Twelve patients with drop-foot secondary to sciatic or common peroneal nerve palsy treated with transfer of the tibialis posterior tendon were followed-up for a mean of 90 (24-300) months. In 10 patients the results were 'excellent' or 'good'. In 11 patients grade 4 or 5 power of dorsiflexion was achieved, although the torque, as measured with a Cybex II dynamometer, and generated by the transferred tendon, was only about 30% of the normal side. Seven patients were able to dorsiflex their foot to the neutral position and beyond. The results appeared to be better in men under 30 years of age with common peroneal palsies. A painful flatfoot acquired in adulthood does not appear to be a significant long-term complication despite the loss of a functioning tibialis posterior tendon.Résumé 12 patients avec pied tombant secondaire à une paralysie sciatique et traités par transfert du tendon tibial postérieur ont été suivis en moyenne 90 mois (24-300). Chez 10 patients les résultats étaient 'Excellent' ou 'Bon'. Chez 11 patients une force de dorsiflexion de grade 4 ou 5 a été atteinte, bien que le couple produit par le tendon transféré, mesuré avec un dynamomètre et le Cybex II n'était que de 30% de la valeur du côté normal. 7 patients étaient capables de relever leur pied en position neutre et au-delà. Les résultats ont paru meilleurs chez les hommes de moins de 30 ans avec paralysie du sciatique poplité externe. Un pied-plat acquis douloureux ne paraît pas être une complication à long terme en dépit de la perte de l'action normal du tendon tibial posterieur.

Badminton is a sport that requires a lot of over-shoulder motion, with the shoulder in abduction/external rotation. This questionnaire study on 188 international top-level badminton players during the World Mixed Team Championships showed that previous or present shoulder pain on the dominant side was reported by 52% of the players. Previous shoulder pain was reported by 37% of the players and on-going shoulder pain by 20% of the players. There were no significant differences in the prevalence of shoulder pain between men and women. The majority of the shoulder pain had started gradually. The pain was usually associated with shoulder activity, and stiffness was a common, associated symptom. Furthermore, the shoulder pain was associated with consequences such as sleeping disturbances, changes in training and competition habits, and it also affected activities of daily living. The majority of the players had sought medical advice and had been given different kinds of treatment. The study showed that shoulder pain is a common and significant problem in world-class badminton players, and the consequences are most likely of importance for their training and playing capacity.

No abstract

Seventeen patients with a mean follow-up of 64.4 months following a tibialis posterior tendon transfer to regain active foot dorsiflexion were clinically examined specifically for signs of tibialis posterior tendon dysfunction. The results show that 8 patients (47%) had Grade 4 or better power of eversion but none had a clinical flatfoot on the Harris-Beath footprints. Only 6% had forefoot abduction; 17% exhibited hindfoot valgus and 82% were able to perform the single-heel rise. Tibialis posterior tendon dysfunction therefore does not appear to be an inevitable sequel of tibialis posterior tendon transfer even in the presence of a functioning peroneal muscle. Other studies have noted that a pre-existent flatfoot was often present in patients with tibialis posterior tendon dysfunction. None of the patients in this study had pre-existent flatfoot. We suggest that a predisposition, in the form of a pre-existent tendency to flatfoot may also be a factor in the pathogenesis of tibialis posterior tendon dysfunction. This may explain the long-term failure of flexor digitorum longus and flexor hallucis longus tendon transfers in the treatment for tibialis posterior tendon dysfunction when the biomechanics of the foot has not been altered.

Motorcycle helmets have been proven to prevent head injury and reduce fatality in road crashes. However, certain studies indicate that the helmet increases the mass to the head, and thus the potential of neck injury due to the flexion/extension of the head-neck segment in a road crash may increase. This study was conducted to evaluate the effects of motorcycle helmets and the ways in which the accidents that occurred affected the incidence of cervical spine injury. Nevertheless, it is not intended to and does not discredit the fact that helmet use prevents many motorcyclists from sustaining serious and fatal head injuries. A total of 76 cases were collected and analyzed based on the data collected from real-world crashes. The Abbreviated Injury Scale (AIS) was used to assess the severity of injury, whereas the statistical Pearson χ(2) correlation method was used for analysis. The results showed that motorcycle helmets did not affect the severity of cervical spine injury. However, when the samples were further subcategorized into different crash modes, it was found that helmets affect the incidence of a severe cervical spine injury. In frontal collisions, the use of helmets significantly reduces the severity of cervical spine injury, whereas in rear-end, side impact, and skidded accidents, the use of helmets increases the probability of a severe cervical spine injury. However, in the latter crash modes, a motorcyclist without a helmet will have to trade-off with head injury. A logistic regression model has been developed with respective crash modes and the probabilities of risk in having severe cervical spine injury have been calculated. Future designs in motorcycle helmets should therefore consider the significance of nonfrontal accidents and the interaction of helmet with other parts of the body by possibly considering the weight of the helmet.

No abstract

Anterior translation in the right shoulders of 23 volunteers was evaluated using ultrasound from an anterior approach with a 10 MHz, 6 cm wide linear transducer. A translatory force of 90 N was used to translate the humeral head in the adduction and internal rotation position, while a translatory force of 60 N was used in the more clinically relevant position of 90° abduction and external rotation position. The overall intra-observer coefficients of variation ranged from 0–13.0% (mean 3.8 ± 2.5%) for examiner I and 0.5–20.9% (mean 5.1 ± 3.9%) for examiner II. The overall inter-observer variation ranged from 0–29.8% (mean 9.3 ± 7.3%). The anterior translation of the humeral head in adduction and internal rotation following 90 N displacement force ranged from -2.6 to 12.9 mm (mean 2.1 ± 3.1 mm) for examiner I and from -4.1 to 4.7 mm (mean 1.1 ± 2.2 mm) for examiner II. The anterior translation of the humeral head in abduction and external rotation following 60 N displacement force ranged from -3.3 to 3.7 mm (mean 0.3 ± 1.9 mm) for examiner I and from -8.3 mm to 4.5 mm (mean -0.7 ± 2.6 mm) for examiner II. The intra-class correlation coefficients (r) for the measured anterior translation between the two examiners for the 2 positions were 0.029 and -0.058 respectively. We concluded that the inter-observer coefficient of variation remained excessive and the agreement in the measured anterior translation between the two examiners was poor. The finding of negative values in the measured anterior translation despite the use of 90 N and 60 N translatory force raises further concerns about the prospective clinical use of this technique at the present moment.