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Biomedical subjects

F W Jobe

Publications and source records attributed to F W Jobe.

At least 19 recordsLinked to original sources
PubMed1992

Medial instability of the elbow in throwing athletes. Treatment by repair or reconstruction of the ulnar collateral ligament.

From September 1974 to December 1987, seventy-one patients were operated on for valgus instability of the elbow. The average length of follow-up of sixty-eight patients (seventy operations) was 6.3 years (range, two to fifteen years). At the operation, a torn or incompetent ulnar collateral ligament was found. Fourteen patients had a direct repair of the ligament, and fifty-six had a reconstruction of the ligament using a free tendon graft. The result was excellent or good in ten patients in the repair group and in forty-five (80 per cent) in the reconstruction group. Seven of the fourteen patients who had a direct repair returned to the previous level of participation in their sport. Of the fifty-six who had a reconstruction, thirty-eight (68 per cent) returned to the previous level of participation. Twelve of the sixteen major-league baseball players who had a reconstruction as the primary operation (no previous operation on the elbow) were able to return to playing major-league baseball, and two of the seven major-league players who had a direct repair returned to playing major-league baseball. Previous operations on the elbow decreased the chance of returning to the previous level of sports participation (p = 0.04). Fifteen patients had postoperative ulnar neuropathy. This was transient in six patients, only one of whom was unable to return to the previous level of sport. The other nine patients had an additional operation for the neuropathy; four were able to return to the previous level of sport.

Adult↗
PubMed1991

Surgical treatment of medial epicondylitis. Results in 35 elbows.

We reviewed 35 of 38 consecutive patients who had operative treatment for medial epicondylitis of the elbow after the failure of conservative management. Their mean age was 43 years and mean follow-up was 85 months. At operation residual tears with incomplete healing were consistently found in the flexor origin at the medial epicondyle and microscopy showed reactive fibrous connective tissue with varying degrees of inflammation. The mean subjective estimate of elbow function was improved from 38% to 98% of normal, while isokinetic and grip strength testing in 16 patients showed no significant difference from the unoperated elbow. Results were excellent in 25 cases, good in nine and fair in one; 86% of the patients had no limitation in the use of the elbow.

Adult↗
PubMed1991

Golf for the mature athlete.

Golf is a different sport from all others discussed in this issue in one important aspect: Almost all of its practitioners play more, rather than less, as they mature. A great many of them play better, too. This additional play and skill can be highly satisfying to the participants; however, it puts them at risk for a number of overuse syndromes directly caused by the motion requirements of golf. In addition, the repetitive nature of the activity can exacerbate pre-existing and age-related orthopedic pathology as well. There is no substitute for attention to the preplay aspects of golf (warm-up, flexibility, and strengthening).

Aged↗
PubMed1991

The elbow.

Explore the source record for details and available documents.

Adult↗
PubMed1989

The diagnosis and nonoperative treatment of shoulder injuries in athletes.

The specific emphasis in this article has been directed toward the diagnosis of prevalent shoulder pathology in a young athletic population; however, as the interest in sports has blossomed in recent years now encompassing a larger age range, the physician must not neglect common pathologic conditions of the older athletes. Fastidious adherence to complete history, physical examination, and a high level of suspicion for uncommon disorders is paramount. Arthritides such as osteo, rheumatoid, septic, and lyme as well as the hematologic disorders of multiple myeloma, lymphomas, leukemia, hemophilia, and Gaucher's disease can all present with shoulder pain. Thoracic outlet syndrome, scalene syndrome, supra-scapular nerve syndrome, and quadrilateral space syndrome comprise a group of nerve compression syndromes that are becoming more apparent as our diagnostic skills improve. Yet, the most pervasive disorders in the young athlete are due to lack of shoulder stability. By understanding the delicate balance in normal shoulder between mobility and stability, the clinician is better able to conceptualize the etiology and progression of the problem, and design the optimal treatment program.

Athletic Injuries↗
PubMed1989

Impingement problems in the athlete.

In summary, there is a delicate balance between the mobility and the stability of the shoulder joint. The young athlete involved in overhand sports is at risk for injury, and must be clinically evaluated and treated differently from the rest of the population. Shoulder impingement and instability are a continuum of abnormalities, beginning with instability and progressing to subluxation, impingement, and, finally, rotator cuff tear. Thus, it is crucial to deal with the core of the problem, (that is, the instability) before dealing with the impingement. A kinesiologic repair is desirable. If that fails, or if there is anatomic damage, an anatomic repair is done. The anterior capsular labral reconstruction is a surgical procedure designed with biomechanical and kinesiologic principles in mind. A rehabilitation program is initiated immediately after surgery. The rehabilitation program is just as important as the surgery.

