Database: MEDLINE <1966 to March Week 2 2002>
Search Strategy:
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1 adductor muscle injur$.tw. (0)
2 limit 1 to (human and english language) (0)
3 adductor.af. (2195)
4 exp muscles/in (4862)
5 3 and 4 (31)
6 limit 5 to (human and english language) (23)
7 (muscle$ and injur$).tw. and 3 (58)
8 limit 7 to (human and english language) (40)
9 6 or 7 (67)
10 limit 9 to yr=1996-2002 (29)
11 6 or 10 (42)
12 from 11 keep 1-42 (42)
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<1>
Unique Identifier
10456822
Medline Identifier
99383822
Authors
Akata T. Murakami J. Yoshinaga A.
Institution
Department of Anaesthesiology and Critical Care Medicine, Kyushu University Hospital, Fukuoka, Japan.
Title
Life-threatening haemorrhage following obturator artery injury during transurethral bladder surgery: a sequel of an unsuccessful obturator nerve block.
Source
Acta Anaesthesiologica Scandinavica. 43(7):784-8, 1999 Aug.
Abstract
In spite of prior blockade of the obturator nerve with 1% mepivacaine (8 ml) utilizing a nerve stimulator, violent leg jerking was evoked during transurethral electroresection of a bladder tumour approximately 1 h after the blockade in a 68-year-old man. The patient became severely hypotensive immediately following the jerking, and a large lower abdominal swelling concurrently developed. The urgent laparotomy indicated that the left obturator artery was severely injured by the resectoscope associated with the bladder perforation, causing acute massive haemorrhage. The patient recovered uneventfully after adequate surgery. Investigation of the literature suggested that both our nerve stimulation technique and anatomical approach were appropriate. It was therefore unlikely that our block resulted in failure because of an inappropriate site for deposition of the anaesthetic. However, consensus does not appear to have been obtained as to the concentration and volume of the anaesthetic necessary for prevention of the obturator nerve stimulation during the transurethral procedures. The concentration and volume of mepivacaine we used might have been too low and/or small, respectively, to profoundly block all the motor neuron fibres of the nerve. Alternatively, stimulation of the obturator nerve might occur because of the presence of some anatomical variant, such as the accessory obturator nerve or its abnormal branching. In conclusion, some uncertainty appears to exist in the effectiveness of the local anaesthetic blockade of the obturator nerve. In order to attain profound blockade of the motor neuron fibres of the obturator nerve and thereby prevent the thigh-adductor muscle contraction which can lead to life-threatening situations, we recommend, even with a nerve stimulator, to use a larger volume of a higher concentration of local anaesthetic with a longer duration in the obturator nerve block for the transurethral procedures.
<2>
Unique Identifier
1015261
Medline Identifier
77108154
Authors
Peterson L. Stener B.
Title
Old total rupture of the adductor longus muscle. A report of seven cases.
Source
Acta Orthopaedica Scandinavica. 47(6):653-7, 1976 Dec.
Abstract
Seven cases of old total rupture of the adductor longus muscle are described. Five patients were referred with the suspicion of a soft tissue tumour. Six patients reported an adequate trauma when thoroughly questioned; four of them had sustained the injury while playing soccer; the seventh patient could not recall any trauma. The diagnosis of this lesion is discussed.
<3>
Unique Identifier
11312186
Medline Identifier
21210886
Authors
Anderson SE. Johnston JO. O'Donnell R. Steinbach LS.
Institution
Department of Diagnostic Radiology, University Hospital of Bern, Inselspital, 3010 Bern, Switzerland.
Title
MR Imaging of sports-related pseudotumor in children: mid femoral diaphyseal periostitis at insertion site of adductor musculature.
Source
AJR. American Journal of Roentgenology. 176(5):1227-31, 2001 May.
Abstract
OBJECTIVE: The objective of this study was to review the imaging appearance of the femurs of five patients who had been referred from outside institutions after presenting with thigh pain and being given a preliminary diagnosis of primary malignant bone tumor. Typically, when making a diagnosis, physicians place emphasis on the characteristic appearances of diseases on MR imaging, but such appearances may be misleading. An awareness of the specific MR imaging pattern of stress-related partial muscle avulsion can lead to the correct diagnosis. CONCLUSION: Femoral diaphyseal periostitis after a sports injury to the adductor musculature in children has a characteristic imaging appearance. This condition can initially appear to be misleadingly aggressive. Knowledge of the findings-particularly of the findings on MR imaging-in the proper clinical setting can help physicians make the correct diagnosis and eliminate unnecessary biopsy or inappropriate treatment.
<4>
Unique Identifier
11517070
Medline Identifier
21407500
Authors
Anderson MW. Kaplan PA. Dussault RG.
Institution
Department of Radiology, University of Virginia Health Sciences Center, Box 170, Charlottesville, VA 22908, USA.
Title
Adductor insertion avulsion syndrome (thigh splints): spectrum of MR imaging features.
Source
AJR. American Journal of Roentgenology. 177(3):673-5, 2001 Sep.
Abstract
OBJECTIVE: "Thigh splints," also known as the adductor insertion avulsion syndrome, is a painful condition affecting the proximal to mid femur at the insertion of the adductor muscles of the thigh. Scintigraphic findings in this syndrome have been described; we report a spectrum of MR imaging abnormalities involving this portion of the femur in a group of patients presenting with hip, groin, or thigh pain. CONCLUSION: Symptoms of vague hip, groin, or thigh pain may be associated with stress-related changes in the proximal to mid femoral shaft (thigh splints). When interpreting MR imaging studies of the pelvis in patients presenting with these symptoms, careful attention should be directed to this portion of the femur. This is especially important because the findings may be subtle, and this region is often at the distal edge of most MR imaging studies of the pelvis and hip.
<5>
Unique Identifier
11681783
Medline Identifier
21537872
Authors
Morelli V. Smith V.
Institution
Department of Family Medicine, Louisiana State University School of Medicine, New Orleans, USA.
Title
Groin injuries in athletes.
Source
American Family Physician. 64(8):1405-14, 2001 Oct 15.
Abstract
Groin injuries comprise 2 to 5 percent of all sports injuries. Early diagnosis and proper treatment are important to prevent these injuries from becoming chronic and potentially career-limiting. Adductor strains and osteitis pubis are the most common musculoskeletal causes of groin pain in athletes. These two conditions are often difficult to distinguish. Other etiologies of groin pain include sports hernia, groin disruption, iliopsoas bursitis, stress fractures, avulsion fractures, nerve compression and snapping hip syndrome.
<6>
Unique Identifier
11079107
Medline Identifier
20531353
Authors
Russell GV Jr. Perry MD. Pearsall AW 4th.
Institution
Department of Orthopedic Surgery, University of Mississippi, Oxford, USA.
Title
Heterotopic ossification of the adductor longus muscle presenting as dyspareunia.
Source
American Journal of Orthopedics (Chatham, Nj). 29(11):879-82, 2000 Nov.
Abstract
Dyspareunia after heterotopic ossification of the adductor longus is a rare complication. We describe a patient with symptomatic heterotopic ossification of the adductor muscle that developed years after sustaining a fracture of the inferior pubic ramus in association with an injury to the adductor longus muscle. The patient's pain was reduced and his dyspareunia resolved after excision of the adductor longus heterotopic ossification and subsequent physical therapy.
<7>
Unique Identifier
8427375
Medline Identifier
93151363
Authors
Speer KP. Lohnes J. Garrett WE Jr.
Institution
Sports Medicine Section, Duke University Medical Center, Durham, North Carolina 27710.
Title
Radiographic imaging of muscle strain injury.
Source
American Journal of Sports Medicine. 21(1):89-95; discussion 96, 1993 Jan-Feb.
