The American journal of sports medicine
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The "gracilis syndrome," a fatigue fracture of traumatic etiology involving the bony origin of the gracilis muscle at the pubic symphysis, is akin to traumatic osteitis pubis and injuries of the adductor longus muscle origin. It is a well-recognized and reported injury in European athletes, but has received less attention in North America. This paper describes a case of this syndrome in a 23-year-old male athlete with a 2-year history of groin, perineal and medial thigh pain, of gradual onset, associated with his participation in rather violent contact sports. ⋯ Radiographically, a bony fragment, including the inferior corner of his left pubis at the symphysis, could be identified. This lesion was surgically excised, and the patient was relieved of his symptoms. The histopathological features of the fragment revealed both viable and nonviable bony trabeculae embedded in fibrous tissue, suggesting that the lesion is an avulsion type of fatigue fracture with the avulsion related to the directional pull of the gracilis muscle.
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Two hundred and fifteen mountaineering accidents occurred in the Sierra Nevada over a 5-year period in climbers on Class V routes. Patients were evaluated for: climbing preparation and training, first aid experience, altitude acclimatization, age, anatomical site of injuries, and cause of the injury. Consideration as to evacuation procedure was also given. ⋯ There were 17 deaths resulting most frequently from head injuries. Few climbers had formal training in basic mountain medicine which was reflected in the poor assessment and management of injuries, with an unnecessary reliance upon others for evacuation. Morbidity and mortality may be lessened by proper climbing preparation--instruction in mountaineering techniques as well as basic mountain medicine--and by prevention of acute mountain sickness and cold injury.
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The medial tibial stress syndrome is a symptom complex seen in athletes who complain of exercise-induced pain along the distal posterior-medial aspect of the tibia. Intramuscular pressures within the posterior compartments of the leg were measured in 12 patients with this disorder. These pressures were not elevated and therefore this syndrome is a not a compartment syndrome. Available information suggests that the medial tibial stress syndrome most likely represents a periostitis at this location of the leg.
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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 immobilized from 3-6 weeks. However, a high recurrence rate could be expected. ⋯ 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.