bluuebunny/crossref_metadata_2025 huggingface dataset:
Migraine precipitated by head trauma in athletes
Authors: Bennett Donald R. , Fuenning Samuel I. , Sullivan George , Weber Jerry
Published: June 2007

Three members of a university football team were evaluated because of migraine symptoms precipitated by head trauma. Analysis of the clinical data from these cases, as well as eight previously reported in athletes, reveals that the head trauma is usually minor and not associated with amnesia; and, after a symptom-free interval most often of several minutes, visual, motor, sensory, or brainstem signs and symptoms begin. These usually last for approximately 15 to 30 min and are followed by headache frequently accompanied by nausea and vomiting. In 9 of 11 cases, attacks have occurred with subsequent head trauma. Only 4 of the 11 athletes admitted to spontaneous episodes, however, the incidence may be higher since they have not been followed for a sufficient period of time. Prophylaxis with antimigrainous drugs does not appear to be indicated. The decision as to future participation in contact sports is based primarily on the results of a thorough neurologic evaluation. The possible long-term sequela of this apparent "benign" con dition, particularly in those athletes with repeated episodes, is not known since the entity has only recently been recognized.

A migraine attack occurring in the course of an athletic event, particularly contact sports, can simulate a serious neu rologic emergency. Despite its frequency in the general popu lation and a propensity for onset in the first three decades of life, migraine has not been appreciated in the past as a possible significant sports medicine problem.
Iliotibial band transfer for anterolateral rotatory instability of the knee
Authors: Teitge Robert A. , Indelicato Peter A. , Kerlan Robert K. , Blazina Martin E. , Jobe Frank W. , Carter Vincent S. , Shields Clarence L. , Lombardo Stephen J. , Kelly Kimberley
Published: June 2007

Forty-eight patients who underwent distal iliotibial band trans fer (Ellison) for anterolateral rotatory instability and who were over 1 year postsurgery presented for examination and an additional six patients completed a written subjective evalua tion. Five patients only had isolated lateral surgery. In 33 patients there was an additional diagnosis of anteromedial rotatory instability. Of the patients 44% had had no previous surgery, while 36% had undergone one procedure and 19% had undergone more than one procedure. In combination with iliotibial band transfer, 74% had a lateral meniscectomy, 44% had a capsular reefing, 38% had a medial meniscectomy, 44% had a pes anserinus transfer, and 8 patients had prosthetic cruciate ligament replacement. In these eight patients, five prosthetic ligaments had fractured and were included but three were intact and were excluded. Thirty-four percent of the patients were initially injured in football. All patients had thorough knee and radiographic examinations; strength mea surements by using the Cybex testing for knee extension; flexion and external rotation; and completed a subjective ques tionnaire. Of the patients 87% responded that they were im proved and thought the surgery was worthwhile. Ninety-one percent had positive jerk tests preoperatively but only 46% were positive at followup. However, while 53% reported no episodes of giving way, 28% reported monthly episodes, 9% weekly episodes, and 8% daily episodes. Only 15% had no difficulty cutting while 55% had some and 26% had extreme difficulty or were unable to do so. Only 23% reported no difficulty with jumping, but 48% had some difficulty, and 30% were unable to jump and had extreme difficulty jumping. Only 28% of patients had returned to their desired level of activity while 46% had reached only 50% of their desired level. Only 13% expressed complete confidence in the knee while 21 (46%) were in the 75 to 90% confidence range, while 22% had less than 50% confidence. Of the patients 29% had lost extension and 57% had lost flexion. Ninety-one percent had increased varus (adduction) instability at followup, but this did not appear to have clinical significance. On follow-up x-ray films 70% had osteophyte formation, 65% had joint space narrowing, 46% had pain requiring aspirin. Eighty percent had atrophy averaging 1.72 cm. Thirty percent had tenderness at Gerdy's tubercle. As in all studies involving the knee ligaments, the many variables are dependent and poor results do not reflect failure of this one part of treatment. No patient was made worse by the procedure; there appears to be defmite reduction in anterolateral rotatory instability after iliotibial band transfer, which was maintained for more than 1 year after surgery.
Biomechanics of hyperextension injuries to the cervical spine in football
Authors: Carter Dennis R. , Frankel Victor H.
Published: June 2007

The biomechanics of cervical spine hyperextension injuries in football players were assessed by using quasi-static-free body analyses. Three situations, i.e., "cases", corresponding to the loading conditions created by three different helmet designs, were examined with the following assumptions: (1) the helmet rim is cut high enough posteriorly so that it does not impinge upon the posterior cervical spine, (2) the helmet rim impacts at the level of the fourth cervical vertebra, and (3) the posterior rim of the helmet strikes the shoulder pads. The results of the analyses suggest that the most dangerous hyperextension sit uation is Case 1 which leads to high forces and possibly serious injury to the upper cervical spine. The impact of the posterior rim of the helmet at the fourth cervical vertebra (Case 2) significantly reduces these forces. This finding directly conflicts with the so-called "guillotine" mechanism of injury. The impact of the posterior rim of the helmet on the shoulder pads (Case 3) creates the least hazardous loading conditions.
The "blind side" of the medial meniscus
Authors: Goldner Richard D. , Kulund Daniel N. , McCue Frank C.
Published: June 2007

The major posterior insertion of the medial meniscus is not into the tibial plateau proper but into a rather deep recess behind the intercondylar eminence.

