Atypical presentation of Parsonage-Turner syndrome confounded by surgical rotator cuff injury.

Parsonage-Turner syndrome (PTS) is a rare neuropathy that commonly presents as unexpected severe shoulder and arm pain that eventually subsides while weakness or paralysis ensues. During exceptions to this classic presentation, confirming PTS can be challenging. Alternative causes of upper extremity pain may confound the diagnostic algorithm.

Inadequate Helmet Fit Increases Concussion Severity in American High School Football Players.

Background: There is limited information on the relationship between football helmet fit and concussion severity.

Hypothesis: Poor helmet fit may predispose football players to a more severe concussion.

Study Design: Descriptive epidemiology study.

Association between GRIN2A promoter polymorphism and recovery from concussion.

Objective: To determine genetic variability within the N-methyl-D-aspartate receptor 2A sub-unit (GRIN2A) gene promoter and its association with concussion recovery time. The hypothesis tested was that there would be a difference in allele and/or genotype distribution between two groups of athletes with normal and prolonged recovery.

Methods: DNA was extracted from saliva collected from a total of 87 athletes with a physician-diagnosed concussion.

Enoxaparin and Warfarin for Venous Thromboembolism Prophylaxis in Total Hip Arthroplasty: To Bridge or Not to Bridge?

Anticoagulation bridges consisting of subcutaneous enoxaparin combined with oral-dosed warfarin are commonly used in orthopedic procedures as chemoprophylaxis against thromboembolic disease. For some patients, these bridges result in complications. One hundred twenty-one patients were evaluated after primary total hip arthroplasty (THA) between 2008 and 2009.

Hypertensive patients show delayed wound healing following total hip arthroplasty.

Background: Prolonged wound-discharge following total hip arthroplasty (THA) is associated with an increased risk of infection. However, the potential role of hypertension in prolonging the duration of wound healing in this population has not yet been investigated. The aim of the present study was to compare healing in this population that has not yet been investigated.

The non-surgical and surgical treatment of tarsal navicular stress fractures.

Stress fractures of the tarsal navicular, first described in 1970, were initially thought to be rare injuries. Heightened awareness and increased participation in athletics has resulted in more frequent diagnosis and more aggressive treatment. The vascular supply of the tarsal navicular results in a relatively avascular zone in the central one-third, which experiences severe compressive forces during explosive manoeuvers such as jumping and sprinting.

Noncontact anterior cruciate ligament injuries: mechanisms and risk factors.

Significant advances have recently been made in understanding the mechanisms involved in noncontact anterior cruciate ligament (ACL) injury. Most ACL injuries involve minimal to no contact. Female athletes sustain a two- to eightfold greater rate of injury than do their male counterparts.

Management of tarsal navicular stress fractures: conservative versus surgical treatment: a meta-analysis.

Purpose: This study was conducted to provide a statistical analysis of previously reported tarsal navicular stress fracture studies regarding the outcomes and effectiveness of conservative and surgical management.

Study Design: Systematic review.

Methods: A systematic review of the published literature was conducted utilizing MEDLINE through Ovid, PubMed, ScienceDirect, and EBSCOhost.

The pathomechanics, pathophysiology and prevention of cervical spinal cord and brachial plexus injuries in athletics.

Cervical spinal cord injuries may occur with catastrophic sequelae (e.g. quadriplegia) in collision sport activities.

Cervical spine injuries and the return to football.

Background: The literature dealing with the diagnosis and treatment of cervical spine injuries is considerable. Absent, however, are comprehensive criteria or guidelines for permitting or prohibiting return to collusion activities such as tackle football.

Objective: The purpose of this report is to describe developmental and posttraumatic conditions of the cervical spine as presenting (1) no contraindication, (2) relative contraindication, or (3) an absolute contraindication to continued participation in tackle football and other contact activities.

Video analysis of trunk and knee motion during non-contact anterior cruciate ligament injury in female athletes: lateral trunk and knee abduction motion are combined components of the injury mechanism.

Background: The combined positioning of the trunk and knee in the coronal and sagittal planes during non-contact anterior cruciate ligament (ACL) injury has not been previously reported.

Hypothesis: During ACL injury female athletes demonstrate greater lateral trunk and knee abduction angles than ACL-injured male athletes and uninjured female athletes.

Design: Cross-section control-cohort design.

Video analysis of anterior cruciate ligament injury: abnormalities in hip and ankle kinematics.

Background: Most anterior cruciate ligament research is limited to variables at the knee joint and is performed in the laboratory setting, often with subjects postinjury. There is a paucity of information on the position of the hip and ankle during noncontact anterior cruciate ligament injury.

Hypothesis: When landing after maneuvers, athletes with anterior cruciate ligament injury (subjects) show a more flatfooted profile and more hip flexion than uninjured athletes (controls).

