bluuebunny/crossref_metadata_2025 huggingface dataset:
Intramedullary Nailing for Chronic Tibial Stress Fractures
Authors: Chang Paul S. , Harris Robert M.
Published: June 2007

Chronic tibial stress fracture is an unusual condition that is primarily seen in athletes and military personnel. Recurrent or recalcitrant stress fractures can be ca reer-ending because they require lengthy nonoperative treatment. We performed a retrospective review of five patients who underwent intramedullary tibial nailing for recalcitrant stress fractures at Womack Army Medical Center, Ft. Bragg, North Carolina, from 1991 to 1994. Interviews were used to survey the patient's history and outcome. We reviewed each case regarding pre operative symptoms, preoperative treatment, surgery performed, radiographic findings, and functional out come. In each case there were several similarities in symptoms and, most notably, radiographic findings and failure of nonoperative therapy for more than 1 year. Each patient had an unusually narrow medullary canal, a thickened anterior cortex, and a linear unicor tical fracture line on the anterior or tension side. Al though functional results varied, all patients reported improvement in their symptoms and could return to limited running. There were two excellent results (de fined as unlimited pain-free running and resolved tibial pain) and three good results. We believe intramedul lary tibial nailing should be considered for treating chronic stress fractures of the midanterior tibia that are recalcitrant to nonoperative therapy in a selected group of patients.
Predictors of Injury Among 1638 Riders in a Recreational Long-Distance Bicycle Tour: Cycle Across Maryland
Authors: Dannenberg Andrew L. , Needle Scott , Mullady Daniel , Kolodner Kenneth B.
Published: June 2007

To assess the incidence of and risk factors for injuries in a group of bicyclists with a well-defined exposure to bicycling, we conducted a prospective study of 1638 recreational bicyclists who rode in the 6-day 339-mile Cycle Across Maryland tour in 1994. The mean age of participants was 39 years (range, 7 to 79), and two- thirds were male. All riders wore helmets. During the tour there were 85 acute traumatic injuries (15.4 per 100,000 person-miles), 76 overuse injuries (13.7 per 100,000 person-miles), and 37 other medical problems (6.7 per 100,000 person-miles). Acute traumatic inju ries were associated with a history of racing versus none (relative risk = 2.2, 95% confidence limits = 1.3, 3.7) and with inexperience, no previous Cycle Across Maryland tours versus one or more (relative risk = 1.7, 95% confidence limits = 1.04, 2.8), but not with sex, training, or prior injuries. Inexperience and lack of pre ride conditioning were risk factors for overuse injuries. The most common overuse injuries and medical prob lems were knee pain, hand or wrist numbness, foot blisters, insect stings and bites, and heat and dehydra tion. Study results provide exposure-based incidence rates of bicyclist injuries and suggest overuse injuries may be reduced by increased preride conditioning.
Long-Term Evaluation of the Elmslie-Trillat-Maquet Procedure for Patellofemoral Dysfunction
Authors: Naranja R. John , Reilly P.J. , Kuhlman Jeffrey R. , Haut Elliott , Torg Joseph S.
Published: June 2007

We evaluated 55 knees in 51 patients after Elmslie- Trillat-Maquet procedures. The procedure involves medialization of the tibial tubercle on a distal pedicle and elevating the tibial tubercle anteriorly 10 mm with a local bone graft. At a mean followup of 74.2 months (range, 13 to 196), all patients completed postopera tive surveys and 38 underwent postoperative exami nations. Subjectively, 9 knees (16%) had excellent results, 24 knees (44%) obtained good results, and 13 knees (24%) had fair results for a total of 84% improve ment overall. Using Fulkerson's functional knee score, 19 knees (35%) had excellent results, 10 knees (18%) had good results, and 11 knees (20%) had fair results for a total of 73% improvement overall. A total of 24 knees (44%) required later screw removal. The most significant findings of this study include 1) an 84% overall subjective improvement in symptoms; 2) the findings that young patients without evidence of pro gressive osteoarthrosis and with patella instability as a primary symptom tend to have the most favorable out come ; and 3) 24 knees (44%) required later screw removal.
What Best Protects the Inverted Weightbearing Ankle Against Further Inversion?
Authors: Ashton-Miller James A. , Ottaviani Robert A. , Hutchinson Christopher , Wojtys Edward M.
Published: June 2007

We measured the maximal isometric eversion moment developed under full weightbearing in 20 healthy adult men (age, 24.4 ± 3.4 years; mean ± SD) with their ankles in 15° of inversion. Tests were performed at both 0° and 32° of ankle plantar flexion in low- and in three-quarter-top shoes with and without adhesive ath letic tape or one of three proprietary ankle orthoses. At 0° of ankle plantar flexion, the mean maximal voluntary resistance of the unprotected ankle to an inversion moment was 50 ± 8 N-m; this increased by an average of 12% (or 6 N-m) when the subject wore a three- quarter-top basketball shoe. The maximal voluntary resistances to inversion moments developed with the ankles further protected by athletic tape or any of three orthoses were not significantly different. Biomechani cal calculations suggest that at 15° of inversion the fully active ankle evertor muscles isometrically developed a moment up to six times larger than that developed when an athlete wears a three-quarter-top shoe alone and more than three times larger than that developed passively when the athlete has tape or an orthosis worn inside a three-quarter-top shoe. We conclude that fully activated and strong ankle evertor muscles are the best protection for a near-maximally inverted ankle at footstrike.
Ten-Year Prognosis of Isolated and Combined Medial Collateral Ligament Ruptures
Authors: Lundberg Magnus , Messner Karola
Published: June 2007

