the Football World Cup just round the corner, this book produced in collaboration with both Italian and foreign experts is particularly topical: I am convinced that the spread of medical-scientific knowledge and innovations is the most efficient way to safeguard the health of athletes and encourage the growth of a "better" football.

Franco Carraro President of the Italian Football Federation

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VI Foreword This wide editorial initiative, conceived and realized by Dr. Piero Volpi, a pre- cious and not replaceable AIC consultant, brings an important scientific contri- bution to medical questions connected to football.

It is noticeable in the work the importance of the Author's direct experiences, first as players and as sport and traumatic doctor then.

AIC has always been strongly engaged in safeguarding the players' health, real protagonists of the sport event, and has, between his leading aims, the fight against doping and the traumas prevention.

The information, the knowledge and the education are fundamental for players who want to successfidly face the fight to defend their physical integrity and professional dignity.

This praiseworthy editorial effort goes exactly in the direction wished by AIC and will be useful for all the football component to enrich their cultural heritage but especially to know how important is the work done by who acts in order to improve sport anyhow.

Sergio Campana President AIC Italian Footballers Association As an F.C. Internazionale executive, and through dealing with the topic in UEFA and FIFA Commision meetings, I have been able to closely follow Piero Volpi's work in these past ten years. I have come to appreciate the preparation and ethics of a person who was "born" on the pitch and has since been through many experiences, first as footballer and later as a sports doctor. This interesting book is the result of an analysis of these two lives that run parallel, but which are not always necessarily linked in the professional world: theory is verified by practice, research addresses the demands and problems faced at the highest com- petitive levels.

The knowledge and possibilities offered by sports medicine today are far superior to those in my generation of footballers. Piero Volpi's book is the most recent and vivid example that today's athlete has the moral and professional duty to consider his own health as one of the most important and decisive aspects of his career - at the very level and on each occasion, starting from the basis, from the decisive transition between playing for fun and playing competitively.

Giacinto Facchetti President, EC. Internazionale Milano

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Preface

Every child has a dream: to play football and become a famous footballer.

When I was 10 years old, my father was used to bring me to San Siro stadium on sunday afternoons to watch the Inter team playing. The great Inter was grow- ing up. Sarti, Burnich, Facchetti.. . it was an absolute and sudden love.

Twenty years later I was climbing that prestigious stadium through the stairs from the locker rooms wearing the shirt of Como team to play a football match of the first league Italian championship against Inter.

Fifteen years later, I was sitting as a chief physician on the bench of the Moratti's Inter team, Ronaldo, Baggio, etc.

Sometimes dreams come true.

With the present book I accomplish today another wish. To enrich the won- derful world of football with scientific and specialistic contributions on football traumatology, a branch that has undergone important hits and progresses.

Football has constant need of medical, diagnostic, clinical, therapeutic knowledge to counteract the increased number of traumas occurring during sport per- formance in order to defend the integrity of its players, beeing them profession- als, amateurs, young or women.

Thanks to my father, to him my dearest memory, thanks for bringing me to the stadium when I was a child.

Thanks to everybody that I met in the football world: players, team compan- ions and competitors, trainers, managers, physicians, physiotherapists, press reporters, fans; I learned from everyone as in a real "gym of lifeyy.

Thanks to the Authors of this book, for their participation and for the high scientific level reached in their chapters.

Thanks to Springer who has been recipient of this idea and was able with great skill to make it real.

Piero Volpi

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Contents

Section I General concepts Epidemiology and Risk Factor

P. VOLPI ...

Aspects of Biomechanics

G. CERULLI, A. CARAFFA, G. ZAMARRA, F. FANTASIA,

M. LORENZINI, D. CHECCARELLI

...

^{1 1}

Training Methods

C.BORDON ... 23 Evaluation of Whole Physical Condition

F. PIGOZZI,A. GUIMBINI, F. FAGNANI,~. DI SALVO

...

33 Biochemical and Haematological Parameters in Football Players

G.BANFI.. ... 43 Prevention of Football Injuries

I. BERKES,A. KYNSBURG, G. PANICS

...

⁵³

Organisation of a Professional Team's Medical Staff and the Physician's Role

P.VOLPI ... 67 Injuries in Women's Football

L. ENGEBRETSEN, K. STEFFEN

...

