bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional analysis of anterior cruciate ligament instability
Authors: Tibone James E. , Antich T.J. , Fanton Gary S. , Moynes Diane R. , Perry Jacquelin 
Published: June 2007

Eighteen males and two females (mean age, 26.5 years) underwent biomechanical assessment and Cybex eval uation prior to ACL reconstruction. Clinically, all patients had at least a 1+ grade with the Lachman, anterior drawer, and pivot shift tests, the majority being graded as 2+. Footswitch, high speed photography, force plate, and indwelling wire electrode data were collected while each subject performed free and fast walking, running, cutting, and stair climbing activities. During walking, single limb support times did not differ between the subject's involved and uninvolved limbs. Knee joint angles were similar between limbs during walking, running, and stair climbing maneuvers. Dynamic EMG tracings during walking demonstrated similar quadriceps and calf activity between limbs, while greater variation in hamstring firing was evident among subjects. During running, the involved limb had a longer duration of medial hamstring activity compared to the lateral hamstring. No significant differences were seen in either vertical or sagittal shear forces during free walking. During fast walking, higher midstance vertical forces (F2) were present in the involved limb (P < 0.05). During running, the involved limb experienced lower vertical forces (P < 0.05), while both anterior and posterior sagittal shear differences were insignificant. Straight cut maneuvers demonstrated significantly lower lateral shear and ver tical forces in the involved limb (P < 0.05). Lower lateral and sagittal shear forces in the involved limb (P < 0.01 and P < 0.05, respectively), combined with a reduced angle of the cut during the cross-cut maneuver, may be the first means to assess the functional pivot shift phenomenon ever documented. Isokinetic Cybex strength testing demonstrated a mean 14% quadriceps deficit and a mean 4% hamstring deficit in the involved limb. Achieving quadriceps and hamstring torque of 86% and 96%, respectively, was not sufficient to eliminate the subjective need for sur gical reconstruction.
Incidence of injuries in high school track and field athletes and its relation to performance ability
Authors: Watson Michael D. , D Paul P. 
Published: June 2007

Two hundred fifty-seven high school track athletes from 17 teams were observed prospectively for one com plete season (77 days) to study the incidence and types of injuries and to establish the relationship among inju ries, duration of training, and individual performance ability. One hundred seventy-four (68%) of the athletes were male and 83 (33%) were female. A total of 41 injuries was observed over this period of time. One injury occurred for every 5.8 males and every 7.5 females. On the average, an injury resulted in 8.1 days of missed practice, 8.7 days for males and 6.6 days for females. Sprinting events were responsible for 46% of all injuries. The majority (83%) of injuries in volved the lower extremities. Management of these injuries varied greatly. A direct correlation was noted between performance level of the athlete and incidence of injuries. The aver age noninjured athlete ranked at the 57.4 percentile based on best seasonal performance while the average injured athlete ranked at the 75.4 percentile. This direct relationship was present for both sexes and within all events, although some variation was noted within these separate groups.
Infrapatellar contracture syndrome
Authors: Paulos Lonnie E. , Rosenberg Thomas D. , Drawbert John , Manning James , Abbott Paul 
Published: June 2007

Infrapatellar Contracture Syndrome (IPCS) is an infre quently recognized cause of posttraumatic knee mor bidity. Unique to this group of patients is the combina tion of restricted knee extension and flexion associated with patella entrapment. IPCS can occur primarily as an exaggerated pathologic fibrous hyperplasia of the anterior soft tissues of the knee beyond that associated with normal healing. It can also occur secondarily to prolonged immobility and lack of extension associated with knee surgery, particularly intraarticular ACL recon struction. IPCS follows a predictable natural history which is divided into three stages. Symptoms, diagnos tic findings, and recommended treatment are deter mined by the stage at presentation. Once beyond its early presentation, IPCS is best treated by an anterior intraarticular and extraarticular capsular debridement and release, followed by extensive rehabilitation. The authors review 28 consecutive cases of IPCS. At fol lowup 3 months to 4 years postoperation, the patients had averaged 2.3 additional surgical procedures follow ing their index procedure or injury. The average increase in extension at followup was 12° with the average increase flexion 35°. Eighty per cent of patients demonstrated signs and symptoms consistent with patellofemoral arthrosis; 16% of the patients demonstrated patella infera. The authors con clude that prevention or early detection and aggressive treatment are the only ways of avoiding complication in these problem cases.
The relationship of the femoral attachment site to the isometric tracking of the anterior cruciate ligament graft
Authors: Melhorn J. Mark , Henning Charles E. 
Published: June 2007

