Endoscopic-Assisted Transaxillary Approach for First Rib Resection in Thoracic Outlet Syndrome.

Purpose: To assess the feasibility, safety, and clinical outcomes of an endoscopic-assisted transaxillary approach of first rib resection for thoracic outlet syndrome (TOS) and to compare the differences in demographic and clinical data between satisfactory and unsatisfactory outcomes using this approach.

Methods: We retrospectively identified patients who underwent endoscopic-assisted first rib partial resection. A transaxillary approach for the first rib resection and neurovascular decompression were undertaken under magnified visualization.

Predictors of Unsuccessful Nonoperative Management of Capitellar Osteochondritis Dissecans.

Background: Osteochondritis dissecans of the humeral capitellum (capitellar OCD) is a common injury among adolescent throwing athletes. Some younger patients with incomplete maturity of the epiphysis and early-stage capitellar OCD are good candidates for nonoperative treatment. However, during initial examination, predicting the need for surgical treatment in patients with capitellar OCD is difficult.

First-Rib Stress Fracture in Overhead Throwing Athletes.

Background: First-rib stress fracture is considered a potential cause of nonspecific atraumatic chronic shoulder pain in adolescent athletes. However, the etiology in throwing athletes with first-rib fracture is still unknown. The purpose of this retrospective study was to investigate the characteristic clinical features and radiographic findings of overhead throwing athletes with first-rib fracture.

Importance of the Wrist Extensor Muscle Training: Two Cases of Elbow Flexorplasty following Traumatic Brachial Plexus Injuries.

The modified Steindler procedure-a reconstructive surgery used to restore elbow flexion following upper brachial plexus injuries-involves shifting the origins of the muscle groups responsible for wrist flexion and forearm pronation originating from the medial epicondyle to the proximal direction to be used as flexors of the elbow. In the postoperative rehabilitation, we focused on strengthening not only the transferred muscle but also the wrist extensor muscles as antagonist muscles. After reconstruction surgery for elbow flexion via the modified Steindler procedure for traumatic brachial plexus injury, we performed long-term rehabilitation to strengthen the antagonist muscles.

Quadrilateral Space Syndrome With Involvement of the Tendon of the Latissimus Dorsi.

Quadrilateral space syndrome (QSS) is the term used to describe axillary nerve palsy due to compression of the axillary nerve and posterior circumflex artery in the quadrilateral space. The precise pathophysiology of QSS is still unclear; hence, a consensus of diagnosis and treatment for QSS has not yet been achieved. The authors present the case of a 17-year-old male baseball player with symptoms of QSS, including right elbow and shoulder joint pain and upper limb numbness while throwing.

7. Usefulness of Low-Intensity Pulsed Ultrasound (LIPUS) for the Treatment of Osteochondritis Dissecans (OCD) of the Humeral Capitellum.

Objectives: LIPUS has been reported to promote bone union in pseudoarthrosis and delayed fracture union as well as to have a beneficial effect in shortening the duration of bone healing in fresh fractures. The purpose of this study was to examine whether LIPUS has an accelerating effect on healing OCD.

Subjects And Methods: From 2008 to 2012, cases with advanced-stage OCD were randomized, and the study was conducted on 51 patients (LIPUS group) who enabled us to decide the treatment efficacy, and gave consent after receiving an explanation on the benefit of LIPUS.

Alteration of Stress Distribution Patterns in Symptomatic Valgus Instability of the Elbow in Baseball Players: A Computed Tomography Osteoabsorptiometry Study.

Background: Repetitive valgus stress applied during a throwing motion can lead to various elbow disturbances, including ulnar collateral ligament (UCL) injury. Subchondral bone density reportedly reflects the cumulative force on a joint surface under actual loading conditions.

Purpose: (1) To evaluate the distribution of subchondral bone density across the elbow joint in asymptomatic baseball pitchers and symptomatic valgus instability pitchers and (2) to clarify the alterations in stress distribution pattern associated with symptomatic UCL insufficiency pitching activities.

Classification of Olecranon Stress Fractures in Baseball Players.

Background: Although the onset mechanism of an olecranon stress fracture (OSF) due to a throwing disorder is believed to involve valgus extension overload, olecranon posteromedial impingement, or triceps traction force, this issue is still debated in the literature.

Purpose: To establish a classification system for the different types of OSFs to improve diagnosis and clarify the onset mechanism.

Study Design: Case series; Level of evidence, 4.

Case report: meralgia paresthetica in a baseball pitcher.

We report a case of meralgia paresthetica occurring in an amateur baseball pitcher who experienced inguinal pain and dysesthesia in the anterolateral thigh during pitching practice. The lateral femoral cutaneous nerve was pushed up by the iliac muscle to the inguinal ligament at the sharp ridge of its fascia and ensheathed in the tendinous origin of the sartorius muscle. Neurolysis of the lateral femoral cutaneous nerve and partial dissection of the inguinal ligament and sartorius muscle promptly relieved the symptoms and the patient resumed pitching 1 month later.

Increase in serum concentrations of inhibin in early onset pre-eclampsia with intrauterine growth restriction.

Aim: Recently, it has been hypothesized that reduced placental blood flow in early pregnancy causes changes in endothelial function, leading to pre-eclampsia. To clarify this clinically, we assessed serum concentrations of inhibin and uric acid in pre-eclamptic women compared with those of normotensive pregnant women.

Methods: One hundred and forty normotensive pregnant women (at 20-41 weeks' gestation) and 50 women with pre-eclampsia (at 24-41 weeks' gestation) were the study subjects.

Delta-aminolevulinic acid-based photodynamic therapy for acne on the body.

Intractable acne on the body was clinically treated with photodynamic therapy (PDT) combining oral administration of delta-aminolevulinic acid (ALA) with polychromatic visible light from a metal halide lamp. The total number of body acne patients was 51. A 10 mg/kg B.