bluuebunny/crossref_metadata_2025_split huggingface dataset:
Torque-velocity relationships of the knee extensor and flexor muscles in individuals sustaining injuries of the anterior cruciate ligament
Authors: Murray Sarah M. , Warren Russell F. , Otis James C. , Kroll Michael , Wickiewicz Thomas L. 
Published: June 2007

Muscle deficits in 58 patients with chronic anterior cruciate ligament (ACL) insufficiency were evaluated after completion of a 6 month rehabilitation program. Quadriceps and hamstring torques were measured on a modified Cybex II isokinetic dynamometer. Twenty- nine of our patients were tested just prior to undergoing ACL reconstruction, and patients who were continuing to tolerate their conditions served as controls. For the surgical group, significant quadriceps deficits (P < 0.01) were found for all speeds and at both the 30 and 60° positions. The nonsurgical group had sig nificant deficits at the 30° position at 180°/sec, and at 60° for the 0°/sec and 30°/sec. However, in comparing the two groups no significant differences were noted. Regarding hamstring deficits in the surgical group, significant deficits were seen only at 30° of flexion at 180°/sec. The nonsurgical group had similar deficits. Of interest was the observation that the ham string:quadriceps (H:Q) ratio was found to be both speed-position dependent. Overall, no correlation was found between the pres ence of strength deficits following a rehabilitation pro gram and the need for surgery.
An unusual cause of back pain in a young athlete
Authors: Clark Andrew , Stanish William D. 
Published: June 2007

Back pain in the young athlete is a common problem seen in many sport medicine clinics. Not only can this be a difficult problem for the physician to manage (due to inability to pinpoint the pathology), but it is a frustrating expenence for the athlete, unable to compete or train effectively. The sport medicine physician must, therefore, always be alert and ob sessed with obtaining a precise diagnosis to be followed by specific treatment. When presented with the adolescent athlete suffering with back pain, one must consider the full gamut of diagnostic possibilities. Mechanical or spondylogenic causes are most common; however, potentially more serious infective, meta bolic, and neoplastic conditions should also be considered.
Shoulder strength following acromioclavicular injury
Authors: Walsh W. Michael , Peterson David A. , Shelton Guy , Neumann Randall D. 
Published: June 2007

The acromioclavicular (AC) joint enjoys the dubious distinction of being one of the few joints in the body whose total dislocation is routinely treated by simply leaving the joint dislocated. Adherents of both conserv ative and operative treatment have presented reasons for their viewpoints. Residual shoulder weakness has been offered as a sequela of untreated acromioclavic ular injury and a reason for repairing the joint. An objective evaluation of shoulder strength would be valuable in determining the optimum treatment for this injury. The purpose of our study was to quantitate, using the Cybex II, the residual shoulder weakness following various modes of treatment. Seventeen pa tients with Grade III AC separations and eight patients with Grade II AC sprains were reviewed. Nine of the Grade III injuries were treated and eight nonoperatively. All Grade II injuries were treated nonsurgically. All pa tients were tested on the Cybex II isokinetic dynamom eter at both slow and fast speeds through various ranges of motion. Grade III injuries treated nonopera tively showed no significant strength deficits. Surgically treated Grade III injuries had a significant strength deficit in vertical abduction at fast speeds (19.8%) when compared to the uninjured shoulder. Interestingly, the Grade II injuries led to a significant weakness in hori zontal abduction (24.3%) at fast velocity. Evaluation of subjective results showed that Grade III injuries treated conservatively had the most pain and stiffness, despite their strong shoulders. Patients with Grade III injuries treated operatively rated their overall outcome below that of those treated conservatively. We conclude that: (1) from the standpoint of objective strength, nonsurgical treatment of Grade III AC injury is as effective as surgical treatment; (2) the dilemma of Grade II AC injury continues, as shown by our findings of significant strength deficits; and (3) patient satisfac tion following treatment of AC injury does not mirror objective strength deficits.
Stability of the loaded ankle
Authors: Stormont Daniel M. , Morrey Bernard F. , An Kai-Nan , Cass Joseph R. 
Published: June 2007