Adult↗
PubMed1989

Shoulder pain in the overhand or throwing athlete. The relationship of anterior instability and rotator cuff impingement.

Shoulder pain in the overhand or throwing athlete can often be traced to the stabilizing mechanisms of the glenohumeral joint. During the physical examination, signs of impingement will often be obvious, whereas subluxation signs are subtle. Use of the Apprehension Test followed by the Relocation Test has proved to be the most sensitive means of detecting occult anterior glenohumeral subluxation. When subluxation is suspected, an examination under anesthesia and orthroscopy are the most helpful next step. Patients can be classified into one of four groups on the basis of the results of the examinations. If conservative rehabilitation fails, then surgery may be considered.

Adolescent↗
PubMed1988

Rotator cuff injuries in baseball. Prevention and rehabilitation.

Rotator cuff and ligamentous capsule injuries are common in the young baseball player. In order to understand these injuries, it is important to first appreciate the delicate balance between shoulder mobility and stability as well as the biomechanics of throwing. This background information makes it easy to see how shoulder injuries are really part of a progressive continuum beginning with instability leading to subluxation, and later impingement which can result in a rotator cuff tear. A detailed and precise history and physical is crucial in determining where a patient might be on the continuum. An accurate evaluation will also help appropriately place a patient in one of the following 4 groups: pure impingement, anterior instability due to trauma with secondary impingement, anterior stability due to a hyperelasticity with secondary impingement, and pure anterior instability. A kinesiological repair is the initial treatment of choice. It is the best preventative or early treatment available, and consists of a specific strengthening programme. If this fails (as in only 5 to 10% of the cases), an anatomical repair is instituted. There are 4 basic guidelines when doing this surgery: (a) maintain muscle attachments and proprioceptive fibres; (b) do not shorten the capsule significantly; (c) build up the anterior labrum; and (d) regain full range of motion quickly through abduction splinting and rehabilitation. A postoperative rehabilitation programme is then diligently adhered to, as it is at least as important as the surgery itself.

Adolescent↗
PubMed1987

Rehabilitation of shoulder joint instabilities.

The overall goal of the rehabilitation period is a return to full range of motion and a strengthening of the muscles that have a role in protecting the shoulder from injury. Rehabilitation is accomplished gradually and is performed initially in a limited range that excludes the terminal 30 degrees at either end. Two key muscle groups are to be strengthened. One group is for the glenohumeral joint: the deltoid, latissimus dorsi, pectoralis major, and the rotator cuff muscles--especially the subscapularis muscle for internal rotation and the infraspinatus and the teres minor muscles for external rotation. The second group, the trapezius, rhomboids, and serratus anterior muscles, is strengthened for scapular control. Finally, general conditioning and trunk flexibility exercises are critical for a return to former competitive levels.

Exercise Therapy↗
PubMed1986

Electromyography and motion analysis of the upper extremity in sports.

This article reviews the results of studies using electromyographic recordings to determine muscle function during athletic activities. Electromyographic recordings were synchronized with high-speed film to provide information on shoulder muscle firing patterns during baseball pitching, swimming, tennis, and golf. The information obtained about the contributions of specific muscles during these activities may be useful in developing effective injury prevention and rehabilitation strategies.

Baseball↗
PubMed1986

Surgical treatment of tears of the rotator cuff in athletes.

Forty-five athletes with either a partial or a complete tear of the rotator cuff were treated with anterior acromioplasty and repair of the tear. The minimum duration of follow-up was twenty-four months (average, forty-two months). Thirty patients had an incomplete tear and fifteen had a complete tear. Postoperatively, thirty-nine (87 per cent) of the patients stated that they were improved compared with their preoperative status, although only thirty-four patients (76 per cent) felt that they had a significant reduction of pain postoperatively. Objectively, twenty-five (56 per cent) of the patients were rated as having a good result, which allowed them to return to their former competitive level without significant pain. Twelve (41 per cent) of the twenty-nine athletes who had been involved in pitching and throwing returned to their former competitive status. Seven (32 per cent) of the twenty-two pitchers and throwers who had been active at a professional or collegiate level returned to the same competitive level. In our experience, a repair of the rotator cuff combined with an acromioplasty in a young athletic population provides satisfactory relief of pain but does not guarantee that the patient will be able to return to his or her former competitive status in all sports.

Acromion↗
PubMed1986

Throwing injuries of the elbow.

