High school cross country running injuries: a longitudinal study.

OBJECTIVE: To determine the incidence rate of injury among high school cross country runners over a 15-year period. DESIGN: Prospective-longitudinal. SETTING: Twenty-three high schools in western Washington State under the surveillance of the University of Washington Athletic Health Care System between 1979-1994. PARTICIPANTS: One hundred and ninety-nine cross country teams. MAIN OUTCOME MEASURE: Injuries resulting from running in a cross country practice or meet. RESULTS: There were 1,622 injuries for an overall injury rate of 13.1/1,000 athletic exposures (AEs), i.e., participation of a runner in a practice or meet. Girls had a significantly higher overall injury rate (16.7/1,000 AEs) than boys (10.9/1,000 AEs) (p < 0.0001). Girls also had significantly higher injury rates than boys for both initial (p < 0.0001) and subsequent injuries (p < 0.0001), especially those at the same body location (p = 0.0001). This difference in risk estimates was consistent over a 15-year period. Nearly three-fourths of the injuries resulted in < or =4 days of disability. Overall, higher rates of initial injuries were reported during practices (9.2/1,000 AEs) than in meets (7.8/1,000 AEs) (p = 0.04). Shin injuries had the highest overall rates of new injury (1.9/1,000 AEs) and reinjury at the same body location (53.9/1,000 AEs). Girls had significantly higher initial injury rates than boys for shin (p < 0.0001), hip. and foot injuries (p < 0.01), and higher reinjury rates for knee. calf, and foot injuries, respectively (p < 0.05). CONCLUSION: The results of this study suggest that girl cross country runners are at higher risk of injury and reinjury than boy cross country runners.

Osteosarcoma of the meninges in association with glioblastoma.

Primary intracranial osteosarcoma not originating in the skull is a distinctly rare tumour, as is post-irradiation sarcoma of short latency. The authors report the case of a 56 year old caucasian male who underwent resection of a glioblastoma of the left temporal region and was subsequently administered partial field external beam radiation therapy (XRT) to a total dose of 5940 cGy. Seven months following the completion of XRT, an enhancing region adjacent to the surgical site was noted on followup magnetic resonance images (MRI), one which increased in size on serial studies. Initial biopsy of the dural lesion adjacent to the temporal resection site revealed a sarcoma with a suggestion of osseous differentiation. Subsequent reoperation with resection of the lesion showed it to be a primary meningeal tumour, and histological evaluation of the lesion demonstrated an osteosarcoma. Immunohistochemical staining for p53 protein performed on both the original glioblastoma and the subsequently resected osteosarcoma showed widespread nuclear positivity. The clinical, radiographic and pathologic features of this unusual case are discussed. Meningeal osteosarcoma should be included among the rare secondary sarcomas of the meninges which may be associated with malignant glioma.

Surgical management of lumbar neuropathic spinal arthropathy (Charcot joint) after traumatic thoracic paraplegia: report of two cases.

Two cases of successful surgical treatment of neuropathic spinal arthropathy (Charcot joint) are reported. Each patient was first seen several years after traumatic paraplegia. One patient had progressive kyphosis and the other had severe pain. Symptoms were relieved in both patients after interbody fusion and posterior fixation by using the lateral extracavitary approach to the spine. Both patients remain symptom free several years after the surgery. Fusion should be performed in symptomatic patients with neuropathic spinal arthropathy: this can be combined with posterior fixation in a single stage by using the lateral extra-cavitary approach.

Identification of exercise-induced asthma among intercollegiate athletes.

Nine hundred eight-three new intercollegiate athletes were evaluated to estimate the frequency of exercise-induced asthma (EIA). Medical history was obtained using a specifically structured interview. Athletes were selected for exercise testing based on positive responses to questions regarding symptoms of respiratory distress after strenuous exercise. Exercise testing was performed in a controlled laboratory setting using a standard exercise protocol. A laboratory diagnosis of EIA was made if the forced expiratory volume in one second (FEV1) fell greater than or equal to 10%, forced expiratory flow at 25% to 75% of vital capacity (FEF25-75%) fell greater than or equal to 20%, and/or peak expiratory flow rate (PEFR) fell greater than or equal to 12.5% after exercise. The frequency of EIA was 2.8%; only nine of the 28 athletes with EIA were detected prior to arrival at college.

The Athletic Health Care and Training Program. A comprehensive approach to the prevention and management of athletic injuries in high schools.

The Athletic Health Care and Training Program was developed to meet the educational, organizational and record-keeping needs of the interscholastic athletic program of the Seattle Public Schools. The program components were the education of coaches, school nurses and student trainers; development of a centralized training room; implementation of written procedures, and establishment of a record-keeping system. At the end of the three-year study period, schools involved in the program were better prepared to handle emergencies than were control schools. Schools involved in the program were found to have an injury-recognition rate comparable to that previously reported for high schools that had athletic trainers, a rate substantially higher than that in the control schools. The experimental schools were judged to have managed these injuries satisfactorily 95% of the time, compared with a satisfactory management rate of 14% for the control schools.