Gymnastics has undergone a tremendous increase in popularity largely due to exposure during the Olympics. The injury rate in gymnastics is exceeded only by football, wrestling, and softball. A prospective analysis of club level gymnastic injuries over one season (1982-83) was conducted. Complete responses from 15 clubs (2,558 participants) were obtained. Parameters of clubs followed were: skill level, student, instructor ratio, safety equipment, and conditioning and warm-up exercises. Data obtained from each participant were: injuries sustained, event in which injury occurred, setting of injury, type of injury, and duration of disability. Results were 62 injuries among 542 competitive and 2,016 noncompetitive level athletes (5.3 per 100 competitors and 0.7 per 100 beginners). Of the 62 injuries, 51 were acute and 11 chronic. Twenty-one injuries occurred during floor exercises, 13 on beam, 9 on vault, 6 on uneven parallel bars, and 2 on springboard. Acute injuries included 21 sprains, 16 fractures, 6 contusions, 4 dislocations, and 4 muscle strains. A significant finding was the increased frequency of acute injury seen at dismount. Also there was a positive correlation between duration of frequency of practice (fatigue) and injury rate. We would define a high risk gymnast as one who is performing at an advanced competitive level, performing floor or beam exercises, and practicing more than 20 hours per week.
The search for less invasive surgical techniques to address the effects of facial aging led to the development of barbed polypropylene sutures for facial suspension. Theoretical advantages of these "threadlifts" included limited scarring, rapid recovery, relative safety, and reduced cost when compared with a standard rhytidectomy. The goal of this study was to evaluate the outcomes of patients undergoing threadlifts to determine the actual complication rates, the durability of results, and the rates of reoperative surgery. A single surgeon's initial 2-year experience with 72 patients undergoing threadlifts was retrospectively reviewed. Preoperative patient demographical and clinical data, operative information, and postoperative outcomes data were compiled and evaluated. A total of 72 thread lifts were performed by 1 surgeon over a 24-month period. Of these patients, 76% underwent threadlift alone, whereas concomitant procedures were performed in 24% of patients. Minor complications were common and usually self-limited. Forty-two percent of patients underwent a secondary procedure after primary threadlift, an average of 8.4 months after the original surgery. Thirty-one percent of patients required revisional surgery for cosmetic reasons an average of 8.7 months after their threadlift. Eleven percent of the patients ultimately required removal of palpable threads. Threadlift is a safe procedure associated with minor complications. Rates of revisional surgery for cosmesis are high after threadlift. Time to revisional surgery for cosmesis is short. Results achieved by threadlift are subtle and short-lived. Threadlift is not a minimally invasive replacement of surgical rhytidectomy. Patients should understand the limitations of this technique and its high rates of revisional surgery.
\s=b\Three cases of an aberrant internal carotid artery presenting at or near the midline in the posterior part of the pharynx occurred. In all three cases, the anomalous finding was not correlated with the presenting symptoms of the patient. In two of the three cases intraoral pulsations were detected during initial examination. In the third case, pulsations were appreciated on reexamination after roentgenographic evaluation. Intraoral photographs, computed tomographic scan, magnetic resonance imaging, and arteriography of these findings are shown. A review of the literature and the embryology of the lateral pharyngeal carotid artery are presented along with the rare finding of the near midline carotid artery and the clinical implications of this anomaly. (Arch Otolaryngol Head Neck Surg 1989;115:519-522) The congenitally tortuous internal carotid artery is an uncommon but important anomaly for the otolaryngologist/head and neck surgeon to recognize. The aberrant carotid artery poses a risk during both major oro¬ pharyngeal tumor resections and less extensive procedures, such as tonsillectomy, adenoidectomy, and palatopharyngoplasty.1Of the general population, 1% to 16%"' have a surgically vulnerable internal carotid artery manifested clinically as detectable lateral pha¬ ryngeal wall pulsations. Dramatic
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