Abstract
We reviewed our experience with computed tomography and magnetic resonance imaging of acute muscle strain injury. We imaged 50 athletes (average age, 28 years; range, 17 to 42) who had an acute muscle strain involving either the adductor, hamstring, quadriceps, or triceps surae muscles. Computed tomography (axial imaging) was used from 1982 to 1987 for 27 athletes. Spin-echo magnetic resonance imaging (axial, coronal, sagittal imaging) was used from 1987 to 1991 for 23 athletes. Computed tomography and magnetic resonance imaging localize the strain injury to a single muscle within a group of synergists; the adductor longus, rectus femoris, and medial head of gastrocnemius muscles are most prone to strain injury. A disruption occurs predictably at the myotendinous junction; fluid collects at the disruption site and dissects along the epimysium and subcutis. Muscle tissue remote from the myotendinous junction clearly demonstrates extensive injury with abundant magnetic resonance imaging signal changes consistent with edema and inflammation. Follow-up computed tomographic and magnetic resonance imaging studies can clearly demonstrate atrophy, fibrosis, and calcium deposition.
<8>
Unique Identifier
1456357
Medline Identifier
93089418
Authors
Akermark C. Johansson C.
Institution
Stockholm Sports Medicine Center, Sweden.
Title
Tenotomy of the adductor longus tendon in the treatment of chronic groin pain in athletes.
Source
American Journal of Sports Medicine. 20(6):640-3, 1992 Nov-Dec.
Abstract
Eighteen tenotomies of the adductor longus tendon were performed in 16 consecutive male athletes (aged 20 to 42) as treatment for chronic groin pain. The criteria for surgery was a history of long-standing (range, 2.5 to 48 months) and distinct pain at the origin of the adductor longus muscle, refractory to conservative treatment. At followup 35 months (range, 4 to 84) after surgery, all patients were improved or free of symptoms. All but 1 of the athletes returned to the same sport within a mean of 6.6 weeks, and 12 of 16 returned to competitive sports within a mean of 14 weeks after surgery. A majority of the patients (10 of 16) returned to full athletic activity, whereas 5 of 16 performed at a reduced level. One patient discontinued his sports activity due to other causes. In conclusion, when conservative treatment fails, tenotomy of the adductor longus tendon gives good long-term functional results in the treatment of chronic groin pain that is localized at the origin of the adductor longus muscle. A decreased muscle strength was observed in this study and did not seem to influence participation in sports.
<9>
Unique Identifier
11292035
Medline Identifier
21187383
Authors
Tyler TF. Nicholas SJ. Campbell RJ. McHugh MP.
Institution
Nicholas Institute of Sports Medicine and Athletic Trauma, Department of Orthopaedics, Lenox Hill Hospital, New York, NY 10021, USA.
Title
The association of hip strength and flexibility with the incidence of adductor muscle strains in professional ice hockey players.
Source
American Journal of Sports Medicine. 29(2):124-8, 2001 Mar-Apr.
Abstract
This prospective study was conducted to determine whether hip muscle strength and flexibility play a role in the incidence of adductor and hip flexor strains in National Hockey League ice hockey team players. Hip flexion, abduction, and adduction strength were measured in 81 players before two consecutive seasons. Thirty-four players were cut, traded, or sent to the minor league before the beginning of the season. Injury and individual exposure data were recorded for the remaining 47 players. Eight players experienced 11 adductor muscle strains, and there were 4 hip flexor strains. Preseason hip adduction strength was 18% lower in the players who subsequently sustained an adductor muscle strain compared with that of uninjured players. Adduction strength was 95% of abduction strength in the uninjured players but only 78% of abduction strength in the injured players. Preseason hip adductor flexibility was not different between players who sustained adductor muscle strains and those who did not. These results indicate that preseason hip strength testing of professional ice hockey players can identify players at risk of developing adductor muscle strains. A player was 17 times more likely to sustain an adductor muscle strain if his adductor strength was less than 80% of his abductor strength.
<10>
Unique Identifier
11101102
Medline Identifier
20550803
Authors
Ahmad CS. Stein BE. Matuz D. Henry JH.
Institution
New York Orthopaedic Hospital, Columbia-Presbyterian Medical Center, New York, USA.
Title
Immediate surgical repair of the medial patellar stabilizers for acute patellar dislocation. A review of eight cases.
Source
American Journal of Sports Medicine. 28(6):804-10, 2000 Nov-Dec.
Abstract
An open surgical repair of the injured medial patellar stabilizers, including the vastus medialis obliquus muscle and the medial patellofemoral ligament, after acute patellar dislocation was studied in eight patients. At initial examination, all patients had tenderness over the adductor tubercle and a positive patellar apprehension sign. Four of eight patients had obvious ecchymosis over the adductor tubercle. Magnetic resonance imaging, diagnostic arthroscopy, and open surgical exploration documented injury to both the medial patellofemoral ligament and the origin of the vastus medialis obliquus muscle. In all patients, the torn muscle was retracted in an anterior and superior direction and an arthroscopic lateral release was performed followed by open primary repair of the medial patellofemoral ligament to the adductor tubercle and repair of the vastus medialis obliquus muscle to the adductor magnus tendon. Patients were evaluated postoperatively with the Kujala scoring questionnaire. The average follow-up was 3.0 years, with a minimum of 1.5 years. No patients experienced a recurrent dislocation. The average Kujala score was 91.9. Patients rated their return to athletic activity at an average 86% of their pre-injury level. The average subjective satisfaction was 96%. In appropriate cases of acute patellar dislocation, we recommend primary repair of the medial patellofemoral ligament and the vastus medialis obliquus muscle to avoid recurrent dislocation, chronic subluxation, pain, and disability.
<11>
Unique Identifier
6650721
Medline Identifier
84077407
Authors
Hunter SC. Marascalco R. Hughston JC.
Title
Disruption of the vastus medialis obliquus with medial knee ligament injuries.
Source
American Journal of Sports Medicine. 11(6):427-31, 1983 Nov-Dec.
Abstract
We reviewed the clinical records of 189 consecutive surgically treated acute ligamentous injuries of the medial compartment of the knee to determine the prevalence of disruptions of the vastus medialis obliquus muscle and to document the results of simultaneous repair of the disruption. Forty knees (40 patients) demonstrated a vastus medialis muscle disruption at the time of surgical repair for the medial ligamentous disruption. All were surgically corrected and the sites of tearing were documented. The vastus medialis obliquus muscle was ruptured from the adductor tubercle in 31 (78%) knees. Of these, the tibial collateral ligament was torn from its femoral attachment in 19 (61%) knees and the meniscofemoral portion of the capsular ligament ligament was torn from its femoral attachment in 23 (74%) knees. The vastus medialis obliquus muscle was ruptured from the patella in seven (18%) knees and was ruptured interstitially in nine (23%) knees. Each of the 40 patients returned for objective, subjective, and functional follow-up evaluation (average, 39 months). At follow-up examination, 88% of the 40 knees were rated as good subjectively, 90% objectively, and 93% functionally. A high correlation exists between tears of the vastus medialis obliquus muscle from its femoral attachment and tears of the medial compartment ligaments from their respective femoral attachments. Surgical repair of disruptions of the vastus medialis obliquus muscle at the time of primary repair of injury to the ligaments of the medial compartment of the knee can prevent subsequent disorder of the extensor mechanism and can produce an objectively, subjectively, and functionally stable knee.
<12>
Unique Identifier
8947416
Medline Identifier
97103044
Authors
Garrett WE Jr.
Institution
Division of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Title
Muscle strain injuries. [Review] [28 refs]
Source
American Journal of Sports Medicine. 24(6 Suppl):S2-8, 1996.
