Abstract:
:In the overhand or throwing athlete, the shoulder is extremely vulnerable to injury due to the repetitive, high-energy forces. When these stresses are applied at a rate that exceeds that of tissue repair, progressive damage to the shoulder's stabilizing structures can occur. With continued throwing, the static restraints become progressively attenuated, allowing anterior glenohumeral subluxation. Initially, the dynamic stabilizers can compensate for this mild instability with increased muscle activity. Prolonged activity, however, may lead to fatigue. Over time, these compensatory mechanisms can become overloaded. The humeral head then may subluxate anteriorly, where it contacts with the coracoacromial arch, ultimately leading to subacromial impingement. Posterosuperior glenoid impingement may also occur as anterior humeral translation allows the undersurface of the tendinous portions of the supraspinatus and infraspinatus to impinge along the posterosuperior border of the glenoid rim. Fortunately, conservative management is effective in most chronic overuse injuries and includes an initial period of relative rest (avoidance of throwing), oral nonsteroidal antiinflammatory medication, a physical therapy program structured to provide local modalities to reduce inflammation, and a strengthening program for the rotator cuff and scapular rotators. For those athletes with continued symptoms, surgical intervention may become necessary. The appropriate surgical treatment depends on the diagnosis. In the young throwing athlete with shoulder pain, it is essential to recognize that instability or occult subluxation, rather than impingement, is the primary underlying pathology. The anterior capsulolabral reconstruction addresses the problem of instability by correcting the capsular redundancy or labral damage or both. When performed in the manner described, muscle attachments and proprioceptive muscle fibers are not disturbed and full shoulder range of motion can quickly be achieved. This most recent surgical technique and postoperative rehabilitation program has resulted in a significant improvement in the ability to correct instability in those athletes who have failed a prolonged course of conservative care. Prevention of these injuries may be attained, it is hoped, through continued research into the basic biomechanics and the pathoanatomy associated with overhand sports.(ABSTRACT TRUNCATED AT 400 WORDS)
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Kvitne RS,Jobe FWsubject
Has Abstractpub_date
1993-06-01 00:00:00pages
107-23issue
291eissn
0009-921Xissn
1528-1132pub_type
杂志文章,评审abstract:UNLABELLED:This study was performed to determine whether patients who sustain an intertrochanteric fracture have better outcomes when stabilized using a sliding hip screw or an intramedullary nail. A 20% sample of Part A and B entitled Medicare beneficiaries 65 years or older was used to generate a cohort of patients w...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,多中心研究
doi:10.1007/s11999-008-0285-5
更新日期:2008-11-01 00:00:00
abstract::Bilateral simultaneous Achilles tendon ruptures are rare, with only ten cases reported in the English literature. Our case is that of a 44-year-old woman, along with a review of the literature. Affected persons usually are on chronic steroid treatment and in the fifth to seventh decades of life. The patient may have c...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-12-01 00:00:00
abstract:BACKGROUND:Cementless fixation remains controversial in TKA due to the challenge of achieving consistent skeletal attachment. Factors predicting durable fixation are not clearly understood, but we presumed bone ingrowth could be enhanced by the quantity of host bone and application of autograft bone chips. QUESTIONS/P...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2214-2
更新日期:2012-07-01 00:00:00
abstract::A prospective, randomized study was performed in 54 female total arthroplasty patients to determine whether straight catheterization in the recovery room might reduce the incidence of postoperative urinary infection, urinary retention, and urinary catheterization. Thirty-one patients were straight catheterized in the ...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1988-06-01 00:00:00
abstract::The Hoffmann external fixator has proved to be an effective means of stabilizing complex femoral fractures in patients in whom prolonged traction or internal fixation is not advisable. It provides for the prompt mobilization of multiple-trauma victims and assists in the evaluation of the "floating knee." Pin tract inf...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-11-01 00:00:00
abstract::The authors reviewed the medical records of 53 patients with a lower cervical spine injury who were treated by anterior decompression, bone grafting, and instrumentation using an anterior cervical spine plate and screws. The average age of the patients was 36 years and the mean followup was 58 months. Twenty-six patie...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000068185.83581.cf