In a matched-pair study of 40 patients, the prognoses of patients with acute isolated partial medial collateral ligament injuries and acute combined medial collateral and anterior cruciate ligament injuries were compared 10 years after initial treatment. All patients in the first group were treated nonoperatively. In the latter group, most medial collateral ligament injuries were total rup tures, which were thoroughly repaired; the torn anterior cruciate ligament was repaired with augmentation in half of the cases. At the follow-up evaluation, both patient groups had similarly high knee functions ac cording to the Lysholm score and similar activity levels (recreational team sports). Knees with combined inju ries had increased sagittal laxity at manual and instru mented assessment. Radiographic signs of knee os teoarthritis were present in half of the knees with combined injuries, but they were absent in knees with isolated injuries. The long-term functional prognosis was similarly good after isolated or combined medial collateral ligament injuries, but patients with combined ruptures had more reinjuries and repeat surgeries, in creased sagittal laxity, and a higher incidence of radio graphic osteoarthritis.
Comparison of Two Anatomic Reconstructions for Chronic Lateral instability of the Ankle Joint
Authors: Karlsson Jon , Eriksson Bengt I. , Bergsten Tommy , Rudholm Olof , Swärd Leif
Published: June 2007

Two anatomic reconstructions for correction of chronic lateral ankle joint instability were compared. In a pro spective, randomized study, 60 patients were allocated to one of two treatment groups: reconstruction of the ligaments as described by Karlsson et al. (Group I) or with the modification of the Broström procedure as described by Gould et al. (Group II). The functional results were evaluated with a scoring scale, and the mechanical stability with standardized stress radio graphs. The minimum follow-up period was 2 years. The functional results were satisfactory in 27 of 30 (90%) patients in Group I and 25 of 30 (83%) in Group II. There was no significant difference between the groups regarding mechanical stability. The mean an terior talar translation in Group I was 7.1 mm (range, 4 to 10) at followup, compared with 6.7 mm (range, 3 to 9) in Group II. The corresponding values for talar tilt were 4.9° (range, 0° to 8°) in Group I and 4.4° (range, 0° to 8°) in Group II. The duration of operation time was significantly longer in Group II and surgical complica tions were more frequent, probably due to the more extensive surgical exposure. This study showed that the majority of patients with chronic ankle instability can be successfully treated with anatomic reconstruc tion of the lateral ankle ligaments. Mechanical stability was restored with both methods.
The Pathomechanics of Chronic, Recurrent Cervical Nerve Root Neurapraxia
Authors: Levitz Craig L. , Reilly Philip J. , Torg Joseph S.
Published: June 2007

This study defined chronic recurrent cervical nerve root neurapraxia, the chronic burner syndrome, character ized the clinical findings, and described the responsible pathomechanics. We studied a subset of 55 athletes (mean age, 22 years) for evaluation of recurrent burn ers. Eleven subjects were professional athletes. The mechanism of injury was extension combined with ip silateral-lateral deviation in 46 patients (83%). Spurl ing's sign was positive in 39 patients (70%). Twenty- nine patients (53%) had developmentally narrowed cervical canals, and 48 patients (87%) had evidence of disk disease by magnetic resonance imaging. The disk disease was in the form of a disk bulge, disk protrusion, or a frank disk herniation deforming the cord. Fifty-one patients (93%) had disk disease or narrowing of the intervertebral foramina secondary to degenerative disk disease. Although burners may be the result of a bra chial plexus stretch injury in high school and collegiate football players seen with acute symptoms, nerve root compression in the intervertebral foramina secondary to disk disease is a more common cause in collegiate and professional players who have recurrent or chronic burner syndromes. There is a high incidence of cervi cal canal stenosis in football players with recurrent burner syndrome. The combination of disk disease and cervical spinal canal stenosis may lead to an alteration in normal cervical spine mechanics that may make these athletes more prone to chronic burner syndromes.
Surgical Management of Refractory Trochanteric Bursitis
Authors: Slawski Daniel P. , Howard Richard F.
Published: June 2007

We reviewed a single surgeon's experience with the surgical management of refractory trochanteric bursitis in an active population group. The surgical procedure consisted of simple longitudinal release of the iliotibial band over the greater trochanter and excision of the subgluteal bursa. To our knowledge, this is the first series to use this technique. Seven hips in five patients form the basis of the study, making it one of the largest surgical series reported. All patients had no improve ment after a minimum of 1 year of nonoperative man agement consisting of nonsteroidal antiinflammatory medication, iliotibial band stretching, diathermy, ultra sound, and injections of local anesthetics combined with corticosteroids (average, 4.8 injections). Patients had experienced symptoms preoperatively for an av erage of 3.8 years and had noted marked limitation in vocational and recreational activities. The preoperative Harris hip score averaged 51.7. Four of the five pa tients (six hips) were available for evaluation at the time of this study, at an average of 20 months postop eratively. The average Harris hip score was 95.0. All patients were satisfied with the surgical results and had returned to unrestricted vocational and athletic activi ties. The remaining patient was last seen 6 months postoperatively and her Harris hip score had improved from 49 to 84.
Effects of Finger and Wrist Taping on Grip Strength
Authors: Rettig Arthur C. , Stube Keith S. , Shelbourne K. Donald
Published: June 2007

