Hypertrophy of the sublime tubercle in elbow ulnar collateral ligament injuries: a case series of baseball pitchers undergoing ulnar collateral ligament reconstruction with short-term follow-up.

Background: The ulnar collateral ligament (UCL) of the elbow is subject to repetitive stress in overhead throwing athletes. This can lead to morphologic changes at the bony attachments of the UCL and hypertrophy of the sublime tubercle. The purpose of this case series is to describe the surgical details and clinical outcomes of a series of competitive baseball pitchers with hypertrophic sublime tubercles who underwent UCL reconstruction (UCLR).

Quadriceps strength changes across the continuum of care in adolescent male and female athletes with anterior cruciate ligament injury and reconstruction.

Objectives: To examine the quadriceps strength (QUADS) on the surgical (SURG) and non-surgical (Non-SURG) limbs in adolescent male and female athletes at pre-operative (PRE), 12 weeks post-operative (12WK), and return to sport (RTS) time points following ACL injury and reconstruction.

Design: Prospective cohort study design.

Setting: Clinical Research Laboratory.

Effects of anterior cruciate ligament reconstruction on patellofemoral joint stress and lower extremity biomechanics at 12 weeks post-surgery and at time of return to sport in adolescent females.

Background: The purpose of this study was to examine kinematic and kinetic differences associated with patellofemoral pain after anterior cruciate ligament reconstruction between limbs at 12-week post-surgery and at time of return to sport.

Method: Twenty-four adolescent females completed 5 consecutive single leg squats on each limb at 12-weeks post-surgery and again during their RTS assessment. Peak knee extension moment, peak hip adduction angle, and patellofemoral joint stress at 45 degrees of knee flexion were calculated.

Computer Assisted Cobb Angle Measurements: A novel algorithm.

Background: The standard for evaluating scoliosis is PA radiographs using Cobb angle to measure curve magnitude. Newer PACS systems allow easier Cobb angle calculations, but have not improved inter/intra observer precision of measurement. Cobb angle and its progression are important to determine treatment; therefore, angle variability is not optimal.

The Development and Validation of a Subjective Assessment Tool for the Hip in the Athletic Population.

Background: No validated functional assessments are available that are designed specifically to evaluate the performance and function of the athletic hip. Subsections of some validated outcome assessments address recreation, but a full assessment dedicated to athletic hip function does not exist. Current hip scoring systems may not be sensitive to subtle changes in performance and function in an athletic, younger population.

Open Navicular Dislocation With Midfoot Dissociation in a 45-Year-Old Man.

Traumatic dislocation of an intact tarsal navicular is an uncommon injury. In this article, we report a case of open medial navicular dislocation in a 45-year-old man. The injury was managed with open reduction and stabilization with Kirschner wires within the acute period.

Return to Golfing Activity After Joint Arthroplasty.

Background: Many patients who are considering total joint arthroplasty, including hip, knee, and shoulder replacement, are concerned with their likelihood of returning to golf postoperatively as well as the effect that surgery will have on their game.

Purpose: To review the existing literature on patients who have undergone major joint arthroplasty (hip, knee, and shoulder), to examine the effects of surgery on performance in golf, and to provide surgeon recommendations as related to participation in golf after surgery. A brief review of the history and biomechanics of the golf swing is also provided.

Transosseous Physeal-Sparing Rotator Cuff Repair in an Adolescent Football Player.

Rotator cuff injuries in the pediatric and adolescent population are rare. These injuries are normally caused by an acute event or by repeated microtrauma as a result of poor mechanics during overhead sporting activities. Overall, these injuries account for fewer than 1% of all rotator cuff tears.

Preliminary trauma radiographs misrepresent pubic diastasis injuries.

The goal of this study was to evaluate the role of portable primary trauma survey radiographs in the evaluation and management of anteroposterior (AP) compression pelvic injuries. A retrospective analysis was conducted at a level I academic trauma center. Twenty-seven adults with AP compressive class pelvic ring injuries who received both portable pelvic radiographs and pelvic computed tomography (CT) imaging in an unbound pelvic state were included.

Impact of Total Shoulder Arthroplasty on Golfing Activity.

Objective: Golf is a widely popular sport in the United States with 29 million Americans participating in the game. With an aging population and increased incidence of glenohumeral degenerative arthritis, the number of active golfers requiring total shoulder replacement is on the rise. This study aims to evaluate the effect of total shoulder replacement on golfing activity.

Spontaneous septic arthritis of the lumbar facet caused by methicillin-resistant Staphylococcus aureus in an otherwise healthy adolescent.

