Aneurysms of the mid axillary artery in major league baseball pitchers—A report of two cases

AbstractTrue aneurysms of the axillary artery and its branches are rarely identified. Our recent experience with successful repairs of symptomatic aneurysms of the axillary arteries at the origin of the circumflex humeral arteries in 2 major league baseball pitchers suggests a condition that may be more common than recognized previously. We report this unique experience with baseball pitchers to focus attention on a condition that should be considered in all athletes with hand pain, numbness, or signs of digital ischemia. In addition, a schedule of rehabilitation and the timing of an appropriate return to competition is presented. (J Vasc Surg 1998;28:702-7.

Rotator Cuff Deficient Arthritis of the Glenohumeral Joint

Rotator cuff deficient arthritis of the glenohumeral joint, especially cuff tear arthropathy, has proved a challenging clinical entity for orthopaedic surgeons ever since Charles Neer originally detailed the problem in 1983. Understanding has improved regarding the pathophysiology and pathomechanics underlying cuff tear arthropathy. Surgical reconstruction options can lead to excellent outcomes for patients afflicted with these painful and functionally limited shoulders. Humeral hemiarthroplasty and reverse total shoulder arthroplasty have jumped to the forefront in the treatment of cuff tear arthropathy. As studies continue to look at the results of these procedures in cuff tear arthropathy, existing indications and treatment algorithms will be further refined. In this article the history and pathophysiology of cuff tear arthropathy are reviewed. Additionally, the clinical findings and results of surgical reconstruction are discussed

Review of the literature on sports related clavicle fractures and analysis on the biomechanics of lesion

There are many injuries associated with the practice of martial arts. There is a growing population of people who practice various forms of martial arts on a daily basis with improper or insufficient supervision making them prone to execute the techniques in an erroneous manner subsequently leading to injury. Fracture of the clavicle during Hapkido training has been associated directly to incorrect execution of basic techniques. During 1998-2000 twelve black belt level Hapkido athletes were reported to present mid clavicle fractures of the right limb directly associated to the erroneous execution of specific basic Hapkido maneuvers. The erroneous techniques where reproduced with healthy trained athletes under a controlled environment to analyze the error in their execution and the biomechanics correlating to the fracture of the clavicle. All the patients were diagnosed with Allman group Ib/ Robinson type 2 fracture of the dominant limb clavicle, directly associated with incorrect execution of the break falling and roll techniques. These when analyzed reproduced very accurately two distinct models of the biomechanics in the pathology of mid clavicle fractures. The two techniques described are practiced in various other styles of martial arts including Judo. These techniques serve as a precise illustration of two biomechanical models used when describing the forces that produce mid clavicle fractures. The analysis of the various techniques incorrectly done, leading to the fracture of the clavicle, represents in vivo mathematical models explaining the mechanisms of lesion. The major risk factors for injury are improper supervision and/or coaching as well as incorrect level of training of the techniques executed