Abstract
One of the most common injuries seen in the office of the practicing physician is the muscle strain. Until recently, little data were available on the basic science and clinical application of this basic science for the treatment and prevention of muscle strains. Studies in the last 10 years represent action taken on the direction of investigation into muscle strain injuries from the laboratory and clinical fronts. Findings from the laboratory indicate that certain muscles are susceptible to strain injury (muscles that cross multiple joints or have complex architecture). These muscles have a strain threshold for both passive and active injury. Strain injury is not the result of muscle contraction alone, rather, strains are the result of excessive stretch or stretch while the muscle is being activated. When the muscle tears, the damage is localized very near the muscle-tendon junction. After injury, the muscle is weaker and at risk for further injury. The force output of the muscle returns over the following days as the muscle undertakes a predictable progression toward tissue healing. Current imaging studies have been used clinically to document the site of injury to the muscle-tendon junction. The commonly injured muscles have been described and include the hamstring, the rectus femoris, gastrocnemius, and adductor longus muscles. Injuries inconsistent with involvement of a single muscle-tendon junction proved to be at tendinous origins rather than within the muscle belly. Important information has also been provided regarding injuries with poor prognosis, which are potentially repairable surgically, including injuries to the rectus femoris muscle, the hamstring origin, and the abdominal wall. Data important to the management of common muscle injuries have been published. The risks of reinjury have been documented. The early efficacy and potential for long-term risks of nonsteroidal antiinflammatory agents have been shown. New data can also be applied to the field with respect to the beneficial effects of warm-up, temperature, and stretching on the mechanical properties of muscle. These benefits potentially reduce the risks of strain injury to the muscle. Fortunately, many of the factors protecting muscle, such as strength, endurance, and flexibility, are also essential for maximum performance. Future studies should delineate the repair and recovery process emphasizing not only the recovery of function, but also the susceptibility to reinjury during the recovery phase. [References: 28]
<13>
Unique Identifier
1456356
Medline Identifier
93089417
Authors
Kalebo P. Karlsson J. Sward L. Peterson L.
Institution
Department of Diagnostic Radiology, East Hospital, University of Gothenburg, Sweden.
Title
Ultrasonography of chronic tendon injuries in the groin.
Source
American Journal of Sports Medicine. 20(6):634-9, 1992 Nov-Dec.
Abstract
Ultrasonography was used in the diagnosis of 36 patients with chronic groin pain localized to the tendons of the rectus abdominis, rectus femoris, adductor muscles, hamstring muscles, and the gluteal muscles. Abnormal findings, such as focal sonolucent areas and discontinuity of tendon fibers, that are indicative of nonhealed partial ruptures were found in 28 patients. These findings differed clearly from the asymptomatic contralateral side, which was used for comparison. The abnormalities were located in three different sites: at the tendon insertion, within the tendon, and at the tendomuscular junction. Ten patients were treated surgically and the findings at surgery correlated well with the ultrasonographic findings of partial tendon tears: 9 were true-positive and 1 was a true-negative. Ultrasonography appears to be a valuable method in the diagnosis of chronic groin pain.
<14>
Unique Identifier
9109789
Medline Identifier
97263917
Authors
van Lith-Bijl JT. Stolk RJ. Tonnaer JA. Groenhout C. Konings PN. Mahieu HF.
Institution
Department of Otolaryngology, Head and Neck Surgery, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Title
Selective laryngeal reinnervation with separate phrenic and ansa cervicalis nerve transfers.
Source
Archives of Otolaryngology -- Head & Neck Surgery. 123(4):406-11, 1997 Apr.
Abstract
OBJECTIVE: To perform selective reinnervation of the laryngeal abductor and adductor muscle groups after injury to the recurrent laryngeal nerve, recovering laryngeal function without impairment by synkinesis. DESIGN: Ten cats underwent the surgical procedure. To reinnervate the posterior cricoarytenoid muscle (abductor), a phrenic nerve graft was anastomosed to the main trunk of the recurrent laryngeal nerve. The adductor branch was severed, and the proximal stump was buried in the posterior cricoarytenoid muscle. The sternohyoid branch of the ansa cervicalis was anastomosed to the distal stump to reinnervate the adductor muscle group. After a period of 10 weeks, the laryngeal function was evaluated with videolaryngoscopy and electromyography of the posterior circoarytenoid and vocalis muscles. RESULTS: Of the 10 cats, 9 could be evaluated. Laryngeal abductor function was comparable with the unaffected side in the 9 cats. During respiratory distress conditions, a minor compromise of the maximal abduction was observed in 5 cats. Phonation was not tested, but spontaneous adduction during expiration was seen in all cats. Reflex closure on ipsilateral, supraglottic, tactile mucosal stimulation was seen in only 2 cats. In each cat, evidence of nerve regeneration and reinnervation of both muscle groups was established with electromyography, electrical stimulation, and histological examination. CONCLUSIONS: Using this selective reinnervation procedure, good laryngeal function can be achieved in the cat model, which may be applicable in humans. By reinnervation of the vocalis muscle, muscle tonus is achieved, which is expected to improve voice quality. Using this procedure, however, no active reflex closure may be expected.
<15>
Unique Identifier
10597802
Medline Identifier
20064672
Authors
Scremin AM. Kurta L. Gentili A. Wiseman B. Perell K. Kunkel C. Scremin OU.
Institution
Department of Physical Medicine and Rehabilitation, University of California at Los Angeles School of Medicine, USA.
Title
Increasing muscle mass in spinal cord injured persons with a functional electrical stimulation exercise program.
Source
Archives of Physical Medicine & Rehabilitation. 80(12):1531-6, 1999 Dec.
Abstract
OBJECTIVE: To determine the magnitude of changes in muscle mass and lower extremity body composition that could be induced with a regular regimen of functional electrical stimulation (FES)-induced lower-extremity cycling, as well as the distribution of changes in muscle mass among the thigh muscles in persons with spinal cord injury (SCI). STUDY DESIGN: Thirteen men with neurologically complete motor sensory SCI underwent a 3-phase, FES-induced, ergometry exercise program: phase 1, quadriceps strengthening: phase 2, progressive sequential stimulation to achieve a rhythmic pedaling motion (surface electrodes placed over the quadriceps, hamstrings, and gluteal muscles); phase 3, FES-induced cycling for 30 minutes. Participants moved from one phase to the next when they met the objectives for the current phase. MEASURES: Computed tomography of legs to assess muscle cross-sectional area and proportion of muscle and adipose tissue. Scans were done at baseline (before subjects started the program), at first follow-up, typically after 65.4+/-5.6 (SD) weekly sessions, and at second follow-up, typically after 98.1+/-9.1 sessions. RESULTS: Increases in cross-sectional areas were found in the following muscles: rectus femoris (31%, p<.001). sartorius (22%, p<.025), adductor magnus-hamstrings (26%, p<.001), vastus lateralis (39%, p = .001), vastus medialis-intermedius (31%, p = .025). Cross-sectional area of adductor longus and gracilis muscles did not change. The ratio of muscle to adipose tissue increased significantly in thighs and calves. There was no correlation among the total number of exercise sessions and the magnitude of muscle hypertrophy. CONCLUSIONS: Muscle cross-sectional area and the muscle to adipose tissue ratio of the lower extremities increased during a regular regimen of 2.3 FES-induced lower extremity cycling sessions weekly. The distribution of changes was related to the proximity of muscles to the stimulating electrodes.
<16>
Unique Identifier
11512298
Medline Identifier
21404565
Authors
Goh LA. Chhem KR. Wang SC. Tho KS.
Institution
Tan-Tock Seng Hospital.
Title
Ultrasonographic features of an adductor longus tear: case report.
Source
Canadian Association of Radiologists Journal. 52(4):252-4, 2001 Aug.
<17>
Unique Identifier
10512343
Medline Identifier
99440895
Authors
Emery CA. Meeuwisse WH. Powell JW.
Institution
Department of Community Health Sciences, Faculty of Medicine, and Sport Medicine Centre, University of Calgary, Alberta, Canada.
Title
Groin and abdominal strain injuries in the National Hockey League.
Source
Clinical Journal of Sport Medicine. 9(3):151-6, 1999 Jul.