The large number of reconstructive procedures in the treatment of ACL reflect a lack of consistent clinical success, thus creating the current controversy over the treatment of ACL injuries. The purpose of this study on the relationship of the femoral attachment site to the isometric tracking of the ACL graft was three-fold: 1) to develop a method for evaluating the femoral attach ment site for the ideal isometric graft tracking pattern; 2) to develop a reference table comparing femoral attachment sites to graft excursion; and 3) to apply this information to the surgical procedure to allow for step wise refinement of the attachment site for improved clinical results. To aid in graphic representation, the attachment sites were identified from radiographs by the sclerotic margin of the drill hole in the bone or the bone trough. These attachment sites were transferred to a trace diagram and compiled to form a composite diagram. Three distinct graft tracking patterns were identified. Group I represented the modified "over-the-top" technique with a deep cancellous bone trough and represented the most isometric tracking. Group II represented the mod ified over-the-top technique with a shallow or no can cellous bone trough and Group III the drill hole tech nique. Groups II and III were nonisometric. In surgery, palpation of the graft for excursion while performing a range of motion allows for review of isometric graft tracking. Stepwise intraoperative refine ment of the femoral attachment site can result in iso metric graft tracking.
Sports injuries at the 1985 Junior Olympics
Authors: Martin Robert K. , Yesalis Charles E. , Foster Dan , Albright John P. 
Published: June 2007

The XIX Junior Olympic Games, hosted in lowa City, lowa, in August of 1985, involved 3,028 athletes who participated for 7 days in 13 different sports at 8 separate sites. Medical coverage for the Games was provided by the University of lowa Sports Medicine Service. Staffing for the events involved approximately 75 physicians, 60 athletic trainers, and other health care personnel. A triage protocol was established prior to the Games whereby the athletic trainer would make first contact with the injured athlete and would evaluate and treat the injury based on standing orders. If in the judgment of the trainer, the athlete needed to be referred to a physician, one would be available, either on site or on call. During the Games, 1,113 medical encounters were recorded, 121 of those being deemed serious enough to withhold an athlete from competition pending further evaluation and treatment. The 121 significant injuries and illnesses involved 116 athletes (66% male, 34% female). Thirty-four percent of the significant injuries only required treatment by the trainer, while 46% were referred to an on site physician and 20% needed a specialty consultant. Seventeen percent of the signifi cant injuries resulted in the athlete being medically disqualified for the remainder of the event. The most common injuries/illnesses were contusions (26%), sprains (21 %), heat (17%), strains (9%), and other illnesses (12%). According to body region, 44% of the 121 injuries were to the lower extremity, 26% to the head, neck, and trunk, and 12% to the upper extremity. Eighteen percent were heat-related illnesses requiring intravenous administration of fluids. Twenty- six percent of the injuries were to body sites injured prior to competition. Athletes who had a history of previous injury to a body part were much more likely to sustain another injury to that body part than were those athletes with no record of previous injury (relative risk = 9.33).
A study of urban bicycling accidents
Authors: Tucci James J. , Barone James E. 
Published: June 2007

This study was undertaken because of the large num ber of bicycle accident victims treated in our emergency room. Its aim was to assess the type, frequency, and mechanism of occurrence of bicycle accidents as well as characterization of the type of injuries sustained and the expense incurred by such accidents. One hundred seventy-two patients injured over a 10 month period were studied. The upper extremity was found to be particularly at risk of injury. Fractures accounted for 20% of all injuries. The most common accident mechanisms were being struck by a motor vehicle, falling from a bicycle, or being struck by a bicycle. Eleven percent of the patients studied were pedestrians. Increasing pedestrian-cyclist awareness and modification of currently used protective gloves are proposed to prevent injuries associated with urban cycling.
Injury to the lateral ankle ligaments of athletes
Authors: Rijke Arie M. , Jones Barrington , Vierhout Pieter A. 
Published: June 2007

Twenty of 26 original athletes with injuries to the lateral ligaments of the ankle were reexamined 2 to 5 years following treatment. The functional quality of their an terior talofibular (TF) and calcaneofibular (CF) ligaments was tested by stress examination, using a commercially available stress device, and was compared with the results of stress examination, arthrography, and sur gery at the time of injury. Surgically treated patients showed a 70% to 100% recovery of the functional properties of the lateral ankle ligaments on comparison with the contralateral, unin jured ankle. Of the six patients treated conservatively With elastic bandages and rest, only one had regained normal function, whereas the others showed minimal or no improvement. Isolated lesions of the anterior TF ligaments, when treated conservatively, may have only a slightly better prognosis than a combined lesion of both anterior TF and CF ligaments in the athletic pop ulation.
Long-term followup of anterior cruciate ligament reconstruction using the quadriceps tendon substitution for chronic anterior cruciate ligament insufficiency
Authors: Kornblatt Ira , Warren Russell F. , Wickiewicz Thomas L. 
Published: June 2007