The shape of the meniscus in relation to the curve of the meniscotome and its angle of approach, and also the surgeon's inability to see posteriorly from an anterior incision make posterior capsular incision desirable in many cases. A poster omedial incision, added to the normal anteromedial one in 40 of 215 medial meniscectomies, did not increase perioperative morbidity.
The uniqueness of the young athlete: musculoskeletal injuries
Authors: Wilkins Kaye E.
Published: June 2007

There is considerable difference in the management of muscu loskeletal injuries in the pediatric athlete. The biomechanical characteristics of the growing bone react differently to applied stresses. Plastic deformation, green-stick, torus, and epiphyseal fractures are types seen only in the pediatric age group. The pediatric athlete fortunately has a much greater remodeling capacity, thus, altering the approach to the treatment of inju ries. An understanding of the different types of injuries in the skeletally immature athlete is essential for those treating this age group.
Three-dimensional kinematics of the taped ankle before and after exercise
Authors: Laughman R.K. , Carr T.A. , Chao E.Y. , Youdas J.W. , Sim F.H.
Published: June 2007

The practice of prophylactic ankle taping or wrapping to reduce the incidence of inversion ankle sprains in athletes has come under attack. The purpose of this study was to measure objec tively one ankle taping technique's ability to withstand the stresses placed upon it by a standardized exercise routine. Electrogoniometers were used to measure the three-dimen sional ankle motion of 20 subjects walking on a level surface and a 10° sideslope. The evaluations were carried out under these three conditions: (1) both ankles untaped, (2) both ankles taped before exercises, and (3) both ankles taped after exercise. The results from this study indicate that the tape does indeed restrict those motions associated with inversion ankle sprain. Methods similar to those described in this study could be used in the evaluation of many current training room practices and thereby provide an objective rationale for their application.
Dynamic patellar brace: A new orthosis in the management of patellofemoral disorders
Authors: Palumbo P.M.
Published: June 2007

The diagnosis and treatment of patellofemoral dys function, especially subluxation of the patella, remains controversial. Many authors feel conservative treat ment will give better long-term results than operative treatment.

To aid in nonoperative treatment of patellofemoral conditions a dynamic patellar stabilizing brace has been developed. The brace applies an active, medially displacing force to the lateral border of the patella and maintains constant pressure during flexion, extension, and rotation of the knee. This brace consists of an elastic sleeve with a patellar cutout and two circum ferentially wrapped "live" rubber arms which apply dynamic tension to a crescent-shaped lateral patellar pad. An elastic circumferential counterarm maintains proper positioning of the pad and prevents rotation of the brace.

The brace, superior to other methods of patellar splinting, is felt to be useful in the diagnosis of sus pected subluxation in patients without the classical stigmata of patellofemoral dysplasia. It has proven useful in the treatment of 39 cases of patellar sublux ation and 4 of patellofemoral arthritis. In a number of cases symptoms were completely eliminated with pro longed use of the brace. The brace is felt to be beneficial in conjunction with vastus medialis rehabil itation in patellar subluxation in growing children; in patients with mild or occasional subluxation, espe cially during specific activities; in persons with dislo cation or subluxation in which surgery is contraindi cated or must be delayed; and in acute subluxation. The brace may also be helpful in the prevention and treatment of chondromalacia and patellar tendinitis.
An epidemiologic study of squash injuries
Authors: Berson Burton L. , Rolnick Audie M. , Ramos Christopher G. , Thornton John
Published: June 2007

A retrospective investigation of squash-related injuries incurred at a private and a public club in New York was undertaken to gain insight into the incidence and nature of such injuries. Telephone interviews were conducted with 200 randomly selected individuals to obtain their entire injury history.

Sixty-nine of the 155 squash players contacted sustained injuries during their participation. Some had multiple injuries. This resulted in an overall injury rate of 44.5%. Strains and sprains accounted for over one- third of the injuries. Nearly one-half of the injuries involved the lower extremity, with the ankle and lower leg being injured most often. Forty-seven percent of the injuries seen were considered disabling because the patients were out of action for more than two weeks after injury.

