Case-control level-III.

Morel-Lavallée lesions are uncommon injuries that can be associated with significant comorbidities if not detected early. Rapid diagnosis in the Emergency Department could significantly improve patient outcomes. We describe the diagnosis of such a lesion through the use of ultrasound imaging in the Emergency Department to utilize a fast, cost-effective imaging technique that does not subject the patient to radiation exposure. Our patient received surgical consultation but improved with conservative management. Ultrasound findings associated with this lesion do not require specialized equipment and should be considered when evaluating soft tissue lesions using point of care ultrasound.

Background: Achilles tightness exacerbates a variety of foot and ankle conditions while increasing the risk of lower extremity injuries. The correlation between Achilles tightness and lower extremity injury rates in a young, athletic population is unknown. Purpose: To evaluate the impact of routine gastrocnemius stretching on ankle flexibility and lower extremity injury rates in youth basketball athletes. Study Design: Cohort study; Level of evidence, 3. Methods: A prospective cohort study enrolling 8 high school basketball teams (4 male teams, 4 female teams) was conducted over a 3-month sporting season. Two schools (2 male teams, 2 female teams) were assigned to a daily gastrocnemius stretching protocol. Two control schools (2 male teams, 2 female teams) followed no protocol. Passive ankle dorsiflexion was measured bilaterally in both groups at 4 time points: preseason, 1 month and 2 months after the start of the season, and postseason (3 months from the start of the season). The number of injuries sustained during the season and the number of games missed because of a lower extremity injury were recorded. Differences in dorsiflexion flexibility measurements and injury rates were analyzed between the protocol and control groups. Results: A total of 106 athletes (46 male, 60 female) were included in the study. The protocol group included 51 athletes (mean age, 15.7 ± 1.2 years) versus 55 athletes (mean age, 16.2 ± 1.0 years) in the control group. Athletes undergoing routine gastrocnemius stretching had significantly higher ankle dorsiflexion flexibility measurements compared with control athletes at all time points ( P < .05 for each time point) while also demonstrating a significant increase in dorsiflexion between the preseason and postseason time points ( P = .04). No significant difference in injury rates was appreciated between the protocol and control groups, and no difference in dorsiflexion flexibility measurements was appreciated between injured and uninjured athletes. Conclusion: The implementation of a gastrocnemius stretching protocol in youth basketball athletes increased ankle dorsiflexion over a single season without decreasing the injury incidence relative to controls in our study. Because the size of our study limited statistical power, a confirmation of the results in a larger study is required.