PubMed HealthSearch

Biomedical subjects

D H Janda

Publications and source records attributed to D H Janda.

9 recordsLinked to original sources

Softball injuries. Aetiology and prevention.

Over 40 million individuals nationally participate in organised softball leagues, playing an estimated 23 million games per year in the United States. It has also been estimated that softball causes more injuries leading to emergency room visits in the United States than any other sport. Between 1983 and 1989, over 2.6 million injuries were documented through selected emergency rooms throughout the United States. In addition, the potential costs of these injuries can be staggering, therefore, prevention is of utmost importance. Prior to implementation of any preventative measures, the aetiology and distribution of injuries must be ascertained. Softball-related injuries can be grouped into 3 categories: (a) sliding-related injuries--the most common injury scenario; (b) collision-related injuries; and (c) falls sustained by the player. Various preventative approaches have been utilised to reduce the incidence of these recreational sports injuries and the associated health care costs. In regard to sliding-related injuries, breakaway bases have been utilised and have been found to reduce sliding-related injuries by approximately 98%. In reference to collision injuries, deformable walls and padded back stops and field maintenance have been found to prevent the majority of injuries secondary to collisions and falls. In addition, better coaching techniques as well as stretching and conditioning programmes have all been found to benefit players in the prevention of their injuries. As physicians, trainers and individuals involved with sporting activities, it is imperative that we turn and focus our attention on prevention. The cornerstone to diminished injuries and subsequent prevention of an injury is a safer environment for the recreational softball player to participate in.

Athletic Injuries

Basic science and clinical application in the athlete's shoulder. A preventative program focusing on the glenohumeral joint.

This program can be implemented as either a preventative program or a rehabilitative program for the upper extremity in the throwing athlete or in nonthrowing athletes involved in overhead activities. The authors have found this program to be easily employed in a university setting. The keystone to its effectiveness is the participating individual. For optimal results, it should be performed as specifically outlined. The likelihood that shoulder symptomatology will develop is higher now that more people are participating in recreational and team sports for cardiovascular fitness. It is, therefore, imperative that a preventative program be developed in both the recreational and professional athletic population.

Athletic Injuries

Nonhuman primate bites.

Nonhuman primate (monkey) bites to researchers and attending animal care staff may present problems in patient management. Such inoculations can transmit serious bacterial and viral infections to the human handlers. Significant local and systemic manifestations can subsequently develop following such an injury. Since Herpesvirus simiae (B virus) is enzootic in Asiatic monkeys of the genus Macaca, and since B virus infection in humans is usually fatal, additional prophylactic and therapeutic measures must be taken when persons are bitten by macaque monkeys. Primate bites require early aggressive intervention.

Acyclovir

Softball sliding injuries. A prospective study comparing standard and modified bases.

In a previous retrospective study, base sliding was found to be responsible for 71% of recreational softball injuries. As most injuries occurred following rapid deceleration impact against stationary bases, quick-release (breakaway) bases were evaluated as a means to modify this mechanism of injury. Six hundred thirty-three softball games were played on breakaway-base fields and 627 games were played on stationary-base fields. Forty-five sliding injuries (7%) occurred on the stationary-base diamonds and only two sliding injuries (less than 1%) occurred on the breakaway-base fields. Implementing the use of breakaway bases in recreational softball leagues could potentially achieve a significant, cost-effective reduction of injuries.

Adult

Objective evaluation of grip strength.

The objective and subjective components of industry-related injuries can lead to difficulties in diagnosis and treatment efforts. Grip strength determinations provide an objective measure that facilitates the evaluation of many occupation-related injuries. In this current study, healthy volunteers were evaluated with standard grip strength measurement and electromyographic recordings in order to characterize normal patterns. These recordings were found to be relatively uniform and reproducible.

Disability Evaluation

The Bankart repair illustrated in cross-section. Some anatomical considerations.

The Bankart repair for chronic anterior shoulder instability effectively addresses the pathologic components responsible for repeated dislocation or subluxation. However, contrary to popular belief, the Bankart repair does not precisely restore the premorbid anatomy. The capsule is reattached to the boney rim of the anterioinferior glenoid deep to and lateral to the torn cartilagenous labrum, thus excluding the labrum from the joint anteriorly. This was demonstrated by cross-sectional cadaver dissections performed to illustrate this complex surgical anatomy to orthopaedic residents in training. In addition, when correlated with double-contrast computerized axial tomography, we noted five predominant patterns of anatomical lesions which by common use have been collectively termed the "Bankart lesion." These are: 1) the rare "classic" Bankart lesion in which the cartilagenous labrum and capsular origin are torn from the glenoid rim; 2) the capsule stripped from the scapular neck and the labrum detached from the glenoid rim remaining fixed to the overlying capsule; 3) the capsule stripped from the scapular neck and the labrum separated from the glenoid rim, but separately; 4) the labrum abraded away and no longer radiographically detectable; and 5) glenoid rim fracture.

Humans

A three-phase analysis of the prevention of recreational softball injuries.

Recreational sports injuries are expensive to society. Prevention of such injuries must be a major public health goal. In a previous retrospective study, base sliding was found to be responsible for 71% of recreational softball injuries. Because most injuries occurred during rapid deceleration against stationary bases, quick-release (break-away) bases were evaluated as a means to modify this mechanism of injury. In a prospective study, 633 softball games were played on a break-away base fields and 627 games were played on stationary base fields. Forty-five sliding injuries occurred on the stationary base diamonds (1 injury for every 13.9 games) and only two sliding injuries occurred on the break-away fields (1 injury for every 316.5 games). The medical costs for injuries on the stationary base fields was 79 times greater than that on the break-away fields. In a 1035 game follow-up study performed on all fields equipped with break-away bases, two sliding injuries occurred (1 injury for every 517.5 games). Installing break-away bases in fields used by recreational leagues would achieve a significant reduction of serious softball injuries (98%) and, therefore, should be mandatory. Based on our findings, the Centers for Disease Control has estimated 1.7 million injuries would be prevented nationally per year, saving $2.0 billion per year nationally in acute medical care costs.

Adolescent