The American journal of sports medicine
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Comparative Study
Use of the Hollywood Impact Base and standard stationary base to reduce sliding and base-running injuries in baseball and softball.
To determine if the use of the Hollywood Impact Base would significantly reduce the frequency of sliding and base-running injuries to baseball and softball players, we recorded injury information for several teams who used these bases and standard stationary bases. The investigators, under the direction of the Central Michigan University team physician, verified each recorded incident by contacting the injured participant. The sample included interscholastic, intercollegiate, recreational, and intramural softball and baseball teams. ⋯ The results (t = -1.94, P < 0.05) verify that using the Hollywood Impact Base significantly reduced the frequency of sliding and base-running injuries. The Hollywood Impact Base injury rate of 0.08% per game compares favorably with the reported breakaway base injury rate. The results of our study verify that the Hollywood Impact Base is similarly effective in reducing the risk of base-related injuries.
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Comparative Study
Comparison of lateral ankle ligamentous reconstruction procedures.
The static restraints of various surgical procedures for chronic lateral ankle instability were compared. Forty cadaveric ankles were divided equally into the following five groups: 1) ankles with intact anterior talofibular and calcaneofibular ligaments, 2) ankles with incised anterior talofibular and calcaneofibular ligaments, 3) ankles with Chrisman-Snook procedure, 4) ankles with Watson-Jones procedure, or 5) ankles with modified Broström procedure. All ankles were placed in a mechanical apparatus for anterior drawer stress and inversion stress tests. ⋯ The modified Broström group had the least amount of anterior talar displacement and talar tilt angle at all forces. There were no significant differences between the Watson-Jones and the Chrisman-Snook procedures in anterior talar displacement and talar tilt. The modified Broström procedure produced a greater mechanical restraint than either of the other procedures.
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Case Reports
Anterior cruciate ligament allograft reconstruction in the skeletally immature athlete.
The purpose of this study was to evaluate anterior cruciate ligament allograft reconstruction in skeletally immature athletes. Eight patients (mean age, 13 years, 6 months; range, 10 to 15 years) with radiographic documentation of open growth plates had anterior cruciate ligament repair and reconstruction with fascia lata or Achilles tendon allograft tissue. A 7-mm graft was centrally placed across the tibial physes and in an over-the-top position on the femur. ⋯ On KT-1000 arthrometer testing, 5 patients had less than 3 mm of increased anterior-posterior displacement (normal knee minus reconstructed knee) and 3 patients had between 3 and 5 mm. The final overall ratings were 6 excellent, 1 good, and 1 fair. The procedure is infrequently used, but appears to have merit in select, skeletally immature athletes who desire not to modify athletic activity or when associated meniscal repairs warrant consideration for reconstruction.
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The results of 101 consecutive arthroscopic meniscal repairs were studied to determine the nature and frequency of associated complications. All arthroscopic repairs were done by the senior author (OS) between November 1984 and June 1991. Our data include 65 patients with associated anterior cruciate ligament injuries, of which 49 underwent concurrent arthroscopic anterior cruciate ligament reconstruction. ⋯ In the subset of patients with intact anterior cruciate ligaments and isolated meniscal lesions, there were no complications associated with lateral repair and an 18% risk of complication with medial repair. Female patients demonstrated a higher likelihood of complication (29%) than male patients (13%). Excluding repair failures, there was an 8% reoperation or rehospitalization rate.
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In a retrospective study to determine the anatomic nature of injuries in thumbs that were treated surgically for either fracture or instability, we reviewed 63 consecutive patients with acute skier's thumb injury. Of the 63 thumbs, 25 (40%) had a fracture. Surgical exploration showed 2 fracture types: a fragment that was attached to the ulnar collateral ligament, and a fragment that was not attached to the ulnar collateral ligament. ⋯ Such an isolated fragment was observed in 10 other cases in which the ulnar collateral ligament was completely disrupted. This type of bony fragmentation cannot be differentiated from a bony avulsion of the ulnar collateral ligament on routine films. Therefore, stress testing the injured thumb is mandatory even when bony avulsion fracture with minimal displacement is suspected from a radiograph, as indeed the fracture may not be a bony avulsion but may be a fragmentation of the ulnar volar aspect of the proximal phalanx associated with a complete disruption of the ulnar collateral ligament.