Fourteen-year prospective results of a high-density polyethylene prosthetic anterior cruciate ligament reconstruction.

Our experience with an ultrahigh molecular weight polyethylene (UHMWPE) braided graft indicates that this prosthetic anterior cruciate ligament (ACL) is not associated with the complications of other prosthetic ligaments and has equivalent results compared to an autograft. Nine patients underwent ACL reconstruction with the UHMWPE prosthetic graft, and seven patients received a bone-patellar-bone autograft. Each patient completed a questionnaire regarding their symptoms, a Tegner score, and a Lysholm Score.

Gender differences in head-neck segment dynamic stabilization during head acceleration.

Purpose: Recent epidemiological research has revealed that gender differences exist in concussion incidence but no study has investigated why females may be at greater risk of concussion. Our purpose was to determine whether gender differences existed in head-neck segment kinematic and neuromuscular control variables responses to an external force application with and without neck muscle preactivation.

Methods: Forty (20 females and 20 males) physically active volunteers participated in the study.

National Athletic Trainers' Association Position Statement: Head-Down Contact and Spearing in Tackle Football.

OBJECTIVE: To present recommendations that decrease the risk of cervical spine fractures and dislocations in football players. BACKGROUND: Axial loading of the cervical spine resulting from head-down contact is the primary cause of spinal cord injuries. Keeping the head up and initiating contact with the shoulder or chest decreases the risk of these injuries.

Cervical spinal stenosis with cord neurapraxia: evaluations and decisions regarding participation in athletics.

Cervical spinal cord neurapraxia (CCN) leads to transient episodes ranging from paresthesia to paresis to plegia (complete paralysis), and occurs in athletes with some demonstrable degree of cervical spinal stenosis. Determination of spinal stenosis requires demonstrating a sagittal diameter of the spinal canal less than 14 mm from C4 to C6. Because radiologic techniques vary affecting the accuracy of this measure, a ratio method was developed comparing the spinal canal to the vertebral body width, demonstrating that a ratio of less than 0.

Complications of joint arthroplasty in patients with end-stage renal disease on hemodialysis.

The mortality and morbidity after hip and knee arthroplasty were reviewed retrospectively during a 3-year period in 14 patients who had chronic renal failure and who were receiving hemodialysis. The patients had a primary total hip or knee replacement, or a revision arthroplasty or resection arthroplasty. Four of the patients (29%) died in the hospital during the postoperative period.

Retrospective report on the effectiveness of a polyurethane football helmet cover on the repeated occurrence of cerebral concussions.

This report reviews the literature and unpublished data and presents survey results related to the use of a polyurethane football helmet cover. Two hundred forty-five individuals, identified by the helmet manufacturer as having purchased at least one device, were sent a survey after the 1992, 1993, and 1994 football seasons; 155 (63.3%) of the surveys were returned.

Cervical cord neurapraxia: classification, pathomechanics, morbidity, and management guidelines.

One hundred ten cases of the transient neurological phenomenon, cervical cord neurapraxia (CCN), are presented. The authors established a classification system for CCN, developed a new computerized measurement technique for magnetic resonance (MR) imaging, investigated the relationship of the cervical cord to the canal, and analyzed clinical, x-ray, and MR data. One hundred nine males and one female were included in the study; the average age of the participants was 21 years (range 13-33 years).

The search for the Holy Grail: a century of anterior cruciate ligament reconstruction.

A perspective on the history of the development of anterior cruciate ligament reconstruction is presented. The lack of critical analyses establishing the relative effectiveness of many previously described procedures is documented.

Management guidelines for participation in collision activities with congenital, developmental, or postinjury lesions involving the cervical spine.

Objective: Conditions involving the cervical spine in athletes requiring a management decision are numerous. This report presents appropriate guidelines for return to collision activities in those with congenital, developmental, or postinjury lesions.

Data Sources: Information was compiled from > 1,200 cervical spine lesions documented by the National Football Head and Neck Injury Registry and an extensive literature review.

Cervical Spine and Brachial Plexus Injuries: Return-to-Play Recommendations.

Great care is required in managing cervical spine and brachial plexus injuries. Athletes who suffer one or more burners (transient brachial plexus injuries) may return to contact activity when they are asymptomatic and neurologically normal and have full cervical motion. A vertebra displaced horizontally more than 3.

Suggested management guidelines for participation in collision activities with congenital, developmental, or postinjury lesions involving the cervical spine.

Many conditions involving the cervical spine in the athlete require a management decision. The purpose of this paper is to present appropriate guidelines for return to collision activities in those with congenital, developmental, or post-injury lesions. Information compiled from over 1200 cervical spine lesions documented by the National Football Head & Neck Injury Registry, an extensive literature review, as well as an understanding of injury mechanisms have resulted in reasonable management guidelines.