Taping of the fingers and wrists by professional and collegiate football players has become increasingly prevalent because many players believe taping pro vides them with increased grip strength. This study was conducted to determine whether taping of the fingers or wrists or both enhances grip strengths in football players. Twenty-five players who self-tape in game situations volunteered for the study. Grip strengths in both taped and untaped conditions (trials) were measured with a hand-held grip dynamometer. Each athlete completed five measurement trials. No statistically significant difference was found between the untaped dominant hand and the dominant hand with the fingers-only taped. There was no significant difference between the untaped nondominant hand and the nondominant hand with the wrist-only taped. The untaped dominant hand was significantly stronger than the taped dominant hand, with mean grip strengths of 142.7 versus 137.8 pounds. The results of these clinical measurements of grip strength showed that, contrary to the perceptions of professional and major college football players, taping of the fingers or wrists or both the fingers and wrists does not improve grip strength.
Achilles Tendon Rupture
Authors: Motta Pierorazio , Errichiello Carmelo , Pontini Italo
Published: June 2007

The two objectives of surgical treatment of closed Achilles tendon ruptures in physically active patients are the restoration of the musculotendinous structure to its proper length and tendon healing. However, faulty wound healing and postoperative tendon rupture are just two complications that can occur. We devel oped a new surgical procedure that permits better tendon repair by using three specially constructed barbed wire hooks and Aldam's cutaneous approach. The integrity of the suture permits an immediate con trolled movement of the ankle with a postoperative orthopaedic brace. Weightbearing can be started after 2 months. We operated on 78 physically active patients with 78 closed Achilles tendon ruptures between February 1989 and November 1994. We reexamined 71 patients after an average of 24.5 months. All the tendons had healed completely without wound compli cations. Early assisted movement of the ankle also helped avoid the need for functional rehabilitation. This technique is easily performed, and the immediate movement of the foot and ankle helps the remodeling of scar tissue, at the same time inhibiting the formation of skin adherences that can later interfere with full movement of the joint.
Quadriceps Muscle Contraction Protects the Anterior Cruciate Ligament During Anterior Tibial Translation
Authors: Aune Arne K. , Cawley Patrick W. , Ekeland Arne
Published: June 2007

The proposed skiing injury mechanism that suggests a quadriceps muscle contraction can contribute to ante rior cruciate ligament rupture was biomechanically in vestigated. The effect of quadriceps muscle force on a knee specimen loaded to anterior cruciate ligament failure during anterior tibial translation was studied in a human cadaveric model. In both knees from six do nors, average age 41 years (range, 31 to 65), the joint capsule and ligaments, except the anterior cruciate ligament, were cut. The quadriceps tendon, patella, patellar tendon, and menisci were left intact. One knee from each pair was randomly selected to undergo de structive testing of the anterior cruciate ligament by anterior tibial translation at a displacement rate of 30 mm/sec with a simultaneously applied 889 N quadri ceps muscle force. The knee flexion during testing was 30°. As a control, the contralateral knee was loaded correspondingly, but only 5 N of quadriceps muscle force was applied. The ultimate load for the knee to anterior cruciate ligament failure when tested with 889 N quadriceps muscle force was 22% ± 18% higher than that of knees tested with 5 N of force. The linear stiffness increased by 43% ± 30%. These results did not support the speculation that a quadriceps muscle contraction contributes to anterior cruciate ligament failure. In this model, the quadriceps muscle force protected the anterior cruciate ligament from injury during anterior tibial translation.
Lumbar Spondylolysis
Authors: Congeni Joseph , McCulloch John , Swanson Kenneth
Published: June 2007

We examined the natural course of athletically active young people with back pain and a diagnosis of spon dylolysis (stress fracture of the pars interarticularis of the facet joint of the lumbar spine). We limited the study to those with "subtle" fractures (normal radio graphs and positive bone scans) and used computed tomography scanning to further characterize this lesion and to determine whether we could demonstrate heal ing in this population. The study group included 40 patients with low back pain and a diagnosis of spon dylolysis by nuclear medicine study. Computed tomog raphy scans were performed with both traditional cuts and reverse-gantry angled cuts to help determine long- term treatment and prognosis. Forty-five percent of patients (18) demonstrated chronic nonhealing frac tures, 40% (16) demonstrated acute fractures in vari ous stages of healing, and 15% (6) demonstrated no obvious fractures. With the diagnosis of spondylolysis being fairly common in young athletes with low back pain, primary care physicians need to have a high index of suspicion in making the diagnosis. Computed tomography scans can play a very important role in diagnosis, assessment of the defect, short-term and long-term management decisions, and in determining prognosis.
Pathologic Changes Associated with Shoulder Dislocations
Authors: Taylor Dean C. , Arciero Robert A.
Published: June 2007

