Common Lower Limb Sports-related Overuse Injuries in Young Athletes

Common Lower Limb Sports-related Overuse Injuries in Young Athletes
Leok Lim Lau,1
MBBCh, MRCS (Edin), MMed (Orthop Surg), Arjandas Mahadev,2
MBBS, FRCS, FAMS, James HP Hui,1
MBBS, FRCS (Edin), FAMS

Abstract
Introduction: Sports injuries in children and adolescent present a unique challenge to the
physician. They are often seen for clinical conditions unique to their age group. This paper
highlights the epidemiological aspect of sports-related overuse injuries in this age group.
Materials and Methods: This retrospective study reviewed all the paediatric patients diagnosed
with overuses injuries during a 5 years and 7 months period. The overuse injuries were anterior
superior iliac spine avulsion fracture, Osgood-Schlatter disease, Sinding-Larson-Johansson
disease, osteochondritis dissecan and Sever’s disease. We reviewed the literature and attempted
to give an overview for each condition and the anatomical differences that contributed to their
occurrence in this age group. Results: A total of 506 cases of the overuse injuries were seen during
the study period. Seventy-three per cent were male patients. The knee joint was the commonest
affected joint while the hip was the least affected joint. The mean age at diagnosis was younger
in female compared to male for all conditions except in Sinding-Larson Johansson syndrome.
Female was diagnosed at a mean age of 11.7 years while male at 10.8 years. Osgood-Schlatter
disease was the commonest among the overuse injuries. There was no discernible racial
predilection for these conditions except in the patients with anterior superior iliac spine avulsion.
Conclusions: Overuse injuries are not uncommon in children and adolescent. An adequate
understanding of the anatomy of the sports the children participated in as well as the anatomical
differences between adult and children may assist the primary care providers better meet
parents’ and coaches’ expectations.
Ann Acad Med Singapore 2008;37:315-9
Key words: Apophysitis, Osgood-Schlatter disease, Osteochondritis dissecan, Overuse injuries,
Sever’s disease, Sinding-Larson-Johansson disease