Purpose: Description of the types of injuries occurring in ‘’semi-professional’’ soccer players, analysis some factors influencing the occurrence and registration of treatment’s options.

Material & Method: Between 1999–2003, 112 males semi-professional soccer players of different levels of skill, aged 16–38 (average: 28,4yrs) sustained 128 injuries during games or practice. Previous injuries, frequency of playing soccer weekly and options of treatment were also registered.

Results: 89% of injuries caused by trauma and 11% by overuse. 68% of injuries involved the lower extremity, 21% the upper extremity, 7% both upper & lower extremity and 4% the spine. Joints sprains predominated (36%), followed by fractures (25%), menisci tears (12%), ligaments injuries (10%), e.t.c. More than 15 different injuries were treated. Injuries to the ankle were most prevalent (42%), followed by the knee (26%) and the wrist (17%). The 2/3 of the injured players were playing soccer ‘’occasionally’’ (no more than 1–2 times per week, usually without any previous training), while the 1/3 had suffered previous injury in the same area of their body. 45% of injured players were > 30yrs old. Most injuries occurred during games. The treatment was surgically or conservatively (in ratio 1:1), depending on the type of injury.

Conclusions: Soccer players sustained a variety of injuries. Poor physical condition (occasionally playing & practicing), and ‘’personal’’ factors (previous injuries, level of skill) seemed to be related with the frequency and the severity of the occurred injuries. The treatment is based on the type of injury.

Aim of study: The rupture of the distal brachial tendon is a relatively infrequent trauma. Our aim is to present the results of surgical confrontation of 3 recent ruptures of that tendon.

Material and method: In 2002 we faced 3 patients of age of 31,.37,.50 years with a recent rupture of distal brachial tendon. The ruptures concerned the left winger bicipital which was the not prevailing hand and happened at the effort of lifting of weight. The intervention was realised between 2nd and 10th day from the rupture. All the damage was argued by MRI. We applied the modified technique at Boyd -Anderson. The repairing of the tendon, via two sections, occured with suture Dexon No 2, via his natural passage, in the tuberositas radii. This technique was preferred in order not to cause damage to the posterior interosseous nerve.

Results: The follow up was 8–12 months from surgery. The results in all three were excellent with full range of movement and force of bending, extent, pronation, supination.

Conclusions: The results that we had lead us to the conclusion that the method of election in the young active adults is the surgical repairing of the tendon in its anatomic place.

Thoracic outlet syndrome (TOS) is characterized by a series of symptoms, which arise from the compression of the neurovascular bundle between the supraclavicular space and its entry to the axilla. The type and intensity of symptoms is relative to the site of compression and the anatomic structures involved.

Between 1990 and 2001, 42 patients were operated for thoracic outlet syndrome utilizing a supra-clavicular incicion (8 bilateral). 12 were male and 30 female. Ages ranged from 21 to 55 years (mean 31). The time interval between the onset of first symptoms and operation was 7 to 12 months in 16 patients and 1 to 4 years in 26 patients. All patients had neurologic symptoms with pain, paresthesias and numbness in the lateral neck, shoulder or arm. The duration and intensity of symptoms was variable. 12 of them had symptoms arising from the arterial compression. Preoperative evaluation included a formal clinical and neurologic examination, radiographs of the chest and cervical spine, Electromyography was often performed if a carpal tunnel syndrome was suspected. Angiography was performed in patients with vascular symptoms. MRI scan of the cervical spine and supraclavicular spaces were routine practice. Most of the patients had undergone prolonged conservative treatment including medication (muscle relaxants and analgesics), physiotherapy, exercises and cervical brace immobilization. This approach produced only temporary improvement or even aggravation of their neurologic complaints.

Intraoperativelly we found: Hypertrophy of the scalene muscle with aberrant or broad insertion on the first rib (31 pts), perineural fibrosis (5 pts), long type cervical rib (2 pts), fibromuscular bands between the 7 transverse process and the first rib (4 pts), vascular bridge pinching the lower trunk (4 pts). In four cases no obvious anatomic finding within the thoracic outlet affecting the brachial plexus could be found. The follow up period ranged from 6 months to 10 years (mean 6 years). Results were classified as excellent in 16, who were free of symptoms. Good in 12, who complained of mild symptoms on daily activities but were significantly improved. Poor in 6 who had persistent or aggravation of their symptoms. 4 patients from the poor results group were treated by 1st rib excision, on a later stage and experienced significant improvement.

The operative complications include one case of pneumothorax and a temporary dysfunction of the phrenic and XI cranial (accessory) nerve. No postoperative complications were found and the average hospitalization period ranged between 24 – 48 hours.

Humeral shaft fractures are among the most frequent fractures encountered in Orthopaedic Traumatology. Their treatment can be either conservative or operative depending on the location (proximal, middle or distal third), type (spiral, oblique, or transverse), radial nerve involvement, concomitant presence of thoracic injuries that preclude general anesthesia, as well as surgeon’s experience. Non union or delayed union complicates some of the conservatively and very few of the operatively treated fractures.

We report of our experience with the management of humeral shaft non unions in 28 patients treated at our institution from 1990 to 2000. Six were male and twelve female aging from 21 to 68 years (mean 45 years).The interval between initial injury and operation varied from 6 months to 3 years (average 10 months).Regarding the location of non union,20 cases were located in the middle, 6 cases in the upper and 2 cases in the distal third.

Operative technique: under general anesthesia using anterolateral approach for middle and distal third and deltopectoral approach for proximal third , the site of pseudarthrosis was exposed. In transverse and slightly oblique fractures a self compression plate was implanted without resection of pseudarthrosis or excessive soft tissue detachment .In spiral and true oblique fractures reduction performed initially, maintained with k-wires and fixated with self compression plate. Upon completion of osteosynthesis suction drain was put ,followed by wound closure and elastic bandage.

Postoperatively a colar cuff was used for 2 weeks .Follow up examination with radiographic evaluation was done after 3 and 6 months.

Signs of incomplete callus formation were obtained after 3 months whereas solid union was achieved after 6 months in all patients without any serious complication.