Abstract
OBJECTIVE: To analyze groin and abdominal strain injuries retrospectively among elite male hockey players in the National Hockey League (NHL) over six seasons of play (1991/92 to 1996/97). DESIGN: Retrospective case series design. SETTING: The NHL. PARTICIPANTS: The NHL participants were an inclusive sample of 7,050 NHL hockey players who played in the NHL from the 1991/92 to the 1996/97 seasons. A subset of 2,600 NHL hockey players who played from the 1995/96 to the 1996/97 seasons was further analyzed. MAIN OUTCOME MEASURES: The injury definition for groin/abdominal strain injury included any injury recorded as a muscle strain injury involving a muscle in any of the abdominal, hip flexor, or hip adductor muscle groups. Femoral, abdominal, and inguinal hernias were also included. Cumulative incidence rates over six seasons of play in the NHL and incidence densities over two seasons of play in the NHL are reported. Specific injury parameters examined included muscle region, time in season, type of session, reinjury, time period in session, position of play, player's experience, mechanism of injury, and time loss. RESULTS: A total of 617 groin/abdominal strain injuries were reported in the NHL over six seasons of play. The cumulative incidence rate in the NHL increased over 6 years of play from 12.99 injuries/100 players/year in the 1991/92 season to 19.87 injuries/100 players/year in the 1996/97 season. The rate of increase was 1.32 (95% confidence interval -0.58, 3.21) injuries/100 players/year. The incidence density of groin/abdominal injury during NHL training camp was five times that during the regular season and 20 times that during the postseason. The incidence density in the NHL during games was six times that during practice. The majority of injuries reported were adductor groin muscle strains. The proportion of injuries reported that were recurrent was 23.5%. There was no significant difference in proportion of injuries reported by time period within a session. The mechanism of injury recorded was noncontact in nature in >90% of injuries reported. Mean time loss due to injury was significantly greater for abdominal injuries (10.59 sessions) than for groin injuries (6.59 sessions). A conservative estimate of the impact of groin/abdominal injury on each NHL team is a game loss of 25 player games/year. CONCLUSION: The impact of groin and abdominal strain injury at an elite level of play in hockey is significant and increasing. Future research in this area is needed to identify risk factors and potentially implement prevention strategies to reduce groin and abdominal strain injury at all levels of play.
<18>
Unique Identifier
2292151
Medline Identifier
91152924
Authors
Rockett JF. Freeman BL 3rd.
Institution
Nuclear Medicine Department, Baptist Hospital East, Memphis, Tennessee 38120.
Title
Scintigraphic demonstration of pectineus muscle avulsion injury.
Source
Clinical Nuclear Medicine. 15(11):800-3, 1990 Nov.
Abstract
An exercise-related avulsion injury of the insertion of the pectineus muscle is described. The abnormality was detected on a 4-hour delayed bone scan. Symptomatic injuries of the adductor muscles are uncommon and are not to be confused scintigraphically with a stress fracture of the proximal femoral shaft.
<19>
Unique Identifier
5086582
Medline Identifier
73042229
Authors
Symeonides PP.
Title
Isolated traumatic rupture of the adductor longus muscle of the thigh.
Source
Clinical Orthopaedics & Related Research. 88:64-6, 1972.
<20>
Unique Identifier
9233753
Medline Identifier
97376982
Authors
Prielipp RC. Robinson JC. Wilson JA. MacGregor DA. Scuderi PE.
Institution
Department of Anesthesiology, The Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC, USA.
Title
Dose response, recovery, and cost of doxacurium as a continuous infusion in neurosurgical intensive care unit patients.
Source
Critical Care Medicine. 25(7):1236-41, 1997 Jul.
Abstract
OBJECTIVES: To determine the optimal dosing of doxacurium as a continuous infusion in neurosurgical patients with traumatic brain injury; to determine the effects of bolus administration of doxacurium on heart rate (HR), blood pressure (BP), and intracranial pressure (ICP); to monitor neuromuscular recovery after discontinuation of prolonged doxacurium infusion; and to compare the cost of doxacurium with other current neuromuscular blocking drugs. DESIGN: Prospective, open-label study. SETTING: Neurosurgical intensive care unit (ICU) of a university-affiliated teaching hospital. PATIENTS: Eight critically ill, mechanically ventilated patients with traumatic head injury and normal renal and hepatic function. Patients had ICP monitoring. INTERVENTIONS: A bolus injection of doxacurium (0.05 mg/kg) followed by a continuous infusion (0.015 mg/kg/hr), adjusted to maintain one twitch during Train-of-Four nerve stimulation of the adductor pollicis muscle. MEASUREMENTS AND MAIN RESULTS: Bolus injections of doxacurium did not alter the HR, BP, or ICP. Patients were paralyzed 66 +/- 12 (SEM) hrs, with recovery of the fourth twitch occurring 118 +/- 19 mins after infusion of the doxacurium was discontined. There were no incidences of prolonged weakness, myopathy, or other adverse events. CONCLUSIONS: Continuous infusion of doxacurium provides stable neuromuscular blockade for neurosurgical patients with traumatic brain injury. Doxacurium is devoid of clinically important interactions with HR, BP, or ICP and is less costly than other neuromuscular blockers used in the ICU.
<21>
Unique Identifier
11596177
Medline Identifier
21479293
Authors
Dobi-Babic R. Katalinic S.
Institution
Department of Forensic Medicine, Rijeka University School of Medicine, Brace Branchetta 20, HR-51000 Rijeka, Croatia. renata.dobi@inet.hr
Title
Death due to accidentally self-inflicted gunshot wound.
Source
Croatian Medical Journal. 42(5):576-8, 2001 Oct.
Abstract
A 37-year-old man, with the entrance gunshot wound on the front of the right leg several cm above the knee, was found dead at home in his bed. No other lesions were observed except a contusion ring around the wound that spread downward and to the right. On autopsy, the wound path was followed upward from the entrance wound (0.7 cm in diameter). The bullet went through the medial aspect of the quadriceps and adductor muscles and continued upward, adjacently to the internal iliac artery, perforating the pelvic floor and the median lobe of the prostate. It passed by the left kidney, injuring its fatty capsule, then went through the mesentery near the left segment of the transverse and descending colon, and entered the thoracic cavity through the diaphragm, injuring the posterior wall of the pericardium and the posterior wall of the left ventricle at the level of the first left rib. The bullet was found in the apex of the left lung. Death was caused by cardiac tamponade.
<22>
Unique Identifier
10483809
Medline Identifier
99411610
Authors
Castro MJ. Apple DF Jr. Hillegass EA. Dudley GA.
Institution
Department of Exercise Science, The University of Georgia, Athens 30602, USA.
Title
Influence of complete spinal cord injury on skeletal muscle cross-sectional area within the first 6 months of injury.
Source
European Journal of Applied Physiology & Occupational Physiology. 80(4):373-8, 1999 Sep.
Abstract
In this study we examined the influence of complete spinal cord injury (SCI) on affected skeletal muscle morphology within 6 months of SCI. Magnetic resonance (MR) images of the leg and thigh were taken as soon as patients were clinically stable, on average 6 weeks post injury, and 11 and 24 weeks after SCI to assess average muscle cross-sectional area (CSA). MR images were also taken from nine able-bodied controls at two time points separated from one another by 18 weeks. The controls showed no change in any variable over time. The patients showed differential atrophy (P = 0.0001) of the ankle plantar or dorsi flexor muscles. The average CSA of m. gastrocnemius and m. soleus decreased by 24% and 12%, respectively (P = 0.0001). The m. tibialis anterior CSA showed no change (P = 0.3644). As a result of this muscle-specific atrophy, the ratio of average CSA of m. gastrocnemius to m. soleus, m. gastrocnemius to m. tibialis anterior and m. soleus to m. tibialis anterior declined (P = 0.0001). The average CSA of m, quadriceps femoris, the hamstring muscle group and the adductor muscle group decreased by 16%, 14% and 16%, respectively (P< or =0.0045). No differential atrophy was observed among these thigh muscle groups, thus the ratio of their CSAs did not change (P = 0.6210). The average CSA of atrophied skeletal muscle in the patients was 45-80% of that of age- and weight-matched able-bodied controls 24 weeks after injury. In conclusion, the results of this study suggest that there is marked loss of contractile protein early after SCI which differs among affected skeletal muscles. While the mechanism(s) responsible for loss of muscle size are not clear, it is suggested that the development of muscular imbalance as well as diminution of muscle mass would compromise force potential early after SCI.
<23>
Unique Identifier
10483809
Medline Identifier
99411610
Authors
Castro MJ. Apple DF Jr. Hillegass EA. Dudley GA.
Institution
Department of Exercise Science, The University of Georgia, Athens 30602, USA.
