bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posterior cruciate ligament injuries
Authors: Moore Howard A. , Larson Robert L. 
Published: June 2007

A retrospective study of 20 patients (19 men and one woman) with clinical diagnosis of posterior cruciate ligament injuries (seen between December 1969 and September 1977) was con ducted. Eighteen patients underwent surgery an average of 2.6 days after injury. Tears of the posterior cruciate ligament were confirmed in all patients and a high incidence of associated ligamentous injuries was noted. No cases of truly isolated posterior cruciate injury were found. The posterior drawer sign was the most accurate test for posterior cruciate disruption. Torn posterior cruciate ligaments, as well as associated liga mentous injuries, were repaired to bone when possible. Irrepa rable disruptions or unstable repairs were reinforced with dy namic tendon transfers. We prefer to use as a tendon transfer the medial one-third of the medial head of the gastrocnemius because it provides static posterior drawer resistance and functions dynamically. The average follow-up period was 30.8 months. A comparison of preoperative and follow-up stability was made and it revealed that all patients exhibited mild residual instability. A functional rating showed that seven patients had excellent results, seven had good, three had fair, and one patient had poor results among those surgically treated. One patient treated conserva tively rated good. The other one was lost to followup. The results of our study demonstrate that early surgical repair with dynamic augmentation, as indicated, can lead to acceptable functional results in the majority of knees with posterior cru ciate ligament injury.
Use of modified Boston brace for back injuries in athletes
Authors: Micheli Lyle J. , Hall John E. , Miller M.E. 
Published: June 2007

The Boston Brace System was developed to attain functional realignment of the scoliotic spine. This system uses prefabri cated thermoplastic pelvic modules which can be rapidly fitted to an individual patient. These modules are available in 20 sizes and designed with a forward flexion of 30° on the anterior margin and 15° on the posterior surface. The resultant antilor dotic straightening of the lumbar spine is important in correct ing the scoliotic spine and has been found to be therapeutically effective in managing a number of other conditions of the spine, including back injuries in the young athlete. A review of the results of treatment of 31 young athletes for back injuries over the past 3 years with the brace, with an average followup of 15 months, reveals good or excellent results in 28 of the 31, or 90%. Best results were attained in spondy lolysis. Therapy for discogenic back pain with the brace was effective in only 50%. Modifications of initial brace design included changing from a posterior opening to an anterior opening module and from polypropylene to polyethylene brace construction. Most patients have continued full athletic partic ipation while in the brace.
Treatment of acute and chronic luxations of the peroneal tendons
Authors: McLennan Jon G. 
Published: June 2007

The study, diagnosis, and treatment of subluxations or dislo cations of the peroneal tendons has received little attention in the orthopaedic literature and has long been an enigma to the orthopaedic surgeon. This study reviews literature regarding this problem, and evaluates a group of patients treated by various modalities at Centinella Valley Hospital to provide, hopefully, a source of reference and suggestions as to treat ment. Operative and nonoperative management of acute or chronic subluxating or dislocating peroneal tendons were evaluated over a 4-year period with a minimum follow-up of 2 years. Most injuries were athletically related. Sixteen patients had demon strable lesions in 19 ankles; all but two were a result of trauma documented at some time. All patients returned for follow-up physical examinations, x-ray films and to answer our question naires assessing their functional status, symptoms, limitations, and progress. In 93% of the patients evaluated, conservative modes of treatment were initiated, although 44% ultimately required operative intervention. Three patients treated nonoperatively had evidence of resubluxation, although functionally there was little objective associated disability. Because morbidity is minimal, conservative modes of treat ment are functionally satisfactory in most instances. However, in acute injuries in individuals involved heavily in athletics, operative reconstruction is desired. All patients required pro tective taping for a minimum of 6 months after injury regardless of mode of treatment.
Lateral instability of the ankle and results when treated by the Evans procedure
Authors: Vainionpää Seppo , Kirves Pekka , Läike Erkki 
Published: June 2007

