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Biomedical subjects

W W Curl

Publications and source records attributed to W W Curl.

35 records · Page 2Linked to original sources
PubMed1989

Bracing and taping in an office sports medicine practice.

Braces can be divided according to their use: rehabilitative, functional, or prophylactic. Rehabilitative braces are used following injury or surgery to allow protection of the injured part while rehabilitation is taking place. Functional braces are used following injury or surgery to allow an individual player to return to athletic activities while protecting the injured part from further damage. Prophylactic braces are used in an attempt to prevent injury to a normal area while engaged in athletic endeavors. Braces are available for the neck, back, and both the upper and lower extremities. There are many commercially available braces that are quite useful and effective. It is still controversial whether or not prophylactic braces prevent knee injuries in contact sports. However, prophylactic braces and/or taping have proved to be quite effective in preventing ankle injuries. It should always be kept in mind, however, whether one is using rehabilitative, functional, or prophylactic braces, that a good rehabilitation program and conditioning should be instituted along with their use to strengthen the involved area and prevent further injuries.

Athletic Injuries↗
PubMed1988

High school football injuries: evaluation.

An epidemiologic survey of the literature on high school football injuries revealed methodologic problems. These numerator-denominator inconsistencies and other confounding factors are discussed. The authors suggest a more reliable system of reporting these parameters to further reduce the risk of high school football injuries.

Adolescent↗
PubMed1988

High school football injuries: identifying the risk factors.

This epidemiologic survey of the literature on the factors contributing to the high number of high school football injuries consolidates the current information on the characteristics and risk factors associated with these injuries. To reduce the incidence of knee sprains and strains, the most common injuries to this population, the following preventive recommendations are presented: 1) optimum maintenance of playing fields; 2) use of the soccer-style shoe; 3) noncontact and controlled activities in practice sessions; and 4) increased vigilance over technique during injury-prone preseason practices. The authors conclude that more research into factors such as exposure time and activity at injury will further reduce the risk to the high school football player.

Adolescent↗
PubMed1982

The anterior cruciate ligament: radiographic and clinical signs of successful and unsuccessful repairs.

Our ten-year observation of anterior cruciate ligament injuries in an active athlete population shows that radiographic evidence of instability and joint deterioration are reliable clinical signs. Radiographic findings in the rotatory unstable knee are subtle six months after injury, but on standard roentgenographic views, which include the notch view, they appear in a sequential order from peaking of the intercondylar tubercles to buttressing osteophytosis. These are objective signs of progressive deterioration that should be a warning to the patient. The early and progressive radiographic signs portend further deterioration if stability is not obtained by restriction of activities, bracing, or reconstruction. Physicians and sports injury specialists should recognize these findings early and offer counsel to the patient at risk.

Athletic Injuries↗
PubMed1980

Hand and forearm infections caused by Aeromonas hydrophila.

This is a report of two cases of hand and forearm infections caused by Aeromonas hydrophila. This organism is resistant to penicillin and most cephalosporins and is found in most freshwater environments. It is recommended that broad-spectrum coverage such as a combination of cephalosporin and aminoglycoside antibiotic be used.

Adolescent↗
PubMedDate not supplied

Isolated tear of the anterior cruciate ligament: 5-year follow-up study.

During the period 1967 to 1971, 64 cadets at the United States Military Academy, West Point, New York, had surgical repair for isolated tear of the anterior cruciate ligament. In a 5-year follow-up study to determine the functional impairment, present disability, and reinjury to the knee, 32 of the 64 patients were located and evaluated by radiographic examination and either by interview or by questionnaire. Twenty-two were commissioned to full duty. 23 had attended ranger or airborne school, and 16 had been in combat. Impairment of ordinary activities was noted by 12 and impairment of athletic endeavors by 24; pain by 71%; swelling by 66%; stiffness by 71%; and instability by 94%. Seventeen of the 32 had had a significant reinjury after the repair of the anterior cruciate ligament. Clinically, we can diagnose the isolated tear of the anterior cruciate ligament by four essential ingredients--a pop at time of injury, inability to continue participation, gross swelling of knee, and maximal swelling within 12 hr. The mechanism of injury is usually deceleration and change of direction, not contact with another player. The follow-up study on this small series indicates that the patients have progressive deterioration of the knee.

Athletic Injuries↗
PubMedDate not supplied

Chondral fractures of the knee. Cause for confusion.

