ABSTRACT
BACKGROUND: Although there have been multiple reports on surgical outcomes of superior labral anterior to posterior (SLAP) lesions in overhead athletes, only a few reports exist in the literature about the results of nonoperative treatment in elite (collegiate or professional) overhead athletes. To determine the clinical outcomes of nonoperative treatment of SLAP lesions in elite overhead athletes. METHODS: Between January 2006 and December 2011, 69 patients were selected. Initial arthroscopic SLAP repair was performed in 19 patients and of the 50 patients who underwent nonsurgical treatment, such as range of motion gain and periscapular muscle strengthening, 14 patients were converted to surgical treatment; 5 patients were lost to follow-up. Medical records of 31 elite overhead athletes who underwent nonsurgical treatment were retrospectively reviewed. Four clinical outcome measures were used: visual analogue scale (VAS) for pain, VAS for satisfaction, American Shoulder and Elbow Surgeons (ASES) score, and subjective feeling of recovery. RESULTS: The average follow-up period was 35.9 months (range, 24–62 months). The VAS for pain decreased from 6.5 to 2.2 (p<0.01) and VAS for satisfaction was 7.6. The ASES score increased from 54.1 to 85.9 (p<0.01). The overall average value of subjective feeling of recovery was 72%. Twenty-three out of 31 elite athletes (74.2%) returned to play after rehabilitation; these 23 athletes performed at the same or higher levels after rehabilitation. CONCLUSIONS: Nonsurgical treatment in elite overhead athletes with SLAP lesion should be considered as a treatment option.
Subject(s)
Humans , Athletes , Elbow , Follow-Up Studies , Lost to Follow-Up , Medical Records , Outcome Assessment, Health Care , Range of Motion, Articular , Rehabilitation , Retrospective Studies , Return to Sport , Shoulder , Surgeons , TearsABSTRACT
BACKGROUND: Although there have been multiple reports on surgical outcomes of superior labral anterior to posterior (SLAP) lesions in overhead athletes, only a few reports exist in the literature about the results of nonoperative treatment in elite (collegiate or professional) overhead athletes. To determine the clinical outcomes of nonoperative treatment of SLAP lesions in elite overhead athletes. METHODS: Between January 2006 and December 2011, 69 patients were selected. Initial arthroscopic SLAP repair was performed in 19 patients and of the 50 patients who underwent nonsurgical treatment, such as range of motion gain and periscapular muscle strengthening, 14 patients were converted to surgical treatment; 5 patients were lost to follow-up. Medical records of 31 elite overhead athletes who underwent nonsurgical treatment were retrospectively reviewed. Four clinical outcome measures were used: visual analogue scale (VAS) for pain, VAS for satisfaction, American Shoulder and Elbow Surgeons (ASES) score, and subjective feeling of recovery. RESULTS: The average follow-up period was 35.9 months (range, 24–62 months). The VAS for pain decreased from 6.5 to 2.2 (p<0.01) and VAS for satisfaction was 7.6. The ASES score increased from 54.1 to 85.9 (p<0.01). The overall average value of subjective feeling of recovery was 72%. Twenty-three out of 31 elite athletes (74.2%) returned to play after rehabilitation; these 23 athletes performed at the same or higher levels after rehabilitation. CONCLUSIONS: Nonsurgical treatment in elite overhead athletes with SLAP lesion should be considered as a treatment option.
ABSTRACT
Fractures of the femoral shaft with marked bowing face some obstacles in fixation of the fracture such as difficulty in insertion of the intramedullary nail (IM nail) or exact contouring plate. Locking compression plates (LCP) are an option to manage this problem. However, we experienced consecutive breakage of LCP twice and IM nail once in an 80-year-old female. Finally, union of the fracture was achieved after fixation of the IM nail and additional plate together. Fractures of the femur shaft with marked bowing are thought to have different biomechanical properties; therefore, we present this case with a review of the literature.
Subject(s)
Aged, 80 and over , Female , Humans , Femur , NailsABSTRACT
PURPOSE: Anterior drawer and varus stress test are commonly used for radiologic evaluation of chronic lateral ankle instability. However, there are controversies regarding the method of measurement and the normal value. This study was performed to investigate radiologic normal values in normal Korean adults and to analyze differences by age and gender. MATERIALS AND METHODS: Sixty Korean adults were recruited and divided in three groups (20 in their twenties, 20 in their thirties, 20 in their forties). There were 10 males and 10 females in each group. The selection criteria were no history of ankle injury and no evidence of instability on physical examination. Radiologic measurement of varus talar tilt and anterior talar translation were performed through anterior and varus stress radiographs using Telos device (150N force). The measurement was repeated twice by three researchers, and intraobserver reproducibility and interobserver reliability were analyzed. The average talar tilt and anterior talar translation were obtained. RESULTS: Talar tilt and anterior talar translation on ankle stress radiographs had good intraobserver reproducibility and interobserver reliability. Talar tilt was average 3.7degrees and 5.1degrees in male and female of twenties of age, 3.9degrees and 4.8degrees in their thirties, 3.4degrees and 4.5degrees in their forties. Anterior talar translation was average 3.5 mm and 4.2 mm in their twenties, 4.1 mm and 3.8 mm in their thirties, 3.6 mm and 4.1mm in their forties. There was no significant difference in talar tilt and anterior talar translation by age. However, there was significant difference in talar tilt by gender. CONCLUSION: Normal range of talar tilt angle in Korean adults was below 8.3degrees, and normal range of anterior talar translation was below 7.6 mm. It seems to be able to serve as a good reference for radiologic evaluation and for treatment of chronic lateral ankle instability.