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Biomedical subjects

M R Hutchinson

Publications and source records attributed to M R Hutchinson.

17 recordsLinked to original sources
PubMed1999

Low back pain in elite rhythmic gymnasts.

BACKGROUND: Rhythmic gymnastics is a sport that blends the athleticism of a gymnast with the grace of a ballerina. The sport demands both the coordination of handling various apparatus and the flexibility to attain positions not seen in any other sport. To attain perfection and reproducibility of their routines, the athletes must practice and repeat the basic elements of their routines thousands of times. In so doing, the athlete places herself at risk of a myriad of overuse injuries, the most common being low back pain. METHODS: To document the presence and severity of low back pain in elite rhythmic gymnasts, a prospective study of seven national team members was undertaken that documented injuries and complaints with daily medical reports over a 7-wk period. These findings were correlated with a retrospective review of 11 elite level gymnasts followed over a 10-month period whose complaints ultimately required evaluation by a physician. RESULTS: Eighty-six percent of the gymnasts in the prospective study complained of back pain at some point over the course of the study. The only injury recorded that required a time loss from sport was a low back injury. The most common complaint requiring a physician's evaluation was low back pain with the diagnoses varying from muscle strains to bony stress reaction or complete fracture of the pars inter-articularis (spondylolysis). No athlete had a spondylolisthesis or ruptured disk. Two had mild scolioses which did not appear to be associated with their low back pain. CONCLUSIONS: It would appear that rhythmic gymnasts are at relative increased risk of suffering low back complaints secondary to their sport.

Adolescent↗
PubMed1998

Comparison of injury patterns in elite hockey players using ice versus in-line skates.

PURPOSE: The purpose of this study was to assess the variation of injury patterns between hockey players who use in-line roller skates versus those who use ice skates. METHODS: Injury surveillance was undertaken on three professional hockey teams. Two performed on in-line skates and one performed on ice skates. Injury patterns including mechanism of injury, anatomic location, time-loss from sport, and injury type were evaluated with respect to the use of type of skate. The number of athletic exposures (AE) was calculated for each athlete to establish a relative risk. All athletes were elite professional athletes, and injuries were recorded and categorized by a certified athletic trainer or physician. RESULTS: Of the 215 games and 1122 athletic exposures evaluated, 142 injuries were recorded that required an evaluation by a physician and 46 of those required a time loss from sport. The total injury rate was similar between the two sports (in-line: 139 per 1000 AE; ice: 119 per 1000 AE) although injuries tended to be more severe in ice hockey (average time loss from sport: ice, 8.3 games; in-line, 6.5 games). CONCLUSIONS: Comparison of injury patterns by anatomic location, mechanism of injury, and injury type were similar between players using the two types of skates except that ice skates were associated with an increase in the number of lacerations, in-line skates were associated with an increased number of injuries secondary to checking and a decreased number of injuries relative to skate equipment, and ice hockey had an increased risk of head and neck injuries compared with hockey on in-line skates.

Female↗
PubMed1998

Improving leaping ability in elite rhythmic gymnasts.

PURPOSE: The purpose of this study was to improve the leaping ability of athletes in rhythmic gymnastics, a high leap demanding sport, using a controlled course of jump training. METHODS: Six elite athletes underwent a course of leap training including pool training and Pilates' Method of Body Conditioning using spring controlled resistance to muscular exertion. Baseline data was obtained on a force plate that measured reaction time, leap height, and explosive power on each athlete before initiating training. RESULTS: After 1 month of training, leap height improved 16.2%, ground reaction time improved 50%, and explosive power improved 220%. With continued maintenance training, no decrease in effect was noted; however, no significant improvement occurred after the first month of training. At 1 yr with discontinuation of the leaping protocol but continued training within the sport, the initial gains were likewise maintained. No injuries occurred during participation in the leaping protocol. CONCLUSIONS: Elite rhythmic gymnasts can safely improve their leaping ability significantly through an intense course of jump training. Continued training with the leaping protocol does not appear to further enhance the benefit; however, the gains appear to be maintained at 4 months and 1 yr post training with or without additional training with the leaping protocol.

Adolescent↗
PubMed1998

Common sports injuries in young tennis players.

