Sports Medicine: Fractures, Sprains, and Other Musculoskeletal Injuries

Family physicians commonly treat athletes with simple fractures and other musculoskeletal injuries that require temporary immobilization. Certain fractures (eg, intraarticular, multiple, open, associated with dislocations or tendon injury) typically are managed by orthopedic subspecialists. During the healing process, a custom-molded or prefabricated orthopedic support, known as an orthosis, may be used to support the injured area and prevent reinjury. To reduce the risk of complications that may develop from orthosis use, timely follow-up is required. Proficiency in specific orthotic applications, such as splint application and cast making, requires continued skill maintenance. Patients with suspected scaphoid bone fractures should initially undergo splinting or bracing in a thumb spica device until fracture is definitively diagnosed or ruled out. Injuries to the extensor tendons of the finger are managed with continuous extension splinting for 4 to 6 weeks. Patients with grade I and II medial collateral ligament injuries heal well with use of a hinged knee brace for 4 to 6 weeks. There is no good evidence for use of a brace after anterior cruciate ligament repair. Lateral ankle sprains are common, and bracing is an integral component of functional rehabilitation and injury prevention. There are specific requirements related to reimbursement for orthoses prescriptions.