Treatment of typical trampoline fracture of the proximal tibia in children: results of minimum 1 year follow-up.

PURPOSE: To evaluate the results of trampoline fracture of the proximal tibia treated with either external fixator or conservative management at a minimum 1-year follow-up. METHODS: A retrospective review was performed on 22 children who between January 2005 and November 2013 presented with proximal metaphyseal fracture due to trampoline injury. Proximal metaphyseal fractures in 22 pediatric patients were clinically and radiologically evaluated. Of 22 subjects, 9 were male, 13 were female, and mean age was 4.2 years (range 2-7). RESULTS: In terms of comorbid injury, 1 proximal humerus fracture, two distal humerus fractures were present. Injury mechanism-wise, jumping with companions who had a weight difference accounted for 16, similar age, but jumping with multiple companions were three, direct crush were three. There were no differences in the valgus angle or length of the legs during the 2 year follow-up period. However, epiphyseal tibia shaft angle significantly decreased and proximal epiphysis was found to be flat compared to the contralateral side. CONCLUSION: Jumping with companion with a large difference in body weight, the first experience of jumping on trampoline and state of extension of knee at the time of injury was revealed to be risk factors for trampoline fractures. During a follow-up period of 1 year or longer, it was concluded that valgus deformity of lower extremity or leg length discrepancy were not noticeable.

What Is the Most Effective Eccentric Stretching Position in Lateral Elbow Tendinopathy?

BACKGROUND: A variety of treatment options suggest that the optimal treatment strategy for lateral elbow tendinopathy (LET) is not known, and further research is needed to discover the most effective treatment for LET. The purpose of the present study was to verify the most effective position of eccentric stretching for the extensor carpi radialis brevis (ECRB) in vivo using ultrasonic shear wave elastography. METHODS: A total of 20 healthy males participated in this study. Resting position was defined as 90° elbow flexion and neutral position of the forearm and wrist. Elongation of the ECRB was measured for four stretching maneuvers (forearm supination/pronation and wrist extension/flexion) at two elbow angles (90° flexion and full extension). The shear elastic modulus, used as the index of muscle elongation, was computed using ultrasonic shear wave elastography for the eight aforementioned stretching maneuverangle combinations. RESULTS: The shear elastic modulus was the highest in elbow extension, forearm pronation, and wrist flexion. The shear elastic moduli of wrist flexion with any forearm and elbow position were significantly higher than the resting position. There was no significant difference associated with elbow and forearm positions except for elbow extension, forearm pronation, and wrist flexion positions. CONCLUSIONS: This study determined that elbow extension, forearm pronation, and wrist flexion was the most effective eccentric stretching for the ECRB in vivo.

What are the anatomical predictive factors of degenerative superior labrum anterior to posterior lesion in rotator cuff tear?

The purpose of this study was to evaluate the influence of anatomical factors degenerative superior labrum anterior to posterior lesion in rotator cuff tear. The study included 421 middle-aged patients treated using arthroscopic surgery for rotator cuff tears. Patients were divided into two groups based on the superior labrum anterior-to-posterior (SLAP). Glenoid inclination, glenoid length, humeral head diameter, acromio-humeral distance (AHD) head-glenoid difference (HGD), head glenoid angle (HGA), size and retraction of rotator cuff tears were evaluated in both groups. In conclusion, a HGD exceeding 10 mm could be anatomically predictive of degenerative SLAP. LEVEL OF EVIDENCE: Case series, Level IV.