Tetanus: A Case Report following an Upper Extremity Injury

Background: The baseball-throwing motion requires a sequential order of motions and forces initiating in the lower limbs and transferring through the trunk and ultimately to the upper extremity. Any disruption in this sequence can increase the forces placed on subsequent segments. No research has examined if baseball pitchers with less lumbopelvic control are more likely to develop upper extremity injury than pitchers with more control. Purpose: To determine if baseball pitchers who sustain a chronic upper extremity injury have less lumbopelvic control before their injury compared with a group of pitchers who do not sustain an injury. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 49 asymptomatic, professional baseball pitchers from a single Major League Baseball organization participated. Lumbopelvic control was measured using an iPod-based digital level secured to a Velcro belt around each player’s waist to measure anteroposterior (AP) and mediolateral (ML) deviations (degrees) during single-leg balance with movement and static bridge maneuvers. During a competitive season, 22 of these pitchers developed upper extremity injuries, while the remaining 27 sustained no injuries. Separate 2-tailed t-tests were run to determine if there were significant differences in lumbopelvic control between groups ( P < .05). Results: There were no significant between-group differences for the stride leg (nondominant) during the bridge test in either the AP ( P = .79) or the ML ( P = .42) directions, or either direction during the drive leg bridge test ( P > .68). However, the injured group had significantly less lumbopelvic control than the noninjured group during stride leg balance in both the AP ( P = .03) and the ML ( P = .001) directions and for drive leg balance in both the AP ( P = .01) and the ML ( P = .04) directions. Conclusion: These results demonstrate that baseball pitchers with diminished lumbopelvic control, particularly during stride leg and drive leg single-leg balance with movement, had more upper extremity injuries than those with more control. Clinicians should consider evaluating lumbopelvic control in injury prevention protocols and provide appropriate exercises for restoring lumbopelvic control before returning athletes to competition after injury. Specific attention should be given to testing and exercises that mimic a single-limb balance task.

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Management of Upper Extremity Injury in Divers

Hand Clinics ◽

10.1016/j.hcl.2016.08.017 ◽

2017 ◽

Vol 33 (1) ◽

pp. 73-80 ◽

Cited By ~ 4

Author(s):

Steven C. Haase

Keyword(s):

Upper Extremity ◽

Extremity Injury ◽

Upper Extremity Injury

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The Child With a Painful Arm: A POCUS Screening Protocol to Identify Fracture in Children With Upper Extremity Injury

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2020.10.001 ◽

2020 ◽

Author(s):

Eric Scheier ◽

Yakir Shir ◽

Uri Balla

Keyword(s):

Upper Extremity ◽

Extremity Injury ◽

Screening Protocol ◽

Upper Extremity Injury

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Use of a Venous Flap From an Amputated Part for Salvage of an Upper Extremity Injury

Annals of Plastic Surgery ◽

10.1097/00000637-200202000-00013 ◽

2002 ◽

Vol 48 (2) ◽

pp. 189-192 ◽

Cited By ~ 13

Author(s):

Darrell Brooks ◽

Rudolf Buntic ◽

Harry J. Buncke

Keyword(s):

Upper Extremity ◽

Extremity Injury ◽

Upper Extremity Injury ◽

Venous Flap

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Cortical Plasticity Following Upper Extremity Injury and Reconstruction

Clinics in Plastic Surgery ◽

10.1016/j.cps.2005.05.008 ◽

2005 ◽

Vol 32 (4) ◽

pp. 617-634 ◽

Cited By ~ 21

Author(s):

Dimitri J. Anastakis ◽

Robert Chen ◽

Karen D. Davis ◽

David Mikulis

Keyword(s):

Upper Extremity ◽

Cortical Plasticity ◽

Extremity Injury ◽

Upper Extremity Injury

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Upper Extremity Injury - Baseball

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000476819.78497.14 ◽

2015 ◽

Vol 47 ◽

pp. 149-150

Author(s):

Elizabeth C. Morris ◽

Anand Kapur

Keyword(s):

Upper Extremity ◽

Extremity Injury ◽

Upper Extremity Injury

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Glenohumeral Internal Rotation Deficit and Risk of Upper Extremity Injury in Overhead Athletes: A Meta-Analysis and Systematic Review

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738118756577 ◽

2018 ◽

Vol 10 (2) ◽

pp. 125-132 ◽

Cited By ~ 22

Author(s):

Robert A. Keller ◽

Anthony F. De Giacomo ◽

Julie A. Neumann ◽

Orr Limpisvasti ◽

James E. Tibone

Keyword(s):

Systematic Review ◽

Range Of Motion ◽

Upper Extremity ◽

Internal Rotation ◽

Meta Analysis ◽

Mean Difference ◽

Extremity Injury ◽

Overhead Athletes ◽

Glenohumeral Internal Rotation Deficit ◽

Upper Extremity Injury

Context: Current perception dictates that glenohumeral internal rotation deficit (GIRD) is a chronic adaptation that leads to an increased risk of pathologic conditions in the dominant shoulder or elbow of overhead athletes. Objective: To determine whether adaptations in glenohumeral range of motion in overhead athletes lead to injuries of the upper extremity, specifically in the shoulder or elbow. Data Sources: An electronic database search was performed using Medline, Embase, and SportDiscus from 1950 to 2016. The following keywords were used: GIRD, glenohumeral internal rotation deficit, glenohumeral deficit, shoulder, sport, injury, shoulder joint, baseball, football, racquet sports, volleyball, javelin, cricket, athletic injuries, handball, lacrosse, water polo, hammer throw, and throwing injury. Study Selection: Seventeen studies met the inclusion criteria for this systematic review. Of those 17 studies, 10 included specific range of motion measurements required for inclusion in the meta-analysis. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 4. Data Extraction: Data on demographics and methodology as well as shoulder range of motion in various planes were collected when possible. The primary outcome of interest was upper extremity injury, specifically shoulder or elbow injury. Results: The systematic review included 2195 athletes (1889 males, 306 females) with a mean age of 20.8 years. Shoulders with GIRD favored an upper extremity injury, with a mean difference of 3.11° (95% CI, –0.13° to 6.36°; P = 0.06). Shoulder total range of motion suggested increased motion (mean difference, 2.97°) correlated with no injury ( P = 0.11), and less total motion (mean difference, 1.95°) favored injury ( P = 0.14). External rotational gain also favored injury, with a mean difference of 1.93° ( P = 0.07). Conclusion: The pooled results of this systematic review and meta-analysis did not reach statistical significance for any shoulder motion measurement and its correlation to shoulder or elbow injury. Results, though not reaching significance, favored injury in overhead athletes with GIRD, as well as rotational loss and external rotational gain.

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