Players over the age of 40 are at increased risk for injury, as are newcomers to the game. Increased injury rates were also associated with an increased frequency of play among females. Only rarely will an injured squash player become permanently impaired.
Medial meniscus repairs
Authors: Cabaud H. Edward , Rodkey William G. , Fitzwater James E.
Published: June 2007

In an effort to determine the healing potential of medial meniscus tears, 20 canine and 12 rhesus knee joints were subjected to transverse medial meniscus lacer ation and repair with a single Dexon suture (Davis & Geck, Pearl River, NY). At four months, 12 out of 32 (38%) had healed completely with restoration of the inner meniscal rim and 18 (56%) showed partial heal ing sufficient to protect the underlying articular carti lage. Only 2 (6%) of the menisci failed to heal. Histo logic evaluation showed that the scar tissue present in the menisci was composed of unorganized collagen without common ground substance components. As a result of these studies, we believe that certain men iscal tears, particularly those involving the vascular periphery, can heal and may be repaired rather than treated by meniscectomy.
Staple capsulorrhaphy for recurrent posterior shoulder dislocation
Authors: Tibone James E. , Prietto Carlos , Jobe Frank W. , Kerlan Robert W. , Carter Vincent S. , Shields Clarence L. , Lombardo Stephen J. , Collins H. Royer , Yocum Lewis A.
Published: June 2007

Recurrent posterior shoulder dislocation or subluxa tion is uncommon but occurs occasionally in athletes Ten patients were treated with a posterior shoulder staple capsulorrhaphy. A posterior Bankhart-type le sion was found in all cases. Eight of the 10 patients had pain relief. The range of motion was usually maintained postoperatively, but no patient returned to his former throwing status. Four patients also had anterior instability. Three patients (30%) had postop erative recurrence of their posterior instability. The two "ligamentous lax" conditions in the series both recurred. The procedure should be supplemented in the "lax" individual. Complications in 4 patients in cluded a painful staple, postoperative adhesions, and symptomatic ectopic bone formation in two patients. Recurrent posterior shoulder dislocation is not a def inite indication for operative repair; patients must be carefully selected.
Repair of peripheral meniscus tears
Authors: Cassidy Robert E. , Shaffer Andrew J.
Published: June 2007

Degenerative joint disease in the knee following me niscus injury and/or surgical removal of the meniscus is an accepted fact. In an attempt to reduce the severity of the degenerative joint disease, 27 patients underwent 29 repairs of tears in the peripheral one- third of the meniscus. Twenty-four were medial, and 5 were lateral. Twenty of the patients were men; 7 were women. Ages of the patients ranged from 13 to 34 years. The surgical technique involved resuturing of the meniscus to the capsule and/or ligaments after debriding the peripheral edge of the tear.

Followup ranged from 6 to 17 months. Three out of 9 patients with slight pain still had some swelling or effusion in the knee intermittently. One of these had a sensation of giving way but no actual buckling. Two of the patients had not returned to full activity 6 months after their surgery. Four patients have had postoperative arthrograms, all of which show evidence of complete healing. Two repairs have been directly visualized, and the suture lines are healed.

The follow-up data support the conclusion that re pair of peripheral tears of the meniscus is possible. However, longer followup is needed to determine the long-lasting effects of meniscus repair and their role in preventing progressive degenerative change within the knee.
Anterolateral rotatory instability of the knee
Authors: Hanks Gregory A. , Joyner David M. , Kalenak Alexander
Published: June 2007

In an attempt to correct anterolateral rotatory instabil ity of the knee, 30 consecutive patients underwent a surgical procedure similar to that described by Ellison (Ellison AE: A modified procedure for the extra-artic ular replacement of the anterior cruciate ligament. American Orthopaedic Society for Sports Medicine Symposium, New Orleans, LA, July 15, 1975), called the iliotibial band transfer. Fashioning the passageway for the transfer closer to the attachment of the fibular collateral ligament on the femur and meticulous fascial closure over the transplant were not found to be crucial to success.

Twenty-nine of the 30 patients were injured during athletic activities, and the remaining patient was in jured in a motorcycle accident. They often complained of an unstable knee with symptoms of pain and giving way.

Twenty-eight patients with a minimum followup of nine months (the average followup was 25 months) were evaluated subjectively by an interview and by objective clinical examination.

Subjective results (including asymptomatic return to their previous level of athletic activity) and clinical improvement of anterolateral rotatory instability (based on the flexion-extension-valgus test or the Slocum anterolateral rotatory instability test) were en couraging. Areas of concern were that a small number of patients developed asymptomatic varus instability and a few had relative strength deficits which may or may not have long-term significance.
Elbow injury in women's gymnastics
Authors: Priest James D. , Weise Debra J.
Published: June 2007

This investigation reports on 30 female gymnasts with 32 elbow injuries acquired in gymnastics. Thirty of the injuries were acute fractures and dislocations, and two developed Panner's disease of the humeral capi tellum.

Primary treatment included 14 closed reductions and 11 open surgical procedures. Those who returned to competition lost an average of 4.1 months.

Spotters were not present during nearly 60% of these injuries. The mechanism which led to a variety of elbow injuries was possibly singular: a fall on an outstretched arm. More than twice as many injuries occurred on thin mats or the bare floor than on thicker mats.

