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Biomedical subjects

F W Jobe

Publications and source records attributed to F W Jobe.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Ulnar nerve entrapment syndrome in baseball players.

Ulnar nerve entrapment at the elbow has been described in the literature. This paper deals with 19 skeletally mature baseball players with ulnar nerve entrapment who underwent surgery for correction of the problem. The surgery consisted of anterior transfer of the nerve and placement deep to the flexor muscles. Six players quit baseball because of continuing elbow problems, nine returned to playing, and four were lost to follow-up. Ulnar nerve entrapment is thought to represent one syndrome in a spectrum of diseases involving the medial side of the elbow in baseball players. The lesion is amenable to surgery.

Adolescent↗
PubMedDate not supplied

The Cybex II evaluation of surgically repaired Achilles tendon ruptures.

Thirty-two patients with 33 complete ruptures of the Achilles tendon with surgical repair were evaluated with the Cybex II isokinetic unit. The evaluations were performed from 6 to 144 months postoperatively. The repaired Achilles tendon had a 16.5% loss of plantarflexion strength and a 17.5% loss of plantarflexion power. The early repairs had a smaller loss of strength and power than late repairs. Twenty-seven of the patients returned to their former level of sports activity.

Achilles Tendon↗
PubMedDate not supplied

Correctable elbow lesions in professional baseball players: a review of 25 cases.

In a retrospective study, 20 of 25 professional baseball pitchers (mean age, 24 years; range, 19 to 28 years) who had had a reconstructive surgical procedure on the dominant elbow had satisfactory results (able to return to competitive throwing for one full season or more after surgery). Gentle motion wasinitiated 1 week after the operation on each patient. Exercises for mobilization and muscle strengthening of grip, arm, and shoulder were increased until throwing was initiated 10 to 12 weeks postoperatively. Throwing was gradually increased over several weeks from 30 feet at no more than half speed for 15 min to 60 feet at three-quarter speed. Pitchers were instructed to warm up before throwing and warm down and to continue this practice after they began competitive throwing. The longest period of follow-up had been 4 years (mean, 2.8 years). Four of the 25 pitchers had unsatisfactory results (released from their team in less than one full season because of ineffective pitching and were not picked up by another team). The cause of the release of the other patient-player is controversial. This 25-patient group is too small and the follow-up period is too short for definite conclusions. Our evidence does suggest that surgical procedures directed at medial soft tissue and posterior intra-articular changes carry better prognosis for competitive throwers than other procedures. The radiohumeral articular condition should be evaluated at surgery.

Adult↗
PubMedDate not supplied

The shoulder in competitive swimming.

Shoulder pain is the most common orthopaedic problem in competitive swimming. In a group of 137 of this country's best swimmers, 58 had had symptoms of "swimmer's shoulder." Population characteristics of this group indicated that symptoms increased with the caliber of the athlete, were slightly more common in men, and were related to sprint rather than distance swimming. The use of hand-paddle training exacerbated symptoms, which were more common during the early and middle season. Consideration of shoulder mechanics in swimming reveals that freestyle, butterfly, and backstroke require similar motions; a swimmer using any of these strokes is susceptible to developing shoulder pain. Swimmer's shoulder represents chronic irritation of the humeral head and rotator cuff on the coracoacromial arch during abduction of the shoulder, the so-called impingement syndrome. Treatment included stretching, rest, ice therapy, oral antiinflammatory agents, judicious use of injectable steroids, and surgery as a last resort.

Adolescent↗
PubMedDate not supplied

Staple capsulorrhaphy for recurrent posterior shoulder dislocation.

Recurrent posterior shoulder dislocation or subluxation is uncommon but occurs occasionally in athletes. Ten patients were treated with a posterior shoulder staple capsulorrhaphy. A posterior Bankhart-type-lesion was found in all cases. Eight of the 10 patients had pain relief. The range of motion was usually maintained postoperatively, but no patient returned to his former throwing status. Four patients also had anterior instability. Three patients (30%) had postoperative recurrence of their posterior instability. The two "ligamentous lax" conditions in the series both recurred. The procedure should be supplemented in the "lax" individual. Complications in 4 patients included a painful staple, postoperative adhesions, and symptomatic ectopic bone formation in two patients. Recurrent posterior shoulder dislocation is not a definite indication for operative repair; patients must be carefully selected.