This prospective observational study was performed on young patients, less than 24 years old, with first- time, traumatic anterior shoulder dislocations. These patients were offered either arthroscopic or nonopera tive treatment. Fifty-three patients chose nonoperative treatment. Sixty-three patients elected to have arthro scopic procedures. The average patient age was 19.6 years. There were 59 men and 4 women. All proce dures were performed within 10 days of dislocation. All 63 patients had hemarthrosis. Sixty-one of 63 (97%) patients treated surgically had complete detachment of the capsuloligamentous complex from the glenoid rim and neck (Perthes-Bankart lesion), with no gross evi dence of intracapsular injury. Of the other two patients, one had an avulsion of the inferior glenohumeral liga ment from the neck of the humerus, and one had an interstitial capsular tear adjacent to the intact glenoid labrum. Fifty-seven patients had Hill-Sachs lesions; none were large. There were six superior labral ante rior posterior lesions, two with detachment of the bi ceps tendon. There were no rotator cuff tears. Of the 53 nonoperatively treated patients, 48 (90%) have de veloped recurrent instability. In this population, the capsulolabral avulsion appeared to be the primary gross pathologic lesion after a first-time dislocation. These findings, associated with the 90% nonoperative recurrence rate, suggest a strong association between recurrent instability and the Perthes-Bankart lesion in this population.
The Effect of Functional Knee Bracing on the Anterior Cruciate Ligament in the Weightbearing and Nonweightbearing Knee
Authors: Beynnon Bruce D. , Johnson Robert J. , Fleming Braden C. , Peura Glenn D. , Renstrom Per A. , Nichols Claude E. , Pope Malcolm H.
Published: June 2007

We investigated the effect of functional bracing on anterior cruciate ligament strain in humans by arthro scopic implantation of a differential variable reluctance transducer on the ligament and measurement of its strain behavior. Strains were measured while "injury mechanism" loads were applied to the weightbearing and nonweightbearing knees for both braced and un braced conditions. For the unbraced knee, there was a significant increase in ligament strain values when sub jects went from a seated position (minimal shear and compressive loads across the knee) to a standing pos ture (substantial shear and compressive loads across the knee). Similar strain values were found between these same seated and standing postures when a 140-N anterior-directed load was applied to the tibia. This indicates that the ligament is strained during weightbearing and demonstrates that the compressive load across the knee produced during weightbearing does not significantly reduce ligament strain values in comparison with the unweighted joint with relaxed muscles for the 140-N load limit of our anterior shear test. Bracing produced a protective effect on the liga ment by significantly reducing the strain values for anterior-directed loading of the tibia up to 140 N with the knee in both weightbearing and nonweightbearing conditions. Likewise, bracing produced a protective effect on the ligament by significantly reducing strain values in response to internal-external torque of the tibia up to 6 N-m with the knee nonweightbearing. The brace strap that contacts the tibia just distal to the insertion of the patellar tendon was instrumented with a load sensor, allowing us to measure the posterior- directed loads applied by the brace to the tibia. Adjust ment of strap tension between low and high settings did not modulate the protective effect of the brace on the ligament.
Obturator Nerve Entrapment
Authors: Bradshaw Chris , McCrory Paul , Bell Simon , Brukner Peter
Published: June 2007

Chronic groin pain in athletes is often difficult to diag nose and treat. There are many anatomic structures in the inguinal and groin region that have the potential to cause pain. We report 32 cases of a previously unde scribed condition in athletes of "obturator neuropathy," a fascial entrapment of the obturator nerve where it enters the thigh. This condition represents a type of groin pain in athletes that is treatable by surgical means. There is a characteristic clinical pattern of ex ercise-induced medial thigh pain commencing in the region of the adductor muscle origin and radiating dis tally along the medial thigh. Needle electromyography demonstrates denervation of the adductor muscles. Surgical neurolysis treatment provides the definitive cure of this problem, with athletes returning to compe tition within several weeks of treatment. The surgical findings are entrapment of the obturator nerve by a thick fascia overlying the short adductor muscle. The role of conservative treatment in the management of this condition is unknown at present.
In Vitro Evaluation of Shoulder External Rotation After a Bankart Reconstruction
Authors: Black Kevin P. , Lim Tae-Hong , McGrady Linda M. , Raasch William
Published: June 2007

The Bankart procedure is a commonly performed an terior shoulder reconstruction that may shorten the anterior capsule. In this study, biomechanical testing was performed to evaluate the effect of the classic Bankart reconstruction on external rotation of the shoulder. The procedure was performed on six fresh- frozen cadaveric specimens that were free of intraar ticular pathologic changes. With the arm in 0° of ab duction, resisting torques about the vertical axis were measured while the humerus was externally rotated. The intact specimens demonstrated a nonlinear load displacement behavior in which little resisting torque was measured until a moderate amount of external rotation was applied. Shortening the capsule by 2 mm resulted in a 40% decrease in the low-tension zone of external rotation, and shortening the capsule an addi tional 5 mm resulted in a 67% decrease in the low- tension zone. This study demonstrates that the normal shoulder capsule is quite sensitive to anterior capsular shortening and suggests that care must be exercised when performing a Bankart reconstruction to avoid overtightening this structure.
Concomitant Meniscal and Articular Cartilage Lesions in the Femorotibial Joint
Authors: Lewandrowski Kai-Uwe , Müller Jens , Schollmeier Georg
Published: June 2007

