Early predictors of functional independence 2 years after spinal cord injury.

Objective: To determine: (1) how well factors measured at admission to an acute care facility predict functional independence measure (FIM) scores, use of personal care assistance, and wheelchair ownership 2 years after traumatic spinal cord injury (SCI); (2) the extent that factors measured during inpatient stay add to these predictions; and (3) if FIM scores differ through use of assistance and wheelchair ownership 2 years after SCI.

Design: Prospective, longitudinal.

Setting: Tertiary care acute, rehabilitation hospitals and home settings.

Factors predicting employment 1 year after traumatic spine fracture.

Study Design: This prospective cohort study evaluates the employment status of 489 persons after traumatic spine fracture.

Objectives: To determine the rate, type, and predictors of employment 1 year after traumatic spine fracture.

Summary Of Background Data: The limited existing literature regarding employment after spine fracture reports variable return-to-work rates, tends to be retrospective, and generally evaluates a limited number of predictor factors at a time.

Incomplete neural deficits in thoracolumbar and lumbar spine fractures. Reliability of Frankel and Sunnybrook scales.

Because neural status is used both as a treatment determiner and outcome measure, a universal, reliable scale is required. Experienced personnel, provided with concise definitions, demonstrated high inter-rater reliability of Frankel and Sunnybrook scales (Pearson correlation coefficients 0.71-0.

A survey of vertebral burst-fracture management in Canada.

In the management of burst fractures, the role of direct surgical removal of retropulsed bony fragments encroaching upon the spinal canal (direct decompression) is controversial. A questionnaire was mailed to 65 neurosurgeons and 36 orthopedic surgeons across Canada to determine the current management of vertebral burst fractures and the willingness of these surgeons to participate in a longitudinal study of the effects of direct surgical decompression in the management of burst fractures. Sixty-nine (44 neurologic and 25 orthopedic) surgeons responded to the questionnaire.

Multiple noncontiguous spine fractures.

The data from a prospective study of 508 spine injuries were reviewed to determine the incidence of multiple noncontiguous spine fractures. All patients were examined at admission and at 1 and 2 years postinjury. This series identified 77 (15.

Spine trauma and associated injuries.

A longitudinal, prospectively gathered data base of spine trauma has been developed. A review of 508 consecutive hospital admissions identified the presence of associated injuries in 240 (47%) individuals, most frequently involving head (26%), chest (24%), or long bones (23%). Twenty-two per cent had one associated injury, 15% had two, and 10% had three or more.

Relationship of turnout to hip abduction in professional ballet dancers.

The ability to externally rotate or turn out the hip is fundamental to ballet. Every classical dancer aims to achieve perfect turnout. The purpose of this study was to determine how much turnout is necessary for maximal abduction.

Spine fractures in winter sports.

In a 7-year review of 1,447 spine fractures, 202 (14%) were due to sporting or recreational causes, of which 84 (42%) were associated with paralysis. This high incidence catastrophic injury is second only to motor vehicle accidents. Snowmobiling (10%), skiing (5%), tobogganing (5%) and ice hockey (3%) accounted for approximately one-quarter of these injuries.

Isokinetic muscle strength parameters for shoulder movements.

A study was carried out on shoulder muscle strength using an isokinetic dynamometer device, and normal parameters were established on 20 men and 20 women for a total of 80 shoulders. This population consisted of fit, athletic individuals with a mean age of 26·65 years and 25·35 years for the women and men; respectively. Peak torque, angle of peak torque, and arc of maximum strength (= peak±2 N m) were measured.

Sonation of lumbar nerve roots as a diagnostic procedure in patients with sciatica.

It has been suggested that sonation of the lumbar nerve roots in patients with sciatica will precipitate their symptoms and therefore may be a useful diagnostic tool in the evaluation of disc protrusions. Thirty healthy subjects (Group 1), mean age 36 (+/- 6) years, were evaluated to establish a baseline response. None had a positive test.

The nonoperative treatment of burst fractures of the thoracolumbar junction.

Treatment of thoracolumbar spine burst fracture with a neurologically intact patient is controversial, with advocates of operative and nonoperative approaches. Of 404 patients in a prospective spinal trauma study, 21 had burst fractures, were neurologically intact, and had greater than 1-year followup. This group was analyzed to evaluate treatment with early mobilization using a thoracolumbar total contact orthosis.

Off-road recreational motor vehicle accidents: hospitalization and deaths.

There is increasing concern over the unregulated use of recreational off-road motor vehicles. A review of 207 patients admitted to a tertiary care hospital over a 5-year period, as well as deaths due to use of recreational vehicles, elicited the following information. Recreational accidents predominantly involved men in their mid-twenties.

Spine Trauma Associated With Off-Road Vehicles.

In brief: A seven-year review of 1,447 cases of spine trauma showed a 10% increase in sports-related spine trauma from 1980 to 1986; 53 cases were associated with use of off-road vehicles (ATVs, snowmobiles, and motorized dirt bikes). Of these 53 injuries, the major contributing factors were alcohol or drug use, inadequate lighting, poor judgment, and young age. The authors suggest the development of safe riding areas, legislation governing safe operation of these vehicles, and a major public education campaign specifically geared toward parents, warning them of the dangers of allowing children to operate these machines.

Etiology and clinical course of missed spine fractures.

A prospective study was designed to document course and outcome. Two hundred fifty-three patients with 274 spinal injuries were reviewed at the time of injury and discharge from hospital, as well as at 1, 2, and 5 years postinjury. Thirty-eight of these patients were identified who had been misdiagnosed at the initial assessment.

Lower extremity flexibility patterns in classical ballet dancers and their correlation to lateral hip and knee injuries.

Knee and hip problems account for up to 40% of injuries in classical ballet. Despite apparent flexibility, many dancers appeared to have tight iliotibial bands that contributed to lower limb problems. Thirty senior female ballet dancers were contrasted with thirty age-matched active volunteers for hip and knee range of motion, and the information derived was correlated with their orthopaedic medical histories.