Between 1968 and 1976 81 ankles of 77 patients with lateral instability of the ankle joint were operated on in the Kotka Central Hospital. Sixty patients with 62 ankle surgeries had postoperative followup. The average follow-up time was 5.2 years and the mean age of the patients was 28.3 years. In addition to the interview during the postoperative examination, all patients had antero posterior (AP) mortice, lateral AP stress, and sagittal stress x- ray films. In the clinical examination ankle joint mobility, stability, peroneal function, predisposition to swelling, and circumference of the calf were investigated. Of the 62 ankles the result was excellent or good in 54 (87%), satisfactory in 5 (8%), and poor in 3 cases (5%). Of the 16 athletes' 18 ankles treated the result was excellent or good in 16 and satisfactory in 2 cases. The Evans procedure prevented talar tilting and gave good stability in anteroposterior direction.
Surgical treatment of patellar instability: Indications and results
Authors: Henry Jack H. , Craven Phillip R. 
Published: June 2007

The purpose of this study was to evaluate a consec utive series of 465 patients with patellar subluxation. Both knees were involved in some patients. Therefore, 557 knees were studied. The average age was 24 years. Specific symptoms and signs were reviewed. Instability, swelling, and patella alta were more com mon in the group requiring surgery. All patients were treated conservatively with specific exercises initially. Failure of this conservative treat ment to significantly improve the symptoms, inability to do the activities of daily living, or expected associ ated pathology were indications for surgery. Surgery was required in 139 patients (27%). Some patients had surgery on both knees. Therefore 149 knees were repaired. The surgical technique consisted of an extensor mechanism realignment. This consisted of release of the lateral patellofemoral ligaments, advancement of the vastus medialis obliquus muscle and, in some cases, transfer of the tibial tubercle. Arthrotomy was done in all cases. Results were evaluated in terms of pain, function, and patellar instability. Signs evaluated preoperatively and postoperatively were tenderness of the retinacu lum or bone, patellar mobility, effusion, muscle atro phy, and tone. Range of motion was also evaluated. The average followup lasted three years.
Acute posterior cruciate ligament injuries
Authors: Loos William C. , Fox James M. , Blazina Martin E. , Del Pizzo Wilson , Friedman Marc J. 
Published: June 2007

One hundred and two posterior cruciate ligament in juries were reviewed (43 chronic and 59 acute re pairs). The 59 acute repairs were profiled as to cause and site of injury, associated ligamentous damage, clinical examination, patient position at surgery, and reoperation rate. Twenty-two patients were followed up. Motor vehicle accidents and athletics were the usual causes of injury. In the 59 acute repairs, the posterior cruciate avul sion site was femoral in 21, midsubstance in 13, and tibial in 25. The high incidence of associated injuries included medial collateral ligament tears, capsular damage, lateral knee component damage, and ante rior cruciate ligament ruptures. Thirteen of 59, be lieved to have isolated tears, had surgery in the prone position. Twelve were subsequently reoperated. Eight of 12 reoperations were done prone initially for an "iso lated" tear. Our acute knees with poor results all had the most supposed "isolated" and midsubstance tears, and the most popliteal surgery. The posterior cruciate ligament tear is due to major violence with associated ligament injuries and has no single universal physical sign. Arthroscopy and ex amination under anesthesia are recommended to pre vent the missed diagnosis (chronic case) or to clarify a suspected "isolated" tear prior to prone popliteal surgery.
Use of the air-inflated jacket in football*
Authors: Cain Thomas E. , Donzis Byron , Meins Jerry 
Published: June 2007

