The American journal of sports medicine
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A retrospective study of 30 patients who met the clinical criteria for saphenous nerve entrapment at the adductor canal is described. Patients experienced symptoms, usually anterior knee pain, for an average of 36 +/- 7 months. Each patient received an average of 1.9 +/- 0.4 saphenous nerve blocks at the adductor canal during treatment. ⋯ Age, medications taken, number of blocks performed, and length of followup were unrelated to outcome. Length of symptoms did significantly correlate with final pain level (r = 0.39, P less than 0.05). The diagnosis of this syndrome, description of the saphenous nerve block at the adductor canal, and the possible etiology are presented.
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Nineteen cases of rupture of the pectoralis major muscle are presented. In 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 reviewed. ⋯ Distal ruptures are usually complete, despite physical signs that may be misleading. 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.
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During the last few decades, the incidence of tendon ruptures has increased in civilized countries. Our material comprises 749 patients who had 832 tendon ruptures treated surgically between 1972 and 1985. There were no competitive athletes among the patients studied. ⋯ Sixty-two point three percent of the patients with Achilles tendon rupture were professionals or white collar workers, which is markedly more than in the Hungarian population (12.7%; P less than 0.001). Two hundred and six Achilles tendon ruptures were studied histologically, and all cases displayed pathological alterations. The results indicate that complete rupture of the Achilles tendon is usually a sequel to a sedentary life-style and participation in sports activities.
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The adverse effects of excessive tourniquet pressure on underlying muscle were studied using a cat model. A direct effect of the magnitude of tourniquet pressure on the degree of muscle disability was observed. The effect of direct pressure on the muscle may contribute to the postoperative weakness seen in the quadriceps muscle. Our data, in conjunction with the results of other studies that correlate certain tourniquet times and pressures with potential adverse effects, suggest that the selection of an appropriate tourniquet pressure and duration will minimize the development of clinically significant complications.
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Chronic recurrent subluxation of the peroneal tendons can be a disabling condition in the young athlete. Conservative techniques of management, including taping, pads, or special shoes, are usually ineffective. Many authors have reported favorable results with surgical reconstruction. ⋯ We are reporting the results of treatment of 12 patients with a sliding fibular graft procedure that has not previously been reported in the literature. Results were excellent in 11 of the 12 procedures. One patient with bilateral repairs reported recurrence of symptoms on one side and required reexploration.