The authors concluded, after the study, that elbow immobilization for as short a time as possible was beneficial to regaining range of motion. We recom mend reducing injuries by employing spotters, using thicker mats, and educating young gymnasts in tech niques of falling.
Patellar tendon avulsion as a complication of Osgood-Schlatter's disease
Authors: Bowers K. Douglas
Published: June 2007

The etiology of Osgood-Schlatter's disease remains a topic for debate. Previous studies by Ogden and Southwick (Osgood-Schlatter's disease and tibial tu bercle development. Clin Orthop 116: 180-189, 1976) strongly support the concept of multiple mi croavulsions of the anterior surface of the developing ossification center of the tibial tubercle as the under lying cause.

Orthopaedic literature fails to associate Osgood- Schlatter's disease with traumatic disruption of the extensor mechanism of the knee. Though the mech anism of injury for such trauma is as common as Osgood-Schlatter's disease itself, such occurrences are rare.

Failure of the point of attachment of the patellar tendon in a patient with markedly symptomatic Os good-Schlatter's disease tends to confirm the etio logic concept of Ogden and Southwick.

Patients with markedly symptomatic Osgood- Schlatter's disease who engage in activities involving rapid deceleration or vigorous vertical acceleration are in a relatively high risk category for disruption of the extensor mechanism. Traumatic avulsion of the patellar tendon in such a patient establishes this re lationship.
Javelin injury to the subclavian artery
Authors: McFadden P. Michael , Ochsner John L.
Published: June 2007

Penetrating arterial injuries are exceedingly rare in athletics. The successful repair of a traumatic tran section of a subclavian artery resulting from a javelin injury is reported. The importance of a high index of suspicion and an expedient and thorough evaluation of penetrating cervical and supraclavicular injuries on the part of the athletic staff and the physician is stressed. Subclavian arterial injuries are discussed and pitfalls in their assessment are listed. The princi ples of surgical management are outlined.
Gait analysis
Authors: Scranton Pierce E. , Pedegana Larry R. , Whitesel James P.
Published: June 2007

This study documents changes in momentary distri bution of forces under the foot, comparing barefoot gait to that with heel cups, medial arch supports, and low-dye taping. Cholesterol crystal force plate analy sis and a computerized Kistler force platform were used in the study. Low-dye taping or a heel cup significantly diminished the duration of forces under the midfoot, medializing the instant center of forces. A medial arch support shifted the instant center of forces laterally, though it did not diminish the duration of forces under the arch. The relationship between these alterations of force distribution and the treat ment of common runner's ailments such as plantar fasciitis, posterior tibial tendinitis, metatarsalgia, and shin splints is much clearer in the light of these results.
The heel pad
Authors: Miller Wallace E.
Published: June 2007

In an attempt to gain insight into the etiology of heel pain, the heel pad was studied via dissection. The dynamic action of the heel pad as well as varying stimuli interpreted as pain were examined in view of their integral relationship to body functions. It is be lieved that the major role played by the heel pad has to do with pressure, and the larger number of nerve endings present to respond to pressure suggests that these are also the nerve endings responsible for the sensation of pain.
Interscalene brachial plexus block anesthesia for the modified Bristow procedure
Authors: Mitchell Eric I. , Murphy Frank L. , Wyche Melville Q. , Torg Joseph S.
Published: June 2007

Administration of local anesthetic agents into the in terscalene space usually provides adequate anesthe sia for surgical procedures on the glenohumeral joint. The anatomic basis and anesthetic technique of inter scalene brachial plexus block are described. A retro spective evaluation of 65 modified Bristow procedures is presented, in which 46 procedures performed under this form of regional anesthesia were compared with the 19 that had primary administration of general anesthesia. Those patients who had regional anesthe sia had, on the average, a shorter hospital stay, sig nificantly less blood loss, and presumably the advan tages of local anesthesia. It is suggested that inter scalene brachial plexus block be considered as a viable alternative to general anesthesia for the modi fied Bristow procedure.
A comparison of men's and women's professional basketball injuries
Authors: Zelisko John A. , Noble H. Bates , Porter Marianne
Published: June 2007

Injuries sustained by male and female professional basketball teams were compared. Injuries from two consecutive seasons were coded, and computer- based cross-tabulations comparing sex, body part, and type of injury were performed. The women's injury frequency was 1.6 times that of men. The body part most frequently injured on both teams was the ankle. Women sustained significantly more knee and thigh injuries as well as sprains, strains, and contusions. Men had significantly more muscle spasms. Other injuries occurred in similar patterns in both sexes. Alterations in training programs are suggested with emphasis on women's strengthening and men's flexi bility.
Evaluation of the Roux-Elmslie-Trillat procedure for knee extensor realignment
Authors: Cox Jay S.
Published: June 2007