Injuries to the rib cage are common in football, but little has been done to protect this area. This paper discusses the effectiveness and usefulness of a pro tective jacket in football. The jacket is highly durable, constructed of urethane-coated nylon, and heat- sealed to take on the shape of several cylinders inter connected by fabric valves which constrict in re sponse to a sudden blow. Its exterior is covered by a 1/8-inch thick Lexan (General Electric, Toledo, OH) shield. The jacket weighs 6.5 oz. It showed impressive results when tested. Testing was done by forcefully swinging a baseball bat against the rib cage protected by the jacket. By digitization of high speed movie filming at 500 frames/second, we were able to determine the speed, velocity, and area of contact. The amount of force deflection was calculated to be 587.6 psi. To inflict this force, a player would have to be traveling 60 miles/hour and strike his opponent with the heel. This lightweight, air-inflated, padded jacket has pro tected and prevented rib cage injuries in professional athletes. It is accepted well by players. This suggests that similar protective equipment for other areas would be useful and represents an advancement in prevent ing injury.
Clinical characteristics of patellar disorders in young athletes
Authors: Reider Bruce , Marshall John L. , Warren Russell F. 
Published: June 2007

The clinical histories of 50 young athletes who com plained of patellar instability or pain were analyzed, and their physical findings were compared to those of 50 controls. The patients were divided into three groups, based on their symptoms. Analysis of their physical findings confirmed the validity of these divi sions. Those who complained of frank dislocation of the patella exhibited the most pronounced stigmata of quadriceps dysplasia, including vastus medialis defi ciency and infrapatellar fat pad enlargement, and had increased general ligamentous laxity, increased mean patellar mobility, and out-facing patellae with concom itantly decreased Q angles in chronic, recurrent cases. Patients who complained of the classic patellar pain pattern, often called "chondromalacia patella," but who denied swelling were designated CMP. They had normal mean ligamentous laxity and mean patellar mobility, an increased incidence of in-facing patellae with concomitantly increased mean Q angle, and fre quently palpable lateral patellofemoral bands. Patients who complained of pain and swelling had physical findings intermediate to the other two groups, and generally correspond to what is usually termed sub luxation of the patella. They exhibited normal general laxity but increased mean patellar mobility, normal mean Q angle but an increased incidence of patellar infacing, and fat pad enlargement.
The injury rate in professional basketball
Authors: Henry Jack H. , Lareau Bernie , Neigut Deborah 
Published: June 2007

The purpose of this study is to review seven years of medical experience with injuries to players of a profes sional basketball club. One of the authors was in volved with all injuries occurring during this period of time. All 71 athletes participating with this club were evaluated, and their specific injuries were studied with regard to incidence, time loss due to injury, and treat ment. Foot, ankle, knee, back, and hand injuries were found to occur most often. The most common as well as the most severe injuries were those of the ankle and knee. The average time loss from play due to injury was amazingly consistent for each specific in jury. Rehabilitation of injuries varied from no playing time loss to two years. Even though knee injuries carry a poor prognosis, the authors conclude that the inci dence of severe injury in professional basketball is low. This study will hopefully serve as useful informa tion for those involved with the care of basketball players.
Natural history of glenohumeral dislocation—revisited
Authors: Henry Jack H. , Genung John A. 
Published: June 2007

The purpose of this study was to evaluate the natural history of glenohumeral dislocation in young athletes. A review of the literature revealed a consensus of opinion that the dislocated shoulder should be immo bilized from 3-6 weeks. However, a high recurrence rate could be expected. One hundred twenty-one patients with acute trau matic anterior dislocations were evaluated (average age—19 years). Methods of immobilization were shoulder immobilizers and slings and swaths. Sixty- two patients were immobilized and 56 (90%) of these suffered recurrent dislocation. Fifty-nine patients were not immobilized and 50 (85%) re-dislocated their shoulders. The length of immobilization had no effect on the recurrence rate. All re-dislocations occurred within 18 months of the initial injury. Seventy-nine patients were operated on for recurrent dislocation. With such a high recurrence rate in the athletic age group, the authors question if immobilization affects the prognosis.
Infectious mononucleosis in the athlete
Authors: Maki Dennis G. , Reich Richard M. 
Published: June 2007

