Spinal injuries in New Zealand rugby and rugby league--a twenty year survey.

AIMS: To establish trends in frequency of serious spinal cord injuries in rugby and rugby league over a 20 year period and to elucidate patterns of injury from retrospective analysis of cases admitted to New Zealand's two spinal injuries units. METHODS: A detailed survey of unit records with follow-up of selected patients; statistical analysis of data. RESULTS: During the 20 years 1976 to 1995, 119 rugby and 22 rugby league players (total 141) were admitted to New Zealand's two spinal injuries units suffering serious spinal injuries and 47 of these became permanently confined to wheelchairs. There was a steady increase in frequency throughout the period studied. Of the injuries 83% occurred in forwards and 17% in backs. In rugby it was the scrum which produced most injuries, and in rugby league it was the tackle. The early season month of April produced most spinal injuries. In the eighteen months since intense compulsory educational programmes on safety were introduced by the New Zealand Rugby Union there have been no serious spinal cord injuries from rugby scrums. CONCLUSION: Contrary to widespread belief, there has not been a decrease in spinal cord injuries in rugby following rule changes in the mid 1980s. The information produced by this retrospective study has been an effective educational platform to make rugby and rugby league safer.

7 alpha-methyl-19-nortestosterone facilitates sexual behavior in the male Syrian hamster.

Steroid hormones from the testes promote attraction to estrous females and facilitate copulation in the male Syrian hamster. We compared the ability of testosterone (T) and MENT, a potent synthetic androgen that does not undergo 5 alpha-reduction, to maintain sexual behavior in castrated males. Steroid treatment was initiated immediately after castration at three levels by means of Alzet osmotic pumps in sexually experienced adult male hamsters. Daily doses were 5, 25, or 100 micrograms T and 1, 5, or 25 micrograms MENT (n = 5/group). Additional castrated males (n = 5) remained untreated. Sexual behavior was recorded during two 10-min tests before, and at 2, 4, 6, and 8 weeks after orchidectomy. MENT and T maintained equivalent levels of behavior at each corresponding dose of androgen (high, medium, or low). The low dose of T or MENT failed to sustain mating behavior. Eight weeks after castration, males receiving the high and medium doses of androgens continued to express intromissions and ejaculations at gonadally intact levels. However, only males receiving the high dose showed anogenital investigation at the same level as intact males. From these data, we conclude that MENT sustains mating behavior in the male hamster, and that chemoinvestigatory behavior requires higher levels of androgens than those necessary for copulation.

Upper-limb surgery for tetraplegia.

We reviewed the results of reconstruction of 97 upper limbs in a consecutive series of 57 tetraplegic patients, treated from 1982 to 1990. Of these, 49 had functional and eight had cosmetic reconstructions. The principal functional objectives were to provide active elbow extension, hook grip, and key pinch. Elbow extension was provided in 34 limbs, using deltoid-to-triceps transfer. Hook grip was provided in 58 limbs, mostly using extensor carpi radialis longus to flexor pollicis longus transfer, and key pinch in 68, mostly using brachioradialis to flexor pollicis longus transfer. Many other procedures were employed. At an average follow-up of 37 months, 70% had good or excellent subjective results, and objective measurements of function compared favourably with other series. Revisions were required for 11 active transfers and three tenodeses, while complications included rupture of anastomoses and problems with thumb interphalangeal joint stabilisation and wound healing. We report a reliable clinical method for differentiating between the activity of extensor carpi radialis longus and brevis and describe a successful new split flexor pollicis longus tenodesis for stabilising the thumb interphalangeal joint. Bilateral simultaneous surgery gave generally better results than did unilateral surgery.

Sacral anterior root stimulation of the bladder in paraplegics.

A Brindley-Finetech sacral anterior root stimulator has been placed intradurally in the spinal canal around the S2, 3, 4 nerve roots in six paraplegics at the Burwood Spinal Injuries Unit, Christchurch, New Zealand. The apparatus developed by Professor G. S. Brindley and the Medical Research Council in London, UK, has proved very useful in driving micturition, in achieving a dry device-free interval between electromicturitions, in reducing the incidence of urinary tract infections, and in some males in achieving a sustained erection. The clinical results are presented with a urodynamic analysis of the outcome.

The Motor-Scooter Handlebar Syndrome: Report of a Case.

A case of acute arterial insufficiency of the right leg of a young man is described, following a blow on the inguinal region from the handlebar of a motor-scooter. A review of the literature suggests that this is an uncommon but clear-cut syndrome.