Title
Influence of complete spinal cord injury on skeletal muscle cross-sectional area within the first 6 months of injury.
Source
European Journal of Applied Physiology & Occupational Physiology. 80(4):373-8, 1999 Sep.
Abstract
In this study we examined the influence of complete spinal cord injury (SCI) on affected skeletal muscle morphology within 6 months of SCI. Magnetic resonance (MR) images of the leg and thigh were taken as soon as patients were clinically stable, on average 6 weeks post injury, and 11 and 24 weeks after SCI to assess average muscle cross-sectional area (CSA). MR images were also taken from nine able-bodied controls at two time points separated from one another by 18 weeks. The controls showed no change in any variable over time. The patients showed differential atrophy (P = 0.0001) of the ankle plantar or dorsi flexor muscles. The average CSA of m. gastrocnemius and m. soleus decreased by 24% and 12%, respectively (P = 0.0001). The m. tibialis anterior CSA showed no change (P = 0.3644). As a result of this muscle-specific atrophy, the ratio of average CSA of m. gastrocnemius to m. soleus, m. gastrocnemius to m. tibialis anterior and m. soleus to m. tibialis anterior declined (P = 0.0001). The average CSA of m, quadriceps femoris, the hamstring muscle group and the adductor muscle group decreased by 16%, 14% and 16%, respectively (P< or =0.0045). No differential atrophy was observed among these thigh muscle groups, thus the ratio of their CSAs did not change (P = 0.6210). The average CSA of atrophied skeletal muscle in the patients was 45-80% of that of age- and weight-matched able-bodied controls 24 weeks after injury. In conclusion, the results of this study suggest that there is marked loss of contractile protein early after SCI which differs among affected skeletal muscles. While the mechanism(s) responsible for loss of muscle size are not clear, it is suggested that the development of muscular imbalance as well as diminution of muscle mass would compromise force potential early after SCI.
<24>
Unique Identifier
8002058
Medline Identifier
95095348
Authors
Sangwan SS. Aditya A. Siwach RC.
Institution
Department of Orthopaedic Surgery, Paraplegia and Rehabilitation, Medical College & Hospital, Rohtak.
Title
Isolated traumatic rupture of the adductor longus muscle.
Source
Indian Journal of Medical Sciences. 48(8):186-7, 1994 Aug.
Abstract
A rare case of traumatic rupture of Adductor longus muscle in a young Kabaddi player is presented. Excision of ruptured muscle mass was done. Maximum follow-up at eighteen months showed no disability.
<25>
Unique Identifier
9630028
Medline Identifier
98291980
Authors
Miyahara M. Sleivert GG. Gerrard DF.
Institution
University of Otago, School of Physical Education, Dunedin, New Zealand.
Title
The relationship of strength and muscle balance to shoulder pain and impingement syndrome in elite quadriplegic wheelchair rugby players.
Source
International Journal of Sports Medicine. 19(3):210-4, 1998 Apr.
Abstract
Wheelchair athletes are susceptible to injuries related to overuse of the shoulder, in particular shoulder impingement syndrome. The present study examined the relationship of shoulder pain to demographic details, isokinetic strength and muscle balance in 8 elite quadriplegic rugby players. Demographic data were collected using personal interviews and each subject was clinically examined for signs of impingement syndrome by a physician. In addition each subject underwent bilateral isokinetic strength testing of the shoulder at 60 and 180 deg/s for abduction/adduction and internal/external rotation. A series of step-wise multiple discriminant analysis successfully predicted clinical symptoms from demographic, muscular strength and balance data. In particular, there was a significant deficit in adductor strength and this was related to shoulder pain and wasting of the scapular muscles. This strength deficit may be due to the high level of spinal lesions in the quadriplegic population. The level of spinal lesion may contribute to the aetiology of shoulder pathology in quadriplegia, and differentiate it from that observed in able-bodied athletes who exhibit weak abductors.
<26>
Unique Identifier
3681443
Medline Identifier
88061632
Authors
Charkes ND. Siddhivarn N. Schneck CD.
Institution
Division of Nuclear Medicine, Temple University Medical School, Philadelphia, PA.
Title
Bone scanning in the adductor insertion avulsion syndrome ("thigh splints").
Source
Journal of Nuclear Medicine. 28(12):1835-8, 1987 Dec.
Abstract
Shin splints is a defined clinical entity resulting from extreme tension on muscles inserting on the tibia, resulting in periosteal elevation which is detectable by bone scanning. The clinical equivalent in the thigh has been described. We found scintigraphic changes in the femurs of seven short, female, basic trainees at the Fort Dix Army base, most of whom were referred for stress fractures elsewhere in the lower extremities. The scan findings were generally noted in the upper or mid femurs, always involved the anteromedial cortex, and were bilateral in five of the seven subjects. The abnormalities were linear and suggested periosteal elevation, and did not have the typical appearance of stress fracture. Since the findings correspond to the insertion of one or more adductor muscle groups, the descriptive term "adductor insertion avulsion syndrome" or "thigh splints" is proposed for this entity.
<27>
Unique Identifier
9258836
Medline Identifier
97403467
Authors
Noah EM. Williams A. Fortes W. Terzis JK.
Institution
Department of Surgery, Eastern Virginia Medical School, Norfolk 23510, USA.
Title
A new animal model to investigate axonal sprouting after end-to-side neurorrhaphy.
Source
Journal of Reconstructive Microsurgery. 13(5):317-25, 1997 Jul.
Abstract
End-to-side neurorrhaphy is a technique that may provide a solution for the problem of distal target reinnervation without injury to the original donor nerve. The technique drew extensive attention after Viterbo reported his experiments in 1992; however, to date, the animal models used to elucidate the process of lateral axon sprouting had the disadvantage of substantial injury to the donor nerve, raising questions about the origin of axons reinnervating the nerve graft. In this report, a new model in the rat is introduced, in which the donor nerve is not damaged and an additional target can be innervated via a nerve graft. The saphenous nerve represents the axonal conduit; the proximal end is coapted end-to-side to the sciatic nerve at the site of a perineurial window. The distal end is passed through the adductor muscles and coapted distally in an end-to-end fashion with the obturator nerve. In one group, a partial neurectomy was performed at the site of coaptation, which led to a lower Sciatic Functional Index (SFI). In the second group, the creation of a perineurial window yielded a normal SFI after end-to-side neurorrhaphy. Compared to the partial neurectomy group, the perineurial window end-to-side neurorrhaphy resulted in significantly less axons in the graft. The new model has the following advantages: (a) minimal injury to the donor nerve; (b) provision of a single additional target (gracilis) whose functional recovery can be assessed morphologically and behaviorally; (c) an opportunity to understand lateral sprouting by providing a non-injury model in which axonal invasion of the graft can originate from nodal axonal outgrowth; and (d) establishment of a noninjury model that can have widespread clinical applications.
<28>
Unique Identifier
11732832
Medline Identifier
21589447
Authors
Triolo R. Wibowo M. Uhlir J. Kobetic R. Kirsch R.
Institution
Motion Study Laboratory, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, OH 44106, USA. rxt24@po.cwru.edu
Title
Effects of stimulated hip extension moment and position on upper-limb support forces during FNS-induced standing--a technical note.
Source
Journal of Rehabilitation Research & Development. 38(5):545-55, 2001 Sep-Oct.
