bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hand injury patterns in softball players using a 16 inch ball
Authors: Degroot Henry , Mass Daniel P. 
Published: June 2007

Softball is a popular recreational and competitive sport among both men and women. The injury rate in softball players is as high as that in baseball and basketball players. We conducted a retrospective analysis of 119 hand injuries in 108 patients treated at the University of Chicago hand clinic. All of the injuries were caused by the impact of a 16 inch circumference softball. Of the 119 injuries, 87 (73%) had bone involvement. Operative treatment was required in 26 (22%) injuries, 23 involving fractures and 3 involving soft tissue only. There was one (3.8%) operative complication. Of all injuries, 101 (86%) involved the finger joints, including 46 (39%) injuries to the distal interphalangeal (DIP) joint, 48 (40%) to the proximal interphalangeal (PIP) joint, and 7 (6%) to the metacarpophalangeal (MCP) joint. The most common DIP joint injury was a mallet injury. This fracture, the most common single type of injury in our series, accounted for 27% of all injuries. Of all mallet injuries, 86% were fractures. The most common PIP joint injury was a volar plate fracture, the second most common injury in our series. Variables such as the patient's sex, dominance or nondominance of hands, and early or late season play were not associated with a higher risk of injury. Certain parts of the hand, such as the more ulnar digits and the DIP and PIP joints, were at particularly high risk of injury.
The biochemical and histological effects of artificial ligament wear particles: In vitro and in vivo studies
Authors: Olson Eric J. , Kang James D. , Fu Freddie H. , Georgescu Helga I. , Mason Gregg C. , Evans Christopher H. 
Published: June 2007

Growing evidence suggests that biochemical mecha nisms play a role in the pathogenesis of arthritis. Car tilaginous wear particles have been shown to induce destructive enzymes and cytokines. To assess the biocompatibility of artificial ACL replacements, the ef fects of wear particles from the following ligaments were analyzed biochemically and histologically: GORE- TEX, Stryker Dacron Ligament Prosthesis, Versigraft carbon, Kennedy LAD, Xenograft, Leeds-Keio, and hu man patellar tendon allograft. Ligaments were frozen and ground to produce wear particles similar to those seen clinically and were added to lapine synovial cell cultures. The resulting conditioned medium was ana lyzed for collagenase, gelatinase, and chondrocyte ac tivating factor (CAF) production. All of the ligaments induced significantly elevated enzyme and CAF production by the synoviocytes, with Xenograft and carbon inducing significantly higher en zyme levels than those of the other five ligaments. Five milligrams of wear particles were injected into the knees of 4 kg to 5 kg rabbits that were analyzed histologically after 14 weeks. Wear particles accumu lated in the periarticular synovial folds and induced modest to severe macrophage infiltration in the syno vium. A hypothetical model explaining the role of artifi cial ligament wear particles in the pathogenesis of arthritis is presented.
The pivot shift phenomenon: Results and description of a modified clinical test for anterior cruciate ligament insufficiency
Authors: Bach Bernard R. , Warren Russell F. , Wickiewicz Thomas L. 
Published: June 2007

Clinical evaluation of knee instability is often difficult to reproduce, and several different physical tests have become popular. In an attempt to elucidate reasons for variations in the degree of pivot shift phenomenon seen with the use of the various tests, we have prospectively evaluated a group of 37 patients with surgically docu mented ACL injuries, noting the effects of hip position and tibial rotation. The patients were examined under anesthesia, and the pivot shift was graded as 0 (absent, or negative), 0.5+ (trace), 1 +, 2+, or 3+ (with locking). All knees were tested in hip abduction, neutral, and hip adduction, and with the tibia in external and internal rotation, so that six positions were evaluated. Hip position strongly correlated with the degree of pivot shift regardless of tibial rotation. Overall, abduc tion produced the greatest degree of pivot shift, fol lowed by neutral and finally adduction. External tibial rotation increased the pivot shift score in abduction and neutral, but not in adduction. A grading system for the subject population showed that abduction/external ro tation (ABDER) resulted in the highest pivot shift scores, and that adduction/external rotation (ADDER) and adduction/internal rotation (ADDIR) resulted in the lowest scores. Nine patients out of 20 with a 3+ pivot shift in ABDER were negative in ADDER. The pivot shift score was dampened at least one grade from ABDER to ADDER in 92% of the patients. We conclude that hip position and tibial rotation affect the degree of pivot shift phenomenon, and it is our impression that the iliotibial band plays a significant role in controlling the degree of pivot shift observed. When examining a knee for ACL insufficiency, it is critical to pay attention to the position of the leg because varia tions in hip position and tibial rotation affect the gra dation of the pivot shift sign and a false negative test may be elicited.
Comparison of maxillofacial and dental injuries in four contact team sports: American football, bandy, basketball, and handball
Authors: Sane Juha 
Published: June 2007

