The Journal of bone and joint surgery. American volume
-
J Bone Joint Surg Am · Sep 1996
Comparative StudyThe relationship of developmental narrowing of the cervical spinal canal to reversible and irreversible injury of the cervical spinal cord in football players.
An evaluation of forty-five athletes who had had an episode of transient neurapraxia of the cervical spinal cord revealed a consistent finding of developmental narrowing of the cervical spinal canal. The purpose of the present epidemiological study was to determine the relationship, if any, between a developmentally narrowed cervical canal and reversible and irreversible injury of the cervical cord with use of various cohorts of football players as well as a large control group. Cohort I comprised college football players who were asymptomatic and had no known history of transient neurapraxia of the cervical cord. ⋯ The findings also support the concept that symptoms may result from a transient reversible deformation of the spinal cord in a developmentally narrowed osseous canal. The low positive predictive value of the ratio (0.2 per cent) however, precludes its use as a screening mechanism for determining the suitability of an athlete for participation in contact sports. Developmental narrowing of the cervical canal in a stable spine does not appear to predispose an individual to permanent catastrophic neurological injury and therefore should not preclude an athlete from participation in contact sports.
-
J Bone Joint Surg Am · Sep 1996
Mid-tarsal and tarsometatarsal arthrodesis for primary degenerative osteoarthrosis or osteoarthrosis after trauma.
We report the long-term results of arthrodesis of the mid-tarsal and tarsometatarsal joints, performed for osteoarthrosis after dislocation with or without a fracture (seventeen patients [seventeen feet]), for primary degenerative osteoarthrosis (twenty-one patients [twenty-two feet]), or for inflammatory arthritis (two patients [two feet]). All forty patients (forty-one feet) had a severe loss of function because of pain. The average age of the patients who had primary degenerative osteoarthrosis was sixty years (range, twenty-seven to seventy-five years) and that of the patients who had post-traumatic osteoarthrosis was forty years (range, twenty-three to sixty-seven years); the two patients who had inflammatory arthritis were forty-four and seventy years old. ⋯ A stress fracture of the second metatarsal developed in three patients, but all three fractures responded to immobilization of the foot. An incisional neuroma developed in three patients, but none of these patients needed additional treatment. We believe that patients who have a severe loss of function due to osteoarthrosis of the mid-tarsal or tarsometatarsal joints can be managed successfully with tarsometatarsal or mid-tarsal arthrodesis, or both.
-
The cases of seven patients who had had acute brachial neuritis (Parsonage-Turner syndrome) were reviewed retrospectively. The patients had been followed for a mean of six years (range, three to ten years) after the onset of the symptoms. ⋯ Weakness in the shoulder had developed at a mean of approximately four weeks after the initial onset of pain. The weakness decreased spontaneously but very gradually in all patients; three patients had persistent, mild weakness at the most recent follow-up evaluation.