One method for correction of patellofemoral malalign ment in acute and recurrent dislocations and sublux ations of the patella involves a lateral retinacular release, medial capsular reefing, and medial displace ment of the infrapatellar tendon insertion. The proce dure was originally described by Roux and later mod ified and popularized by Elmslie and Trillat. It allows adequate evaluation and easy adjustment of the ex tensor mechanism at the time of surgery. This current report is an evaluation of 116 of these procedures followed for at least one year and examined by an orthopaedic surgeon. This evaluation indicates that this is a satisfactory method for prevention of recur rent subluxation of the patella with recurrence in only 7% of the cases. A critical evaluation of the re sults of the procedure reveals only 66% were rated as good or excellent. The results were directly re lated to associated intraarticular pathology such as hemarthrosis, patellar chondromalacia, degenerative changes on the femoral or tibial articular surfaces, torn or absent semilunar cartilages, torn anterior cru ciate ligaments, and insufficient correction of either patella alta or a wide quadriceps angle. The procedure has been slightly modified and the indications for the procedure have been revised.
Cryotherapy in ankle sprains
Authors: Hocutt John E. , Jaffe Rebecca , Rylander C. Roy , Beebe J. Kirk
Published: June 2007

This study assesses recovery from ankle sprains. Thirty-seven final participants were categorized ac cording to the severity of their injury and the use of cryotherapy (15 minutes, one to three times per day) versus heat therapy (15 minutes, one to three times per day) for a minimum of three days. Therapy com menced either less than one hour, from one to 36 hours, or greater than 36 hours after the traumatic event. Sprains were graded into five categories based on the severity of the injury, but only two categories, subject to conservative treatment, are considered in this study.

The study showed that cryotherapy started within 36 hours after the injury was statistically more effec tive than heat therapy for complete and rapid recov ery. Patients in a group with Grade four sprains (un able to bear weight because of pain) reached full activity in 13.2 days compared to 30.4 days in a group using cryotherapy initiated 36 hours after injury or to 33.3 days in a group using heat therapy.

Therefore, early use of cryotherapy, continued with adhesive compression, is an effective treatment of ankle sprains yielding earlier complete recovery than late cryotherapy or heat therapy.
The relationship of upper extremity strength to throwing speed
Authors: Pedegana Larry R. , Elsner Richard C. , Roberts Diana , Lang Janice , Farewell Vern
Published: June 2007

Cybex II lsokinetic Dynamometer (Lumex Corp, Ron konkoma, NY) tests for the upper extremity strength of eight professional baseball players, together with radar gun measurements of their individual throwing speeds, were subjected to statistical analysis. Results of simple and multiple regression analysis showed a relationship between the strength of the elbow exten sion and wrist extension movements and throwing speed.
Bilateral distal radius and ulnar fractures in adolescent weight lifters
Authors: Gumbs Vincent L. , Segal David , Halligan James B. , Lower Gregory
Published: June 2007

Two cases of bilateral radius and ulnar fractures in adolescent weight lifters are described. The fractures healed without complications. However, the authors stress that these injuries can be prevented if coaches, trainers, and sports medicine physicians are aware of their occurrence and undertake necessary preventative measures. Adequate supervision with spotters at the end of each bar, appropriate foot wear, and, above all, the maximum level of concentration are key factors in preventing these injuries.
Jumper's Knee
Authors: Ferretti Andrea , Ippolito Ernesto , Mariani Pierpaolo , Puddu Giancarlo
Published: June 2007

Jumper's knee (patellar or quadriceps tendon tendon itis) is found in a high number of athletes, especially in volleyball and basketball players. Conservative treatment (rest, stretching, physical therapy and an tiinflammatory drugs) is usually successful. The ath letes often recover completely and resume their sports activity. The purpose of this study is to present the histologic findings and our surgical repair of 18 knees of patients who underwent surgery after failure of conservative treatment.

Histologic findings confirm that the so-called "jumper's knee" is a pathology localized at the bone- tendon junction. In all cases the following abnormali ties were found:pseudocystic cavities at the borderline between mineralized fibrocartilage and bone, disap pearance of the "blue line," increased thickness of the insertional fibrocartilage with myxomatous and hyaline metaplasia, mineralization, and ossification of the fibrocartilage far from the "blue line." Abnormali ties of the patellar tendon were observed only in one patient who received local injection of corticosteroids.

Eleven of the 18 surgically treated knees obtained a satisfactory result with complete resumption of sports activity.
Injury account during the 1980 NCAA wrestling championships
Authors: Kersey Robert D. , Rowan Linda
Published: June 2007

Data were gathered during the 1980 NCAA Wrestling Championships in order to document various specifics involving the injuries sustained by the participating ath letes. Any time a match was stopped for medical rea sons, specific information was recorded and later or ganized to indicate any injury tendencies in wrestling.

Of the 353 athletes who participated in the champi onships, 110 incurred injuries requiring the attention of a physician and/or an athletic trainer. Results indicated an overall injury rate per athlete of 31.2% with no conclusive trends considering the weight classification. Injury variety was great with only six athletes (5.5%) injured severe enough to require withdrawal from the tournament. The head-face-neck region was the most commonly injured area (36.4%). Data suggest the fa tigue may affect the injury rate while results related to wrestler position and match score seemed to be incon clusive.
Mountaineering accidents in the Sierra Nevada
Authors: Mclennan Jon G. , Ungersma John
Published: June 2007

Two hundred and fifteen mountaineering accidents oc curred in the Sierra Nevada over a 5-year period in climbers on Class V routes. Patients were evaluated for: climbing preparation and training, first aid experi ence, altitude acclimatization, age, anatomical site of injuries, and cause of the injury. Consideration as to evacuation procedure was also given.