Maxillofacial and dental injuries were studied in regis tered players of American football, bandy, basketball, and handball in Finland between 1979 and 1985. In American football, where facial protection is complete and mandatory, maxillofacial and dental accidents ac counted for only 1.4% of all accidents. In bandy, where facial protection was inadequate during the time of study (only the helmet and extraoral mouth protector were mandatory), the respective figure was 10.6%. The most frequent causes of injury were a blow from an other player (in American football, basketball, and hand ball) or a blow from the stick (in bandy). In American football, the mean cost of treatment related to maxillofacial and dental injuries was only 60% of the mean total cost of all injuries. In contrast, the mean cost of treatment for maxillofacial and dental injuries in basketball and bandy was twice and three times as high, respectively, as that for all injuries. The need for adequate facial protection in contact sports is also discussed.
Proprioception in the anterior cruciate deficient knee
Authors: Barrack Robert L. , Skinner Harry B. , Buckley Steven L. 
Published: June 2007

Proprioception was quantified in a group of patients who had documented complete ACL tears. Threshold to detection of passive change in position of the knee was measured using a well-described test. Eleven pa tients with arthroscopically proven complete ACL tears and findings consistent with moderate to severe anter olateral rotatory instability were tested. Testing was done within the 30° to 40° range of knee flexion. Patients were blindfolded and the injured and uninjured knees were tested in random sequence so that the normal knee could serve as an internal control. Testing was also done in a blind manner, i.e., the examiner did not know which knee had been injured. An age- matched control group underwent identical testing. Po tentially significant variables such as age, time from injury, and degree of rehabilitation as measured by thigh circumference and isokinetic testing of the knee were included in a multivariate analysis. Control subjects demonstrated virtually identical threshold values between their two knees, the mean variation being less than 2%. The test group, however, showed a significantly higher mean threshold value for the injured versus the noninjured knee (P < 0.01), the mean variation being over 25%. Multivariate analysis demonstrated that changes recorded in the propriocep tion of the injured knee were attributable to the loss of the ACL rather than to other variables. Patients who have complete ACL tears and moderate to severe rotatory instability may also experience a decline in proprioceptive function of their knee.
Isokinetic muscular performance of the quadriceps in elite ice hockey players
Authors: Johansson Christer , Lorentzon Ronny , Fugl-Meyer Axel R. 
Published: June 2007

On four occasions during a period of 17 months, iso kinetic maximum knee extensor output (peak torque and contractional work) and input (integrated electro myographic activity) during single and repetitive con tractions were measured in 10 male elite ice hockey players. The tests were performed in the middle and at the end of the competitive season, and after two off ice training periods involving different types of training. No significant changes in peak torque at single max imum contractions occurred for the whole group of players during the investigation. Nor did the slope of decline in contractional work or the plateau level of the ratio of contractional work:integrated electromyo graphic activity during repetitive contractions change significantly. The most obvious finding was great inter individual differences in muscular performance. Intrain dividually, changes in both peak torque as well as in slope of decline in contractional work and in plateau level of the ratio of contractional work:integrated elec tromyographic activity occurred during the different training periods. We conclude that local muscle adap tations, measured by isokinetic procedures, occur in the quadriceps as a result of ordinary training and games in elite ice hockey players. Because of the great interindividual differences in muscular performance and the different responses to similar training, we suggest individual programs for leg muscle training in ice hockey players.
Extraarticular reconstruction of the anterior cruciate ligament insufficient knee
Authors: Durkan John A. , Wynne Garnet F. , Haggerty Joseph F. 
Published: June 2007

