Gymnastic wrist injuries

The evolution of enteral feeding via tubes, syringes, and other mechanical devices probably began in Egypt before the birth of Christ. Today's feeding tubes are a safe and effective means for providing long-term feeding to patients unable to maintain sufficient nutrition by oral intake. The needs of enterally-fed patients are presently being met with feeding tubes that are biocompatible, easy to use, and relatively inexpensive to manufacture.     

Common wrist injuries

Patients with wrist injuries often present to primary care physicians. Many times, mild clinical injury involves significant damage to carpal bones and soft tissue elements. The long-term outcome of these injuries depends on prompt diagnosis and appropriate therapy. Familiarity with the functional anatomy and physical examination of the wrist, accompanied by radiologic evaluation, may aid the physician in differentiating simple sprains from potentially debilitating wrist injuries.     

The imaging of sports injuries

Radiology plays a critical role in the evaluation of a traumatized athlete. The goal is to provide as much information as possible to allow timely and appropriate patient care. To select the best "diagnostic pathway," close communication between the clinician and the radiologist is mandatory. This saves time, money, and radiation exposure. Although plain radiographs remain the primary imaging technique for the diagnosis of musculoskeletal trauma, certain injuries can be more fully evaluated by fluoroscopy, arthrography, nuclear medicine scanning, computed tomography (CT), arthrography followed by CT, or magnetic resonance imaging. This article reviews the uses of each imaging technique in the diagnosis of musculoskeletal trauma and its most appropriate application. A discussion of pediatric skeletal trauma is included.     

Preventing mouth injuries during sports

In the presence of MgATP or MgADP the E. coli chaperonin proteins, GroEL and GroES, form a stable asymmetric complex with a stoichiometry of two GroEL7:one GroES7: seven MgADP. The distribution of the ligands between the two heptameric GroEL rings is crucial to our understanding of the mechanism of chaperonin-assisted folding, being either cis (i.e. [GroEL7.MgADP7.GroES7]-[GroEL7]) or trans (i.e. [GroEL7.MgADP7]-[GroEL7.GroES7]. On the basis of cross-linking experiments with 8-azido-ATP and the heterobifunctional reagent, N-succinimidyl 3-(2-pyridyldithio) propionate (SPDP), it was suggested that GroES and MgADP are bound to the same GroEL ring which resists proteinase K digestion [Nature 366 (1993) 228-233]. However, we find that the SPDP-promoted cross linking of GroES and GroEL occurs in the absence of Mg2+, ADP or ATP, which are required for the formation of the asymmetric complex. Cross-linking is shown to occur only when the SPDP-modified GroES is co-precipitated with GroEL by trichloracetic acid. Furthermore, there are structural grounds for questioning whether SPDP can crosslink, in a physiologically relevant manner, an amino group of GroES with any of the cysteinyl groups of GroEL.     

Elbow, forearm and wrist injuries in the athlete

Competitive and recreational athletes sustain a wide variety of soft tissue, bone, ligament, tendon and nerve damage to their upper extremities. Most such injuries are related to direct trauma or repetitive stress, and account for a significant amount of 'down time' for athletes participating in a wide range of sports, particularly those in which the arm is utilised for throwing, catching or swinging. Overuse injuries to the elbow include musculotendinous injuries, ulnar nerve injuries and ligamentous injuries. Osteochondrol lesions of the capitellum and posterior impingement injuries in the joint are frequently seen in athletes as well. Acute traumatic injuries to the elbow include tendon ruptures, elbow dislocations and intra-articular fractures. Forearm overuse injuries in athletes include fracture of the carpal scaphold, fracture of the hook of the hamate, Kienbock's syndrome and pisoquetral syndromes. ligamentous injuries include scapholunate, lunotriquetral and midcarpal instability injuries. Injuries to the distal radio-ulnar joint and triangular fibrocartilage are also quite common in athletes, and require careful evaluation and treatment.     

Primary care of hand and wrist athletic injuries

Athletic injures to the hand and wrist can range from simple sprains to severe fractures or soft-tissue disruptions that can permanently threaten the normal function of the extremity. This article deals with some of the more commonly noted sports-related injures to the hand and wrist to help the team physician make the correct diagnosis and establish the most effective treatment plan, so that the athlete may achieve maximum results and ultimately return to full participation in their sport.     

Rehabilitation and use of protective devices in hand and wrist injuries

Hand and wrist injuries are common among athletes. Although the hand does not often bear weight and these injuries do not always sideline an athlete, careful attention must be paid when treating injuries of the hand and wrist. Rehabilitation is given for common injuries of the hand and wrist, including exercises and protective splints and braces. Details on how to fabricate a playing cast for athletes are also discussed.     

The role of arthroscopy in the treatment of wrist injuries in the athlete

Wrist arthroscopy provides an ideal means of evaluating intraarticular soft-tissue injuries of the wrist. Many lesions such as tears of the triangular fibrocartilage complex can be treated by arthroscopic means as well. Reduction of articular fractures of the distal radius and pin fixation, reduction of scaphoid fractures and intramedullary fixation, and arthroscopic reduction and transcutaneous pin stabilization of acute carpal dissociation patterns can all be accomplished with minimally invasive techniques under arthroscopic control. These measures often provide the athlete with shorter periods of immobilization and earlier return to athletic competition. Wrist arthroscopy provides a very useful adjunct to the treatment armamentarium of all sports medicine physicians.     