Abstract
This study explores the effects of active hip extension moment produced by electrical stimulation on the support forces the arms must exert through an assistive device during quiet erect standing with functional neuromuscular stimulation (FNS) in individuals with spinal cord injuries (SCI). A static sagittal plane biomechanical model of human standing was developed to predict the effects of stimulated hip extension moment and sagittal plane hip angle on the arm support necessary to maintain an upright posture. Two individuals with complete thoracic SCI were then tested while they stood with continuous stimulation to the knee and trunk extensors. The steady-state active extension moment exerted at the hip was varied by activating different combinations of hip extensor muscles with continuous stimulation while steady-state support forces applied to the arms and feet during standing were measured. The steady-state support forces imposed on the arms during quiet standing decrease with increased stimulated hip extension moment and are highly dependent upon hip flexion angle, as predicted by the biomechanical simulations. Experimentally, the combination of gluteus maximus and semimembranosus stimulation produced three times more steady-state hip extension moment than did stimulation of the gluteus maximus and adductor magnus. This resulted in a ten-fold decrease in body weight supported on the arms. More vertical postures (smaller hip flexion angles) improve the effectiveness of the hip extensor muscles in reducing the support forces placed on the arms. A single Newton-meter of stimulated hip extension moment with the hips fixed at 5 degrees of flexion results in almost five times the reduction in arm support forces as with the hips at 20 degrees. To minimize the forces applied by the arms on an assistive device for support while standing with FNS, these preliminary results suggest that (1) efforts should be made to assume the most erect postures possible and (2) muscles and stimulation paradigms that maximize active hip extension moment should be chosen.
<29>
Unique Identifier
11059915
Medline Identifier
20511722
Authors
Wilson S. Chandler R. Neitzschman HR.
Institution
Louisiana State University Health Sciences Center, New Orleans, USA.
Title
Radiology case of the month. A groin mass. Adductor muscle pseudotumor.
Source
Journal of the Louisiana State Medical Society. 152(10):475-6, 2000 Oct.
<30>
Unique Identifier
9464759
Medline Identifier
98124406
Authors
McKinley BA. Parmley CL. Butler BD.
Institution
University of Texas-Houston Medical School, Department of Anesthesiology, 77030, USA. bmckinle@anes1.med.uth.tmc.edu
Title
Skeletal muscle PO2, PCO2, and pH in hemorrhage, shock, and resuscitation in dogs.
Source
Journal of Trauma-Injury Infection & Critical Care. 44(1):119-27, 1998 Jan.
Abstract
OBJECTIVE: To test fiber-optic PO2, PCO2, and pH sensors placed in skeletal muscle as monitors of hemorrhage, shock, and resuscitation, compared with mean arterial blood pressure, cardiac output, and blood gas variables. DESIGN: Observational study in physiology laboratory, using a canine controlled hemorrhagic shock model. MATERIALS and METHODS: Mongrel dogs (20-35 kg; n = 10) were monitored with arterial, venous, and pulmonary artery catheters. A probe (0.5 mm in diameter) with fiber-optic PO2, PCO2, and pH sensors was placed percutaneously in the adductor muscle of the right medial thigh. Mean arterial blood pressure of 45 to 50 mm Hg was maintained for 1 hour with controlled hemorrhage, after which shed blood was reinfused. The animals were monitored for 4 hours after reinfusion. MEASUREMENTS and MAIN RESULTS: Skeletal muscle PO2 (PmO2) decreased from 31+/-9 to 5+/-4 mm Hg during shock and recovered with reinfusion. Skeletal muscle pH (pHm) decreased from 7.24+/-0.10 to 6.94+/-0.12 during shock, to 6.90+/-0.13 with reinfusion, and recovered to near baseline 2 hours after reinfusion. PmCO2 increased from 48+/-14 to 134+/-86 mm Hg during shock, to 138+/-92 mm Hg with a time course inverse to pHm, and recovered to near baseline 30 minutes after reinfusion. On average, skeletal muscle PCO2 (PmCO2) and pHm did not recover to baseline, possibly indicating persistent anaerobic metabolic effects. O2 delivery, mixed venous PO2, mixed venous O2, saturation and PmO2 responded with similar time courses. CONCLUSION: PmO2, PmCO2, and pHm can be monitored simultaneously for several hours with fiber-optic sensors in a single, small probe. PmO2 may provide information comparable to O2 delivery. PmCO2 may reflect adequacy of perfusion. pHm may indicate success of resuscitation. This technology may offer new insight into the extent of injury and refinement of shock resuscitation and monitoring.
<31>
Unique Identifier
9464759
Medline Identifier
98124406
Authors
McKinley BA. Parmley CL. Butler BD.
Institution
University of Texas-Houston Medical School, Department of Anesthesiology, 77030, USA. bmckinle@anes1.med.uth.tmc.edu
Title
Skeletal muscle PO2, PCO2, and pH in hemorrhage, shock, and resuscitation in dogs.
Source
Journal of Trauma-Injury Infection & Critical Care. 44(1):119-27, 1998 Jan.
Abstract
OBJECTIVE: To test fiber-optic PO2, PCO2, and pH sensors placed in skeletal muscle as monitors of hemorrhage, shock, and resuscitation, compared with mean arterial blood pressure, cardiac output, and blood gas variables. DESIGN: Observational study in physiology laboratory, using a canine controlled hemorrhagic shock model. MATERIALS and METHODS: Mongrel dogs (20-35 kg; n = 10) were monitored with arterial, venous, and pulmonary artery catheters. A probe (0.5 mm in diameter) with fiber-optic PO2, PCO2, and pH sensors was placed percutaneously in the adductor muscle of the right medial thigh. Mean arterial blood pressure of 45 to 50 mm Hg was maintained for 1 hour with controlled hemorrhage, after which shed blood was reinfused. The animals were monitored for 4 hours after reinfusion. MEASUREMENTS and MAIN RESULTS: Skeletal muscle PO2 (PmO2) decreased from 31+/-9 to 5+/-4 mm Hg during shock and recovered with reinfusion. Skeletal muscle pH (pHm) decreased from 7.24+/-0.10 to 6.94+/-0.12 during shock, to 6.90+/-0.13 with reinfusion, and recovered to near baseline 2 hours after reinfusion. PmCO2 increased from 48+/-14 to 134+/-86 mm Hg during shock, to 138+/-92 mm Hg with a time course inverse to pHm, and recovered to near baseline 30 minutes after reinfusion. On average, skeletal muscle PCO2 (PmCO2) and pHm did not recover to baseline, possibly indicating persistent anaerobic metabolic effects. O2 delivery, mixed venous PO2, mixed venous O2, saturation and PmO2 responded with similar time courses. CONCLUSION: PmO2, PmCO2, and pHm can be monitored simultaneously for several hours with fiber-optic sensors in a single, small probe. PmO2 may provide information comparable to O2 delivery. PmCO2 may reflect adequacy of perfusion. pHm may indicate success of resuscitation. This technology may offer new insight into the extent of injury and refinement of shock resuscitation and monitoring.
<32>
Unique Identifier
8887901
Medline Identifier
97042702
Authors
Finn PJ. Plank LD. Clark MA. Connolly AB. Hill GL.
Institution
University Department of Surgery, Auckland Hospital, New Zealand.
Title
Assessment of involuntary muscle function in patients after critical injury or severe sepsis.
Source
Jpen: Journal of Parenteral & Enteral Nutrition. 20(5):332-7, 1996 Sep-Oct.
Abstract
BACKGROUND: Study of involuntary skeletal muscle function (MFA) has been well accepted in the area of nutrition assessment and potentially offers a means for following progress of the critically ill patient. We report on the application of this technique to intensive care patients. METHODS: MFA was performed by study of the contraction/relaxation characteristics of the adductor pollicis muscle of the thumb after ulnar nerve stimulation. Serial measurements were made in 16 critically injured patients and 28 patients with severe sepsis and were compared with those obtained from 26 control subjects. Extent of loss of total body protein (TBP) was quantified with in vivo neutron activation. RESULTS: Significant difficulties exist in applying this technique to intensive care patients. In the critically injured, only five acceptable traces could be obtained from a possible 58 measurements. For patients with severe sepsis it was possible to obtain an acceptable trace on 12 of 56 occasions. Neuromuscular blockade and lack of patient cooperation were significant impediments to MFA study. Although frequently perceived as unpleasant by these patients, there was no long-term morbidity associated with MFA. No significant differences were seen in maximal relaxation rate at 30 Hz (MMR30) or force frequency ratios (F10/50 and F30/ 50) between trauma patients and controls. In the sepsis patient group, a significantly higher F10/50 was measured (52% +/- 3% severe sepsis vs 40% +/- 1% control subjects, p < .01). Six patients had MFA measured approximately 21 days after the illness, by which stage they had lost 11% of their initial TBP. Compared with control subjects, no significant differences were observed in MRR30 or F30/50, whereas a higher value for F10/50 was measured (48% +/- 1% critical illness vs 40% +/- 1% control subjects, p < .01). CONCLUSIONS: The MFA technique is difficult to apply to intensive care patients. No significant disturbance to MFA is seen after critical injury. Severe sepsis results in an elevation of F10/ 50 only. When able to be obtained, MFA results do not reflect the extent of proteolysis but are indicative of the state of cellular energetics.
