The American journal of sports medicine
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This case report documents an acute tear of the gastrocnemius muscle which resulted in an acute compartment syndrome of the anterior, lateral, and superficial posterior compartments of the leg. Prompt diagnosis by physical examination and Wick catheter, followed by surgical compartment release, resulted in a well-functioning extremity. Followup at 18 months revealed a normally functioning extremity, and Cybex evaluation revealed increased muscle strength in the involved extremity.
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Between 1980 and 1983, 21 young, high-performance gymnasts with stress changes related to the distal radial epiphysis, were treated and followed for a mean of 24 months (range, 6 to 42 months). Eleven of the gymnasts presented with roentgenographic changes of the distal radial epiphysis, and in these recovery took at least 3 months. ⋯ No residual growth-related problems have been observed. Possible etiologic factors are discussed, and the literature as it pertains to stress-related adaptation and injury in the growing athlete is reviewed.
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Nerve injuries associated with inversion sprains of the ankle have been mentioned in the literature on a case presentation basis only. Sixty-six consecutive patients with Grade II (30) and Grade III (36) ankle sprains were examined by electromyography 2 weeks after injury to determine the presence and distribution of nerve injuries. Ankle active range of motion (AROM) and the number of weeks postinjury when the patient could heel/toe walk and return to full activity were also noted. ⋯ Ankle AROM was impaired, and heel/toe walking (5.1 weeks) and return to full activity (5.3 weeks) were markedly prolonged. The likely cause of this injury is considered to be a mild nerve traction or a hematoma in the epineural sheath at the bifurcation of the sciatic nerve into peroneal and posterior tibial branches. This report indicates that a consistently high percentage of patients with Grade III ankle sprains sustain a significant injury to both motor nerves in the leg and that rehabilitation time is markedly prolonged.
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Tourniquet application is commonly used during surgery on an extremity to create a bloodless field. Investigations have focused on the ultrastructural, histochemical, and biochemical effects of tourniquet ischemia on muscle. Few studies, however, have examined the influence of tourniquet ischemia on the contractile properties of muscle. ⋯ Furthermore, both TPT and 1/2RT demonstrated consistent changes. These results indicate that the contractile properties of both the soleus and plantaris are dramatically effected by a 2 hour tourniquet. They further suggest that there may be a differential response based upon fiber type.