Ulnar nerve entrapment at the wrist: cases from a hand surgery practice

PURPOSE: We evaluated the feasibility of 18 Fluoride Positron Emission Tomography (18F-PET), investigated the characteristics appearance of bony structures, and compared the quality of 18F-PET images with conventional bone scans (BS). METHOD: 18F-PET scans were performed in 59 patients additional to conventional bone scintigraphy. RESULTS: Even very small details in the spine like the spinous and transverse processes were clearly visible with 18F-PET. Only half of these structures were visualised with BS. When visualising the vertebral bodies of the first rib from the clavicles and the twelfth rib from the kidneys, we arrived at similar results. Hot spots in the skull or at the manubriosternal joint were observed in 29% of the patients without any evidence of trauma, degeneration or metastasis. CONCLUSION: 18F-PET shows more details of the skeleton compared to BS. Some hot spots not occurring with BS must be regarded as physiological.     

Suprascapular nerve rotator cuff compression syndrome in volleyball players

OBJECTIVE AND DESIGN: Eighteen active acromegalics entered a prospective open study with cabergoline (CAB), a dopaminergic drug much more potent than bromocriptine (Br). METHODS: CAB was administered for 6 months at doses ranging between 0.5 mg twice weekly and 0.5 mg/day. Clinical-anamnestic characteristics of the patients were: (i) sensitivity to dopamine agonist drugs (10 patients); (ii) resistance to somatostatin analogs (SAs) (8 patients): (iii) intolerance to SA (3 patients). In 2 patients marked hyperprolactinemia was present. RESULTS: Basal GH was 6.6 microg/l (2.2-50) (median (range)), and on treatment it was 3.5 microg/l (1.2-34) (P=0.013). The corresponding IGF-I values were 720 microg/l (410-1438) and 375 microg/l (167-1260) respectively (P=0.00001). Individual GH levels decreased below 2 microg/l in 5 patients, and between 2 and 5 microg/l in another 5 patients. IGF-I levels were suppressed below 50% of baseline in 8 patients and normal age-adjusted IGF-I values were reached in 5 patients (27% of the series). The retrospective comparison with previous chronic treatment with Br in the 10 suitable patients showed a greater effectiveness of CAB (IGF-I decrease on CAB treatment, 46.8%, on Br treatment, 31%, P=0.02). Adenoma shrank in the 3 patients whose pituitary imaging was repeated during CAB. CONCLUSIONS: These results envisage that CAB may represent a worthy therapeutic tool in acromegalic patients, inducing a degree of IGF-I and GH suppression comparable to SAs, administered by the oral route and much less expensive.     

Ulnar nerve palsy in Paget's disease

A 73-year-old housewife with enlargement of her distal right humerus and especially the medial epicondyle due to Paget's disease developed an ulnar nerve palsy. Transposition of her ulnar nerve anterior to her elbow completely relieved her symptoms. A similar case of ulnar nerve palsy associated with expansion of the distal humerus due to Paget's disease seems not to have been previously reported.     

Distal nerve entrapment following nerve repair

Failure of nerve repair or poor functional outcome after reconstruction can be influenced by various causes. Besides improper microsurgical technique, fascicular malalignment and unphysiologic tension, we found in our clinical series that a subclinical nerve compression distal to the repair site can seriously impair regeneration. We concluded that the injured nerve, whether from trauma or microsurgical intervention, could be more susceptible to distal entrapment in the regenerative stage because of its disturbed microcirculation, swelling and the increase of regenerating axons followed by increased nerve volume. In two cases we found the regenerating nerve entrapped at pre-existing anatomical sites of narrowing resulting in impaired functional recovery. In both cases the surgical therapy was decompression of the distal entrapped nerve and this was followed by continued regeneration. Thorough clinical and electrophysiologic follow-up is necessary to detect such adverse compression effects and to distinguish between the various causes of failed regeneration. Under certain circumstances primary preventive decompression may be beneficial if performed at the time of nerve coaptation.     

Behavior of college baseball players in a virtual batting task.

A baseball batting simulation was used to investigate the information used to hit a baseball. Measures of spatial and temporal swing accuracy were used to test whether batters (a) use speed to estimate pitch height, (b) initiate a constant swing duration at a fixed time to contact, (c) are influenced by the history of previous pitches and pitch count, and (d) use rotation direction. Batters were experienced college players. Pitch speed variance led to predictable spatial errors, and spatial accuracy was worse than temporal accuracy. Swing duration was generally variable. The history of the previous 3 pitches and the pitch count had significant effects on accuracy, and performance improved when rotation cues were added. There were significant effects of expertise on hitting strategy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peripheral nerve entrapment in Paget''s disease

Thirteen anthropometric measurements of Kaffa district schoolchildren in Ethiopia were factor analysed. Two factors emerged which may be interpreted as (a) body size and (b) fat mass.     