The stabilizing capacity of the ligaments and articular surface in the ankle was determined under defined physiologic loading conditions. The concept of primary and secondary constraints was adapted to the ankle. With physiologic loading, the articular surface ac counted for 30% and 100% of stability in rotation and version, respectively. That the articular surface was the sole source of inversion and eversion stability under the prescribed physiologic loading conditions has not been previously reported. The demonstration that the articular surface resists inversion displacement in the loaded ankle supports the conclusion of previous studies that rotation, rather than inversion, may account for a type of clinically sympto matic ankle instability. Further, ankle instability may occur during loading and unloading but not once the ankle is fully loaded. The results of our study confirm the importance of the anterior talofibular and calcaneo fibular ligaments and suggest an important role for the deltoid ligament.
The emergency care network of a ski marathon
Authors: Gannon Daniel M. , Derse Arthur R. , Bronkema Pamela J. , Primley Donald M. 
Published: June 2007

In this paper we report the system of emergency care that was used in a large-scale cross-country ski mara thon. We describe the typical terrain encountered, per sonnel required, physical facilities, communication sys tem, injury protocol, and types and numbers of injuries seen. We have found that many injuries can occur in a cross-country ski race, given specific race conditions. A complete and efficient emergency care network is essential to the success of any athletic event similar to the one we report. These races are rapidly growing in number and size, yet we could not find any previous reports in the literature pertaining to the medical care necessary. We hope to provide a model for emergency care that can be applied to many different athletic events involving large numbers of participants and cov ering great distances.
Glenoid labrum tears related to the long head of the biceps
Authors: Andrews James R. , Carson William G. , Mcleod William D. 
Published: June 2007

Tears of the glenoid labrum were observed in 73 base ball pitchers and other throwing athletes who under went arthroscopic examination of the dominant shoul der. Most of the tears were located over the anterosu perior portion of the glenoid labrum near the origin of the tendon of the long head of the biceps muscle into the glenoid. At arthroscopy, the tendon of the long head of the biceps appeared to originate through and be continuous with the superior portion of the glenoid labrum. In many cases it appeared to have pulled the anterosuperior portion of the labrum off the glenoid. This observation was verified at arthroscopy by viewing the origin of the biceps tendon into the glenoid labrum as the muscle was electrically stimulated. With stimulation of the mus cle, the tendinous portion became quite taut, particu larly near its attachment to the glenoid labrum, and actually lifted the labrum off the glenoid. Three-dimensional high-speed cinematography with computer analysis revealed that the moment acting about the elbow joint to extend the joint through an arc of about 50° was in excess of 600 inch-pounds. The extremely high velocity of elbow extension which is generated must be decelerated through the final 30° of elbow extension. Of the muscles of the arm that provide the large deceleration forces in the follow-through phase of throwing, only the biceps brachii traverses both the elbow joint and the shoulder joint. Additional forces are generated in the biceps tendon in its function as a "shunt" muscle to stabilize the glenohumeral joint during the throwing act. On the basis of our observations that (1) the biceps tendon is subjected to large forces during throwing, (2) most tears of the glenoid labrum occur at the antero superior portion near the origin of the biceps tendon, and (3) the biceps tendon lifts the labrum off the glenoid when its muscle is stimulated, we believe that the tendon of the long head of the biceps may be a cause of tearing of the glenoid labrum in the throwing athlete.
A biomechanical study of human lateral ankle ligaments and autogenous reconstructive grafts
Authors: Attarian David E. , Mccrackin Hugh J. , Devit Dennis P. , Mcelhaney James H. , Garrett William E. 
Published: June 2007

