The purpose of this study was to evaluate the humeral tunnel characters and clinical relevance according to entry point of the humeral tunnel in the baseball players. It was hypothesized that the medial collateral ligament (MCL) reconstruction with nonanatomical starting location of the humeral tunnel (inferior edge of the medial epicondyle: group NA) provided less favorable radiological and clinical outcomes compared to that with anatomical starting location (original footprint of the MCL: group A). The retrospective case review yielded 19 consecutive athletes who underwent isolated MCL reconstruction using the docking technique. Three dimensional-computed tomography scan was performed at 3 months, and the iso-surfacing by marching cubes algorithm were applied to evaluate the length and angle of humeral tunnel. Three outcome measures were used in this study: the visual analog scale for pain, range of motion and the Conway scale. The angle of the humeral tunnel was measured 12.2° (range, 7.9°–25.2°) in the group NA and 15.5° (range, 9.8°–30.4°) in the group A (p<0.05). The mean length of humeral tunnel is measured 16.3 mm (range, 11.7–20.1 mm) in the group NA and 15.2 mm (range, 10.3–19.1 mm) in the group A (p<0.05). MCL reconstruction brought substantial improvement in pain and function. However, between-group comparison revealed no statistical differences in all outcome measurements. The MCL reconstruction using the docking technique provided favorable clinical outcomes in baseball players. Although the humeral tunnel angle and length were different depending on the humeral entry points, clinical differences between the two entry points were not found.
Athletes ; Baseball* ; Collateral Ligaments* ; Humans ; Outcome Assessment (Health Care) ; Range of Motion, Articular ; Retrospective Studies ; Visual Analog Scale

The purpose of this study is to evaluate the ultrasonographic findings of little leaguer's shoulder among adolescent baseball players. Forty-two little leaguer's shoulder patients (age, 11–16 years; mean, 13.8 years; right, 39; left, 3), based on plain X-ray, were examined by bilateral shoulder ultrasonography. All patients were divided into groups on the basis of sonographic abnormalities and bilateral differences of physeal gap were measured in the cases of significant physeal widening. Sonographic abnormalities of dominant shoulder were physeal irregularity (45%), physeal fragmentation (21%), periosteal thickening (36%) and physeal widening (83%) that was the most common abnormalities. Seven of 42 patients (group A) had only physeal irregularity with minimal physeal widening, 26 patients (group B) had more than 1-mm physeal widening compared with nondominant shoulder. Nine patients (group C) had both physeal widening and fragmentation. Mean physeal gaps of the dominant and nondominant shoulders in 35 patients (group B and C) were 3.4±0.8 mm and 1.4±0.1 mm, respectively (p=0.013) and increased average physeal gap of dominant shoulder was 2.0±0.8 mm. Among three groups of patients, the duration of symptom was significant longer in group C (p=0.011). Physeal widening and fragmentation were associated with progression of the disease, but physeal irregularity was relatively early sonographic finding. Ultrasonography is a useful tool to evaluate the status of proximal humeral epiphysis and can aid early diagnosis of little leaguer's shoulder in the field.
Adolescent ; Baseball ; Early Diagnosis ; Epiphyses ; Humans ; Humerus ; Shoulder* ; Ultrasonography

From a biomechanical standpoint, the main pathologic abnormality of fifth metatarsal stress fracture is the location where repetitive tensile stress concentrated. Decreasing tensile force in this region would be a proper treatment. Therefore, the purpose of this study is to evaluate the precise sagittal and coronal location of the fifth metatarsal stress fracture. Between June 2012 and May 2013, 38 athletes with a fifth metatarsal stress fracture were treated. To evaluate the precise sagittal location of the fracture, the entire length of the fifth metatarsal was measured and the distance from tuberosity to the fracture line was measured. To evaluate the precise coronal location of the fractures, coronal computed tomography images were obtained for incomplete fracture cases. The fracture location was classified as four quadrants. Thirty patients were classified into zone III fracture. However, the fracture is located in zone II for remaining eight cases. The median value of ratio between whole length and the distance from tuberosity to the fracture was 0.35 (range, 0.29–0.40) Among 33 incomplete fracture cases, there were 28 patients whose fracture developed in plantolateral quadrant, four patients at the lateral side and a patient for plantar side. The main pathologic abnormality is at the plantar lateral side because of the repetitive stress concentrated there.
Athletes ; Fractures, Stress* ; Humans ; Metatarsal Bones*

