bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilaterality in anterior cruciate ligament injuries
Authors: Souryal Tarek O. , Moore Howard A. , Evans J. Pat 
Published: June 2007

Nonsimultaneous, bilateral ACL injuries are not uncom mon. We studied a group of patients with these injuries to determine possible predisposing factors that could aid in early detection and prevention of contralateral ACL injury. Retrospective analysis of 1,120 patients with ACL ruptures who were treated between 1983 and 1987 revealed 45 patients with bilateral ruptures. Complete follow-up data were available for 41 of these patients. We examined age at initial injury, sex, interval between initial and contralateral ACL injury, mechanism of injury, activity at injury, medical and family histories, treatment of initial injury, and radiographic measurement of inter condylar notch width. The overall incidence of bilaterality was 4.01 % in the 28 male and 13 female patients. Their average age was 19 years and 10 months. The average interval between initial and contralateral injury was 47 months. A non contact cutting maneuver was the most common mech anism of injury. We devised a method to measure and compare in tercondylar notch widths on plain radiographs. We com pared the mean notch width index (NWI) of the bilateral group to the mean NWI of a group of 50 consecutive patients with "normal" knees and to the mean NWI of 50 consecutive patients with acute ACL ruptures. The mean NWI for the normal group was .2338, for the acute ACL group, .2248, and for the bilateral group, .1961. We noted a statistically significant difference when we compared the bilateral group to the normal and acute groups (P < 0.0001, respectively). There was no statistically significant difference between the NWI of the normal and acute ACL groups. None of the other variables studied were found to be significant. We identified a large subgroup of patients (59%) in the bilateral group who had sustained their initial injury at a relatively young age (average, 16 years) through noncontact mechanisms and who had a low NWI. These patients sustained their contralateral injury within 2 years of their initial ACL injury (average interval, 15 months) regardless of their initial treatment. We believe that young individuals who sustain an ACL tear by noncontact mechanisms and have a low NWI, carry a significant risk for contralateral ACL rup ture and should be strongly counseled regarding that possibility.
Surgical treatment of lateral ankle instability syndrome
Authors: Sammarco G. James , Diraimondo Charles V. 
Published: June 2007

Lateral ankle instability syndrome is defined by pain and instability caused by ligament laxity. Anterior talo fibular ligament laxity, with or without calcaneofibular laxity and other abnormalities, is often present in con junction with peroneus brevis tendon tears, abnormal ligament placement, tibialis posterior tendon tears, os teochondritis dissecans, arthritis, synovitis, loose bod ies, and tarsal coalition. Surgical reconstructions were performed on 43 ankles using a split peroneus brevis tendon graft routed through osseous tunnels in the talus, fibula, and calcaneus and resutured to the recon structed anterior talofibular and calcaneofibular liga ments. The tunnel locations, transfer routes, and ten don reinforcement were modifications based on the Elmslie procedure. Good and excellent results were achieved in 91% of the patients. Ninety-eight percent of the patients achieved stability. Followup was from 9 months to 11 years. Twenty-one patients had preop erative and intraoperative findings that required addi tional procedures. Thorough evaluation of patients with lateral ankle instability syndrome increases the frequency of finding associated abnormalities, which if left uncorrected, may adversely affect the outcome of surgery.
Pathomechanics of posterior sag of the tibia in posterior cruciate deficient knees
Authors: Ogata Kosuke , McCarthy John A. , Dunlap Janet , Manske Paul R. 
Published: June 2007