The effect of high altitude exposure impairs judgment and muscular coordination and implies poor acclimati zation. Acute mountain sickness and hypothermia were documented in 104 patients, the majority of whom sustained injuries resulting from judgmental errors.

Ninety-four injuries involved the ankle and lower tibia, an incidence similar to that seen in alpine skiing a decade ago. There were 17 deaths resulting most frequently from head injuries.

Few climbers had formal training in basic mountain medicine which was reflected in the poor assessment and management of injuries, with an unnecessary reli ance upon others for evacuation.

Morbidity and mortality may be lessened by proper climbing preparation—instruction in mountaineering techniques as well as basic mountain medicine—and by prevention of acute mountain sickness and cold injury.
Reconstruction of the anterior cruciate ligament using free tendon graft
Authors: Zaricznyj B.
Published: June 2007

Twenty-seven patients were treated with an intraarti cular tendon graft reconstruction of the anterior cruciate ligament. The tendon of the extensor of the fifth toe was used in five patients and the tendon of the semi tendinosus muscle used in 22 patients. Followup ranged from 2 to 9 years, averaging 5.4 years. Fifteen patients remained pain-free, nine complained of only occasional ache, and three had more severe discom fort. One of those patients ruptured the graft postop eratively.

Twenty patients were able to return to recreational sports and three to competitive sports. All patients were able to return to their previous occupations. Nine pa tients had evidence of severe or moderately severe arthritic changes in the injured knee prior to surgery, and an additional five patients had chondromalacia or early arthritic changes. The severity of arthritic changes was directly related to the time interval between injury and reconstruction of the ligament and also to the severity of the injury. Patients with arthritic changes greatly benefited from reconstruction of the ligament. The stability of the reconstructed ligament did not change during the followup if integrity of other ligaments was preserved or reconstructed.
Acute posterolateral rotatory instability of the knee
Authors: Delee Jesse C. , Riley Mark B. , Rockwood Charles A.
Published: June 2007

Posterolateral rotatory instability of the knee, a poste rior rotational subluxation of the lateral tibial plateau in relation to the lateral femoral condyle, is an unusual condition. Twelve cases of acute posterolateral rotatory instability are presented with an average followup of 7.5 years after surgical repair. Clinical signs suggestive of this injury included posterolateral knee tenderness, and a contusion or abrasion over the anteromedial aspect of the tibia. Indications for operative repair in cluded a 2+ or greater varus instability of the knee at 30° flexion in association with a positive external rota tion recurvatum or posterolateral drawer test. At oper ation, the consistent finding was a tear in the arcuate ligament complex in all patients.

Primary operative repair resulted in stable and func tional knees in 8 of 11 patients without evidence of degenerative joint disease at 7½ years postinjury. Roentgenographic evidence of degenerative joint dis ease was present in three patients, two of whom had some residual posterolateral laxity.

Results were evaluated subjectively, objectively, and functionally. There were eight good, three fair, and no poor subjective results; eight good, two fair, and one poor objective results; and seven good, three fair and one poor functional results. The single objective and functional poor result had a deep infection postopera tively.

Eight of the 11 patients participated in recreational sports following repair and no patients were limited in the activities of daily living.
Hand and forearm strength and its relation to tennis
Authors: Strizak Alan M. , Gleim Gilbert W. , Sapega Alexander , Nicholas James A.
Published: June 2007

Eight expert tennis players and 12 nontennis playing controls were studied to determine the relationship between dominant and minor extremities in regard to hand and forearm isometric strength. The results re vealed that overall strength, including wrist extension, was significantly greater (P 0.01) in the dominant arm in both groups. The tennis players were distinguished from the controls by significantly increased strength of metacarpophalangeal joint extension of the fingers on the dominant side. Examination of a group of 16 "tennis elbow" sufferers demonstrated no significant extensor strength differential in the dominant arm, with no re ports of pain during the testing procedure. The in creased strength of hand extension in elite tennis play ers may be significant in explaining the observed rarity of "tennis elbow" in these individuals.
Reconstruction procedures for anterior cruciate ligament insufficiency: A computer analysis of clinical results
Authors: Jensen Jack E. , Slocum Donald B. , Larson Robert L. , James Stanley L. , Singer Kenneth M.
Published: June 2007

A pre- and postoperative study of 205 patients who had surgical reconstruction of the anterior cruciate lig ament (ACL) of the knee was evaluated with the use of a prototype computer program. An average followup of 4.1 years revealed a 27% improvement in subjective complaints and a 8% improvement in objective findings. The anterior drawer test was improved 25% and sub luxation of the lateral tibial plateau (ALRI) was improved 118% correlating highly (P < 0.001) with a good result. Seventy-four percent of patients had undergone medial meniscectomy, 58% lateral meniscectomy, and 41% had both menisci removed at followup after reconstruc tion. Ninety-two percent of the 121 patients responding to a final subjective complaint evaluation felt that their knee was significantly improved (average 6.1 years after reconstruction). The computer demonstrated a wide variation in the results of reconstruction within the intraarticular, extraarticular, and combined groups. The addition of associated procedures to the main recon structive procedure significantly affected the results. This study reveals improvement of subjective com plaints and objective findings after reconstructing the anterior cruciate ligament and proposes the use of computer analysis for specific evaluation of different procedures.
Roentgenographic skeletal injury patterns in parachute jumping
Authors: Petras Adam F. , Hoffman Eric P.
Published: June 2007