This paper reports an analysis for treatment of antero lateral rotatory instability by the Ellison procedure, a technique involving rerouting a portion of the iliotibial band posterior to the fibular collateral ligament. A de tailed description of the operative procedure is pre sented. One hundred four patients were evaluated for subjec tive improvement. The average length of followup was 51 months (range, 24 to 100 months). Eighty-one pa tients (80%) had a good or excellent result, 15 patients (14%) were rated fair, and 6 patients (6%) were rated poor. Sixty-three patients returned for a detailed clinical examination (average followup was 53 months; range, 24 to 100 months). An excellent or good objective rating was achieved in 49 patients (78%). Ten patients (16%) were rated as fair, and four patients (6%) were rated as failures. We recommend the Ellison procedure for the recre ational athlete as a safe and effective mode of treatment for anterolateral rotatory instability.
Analysis of rehabilitation techniques after anterior cruciate reconstruction
Authors: Anderson Allen F. , Lipscomb A. Brant 
Published: June 2007

Numerous postoperative therapies have been advo cated for the rehabilitation of patients who have under gone ACL reconstruction. The effectiveness of these various methods, many of which are based on sound scientific principles, has yet to be documented. The purpose of this study was to determine the efficacy of five commonly used rehabilitation programs. Five groups of 20 patients, all of whom underwent the same method of ACL reconstruction, were compared in order to determine the effects of the following treatments (some in combination): transcutaneous electrical nerve stimulation (TENS), immobilization in flexion, immobili zation in extension, electrical muscle stimulation (EMS), and continuous passive motion (CPM). Clinical evalua tion, volumetric thigh measurements, instrumented varus-valgus stress testing, KT-1000 arthometer (Med metric, San Diego, CA) measurements, and Cybex II (Cybex, Division of Lumex, Ronkonkoma, NY) muscle evaluation were used to examine the patients. TENS did not reduce the amount of pain medication required, nor was there improvement in any other clin ically measurable parameter of performance. There was no clear difference in stability between those treated in extension and those treated in flexion; however, since three patients who were treated in extension required manipulation, there may be some advantage to treating patients with early limited range of motion in flexion. EMS did not reduce atrophy but it did minimize strength decrease during immobilization. EMS also resulted in significantly greater range of motion than those treated with extension or flexion with early limited motion. Compared to all groups, EMS patients had a significant reduction in the incidence of patellofemoral crepitation. As compared to immobilization in extension, CPM re duced the need for manipulation, but was not as effec tive as early limited range of motion. The optimal rehabilitation program included EMS and immobilization in flexion with early limited range of motion.
The effect of knee braces on lateral impact loading of the knee
Authors: Baker Bruce E. , V Edward , Orthotist Cert , Bogosian Stephen P. , Werner Frederick W. , Mech Eng M. , Murphy Dennis 
Published: June 2007

Disruption of the medial supporting structures of the knee occurs commonly in contact sports such as Amer ican football and lacrosse. A limited number of clinical and laboratory studies currently document the effec tiveness of bracing. The purpose of this project was to determine if commercially available bracing could be shown to produce objective evidence of medial stabili zation of the knee. Our model involves the use of a cadaver lower extremity with a fixed foot and sus pended femur with a free knee and a lateral impact load applied simulating a clipping injury. Force transducers were placed on the ACL and medial collateral ligament (MCL) and an electrogoniometer was attached to the extremity. The prophylactic braces studied had a limited capac ity to protect the MCL from direct lateral stress with the knee in full extension. In flexion or with a change in direction of the load, the protective effect is greatly reduced. The functional braces had a capacity to limit abduction and rotational stresses on the MCL in flexion and extension.
Electromyographic analysis of elbow function in tennis players
Authors: Morris Michael , Jobe Frank W. , Perry Jacquelin , Pink Marilyn , Healy Bitte S. 
Published: June 2007