This study was an investigation of the pathomechanics of posterior sag of the tibia in knees with posterior knee instability caused by PCL deficiency. By using fresh cadaver knees, the authors hoped to define the rela tionship of the posterior joint capsule and the medial and lateral collateral ligaments (MCL, LCL) with poste rior knee instability in the PCL deficient knee. Thirty newtons of posterior stress were applied to the knees to simulate postoperative conditions. Roentgeno graphic methods were then used to evaluate posterior sag and change in the distance between the origin and insertion of the PCL. Strain gauges were used to meas ure the actual strain of the PCL and the collateral ligaments. The PCL, the posterior capsuie, and the medial and lateral collateral ligaments were sequentially divided and the above measurements were then re peated in the same way, using 30 N of applied posterior stress. When only the PCL was cut, posterior sag and medial rotation of the tibia occurred with increasing severity as flexion increased. No sagging or rotation of the tibia was observed at full extension in the knees that had isolated PCL "injury". When the posterior capsule was sectioned, no significant changes were noted in the severity of the sag or the rotation. When the MCL or LCL was divided in a PCL deficient knee, greater sag occurred with flexion and a significant sag was observed even at full extension. The MCL "injury" was associated with increased medial rotation, whereas LCL "injuries" were associated with lateral rotation of the tibia. Strain measurements on the mid- substance of the PCL were at a minimum at full exten sion and at a maximum at 90° of flexion with a passive range of motion from 0° to 90°. Both the MCL and LCL demonstrated an inverse relationship to the PCL in the intact knee: maximum strain on the MCL and LCL were at full extension. This study suggested that in cases with a PCL injury, postoperative immobilization in full extension appears to be beneficial if MCL and LCL stability can be achieved, as these ligaments will prevent sagging in full extension, when the PCL is under the least strain. Our study also suggested that a significant posterior sag in full extension is indicative of an associated collateral ligament injury and can be partially assessed by rotation of the tibia.
Comparative functional analysis of the Bristow, Magnuson-Stack, and Putti-Platt procedures for recurrent dislocation of the shoulder
Authors: Regan William D. , Webster-Bogaert Susan , Hawkins Richard J. , Fowler Peter J. 
Published: June 2007

Literature on anterior shoulder instability deals most often with elimination of recurrence following recon struction. We analyzed the subjective function, loss of motion and shoulder strength of three operative pro cedures : Magnuson-Stack, Bristow, and Putti-Platt. A retrospective review of 27 patients, 9 in each surgical group, with no postoperative dislocations or on-going pain was performed. All patients were male, right hand dominant with the right shoulder affected. Average time of followup was 6.75 years (range, 4.2 to 10.3 years). All patients completed a questionnaire and had their range of motion measured by a hand-held goniometer and their shoulder strength tested on the Cybex II Dynomometer. Peak torque as a percent of body weight and side-to-side differences were calculated for six arm positions and compared to nine right hand dominant controls of similar age and recreational activ ity. Sixty percent returned to throwing sport. One Mag nuson-Stack and Bristow patient felt full functional re turn to preinjury level. Three patients in each of these two groups returned to unmodified throwing sport whereas no Putti-Platt patient attained this level. Deficit of external rotation at shoulder neutral measured 4.7°, Magnuson-Stack; 12.2°, Bristow; and 21.8°, Putti- Platt. At 90° shoulder abduction, similar deficits in external rotation measured 6.4°, 11.6°, and 28.8° re spectively. These values were statistically significant employing analysis of variance. We compared the operative groups as a whole to the controls and compared the operative groups to each other. Statistically significant weakness was found in external rotation of all patients as opposed to control subjects at shoulder 90° abduction and neutral position (P < 0.05). No flexion weakness was found in the Bristow group. We have concluded that functional re turn to throwing sport favors the Magnuson-Stack and Bristow patients over the Putti-Platt. Statistically signif icant differences of external rotation loss exists at shoulder 90° abduction. The operative group was sta tistically significantly weaker than controls in external rotation at shoulder neutral and 90° abduction. Also, there was no relative weakness between groups.
Fat pad adhesion to partially torn anterior cruciate ligament: A cause of knee locking
Authors: Finsterbush A. , Frankl U. , Mann G. 
Published: June 2007