A total of 90,000 parachute jumps made during a 1 year period resulted in 615 (0.68%) injuries secondary to jumping. Of these 615 cases, 70 jumpers (0.08%) had 71 skeletal injuries as confirmed by roentgeno graphic examination. Forty-one (57.7%) of the 71 inju ries involved the ankle, and 12 (16.9%) were compres sion fractures of the thoracolumbar spine. The remain ing injuries were distributed as follows: shoulder, six (8.5%); calf, six (8.5%); pelvis, 3 (4.2%); foot, two (2.8%); and thigh, one (1.4%). The various mechanisms leading to these injuries are presented.
Posterior compartment fractures of the ankle
Authors: Paulos Lonnie E. , Johnson Charles L. , Noyes Frank R.
Published: June 2007

This paper brings to the reader's attention an injury and symptom complex resulting from an ankle sprain during athletic competition. Twenty patients were re viewed and followed over a 3½ year period of time. Three patients presented acutely and 17 patients pre sented after an extended period of time with residual ankle morbidity. Common to this group of patients was a history of having sustained an ankle sprain, most commonly secondary to a forced plantar flexion type injury. Subsequent disability was generally posterior and postero-lateral ankle pain associated with running and/or jumping. Clinical examination invariably demon strated posterior ankle pain, particularly with forced plantar flexion of the foot. All patients demonstrated bony changes in the area of the posterior talus and/or tibia by x-ray, and all patients had a positive technicium bone scan of the posterior ankle area.

If the injury is diagnosed acutely, cast immobilization is the treatment of choice. If diagnosed late, it is sug gested that for those patients who fail conservative treatment, surgical removal of the fragment is best. The majority of patients in this study required surgical extir pation of the posterior talus bony fragment in order to relieve symptoms and return to full sports competition.
Skiing orthosis for recurrent shoulder dislocation
Authors: Metheny Jeffry A.
Published: June 2007

A functional orthosis has been designed and imple mented with the Alpine skier in mind. The unique fea tures include a stabilizing pelvic band and dynamic abduction and external rotation check straps. A case report is presented.
The effect of a patella brace on performance in a knee extension strength test in patients with patellar pain
Authors: Lysholm Jack , Nordin Marketta , Ekstrand Jan , Gillquist Jan
Published: June 2007

The object of this study was to analyze the quadriceps muscle peak strength with the Cybex-II isokinetic dy namometer in patients with patellofemoral arthralgia with and without a patella brace.

Twenty-four patients, 18 women and 6 men, were studied. All had patellofemoral arthralgia. The diagnosis was made on typical clinical findings, but was supple mented with arthroscopy in seven patients with pain also over the medial joint line. After a 2 week adaptation period with the brace, a Cybex-II test was done with and without the brace. The other leg was tested as control. Twenty-one patients (88%) improved their per formance in the strength test with the brace (mean difference 13.7 ± 9.1 %). With the brace, 14 patients (58%) performed at 95% of their control leg or more compared to 6 (25%) without the brace. Patients under the age of 30 years had a better effect than patients over that age.
Myoglobinemia and endurance exercise: A study of twenty-five participants in a triathlon competition
Authors: Thomas Ben D. , Motley Carol P.
Published: June 2007

Twenty-five athletes competing in a triathlon, an endur ance competition, were studied to determine the rela tionship of sustained muscle exertion with myoglobin emia and clinical rhabdomyolysis. Of 24 athletes who completed the event, each individual demonstrated a dramatic rise and fall in serum myoglobin over a 24 hour period, with an average peak level of 842 ng/ml. While all subjects exhibited symptoms of myalgia after exertion, none required hospitalization. A significant correlation was demonstrated with average serum my oglobin and finishing time ( P < 0.0125) and postexer cise temperature ( P < 0.05). Appropriate training of individuals, whether athletes or military recruits, ap pears to be an important factor in reducing myoglobin emia. Exercise-induced myoglobinemia appears to be dependent on intensity of athletic performance, meas ured as a function of time, distance, and activity per formed. The athletes who finished first had the highest levels of myoglobinemia.
Chronic leg pain in athletes due to a recurrent compartment syndrome
Authors: Martens Marc A. , Backaert Marc , Vermaut Gery , Mulier Jozef C.
Published: June 2007

A series of 29 patients, all engaged in sports activity on a regular basis, suffering from recurrent compart mental syndrome, is reported. The syndrome is not restricted only to long distance runners but to athletes involved in a variety of sports activities (soccer, volley ball, cycle racing, gymnastics, judo, physical education, and long distance running). Although most patients presented activity-related leg pain, some patients mainly complained of ankle weakness and recurrent ankle distortions at fatigue.