The frequency of concomitant meniscal and articular cartilage lesions in the femorotibial joint was analyzed in a retrospective study of 1740 knee joints examined arthroscopically with the objective of determining pos sible correlations between the two knee joint abnormal ities. Articular cartilage lesions were found in 81.4% (N = 1416) of femorotibial joints examined and menis cal derangements were noted in 72.8% (N = 1268). In the medial compartment, concomitance was noted in 76.3% (821 of 1076) on the femoral condyles and in 48.6% (523 of 1076) on the tibial plateau. In the lateral compartment, 43.1 % (212 of 492) of the knees with deranged menisci had femoral and 55.1 % (271 of 492) had tibial articular lesions. Medial meniscal lesions were more frequently associated with femoral and tibial chondral degeneration than lateral meniscal derange ments (P < 0.001). Longitudinal, bucket-handle, and complex tears of the medial meniscus were signifi cantly more often associated with articular cartilage damage than horizontal cleavage, flap, or radial tears. Degeneration of the meniscus was highly correlated with chondral destruction in both compartments. No cause-and-effect relationship could be established, but practical implications of these findings are discussed.
Predictors of Injury in Ice Hockey Players
Authors: Smith Aynsley M. , Stuart Michael J. , Wiese-Bjornstal Diane M. , Gunnon Chris
Published: June 2007

Eighty-six male high school ice hockey players partic ipated in this prospective study to determine both the incidence of injury in high school ice hockey and the influence of physical, situational, and psychosocial fac tors. Physical factors included height, weight, vision, previous injuries, musculoskeletal abnormalities, and injuries present at the time of screening evaluations. Situational factors examined were level of participa tion, playing time, player position, and games versus practices. Psychosocial factors such as confidence, stress, social support, positive states of mind, and mood states were also examined to determine their influences on injury. Twenty-seven injuries occurred during the 1994 to 1995 season. As hypothesized, the overall incidence of injury in high school hockey games (34.4 per 1000 player-game hours) was less than the incidence of injury in Junior A hockey (96.1 per 1000 player-game hours) and was more than previously re ported for Bantam youth hockey (10.9 per 1000 player- game hours). Injuries occurred more often in games than in practices, usually as a result of collisions. Phys ical factors such as player position and previous inju ries did not significantly predict injuries, but players in the high playing time group were more likely to be injured. Psychosocial factors of low vigor and high fatigue as measured by the Incredibly Short Profile of Mood States (ISPOMS) significantly predicted high school ice hockey injuries.
An Analysis of Anterior Cruciate Ligament Reconstruction in Middle-Aged Patients
Authors: Heier Keith A. , Mack David R. , Moseley J. Bruce , Paine Russell , Bocell James R.
Published: June 2007

The purpose of this study was to evaluate the results and complications of anterior cruciate ligament surgery in middle-aged patients. Forty-five consecutive pa tients over 40 years old (average age, 44.6 years) who had arthroscopically assisted anterior cruciate liga ment reconstructions with midthird patellar tendon au tografts were evaluated. The patients returned for in terviews, physical examinations, radiographs, Biodex dynamometer strength testing, and KT-1000 arthrom eter testing at an average of 37 months after their surgeries (range, 24 to 96 months). The mean Lysholm and Gillquist score was 91, which corresponds to symptoms only with vigorous activity. The overall scores from the International Knee Documentation Committee form were 29 (64%) normal or nearly nor mal and 2 (4%) severely abnormal. Side-to-side differ ences as determined by the KT-1 000 arthrometer were ≤3 mm in 31 of 40 patients (78%), between 3 and 5 mm in 4 patients (10%), and >5 mm in 5 patients at 30 pounds of anterior displacement. Seventy-six percent of the patients (N = 34) returned to their preoperative activity levels. Three patients required repeat arthro scopic surgery for persistent knee pain and two pa tients had graft ruptures. This study shows that when middle-aged patients undergo surgery, their results can be successful and satisfying to a degree similar to those of younger patients.
A Randomized Controlled Trial of Piroxicam in the Management of Acute Ankle Sprain in Australian Regular Army Recruits
Authors: Slatyer Mark A. , Hensley Michael J. , Lopert Ruth
Published: June 2007

Three hundred sixty-four Australian Regular Army re cruits with acute ankle sprains sustained during train ing were randomized to treatment with either piroxicam or placebo. Compared with the placebo group, sub jects treated with piroxicam had less pain, were able to resume training more rapidly, were treated at lower cost, and were found to have increased exercise en durance on resumption of activity. Nausea was the only side effect reported significantly more often in the treatment group than in the placebo group (6.8% ver sus 0.3%). Interestingly, subjects treated with piroxi cam showed some evidence of local abnormalities such as instability and reduced range of movement. We conclude that nonsteroidal antiinflammatory agents should form an integral part of the treatment of acute ankle sprains.
Analysis of a Semitendinosus Autograft in a Rabbit Model
Authors: Blickenstaff Kyle R. , Grana William A. , Egle Davis
Published: June 2007