Muscle activity about the elbow during tennis strokes in nine professional and collegiate level players was studied using indwelling EMG and high speed photog raphy. Eight muscles were evaluated for the serve, forehand, and backhand strokes. The serve was di vided into six stages and the ground strokes into four stages. EMG tracings were subjected to analog-to- digital conversion and a relative measure of quantity was obtained. Analysis of variance and Tukey tests were then done to assess statistical significance (P < 0.05). The ground strokes showed low activity in all muscles tested during the preparation phase. During the accel eration phase, both the backhand and forehand showed a generalized increase in all muscle activity. Both strokes showed marked activity of the wrist extensors and, in addition, the forehand showed high activity in the brachialis and biceps. In the follow-through phase, there was a generalized decrease in muscle activity. The serve showed low activity in all muscles tested during the wind-up phase. The wrist extensors in creased their activity in the cocking phase, with marked activity in late cocking. The pronator teres and the triceps showed increased activity in the acceleration phase. Follow-through phase showed low muscle activ ity except for the biceps, which increased in late follow- through. In conclusion, the muscles of the elbow help stabilize the elbow as a unit during the ground strokes in these high level players. Power in the serve comes from increased activity in the triceps and pronator teres. The predominant activity of the wrist extensors in all strokes may be one explanation for predisposition to injury.
Metabolic costs and heart rate responses to treadmill walking in water at different depths and temperatures
Authors: Gleim Gilbert W. , Nicholas James A. 
Published: June 2007

Treadmill walking/jogging in water is a potentially useful therapeutic modality. Since energy costs of this activity are unknown, we compared oxygen consumption (VO2) of treadmill walking/jogging in water to a dry treadmill at speeds of 40.23 to 160.9 meters/min (m/m) in 13.4 m/m increments in 11 subjects. At speeds ≥53.6 m/m, ankle depth, below knee, midthigh, and waist depth walking/jogging in water significantly elevated VO2 and heart rate (HR) above dry treadmill walking (P < 0.05). At speeds ≥134.1 m/m, VO 2 of waist depth jogging was not significantly greater than dry jogging. These findings showed no gender specificity. Treadmill walk ing/jogging in waist depth water at temperatures of 30.5°C and 36.1 °C was compared to dry treadmill walking in five subjects. The rate of increase of HR compared to VO2 was significantly greater at 30.5°C than dry walking, and greater at 36.1° C than 30.5°C (P < 0.05). Treadmill walking in water can double the oxygen cost of movement depending on the depth and speed, and the response to increasing speed is nonlinear. Water temperature affects the relationship of HR to VO2 at waist depth, suggesting that water temperature can add a significant thermal load to the cardiovascular system. Metabolic and cardiovascular demands of treadmill walking/jogging in water must be considered when using this modality since greater external work results at much lower speeds than on land.
Quality assessment of athletic trainers
Authors: Foster Danny T. , Yesalis Charles E. , Ferguson Kristi J. , Albright John P. 
Published: June 2007

This paper reports the first published assessment of the quality of services provided by athletic trainers. Medical coverage for the 1985 Junior Olympic Games was provided by certified athletic trainers (ATC), phy sicians, and other health care personnel. This study assessed the services of the 30 attending ATCs who managed 121 significant injuries. Standard injury infor mation was collected by the ATCs and separately col lected by their physicians. Nine months after the Games, phone interviews were conducted with the injured participants and assessment questionnaires were given to the attending physicians. Results re vealed that young, injured, Junior Olympic participants generally did not inform their parents about their injuries or medical contact while at the Games. Athletes and physicians overwhelmingly agreed that they were pos itively impressed with the capabilities of the ATCs with whom they had contact. About 70% recovered from the symptoms and limitations of injury, as determined by the athlete, within the month following the Games. About 17% sustained some type of injury recurrence to the same body part, and at 9 months about 97% of the athletes had fully recovered from their injuries. These data not only indicate that athletic trainers can accurately identify minor athletic injury but signify the importance of long-term followup in our athletic popu lations. Multisport events, such as the Junior Olympic Games, impose considerable problems to a communi cation effort. The athletic trainer, as an ever-present figure in collegiate and professional circles, can be the central focus of an adequate communication effort re garding the patient care of other athletic populations.
Wrist pain syndrome in the gymnast
Authors: Mandelbaum Bert R. , Bartolozzi Arthur R. , Davis Craig A. , Teurlings Luc , Bragonier Bruce 
Published: June 2007

