Nonoperative Management of Sublime Tubercle Fractures in Adolescent Throwing Athletes: Improved Results With Cast Immobilization.

Background: Avulsion fractures of the sublime tubercle of the ulna are a cause of medial elbow pain and instability in overhead athletes.

Purpose: To compare outcomes after sublime tubercle avulsion fracture managed as a fracture (with cast immobilization) versus a soft tissue injury (without immobilization and with early range of motion [ROM]) to determine how to achieve the best outcomes for these injuries in adolescent throwing athletes.

Study Design: Cohort study; Level of evidence, 3.

Management of Pediatric and Adolescent Sublime Tubercle Injuries: Isolated and Complex Patterns Demonstrate Distinct Etiologies and Radiographic Outcomes.

Background: The aim of this study was to assess the patient demographics, epidemiology, mechanism of injury, and natural history of sublime tubercle avulsion injuries.

Methods: A multicenter retrospective study was performed in which sublime tubercle avulsion injuries were identified by surgeon records and database query of radiology reports. Demographic data and imaging were reviewed for each case, and injuries were classified as type 1 (isolated injuries with a simple bony avulsion or periosteal stripping) or type 2 (complex injuries with an associated elbow fracture or dislocation).

A Simple and Versatile Test for Elbow Posterolateral Rotatory Instability.

Background: Posterolateral rotatory instability (PLRI) results from lateral ulnar collateral ligament (LCL) deficiency. The lateral pivot shift test is used to diagnose PLRI but can be difficult to perform and is poorly tolerated. We present a new maneuver, the Posterior Radiocapitellar Subluxation Test (PRST), that we believe is easier to perform.

Infection of a Retained Peripheral Nerve Stimulation Lead: A Case Report.

Percutaneous peripheral nerve stimulation is used to provide analgesia for weeks or even months. While infection of any percutaneously implanted object is a concern, it is exceedingly rare for helically coiled leads, with a reported incidence of less than 1 infection for every 32,000 indwelling days. We now report an infected helically coiled lead requiring sedation for extraction and complicated by lead fracture during removal, leaving a remnant in situ.

Recurrent Carpal Tunnel Syndrome Associated with Mycobacterium szulgai Infection: A Case Report.

Case: We present the case of an otherwise healthy 77-year-old male retired firefighter and recreational pheasant hunter who presented with recurrent symptoms of carpal tunnel syndrome and tenosynovitis because of Mycobacterium szulgai. He was initially treated unsuccessfully for a presumed seronegative rheumatologic flare, followed by surgical diagnosis and treatment including revision carpal tunnel release with tenosynovectomy, and a secondary debridement and wound closure. His symptoms resolved after several months of multidrug antibiotic therapy with only mild residual median nerve deficit.

A biomechanical assessment of tendon repair after radiofrequency treatment.

After acute tendon injury, rapid mobilization prevents adhesions and improves the ultimate strength of the repair. Radiofrequency (RF) ablation is proposed to enhance angiogenesis in the early stages of healing. The mechanism and effect of RF have not yet been described in an animal model of tendon injury.

Augmentation of tendon healing with butyric acid-impregnated sutures: biomechanical evaluation in a rabbit model.

Background: Butyric acid (BA) has been shown to be angiogenic and to enhance transcriptional activity in tissue. These properties of BA have the potential to augment biological healing of a repaired tendon.

Purpose: To evaluate this possibility both biomechanically and histologically in an animal tendon repair model.

Comparison of mechanical stability in double-row rotator cuff repairs between a knotless transtendon construct versus the addition of medial knots.

Purpose: Our purpose was to investigate the importance of medial-row knot tying to mechanical stability in a double-row rotator cuff repair by comparing a knotless construct with transtendon anchor passage versus a similar construct implementing medial knots.

Methods: A standard defect was created in the infraspinatus tendons of 14 bovine humeri. All defects were repaired with 2 medial and 2 lateral anchors (SutureCross System; KFx Medical, Carlsbad, CA).

The effect of kneeling during spine surgery on leg intramuscular pressure.

Background: Acute compartment syndrome has been an underreported complication during spine surgery with the patient positioned on the so-called 90/90 kneeling frame (with 90 degrees of both hip and knee flexion), presumably because of elevated intramuscular pressures in the dependent leg compartments. The purpose of the present study was to characterize and quantify certain parameters that affect the risk for acute compartment syndrome experimentally and to make objective comparisons with other spine surgery positions.

Methods: Eight healthy volunteers were positioned in three spine surgery positions: the 90/90 kneeling position, the so-called 45/45 suspended position (with the hips and knees both flexed to 45 degrees with the legs suspended on a sling), and the prone position.

Noninvasive measurements of intramuscular pressure using pulsed phase-locked loop ultrasound for detecting compartment syndromes: a preliminary report.

Objectives: To develop a human model for compartment tamponade and test the efficacy of ultrasonic pulsed phase-locked loop (PPLL) fascial displacement waveform analysis for noninvasive measurement of intramuscular pressure (IMP).

Design: Human subject experiment.

Setting: University Level 1 trauma center.

Paraspinal muscle vasculature contributes to posterolateral spinal fusion.

Study Design: Study of posterolateral fusions in a rabbit model.

Objectives: To characterize the contribution of paraspinal musculature to the healing of posterolateral spinal fusions in a rabbit model.

Summary Of Background Data: Previous studies have demonstrated that successful spinal arthrodesis requires vascular ingrowth from adjacent decorticated bone.

Reduced mechanical efficiency in chronic obstructive pulmonary disease but normal peak VO2 with small muscle mass exercise.

We studied six patients with chronic obstructive pulmonary disease (COPD) (FEV1 = 1.1 +/- 0.2 L, 32% of predicted) and six age- and activity level-matched control subjects while performing both maximal bicycle exercise and single leg knee-extensor exercise.