<33>
Unique Identifier
9604200
Medline Identifier
98267559
Authors
Tuite DJ. Finegan PJ. Saliaris AP. Renstrom PA. Donne B. O'Brien M.
Institution
Department of Anatomy, University of Dublin, Trinity College, Ireland.
Title
Anatomy of the proximal musculotendinous junction of the adductor longus muscle.
Source
Knee Surgery, Sports Traumatology, Arthroscopy. 6(2):134-7, 1998.
Abstract
Injuries to the adductor longus commonly occur in the proximal part of the muscle tendon unit, close to the insertion site on the pubic bone. Ultrasonography, magnetic resonance imaging (MRI) and surgery have been helpful in localising the lesions, but the exact anatomy of the musculotendinous junction (MTJ) and insertion of the muscle remain unclear. We studied the anatomical features of the MTJ and measured the dimensions of the tendinous insertion into the pubic bone on 37 cadavers: 18 men and 19 women. The medial boundaries were the longest part of the tendon bilaterally in women, while the lateral aspect of the left muscle was greater in men. Tendinous fibres were predominantly found on the anterior surface, while the posterior surface consisted mainly of muscle tissue. The MTJ was clearly demarcated. There were several types of anomalies present which partially explains the difficulty in localising the site of injury and highlights the importance of individualized treatment.
<34>
Unique Identifier
6789233
Medline Identifier
81245589
Authors
Oxburn MS. Nichols JW.
Title
Pubic ramus and adductor insertion stress fractures in female basic trainees.
Source
Military Medicine. 146(5):332-4, 1981 May.
<35>
Unique Identifier
2532710
Medline Identifier
90114298
Authors
Fleckenstein JL. Peshock RM. Lewis SF. Haller RG.
Institution
Department of Radiology, University of Texas, Southwestern Medical Center, Dallas 75235.
Title
Magnetic resonance imaging of muscle injury and atrophy in glycolytic myopathies.
Source
Muscle & Nerve. 12(10):849-55, 1989 Oct.
Abstract
Exertional muscle pain, contractures, recurrent rhabdomyolysis, and pigmenturia are common in certain muscle glycolytic disorders. However, the frequency, distribution, and long-term significance of these findings are poorly understood. First we performed magnetic resonance imaging (MRI) of the extremities as a screening test for the detection of muscle abnormalities incurred in activities of daily living in four patients with myophosphorylase deficiency (MPD) and three with muscle phosphofructokinase deficiency (PFKD). MRI findings of abnormal muscles detected upon screening were next compared with changes observed in a prospective study of muscle contractures involving the forearms of four of the patients (two MPD, two PFKD). Screening revealed abnormalities of proximal thigh muscles in three of seven patients, in two of whom (one MPD, one PFKD) a recent history of exertional myalgia coincided with increases in T1 and T2 estimates of isolated thigh muscles. In the third patient (PFKD), focal atrophy of the adductor magnus was present bilaterally. In prospective studies, focal areas of prolonged T1 and T2 appeared in the flexor digitorum superificalis in all four cases and in the flexor digitorum profundus in two cases. Serial imaging suggested that the onset of MRI abnormalities begins within 24 hours of contracture and persists for at least several days and possibly for much longer, with complete recovery apparently the rule. These cases suggests a high prevalence of focal muscle abnormalities in patients with glycolytic myopathies and show the potential of MRI to detect them.
<36>
Unique Identifier
9500396
Medline Identifier
98160032
Authors
Wang BH. Ye C. Stagg CA. Lin M. Fawcett T. VanderKolk CA. Udelsman R.
Institution
Division of Plastic and Reconstructive Surgery at The Johns Hopkins University School of Medicine, Baltimore, Md, USA.
Title
Improved free musculocutaneous flap survival with induction of heat shock protein. [see comments.].
Comments
Comment in: Plast Reconstr Surg. 1999 Jan;103(1):336-7 ; 9915213
Source
Plastic & Reconstructive Surgery. 101(3):776-84, 1998 Mar.
Abstract
The cellular response to a wide variety of stresses results in the synthesis of a family of stress response proteins termed heat shock proteins. Recent studies have demonstrated that heat shock proteins produced in response to an initial stress seem to protect against subsequent unrelated stresses. Importantly, hyperthermia-induced heat shock proteins provided protection from ischemia/reperfusion injury in several organ transplantation models. We hypothesized that free musculocutaneous flap survival could be improved by enhancing the flap's tolerance to relative ischemia by the prior induction of heat shock proteins. Accordingly, we determined the heat shock protein response in skin and muscle after systemic or local heating and examined the effect on free musculocutaneous flap survival in a rat model. Free musculocutaneous flaps incorporating thigh adductor muscles and a 2 x 6-cm2 skin paddle were transplanted to the ipsilateral groin in three groups of male Wistar rats. Systemically heated rats (n = 6) were anesthetized and incubated for 30 minutes at 42 degrees C 6 hours before free musculocutaneous tissue transfer. Locally heated rats (n = 6) were anesthetized, and their donor site anterior thigh was placed for 30 minutes on a heating block set at 44 degrees C 6 hours before free tissue transfer. Control rats (n = 5) did not have heating pretreatment but underwent identical anesthesia. Animals were sacrificed on postoperative day 3, at which time skin loss (cm2) and muscle viability, quantified by nitroblue tetrazolium staining time, were assessed in a blinded fashion. The skin and muscle from the free flap were analyzed for HSP72 mRNA and protein using quantitative Northern and Western blot techniques. All free musculocutaneous flaps were viable. However, the locally and systemically heated rats demonstrated a marked improvement of skin survival, which correlated with increased skin levels of HSP72. There were no differences in nitroblue tetrazolium muscle staining times or muscle levels of HSP72 among the three groups. These findings suggest that prior heat-induced heat shock proteins result in improvement in musculocutaneous flap survival, which may have direct clinical applications, especially in high-risk patients.
<37>
Unique Identifier
9036441
Medline Identifier
97157167
Authors
Iovane A. Midiri M. Caruso G. Finazzo M. Lo Bello M. Lagalla R.
Institution
Istituto di Radiologia Pietro Cignolini, Universita degli Studi, Palermo.
Title
[Stener lesions: ultrasonography assessment in 12 cases]. [Italian]
Source
Radiologia Medica. 92(5):535-8, 1996 Nov.
Abstract
We investigated the ultrasonographic (US) features of Stener injury and thus the role of US in the diagnosis of this condition. Stener injuries are characterized by the tear of the cubital ligament system of the first metacarpophalangeal joint during hyperabduction. This condition may be associated with the displacement of the ligament proximal stump above the thumb adductor muscle. We examined 12 patients (9 men and 3 women) with a clinical diagnosis of joint instability due to hyperabduction of the first metacarpophalangeal joint. All the US exams were performed with a linear probe (7.5-10 MHz); a 13-MHz probe was also used in 7 patients. All the patients were submitted to radiography in the standard projections, to detect associated bone injuries. US allowed the identification of a round lesion surrounded by a hypoechoic halo, between the distal edge of the dorsal interosseous muscle of the first finger and the first metacarpal bone (the proper Stener injury) in 4/12 patients. In contrast, no typical sign was shown in the other 8 patients. US results were then compared with surgical findings. The diagnosis of proper Stener injury was surgically confirmed in 4 patients. Only 2 patients with clinical signs of thumb instability, who were negative for Stener injuries at US, were submitted to surgery which demonstrated the ligament tear responsible for joint instability, but ruled out the displacement. To conclude, US must be integrated with clinical signs because this imaging method accurately shows complete tears with displaced proximal stump of the cubital ligament.
