RESUMEN
Our clinical experience has demonstrated that the development of elbow injuries is often secondary to dysfunction of the shoulder and/or cervical regions. In response to this observation, we have developed a rehabilitation protocol for the entire upper quarter as the focus of our management of elbow injuries. Our approach addresses range of motion deficits in shoulder rotation, weakness of shoulder external rotation and abduction, cervical facet impingement, and other associated deficits, with the goal being restoration of the flexibility, strength, endurance, proprioception, and coordination needed for activity. Presented are specific elements of this approach, possible mechanisms of injury involved, and a case history. J Orthop Sports Phys Ther 1990;11(9):402-409.
RESUMEN
A three-part clavicle fracture not previously described is presented. Treatment of distal clavicle fractures is reviewed, and operative treatment for this type of fracture is recommended. A 3/32 K-wire is inserted under direct vision and X-ray control. The acromioclavicular joint is not entered, and the wire is bent 90 degrees at its distal tip and removed once the fracture has united. In the case reported full use was possible in 6 months.
Asunto(s)
Traumatismos en Atletas/cirugía , Clavícula/lesiones , Fracturas Abiertas/cirugía , Adulto , Traumatismos en Atletas/diagnóstico por imagen , Ciclismo , Clavícula/diagnóstico por imagen , Clavícula/cirugía , Fijación Interna de Fracturas , Fracturas Abiertas/diagnóstico por imagen , Humanos , Masculino , RadiografíaRESUMEN
Four cases in professional athletes and a ballet dancer of what we would like to term the anterior impingement syndrome of the ankle are described. A brief review of the very sparse literature is presented. The cause is felt to be the repeated pull of the anterior ankle joint capsule and the impingement of the talus against the tibia in running and jumping leading to calcific deposits along the lines of the capsular fibers. We feel that any athlete who has pain or limitation of motion secondary to the anterior impingement syndrome should be considered for surgical removal of the offending spurs. The four patients were able to return to their previous activity levels.
Asunto(s)
Traumatismos del Tobillo , Traumatismos en Atletas/cirugía , Adulto , Traumatismos en Atletas/complicaciones , Baile , Humanos , MasculinoRESUMEN
Sixteen elbows of fourteen patients were analyzed five to sixty months after treatment for ulnar neuritis or neuropathy by anterior transposition of the ulnar nerve using a non-compressing fasciodermal sling to maintain the anterior position. This procedure creates a septum in the mid-lateral plane that lies posterior to the transposed nerve at the level of the medial epicondyle. Unlike previous procedures, no structure other than subcutaneous fat is located superficial to the nerve. Seven patients were baseball pitchers who had experienced transient but severe ulnarnerve paresthesias during the act of throwing. Of the sixteen extremities only one, the limb of a severely diabetic patient with bilateral ulnar neuropathy, was not relieved of preoperative complaints. There were no complications. The procedure is simple, postoperative immobilization is needed for only a brief period, and rehabilitation is rapid.
Asunto(s)
Nervio Cubital/cirugía , Adolescente , Adulto , Anciano , Béisbol , Codo/cirugía , Electromiografía , Femenino , Humanos , Masculino , Métodos , Persona de Mediana Edad , Movimiento , Conducción Nerviosa , Enfermedades del Sistema Nervioso Periférico/diagnóstico , Enfermedades del Sistema Nervioso Periférico/cirugía , Nervio Cubital/anatomía & histologíaRESUMEN
Although the long term prognosis for many injuries of the hind foot is poor, prompt diagnosis and treatment can lead to a satisfactory result. Failure to treat these injuries promptly can lead to circulatory problems and skin necrosis. Stiffness and post-traumatic arthritis may occur despite adequate treatment due to the complex anatomy of the region. With the exception of certain rare fractures of the os calcis, displaced fractures of the talar neck and body and fracture-dislocations, injuries in this region of the foot heal best after closed treatment and early mobilization of the ankle and foot. Associated bodily injuries elsewhere, particularly those involving the spine, ankle, and tarsometatarsal joints should be anticipated in extensive injuries of the hind foot.