Tennis is a popular racquet sport played by boys, girls, men and women. Tennis players frequently begin playing in childhood and may continue playing into late adulthood. Preadolescent and adolescent players have open growth plates and a reduced muscle power, lower level of coordination and smaller stature compared with adult players. The physical characteristics of the young tennis player mean that unique demands are placed on the developing athlete which can, in turn, be associated with different types and patterns of injury. The most common types of injury in tennis players of all ages are muscle sprains and ligament sprains secondary to overuse. These are a particular problem in the adolescent age group because, in general, this group begin playing with a lower level of physical conditioning. Fortunately, injuries in younger players are usually not longstanding and the overuse (chronic) problems seen in older players, such as patellar tendinosis and tennis elbow, are less common in younger players. Anatomically, lower extremity injuries are twice as common as those to the upper extremity or spine, with ankle injury being the most common. Prevention of injury in young tennis players, or at least a reduction in the incidence, is possible. Some traumatic injuries, including contusions, abrasions, lacerations and fractures, may be unavoidable as a result of aggressive play, but others may be prevented by monitoring equipment and the court surface to ensure a safe field of play. The prime target of prevention in young tennis players should be overuse injuries. The principles of 'overload' and staged involvement are of particular importance in this age group. A gradual, progressive increase in the intensity of tennis practice, the slow introduction of new court surfaces and a staged progression in the teaching of tennis skills can help to reduce the incidence of injury in young tennis players.

Adult↗
PubMed1996

Orthopedic surgery residents and the CDC and AAOS HIV precautionary measures.

A randomized national survey of orthopedic surgery residents concerning their knowledge, attitudes, and behaviors of the Centers for Disease Control's and the American Academy of Orthopaedic Surgeons' (AAOS) universal human immunodeficiency virus (HIV) precautionary measures was conducted. The residents' basic knowledge about the HIV precautionary measures was, in general, poor. Thirty-seven percent indicated that they were "uncertain" or "would not" care for HIV positive patients. Further, the residents' practice behaviors in many instances did not fulfill prescribed universal precautions. Sound educational and professional programs, such as those initiated by the AAOS, are needed to increase the knowledge and improve the practice behaviors of orthopedic residents.

Adult↗
PubMed1995

Knee injuries in female athletes.

Female athletes are at increased risk for certain sports-related injuries, particularly those involving the knee. Factors that contribute to this increased risk are the differences in sports undertaken and in gender anatomy and structure. Gender differences include baseline level of conditioning, lower extremity alignment, physiological laxity, pelvis width, tibial rotation and foot alignment. Sports like gymnastics and cheerleading create a noncontact environment, but can result in significant knee injuries. In quick stopping and cutting sports, females have an increased incidence of anterior cruciate ligament (ACL) injury by noncontact mechanisms. Patellofemoral (PF) disorders are also very common in female athletes. Awareness of these facts helps the sports medicine professional make an accurate diagnosis and institute earlier treatment-focused rehabilitation with or without surgery. Further prospective and retrospective research is needed in areas of epidemiology, mechanisms, severity and types of knee injuries. The goal is to lessen the severity of certain knee injuries and to prevent others.

Athletic Injuries↗
PubMed1995

Upper extremity injuries in young athletes.

With the knowledge base of normal anatomy, development, biomechanics, and differential diagnosis, the sports medicine professional can treat injured young athletes with greater efficiency. In addition, microtraumatic injuries may be prevented by emphasizing safe parameters of participation, proper throwing techniques, and careful monitoring of the amount of practice time and intensity. Gymnasts using apparatus should always have spotters. The height of towers and basket tosses by cheerleaders should be limited by age and ability. Proper pitching techniques, not the fastest pitch or youngest curve, should be taught to baseball players. "Play it safe" should be the rule. Finally, by establishing an early and precise diagnosis, potential complications from injuries can be lessened.

Arm Injuries↗
PubMed1995

Injury surveillance at the USTA Boys' Tennis Championships: a 6-yr study.