At The Hospital for Special Surgery, the quadriceps tendon substitution (QTS), as described by Marshall, was performed for ACL insufficiency from 1973 to 1980. A review of the initial 60 patients with a minimum of 4 years followup (average, 5.5 years) has been concluded. Thirty-eight patients returned for examina tions, and 11 returned questionnaires. Associated me dial procedures were performed in 29 of the 38 exam ined patients. Medial meniscus surgery was performed in 86% and lateral meniscus surgery in 28.9%. At followup, giving way, which was the main preoperative complaint, was eliminated in 30/38 examined and 9/11 questionnaire patients (79%). In the examined group, three patients were clear failures and five had mild transient instability. The pivot shift was present in 17 of 38 (45%) patients examined: 21 patients were neg ative, 9 were 1 + or a grind, 8 were 2+, and none were 3+. We have concluded that the QTS procedure will eliminate symptomatic instability in 79% of our patients, but the high rate of a residual pivot shift (45%) and symptoms of instability (21 %) require the addition of an extraarticular sling procedure. This appears to be re lated to the relatively poor strength characteristics of the tissue used in the QTS substitution.
Skiers' lower leg shaft fracture
Authors: Peter Robin E. , Bachelin Pierre , Fritschy Daniel 
Published: June 2007

We report our experience using Sarmiento's method for the conservative treatment of 91 consecutive frac tures of the lower leg. The mean age of the patients in our series was 34 years. One patient had an open fracture. All of the patients were followed and were evaluated clinically and radiographically 6 to 12 months after injury. After a period of immobilization by traditional methods (traction/long leg cast), the Sarmiento brace was ap plied at a mean of 42 days, allowing early weightbearing and mobilization. The brace was removed at a mean of 90 days. Clinical results were excellent; there was minimal persistence of knee or ankle limitation; 84% of the patients had less than 5 mm of final shortening; 96% had less than 4° of final angulation. Work was resumed at a mean of 103 days. We had one nonunion, which we treated operatively 6 months after injury by osteosynthesis and autologous bone grafting. All of the patients were asked to complete a questionnaire; 51 % responded, with an average followup of 5 years (range, 1 to 10 years). These patients had been able to resume sports activity 8 months after injury; 52% were skiing 1 year after injury, and 96% were satisfied with the treatment method used. One patient complained of persistent pain.
Fractures of the posterolateral tibial plateau
Authors: Waldrop John I. , Macey Theodore I. , Trettin John C. , Bourgeois Warren R. , Hughston Jack C. 
Published: June 2007

We reviewed the clinical records and operative notes of 28 patients with fractures of the posterolateral tibial plateau seen at our institution from 1949 to 1982. Five of the 28 patients had chronic depressions of the posterolateral tibial plateau after initial treatment else where. All five were disabled because of significant functional instability when the knee was in flexion. There were 23 acute fractures, of which 4 were initially nondisplaced and treated nonoperatively. One nonop erative patient was lost to followup; the remaining three were rated as having had good or excellent results. Nineteen patients had acute depressed fractures and were treated operatively with open reduction, elevation of the depressed area, and bone grafting, with or without internal fixation. All patients treated operatively at the time of injury were seen for followup from 24 to 145 months postoperatively, with a mean followup of 59 months. One patient was lost to followup; the other 18 were rated using both objective and subjective criteria. Seventeen (94%) achieved a final rating of excellent or good; one patient (6%) achieved a rating of fair. We have observed these fractures occurring in a younger population and producing significant disability in activities requiring a stable knee in flexion. The depressed posterolateral tibial plateau fracture is best assessed by AP, lateral, and 45° internal oblique views on radiographic examination. Because of continued disability caused by chronic, depressed fractures of this type, we recommend open reduction and bone grafting in acute cases to eliminate instability in flexion. This procedure produces good or excellent results in most cases.
Preoperative instrumented testing of anterior and posterior knee laxity
Authors: Anderson Allen F. , Lipscomb A. Brant 
Published: June 2007