<38>
Unique Identifier
948592
Medline Identifier
76245210
Authors
Schneider R. Kaye J. Ghelman B.
Title
Adductor avulsive injuries near the symphisis pubis.
Source
Radiology. 120(3):567-9, 1976 Sep.
Abstract
Avulsion injuries occurring near the symphisis pubis are related to the sites of origin of the adductor longus, adductor brevis, and gracilis muscles. Young athletes complain of pain near the symphisis which is increased by active adduction of the limb against resistance. Radiographic findings, similar to those found in infection and neoplasms, are mixed bone destruction and sclerosis on one side of the symphisis, frequently extending inferior pubic ramus.
<39>
Unique Identifier
10502993
Medline Identifier
99432611
Authors
Ogata K. Yamada T. Yoshimura T. Taniwaki T. Kira J.
Institution
Department of Neurology, Faculty of Medicine, Kyushu University, Fukuoka.
Title
[A case of spinal myoclonus associated with epidural block for lumbago]. [Japanese]
Source
Rinsho Shinkeigaku - Clinical Neurology. 39(6):658-60, 1999 Jun.
Abstract
We herein report a case of spinal myoclonus following the administration of epidural anesthesia. A 25-year-old woman underwent lumbar epidural anesthesia because of lumbago and cramps in her left lower limb. She immediately felt a lancinating pain in her left limb during anesthesia at the level of L 4/5 and soon developed myoclonus in her left thigh. The neurological examination revealed rhythmic myoclonus in the left quadriceps and adductor thigh muscles. The myoclonus disappeared after performing a blockade of the left L 4 spinal root by using 1.5 ml of 1% lidocaine. An injury to the left L 4 nerve root during the epidural anesthesia possibly caused an abnormal transmission of the impulses or ectopic hyperexcitability in the nerve root, which might lead to the disturbance of the spinal inhibitory interneurons and hyperexcitability of the anterior horn cells causing myoclonus. Since she did not demonstrate any muscular weakness, nor sensory loss during the lidocaine block, the 1% lidocaine appeared to block the sympathetic nerves or to suppress the ectopic hyperexcitability. The sympathetic nerves may be involved in the development of her spinal myoclonus.
<40>
Unique Identifier
10947172
Medline Identifier
20401996
Authors
Huk I. Brovkovych V. Nanobashvili J. Neumayer C. Polterauer P. Prager M. Patton S. Malinski T.
Institution
Department of Vascular Surgery, University of Vienna, Austria.
Title
Prostaglandin E1 reduces ischemia/reperfusion injury by normalizing nitric oxide and superoxide release. [see comments.].
Comments
Comment in: Shock. 2000 Aug;14(2):243-4 ; 10947173
Source
Shock. 14(2):234-42, 2000 Aug.
Abstract
To test the effects of prostaglandin E1 on 2.5 h of ischemia followed by 2 h of reperfusion, continuous nitric oxide measurements (electrochemical) were correlated with intermittent assays of superoxide and peroxynitrite levels (chemiluminescence) and ischemia/reperfusion injury in rabbit adductor magnus muscle. Administering prostaglandin E1 (1 microg/kg) before or during ischemia/reperfusion caused normalization of the release of nitric oxide, superoxide, and peroxynitrite to slightly above preischemic levels. This pattern was dramatically different from that observed during ischemia/reperfusion alone, where nitric oxide concentration increased three times above its basal level. Normalization of constitutive nitric oxide synthase activity in the presence of prostaglandin E1 was associated with a significant reduction of superoxide and peroxynitrite production and subsequent reduction of ischemia/reperfusion injury. At 2 h of reperfusion, vasoconstriction associated with ischemia/reperfusion injury was eliminated, and edema was significantly mollified but still apparent. Prostaglandin E1 treatment does not directly inhibit constitutive nitric oxide synthase, like the inhibitor N(omega)-monomethyl-L-arginine. Some phenomenon associated with ischemia turns on endothelial constitutive nitric oxide synthase to start transforming L-arginine and oxygen into nitric oxide, but prostaglandin E1 seems to inhibit this phenomenon. Thus, essential local L-arginine pools are not depleted, and normal basal levels of essential nitric oxide are maintained, whereas cytotoxic superoxide and peroxynitrite production by L-arginine-deficient constitutive nitric oxide synthase is prevented.
<41>
Unique Identifier
10492031
Medline Identifier
99419780
Authors
Lynch SA. Renstrom PA.
Institution
Department of Orthopaedics, Penn State University, Hershey Medical Center, Pennsylvania, USA.
Title
Groin injuries in sport: treatment strategies.
Source
Sports Medicine. 28(2):137-44, 1999 Aug.
Abstract
Groin pain in athletes is a common problem that can result in significant amounts of missed playing time. Many of the problems are related to the musculoskeletal system, but care must be taken not to overlook other more serious and potentially life threatening medical cases of pelvis and groin pain. Stress fractures of the bones of the pelvis occur, particularly after a sudden increase in the intensity of training. Most of these stress fractures will heal with rest, but femoral neck stress fractures can potentially lead to more serious problems, and require closer evaluation and sometimes surgical treatment. Avulsion fractures of the apophyses occur through the relatively weaker growth plate in adolescents. Most of these will heal with a graduated physical therapy programme and do not need surgery. Osteitis pubis is characterised by sclerosis and bony changes about the pubic symphysis. This is a self-limiting disease that can take several months to resolve. Corticosteroid injection can sometimes hasten the rehabilitation process. Sports hernias can cause prolonged groin pain, and provide a difficult diagnostic dilemma. In athletes with prolonged groin pain, with increased pain during valsalva manoeuvres and tenderness along the posterior inguinal wall and external canal, an insidious sports hernia should be considered. In cases of true sports hernia, treatment is by surgical reinforcement of the inguinal wall. Nerve compression can occur to the nerves supplying the groin. In cases that do not respond to desensitisation measures, neurolysis can relieve the pain. Adductor strains are common problems in kicking sports such as soccer. The majority of these are incomplete muscle tendon tears that occur just adjacent to, the musculotendinous junction. Most of these will respond to a graduated stretching and strengthening programme, but these can sometimes take a long time to completely heal. Patience is the key to obtain complete healing, because a return to sports too early can lead to chronic pain, which becomes increasingly difficult to treat. Management of groin injuries can be challenging, and diagnosis can be difficult because of the degree of overlap of symptoms between the different problems. By careful history and clinical examination, with judicious use of special tests and good team work, a correct diagnosis can be obtained.
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Unique Identifier
8171224
Medline Identifier
94225105
Authors
Karlsson J. Sward L. Kalebo P. Thomee R.
Institution
Department of Orthopaedics, East Hospital, University of Goteborg, Sweden.
Title
Chronic groin injuries in athletes. Recommendations for treatment and rehabilitation.
Source
Sports Medicine. 17(2):141-8, 1994 Feb.
Abstract
Chronic muscle and tendon injuries to the groin are common sports injuries. The symptoms of groin injuries are often uncharacteristic which can result in a delay in the correct and specific diagnosis being reached. The most common injury is the overuse strain resulting in chronic tendinitis of the adductor muscle/tendon units, especially the adductor longus. The rectus femoris and rectus abdominous muscles and tendons are also commonly affected. Computed tomography, magnetic resonance imaging and ultrasonography have been widely adopted to diagnose muscle/tendon injuries to the groin. Ultrasonography has been shown to be accurate and sensitive in diagnosing tendon injuries in the groin region, especially small partial ruptures of the muscle/tendon unit. Ultrasonography has the advantage of being fast, inexpensive and widely available. Normal findings are readily distinguished from pathological findings providing valuable pre-operative information, such as location and extent of the injury. The differential diagnoses are many and often difficult to reach. The most commonly overlooked differential diagnoses are chronic prostatitis and hernias. A multidisciplinary approach is valuable in many cases. The recommended treatment is well planned and gradually increased rehabilitation programme during the first stages. Surgery for acute injuries is rarely indicated. Surgery, for example tenotomy of the adductor longus, has given satisfactory results in many athletes when nonsurgical treatment has failed.