First aim of this study was to compare the results of the intramedullary nail fixation and plate fixation for the management of humeral shaft fracture with butterfly fragments. Second aim of this study was to appraise the necessity of anatomical reduction and fixation for butterfly fragment in humeral shaft fracture. Thirty-one patients with comminuted humeral shaft fracture were treated by reduction and internal fixation with intramedullary nail or plate. The criteria for inclusion were AO classification type B, follow-up period more than 12 months, diaphyseal fracture without involvement of joints. Eighteen patients underwent intramedullary nail fixation and 13 by plate fixation. The outcome was assessed in terms of the union rate, union time, incidence of complications, and functional outcome of shoulder joint. The union rate was 94.4% in intramedullary nail group and 100% in plate group. The average union time was found to be no significant difference between two groups (p>0.05). There was no significant difference in the American Shoulder and Elbow Surgeons' score and range of motion of shoulder and elbow joint between the two groups in last follow-up (p>0.05). The union rate and average union time and functional outcome of shoulder joint was no significant difference between the intramedullary nail fixation and plate fixation for the management of humeral shaft fracture with butterfly fragments. It is recommended to select skillful technique to avoid technical errors rather than technique to fix of butterfly fragments.
Bone Plates ; Butterflies* ; Classification ; Elbow ; Elbow Joint ; Follow-Up Studies ; Fracture Fixation ; Fractures, Comminuted ; Humans ; Humerus ; Incidence ; Joints ; Range of Motion, Articular ; Shoulder ; Shoulder Joint

With increased participation in sporting activity, overuse tendon injuries are a major problem in sports medicine. Tendinopathy is generic descriptive term for the clinical conditions in and around tendons arising from overuse. Tendinopathy is debilitating condition that results in significant deficits in performance and prolonged time away from activity. Histological studies show either absent or minimal inflammation. There are three main theories to explain the development of tendinosis, including the mechanical theory, vascular theory, and neural theory. Risk factors are divided into intrinsic factors and extrinsic factors. The management of tendinopathy revolves around modulating tendon pain, as pain is the presenting and limiting factor for activity. Despite an abundance of therapeutic options, the scientific evidence base for managing tendinopathies is limited. The aim of this review is to report the options for most widely used conservative management of tendinopathy.
Athletic Injuries* ; Inflammation ; Intrinsic Factor ; Risk Factors ; Sports Medicine ; Sports* ; Tendinopathy* ; Tendon Injuries ; Tendons

Endurance exercise training such as marathon can increase the ability of exercise performance. Muscle glycogen is associated with an exercise performance, because glycogen depletion is primary causes of muscle fatigue. This review summarizes the glycogen saving effect according to duration of endurance exercise training. Long-term endurance exercise-induced mitochondrial biogenesis contributes to glycogen saving effect that is reduced glycogen breakdown and lactate accumulation. Glycogen sparing is due to a smaller decrease in adenosine triphosphate and phosphocreatine and a smaller increase in inorganic phosphate in the working muscles. It takes required endurance exercise training for about 4 weeks or more. Single bout or short-term endurance exercise is not sufficient to bring an increase in functional mitochondria. But peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) increases rapidly after single bout of endurance exercise. PGC-1α downregulates glycogenolytic and glycolytic enzymes to reduce muscle glycogen breakdown and lactic acid accumulation after short-term endurance exercise.
Adenosine Triphosphate ; Glycogen* ; Glycogenolysis ; Lactic Acid ; Mitochondria ; Muscle Fatigue ; Muscle, Skeletal* ; Muscles ; Organelle Biogenesis ; Peroxisomes ; Phosphocreatine