The purpose of this study was to evaluate the histo logic and biomechanical changes that occur between 12 and 52 weeks in an intraarticular, semitendinosus autograft placed through tibial and femoral drill holes in a rabbit model. The results of this study show that, in this rabbit model, the soft tissue graft maintained its biologic fixation in the osseous tunnel when stressed to failure at 1 year. The bony fixation occurred by the formation of an indirect tendon insertion, and this for mation was complete by 26 weeks. At 52 weeks, large differences persisted in the strength and stiffness of the graft compared with the normal semitendinosus tendon and anterior cruciate ligament. Based on the results of this study, we support a cautious approach in returning patients to early full activity, including sports, after anterior cruciate ligament reconstruction with a semitendinosus autograft.
Electromyographic Activity in Expert Downhill Skiers Using Functional Knee Braces After Anterior Cruciate Ligament Injuries
Authors: Németh Gunnar , Lamontagne Mario , Kam San Tho  , Eriksson Ejnar
Published: June 2007

We studied six expert downhill skiers who had sus tained anterior cruciate ligament injuries and had dif ferent degrees of knee instability. The aim was to measure possible changes in electromyographic activ ity recorded from lower extremity muscles during downhill skiing in a slalom course without and with a custom-made brace applied to the injured knee. Sur face electrodes were used with an eight-channel tele metric electromyographic system to collect recordings from the vastus medialis, biceps femoris, semimem branosus, semitendinosus, and gastrocnemius media lis muscles from both legs. Without the brace, the electromyographic activity level of all muscles in creased during knee flexion. The biceps femoris mus cle was the most activated and reached 50% to 75% of the maximal peak amplitude. With the brace, the elec tromyographic activity increased in midphase during the upward push for the weight transfer and the peak activity occurred closer to knee flexion in midphase. Also, the uninjured knee was influenced by the brace on the injured leg, a decrease in electromyographic activity was seen in midphase. Spearman's rank cor relation revealed a significant correlation between an increase in biceps femoris activity of the injured leg and increasing knee instability. We suggest that the brace caused an increased afferent input from propriocep tors, resulting in an adaptation of motor control pat terns secondarily modifying electromyographic activity and timing.
Early Season Anterior Cruciate Ligament Tears
Authors: Shelton Walter R. , Barrett Gene R. , Dukes Andrea
Published: June 2007

An anterior cruciate ligament tear before or early in an athlete's season presents a treatment dilemma: surgi cally repair the ligament and end the season, or use rehabilitative exercises and bracing to quickly return the athlete to play. We conducted a prospective study of 43 athletes (44 acute tears) over 44 months to determine criteria for early return to play and if an early return is safe. All patients had an acute injury in a previously normal knee, a positive Lachman test, and KT-1000 arthrometry indicating ligament abnormali ties. Magnetic resonance imaging of each injured knee showed an anterior cruciate ligament tear but no me niscal tear. Thirty patients (31 tears) returned to play with rehabilitation and a brace at an average of 5.7 weeks after injury: Only 12 patients returned to their sports without recurrent buckling of their injured knees; 18 patients (19 knees) had recurrent buckling during play. Thirteen patients could not return to play. Patients were observed until they 1) had ligament reconstruc tion (29 patients, 29 tears), 2) gave up their sports because of instability but did not elect surgery (3 pa tients), or 3) returned to play in a brace and declined surgery (11 patients, 12 tears). All who elected recon struction experienced recurrent knee buckling. We found 23 meniscal tears (17 knees) in the 29 patients undergoing reconstruction.
The Thermal Properties of Bovine Joint Capsule
Authors: Naseef George S. , Foster Timothy E. , Trauner Kenneth , Solhpour Shahram , Anderson R. Rox , Zarins Betram
Published: June 2007

Orthopaedic surgeons have recently adapted the hol mium:yttrium-aluminum-garnet (YAG) laser for the shrinkage of capsular tissues for treatment of glenohu meral instability. The molecular mechanism of capsular shrinkage has not been documented to date. This study examined the effects of heating on bovine calf knee capsule and subsequent shrinkage of the cap sule. Capsule specimens were placed in a saline bath at temperatures ranging from 55° to 75°C for 1, 3, 5, and 10 minutes. Shrinkage was quantified by digital imaging, and the tissue was examined by light and polarized light microscopy. Tissue contraction was not measurable at or below 57.5°C. At 60°C, tissue shrink age occurred with corresponding basophilic staining and loss of birefringence in collagen fibers. For speci mens heated at 60°C and 62°C, shrinkage directly correlated with duration of thermal exposure. Maximal shrinkage of approximately 50% in length occurred at and above 65°C with thermal exposures of 1 minute or greater. This study demonstrates that thermal shrink age of bovine knee capsule correlates with denatur ation of collagen fibers and depends on both time and temperature. Capsular shrinkage treatments may be performed with any energy source that is capable of well-controlled heating of capsular tissue and does not depend on the special properties of laser light.
Surgical Treatment of Displaced Medial Epicondyle Fractures in Adolescent Athletes*
Authors: Case Steven L. , Hennrikus William L.
Published: June 2007