75 Referee Lesions

J. ESPREIGUERA-MENDES, C. ARCE ... ⁸⁹

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X Contents

Future treatmentsfor Football lnjuries

M.FERRETTI,B.A.ZELLE,F.H.FU ... ¹⁰¹

Section II: Specific lnjuries

Maxillo-Facial Traumatology

R. BRUSATI, F. BIGLIOLI

...

^{1 13}

Upper Extremity lnjuries

P.VOLPI, R. POZZONI, M. GALLI, C. BAIT ... ¹²³

Shoulder Dislocation

R.ZINI

...

¹²⁷

Back Problems

E. ROLLAND, G. SAILLANT ... ¹⁴³

Muscle lnjuries

D. TORNESE, G. MELEGATI, P.VOLPI

...

¹⁵³

Tendon lnjuries

M.K. SAYANA, N. MAFFULLI ... ¹⁶⁵

Groin Pain

A. FERRETTI, A. DE CARLI, E. MONACO

...

¹⁸³

Meniscal Lesions

M.DENTI,D.LOVETERE

...

¹⁹⁷

Anterior Cruciate Ligament lnjuries

P. AGLIETTI, F. GIRON, P. CUOMO

...

²⁰⁵

Anteromedial Knee Instability

M. MARCACCI, S. ZAFFAGNINI

...

^{2 17}

Medial Side Injury of the Knee

P. ADRAVANTI, A. AMPOLLINI

...

²³¹

Posterior Cruciate Ligament lnjuries

P.P. MARIANI, F. MARGHERITINI ... ²⁴⁵

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Contents XI

Articular Cartilage Lesions in Football Players

L. PETERSON, C. ERNEST ... ²⁵⁵

Patellofemoral Problems

A. SCHIAVONE PANNI, M. TARTARONE,A. PATRICOLA, D. SANTAITI

...

²⁶³

Footballer's Arthritic Knee

S. LUSTIG, T. AIT SI SELMI, E. SERVIEN, G. TROTTA, P. NEYRET ... ²⁷⁵

Leg Fractures

KARLP.BENEDETTO

...

²⁸⁷

Malleolar Fractures

F. CASTOLDI, R. ROSSI, A. MARMOTTI, R. DEL DIN, P. ROSSI ... ²⁹⁷

Ankle Ligament Injuries

A.VENTURA,A.LANZETTA

...

³⁰⁷

Osteochondral Ankle Defects

M.ZENGERINK,N.VANDUK ... ³¹⁹

Chronic Footballer's Ankle

E. GIZA, B. MANDELBAUM

...

³³³

Foot Problems

S. GIANNINI,A. FERRUZZI, M. MOSCA, C. BIAGINI ... ³⁵³

Stress Fractures

F. BENAZZO, M. MOSCONI, G. ZANON

...

³⁶⁵

Rehabilitation after Football Injuries

S.WERNER ... ³⁷⁵

Return to Play

A. CACCHIO, G. MELEGATI, P.VOLPI

...

³⁸⁹

Protective Equipment

D.T. KIRKENDALL ... ⁴⁰¹

Subject Index

...

⁴¹⁷

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Contributors

ADRAVANTI PAOLO

Casa di Cura "Citti di Parma"

Parma, Italy AGLIETTI PAOLO First Orthopaedic Clinic University of Florence Florence, Italy AIT SI SELMI TARIK Centre Livet

Service Professeur Philippe Neyret Caluire, France

AMPOLLINI ALDO

Casa di Cura "Citti di Parma"

Parma, Italy ARCE CARLOS

Orthopaedics and Sports Trauma Department

Pedro Hispano Hospital Matosinhos, Portugal ARCHILLETTI ANTONIO

Laboratory of Clinical Biomechanics

"Let People Move"

Perugia, Italy BAIT CORRADO

Center for Sports Rehabilitation

Galeazzi Orthopaedics Institute Milan, Italy

BANFI GIUSEPPE

Facolti di Scienze Motorie Universitl di Milano Istituto Ortopedico Galeazzi Milano, Italy

BENAZZO FRANCESCO Orthopaedics and Trauma Department, University of Pavia Policlinico San Matteo

Pavia, Italy BENEDETTO KARL P.