Although almost always a benign, self-limiting disease, infectious mononucleosis accounts for considerable symptomatic illness in the young athlete and can, on occasion, be truly life-threatening. Recognition of the syndrome "glandular fever," vis-a-vis infectious mononucleosis—fever, pharyngitis, lymphadenopa thy, and splenomegaly, with characteristic changes in the peripheral blood leukocytes—dates back over a half a century. However, seroepidemiologic studies have only recently established its viral causation and epidemiology. This acute infection by the Epstein-Barr virus is unique pathophysiologically—an acute, self- limiting, lymphoproliferative disorder with autoimmune features—and may well be the cause or one of the causes of several malignant neoplasms, Burkitt's lym phoma, and nasopharyngeal carcinoma. This review (1) describes infectious mononucleosis, pathophysiologically, clinically, and epidemiologically; and outlines its most frequent and serious complica tions ; (2) discusses how to reliably diagnose infectious mononucleosis and evaluate the heterophile-negative case; and (3) addresses management, especially the thorny issues of the use of corticosteroids and restric tion from athletic training and participation.
The adolescent "swimmer's back"
Authors: Wilson Franklin D. , Lindseth Richard E. 
Published: June 2007

Three patients with backache, aggravated by swim ming the butterfly stroke, were subsequently diag nosed as having Scheuermann's kyphosis. These pa tients were treated with conventional methods. How ever, they were allowed additional time out of the brace to participate in swimming and were encour aged to do so, but they withheld from the butterfly stroke. An average of 27% correction of curvature was seen with an average follow-up of 1.6 years. Symp toms subsided in all cases. We feel that the psycho logical and emotional well-being of the athlete can likewise be enhanced by continual participation with out compromising the overall result.
Evaluating parameters of a professional hockey team
Authors: Minkoff Jeffrey 
Published: June 2007

A championship professional hockey team was eval uated with regard to three systems: cardiovascular, muscular, and visual. The cardiovascular system was tested three times during the season, revealing little significant variation in fitness parameters from the preseason to the late-season periods. The visual and muscular testings were performed only during the preseason. Visual functions, especially eye speed and span, were positively correlated to face-off ability, shot accuracy, and goal-tending capability. Muscular testing demonstrated the importance of hip strength in power skating; a rationale for the use of knee extension hip flexion and knee extension hip abduc tion ratios is clearly established. The most striking correlations were found in relat ing skating skills to muscle testing performances of the left lower extremity as opposed to the right. Regression analysis of the data made it possible to predict super-star capability with 100% correlation to only three simple tests.
Valgus extension overload in the pitching elbow
Authors: Wilson Franklin D. , Andrews James R. , Blackburn Turner A. , Mccluskey George 
Published: June 2007

Five baseball pitchers, three college and two profes sional, with an average age of 24 years, exhibited pain between the acceleration phase and follow- through phase of the pitching motion. This caused the players to be unable to continue at the level of com petition necessary to play. A significant osteophyte on the posteromedial aspect of the olecranon process was identified in all pitchers. This caused impingement with the articular wall of the olecranon fossa and often created an area of chondromalacia. The more com monly identified posterior osteophyte was present in all cases. However, if just this posterior osteophyte is removed, the described lesion will be missed, with resultant persistent disability. Surgical excision of the posteromedial osteophyte through a relatively atraumatic posterolateral ap proach allowed early return of function without mor bidity. With an average follow up of 1 year, all of the pitchers returned for one full season at maximum effectiveness.
Rotational motion of the knee*
Authors: Zarins Bertram , Rowe Carter R. , Harris Bette Ann , Watkins Mary P. 
Published: June 2007