Knee pain in the athlete can pose difficulty in diagnosis. At the United States Military Academy at West Point we have had occasion to see a group of patients presenting with meniscal symptoms of locking, catching, giving way, and joint line tenderness who, on arthroscopic examination, have chondral fractures of the medial or lateral femoral condyle. These individuals have undergone arthroscopy and debridement of the chondral defect. Both retrospectively and prospectively we have been unable to find any defects on radiographs and there appears to be purely cartilaginous involvement. These individuals appear to have a relatively poor prognosis for recovery after arthroscopy. Treatment has been a standard course of range of motion exercises, strengthening, and antiinflammatory medications. However, the mean rehabilitation time has been almost triple the time associated with a routine meniscal injury. We feel that it is important to discuss the chondral fracture so that the orthopaedic surgeon can be aware of this possibility in the differential diagnosis of knee pain in the athlete.

Adolescent↗
PubMedDate not supplied

High school football injuries: evaluation.

An epidemiologic survey of the literature on high school football injuries revealed methodologic problems. These numerator-denominator inconsistencies and other confounding factors are discussed. The authors suggest a more reliable system of reporting these parameters to further reduce the risk of high school football injuries.

Adolescent↗
PubMedDate not supplied

High school football injuries: identifying the risk factors.

This epidemiologic survey of the literature on the factors contributing to the high number of high school football injuries consolidates the current information on the characteristics and risk factors associated with these injuries. To reduce the incidence of knee sprains and strains, the most common injuries to this population, the following preventive recommendations are presented: 1) optimum maintenance of playing fields; 2) use of the soccer-style shoe; 3) noncontact and controlled activities in practice sessions; and 4) increased vigilance over technique during injury-prone preseason practices. The authors conclude that more research into factors such as exposure time and activity at injury will further reduce the risk to the high school football player.

Adolescent↗
PubMedDate not supplied

Operative ankle arthroscopy. Long-term followup.

Ankle arthroscopy has become an accepted procedure for the treatment of various intraarticular disorders. More than 100 ankle arthroscopies have been performed at our institution since 1983. To better define the role of arthroscopic surgery in the treatment of ankle disorders, we evaluated the preoperative examination and indications, operative data, and radiographs of those patients with a minimum of 1 year of followup. Fifty-eight ankles in 57 patients were identified; their average follow-up period was 25 months (range, 12 to 49 months). Preoperative diagnoses were synovitis (26), transchondral defects of the talus (17), degenerative joint disease (8), and osteophytes or loose bodies (7). Subjective results were good or excellent in 64% of cases. The best overall results were achieved in patients with synovitis (77%) and transchondral defects of the talus (71%). Degenerative joint disease patients did not do well. They had only 12% good or excellent results and a 43% rate of subsequent fusion. Complications included superficial and deep infections, temporary and permanent paresthesias, and hemarthroses; the overall complication rate was 15%. In conclusion, operative ankle arthroscopy can be useful in selected patients. It is an effective surgical procedure in patients with synovitis and transchondral defects of the talus. The benefits and long-term results are less predictable with loose bodies and impinging osteophytes; the results are poor with degenerative joint disease. There appears to be a significant risk of complication with ankle arthroscopy; however, with proper indications, a thorough knowledge of anatomical landmarks, and meticulous technique, good results can be obtained.

Adolescent↗
PubMedDate not supplied

Upper trunk brachial plexopathy. The stinger syndrome.

This study was designed to determine the cause of upper trunk brachial plexopathy, which is referred to as a "stinger" or a "burner." This injury often has been thought to occur secondary to traction when an athlete sustains a lateral flexion injury of the neck. At the United States Military Academy, a 4-phase study was begun with 261 tackle football players (236 intramural- and 25 varsity-level players) to investigate this injury. Electromyography and nerve root stimulation studies were used to delineate the lesion, which was found in a total of 32 players who continued throughout the study. This study demonstrated that a much more common mechanism of injury resulting in the stinger syndrome is probably compression of the fixed brachial plexus between the shoulder pad and the superior medial scapula when the pad is pushed into the area of Erb's point, where the brachial plexus is most superficial. An orthosis was designed to protect the brachial plexus from the compressive force of the shoulder pad. In preliminary trials, this orthosis had been very effective in decreasing the number of episodes in which stinger injuries occurred.