Isolated damage to the ACL was found on arthroscopic examination of 51 patients who had symptomatic knees. There were 47 male and 4 female patients. The average age of the patients was 26.5 years, ranging from 13 to 43 years. Twenty-four of the patients had isolated partial tears of the ACL, and 27 had isolated complete tears. The purpose of this study was to examine the clinical patterns and arthroscopic findings in these two groups. On examination, 12 patients were found to have locked knees. An additional six patients gave a history of knee locking. All 18 of these patients were clinically suspected of having meniscal damage; however, only partial and complete ACL tears were found at arthros copy. Of these 18 patients who had locking knees, 15 had a partial tear of the ACL and 3 had a complete tear. Locking was involved primarily in the group with partial ACL tears (15 of 24); only 3 of the 27 patients who had complete tears described locking. Of the 12 patients who had locked knees on examination, all were found to have fibrosis and adhesions of the fat pad and the synovium adjacent to the ACL stump. All 12 of these patients had a partial tear of the ACL. The fibrosis and adhesions were histologically documented in 10 of those 12 patients. The three patients who had partial ACL tears and histories of locking were not observed to have adhesions of synovium to the fat pad, but did have an entrapped remnant of ACL between the tibial plateau and femoral condyle. The remaining three pa tients, who had a history of locking and a complete ACL tear, also had a free part of the torn ACL inter posed between the femoral condyle and the tibial pla teau. These findings suggest that a mechanical factor is involved in the locking of knees of patients who have partial tears of the ACL.
Effect of standard and Aircast tennis elbow bands on integrated electromyography of forearm extensor musculature proximal to the bands
Authors: Snyder-Mackler Lynn , Epler Marcia 
Published: June 2007

Classic tennis elbow, or lateral epicondylitis, has been described as an overuse or misuse injury resulting in a tendinitis. The extensor carpi radialis brevis (ECRB) and extensor digitorum communis (EDC) have been impli cated as primary culprits in this pathology. Tennis elbow has been treated using a constrictive band placed several centimeters distal to the origin of these two muscles. Aircast (Aircast Inc., Summit, NJ) has devel oped a new style of band that employs an air-filled bladder as the counterpressure element. This study tested the effect of both standard and Aircast bands on EMG activity of the EDC and ECRB proximal to the band compared to control values. Ten normal subjects, ranging in age from 20 to 43 years, were tested. Right upper extremities were tested in all cases. The subjects' forearms were stabilized in the CYBEX II forearm stabilization V-pad. The ECRB and EDC were then impaled with monopolar EMG needle electrodes. The CYBEX data were recorded using the HUMAC system and the EMG data were recorded and analyzed using the Cadwell 7400. EMG data were recorded at 80% of maximum voluntary isometric contraction (MVIC) with no band, the standard band, and the Aircast band. An analysis of variance (ANOVA) with repeated meas ures of integrated EMG (IEMG) and Duncan's multiple comparison tests revealed that the Aircast caused a significant reduction in IEMG of the ECRB and EDC when compared with control values and the standard band. The decrease in IEMG with the standard band was not statistically significant. This may begin to pro vide an explanation for the anecdotal reports of the clinical effectiveness of the air-bladder type of counter force bracing.
The effects of cold therapy in the postoperative management of pain in patients undergoing anterior cruciate ligament reconstruction
Authors: Cohn B.T. , Draeger R.I. , Jackson D.W. 
Published: June 2007

This prospective study assessed 54 consecutive ar throscopically assisted ACL reconstructions for the amount of postoperative pain relief provided by cold therapy, using the Hot/Ice Thermal Blanket. Twenty- six randomly selected patients undergoing this proce dure were compared to a control group consisting of 28 patients having the identical procedure in which the Hot/Ice unit was not used postoperatively. The initial ACL injury in both groups was sports related with the exception of three patients whose injury occurred while on the job. The Hot/Ice Thermal Blanket consists of two rubber pads (blankets) connected by a hose to the main cooling unit. The pads were applied to either side of the oper ated knee in the operative suite. The pads received fluid which was circulated from the main unit. The temperature of the fluid was set at 50° in the recovery room and the unit was run continuously until the time of discharge, which was approximately 4 days. Hot/Ice patients required 53% less injectable Demerol and 67% less oral Vistaril than patients in the control group. Hot/ Ice patients had made the conversion from injectable to oral pain medication an average of 1.2 days sooner than did their non-Hot/Ice counterparts. There was no appreciable difference in length of hospital stay. Physi cal therapy and nursing records documented a greater percentage of compliant patients in the Hot/Ice group. According to these records the Hot/Ice patients were more helpful in self-assistance, were out of bed and ambulating in the halls more quickly, and did their range of motion exercises with greater ease. The results of this study support the potential benefit in pain reduction by use of a Hot/Ice Thermal Blanket in the postopera tive recovery of patients undergoing ACL reconstruc tion.
Implications of muscular defense in testing for the anterior drawer sign in the knee
Authors: Iversen Bjørn Franc , Stürup Jens , Jacobsen Klaus , Andersen Jens 
Published: June 2007

