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Biomedical subjects

B R Mandelbaum

Publications and source records attributed to B R Mandelbaum.

24 records · Page 2Linked to original sources
PubMedDate not supplied

Achilles tendon ruptures. A new method of repair, early range of motion, and functional rehabilitation.

We prospectively treated 29 athletes who had Achilles tendon ruptures according to a functional rehabilitation protocol. The 25 male and 4 female patients had a mean age of 35 years (range, 19 to 56). The repair was performed with a Krackow suture of No. 2 nonabsorbable polyfilament. Patients began range-of-motion exercises 72 hours after surgery, used a posterior splint for 2 weeks, and then began ambulation in a hinged orthosis. Six weeks after surgery, use of the orthosis was discontinued, full weightbearing was allowed, and progressive resistance exercises were initiated. Isokinetic strength and endurance testing were performed at 3, 6, and 12 months after surgery. There were no reruptures. Two patients developed superficial wound infections that responded to debridement or local wound care. One patient suffered a pulmonary embolism. At 3 months' followup, isokinetic testing showed the mean functional deficits were 36% and 35% of the opposite leg at 60 and 120 deg/sec, respectively. By 6 months, the mean deficits were 2.9% and 2.3% at 60 and 120 deg/sec, respectively. All patients returned to preinjury activity levels at a mean of 4 months (range, 3 to 7) after repair. By 12 months, there were no significant differences in ankle motion, isokinetic strength, or endurance as compared with the uninvolved side.

Achilles Tendon↗
PubMedDate not supplied

Factors associated with wrist pain in the young gymnast.

We conducted a cross-sectional survey of 52 nonelite gymnasts (32 girls, 20 boys; average age, 11.8 years) to assess their history of training and wrist pain within the last 6 months. An intensity index was created using the number of training hours per week and the athletes' skill levels. Wrist pain was prevalent in 38 (73%) of the gymnasts. Gymnasts with wrist pain were older (12.6 years versus 9.7 years; P = 0.0002), trained more hours per week (13.5 versus 7.7; P = 0.0002), trained at a higher skill level (P = 0.01), and began training at an older age (7.0 years versus 5.1 years; P = 0.006). Analysis of intensity versus age suggested that a threshold of training intensity may be important in the development of wrist pain. Logistical regression found these factors to be independently associated with wrist pain: intensity (P = 0.036), age > 10 years (P = 0.018), age < 14 years (P = 0.016), and the age of initiation of training (P = 0.020). This study demonstrates that wrist pain is a common problem among nonelite young gymnasts. Training intensity, relative to the age of the participant and the age when training was initiated, appears to be an important determinant of the development of wrist pain in this population.

Adolescent↗
PubMedDate not supplied

Acute and chronic brain injury in United States National Team soccer players.

We designed a study to determine whether chronic encephalopathy occurs in elite, active soccer players resulting from repetitive heading of the soccer ball. Studies have suggested that the cumulative effects of heading a ball can cause a chronic brain syndrome similar to dementia pugilistica, which is seen in professional boxers. Twenty of 25 members of the U.S. Men's National Soccer Team training camp (average age, 24.9; average years of soccer, 17.7), who completed a questionnaire on head injury symptoms and had magnetic resonance imaging of the brain, were compared with 20 age-matched male elite track athletes. The soccer players were surveyed about playing position, teams, number of headers, acute head injuries, and years of playing experience. An exposure index to headers was developed to assess a dose-response effect of chronic heading. The soccer and track groups were questioned regarding alcohol use and history of acute head traumas. Questionnaire analysis and magnetic resonance imaging demonstrated no statistical differences between the two groups. Among the soccer players, symptoms and magnetic resonance imaging findings did not correlate with age, years of play, exposure index results, or number of headers. However, reported head injury symptoms, especially in soccer players, correlated with histories of prior acute head injuries (r = 0.63). These findings suggest that any evidence of encephalopathy in soccer players relates more to acute head injuries received playing soccer than from repetitive heading.

Acute Disease↗
PubMedDate not supplied

Distal radial growth plate injury and positive ulnar variance in nonelite gymnasts.

To assess the prevalence of stress injury to the distal radial growth plate and of positive ulnar variance in a nonelite gymnast population, we administered a radiographic survey and questionnaire to 44 skeletally immature nonelite gymnasts (27 girls and 17 boys). The subjects trained an average of 11.9 hours per week. Radiographic findings consistent with stress injury of the distal radial physis were found in 25% (11 of 44) of participants. Ulnar variance was found to be more positive in the gymnasts when compared with age-predicted norms. An average side-to-side difference in ulnar variance of 0.9 mm was observed. Radiographic findings of stress injury to the growth plate and the amount of ulnar variance were not associated with age, sex, training intensity, wrist pain, height, or weight. There was also no significant relationship between ulnar variance and radiographic findings. The mean ulnar variance in nonelite gymnasts was between that measured for elite gymnasts and nongymnasts. These results indicate that stress injury of the distal radial growth plate occurs in a significant percentage of nonelite gymnasts. It also appears that ulnar variance is more positive than would otherwise be predicted, suggesting growth inhibition of the distal radius, a growth stimulation of the ulna, or a combination of both.

Adolescent↗
PubMedDate not supplied

Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies.

An estimated 80,000 anterior cruciate ligament (ACL) tears occur annually in the United States. The highest incidence is in individuals 15 to 25 years old who participate in pivoting sports. With an estimated cost for these injuries of almost a billion dollars per year, the ability to identify risk factors and develop prevention strategies has widespread health and fiscal importance. Seventy percent of ACL injuries occur in noncontact situations. The risk factors for non-contact ACL injuries fall into four distinct categories: environmental, anatomic, hormonal, and biomechanical. Early data on existing neuromuscular training programs suggest that enhancing body control may decrease ACL injuries in women. Further investigation is needed prior to instituting prevention programs related to the other risk factors.

Adult↗