Pediatric wheelchair athletics: sports injuries and prevention

Two hundred and forty-seven competitors at the 1990 Junior National Wheelchair Games (USA) were surveyed for general information, training techniques, and injury patterns. Eighty-three athletes (34%) responded to the retrospective survey. Injuries were reported by 97% of those participating in track, 22% of the field participants, and 91% of the swimming competitors. A wide variety of injuries was reported ranging from minor bruises, blisters and abrasions to more serious problems (bladder infections, hyperthermia, and soft tissue injuries). While information-reporting biases may be inherent in this type of study, these data are significant in that they are the first obtained for this specific pediatric population via a systemic scientific approach and not from merely anecdotal information.     

Lower leg and foot injuries in tennis and other racquet sports

Injuries to the lower extremity are common in racquet sports. These can be either acute or chronic. Although acute injuries usually respond to treatment, chronic injuries are often less amenable to treatment. The occurrence of both kinds of injuries, however, can often be prevented by proper training techniques including stretching and strengthening exercises. These exercises are also important components of a proper rehabilitation program.     

Women's injuries in collegiate sports. A preliminary comparative overview of three seasons

The purpose of this article was to provide a preliminary overview of the injury experiences among collegiate women athletes which were reported to the National Athletic Injury/Illness Reporting System (NAIRS) during its first 3 operational years (1975 to 1978). More dissimilarities in injury patterns were observed between women's sports than between comparable men and women's sports. The results thereby are interpreted that injuries to women athletes are essentially sport-related, not sex-related. Further investigative reports on women athletic injuries should be delimited to respective sports and over a period of time. Attention should be given to the patterns of injury within a sport, including shifts in patterns, so that practicable preventive measures can be perceived, implemented, and subsequently evaluated.     

Considerations for the orthopedic nurse in diagnosis and treatment of adolescent sports injuries

Injured adolescent athletes are challenging clients for the primary practitioner. Their unique physiological and psychological attributes dictate changes in traditional orthopedic practice and call for a holistic patient focus to address their varied needs. Understanding of common athletic injuries will effectively guide the practitioner's clinical evaluation and assist in recognizing those patients requiring more complex orthopedic diagnosis and care.     

Trendy inline skating sports. Pattern of injuries and groups at risk

One hundred and eighty-two patients presented with 200 inline-skating injuries over a 30-month period. Of these, 14% were admitted to hospital, 10% required operative treatment. Fractures (49%), contusions/lacerations (27%) and capsular/ligamentuous injuries (16%) were the most prevalent types of injury. Children had an even higher risk of sustaining fractures (62%). Falling on the extended arm caused 44% of all injuries. Thirteen percent resulted from torque mechanisms of the leg, whereas direct trauma to elbow or knee (5% each) were uncommon injury mechanisms. Injuries of the elbow, forearm, wrist and hand accounted for 55.5% of all cases and 71% of all fractures. Head (13%), knee (9.5%) and ankle (9%) were other regions frequently involved. Protective equipment was often used only for uninjured regions, whereas the injured regions had most often been left unprotected.     

Remedies for common family ailments: 11. Relieving the pain of sports injuries

Many sports injuries involve tissue damage which results in the release of chemical mediators such as prostaglandin. These stimulate the nerve endings, producing pain. Many topical analgesics, eg aspirin and NSAIDs, act by inhibiting these chemical mediators. Others work on the "counter-irritant" principle, or by producing local heat or cold. Anyone on other medication or with existing medical conditions should consult a pharmacist or doctor before embarking on analgesics.     

Biomechanics of atherosclerotic plaque

Atherosclerosis is the leading cause of death in the U.S. In balloon angioplasty, pressure is applied directly to atherosclerotic plaque to reopen the occluded blood vessel. The mechanical behavior of the plaque often determines the outcome of the angioplasty. Little information on the material properties of atherosclerotic plaque is available, yet the properties govern the plaque's behavior. Our discussion of the experimental testing and numerical analysis of plaque is directed toward summarizing the current knowledge of plaque material properties. Atherosclerotic plaque exhibits a wide range of behaviors consistent with the variability in the underlying composition. Overall, plaques exhibit nonlinear and inelastic mechanical behavior, although geometry and material properties are not well known. The histomorphological composition is critical in determining the plaque's mechanical response. Finite element approximations have been used to study the stresses developed in the diseased vessel; however, material properties are a critical component of a finite element analysis: the predictive capabilities depend on how accurately the material is modeled. When more information on plaque behavior is generated through careful and extensive experimental investigations, better models will be constructed to more accurately predict plaque responses. As the biomechanics community learns about plaque mechanics, we can use the knowledge to enhance the reliability of interventional procedures.     

Biomechanics of whiplash injury

The cooling effect of topicals has been used in the dermatological therapy as "physical effect" on the skin for more than hundred years. This effect of dermatologicals releasing free water is widely accepted, but current knowledge does not correspond to today's possibilities of experimental thermographic tests in man. The present paper describes the results published up to now and the current testing methods in vivo and in vitro.