This study was performed with the aim of shedding some light on the effect of muscular guarding during clinical testing of the knee for anteroposterior laxity. Twenty physicians were tested on a knee phantom, for force used during testing for the anterior drawer sign. The force used averaged 109 N (range, 70 to 180 N). Fifteen patients were examined by stress radiogra phy. Radiographs were taken with the knee flexed to 90° (the drawer test position) and with the knee flexed to 15° (the Lachman position). A comparison was made between the laxity measured on forward traction in the relaxed knee, and during traction while the patient was instructed to counteract the forward displacement of the tibia by tensing the hamstrings, thus simulating muscular defense. The test procedure was executed first with 80 N and then with 160 N applied. The opposing effect of tensing the hamstrings on the anterior shift of the tibia was significantly less at 15° of knee flexion (with 80 N, P < 0.02; with 160 N, P < 0.05) than at 90°. With the hamstrings tensed and the knee flexed to 90°, no statistically significant gain in drawer sign was achieved by increasing the force from 80 to 160 N. With the knee in the Lachman position, increasing the force produced a significantly greater anterior drawer sign (P < 0.01).
Rupture of the pectoralis major muscle
Authors: Kretzler Harry H. , Richardson Allen B. 
Published: June 2007

Nineteen cases of rupture of the pectoralis major mus cle are presented. ln 16 cases the rupture was repaired; in 3 cases repair was not performed. Physical findings and surgical technique are described and the anatomy of the insertion of the pectoralis major muscle is re viewed. Nine of the patients in this series sustained their injury while performing the bench press. The ma jority of the remaining patients were also involved in sports when injury occurred. Eleven of the ruptures were in the nondominant arm and eight in the dominant arm. All of the patients complained of weakness, pain, and deformity, with weakness being the major com plaint. Following surgery and rehabilitation, all 16 patients who underwent repair were relieved of pain. The de formity was corrected in all 16 patients, although 2 patients who had a 5 year interval from repair to rupture did not achieve a completely normal contour. Thirteen of the 16 patients reported a full return to strength. The others had significant improvements. Ruptures of the pectoralis major muscle are uncom mon, but not rare. Ruptures occurring under tension tear at or near the insertion onto the humerus, as in all 19 cases in this series. Distal ruptures are usually complete, despite physical signs that may be mislead ing. Distal tears are reparable, even after a delay to treatment. After surgical repair, the majority of patients may expect relief of pain, return of strength and normal contour, and maintenance of range of motion.
A dynamic analysis of a functional brace for anterior cruciate ligament insufficiency
Authors: Cook Frank F. , Tibone James E. , Redfern Fredrick C. 
Published: June 2007