更新日期:2003-06-01 00:00:00
abstract::A 14-year-old girl with painful scoliosis was found to have an osteoid osteoma involving the body of the left seventh rib. Excision of the tumor was facilitated by intraoperative bone scanning that precisely located its position. Following surgery, preoperative pain was completely relieved and the spinal curvature had...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-05-01 00:00:00
abstract::Higher oxidative stress reportedly plays a key role in muscle damage caused by immobilization and subsequent remobilization. However, we have no clear understanding regarding oxidative stress during immobilization and remobilization. The purpose of this study was to clarify the characteristics of oxidative stress by m...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000150464.29883.ca
更新日期:2005-05-01 00:00:00
abstract::Two current areas of research on hard tissues have focused upon acidic lipids associated with the local mechanism of calcification and the presence of matrix vesicles as the loci for initial mineralization. Data which show that acidic phospholipids are a component of the vesicle membrane provide a common denominator b...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-07-01 00:00:00
abstract::This is a report of replantation of a completely severed forefoot which was divided through the distal tarsus by a samurai sword cut. Primary reconstruction of bone, vessels, nerve and skin was carried out 2 hours following amputation. Neither the long extensor nor the long flexor tendons were repaired. Three years fo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1979-03-01 00:00:00
abstract::A 4-year-old boy with congenital pseudarthrosis of the tibia had two unsuccessful operative attempts for union. After these procedures the patient had a 6-cm leg length discrepancy and an equinovalgus foot deformity. Because of these deformities he underwent Syme amputation at the ankle and was fitted with a total con...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1998-06-01 00:00:00
abstract:PURPOSE:A giant cell tumor (GCT) of bone presenting in the distal radius is rare, however, when they occur, Campanacci Grade III tumors can present formidable reconstructive challenges. They are associated with a high local recurrence rate with intralesional treatment, therefore approaches to reconstruct the wrist afte...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-016-4975-0
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:More than 100 MRIs per 1000 inhabitants are performed in the United States annually, more than almost every other country. Little is known regarding the cost of obtaining an MRI and factors associated with differences in cost. QUESTIONS/PURPOSES:By surveying all hospital-owned and independent imaging center...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-016-5181-9
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:Musculoskeletal injury is the most common reason that soldiers are medically not ready to deploy. Understanding intrinsic risk factors that may place an elite soldier at risk of musculoskeletal injury may be beneficial in preventing musculoskeletal injury and maintaining operational military readiness. Findi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-015-4342-6
更新日期:2015-09-01 00:00:00
abstract::Failure of bone grafting in scaphoid nonunion presents the hand surgeon a perplexing set of problems. Controversy remains as to the best course of treatment in this difficult situation. The authors have retrospectively reviewed during a 5-year period the patients treated at the Mayo Clinic who have gone on to a second...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199606000-00015
更新日期:1996-06-01 00:00:00
abstract::International Classification of Diseases coding of patient charts is used by hospitals to allow for billing of patients. Coding information also is used for assessing physician effectiveness. The purpose of the current study was to examine hospital coding for patients having total hip arthroplasty. One hundred consecu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200209000-00014
更新日期:2002-09-01 00:00:00
abstract::Patients who are young or active or both who require total joint replacement pose a unique challenge; their high activity demands wear-resistant bearings that will perform for decades, without suffering from the adverse effects of accumulated wear products. We discuss the tribologic and biologic properties of newly in...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-200401000-00017
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Although postoperative spinal epidural hematoma (SEH) is not uncommon, hematomas that require surgery are rare. Cauda equina syndrome (CES) may be associated with postoperative SEH. In these cases, early recognition and emergency decompression can prevent further damage and better neurologic recovery. CASE ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2031-7