Trauma Surgery and Sports Medicine Academic Hospital Feldkirch Austria

BERKES ISTVAN

Department of Sports Orthopaedic Medicine and Rehabilitation Faculty of Physical Education and Sports Science, Semmelweis University Budapest, Hungary

BIAGINI CHIARA

Orthopaedics Department University of Bologna Rizzoli Orthopaedic Institute Bologna, Italy

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XIV Contributors BIGLIOLI FEDERICO

Maxillo-Facial Surgery Unit Ospedale San Paolo Milan, Italy BORDON CLAUDIO U.S. Citth di Palermo Palermo, Italy BRUSATI ROBERTO Maxillo-Facial Surgery, University of Milan, Italy Maxillo-Facial Surgical Unit Ospedale San Paolo

Milan, Italy CARAFFA AURO University of Perugia

Orthopaedics and Traumatology Department

R. Silvestrini Hospital Laboratory of Clinical Biomechanics

"Let People Move"

Perugia, Italy CACCHIO ANGELO

Dipartimento di Neuroscienze Unith Operativa di Medicina Fisica e Riabilitazione Ospedale San Salvatore L'Aquila, Italy

CASTOLDI FILIPPO

University of Turin Medical School

"Umberto I" Hospital Turin, Italy

CERULLI GIULIANO University of Perugia

Orthopaedics and Traumatology

Department

R. Silvestrini Hospital Laboratory of Clinical

Biomechanics "Let People Move"

Perugia, Italy

CHECCARELLI DANIELE University of Perugia

R. Silvestrini Hospital Perugia, Italy

C u o ~ o PIERLUIGI First Orthopaedic Clinic University of Florence Florence, Italy DE CARLI ANGELO

Orthopaedic Unit and Kirk Kilgour Sports Injury Center

San Andrea Hospital University "La Sapienza"

Rome, Italy DEL DIN RAINERO

Third Department of Orthopaedics and Traumatology

"Umberto I" Hospital, Turin, Italy DENTI MATTEO

Sports Traumatology and Arthroscopic Surgery Unit

Galeazzi Orthopaedics Institute Milan, Italy

DI SALVO VALTER University Institute of Movement Sciences Rome, Italy

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Contributors XV ENGEBRETSEN LARS

Orthopaedic Center Ulleval University Hospital Oslo, Norway

ERNEST CHRISTIAN Gothenburg Medical Center Wstra Frolunda, Sweden ESPREGUEIRA-MENDES JOAO Orthopaedic and Sports Trauma Department

Minho University and Porto University Porto, Portugal FAGNANI FEDERICA University Institute of Movement Sciences Rome, Italy

FANTASIA FABIANO University of Perugia

FERRETTI ANDREA

San Andrea Hospital University "La Sapienza"

Rome, Italy FERRETTI MARIO University of Pittsburgh School of Medicine

Department of Orthopaedic Surgery Kaufmann Building

Pittsburgh, USA

Fu FREDDIE H.

University of Pittsburgh School of Medicine

Department of Orthopaedic Surgery Kaufmann Building

Pittsburgh, USA GALLI MARCO

Sports Traumatology and Arthroscopic Surgery Unit Galeazzi Orthopaedics Institute Milan, Italy

GIANNINI SANDRO Orthopaedics Department University of Bologna Rizzoli Orthopaedic Institute Bologna, Italy

GIOMBINI ARRIGO University Institute of Movement Sciences Rome, Italy

GIRON FRANCESCO First Orthopaedic Clinic University of Florence Florence, Italy GIZA ERIC

Santa Monica Orthopaedic Sports Medicine and Research Foundation Santa Monica, USA

KIRKENDALL DONALD T.

Department of Exercise and Sport Sciences

University of North Carolina Chapel Hill, USA

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XVI Contributors KRISHNA SAYANA, MURALI

Department of Trauma and Orthopaedics

University Hospital of North Staffordshire Post Graduate Medicine Keele Medical School

Stoke-on-Trent, United Kingdom KYNSBURG AKOS

Department of Sports Orthopaedic Medicine and Rehabilitation Faculty of Physical Education and Sports Science, Semmelweis University Budapest, Hungary

LANZETTA ALBINO 1st Division, Traumatology Sport Centre

Orthopaedic Institute Gaetano Pini Milan, Italy

Lo VETERE DARIO Sports Traumatology and Arthroscopic Surgery Unit Galeazzi Orthopaedics Institute Milan, Italy

L~RENZINI MICHELA University of Perugia

LUSTIG SBBASTIEN Centre Livet Service Professeur Philippe Neyret Caluire, France

MAFFULLI NICOLA

Department of Trauma and Orthopaedics

University Hospital of North Staffordshire Post Graduate Medicine Keele Medical School Stoke-on-Trent United Kingdom MANDELBAUM BERT