This study deals with the quantitation of axial rotation at the knee. Passive rotation of the knee was measured at various degrees of flexion on 17 subjects with normal knees and 19 patients with unilateral anterolateral ro tatory instability. Normal subjects were found to have bilateral sym metric rotational knee motion at each angle of flexion tested. When the knee is in a position of flexion be tween 30 and 90°, there are approximately 45° external and 25° internal rotation. Rotatory motion decreases with further extension and, at 5° of flexion, the knee has 23° external and 10° internal rotation. The knee with a torn anterior cruciate ligament and anterolateral rotatory instability was found to have an arc of rotation similar to the contralateral knee and to the control knees between 30 and 90° flexion. At 15° of flexion, a slightly greater arc of rotation was meas ured compared to normal knees. At 5° of flexion, a significantly greater range of external (to 41 °) as well as internal (to 14°) rotation was measured.
Functional performance of the knee after intraarticular anesthesia
Authors: Barrack Robert L. , Skinner Harry B. , Brunet Michael E. , Haddad Ray J. 
Published: June 2007

Ten healthy young volunteers underwent gait analysis and tests of knee joint position sense. Gait analysis included determination of stride characteristics (veloc ity, cadence, gait cycle, stride length, and single limb support time), force plate analysis, and motion analysis of the knee. The tests of joint position sense examined the ability of the subject to reproduce passive position ing of the knee and the ability to detect change in angle at the knee joint. In a double-blind manner, 10 cc of sterile fluid were injected into the left knee of each volunteer. Five received 2% lidocaine, the other five received sterile saline. All tests were then repeated. No statistically significant difference was observed in any measurement before and after injection in either test group. It is concluded that intraarticular anesthesia has no effect on gait pattern or joint proprioception as measured. Intraarticular local anesthesia is used in sports medi cine to alleviate pain during arthroscopy of the knee under local anesthetic. The possibility of permitting damage in the early postoperative period due to loss of joint position sense is addressed in this paper. The results of this study suggest that injection of local anesthetic into a joint with an intact joint capsule does not compromise joint position sense as measured in this study. Furthermore, no change in gait parameters was observed in the functional task of ambulation. It must be noted that no conclusions regarding the loss of pain sensation can be made from the results of this study. Also, no conclusions regarding competitive ac tivity can be drawn from this study.
Optimization of knee ligament position for lateral extraarticular reconstruction
Authors: Krackow Kenneth A. , Brooks Robert L. 
Published: June 2007

A kinematic study of five adult cadaver knees was performed to determine the behavior of the separation distances connecting all combinations of a network of points on the lateral side of the knee. Measurements were obtained between each pair of points at the level of the capsule for seven different angles of flexion ranging from 0 to 125°. The data obtained allow further analysis of tendinous reconstructions attached to each pair of points as regards stretching and laxity through out a normally occurring range of motion. The Rowe- Zarins combined intra- and extraarticular reconstruc tion, the Sling-and-Reef procedure, and other extraar ticular methods were analyzed in light of these data. Attachment of a reconstruction at the proximal an terolateral tibia, in front of Gerdy's tubercle paired with femoral attachment high and proximal to the origin of the lateral collateral ligament on the femur, was ob served to demonstrate favorable behavior for several reasons. First, such a check reign represents an ob vious, major restraint to anterior translation as it is positioned well posteriorly on the femur and anteriorly on the tibia. Second, the attachment points were seen to demonstrate maximum separation between 15 and 45° of flexion, thereby not being forced into any unde sirable stretching if the knee were to move normally throughout the other portions of the motion cycle. Consequently, obligate stretch with full flexion or full extension would appear unlikely. Separation distances between attachment points were highly dependent upon changes in the femoral fixation point and much less variable as a result of tibial attachment position. Placing the knee through a flexion-extension range of motion with the tibia held unnaturally in external rotation, which is frequently done in the operating room, violates the normal kinematic pattern of knee motion. As a result, unsuitable attachment points may erro neously appear well behaved. This observation may offer one important explanation for long-term stretching of a ligament reconstruction which appeared satisfac torily tight and strong at the time of surgery. The data obtained allow proper positioning of anterolateral re constructions so that this mode of stretching will not be encountered as a result of normal knee motion.