We report the case of a 16-year-old boy with isolated septic arthritis of a lumbar facet. This rare presentation of an infection in a lumbar facet joint occurred after minor trauma sustained in a football game. Septic arthritis of the spinal facet joint is an uncommon phenomenon.

Dedicated orthopaedic operating rooms: beneficial to patients and providers alike.

Objective: Dedicated orthopaedic operating rooms (DOORs) are increasingly popular solutions to reducing after-hours procedures, physician fatigue, and elective schedule disruptions. Although the benefits to surgeons are well understood, there are comparatively few studies that explore the effects of DOORs on patient care. We compared treatments and outcomes for all consecutive patients with femoral neck fractures, 4 years before and 4 years after implementation of a DOOR-based schedule.

The foot and ankle examination.

Most foot and ankle disorders can be diagnosed after a proper history and clinical examination and can be effectively managed in a primary care setting. It is important to assess the entirety of patient disorders that present as they can be multifactorial in cause. A broad differential should include disorders of bones, joints, muscles, neurovasculature, and surrounding soft tissue structures.

Management of chronic musculoskeletal pain.

Chronic musculoskeletal pain results from a complex interplay of mechanical, biochemical, psychological, and social factors. Effective management is markedly different from that of acute musculoskeletal pain. Understanding the physiology of pain transmission, modulation, and perception is crucial for effective management.

Spinal cord compression in pseudohypoparathyroidism.

Background Context: Spinal cord compression associated with pseudohypoparathyroidism (PHP) is an increasingly reported sequelae of the underlying metabolic syndrome. The association of neurologic dysfunction with PHP is not well appreciated. We believe this to be secondary to a combination of underlying congenital stenosis, manifest by short pedicles secondary to premature physeal closure, and hypertrophic ossification of the vertebral bony and ligamentous complexes.

Bacillus cereus fasciitis: a unique pathogen and clinically challenging sequela of inoculation.

Bacillus cereus is an aerobic, spore-forming, gram-positive rod. It has historically been associated with "fried rice syndrome," a foodborne diarrheal and emetic illness resulting from eating fried rice dishes that have been sitting at room temperature for hours. We report the case of a 9-year-old boy who developed culture-positive B cereus fasciitis of the right lower extremity after being impaled on a tree branch.

Catastrophic fracture of a stable metal acetabular component.

Various modes of failure of primary and revision total hip arthroplasty have been well documented in the literature over the past 30 years. Concerns over polyethylene wear, osteolysis, and hypersensitivity reactions leading to component loosening and early revision have been evaluated and reported in the literature. Routine follow-up is important to monitor for postoperative issues that might lead to the subsequent need for revision.

Niacin-induced "flush" involves release of prostaglandin D2 from mast cells and serotonin from platelets: evidence from human cells in vitro and an animal model.

Niacin lowers serum cholesterol, low-density lipoprotein, and triglycerides, and it raises high-density lipoprotein. However, most patients experience cutaneous warmth and vasodilation (flush). Acetylsalicylic acid (ASA) can reduce this flush, presumably by decreasing prostaglandin D(2) (PGD(2)) release from macrophages.

Corticotropin-releasing hormone induces skin vascular permeability through a neurotensin-dependent process.

Many skin disorders are associated with increased numbers of activated mast cells and are worsened by stress; however, the mechanism underlying these processes is not understood. Corticotropin-releasing hormone (CRH) is secreted under stress from the hypothalamus, but also in the skin, where it induces mast cell activation and vascular permeability. We investigated the effect of CRH in a number of animal models by using i.

Theophylline as 'add-on' therapy to cetirizine in patients with chronic idiopathic urticaria. A randomized, double-blind, placebo-controlled pilot study.

Background: Chronic urticaria is a prevalent condition associated with substantial disability. Its pathogenesis is not clearly understood and is divided into autoimmune and chronic idiopathic urticaria (CIU). We investigated if the non-specific phosphodiesterase inhibitor theophylline could provide additional benefit to the histamine-1 receptor (H-1R) antagonist cetirizine in CIU.

Stevens-Johnson syndrome and toxic epidermal necrolysis: a review of the literature.

Objective: To perform a comprehensive review of Stevens-Johnson syndrome and toxic epidermal necrolysis.

Data Sources: A MEDLINE search was performed for the years 1975 to 2003 using the keywords Stevens-Johnson syndrome and toxic epidermal necrolysis to identify relevant articles published in English in peer-reviewed journals.

Study Selection: All clinical studies that reported on 4 or more patients, review articles, and experimental studies that concerned disease mechanisms were selected and further analyzed.