Metatarsal lengthening by distraction osteogenesis was performed on 17 brachymetatarsia patients with 39 metatarsal bones. To lengthen the first metatarsal in an attempt to prevent development of varus deformity of the hindfoot after lengthening, horizontal lengthening in the anterior direction was performed rather than lengthening through the anatomical axis. In addition, care was taken to ensure that the fourth metatarsal bone screw did not interpose with the fifth extensor tendon during the fourth metatarsal lengthening. Lengthening was successful except in 1 case with mean lengthening of 19.5 mm (48.8%) for the first metatarsal and 17.1 mm (36.2%) for the fourth metatarsal. Because of joint stiffness, plantar capsulotomy was performed on 7 cases, 6 of which had been previously operated on bilaterally. Varus deformity of the hindfoot after the first metatarsal lengthening and entrapment of the fifth extensor tendon after the fourth metatarsal lengthening was not detected in any case.
BackgroundVarious training schemes have sought to improve golf-related athletic ability. In the golf swing motion, the muscle strengths of the core and arms play important roles, where a difference typically exists in the power of arm muscles between the dominant and non-dominant sides. The purposes of this study were to determine the effects of exercises strengthening the core and non-dominant arm muscles of elite golf players (handicap < 3) on the increase in drive distance, and to present a corresponding training scheme aimed at improving golf performance ability.MethodsSixty elite golfers were randomized into the control group (CG, n = 20), core exercise group (CEG, n = 20), and group receiving a combination of muscle strengthening exercises of the non-dominant arm and the core (NCEG, n = 20). The 3 groups conducted the corresponding exercises for 8 weeks, after which the changes in drive distances and isokinetic strength were measured.ResultsSignificant differences in the overall improvement of drive distance were observed among the groups (p < 0.001). Enhancement of the drive distance of NCEG was greater than both CG (p < 0.001) and CEG (p = 0.001). Except for trunk flexion, all variables of the measurements of isokinetic strength for NCEG also showed the highest values compared to the other groups. Examination of the correlation between drive distance and isokinetic strength revealed significant correlations of all variables except trunk flexion, wrist extension, and elbow extension.ConclusionThe combination of core and non-dominant arm strength exercises can provide a more effective specialized training program than core alone training for golfers to increase their drive distances.
The authors treated congenital muscular torticollis by sternocleidomastoid muscle release in 32 patients over 8 years of age who had not received any prior medical treatment or in whom torticollis had recurred since initial treatment. The results were analyzed to compare clinical results after an average of 39 months (range 24-74 months) by dividing the patients into two groups: patients who were still in the growing period (group 1, n=19) and patients who had finished growth (group 2, n = 13) at surgery. According to the total score table by Cheng et al (which includes motion deficits, craniofacial asymmetry, scar, band, head tilt, and subjective assessment), there were 13 excellent and 6 good results in group 1 and 2 excellent, 8 good, and 3 fair results in group 2. The clinical results were statistically less successful in group 2 than in group 1 by Cheng's score table (P <0.05). However, most patients showed marked improvement in neck motion and head tilt, with satisfactory functional and cosmetic results. Thus, in patients older than school age, even for those who have finished growth, sufficient unipolar or bipolar release of the sternocleidomastoid muscle and intensive postoperative care are expected to yield satisfactory treatment results.
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