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Musculoskeletal injury in children and skeletally immature adolescents: Overview of treatment principles for nonoperative injuries

Authors
Gabriel P Brooks, PT, DPT, SCS, MTC
Albert C Hergenroeder, MD
Section Editor
Joseph Chorley, MD
Deputy Editor
James F Wiley, II, MD, MPH

INTRODUCTION

This topic provides an overview of the basic principles of and modalities used in the treatment of nonoperative musculoskeletal injuries in young athletes. Rehabilitation of musculoskeletal injuries, with an emphasis on the physical therapy program, is discussed separately. (See "Musculoskeletal injury in children and skeletally immature adolescents: Overview of rehabilitation for nonoperative injuries".)

The discussion that follows assumes that fractures and joint instability have been excluded. The evaluation of musculoskeletal trauma and the management of fractures and unstable joints are discussed separately (refer to UpToDate topics on the specific bone or joint in which fracture or dislocation is suspected)

EPIDEMIOLOGY

Approximately 60 million US youth aged 6 through 18 years participate in organized sports each year [1]. Analysis of sports and recreation related injury episodes in the United States has shown an average annual estimate of 8.6 million injury episodes with an age-adjusted rate of 34.1 per 1000 population [2]. Overall, injury rates are higher among males and children between the ages of 5 to 14 years. Approximately 50 percent of injuries require medical attention. Injuries to the lower extremities are most common (42 percent) followed the upper extremities (30 percent), and head and neck (16 percent).

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases report there are more than 2.6 million children younger than 19 years of age who were treated in emergency departments for musculoskeletal injuries due to sport participation [3]. Musculoskeletal injuries are also the most common reason for injury-related visits to primary care physicians. Sprains and strains, growth plate injuries, and repetitive motion injuries account for the majority of injuries.

Although most children and adolescents with musculoskeletal complaints can be managed by primary care providers with appropriate training, such children often are referred to specialists [4]. Primary care providers (including pediatricians, family physicians, and internists) and providers trained in physical medicine and rehabilitation frequently report a lack of confidence and/or training in the management of musculoskeletal problems [5-8].

                    
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Literature review current through: Nov 2017. | This topic last updated: Sep 05, 2017.
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