A prospective study was performed on 50 patients who were thought or suspected to have cruciate ligament tears. Each patient had a clinical examination preoper atively and under anesthesia and instrumented exami nation using the MedMetric KT-1000 arthrometer, Stry ker knee laxity tester, and Genucom knee analysis. The diagnosis was confirmed by arthrotomy or arthroscopy. Thirty had acute knee injuries (within 2 weeks), 9 had subacute (2 weeks to 3 months), and 11 had chronic injuries. The surgical findings demonstrated that five had other maladies, but no cruciate ligament tears. Two had a partial ACL tear, and the remaining 43 patients had at least one cruciate tear. The preoperative clinical examination for cruciate lig ament integrity was completely correct in 92%, correct but incomplete in 6%, and incorrect in 2%. Examination under anesthesia was correct in 98%, the KT-1000 was correct in 75% (involved knee minus noninvolved knee was ≥3 mm laxity equal to ACL tear), the Stryker was correct in 75%, and Genucom in 70%. The average laxity of those with ACL tears was 4.4 mm with the KT- 1000, 4.6 mm with the Stryker, and 2.0 mm with the Genucom. The methods of testing with the Stryker and the KT- 1000 are similar and the laxity recorded in patients with a torn ACL were almost identical. However, the KT- 1000 can be used to identify the quadriceps neutral position and therefore more accurately determine PCL instability. The Genucom has the most versatility, but the laxity recorded in patients with a torn ACL was significantly lower than the other devices. It had the poorest correlation with the clinical Lachman test. This study suggests that clinical examination by an experienced examiner is the most accurate way to determine cruciate ligament integrity. However, instru mented testing was beneficial. In many cases, confi dence in clinical diagnosis was improved by instru mented confirmation.
External stabilization of the anterior cruciate ligament deficient knee during rehabilitation
Authors: Maltry J.A. , Noble P.C. , Woods G.W. , Alexander J.W. , Feldman G.W. , Tullos H.S. 
Published: June 2007

Using cadaveric specimens, we studied the effect of ACL deficiency upon anterior tibial translation during extension of the knee joint. Five knees were loaded via the quadriceps mechanism until flexion angles of 10°, 25°, 40°, and 60° were attained. At each angle, the anterior-posterior position of the tibia was documented with biplane radiography, both before and after division of the ACL. In every specimen, anterior tibial translation increased with loss of the ACL and was greatest at 25° of flexion, where an average displacement of 3.3 mm was observed. Subluxation was not significant at flex ion angles exceeding 60°, regardless of ACL deficiency. We also examined the effect of an external restraining force on tibial subluxation in the ACL deficient knee. Posteriorly directed forces of 0 N, 45 N (10 pounds), 90 N (20 pounds), 135 N (30 pounds), and 225 N (50 pounds) were applied to the tibia at the level of the tibial tubercle. Anterior subluxation was eliminated through application of forces ranging from a maximum of 106 N (23.6 pounds) at 10° to only 13 N (2.9 pounds) at 60°.
Morphologic and histologic abnormalities in female and male rats treated with anabolic steroids
Authors: Yu-Yahiro Janet A. , Michael Roger H. , Nasrallah David V. , Schofield Brian 
Published: June 2007

A two-part study was performed to determine the ef fects of high doses of anabolic steroids on weight, appetite, and organ histology. Initially, 30 white Wistar rats, 15 males and 15 females, were treated weekly with either 0.52 cc of physiologic saline or nandrolone decanoate. After 6 weeks, female treated and control rats had comparable weight gains, but male treated rats were significantly lighter than controls. Rats were sacrificed and organs dissected for histologic prepara tion. Treated male livers had less lipid than control males. The uteri of treated females displayed abnormal vacuolization, stromal edema, and peliosis. In Part 11, 12 male rats, 6 treated and 6 control, were given the drug or saline in a manner identical to that in Part I. Treated rats had lower weights from Weeks 1 through 6 and ate less than controls. Upon sacrifice, treated rats' kidneys were heavier, and testes and liver were lighter compared to controls. Roentgenographic studies of tibias from Parts I and II showed no significant differences in tibial length or height of growth plate between treated and control groups. In summary, when anabolic steroid use is studied in the rat model, numer ous pathological and anatomical changes occur.
Modified criteria for the objective diagnosis of chronic compartment syndrome of the leg
Authors: Pedowitz Robert A. , Hargens Alan R. , Mubarak Scott J. , Gershuni David H. 
Published: June 2007

One hundred fifty-nine patients were referred to the authors for evaluation of chronic exertional leg pain from 1978 to 1987. The records of 131 patients were complete and available for retrospective review. Forty- five patients were diagnosed as having a chronic com partment syndrome (CCS) and seventy-five patients had the syndrome ruled out by intramuscular pressure recordings. The only significant difference found be tween the two groups on history and physical exami nation was a 45.9% incidence of muscle herniae in the patients with CCS, compared to a 12.9% incidence in those without the syndrome. One-third of the patients with the syndrome and over one-half of those without it reported persistent, moderate to severe pain at 6 month to 9 year followup. Modified, objective criteria were developed for the diagnosis of CCS. The criteria were based upon the intramuscular pressures recorded with the slit catheter before and after exercise in 210 muscle compartments without CCS. In the presence of appropriate clinical findings, we consider one or more of the following intramuscular pressure criteria to be diagnostic of chronic compartment syndrome of the leg: 1) a preex ercise pressure ≥ 15 mm Hg, 2) a 1 minute postexercise pressure of ≥30 mm Hg, or 3) a 5 minute postexercise pressure ≥20 mm Hg.