Alcohol and the athlete have been linked together since ancient times. It continues to be the most commonly consumed drug among the athletic population. Alcohol use carries significant potential adverse effects for both the health and welfare of the individual. It is suggested that alcohol related problems may be more prevalent in the athletic population due to their risk taking mentality and the age profile of athletes (18- to 24-year-old males). Alcohol consumption also appears to have a causative effect in sports related injury, with an injury incidence of 54.8% in drinkers compared with 23.5% in nondrinkers (p < 0.005). This may be due in part to the hangover effect of alcohol consumption, which has been shown to reduce athletic performance by 11.4%. Alcohol is a potentially lethal drug and is a banned substance for certain Olympic sports. Education is the cornerstone for appropriate social use of this drug. Athletes and coaches need to be aware of the sports related adverse effects of alcohol consumption and its role in sports injury and poor physiological performance. It is recommended that alcohol should be avoided by the serious athlete.

We have carried out a blind, prospective study of 50 consecutive patients undergoing replacement arthroplasty of the hip using two different approaches. Clinical assessment, including the Harris hip score and a modified Trendelenberg test, and electrophysiological examination of the abductor muscles of the hip were undertaken before and three months after surgery. We found that 48% of patients had preoperative evidence of chronic injury to the superior gluteal nerve. Perioperative injury to the nerve occurred commonly with both approaches to the hip.We did not find a significant correlation between injury to the superior gluteal nerve and clinical problems. The superior gluteal nerve may be compromised during total hip arthroplasty.1 The direct lateral approach of Hardinge puts this nerve at risk when the gluteus medius is split and retracted anteriorly. 2 We have made a prospective study of 50 consecutive patients undergoing total hip arthroplasty, to establish whether there was a greater incidence of injury to the superior gluteal nerve associated with a particular approach to the hip. The operating surgeons used either a direct lateral or a transtrochanteric approach, in accordance with their normal practice. The patients were assessed clinically and electrophysiologically before and at three months after operation. Patients and MethodsAll 50 patients suffered from primary osteoarthritis and all gave informed consent. Patients were excluded from the study if there was a known history or any signs of abnormal nerve function. Two patients were withdrawn from the study after the initial assessment. The remaining 19 men and 29 women had a mean age of 69.8 years (52 to 83). The direct lateral approach, as described by Hardinge, was used in 25 and the transtrochanteric approach in 23. The mean operating time was 90.3 minutes for the direct lateral group and 94 minutes for the transtrochanteric group. In each case preoperative needle electromyographiy (EMG) was carried out to examine the superior gluteal nerve supplying the gluteus medius, gluteus minimus and tensor fascia lata. The more distal muscles, vastus medialis (L4), tibialis anterior (L5) and medial gastrocnemius (SI), were also assessed to determine if there was any evidence of a more widespread denervating process, such as lumbar radiculopathy, which would compromise the roots of the superior gluteal nerve (L4, L5, S1). The EMGs were carried out by a clinical neurophysiologist (CO'B). The muscles were examined using the criteria of the American Academy of Electrophysiological Medicine for needle EMG.3 Rest and insertional activity was assessed first, followed by observations of the recruitment pattern and the motor unit action potential (MUAP). Acute or ongoing denervation was diagnosed if there was increased insertional activity (>300 m/s), evidence of positive sharp waves, fibrillation potentials, complex repetitive discharges or other abnormal rest or insertional potentials. 4 Ongoing denervation or re-innervation was determined by the morphology and a...

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Parsonage-Turner syndrome is the term used to describe a neuritis involving the brachial plexus. It may present with symptoms of an isolated peripheral nerve lesion, although the pathology is thought to lie more proximally. A case describing an isolated anterior interosseus nerve palsy due to an acute brachial neuritis is presented where the electromyographic findings confirmed the diagnosis, but also demonstrated the coexistence of a dual pathology in the form of a cervical radiculopathy. The literature is reviewed regarding etiology, treatment, and prognosis.