With the burgeoning popularity of racquet and throwing sports in our society, an increasing awareness of the elbow injuries sustained with repetitive upper extremity activity is important. Particular attention should be paid to proper technique, equipment, and duration of activity, and preventive measures should be taken. In the adolescent or adult individual who sustains elbow injury, it is imperative that the treating physician recognize the pathologic stage early in order to minimize the consequences of these activities. Only with a thorough history and physical examination of this complex joint and a firm understanding of the forces generated during activity will the sports medicine physician entertain the proper diagnosis and initiate a treatment protocol that is likely to be successful.

Athletic Injuries↗
PubMed1986

Reconstruction of the ulnar collateral ligament in athletes.

Reconstruction of the ulnar collateral ligament using a free tendon graft was performed on sixteen athletes. All participated in sports that involved throwing (mostly professional baseball), and all had valgus instability of the elbow. After reconstruction and rehabilitation, ten of the sixteen patients returned to their previous level of participation in sports, one returned to a lower level of participation, and five retired from professional athletics. Despite precautions, there was a high incidence of complications related to the ulnar nerve. Two patients had postoperative ulnar neuropathy (one late and one early) that required a secondary operation, but they eventually recovered completely. Three others reported some transient postoperative hypoesthesia along the ulnar aspect of the forearm that resolved after a few weeks or months.

Adult↗
PubMed1985

The coracoid transfer for recurrent anterior instability of the shoulder in adolescents.

Thirty-six shoulders with recurrent anterior dislocation or subluxation in thirty-four adolescent patients were treated with a modified Bristow procedure. The average length of follow-up was five years and ten months. Postoperatively, two patients had recurrent anterior subluxation on one occasion and none had recurrent anterior dislocation. The average loss of external rotation was 10 degrees. Despite the fact that young patients have a high rate of recurrence after anterior dislocation or subluxation of the shoulder, the modified Bristow procedure is an effective method of treating recurrent anterior instability of the shoulder in adolescents.

Adolescent↗
PubMed1985

Shoulder impingement syndrome in athletes treated by an anterior acromioplasty.

Shoulder pain caused by a impingement syndrome commonly affects an athlete's performance. Thirty-five shoulders in 33 athletes had an impingement syndrome treated by an anterior acromioplasty after failure of conservative treatment. Thirty-one of 35 shoulders (89%) were subjectively judged improved by the patients from their preoperative status. The moderate and severe pain was reduced from 97% of the shoulders preoperation to 20% postoperation. The pain at rest and with activities of daily living was reduced from 71% of the shoulders preoperation to 9% postoperation. However, only 15 of 35 operated shoulders (43%) allowed return to the same preinjury level of competitive athletics, and only four of 18 athletes involved in pitching and throwing returned to their former preinjury status. This operation is satisfactory for pain relief but does not allow an athlete to return to his former competitive status. A prolonged rehabilitation program may improve the results.

Acromion↗
PubMed1979

Isolated lateral meniscectomy. A study of twenty-six patients with isolated tears.

To better define the role that the lateral meniscus plays in stabilizing the knee, a study was made of twenty-six patients who had an uncomplicated lateral meniscectomy between 1972 and 1977. Patients with any degree of ligament instability, cruciate or collateral, prior to lateral meniscectomy were eliminated from the study. Also eliminated were any patients with roentgenographic evidence of degenerative arthrits, osteochondritis dissecans, or loose bodies. Only patients whose operative reports stated that the articular cartilage of the lateral compartment was either grossly normal or showed Grade-1 chondromalacia (less than one centimeter in diameter and only softening of the cartilage) at the time of surgery were included in the review. The meniscal lesions included bucket-handle tears, horizontal cleavage tears, and multiple linear defects. No grossly cystic menisci were included in the study. Two menisci demonstrated cystic degenerative changes on histological section. In sixteen patients some degree of ligament instability developed. The longer the interval between injury to the meniscus and its excision, the less satisfactory the result. Only fifteen (54 per cent) of the patients reported satisfactory results, and twenty lost some motion of the knee. We concluded that stability of the knee joint is a multifactorial problem, in which the lateral meniscus certainly plays an important part.

Adolescent↗
PubMed1977

Human patellar-tendon rupture.

The first biomechanical analysis of a human patellar-tendon rupture during actual sports competition is reported. Cinematographic data for analysis were collected at a national weight-lifting championship. Dynamic equations to mathematically model the lifter were developed to compute time course and magnitudes of hip, knee and ankle-joint moments of force and of tensile loading of the patellar tendon before and during tendon trauma. Results provided evidence that the range of maximum tensile stress of the tendon may be considerably greater during rapid dynamic loading conditions, as in many sports situations, than maximum tensile stress obtained during static test conditions.

Adult↗