Gymnast wrist pain syndrome presents a difficult diag nostic and therapeutic challenge. It is common and debilitating among gymnasts, resulting in a reduction in training and performance, and may be the result of a response to repetitive trauma during the period of growth and development. This study was undertaken to define and characterize factors contributing to the causes and development of gymnast wrist pain and to establish an effective means of systematic and compre hensive evaluation and treatment. Thirty-eight collegiate gymnasts (20 UCLA: 9 female, 11 male; 18 NCAA: all male) were evaluated by radio graph and questionnaire. Seventy-five percent (22) of the males and 33% (3) of the females had had wrist pain for at least 4 months. The UCLA males averaged 2.82 ± 1.94 mm positive ulnar variance; this was sig nificantly greater than that of the NCAA males, who averaged 1.28 ± 1.02 mm (P < 0.02). The UCLA females averaged 1.44 ± 1.88 mm positive ulnar vari ance. All of the gymnasts had significantly greater variance than had the controls, who averaged -0.52 mm (P < 0.0001). The pommel horse routine was consistently responsible for wrist pain among the males. Anatomical and histological correlation of cryosec tions with magnetic resonance imaging (MRI) was per formed to establish the usefulness of MRI in the diag nosis of wrist pain. MRI was able to differentiate the complex transitions between cortical and trabecular bone, articular surfaces, the ligaments, and the trian gular fibrocartilage (TFC) complex of the wrist joint. A therapeutic algorithm was established to facilitate the evaluation and management of gymnast wrist pain. Arthroscopic surgery was successful, and arthroscopic findings correlated well with those of MRI and arthrog raphy. Prospective studies are now underway in the pediatric and adolescent population to define further the causes and development of wrist pain problems in gymnasts.
Four to ten year followup of unreconstructed anterior cruciate ligament tears
Authors: Pattee Gary A. , Fox James M. , Del Pizzo Wilson , Friedman Marc J. 
Published: June 2007

Both operative and nonoperative methods have been advocated for the treatment of ACL tears. However, the optimum management of this injury remains contro versial. In the present study, patients treated nonoper atively were evaluated retrospectively 4 to 10 years after ACL tears were documented by arthroscopy and by mild to moderate pivot shifts under anesthesia. Forty-nine patients who underwent arthroscopic eval uation of the knee between 1976 and 1982 were found to have complete tears of the ACL. A mild to moderate pivot shift was present under anesthesia. One or both menisci were torn in two-thirds of the knees, requiring partial meniscectomies. The average age of the patients was 27 years (range, 16 to 46 years). Because of persistent disabling instability, 9 patients (18%) under went late ACL reconstruction. The remaining 40 pa tients were evaluated at an average of 5.6 years after documentation of the tear (range, 4 to 10 years). At followup, 25 (62%) of the 40 patients had satisfac tory subjective results. Eight of the patients (20%) had returned to their preinjury level of athletic activities without restrictions, and 10 (25%) functioned at the same level but with symptoms, some patients requiring bracing. Seventeen patients (43%) had diminished their level of sports activities, while 5 patients (12%) had given up all sports. Only 2 patients required late men iscectomies. On physical examination, 27 patients (87%) had pivot shifts. Instrumented laxity testing revealed an injured to normal difference of 3.1 mm with a 20 pound force. Radiographic studies were interpreted as normal in 35% of the knees, whereas 65% demonstrated mild degenerative changes. Overall, objective results were satisfactory in only 7 (23%) of the 31 patients, although 19 (61 %) were satisfied with their functional results. Numerous procedures are available for stabilizing the ACL insufficient knee. With improvement in our ability to diagnose an acute ACL tear, management must be based not only on the initial clinical findings, but on the patient's level of activity and functional expectations. Although only slightly more than 60% of the patients had satisfactory subjective results, many had adapted quite well to their ultimate functional disability through modification of activities. Few patients, however, re turned unrestricted to their preinjury level of function.