Hamstring muscle strains were responsible for the loss of playing time of a significant number of football players at the University of Nebraska in the early 1970s. After the acquisition of a Cybex II isokinetic dynamometer, the number of injuries was noted to decrease. A retrospective study was performed over the period 1973 to 1982. Players in Group I, from 1973 to 1977, underwent a training program consisting of a supervised winter running program and self-designed year-long stretching, running, and weight lifting. Hamstring injuries were managed with rest, ice, and elevation initially and, by the third day, mild running was instituted. On the average, by the 14th day the athlete had demonstrated adequate speed and agility and was allowed to return to action. Group II consisted of players from the 1978 to 1982 period. These players received supervised winter running programs and staff-designed year-long stretching, running, and weight lifting programs. In addition, all athletes had baseline testing of hamstrings and quadriceps. Deficits were corrected to a desired ratio of 0.60. Injured players in Group II were treated with rest, ice, and elevation initially. High speed isokinetic workouts were begun on the third day with testing on the fifth day. They were allowed to begin jogging when the peak torque of hamstrings equaled 70% of baseline. Players returned to action when peak-torque reached a level of 95% of the baseline score or a hamstrings:quadriceps ratio of 0.55 or greater. Average time out of action was 2 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)
While the posterolateral technique is the accepted fusion method for chronic mechanical back pain, the results are variable and the indications are narrow. In an attempt to resolve this problem the role of internal fixation has been explored. Relative stiffness and strength under flexion loading of four lumbosacral fixation systems-( I ) translaminar facet joint screws, (2) Luque rectangular box, (3) Luque fixation to the pelvis via the Galveston technique, and (4) two-part pelvic spinal rod systemwere evaluated and compared to the normal spine with and without posterior ligaments. The stiffness of the normal intact spine was found to be nonlinear: the bending moment is a function of the square of the flexion rotation. Internal fixation resulted in a twofold increase in stiffness. Facet screws were 20% stiffer and the pelvic-spinal system 2.3 times stiffer (p = 0.001) than the Luque systems but all had similar strength. A retrospective study of 135 consecutive posterolateral lumbosacral spine fusions was conducted to determine what factors improved the fusion rate, clinical results, and time to fusion. Diagnosis and previous surgical treatment, discectomy or fusion, were of no significance. The radio-graphic and clinical results were highly correlated (p = 0.0001). Electrical stimulation failed to improve the results. Internal fixation with facet joint screws or rods to the pelvis was found to statistically decrease the pseudarthrosis rate and reduce the time required for spine fusion (p = 0.02). The surgical technique consists of translaminar facet screws and segmental fixation to the pelvis using a new implant system.
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