The wick catheter technique proved to be most useful to determine which compartments were involved. The severity of clinical symptoms correlated highly with the anomalies of the tissue pressure measurements. The predominance of deep posterior compartment and mul tiple compartment involvement are in contrast with most previous reports. Conservative treatment was unsuccessful in every patient, whereas surgical de compression of the involved compartments yielded fa vorable results in those cases where all the involved compartments were released.
Medical services provided at the 1982 Southern Open Golf Tournament
Authors: Thomas Dennis R. , Amos William L.
Published: June 2007

This study describes the medical services provided the players, players' families, caddies, Professional Golf Association (PGA) officials, tournament workers, and spectators during the 1982 Southern Open Golf Tour nament. One first aid center, staffed by one physician and one nurse, was available to approximately 12,000 people during the 7 day event. The facility was stocked with routine diagnostic and therapeutic supplies, as well as routine and emergency drugs. Of the 92 patients seen, only one, who presented with a seizure, required hospital management. Spectators accounted for 20% of the visits. The remaining visits were by the tourna ment population for acute care. It was concluded that additional orthopaedic supplies needed to be readily available. Additional emergency equipment and drugs are recommended. The available and needed supplies should provide a reference for stocking first aid stations at future similar outdoor events that attract large crowds with varied medical needs.
The effects of ice massage on delayed muscle soreness
Authors: Yackzan Laura , Adams Cara , Francis Kennon T.
Published: June 2007

The following hypotheses were tested in the present study: (1) cryotherapy would reduce delayed muscle soreness (DMS) in eccentrically exercised muscles; (2) early cold treatment would reduce this soreness more than later postexercise treatment times; and (3) joint range of motion (ROM) would be inversely related to the subjective soreness ratings. Subjective sensations of muscular soreness and changes in elbow joint ROM were assessed in 30 subjects at 0, 24, 48, and 72 hours following eccentric-biased exercise in the elbow flexors. Cold treatments were applied immediately, 24 or 48 hours following a single exercise session. In response to the eccentric exercise, significant muscle soreness increases and elbow ROM decreases were observed in all exercised muscles from 24 to 48 hours postexercise. No differences in muscle soreness or elbow ROM changes were observed between treated and untreated arms except for one. Subjects treated at 24 hours postexercise reported greater soreness in their arms compared to untreated arms just prior to treatment (24 hour postexercise). The results do not support the efficacy of cold in reducing DMS. A negative correlation between muscle soreness and elbow ROM at 48 and 72 hours postexercise indicated that an increase in soreness was associated with a decrease in ROM.
A Guideline for cardiopulmonary conditioning in the middle-aged recreational athlete
Authors: Raven Peter B. , Smith Michael L.
Published: June 2007

The aging process predisposes man to a greater con cern for and sensitivity to his health and fitness. Regular exercise can improve and maintain an individual's gen eral health regardless of the fitness level at the onset of the exercise regimen. We have noted that age does not significantly reduce the benefits (trainability) at tained from exercise; however, it does appear that a prolonged sedentary lifestyle will diminish the fitness level that can be achieved.

Cardiopulmonary fitness is primarily a function of the oxygen transport system and, therefore, is monitored by determining maximal aerobic capacity (VO2max). The VO2max is a highly reproducible parameter related to cardiac output and the arteriovenous oxygen differ ence. Exercise conditioning can improve the VO2max by augmenting both the cardiac output and the oxygen extraction within the capillaries. Resting stroke volume is increased by a conditioning effect and resting brady cardia is common. Changes in total peripheral resist ance (TPR) and blood pressure are not as readily demonstrable. To produce a conditioning effect and maintain fitness it is recommended that dynamic exer cise at intensities of 60 to 90% of the maximum heart rate reserve for at least 15 minutes should be per formed at least 3 days/week. The total work load (as a function of intensity and duration) appears to be the most important criterion for producing a conditioning effect. Proper testing and evaluation is necessary for a clinician in prescribing an exercise program that is safe and effective. With the middle-aged individual precau tions must be taken to discern any risks for a cardio vascular event or structural injury.
Musculoskeletal profile and incidence of musculoskeletal injuries in lightweight women rowers
Authors: Howell Damien W.
Published: June 2007

There is a lack of information dealing with the muscu loskeletal profile of common injuries in women rowers.

Strength and flexibility of trunk/pelvic muscles were qualitatively described in 17 elite lightweight women rowers. Questionnaires regarding incidence of muscu loskeletal injuries in this population were completed. Correlations between musculoskeletal profiles and in cidence of injury were determined.

Results indicate elite lightweight women rowers have a high incidence of low back pain and discomfort. Seventy-five percent of the sample demonstrated hy perflexion of the lumbar spine. There was a high posi tive correlation between hyperflexion motion of the lumbar spine and incidence of low back pain. There was a high negative correlation between adherence to a regular stretching program and incidence of low back pain.