Adolescent↗
PubMedDate not supplied

The modification Bristow-Helfet procedure for recurrent anterior shoulder subluxations and dislocations.

A review of 107 cases in which the Bristow-Helfet procedure was done for recurrent anterior shoulder subluxation and dislocation is presented. The redislocation rate was 2% with very few complications. Eighty-nine percent of the patients were satisfied with the procedure. Mean loss of external rotation was 12.6 degrees. Six of the 41 patients with dominant shoulder surgery were capable of throwing in the same manner as they did prior to injury. Five of 24 patients (21%) with a diagnosis of recurrent anterior subluxation continued to have symptoms of instability following surgery. Associated symptoms of posterior or voluntary subluxation may preclude a satisfactory result.

Adolescent↗
PubMedDate not supplied

Delineation of diagnostic criteria and a rehabilitation program for rotator cuff injuries.

In the examination and rehabilitation of patients with shoulder injuries it is necessary to isolate the individual rotator cuff muscles as much as possible. We subscribe to the belief that, independent of the deltoid, the rotator cuff muscles can become fatigued, injured, or atrophied individually, Accordingly, we feel that these muscles must be considered separately during examination and rehabilitation. This paper describes methods and positions to isolate the cuff and, thus, enable the examiner to be more precise in diagnosis and treatment. In addition, individual exercises for each component are described.

Athletic Injuries↗
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An EMG analysis of the shoulder in throwing and pitching. A preliminary report.

Five male subjects' throwing and pitching motions were analyzed by dynamic electromyography and high speed photography. Electrodes inserted into the deltoid and rotator cuff muscles attempted to define muscle activation patterns during the throwing and pitching cycle. The wind-up or preparation (Stage I) had no consistent pattern. Cocking (Stage II) had a sequential muscle activation pattern of first deltoid activity, followed by the S.I.T. muscles and finally by the subscapularis muscle. Acceleration (Stage III) had a lack of muscle activity, even though the arm was accelerating forward in space. Follow-through (Stage IV) was the most active stage with all the muscles firing intensely. The muscle patterns observed during the cycle were largely characteristic of attempts to decelerate the arm.

Adult↗
PubMedDate not supplied

An EMG analysis of the shoulder in pitching. A second report.

This is the second report in a series of projects dealing with electromyographic (EMG) analysis of the upper extremity during throwing. Better understanding of the muscle activation patterns could lead to more effective preseason conditioning regimens and rehabilitation programs. Indwelling wire electrodes recorded the output from the biceps, long and lateral heads of the triceps, pectoralis major, latissimus dorsi, serratus anterior, and brachialis for four professional baseball pitchers. These signals were synchronized electronically with high speed film records of a fast ball. The EMG signals were converted from analog to digital records. Results showed that wind-up and early cocking phases showed minimal activity in all muscles, and such firing which occurred was of low intensity. Late cocking, which occurred after the front foot was firmly planted, showed moderate activity in the biceps. Cocking was terminated by the pectoralis major and latissimus dorsi. At this point, the trunk began to rotate forward, while the arm remained elevated and the elbow flexed. Also, the shoulder was moving to maximum external rotation. During the acceleration phase, the biceps was notably quiescent, while the pectoralis major, latissimus dorsi, triceps, and serratus anterior were all active. Muscle action at this time terminated external rotation and elbow flexion; i.e., the muscles fired as decelerators and also initiated the opposite actions for ball acceleration, internal rotation and elbow extension. Follow-through was not only a time of eccentric contraction with muscle activity decelerating the upper extremity complex, it was also an active event with the shoulder moving across the body and the elbow into extension with forearm pronation.

Adult↗
PubMedDate not supplied

Elbow flexion analysis in Bristow patients. A preliminary report.