Adult↗
PubMedDate not supplied

Magnetic resonance imaging of iliotibial band syndrome.

Seven cases of iliotibial band syndrome and the pathoanatomic findings of each, as demonstrated by magnetic resonance imaging, are presented. These findings were compared with magnetic resonance imaging scans of 10 age- and sex-matched control knees without evidence of lateral knee pain. Magnetic resonance imaging signal consistent with fluid was seen deep to the iliotibial band in the region of the lateral femoral epicondyle in five of the seven cases. Additionally, when compared with the control group, patients with iliotibial band syndrome demonstrated a significantly thicker iliotibial band over the lateral femoral epicondyle (P < 0.05). Thickness of the iliotibial band in the disease group was 5.49 +/- 2.12 mm, as opposed to 2.52 +/- 1.56 mm in the control group. Cadaveric dissections were performed on 10 normal knees to further elucidate the exact nature of the area under the iliotibial band. A potential space, i.e., a bursa, was found between the iliotibial band and the knee capsule. This series suggests that magnetic resonance imaging demonstrates objective evidence of iliotibial band syndrome and can be helpful when a definitive diagnosis is essential. Furthermore, correlated with anatomic dissection, magnetic resonance imaging identifies this as a problem within a bursa beneath the iliotibial band and not a problem within the knee joint.

Adult↗
PubMedDate not supplied

Ankle flexibility and injury patterns in dancers.

Lower-extremity injuries are common among dancers and cause significant absences from rehearsals and performances. For this study of lower-extremity injuries in 101 ballet and 47 modern dance students, injuries requiring medical attention sustained over 1 academic year were associated with the following data obtained at the beginning of the school year: ankle flexibility, sex, dance discipline, previous injury, body mass index, and years of training. Eighty-three of the 148 students (age range, 12 to 28 years) reported prior lower-limb injuries, the most common being ankle sprains (28% of all dancers). Previous leg injuries correlated significantly with lower dorsiflexion measurements and with more new injuries. Female students had greater ankle and first metatarsophalangeal flexibility. Modern dancers had greater ankle inversion. Ninety-four students sustained 177 injuries during the study, including 75 sprains or strains and 71 cases of tendinitis. Thirty-nine percent (N = 69) were ankle injuries; 18% (N = 33) were knee injuries; 23% (N = 40) were foot injuries; and 20% (N = 35) were either hip or thigh injuries. Sixty-seven percent (N = 78) of the injured students were ballet dancers. Age, years of training, body mass index, sex, and ankle range of motion measurement had no predictive value for injury; previous injury and dance discipline both correlated with increased risk of injury.

Adolescent↗
PubMedDate not supplied

Nocardia asteroides sepsis of the knee.

Nocardia asteroides as an infecting agent has been an increasingly identified pathogen in humans, especially in immunosuppressed hosts. The Nocardia organisms as a cause of septic arthritis have been very unusual and in all previously reported cases have occurred in immunosuppressed patients. This is a report of two additional patients, one of whom has had no history of immunosuppression either before infection or subsequent to treatment and resolution of the infection. The second is a case of a questionably immunosuppressed patient with Nocardia asteroides septic arthritis. These cases reemphasize the importance of performing not only the most common aerobic and anaerobic bacterial cultures but also fungal and acid-fast bacilli cultures for early identification of less common organisms and for the initiation of appropriate therapy.

Adult↗
PubMedDate not supplied

Agility training following anterior cruciate ligament reconstruction.

The treatment program after anterior cruciate ligament (ACL) injury or reconstruction at the United States Military Academy embraces the four cornerstones of rehabilitation--strength, aerobic fitness, coordination, and confidence. It is divided into six phases--presurgery, to prepare the patient for postoperative rehabilitation; postoperative (or postinjury), to allow healing and to prevent thrombosis and muscle atrophy; early healing, to maintain muscle tone and joint motion in a protective device; late healing (water stage), to begin proprioceptive and agility training while regaining joint motion; healed (land stage), to gain greater agility and confidence in controlled situations; competition, to demonstrate if the rehabilitation program has been successful. This paper concentrates on the criteria for advancing from the water phase to the land phase and then to competition. The patient reverts to the preceding phase if pain or swelling is apparent. Full participation in competition is not permitted unless the patient masters all phases and can compete in athletics without fear of reinjury.

Athletic Injuries↗