Tensiomyography (TMG) is known as non-invasive method which assesses the muscular characteristics such as contraction velocity or maximal displacement of the belly. The aim of this study was to evaluate muscular responses by TMG after muscle injury and to introduce using TMG first in Korea. This study was performed with a subject who was diagnosed with muscular injury and consent measuring and following up TMG analyses. A female patient, who was diagnosed left hip adductor muscle strain, underwent magnetic resonance imaging (MRI) and TMG at intervals of two weeks. We obtained decreased in displace maximum (Dm, 4.14 vs. 5.69) and altered curve shape in the injured muscle at the initial TMG assessment in comparison to the non-injured side. After two weeks, MRI findings and symptom were improved and Dm in the injured side increased as in the non-injured muscle. These findings suggest that a decrease in Dm indicate increased in muscle stiffness after muscle injury, and an increase in Dm as in the non-injured side after two weeks indicate recovered status. TMG may be useful as a simple and non-invasive device for monitoring muscle function after muscle injury and during the recovery.
Female ; Hip ; Humans ; Korea ; Magnetic Resonance Imaging

Ulnar tunnel syndrome (UTS) is a compressive neuropathy of the upper extremity that shows various clinical symptoms according to the anatomic region of the compression site. Numerous factors may cause UTS, and most publications are case reports describing various etiologies; thus, obtaining a correct diagnosis is often challenging. Giant cell tumor of the tendon sheath (GCTTS) is well described to be a common benign soft tissue tumor of the hand; however, it is rarely reported to cause UTS. We report a case of GCTTS in Guyon's canal causing UTS that was misdiagnosed as handlebar palsy.
Diagnosis ; Giant Cell Tumors* ; Giant Cells* ; Hand ; Paralysis* ; Tendons* ; Ulnar Nerve Compression Syndromes ; Ulnar Neuropathies ; Upper Extremity

Scapulothoracic bursitis refers to inflammation of the bursae secondary to trauma or overuse owing to sports activities or work. It usually causes persistent pain and scapulothoracic crepitus by irritation of bursa but can be presented as painless mass around chest wall. We report a case of scapulothoracic bursitis in a baseball pitcher presenting as rapidly growing chest wall mass confused with a soft tissue tumor. Computed tomography and magnetic resonance imaging revealed as a well-demarcated cystic mass situated between the scapula and chest wall. Incisional drainage resulted in complete resolution of the mass within a couple of weeks. Scapulothoracic bursitis may be presented as painless huge mass in overhead sports athlete and one of the differential diagnoses of soft tissue tumor of the chest wall.
Athletes ; Baseball* ; Bursitis* ; Diagnosis, Differential ; Drainage ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Scapula ; Sports ; Thoracic Wall

This study aimed to examine the relationship between exercise and psychological stress among the rural population. We performed logistic regression to calculate the odds ratio (OR) and 95% confidence interval (CI) of the relationship between exercise and psychological stress after adjusting for sex, age, drinking, smoking, and BMI. In the results, the OR value (95% CI) for the people who worked out regularly, as compared to non-participation, was 0.540 (0.392-0.744). In the case of exercise frequency per week, OR values for the people who exercised 1-4 days per week and more than 5 days per week, as referred to non-participation, were 0.506 (0.265-0.968), 0.453 (0.233-0.879), respectively. In the case of exercise amount per week, OR values for the people who took part in exercising less than 150 minutes, more than 150 minutes and less than 300 minutes, more than 300 minutes and less than 600 minutes, and more than 600 minutes, as compared to non-participation, were 0.535 (0.295-0.972), 0.315 (0.161-0.619), 0.475 (0.282-0.802), 0.762 (0.406-1.430), respectively. Regardless of exercise frequency, there was an inverse association between exercise participation more than 150 minutes and less than 600 minutes per week and psychological stress, and the most effective way to reduce psychological stress was taking part in exercise more than 150 minutes and less than 300 minutes per week.
Drinking ; Logistic Models ; Odds Ratio ; Rural Population* ; Smoke ; Smoking ; Stress, Psychological*