Background: Rotator cuff pathology is a common source of shoulder pain with variable etiology and pathoanatomical

Background: Little is known about the epidemiology of clavicle fractures in United States (US) high school athletes. Sports participation among high school students has increased steadily, placing increased numbers at risk of sports-related injury. Purpose: To describe the epidemiology of clavicle fractures among high school athletes, including injury rates by sex, sport, and type of play and trends in operative versus nonoperative treatment. Study Design: Descriptive epidemiology study. Methods: The study data set included all athlete-exposure (AE) and clavicle fracture data collected from 2008-2009 through 2016-2017 from a large sample of US high schools as part of the National High School Sports-Related Injury Surveillance Study for students participating in boys’ football, boys’/girls’ soccer, boys’/girls’ basketball, boys’/girls’ volleyball, boys’ wrestling, boys’ baseball, girls’ softball, girls’ field hockey, boys’ ice hockey, boys’/girls’ lacrosse, boys’/girls’ swimming and diving, boys’/girls’ track and field, girls’ gymnastics, girls’ cheerleading, boys’/girls’ tennis, and boys’/girls’ cross-country. Results: Overall, 567 clavicle fractures were reported during 31,520,765 AEs, an injury rate of 1.80 per 100,000 AEs. Injury rates varied by sport, with the highest rates in the boys’ full-contact sports of ice hockey (5.27), lacrosse (5.26), football (4.98), and wrestling (2.21). Among girls’ sports, the highest rates were in soccer (0.92), lacrosse (0.26), and basketball (0.25). In sex-comparable sports, injury rates were still significantly higher among boys (1.03) than girls (0.35) (rate ratio, 2.91; 95% CI, 1.97-4.30). Injury rates were significantly higher in competition (4.58) as compared with practice (0.87) (rate ratio, 5.27; 95% CI, 4.44-6.26). Most injuries were treated conservatively (82.7%) rather than operatively (17.3%). Time to return to sports varied, with a greater proportion of medical disqualifications among those treated operatively (40.0%) as compared with those treated conservatively (22.6%) (injury proportion ratio, 1.77; 95% CI, 1.31-2.39). Conclusion: Although clavicle fracture rates are relatively low, they vary by sport, sex, and activity. Understanding such differences should drive more effective, targeted injury prevention efforts. Increased time loss from sports with surgical versus conservative treatment may have been influenced by factors including injury severity and its timing relative to the season’s progress.

Locomotion and mating ability are crucial for male reproductive success yet are energetically costly and susceptible to physiological stress. In the Sierra willow beetle Chrysomela aeneicollis, male mating success depends on locating and mating with as many females as possible. Variation at the glycolytic enzyme locus phosphoglucose isomerase (Pgi) is concordant with a latitudinal temperature gradient in these populations, with Pgi-1 frequent in the cooler north, Pgi-4 in the warmer south, and alleles 1 and 4 in relatively equal frequency in areas intermediate in geography and climate. Beetles experience elevated air temperatures during a mating season that causes differential physiological stress among Pgi genotypes, and running speeds of individuals homozygous for Pgi-4 are more tolerant of repeated thermal stress than individuals possessing Pgi-1. Here the importance of running behavior for male mating activity was examined, and differential effects of thermal stress among Pgi genotypes on male mating activity were measured. In nature, males run more than females, and nearly half of males mate or fight for a mate after running. In the laboratory, mating activity was positively correlated with running speed, and repeated mating did not reduce running speed or subsequent mating activity. Males homozygous for Pgi-4 mated longer and more frequently after heat treatment than 1-1 and 1-4 males. All heat-treated males had lower mating frequencies and higher heat shock protein expression than control males; however, mating frequency of recovering 4-4 males increased throughout mating trials, while treated 1-1 and 1-4 males remained low. These results suggest that effects of stress on mating activity differ between Pgi genotypes, implying a critical role for energy metabolism in organisms' response to stressful temperatures.

Articular cartilage injuries in the glenohumeral joint present a unique and difficult problem for the patient and surgeon alike. Various etiologies exist for the development of these cartilage lesions; therefore, treatment options are vast and must be chosen thoughtfully, especially in the young, active patient. Across all treatment modalities, the goal is for the patient to regain lasting function and mobility while decreasing pain.

Patients who sustain trauma to the knee should be carefully evaluated for ligamentous avulsion injuries. Avulsion fractures in adults represent substantial traumatic injuries, and associated injuries should be suspected. While the MCL is an extracapsular structure, this case report demonstrates that the MCL femoral-sided osseous attachment can displace intra-articularly.