The purpose of this study was to investigate the bio mechanical behavior of human anterior talofibular and calcaneofibular ligaments, as well as peroneus brevis, split peroneus brevis, and toe extensor tendon grafts. This article represents the first published data compar ing the most frequently injured ankle ligaments to the most commonly used autogenous reconstructive grafts. Twenty fresh human ankles provided the bone-liga ment-bone and tendon graft specimens for biomechan ical testing on a Minneapolis Testing System. Protocol consisted of cyclic loading at physiologic deflections, followed by several load-deflection tests at varying velocities, followed by a final extremely rapid load to failure test. The load-deflection data for all ligaments and tendons demonstrated nonlinearity and strain rate dependence. The maximum load to failure for the anterior talofibular ligament was the lowest of all specimens tested, while its strain to failure was the highest. The loads to failure of the peroneus brevis and split peroneus tendons were signficantly greater than the anterior talofibular ligament and approximately equal to the calcaneofibular liga ment. Strains to failure for all tendons were significantly less than ligament strains. The high strain to failure of the anterior talofibular ligament demonstrates its physiologic function of allow ing increased ankle plantar flexion-internal rotation, while its low load to failure shows its propensity for injury. The greater strength of the tendon grafts ex plains the success of most reconstructive procedures in reestablishing stability in chronic ankle sprains; at the same time, the data presented suggest that those surgical procedures sacrificing the entire peroneus brevis tendon are unnecessary. Finally, the greater stiffness of the tendon grafts may cause postoperative decreases in ankle and subtalar motion.
Instrumented measurement of anterior knee laxity in patients with acute anterior cruciate ligament disruption
Authors: Daniel Dale M. , Stone Mary Lou , Sachs Raymond , Malcom Lawrence 
Published: June 2007

Instrumented anterior/posterior laxity measurements were performed on 138 patients evaluated within 2 weeks of injury with their first traumatic knee hemar throsis. All patients were tested with the MEDmetric Arthrometer model KT-1000 in a knee injury clinic. Seventy-five of the patients had knee arthroscopy. Thirty-three had arthrometer laxity tests under anes thesia. Eighty-seven percent of patients arthroscoped had anterior cruciate ligament (ACL) tears and 41 % had meniscus tears. One hundred twenty normal subjects were tested to establish normal anterior laxity values. Three tests were used to evaluate anterior laxity: anterior displacement between a 15 and 20 pound force (compliance index), anterior displacement with a 20 pound force, and an terior displacement with a high manually applied force. Displacement measurements in normal subjects re vealed a wide range of normal laxity with a small right knee-left knee difference. For example, the 20 pound anterior displacement range was 3 to 13.5 mm with a right knee-left knee difference (mean ± SD, 0.8 ± 0.7 mm). Eighty-eight percent of the normals had a right- left difference of less than 2 mm. In the 53 patients arthroscoped who had complete ACL tears, the anterior laxity measurements performed in the clinic were suggestive or diagnostic of pathologic anterior laxity in 50 patients.
Skiers' thumb injuries associated with flared ski pole handles
Authors: Primiano George A. 
Published: June 2007

Three skiers presented for treatment of significant thumb injuries sustained while skiing. Each patient was using a strapless ski pole handle with a flared thumb support. These skiers felt their interphalangeal (IP) joint flexion was blocked by the flare of their ski pole handle, causing their protruding thumb tip to be the point of initial impact, thus leading to their injury. Prior to use of any ski pole handle, full flexion of the gloved thumb IP joint should be verified.
Replacement of the anterior cruciate ligament using a synthetic prosthesis
Authors: Arnoczky Steven P. , Warren Russell F. , Minei Joseph P. 
Published: June 2007

The ACL of 21 adult mongrel dogs was replaced with a knitted dacron velour prosthesis. The biologic fate of these synthetic grafts was then evaluated at various intervals from 1 to 12 months postoperatively using routine histology and a vascular injection (Spalteholz) technique. Following implantation the knitted dacron prosthesis was encapsulated with a vascular synovial tissue in a manner similar to that observed with autogenous pa tellar tendon grafts. This revascularization process was followed by a proliferation of fibroblasts throughout the extent of the prosthesis. While the grafts appeared to support a fibrous tissue proliferation in and around the design of the prosthesis, this tissue demonstrated only a random orientation of collagen fibers as late as 1 year postoperatively. It would appear, therefore, that al though the knitted dacron prosthesis is capable of inducing and supporting tissue encapsulation and in growth, it does not allow for the functional orientation of this tissue.
A preliminary study on the measurement of static and dynamic motion at the glenohumeral joint
Authors: Bonci Christine M. , Hensal Frederick J. , Torg Joseph S. 
Published: June 2007