Injuries that required physical or medical assistance were recorded for participants at the United States Tennis Association National Boys' Tennis Championships from 1986-1988, 1990-1992 (N = 1440, 240 athletes per year). Over the 6-yr period, a total of 304 athletes (or 21.1%) sustained new or recurrent injuries that required evaluation by the medical team. New injuries alone numbered 145 (incidence rate of 9.9 per 100 athletes). The analysis of injuries showed a higher rate of lower than upper extremity injuries. When evaluated by anatomic regions, back injuries were most common followed by thigh, shoulder, and ankle injuries, respectively. When evaluated by injury type, strains and sprains were most common (71% of all injuries) with fractures and dislocations being rare (1.3% of all injuries). The lower extremity provided the majority of sprain type injuries with 87.5% of ligament sprains coming from the knee and ankle. Injuries with tennis eponyms (i.e., tennis toe, tennis leg, tennis elbow, and tennis shoulder) were rare (0%-5% of all injuries). It would appear that these young elite athletes are at significant risk of injury.

Adolescent↗
PubMed1994

Midline fascial splitting approach to the iliac crest for bone graft. A new approach.

The midline fascial splitting approach is a modified midline approach to the iliac crest for bone graft that takes advantage of the anatomic planes between layers of the dorsal lumbar fascia. Two hundred consecutive grafts were taken by this technique with one superficial infection, two cases of serous hematoma, and three patients with significant postoperative pain at the harvest site, for an overall complication rate of 3%. In comparison, bone grafts were harvested from 200 consecutive patients by the midline subcutaneous approach to the iliac crest with 2 deep infections, 1 cluneal nerve injury, 15 patients with severe and disabling pain at the harvest site, and 12 patients with a serous hematoma, for an overall complication rate of 15%. The midline fascial splitting approach significantly reduced the incidence of postoperative serous hematoma (P < 0.007) as well as the incidence of significant and disabling pain (P < 0.001). In addition, the approach is simple, straightforward, anatomic, and decreases trauma to soft tissues.

Bone Transplantation↗
PubMed1994

Common compartment syndromes in athletes. Treatment and rehabilitation.

Compartment syndromes in athletes are rare, but they can also be limb-threatening events. Chronic exertional compartment syndrome (CECS) is a less emergent form where symptoms recur with repetitive loading or exertional activities. CECS is the most common form of compartment syndrome seen in athletes. Acute compartment syndromes may also occur in athletes secondary to direct trauma or may develop from pre-existing CECS. The leg is by far the most common site of compartment syndrome in athletes. The thigh, forearm, and foot are the next most common sites, although any fascially limited compartment can be affected. Awareness of the clinical presentation and pathophysiology of compartment syndromes can help the examiner make a prompt and accurate diagnosis. The treatment of acute compartment syndrome is emergent while the treatment of CECS is not. Conservative treatment and rehabilitation can be successful in treating CECS. Acute compartment syndromes must be treated immediately with surgical decompression. With CECS, if conservative treatment fails, surgical decompression is also indicated. Some authors have suggested that the results of surgical fasciotomy and rate of return to sport for athletes with CECS has not been uniform. If the diagnosis is accurate and carefully documented, a high degree of success with athletes returning to sport can be expected.

Athletic Injuries↗
PubMed1993

Arthroscopic decompression of shoulder impingement secondary to Os acromiale.

Os acromiale is the result of failure of one of the outer ossification centers of the acromion to unite with the more medial portion. This creates an additional motion segment which may itself contribute to impingement syndrome of the shoulder or which may create hypertrophy or spurs which directly impinge on the cuff. Three cases of impingement syndrome of the shoulder with associated os acromiale are presented. All three were initially relieved with arthroscopic subacromial decompression of either the entire os acromiale or simply of the impinging spur. After 1 year, however, all three had recurrent or continued complaints of pain and/or impingement. Therefore, it would appear that arthroscopic subacromial decompression is not a solution to impingement syndrome secondary to os acromiale. Careful preoperative radiographic evaluation to rule out all causes of impingement syndrome including os acromiale is essential so that the surgeon may better choose an approach to decompression.

Acromion↗
PubMed1993

Fracture-dislocation of the thoracic and lumbar spine: advantages of halo-bifemoral traction.