Eight adolescent athletes (average age, 11 years; range, 9 to 15) underwent open reduction and internal fixation of acute, displaced medial epicondyle frac tures. Fixation was achieved with a screw and washer. Four patients (50%) had associated elbow disloca tions. Elbow motion in a brace was initiated 4 days after surgery. The brace allowed full flexion and exten sion but protected the elbow against valgus stress. Bracing was continued for 4 weeks. The average du ration of followup was 10 months (range, 6 to 13). All fractures united, and full motion was achieved in seven patients. One patient lost 5° of hyperextension com pared with the opposite elbow. All eight elbows were stable to valgus stress and were pain-free. All patients returned to full sports activity.
Two- to Five-Year Followup of Arthroscopic Bankart Reconstruction Using a Suture Anchor Technique
Authors: Koss Stephen , Richmond John C. , Woodward John S.
Published: June 2007

This is a retrospective review of 27 patients (27 shoul ders) with recurrent anterior instability who underwent arthroscopic Bankart reconstruction with a suture an chor technique between 1990 and 1993. Average length of followup was 40 months (range, 26 to 64). The average Bankart rating score was 88 (range, 45 to 100) with 70% good-to-excellent results and 30% fair- to-poor results. The average University of California (Los Angeles) shoulder function score was 32 (range, 27 to 35). The average loss of external rotation in abduction was 1°. Eight patients (30%) failed the pro cedure and had recurrent anterior shoulder instability; seven of these had repeat traumatic events. A Pearson chi-square analysis of multiple variables was per formed to determine which variables correlated with a successful result. A higher success rate was obtained if the patient had five or fewer dislocations before surgical reconstruction. This technique should be lim ited to patients not returning to contact sports, or in whom the improved cosmetic result or increased post operative external rotation of the arthroscopic proce dure are valued.
The East Asian Economic Crisis: Surging U.S. Imperialism?
Authors: Medley Joseph E.
Published: June 2007

The financial crisis that engulfed Asian countries in 1997-98 allowed the United States and the International Monetary Fund to attack the East Asian model of development. In return for needed aid, the IMF required the affected Asian countries to implement deregulatory, free-market "reforms" which exacerbated their economic crises and curtailed their economic sovereignty. These countries, including Japan, are resisting U.S. and IMF attempts to dismantle what has been a relatively successful model of economic development.
Money and the Analysis of Capitalism: The Significance of Commodity Money
Authors: Lapavitsas Costas
Published: June 2007

Monetary theory based on commodity money possesses sound foundations for analysis of capitalist monetary phenomena. "Valueless" forms of money (fiat and credit) have their roots in the nature and functions of commodity money. The evolution of the form of money is explained by the adequacy of each particular form for the functions which money is called to perform in capitalist exchange. Performing these functions encourages the development of money's form, leading to the emergence of several types of non-commodity ("valueless") money. This paper considers especially the adequacy of commodity, fiat, and credit money as means of exchange; adequacy is fully specified by examining determination of the exchange value of these forms of money. The process of determination is different for each: spontaneous hoarding for the first, arbitrary specification of quantity for the second, credit advance and repayment for the third. In this context, it is shown that the intrinsic value of commodity money can play an anchoring role for money's exchange value. The quantity theory of money has explanatory power with regard to the exchange value of fiat money and, under certain conditions, of credit money.
The nature of surplus value in the "new solution"
Authors: Campbell Al
Published: June 2007

The "new solution" to the transformation problem in Marx's labor theory of value rests on treating two aspects differently than in the traditional formulation: net value is used instead of gross value to avoid double counting, and the division of new value into variable capital and surplus value is determined at the point of production by the wages paid to the workers, instead of by the bundle of goods they subsequently select with their consumption decision. Campbell [Review of Radical Political Economics 29 (3) (1997) 59] developed a simple but formal presentation of the first of these issues. This paper addresses as the other crucial issue in the new solution approach, the issue of determining variable capital and surplus value. The role of the money wage in the process is highlighted. Comparison to the treatment of these issues in the traditional formulation is included for the purpose of better understanding the nature of the new solution.
Inflation and stabilization in Brazil: a political economy analysis
Authors: Saad-Filho Alfredo , Mollo Maria de Lourdes R.
Published: June 2007

This article outlines a political economy analysis of Brazilian high inflation and stabilization. The paper explains the distributive and monetary aspects of inflation and the gradual fragmentation of the Brazilian currency. It also reviews the most important aspects of the Real stabilization plan, the de-indexation of the economy, and its rapid "liberalization" and "internationalization." The paper shows that, in spite of the successful reduction of inflation, the Real plan was highly vulnerable to shifts in international liquidity; partly for these reasons, it led to de-industrialization and high unemployment. In addition to this, the Real plan contributed to an increase in income inequality and the development of sharp social conflicts in Brazil. These weaknesses were the main factors responsible for the currency crisis in January 1999.
Value and the quest for the core of capitalism
Authors: Laibman David
Published: June 2007

Despite its exasperating opacity and lack of closure, the value debate has a vital objective: to grasp those defining aspects of capitalist society that do not appear on the visible surface space of conscious individual actors. In pursuit of this objective, careful conceptual analysis reveals that the long-standing "transformation problem" is misconceived; that the labor value dimension in the abstract capitalist economy is determinate and unique. This solution to age-old puzzles enables us to renew the study of the relation between labor-as-value and the homeostatic and systemic aspects of capitalist reproduction that cannot be reduced to individual constrained optimization.
Realization and costs: reply to Goldstein
Authors: Sherman Howard J.
Published: June 2007

