Biomedical subjects

J Tibone

Publications and source records attributed to J Tibone.

7 recordsLinked to original sources

PubMed1999

Extensor carpi radialis brevis. An anatomical analysis of its origin.

We studied the origin of extensor carpi radialis brevis using 40 fresh frozen human cadaver specimens. Ten were stained with haematoxylin and eosin and trichrome which showed the collagenous structure of the extensor tendons at their origin. Gross anatomical observation showed that there was no definitive separation between brevis and communis at the osseotendinous junction. The histological findings confirmed the lack of separation between the two tendons. The extensor tendons were in close proximity to the joint capsule but trichrome staining showed no interdigitation of the tendon with the capsule. The validity of ascribing the pain of lateral epicondylitis to extensor carpi radialis brevis must be questioned. It appears to arise more from the 'common extensor' origin.

Dissection↗

PubMed1990

Capsulorrhaphy with a staple for recurrent posterior subluxation of the shoulder.

Twenty athletes who had recurrent posterior subluxation of the shoulder, eight of whom also had associated anterior instability, were treated with capsulorraphy with a posterior staple. Nine patients had an unsatisfactory result: six had recurrence of the posterior instability and three still had moderate or severe pain. Five of six patients who had lax ligaments had a recurrence. Complications developed in five patients: pain from a staple in one, postoperative adhesions in two, and ectopic bone in two. Only one patient was able to throw as well as he had before the injury. Staple capsulorrhaphy is not acceptable treatment for posterior subluxation of the shoulder because it is associated with a high rate of failure and complications.

Adolescent↗

PubMed1988

Dynamic electromyographic analysis of the throwing shoulder with glenohumeral instability.

Fifteen male athletes who were skilled in throwing and who had chronic anterior instability of the shoulder (Group 1) were evaluated by dynamic intramuscular electromyography while pitching a baseball. Indwelling wire electrodes recorded the levels of activity in the biceps, middle deltoid, supraspinatus, infraspinatus, pectoralis major, subscapularis, latissimus dorsi, and serratus anterior throughout the entire pitching sequence. These signals were synchronized electronically with records of the pitch that were made using high-speed photography. The pitch was divided into five phases: wind-up, early cocking, late cocking, acceleration, and follow-through. The results were compared with previous identical studies of twelve healthy, uninjured male athletes who were skilled in throwing (Group 2). Activity increased mildly in the biceps and supraspinatus in Group 1 as compared with Group 2. Similar patterns of activity were demonstrated in the deltoid. In Group 1 the infraspinatus had increased activity during early cocking and follow-through but had decreased activity during late cocking. The pectoralis major, subscapularis, latissimus dorsi, and serratus anterior in Group 1 all were shown to have markedly decreased activity. The study revealed a difference between Groups 1 and 2 in all of the muscles of the shoulder that were tested with the exception of the deltoid. The mildly increased activity levels of the biceps and supraspinatus that were found in Group 1 may compensate for anterior laxity. The marked reduction in activity in the pectoralis major, subscapularis, and latissimus dorsi added to the anterior instability by decreasing the normal internal-rotation force that is needed during the phases of late cocking and acceleration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1978

Heterotopic ossification around the hip in spinal cord-injured patients. A long-term follow-up study.

Twenty patients with spinal cord injury complicated by ossification around the hip were followed for eighteen months or more. The bone scan, roentgenogram, level of alkaline phosphatase, and range of hip motion of each patient were analyzed. The average follow-up was forty months. The heterotopic ossification usually did not mature until after one and one-half years. The roentgenograms were of no value in judging its maturity. The bone scan correlated well with the results of the alkaline phosphatase testing in judging maturity of the ossification. We concluded that before operative resection, a patient should have a normal level of alkaline phosphatase, decreasing activity on the bone scans, and a restriction of motion to less than 50 degrees of hip flexion.

Adolescent↗

PubMedDate not supplied

Gore-Tex prosthetic ligament in anterior cruciate deficient knees.

Reconstruction for symptomatic anterior cruciate deficient knees has yielded varying success rates. Prosthetic cruciate replacement has recently become a potentially attractive alternative. The results of the Gore-Tex polytetrafluoroethylene ligament, which is intended as a permanent replacement, are reported. Eighty-two patients were followed prospectively, mean age was 28 years (range, 16 to 51 years) and mean followup was 18 months (range, 12 to 30 months). Subjective scores improved in all categories, including pain, swelling, giving way, locking, and stair climbing. All patients without complications had no episodes of actual giving way, considered themselves improved, and returned to activities of daily living at 3 weeks and athletics at 8 months. Range of motion lacking at 3 months was 2 degrees of extension and 10 degrees of flexion, and at 12 months was 0 degrees of extension and 4 degrees of flexion. All mean objective data, including the anterior drawer, Lachman, and pivot shift, demonstrated improvement at final followup. Cybex testing revealed improvement in relative quadriceps strength from 88% to 99%. The KT-1000 Arthrometer showed improvement in the injured-normal knee difference score throughout the follow-up period. Of importance is that while final objective data was improved over initial data, an early nonprogressive shift toward loosening was indicated by worsening of the drawer, Lachman, pivot shift, and KT-1000 scores. This shift may be attributed to resorption of interposed soft tissue, creep, or loosening of the graft. Subjective scores remained stable after improving. Complications included four ruptures, four chronic sterile effusions with partial attenuation, one infection, and one symptomatic loose body.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

EMG analysis of the scapular muscles during a shoulder rehabilitation program.

The purpose of this study was to determine which exercises most effectively use the scapular muscles. Eight muscles in 9 healthy subjects were studied with indwelling electromyographic electrodes and cinematography while performing 16 exercises. The 8 muscles studied were the upper, middle, and lower trapezius; levator scapula; rhomboids; pectoralis minor; and the middle and lower serratus anterior. Each exercise was divided into arcs of motion and the electromyographic activity was quantified as a percentage of the maximal manual muscle test. The optimal exercises for each muscle were identified based on intensity (greater than 50% maximal manual muscle test) and duration (over at least 3 consecutive arcs of motion) of the muscle activity. Twelve of the exercises qualified as top exercises for all of the muscles. On further analysis, a group of 4 exercises was shown to make up the core of a scapular muscle strengthening program. Those 4 exercises include scaption (scapular plane elevation), rowing, push-up with a plus, and press-up.

Adult↗

PubMedDate not supplied

Strength testing after third-degree acromioclavicular dislocations.

Twenty male patients with a grade III acromioclavicular joint dislocation were evaluated more than 2 years after their injury; the average followup was 4.5 years. Strength testing was performed with a Cybex II dynamometer in three planes evaluating flexion, extension, internal rotation, external rotation, abduction, and adduction at 60 and 120 deg/sec. Subjective complaints were minor and neither daily activities nor athletic participation were impaired. Objectively, only one patient had tenderness over the acromioclavicular joint. All patients had full motion and negative impingement signs. Strength testing with the Cybex II dynamometer showed no significant difference (P less than 0.05) between the injured and uninjured shoulder for strength in internal rotation, external rotation, abduction, adduction, extension, or flexion at speeds of 60 and 120 deg/sec. This study shows that the strength of the shoulder is not significantly affected by conservative treatment of grade III acromioclavicular dislocations. Conservative treatment results in minimal or no functional deficit. The authors recommend that grade III acromioclavicular dislocations be treated nonoperatively.

Acromioclavicular Joint↗