Thoracic and lumbar fracture-dislocations with 100% spinal column displacement are uncommon injuries that usually have associated neurologic injury. Severe spinal malalignment and instability can result in blood loss, tenting of skin and, severe pain. Four patients with thoracic or lumbar fracture-dislocations were initially treated and reduced with halo-bifemoral traction. Fracture reduction with halo-bifemoral traction decreased pain, controlled instability, relieved skin pressure, and prevented the need for acute surgical intervention. In addition, use of halo-bifemoral traction allowed for the resolution of spinal shock, allowed time for complete presurgical planning, and simplified the reduction portion of the operative procedure, thereby reducing operative time and blood loss.

Accidents↗
PubMed1993

Isolated fracture-dislocation of the fourth carpometacarpal joint. A report of two cases.

Dislocations and fracture-dislocations of isolated and multiple carpometacarpal (CMC) joints are rare injuries that usually result from the impact of a clenched hand on an immobile object. Various authors have presented combinations of dislocations of any or all of the CMC joints. Isolated fracture-dislocation of the fourth CMC joint, however, is either exceedingly rare or highly underreported. Two cases of isolated fracture-dislocation of the fourth CMC joint are presented here: in both, the appearance of the hand suggested a fracture-dislocation of the CMC joint, and the isolated lesion was confirmed at the time of surgery. Both patients were treated with open reduction and internal fixation and had good results at 2 years.

Adult↗
PubMedDate not supplied

Reproducibility of anatomic tibial landmarks for anterior cruciate ligament reconstructions.

We evaluated the reproducibility of landmarks used for accurate anatomic placement of the tibial tunnel in anterior cruciate ligament reconstruction. Landmarks evaluated were the medial tibial eminence, the posterior cruciate ligament, the "over-the-back" position, the true posterior border of the tibia, and the posterior border of the lateral meniscus. Forty-two pairs of cadaveric knees were dissected, and anatomic measurements were made regarding the anterior cruciate ligament insertion and these various landmarks. Statistical analysis was used to confirm reproducibility and significance. Measurements based on the medial tibial eminence and posterior border of the meniscus were particularly erratic. The most reproducible anatomic landmark was the posterior cruciate ligament. The anterior border of the posterior cruciate ligament was consistently 6.7 mm posterior to the posterior border of the anterior cruciate ligament and 10.9 mm posterior to the central sagittal insertion point of the anterior cruciate ligament. The over-the-back position was consistently in contact with the anterior border of the posterior cruciate ligament if the knee was flexed with a posterior-directed force applied. In this position, the over-the-back position was equally reproducible as compared with the posterior cruciate ligament. Measurements gauged from the true posterior border of the tibia gave a second rigid bony landmark but with a wider standard deviation than the posterior cruciate ligament-based landmarks. The relative anterior-posterior dimension of the tibia did not correlate with the relationship between the anterior cruciate ligament and other anatomic landmarks.

Anterior Cruciate Ligament↗
PubMedDate not supplied

Loss of extension after reconstruction of the anterior cruciate ligament.

The most common complication of anterior cruciate ligament (ACL) reconstruction is loss of extension, which is often functionally worse for patients than their preoperative instability. Many preventable surgical and nonsurgical etiologic factors have been identified. Accurate placement of the tibial tunnel, adequate notchplasty, and the routing of the femoral side of the graft are all critical factors. Several studies report that early range-of-motion therapy emphasizing immediate postoperative "hyperextension" and avoiding immobilization in flexion reduces the rate of loss of extension. Initial studies investigating the effect of acute versus chronic ACL reconstruction suggested that acute reconstruction is associated with a higher rate of loss of extension. However, the authors of two recent studies in which modern techniques were used have disputed this conclusion. It is likely that the loss of extension historically seen with acute ACL reconstructions was related to tibial tunnel placement and postoperative immobilization. It is possible that the timing of acute ACL reconstruction has less of an effect than originally postulated. On the basis of the results of several biomechanical studies, it appears that ACL reconstruction may be performed with the knee in full extension during graft placement with excellent results and a very low rate of loss of extension. Use of the descriptive term "loss of extension" is preferred to the often misleading terms "arthrofibrosis" and "flexion contracture."

Anterior Cruciate Ligament↗