Seven male nonathletes who had Bristow procedures for shoulder dislocation were analyzed by dynamic electromyography (EMG) and Cybex strength measurement to evaluate the function of elbow flexion. Bilateral strength of elbow flexion also was measured in the 10 controlled subjects to compare the dominant and nondominant arms. The EMG data showed the operated short head of biceps function at low constant intensity, compared with the nonoperated side, while the long head of biceps and brachialis increased their activity. The strength measured by the Cybex demonstrated the elbow flexion on the operated side was not significantly different from the normal group. These data demonstrated that the Bristow procedure reduced the dynamic response of the short biceps which was compensated for by the increase in level of activity of the long heads and brachialis muscle. As a result, normal range of elbow function was restored. Our patients had had intense rehabilitation programs. This appears to be an essential part of the postoperative management to develop the needed compensatory muscle action.

Adult↗
PubMedDate not supplied

Patellar and quadriceps tendon ruptures--jumper's knee.

We reviewed 13 patients with end stage jumper's knee, 10 with patellar tendon ruptures, and 3 with ruptures of the quadriceps tendon to evaluate our long-term results in treating these tendon ruptures in an athletic population. The focus was on the natural history, the time until return, and the level of return, to athletic activity. Jumper's knee affected all patients to a varying degree prior to rupture. Basketball was the most common sport involved. At followup, averaging 4 1/2 years, patients underwent functional and clinical, as well as Cybex and roentgenographic, evaluations. Results indicated patellar tendon ruptures, where the ruptures are complete, have a more favorable prognosis than those of the quadriceps tendon which are incomplete. All of the latter patients continued to have quadriceps tendinitis following repair. In both groups, the poor results were obtained in patients with chondromalacia and/or patella alta. Cybex testing yielded results of greater than 100% strength in three patients with patellar tendon ruptures, but no patient with quadriceps rupture had comparable test results. There was no apparent relationship between ruptures and cortisone injections. Patellar and quadriceps tendon ruptures from indirect injury in athletes represent the end stage of jumper's knee and result from repetitive microtrauma. Excellent function usually follows repair of patellar tendon ruptures when surgery is performed early and care is taken to restore normal patellar tendon length. Results of quadriceps ruptures are less satisfactory since these ruptures are usually incomplete and all degenerative tissue may not be involved in the healing response.

Adult↗
PubMedDate not supplied

Fine wire electromyography analysis of muscles of the shoulder during swimming.

Fine wire EMG of the shoulder was performed on 11 swimmers; 5 performed during dry land studies and 7 during aquatic studies. One individual underwent both studies. A cinematographic analysis was synchronized with the EMG data to determine what muscles were firing at each phase of the swim stroke. Eight muscles were studied: biceps, subscapularis, latissimus dorsi, pectoralis major, supraspinatus, infraspinatus, serratus anterior, and deltoid. Three strokes were analyzed: freestyle, breaststroke, and butterfly. The freestyle and butterfly are frequently associated with impingement type syndromes in swimmers. It was determined that the supraspinatus, infraspinatus, middle deltoid, and serratus anterior were predominately recovery phase muscles. The latissimus dorsi and pectoralis major were predominately pull-through phase muscles. The biceps had mixed inconsistent activity during both phases. From dry land quantifications of the EMG signal it was determined that the serratus anterior functions near maximal muscle test during each stroke, and theoretically may fatigue with repetition. It is hoped that a training program aimed to strengthen the scapular rotators may help alleviate impingement syndrome in swimmers.

Adult↗
PubMedDate not supplied

The operative treatment of scapulothoracic bursitis in professional pitchers.

Four professional pitchers with resistant scapulothoracic bursitis who have required surgical excision of the thickened bursa are reported. The average time duration of symptoms prior to surgery was 18.8 months. Conservative therapy consisting of rest, shoulder exercises, antiinflammatory medications, and cortisone injections failed to resolve the bursitis, and each pitcher was unable to compete secondary to pain. The incision was posterior, just distal to the tip of the scapula. The specimens contained cleft-like spaces lined by synovial tissue consistent with a bursa. All four pitchers returned to professional baseball the year following surgical excision of the bursa. We recommend early, aggressive, conservative therapy for scapulothoracic bursitis in the throwing athlete. Pitchers with a thickened, resistant scapulothoracic bursitis should have the bursa surgically excised.

Adult↗