Measurement of glenohumeral joint motion has, for the most part, been performed with the simple goniometer. The purpose of this paper is to describe a method for measuring and recording static and dynamic external rotation of the glenohumeral joint using the Cybex II Isokinetic Dynamometer and an MFE model 815 X-Y plotter. Static range of motion was assessed at 60 deg/ sec using a slow arm action externally from a 90° abduction position. Dynamic motion was recorded at 300 deg/sec using a rapid rotational whipping action from a 90° abducted position. Measurements were recorded on three groups of athletes, and the influences of sex, hand dominance, overarm activity, and surgery were analyzed. The sub jects in the first two groups were divided according to sex and their participation in overarm versus nonover arm (control) activities. Static and dynamic motion in both groups was significantly influenced by sex and hand dominance (P < 0.05). Although there was no overall difference in the motion measurements between the control and overarm groups, the interaction of this factor with sex and type of measurement was signifi cant. Males who participated in overarm activities had, on the average, more static range of motion than males in the control group. A third group that had undergone a modified Bristow procedure for recurrent dislocation/subluxation of the shoulder demonstrated that static and dynamic range of motion were significantly reduced by the surgery (P < 0.05). The average differences in static and dynamic motion between the surgical arm and its nonsurgical counterpart were 17.5° and 21°, respectively, resulting in an overall range of motion difference of 19°. The Cybex II Isokinetic Dynamometer and X-Y plotter provided a viable mechanical means of receiving and recording the full external rotation motion potentials of the limbs at varying speeds of movement. A combina tion of both static and dynamic measurement tech niques can provide a more quantitative assessment of the functional range available at the glenohumeral joint based on slow and high speed movement capabilities.
A performance test to monitor rehabilitation and evaluate anterior cruciate ligament injuries
Authors: Tegner Yelverton , Lysholm Jack , Lysholm Marketta , Gillquist Jan 
Published: June 2007

A performance test simulating components of sports was devised to evaluate dysfunction after ACL injury. The test included a one-leg hop, running in a figure of eight (straight running and turn running measured sep arately), running up and down a spiral staircase, and running up and down a slope. Twenty-six men with ACL injury, most of them soccer players, and 66 uninjured male soccer players were studied. Patients with ACL injury performed signifi cantly less well than the uninjured players. Test items of special interest were turn running in the figure of eight, stair running, and slope running, all of which place high demand on the knee. It is concluded that a performance test of this design is useful for monitoring rehabilitation and for evaluating the patient's condition. Before sports can be resumed at the original level, normal strength and normal per formance should be regained.
Prophylactic knee bracing in college football
Authors: Hewson George F. , Mendini Ricky A. , Wang Jon B. 
Published: June 2007

American football can be harmful to knees. In an at tempt to reduce the number and severity of knee injuries, the intercollegiate football team at the Univer sity of Arizona (Pacific Ten Conference) has been using protective braces since 1981. Objective evaluation of the effectiveness of this program is the purpose of this study. All linemen, offensive and defensive, as well as linebackers and tight ends were considered to be the players at greatest risk and were required to use the braces. The brace used was the Anderson Knee Sta bler. Each player at each practice session or game was counted as one exposure. During the 4 years of brace use, there were 28,191 exposures, while the control group numbered 29,293 exposures. The data were analyzed from the perspectives of days lost from prac tice or games, player's position, the type and severity of injury, and the rate of injury per 100 players per season. Players at risk showed no trend to change in injury rate. Of the players at risk, the type and severity of injury in nonbraced and in braced groups were similar. A significant finding in players at risk was a two fold increase in knee ligament injury rate per 100 players when compared to rates for an entire team. The number of season-ending injuries remained unchanged. Prac tice time missed for third-degree medial ligament, and for medial meniscus injuries, was significantly lower in the braced group, but this was due to improved treat ment techniques initiated in 1981. Seven NCAA rule changes, directed at reducing knee injuries, have been introduced since 1981. Neither the rule changes nor the braces nor the combination thereof have had any apparent effect on the trend to knee injury in this study. We conclude that, in this study, knee injury prevention in a college football team was not improved by prophy lactic knee bracing.
Arthroscopic percutaneous lateral patellar retinacular release
Authors: Lankenner Peter A. , Micheli Lyle J. , Clancy Ruth , Gerbino Peter G. 
Published: June 2007