A dynamic, in vivo, functional analysis of braces de signed for ACL insufficiency has never been reported. In this study, 14 athletes who had arthroscopically proven absent ACLs were evaluated in the Biomechan ics Laboratory at the Centinela Hospital Medical Center. None of the ligaments were repaired or reconstructed. Footswitch, high speed photography, and force place data were recorded while the athletes performed run ning and cutting maneuvers with and without their custom fitted C.Ti. braces (Innovation Sports, Irvine, CA). Cybex testing, KT-1000 evaluation, and radio graphs were collected for each subject. Statistical analysis showed that while performing cut ting maneuvers, braced limbs generated significantly increased shear forces compared to the same limb unbraced. During straight line running, braced limbs generated significantly less lateral and aft shear forces compared to the same limb unbraced. Running velocity increased while wearing a brace for most athletes, but this was not statistically significant. As expected, the sound limb generated significantly greater shear forces than the unbraced involved limb during most cutting maneuvers. Athletes who did not achieve 80% of the Cybex (Cybex, Division of Lumex, Ronkonkoma, NY) quadri ceps torque of the sound limb generated significantly more forces during cutting maneuvers while wearing their braces. The cutting angle, approach time to the cut, and time on the force plate showed no significant differences during brace wear. We conclude that the C.Ti brace allows significantly better running and cutting performances for athletes who have torn ACLs. Athletes who have not achieved 80% of quadricep strength as measured by Cybex testing showed even more improvement while wearing their braces. Brace prescribers are cautioned that braces do not prevent abnormal anterior tibial displace ment in anterior cruciate deficient knees and the long- term effects of brace wear are unknown.
Ibuprofen in the treatment of acute ankle joint injuries
Authors: Fredberg Ulrich , Hansen Poul Anders , Skinhøj Anette 
Published: June 2007

Sixty-eight patients who presented to the casualty ward with acute ankle joint injuries were studied to examine the effect of ibuprofen on pain and ankle swelling. Thirty-two patients were treated with placebo tablets and 36 with 600 mg ibuprofen tablets taken four times a day for 4 to 6 days. All of the patients were immobi lized and requested to keep the foot elevated. The results showed that ibuprofen had no effect on the ankle swelling. The need for additional analgesics was not influenced by treatment with ibuprofen, which means that ibuprofen has no effect on pain. The time elapsed from occurrence of the injury to arrival at the casualty ward was negatively correlated to the reduc tion of ankle joint swelling during the treatment period. Treatment with ice-sprays, icebags, or cold water dur ing the acute stage of injury did not influence the reduction of swelling during the treatment period.
The accident-prone and overuse-prone profiles of the young athlete
Authors: Lysens Roeland J. , Ostyn Michel S. , Auweele Yves Vanden , Lefevre Johan , Vuylsteke Magda , Renson Luc 
Published: June 2007

A 1 year prospective study was done to develop an accident-prone and overuse-prone profile of young ath letes. A group of 185 freshman physical education students (118 males; 67 females) of the same age (18.3 ± 0.5 years) trained under the same conditions and were exposed to similar extrinsic risk factors. Using a descriptive statistical technique, an analysis of correspondence, the complex interrelation between the criterium variables (acute injuries and overuse inju ries) and the predictor variables (intrinsic risk factors; physical characteristics—antropometric data, physical fitness parameters, flexibility aspects and malalignment of the lower extremities; and psychological factors— 16 personality traits) was estimated for males and females separately. Although dynamic strength seems to be an important risk factor in acute injuries, sports accidents must be seen in relation to psychological factors. However, the overuse-prone profile is mainly based on physical traits: a combination of muscle weakness, ligamentous laxity, and muscle tightness predisposes to stress injuries. In addition, these overuse effects are intensified by large body weight and length, a high explosive strength, and malalignment of the lower limbs. Nevertheless, it has to be kept in mind that psychosomatic factors play a role in how one experiences these overuse phenomena.
Upper extremity injuries in snow skiers
Authors: Van Dommelen Bruce A. , Zvirbulis Raimonds A. 
Published: June 2007

All skiers with upper extremity injuries seen at the Henry Ford Hospital between 1983 and 1986 were evaluated in terms of age, sex, skill of the skier, type of snow conditions, pole type, grip type, direction of fall, and mechanism of injury. Our primary objective was to evaluate whether the type of pole used had an effect on the injury rate. We found that the strap handled pole without any platform had the lowest injury rate. The saber type pole handle had the highest injury rate. Other observations showed ulnar collateral ligament injury of the thumb to be the most common upper extremity injury to skiers. A proportionally high number of skiers with upper ex tremity injuries were advanced skiers.