Biomedical subjects
Publications and source records attributed to A Kalenak.
Power take-off injuries are uncommon, but serious and potentially fatal. Seven cases are reported demonstrating the violent trauma that can be incurred. The danger associated with use of machines with this and other power equipment is emphasized. Safety shields should be improved, and operators educated about the importance of retaining the shields and using machinery properly at all times.
This is a case report of a 74-year-old man with an ununited fracture of the lateral condyle of the humerus of 50 years duration. There was minimal loss of motion, a moderate cubitis valgus deformity, and a definite ulnar nerve palsy. Despite the deformity and ulnar palsy, he was able to provide for himself and to perform satisfactorily as a laborer.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Controversy exists on the relationship of knee ligament stability to knee injuries. Subjective evaluation of joint tightness or looseness has been proposed as a criterion for prescribing selective corrective strengthening or stretching exercises. Biomechanical studies of knee ligament stability were performed on 401 college football players from 1969 to 1971. Forty-three knee ligament injuries occurred during this period of time, 19 (44.2%) in "loose-jointed" players and 24 (55.8%) in "tight-jointed" players. Joint laxity tests were performed on 72 college football players; the distribution of college football players failing to perform each of the tests was quite different from that reported for professional football players. There was no relationship between the subjective joint laxity tests and the objective biomechanical tests of knee ligament stability. We conclude that it is not possible to predict knee injuries by subjective evaluations of joint laxity or by objective biomechanical knee ligament evaluations and that exercise programs based on subjective studies are therefore not sound.
Cryotherapy is the treatment of choice in the management of acute athletic injuries. Ice is readily available and simple to apply. The rationale for its use is based on well-defined physiologic observations. The application of heat is not indicated in the immediate treatment of acute athletic injuries. If applied early and injudiciously, heat may adversely affect resolution of the trauma and prolong the rehabilitation of the athlete.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A segmented polyurethane prosthetic anterior cruciate ligament prototype has been developed and its in vivo integrity assessed in canine subjects. Prosthetic ligaments surgically implanted for 3, 4, 6, 8, 12, and 16 months were assessed clinically in living subjects, at time of autopsy, and microscopically postautopsy. It was found that the ligaments were adequate in strength to provide stability and last for periods up to 16 months. Notching of the ligaments was observed at two designated friction points.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
In an attempt to correct anterolateral rotatory instability of the knee, 30 consecutive patients underwent a surgical procedure similar to that described by Ellison (Ellison AE: A modified procedure for the extra-articular replacement of the anterior cruciate ligament. American Orthopaedic Society for Sports Medicine Symposium, New Orleans, LA, July 15, 1975), called the iliotibial band transfer. Fashioning the passageway for the transfer closer to the attachment of the fibular collateral ligament on the femur and meticulous fascial closure over the transplant were not found to be crucial to success. Twenty-nine of the 30 patients were injured during athletic activities, and the remaining patient was injured in a motorcycle accident. They often complained of an unstable knee with symptoms of pain and giving way. Twenty-eight patients with a minimum followup of nine months (the average followup was 25 months) were evaluated subjectively by an interview and by objective clinical examination. Subjective results (including asymptomatic return to their previous level of athletic activity) and clinical improvement of anterolateral rotatory instability (based on the flexion-extension-valgus test or the Slocum anterolateral rotatory instability test) were encouraging. Areas of concern were that a small number of patients developed asymptomatic varus instability and a few had relative strength deficits which may or may not have long-term significance.
This report on fractures and refractures in intercollegiate athletes covers an 11-year period from the early Fall of 1968 through the Spring of 1979. Two hundred thirty-one fractures occurred in 219 athletes. Of these athletes, 185 were male and 34 were female. Fractures occurred in 18 sports. Of these 18, football, basketball, wrestling, and soccer led in number for Men's (M) teams, and gymnastics, lacrosse, and volleyball led for Ladies' (L) teams. (Because of this institution's early involvement with Title IX, and the strong position taken by our administration, our teams are designated Gentlemen (Men for short), which constitute the LIONS, and Ladies, which make up the LADY LIONS.) No fractures were noted in the other 11 intercollegiate teams of cheerleading (M and L), bowling (M and L), golf (M and L), fencing (L), rifle (coed), tennis (M and L), and volleyball (M). Boxing, ice hockey, rugby, soccer, and synchronized swimming are club sports at the Pennsylvania State University and are not included in this study. The most common of the 17 fracture sites were the finger, hand, face, foot, nose, and leg, regardless of sport or gender. Fourteen of fifteen refractures occurred in collision/contact sports, and essentially the same mechanical forces caused both fractures. In football most fractures occurred during highly successful seasons.
A retrospective study of 30 patients who met the clinical criteria for saphenous nerve entrapment at the adductor canal is described. Patients experienced symptoms, usually anterior knee pain, for an average of 36 +/- 7 months. Each patient received an average of 1.9 +/- 0.4 saphenous nerve blocks at the adductor canal during treatment. Baseline pain level (measured by the visual analog scale) was 6.4 +/- 0.3. Final pain level at followup was significantly decreased (2.8 +/- 0.5, P less than 0.001). Eighty percent of patients had improved after a series of blocks. Age, medications taken, number of blocks performed, and length of followup were unrelated to outcome. Length of symptoms did significantly correlate with final pain level (r = 0.39, P less than 0.05). The diagnosis of this syndrome, description of the saphenous nerve block at the adductor canal, and the possible etiology are presented.
From 1979 to 1986, isolated repair of a peripheral vascular zone meniscal tear was performed in 22 patients (23 menisci) who had ACL insufficiency. For various reasons none of these patients underwent repair or reconstruction of their ACL. The meniscus repair was done by open arthrotomy in 12 cases and by arthroscopic techniques in 11 cases. The purpose of this study was to evaluate the success rate of a meniscal repair in an anterior cruciate deficient knee. The average age of the patients at the time of surgery was 25 years and the average followup was 56 months. Six patients (26%) had mild occasional pain not requiring medication and one patient had moderate pain requiring nonnarcotic pain medication. Eight patients (26%) had occasional giving way episodes and one of them underwent ACL reconstruction 5 years later because of frequent giving way. One patient required a postoperative manipulation for inadequate range of motion, but there were no neurovascular injuries or infections. There were three patients (13%) who had failed repairs or a retear and required subsequent subtotal meniscectomies. None of the other patients had any clinical symptoms or signs of a meniscal tear. There were no significant differences between the results of open or arthroscopic repair. Even though the failure rate of meniscus repair may be greater in an unstable knee, we conclude that meniscus repair is not contraindicated in an anterior cruciate deficient knee.