Thirty-four arthroscopic lateral patellar retinacular re leases in 26 patients were evaluated retrospectively. Patients were carefully assessed for residual pain; they were also evaluated by various physical examination criteria. In addition, objective measurements of quadri ceps and hamstring strength were obtained with the Cybex II Isokinetic Dynamometer. The surgical technique and postoperative manage ment are presented. Overall, there were 9% excellent results, 53% good results, 26% fair results, and 12% poor results. A total of 64.7% of the knees were im proved by the procedure.
Healing of experimental muscle strains and the effects of nonsteroidal antiinflammatory medication
Authors: Almekinders Louis C. , Gilbert Jerome A. 
Published: June 2007

The healing process of muscle strains and the effect of nonsteroidal antiinflammatory medication were studied using an experimental animal model. A standardized strain of the tibialis anterior muscle in adult male rats was produced by a controlled stretch of the muscle. Groups I and II underwent a unilateral strain of the tibialis anterior muscle and were immobilized in the postinjury period. The rats in Group II were fed piroxi cam in the postinjury period. Group III underwent a sham procedure and were also immobilized. At 0, 2, 4, and 11 days postinjury both injured and contralateral control muscles were evaluated by determining tensile strength characteristics and histologic appearance. Group I showed a significant drop in maximum failure load to 25.7% of the control leg at Day 2 with a gradual return to the level of Group III at Days 4 and 11 (40.9% and 50.1 %). Group II showed a similar drop but was still stronger than Group I at 2 days with 40.8% of the control leg and continued to drop until 4 days postinjury (33.7%). Histology showed a delay in inflammatory reaction and muscle regeneration in Group II. At 11 days both Groups I and II showed regenerated muscle fibers bridging the entire defect and an increase in endomyseal fibrosis. It is concluded that muscle strains continue to weaken in the early postinjury period. Non steroidal antiinflammatory medication, such as piroxi cam, might delay muscle regeneration.
Digital ischemia in baseball players
Authors: Sugawara Makoto , Ogino Toshihiko , Minami Akio , Ish Sechi 
Published: June 2007

Eight baseball players developed digital ischemia as a result of repetitive ball impact. Symptoms and signs were coolness, numbness, cyanosis, paleness, and a positive reaction to the digital Allen's test. Seven of the eight players developed digital ischemia between the ages of 16 and 17. Angiograms of four patients with an occluded index digital artery are presented. Thermo- grams of four patients with a cool area of the left index finger are also presented. We investigated the incidence of digital ischemia by administration of a questionnaire. The respondents were 578 players belonging to clubs in junior high schools, high schools, and colleges. No digital ischemia was found in 207 junior high school baseball players. The incidence increased in high school (66 of 299) and college (29 of 72). The probability of developing digital ischemia corresponded to the accumulated playing time. Digital ischemia occurred characteristically in the left index finger.
Acute ligamentous diastasis of the ankle without fracture
Authors: Marymont John V. , Lynch Mary A. , Henning Charles E. 
Published: June 2007

Diastasis of the ankle syndesmosis without fracture is an uncommon injury. We present the results of bone scintigraphy as well as stress radiographs of the ankle performed on 27 athletes with suspected acute dias tasis of the ankle without fracture. Scintigraphy is a reliable procedure to guide initial management of those patients in whom stress radiographs of the ankle cannot be obtained because of pain or swelling, or in whom the radiographs were considered unreliable. Scintigraphy correctly identified all 20 patients with positive stress tests (sensitivity = 100%). Two of seven patients with negative stress tests had positive scans (specificity = 71 %), for an accuracy of 93%. We feel that scintigraphy is of value in a small subset of patients with suspected acute diastasis of the ankle syndesmosis on whom stress radiographs cannot be performed, or are considered inadequate in the imme diate postinjury period.