The American journal of sports medicine
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Initial reports of herpes gladiatorum, a skin infection of wrestlers caused by herpes simplex virus (HSV), focused on case histories and clinical presentations of this disease. To more adequately address broader epidemiologic questions concerning this skin infection, we surveyed members of four southeastern college wrestling teams, sampled high school and college athletic trainers nationwide, and obtained serum specimens from members of one college wrestling team for HSV antibody studies. Nine of 48 (18.8%) college wrestlers in the southeastern athletic conference reported histories of herpes gladiatorum. ⋯ I. 2.2 to 40.0). The national survey of athletic trainers indicated that 7.6% of college wrestlers and 2.6% of high school wrestlers had HSV skin infection during the 1984-85 season. Herpes gladiatorum is a common problem among college wrestlers, and morbidity associated with this skin disease can be significant.
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In 91 patients evaluated between 1982 and 1985, tibial collateral ligament bursitis was diagnosed. This entity has not been described since the work of Brantigan and Voshell in 1943. The diagnosis was based on the findings of tenderness over the tibial collateral ligament at the joint line, without a history of mechanical symptoms. ⋯ Another 23% did not improve and ultimately underwent an arthroscopic partial medial meniscectomy. Tibial collateral ligament bursitis is an entity that should be considered in any patient with medial joint pain in the knee. Treatment is simple, effective, and offers low morbidity.
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During operations on the knee, such as open meniscectomy and pes anserinus transplant for chronic anteromedial rotatory instability of the knee, the infrapatellar nerve may easily be damaged or severed. Knowledge of the normal anatomical variations of this nerve is thus of importance to the surgeon, so that he can avoid postoperative distress caused by unintentional injury to the infrapatellar nerve. Anatomical variations of this nerve have been studied in 20 cadavers, with particular reference to its relationship to the sartorius and the nerve's distance from the medial femoral epicondyle. ⋯ Four types of nerve were found and classified according to their relationship to the sartorius: posterior, penetrating, parallel, and anterior. The commonest type was the posterior (62.2%), where the nerve emerged at the posterior border of the sartorius before passing superficial to it to supply the skin and fascia over the front and medial aspect of the knee and the proximal part of the leg. Situated furthest from the medial femoral epicondyle was the parallel type (average, 105.7 mm), which runs parallel to the posterior border of the sartorius before crossing it at infrapatellar level.
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Case Reports
Injury to the brachial plexus during Putti-Platt and Bristow procedures. A report of eight cases.
Eight patients with documented recurrent anterior dislocation of the shoulder sustained iatrogenic brachial plexus injuries during either Putti-Platt or Bristow procedures. Two patients also sustained axillary artery injuries. There were six males and two females. ⋯ Two musculocutaneous, one median and one axillary nerve required grafting. Injury to the brachial plexus was associated with inadequate knowledge of regional anatomy, blind clamping of axillary artery lacerations, use of axillary incisions which limited exposure, and failure to identify the musculocutaneous nerve during Bristow procedures. If a brachial plexus injury occurs during a Putti-Platt or a Bristow procedure and the lesion does not rapidly, progressively, and completely recover, the brachial plexus should be explored since there is a high likelihood of structural neurologic injury.