更新日期:2012-06-01 00:00:00
abstract::Chronic spontaneous dislocation of the sternoclavicular joint occurs more frequently in athletes than nonathletes, causing weakness and sometimes pain during prolonged stress upon the arm. Five such joints were successfully treated in 4 patients by means of a dynamic method of repair--tenodesis of the sternal head of ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1979-05-01 00:00:00
abstract::Postoperatively a suspension of Staphylococcus aureus was injected intravenously in rabbits with experimental total knee arthroplasties. Four weeks after the operation 70% of the total joint replacements were infected whereas a bacterial survey revealed ony occasional positive cultures from the kidneys. The infected j...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-09-01 00:00:00
abstract::Plaster casts, custom-fabricated fracture braces, and prefabricated fracture braces were compared in the laboratory for the stability they provided to closed, experimental, diaphyseal fractures of the tibia and fibula on anatomic specimens. The stability was comparable for each type of device tested for the loading co...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-06-01 00:00:00
abstract::Laboratory experiments show the following relationships between electricity and bone: (1) stressed bone exhibits electronegativity in areas of compression, (2) living, nonstressed bone exhibits electronegativity in areas of bone growth and healing, and (3) the application of low magnitude direct current to bone induce...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-05-01 00:00:00
abstract::The response of protodifferentiated and differentiated bone cells to bovine bone morphogenetic protein (bBMP) was observed in implants in the adult rabbit distal femoral metaphysis. Bovine serum albumin and denatured bBMP were implanted in the contralateral femur of controls. The changes of the bone marrow reflected t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-05-01 00:00:00
abstract::To determine histomorphometric and bone strength distribution of the proximal humerus, analyses were done on 24 freshly harvested human cadaveric humeri. Median ages of 46 and 69 years were recorded respectively for the male group (n = 11; minimum, 34 years; maximum, 76 years) and the female group (n = 13; minimum, 46...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000092968.12414.a8
更新日期:2003-10-01 00:00:00
abstract::Experiments in animals have shown that estrogen is chondrodestructive. The existence of 17 beta-estradiol receptor in rabbit chondrocyte and canine cartilage suggests that estrogen is associated with the development of osteoarthrosis (OA). The increased frequency of knee OA in obese postmenopausal women, who are often...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-06-01 00:00:00
abstract::Thirty intraarticular calcaneal fractures were studied by computed tomography and then treated with a variety of closed methods. A classification of the fractures was devised according to the amount of displacement of the posterior facet. Follow-up evaluation showed that Type I fractures recovered function and healed ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::While the entity of nonsecretory myeloma is rare, its diagnosis may be delayed or remain undetected if too much reliance is placed on the presence of a serum or urinary M component, which traditionally has been considered an important, if not essential, feature of plasma cell myelomatosis. Nonsecretory myeloma is char...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-11-01 00:00:00
abstract::The aim of this study was to describe the course of untreated or conservatively treated arthrosis of the knee joint. Of 265 patients presenting with knee pain who had weightbearing radiographs taken between 1970 and 1973, 132 (33 men and 99 women) responded to and participated in a clinical followup 20 years later usi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199707000-00019
更新日期:1997-07-01 00:00:00
abstract::Onset of firing for the quadriceps, hamstrings, and gastroc soleus groups during running, both on a treadmill and over ground, was determined in seven normal adult male subjects. Surface and wire electrode data were collected simultaneously from 959 individual gait cycles. The mean velocity over ground was 274 +/- 38 ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-06-01 00:00:00
abstract::Mineral-matrix interactions regulate the process of hydroxyapatite formation in bones and teeth. In mineralizing tissues, many anionic macromolecules bind to mineral. By means of this binding, such molecules are able to regulate the size and shape of the mineral crystals, determine the site of initial crystal depositi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1992-08-01 00:00:00