Four cases of unusual complications following traumatic dislocation of the hip in children are presented along with a review of the literature. All patients presented with posterior or posterosuperior dislocations, and two had associated pelvic or acetabular fractures. One patient had a small, shallow acetabulum caused by premature closure of the triradiate cartilage and damage to the superior gluteal nerve. The combination of triradiate epiphyseal closure and abductor muscle weakness secondary to superior gluteal nerve damage contributed to subsequent femoral head subluxation. One patient presented with a previously unrecognized fracture dislocation. Two patients presented with recurrent dislocations, one with a posterior capsular defect indicated by arthrography. The patient with this defect was treated with surgical repair, whereas the other patient was treated nonsurgically.

Buttocks↗

PubMedDate not supplied

Symptomatic shoulder instability due to lesions of the glenoid labrum.

Lesions of the glenoid labrum can be associated with and cause shoulder instability and symptomatology by (1) allowing the shoulder to dislocate recurrently (anatomical instability); (2) allowing the shoulder to subluxate (anatomical instability); and (3) allowing the shoulder to click, catch, and lock secondary to partially attached fragments becoming interposed between the articular surfaces (functional instability). The latter two clinical entities are usually associated with "lesser" labral damage and diagnosis can be difficult. Six illustrative cases are presented and salient diagnostic and therapeutic points are discussed. The glenohumeral axillary arthrotomogram is presented as a sensitive diagnostic test for detecting labral lesions.

Adolescent↗

PubMedDate not supplied

Biomechanics of baseball pitching. A preliminary report.

Fifteen professional major league pitchers were filmed with high speed cinematography. One hundred forty-seven pitches were analyzed using an electromagnetic digitizer and a microcomputer. Three phases of throwing were studied: cocking, acceleration, and follow-through. The cocking phase is the period of time between the initiation of the windup and the moment at which the shoulder is in maximum external rotation. This phase occurs in approximately 1500 ms, and the shoulder is brought into an extreme position of external rotation. The acceleration phase and the initial stages of the follow-through phase produce extraordinary demands on the shoulder and elbow. The acceleration phase begins with the throwing shoulder in the position of maximum external rotation and terminates with ball release. This phase occurs in approximately 50 ms, and peak angular velocities averaging 6,180 deg/sec for shoulder internal rotation and 4,595 deg/sec for elbow extension were measured. The follow-through phase begins at ball release and continues until the motion of throwing has ceased. This phase occurs in approximately 350 ms.

Acceleration↗

PubMedDate not supplied

Rehabilitation of the pitching shoulder.

Shoulder pain is a common complaint among baseball pitchers. Frequently, the nature of shoulder pathology can be traced to lack of flexibility and muscular imbalance. This paper describes: the normal biomechanics of a properly functioning shoulder during a baseball pitch, pathomechanics of shoulder problems, flexibility requirements of the throwing shoulder, and the muscular balance necessary for an effective throwing shoulder. Appropriate examination procedures are described along with remedial exercises which ensure normal glenohumeral motion and integrated muscle action.

Athletic Injuries↗

PubMedDate not supplied

Avulsion fractures of the pelvis.

Avulsion fractures of the pelvic apophyses are seen infrequently but they show a consistent pattern in mechanism, patient's age, symptoms, physical findings, and roentgenographic appearance. Some disagreement exists in the literature concerning the treatment of these fractures. This study indicates that early diagnosis and a carefully directed nonoperative treatment program will produce positive results for avulsion fractures of the pelvis. Twenty-seven cases of acute avulsion fracture of the pelvis were successfully treated in a directed nonoperative program.

Adolescent↗