This is a reply to an article which argued that supply-side costs are solely responsible for cyclical contractions and that demand plays only a negligible role. My reply emphasizes that cyclical downturns are caused by both limited demand and rising costs. The limited demand is caused by shifts in income distribution away from workers, while the rising costs include raw material prices as well as interest rates.
A new financial social structure of accumulation in the United States for long wave upswing?
Authors: O'Hara Phillip Anthony
Published: June 2007

This paper examines the question of whether a new financial social structure of accumulation (FSSA) is being developed, or has already evolved, in the United States to contribute towards long wave upswing during the early years of the 21st century. Attention is given to three main requirements for a FSSA within the circuit: the promotion of sufficient (a) financial stability, (b) conflict resolution between finance and industry, and (c) sustainable bank productivity and profitability. The current system is characterized by major financial instability, due to the growth and crash of speculative bubbles. It is also insufficiently resolving conflict between finance and industry, since finance does not expand production to the required degree. Also, the banking sector has been undergoing insufficient productivity and unsustainable profitability. Overall, it is unlikely that a developed FSSA is currently in place to promote long wave upswing.
Can U.S. Cities Afford Living Wage Programs? An Examination of Alternatives
Authors: Luce Stephanie , Pollin Robert
Published: June 2007

Since 1994, so-called "living wage" ordinances have passed in 20 cities in the United States, and activists are advancing similar proposals throughout the country. These proposals are a response to the declining real wages of low-wage workers in the United States-what David Gordon termed "the wage squeeze" in Fat and Mean-and, in particular, to the 30 percent fall in the real value of the minimum wage from its peak in 1968. We consider here the main arguments advanced by opponents of living wage proposals: 1) they will place a heavy burden on municipal government budgets, forcing, among other things, cuts in vital city services that benefit low-income people; 2) they will encourage local businesses to relocate and discourage new businesses from investing within cities that have such ordinances; and 3) they will cause unemployment among low-wage workers. Examining these issues in the context of proposals that were either passed or considered in different cities, we find that none of the criticisms of living wage proposals stand up to careful scrutiny or evidence. Rather, living wage proposals are affordable and workable. They represent a small but significant step toward reversing the "wage squeeze" so carefully documented and analyzed in Fat and Mean.
Still Underwhelmed: Indicators of Globalization and Their Misinterpretation
Authors: Sutcliffe Bob , Glyn Andrew
Published: June 2007

Globalization is widely misinterpreted. In particular Its quantitative extent and novelty are exaggerated. This article aims to put the facts in historical and statistical perspective. It criticizes the use of inappropriate statistical measures, conclusions drawn from little data, and the failure to make historical comparisons, or to see counter-globalization tendencies and limits to globalization. The best measures suggest that globalization is neither so new nor so great as is often supposed. The political implications of this argument are briefly explored.
Exercise Locus of Control, Behavior, and Intention Among Mexican American Youth
Authors: Guinn Bobby , Vincent Vern , Dugas Donna , Semper Tom , Jorgensen Layne , Nelson Larry
Published: June 2007

Mexican American youth have higher physical inactivity rates than their Black or non-Hispanic White counterparts. The purpose of this study was to examine the relationships among exercise locus of control, age, present exercise level, weight status, and gender with intention to exercise in a sample of Mexican American youth. The study sample consisted of 216 boys and 185 girls ranging in age from 10 to 15 years, and data were collected through a self-report survey instrument and height and weight measures to calculate body mass index. Structural equation modeling was employed to test for variable associations. Results suggested that for boys and girls, current exercise involvement had the greatest influence on intent to be physically active, and age had a mediating effect because of the increased importance of the powerful others’ exercise locus of control belief as one grew older.
Pædiatric HIV/AIDS: School Implications
Authors: Roberts Jillian
Published: June 2007

Recent advances in HIV/AIDS treatments are extending the life expectancy of many infected children, allowing them to survive well into their school age years. However the mixing of pædiatric HIV/AIDS and school systems has not been an easy one. This article discusses the primary ethical dilemmas involved when children with HIV/AIDS attend school: a) the right to admittance and b) the right to privacy. A review of the American and Canadian ethical and legal findings surrounding these two contentious issues is offered.
Serving Children with HIV/AIDS in Canadian Public Schools: An Interpretation of the CPA Guidelines for Non-Discriminatory Practice
Authors: Roberts Jillian , Pettifor Jean , Cairns Kathleen , DeMatteo Dale
Published: June 2007

As a result of recent advances in HIVIAIDS treatments, the near future will bring a significantly increased number of children either infected with - or affected by - HIV/AIDS into public schools in Canada. In order to help the psychologist and other professionals involved in the education of children, we have interpreted the Canadian Psychological Association (CPA) Guidelines for Non-Discriminatory Practice in this context. As with the Canadian Code of Ethics for Psychologists (CPA, 1991) the general principles of the Guidelines for Non-Discriminatory Practice include: I. Respect for the Dignity of Persons, II. Responsible Caring, III. Integrity in Relationships, and IV Responsibility to Society. In addition, we have included practical vignettes in the hope of stimulating continued dialogue.