Santa Monica Orthopaedic Sports Medicine and Research Foundation Santa Monica, USA

MARCACCI MAURIZIO Rizzoli Orthopaedic Institute Sports Traumatology and Orthopaedics Division Biomechanics Laboratory Bologna, Italy

MARGHERITINI FABRIZIO University of Motor Sciences Unit of Sports Traumatology Rome, Italy

MARIANI PIER PAOLO University of Motor Sciences Unit of Sports Traumatology Rome, Italy

MARMOTTI ANTONGIULIO Third Department of Orthopaedics and Traumatology

University of Turin

Medical School Mauriziano

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Contributors XVII MELEGATI GIANLUCA

MONACO EDOARDO

St. Andrea Hospital University "La Sapienzayy Rome, Italy

M o s c ~ MASSIMILIANO Orthopaedics Department University of Bologna Rizzoli Orthopaedic Institute Bologna, Italy

MOSCONI MARIO

Clinica Ortopedica e Traumatologia dell'universitl degli Studi di Pavia Centro Studi e Ricerche in Medicina e Traumatologia dello Sport

Policlinico San Matteo Pavia, Italy

NEYRET PHILIPPE Centre Livet Service Professeur Phiippe Neyret Caluire, France PANICS GERGELY

Department of Sports Orthopaedic Medicine and Rehabilitation Faculty of Physical Education and Sports Science

Semmelweis University Budapest, Hungary

PATRICOLA ALESSANDRO ANTONIO ISpeO

Istituto Specialistico Ortopedico Casa di Cura "San Giuseppe"

Rome, Italy PETERSON LARS

Gothenburg Medical Center Vastra Friilunda, Sweden PIGOZZI FABIO

University Institute of Movement Sciences Rome, Italy

P o z z o ~ ~ ROBERTO Sports Traumatology and Arthroscopic Surgery Unit Galeazzi Orthopaedics Institute Milan, Italy

ROLLAND ERIC

Orthopaedic Surgery Service PitiC SalpEtriCre Hospital Paris, France

ROSSI PAOLO

3rd Department of Orthopaedics and Traumatology

Ross1 ROBERTO

Orthopaedics and Traumatology University of Turin

Medical School

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XVIII Conttibutors

SAILLANT G~RARD

Orthopaedic Surgery Service Piti6 Salp&tri&re Hospital Paris, France

SANTAITI DANIELE ISpeO

Rome, Italy

SCHIAVONE PANNI ALFREDO ISpeO

Rome, Italy SERVIEN ELVIRE Centre Livet Service Professeur Philippe Neyret Caluire, France STEFFEN KATHRIN Oslo Sports Trauma Research Center Norwegian School of Sport Sciences Oslo, Norway TARTARONE MARIO ISpeO

Rome, Italy TORNESE DAVIDE

TROTTA GIUSEPPE Centre Livet Service Professeur Philippe Neyret Caluire, France

VAN DIJK C. NIEK

Department of Orthopaedic Surgery Academic Medical Centre

University of Amsterdam Amsterdam, The Netherlands VENTURA ALBERTO

1st Division, Traumatology Sport Centre

Orthopaedic Institute Gaetano Pini Milan, Italy

VERCILLO FABIO University of Perugia

VOLPI PIERO

WERNER SUZANNE Section of Sports Medicine Division of Molecular Medicine and Surgery Karolinska Institutet Stockholm, Sweden ZAFFAGNINI STEFANO Rizzoli Orthopaedic Institute Sports Traumatology and

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Conttibutoa XIX Orthopaedics Division

Biomechanics Laboratory Bologna, Italy

ZAMARRA GIOVANNI University of Perugia

Orthopaedics and Traumatology Department of Perugia

ZANON GIACOMO

Clinica Ortopedica e Traumatologia dell'Universit8 degli Studi di Pavia Centro Studi e Ricerche in Medicina e Traumatologia dello Sport

Policlinico San Matteo Pavia, Italy

ZELLE BORIS A.

University of Pittsburgh School of Medicine

Department of Orthopaedic Surgery Pittsburgh, USA

ZENGERINK MAARTJE

Department of Orthopaedic Surgery Academic Medical Centre

University of Amsterdam Amsterdam

The Netherlands ZINI RAUL U.O. Ortopedia Azienda Ospedaliera San Salvatore Pesaro, Italy