Suprascapular nerve entrapment in a basketball player

A basketball player was shown to have a suprascapular nerve lesion without any history of shoulder girdle trauma. This acute neuropathy, never previously described in basketball players, is a result of repeated micro-trauma, due to nerve traction over the coracoid notch during violent movement ("dunking" most probably). Clinically, he was unable to abduct his arm and had some difficulty in external rotation. He developed atrophy in both the supra- and the infraspinatus muscles. Nerve conduction latency to the supraspinatus muscle was 8.0 ms, and to the infraspinatus, 8.5 ms. The compound muscle action potential registered in the supraspinatus was 1.224 mV, and in the infraspinatus, 1.237 mV. After 3 weeks of inactivity, recovery was spontaneous and practically complete.     

Multiple nerve entrapment syndromes in office workers

Reports of nerve compression syndromes have been increasing in frequency. The authors discuss evaluation, management, and surgical repair of these multifactorial disorders.     

The effect of ocular dominance on the performance of professional baseball players

OBJECTIVE: The purpose of the study was to determine whether a performance difference exists between baseball players with "same" (right-right) and "crossed" (right-left) hand-ocular dominance. DESIGN: A cohort study design was used. PARTICIPANTS: Four hundred and ten major and minor league members of the Los Angeles Dodgers professional baseball team. INTERVENTION: Measurement of ocular dominance. MAIN OUTCOME MEASURES: Batting average and earned run average (ERA). RESULTS: Same/crossed dominance (with P values in parentheses) are as follows: Batting averages: major league-0.271/0.251 (0.20); minor league-0.274/0.270 (0.57); ERA: major league-3.34/3.56 (0.66); minor league-4.00/4.20 (0.54). CONCLUSIONS: Hand-ocular dominance patterns do not have an effect on batting average or ERA.     

Frequency-dependent performance and handedness in professional baseball players (Homo sapiens).

I used data on handedness and pitching and hitting performance in annual cohorts of professional baseball players (1957-2005) to test the hypothesis that handedness among pitchers was subject to negative frequency-dependent selection. As predicted by this hypothesis, right-handed pitchers were more successful (i.e., opposing batters hit more poorly against them) when they were relatively rare in the population. Contrary to the predictions of this hypothesis, however, left-handed pitchers were more successful when they were relatively common. Both right- and left-handed batters performed better in years dominated by right-handed pitchers, despite the fact that right-handed batters perform relatively poorly against right-handed pitchers. I suggest that batters form cognitive representations based on pitcher handedness, and that these representations are strengthened by repeated exposure or priming. When the pitcher handedness polymorphism is more balanced (e.g., 67% right-handed, 33% left-handed), these cognitive representations are less effective, which leads to decreased batting averages and improved performance by all pitchers. Furthermore, these cognitive representations are likely to be more critical to the success of right-handed hitters, who have reduced visuomotor skills relative to left-handed hitters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal field assessment of equity effects on the performance of major league baseball players.

A time-series analysis was used to test predictions based on equity theory in a naturally occurring experiment involving 23 major league baseball players who began the 1976 season without contracts. It was posited that due to historical changes in the reserve system, these players would perceive themselves as undercompensated relative to salient others, and due to substantial reductions in salary as compared to their 1975 compensation, they would also perceive themselves as undercompensated relative to self-referents from the previous year. Such perceptions should produce lower performance. This hypothesis was supported for performance as measured by batting average, home runs, and runs batted in but not for runs scored. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Equity and the performance of major league baseball players: An extension of Lord and Hohenfeld.

Extended R. G. Lord and J. G. Hohenfeld's (see record 1980-13102-001) assessment of equity effects on the performance of major league baseball players. The sample is expanded to include 30 (average age 30.6 yrs) players in the 1st 3 free-agent reentry drafts and to include comparisons with teammates and a sample of 30 (average age 29.5 yrs) traded players. Equity theory predictions of decrements in performance during a year of undercompensation were not supported. Performance of free agents was also found to be not significantly different from that of either teammates or traded players. Sample differences are identified, and results are interpreted within an expectancy theory, as well as an equity theory, framework. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Medial synovial entrapment syndrome of the hip in Chinese children

BACKGROUND: "Medial synovial entrapment syndrome of the hip" is a preliminary name given by the authors to describe the topic of this paper. The authors hope to elicit the concern of clinicians and further explore the feasibility of this nomenclature for the described syndrome. METHODS: A total of 26 children with synovial disorder of the hip complained of limited motion and pain of various degrees in the hip, and a limp or refusal to bear weight. Clinical presentation, image studies, course and management were thoroughly reviewed and compared with other well-established synovial disorders of the hip. RESULTS: Twenty-two of the patients were cured by bedrest, skin traction and manipulative reduction. The remaining four patients were treated with surgery and had satisfactory results. Because of its unique clinical manifestation and the good results obtained from manipulative reduction, it is difficult to compare this condition with any other well-established disease entities. Thus, the authors suggest medial synovial entrapment syndrome of the hip (SES) as a preliminary name. CONCLUSIONS: Based on the 26 Chinese children with SES studied, the authors used clinical, anatomic and biomechanical bases for deriving this nomenclature. The similarity between transient synovitis and SES is discussed.