Isokinetic Measurement of a Concentric and Eccentric Strength of the Rotators in Throwing / 대한스포츠의학회지

The shoulder injury was resulted from muscle imbalance between acceleration and deceleration during the throwing. The agonist-antagonist muscle strength relationship for throwing was formerly described as functional ratios of eccentric external rotator to concentric internal rotator moments and eccentric internal rotator to concentric external rotator moments. The purpose of this study was to measure the ratio of concentric and eccentric strength of the shoulder rotators by isokinetic muscle performance in Korean throwing college athletes for descriptive data. On 10 dominant shoulders of asymptomatic throwing college athletes applying Cybex II isokinetic dynamometer, concentric and eccentric muscle strength of the rotators were measured at the speed of 90degrees/s, 180degrees/s, 240degrees/s. Maximal torque ratio of the eccentric strength of the external rotator against the concentric strength of the internal rotator was 1.25, 1.13, 1.21 at the each speed. The functional external eccentric-to-internal concentric ratio was similar with previous published studies. There was no significant difference between each speed. Eccentric strength of the external rotator was higher than concentric strength of the internal rotator during internal and external rotation at all speeds. This functional assessment of strength testing that reflected the importance of eccentric external rotation strength for the dynamic shoulder joint stability during the throwing. Therefore, the increase of the eccentric strength of the external rotator would be helpful to prevent the shoulder injury and to treat for rehabilitation of injured shoulder.

A Case of Sleeve Fracture at the Superior Pole of the Patella Secondary to Disuse Osteopenia

Sleeve fracture at the inferior pole of the patella in children is relatively common, yet it is rare for the superior pole to be affected. So, only a few such cases have currently been reported. We experienced a 15 years-old patient with a sleeve fracture at the superior pole of the patella secondary to disuse osteopenia after cast immobilization due to knee trauma. We report on this case and we review the relevant literature.

Delayed Paraplegia after Successful Percutaneous Vertebroplasty in a Patient with Osteoporotic Compression Fracture: A Case Report

STUDY DESIGN: A case report. OBJECTIVES: We report a case of a female patient initially diagnosed as osteoporotic vertebral fracture without any noticeable injuries to posterior ligament complex, who later developed with incomplete paraplegia resulting from an unrecognized trauma after vertebroplasty. SUMMARY OF LITERATURE REVIEW: Vertebroplasty remains a safe and effective procedure for osteoporotic vertebral fracture. However, there have been many reports regarding neural injury associated with cement leakage. MATERIALS AND METHODS: An 81-year old woman with a sudden motor weakness and a sensory loss on her lower extremities after an unrecognized trauma was admitted to our clinic. She had undergone a vertebroplasty twelve days before the admission. At the time of vertebroplasty, Magnetic resonance (MR) imaging showed a compression fracture at T10 vertebra without any posterior ligament complex (PLC) injury. Follow up MR imaging was taken 12 days after vertebroplasty, and it revealed posterior shift of T10 body with a fracture of spinous process, tear of left facet joint capsule, partial tear of interspinous ligament of T10-11 with retrolisthesis, and narrowing of spinal canal at T10-11 by T11 lamina. RESULTS: Immediate surgical treatment was performed to decompress the neural structures, and to stabilize the spinal column. However, neurological recovery was unsatisfactory. CONCLUSIONS: Spinal surgeons should be aware of the possibility of the development of any neurologic deterioration, even if successful vertebroplasty is performed.

Medial Patellofemoral Ligament Reconstruction Using the Autogenous Hamstring Tendon for Recurrent Patellar Instability: A Preliminary Report

PURPOSE: We present the short-term results of medial patellofemoral ligament (MPFL) reconstruction using the autogenous hamstring tendon for recurrent patellar instability. MATERIALS AND METHODS: Seven patients with recurrent patellar instability were treated with MPFL reconstruction using a semitendinosus or gracilis autograft from February 2008 to November 2008. All the patients were evaluated preoperatively and postoperatively according to the physical findings, scores and radiographs, with a mean follow-up of 13.6 months (range: 12~15 months). RESULTS: The apprehension test was positive in all the knees preoperatively and no knee was found to be positive at the follow-up. The grind test was positive in all the knees preoperatively and one knee was found to be positive at the follow-up. The Q-angle was 16.9degrees preoperatively and 18.3degrees at the follow-up. The Kujala score improved from 33.7 points to 94.1 points (p=0.018), the Lysholm score improved from 42.4 points to 92.6 points (p=0.018) and the Tegner activity level improved 2.1 to 5.1 (p=0.026). The congruence angle was 10.2degrees preoperatively and -3.4degrees at follow-up (p=0.018). The patellar height was 1.95 preoperatively and 1.6 at follow-up (p=0.028). There were no patients with recurrent dislocation. CONCLUSION: MPFL reconstruction using the autogenous hamstring tendon for recurrent patellar instability is an effective operation, according to the short term follow-up.

Interposition Arthroplasty with Pectoralis Major Muscle Transfer for the Shoulder Arthropathy: 2 Cases Report

Interpostion arthroplasty with allograft has been known as a useful option for the shoulder arthropathy, but it has a limitation to immune response. We performed the pectoralis major muscle transfer for shoulder arthropathy. From January 2007 to December 2007, we performed the pectoralis major muscle transfer in 2 patients. They were 1 man and 1 woman, and the mean age of the patients was 70 years (range, 65 to 75). The average follow-up after surgery was 13 months (range, 12 to 14). We analyzed the clinical results by the American Shoulder and Elbow Surgeons (ASES) Score, and evaluated the pain by Visual Analogue Scale. The level of pain reduced from a preoperative average of 10 to a postoperative average of 1. The ASES scores increased from a preoperative mean of 9 to a postoperative mean of 58. These results indicated that interposition arthroplasty with the pectoralis major muscle transfer is a reliable treatment method for the shoulder arthropathy improving shoulder pain, and patient satisfaction.