Rupture of the Extensor Hallucis Longus Muscle Secondary to Repetitive Overuse in a Taekwondo AthleteA Case Report.

Closed rupture of the extensor hallucis longus (EHL) tendon is rare, with most cases caused by either direct penetrating trauma or predisposing factors such as corticosteroid injection and iatrogenic trauma incidences. Almost all of the previous case reports have reported on rupture of the EHL tendon rather than the EHL muscle. In this report, we highlight an unusual clinical presentation of a rupture of the EHL muscle and discuss its predisposing factors. This patient was a taekwondo athlete with EHL muscle rupture secondary to repetitive overuse without any underlying systemic or local predisposing factors or direct trauma. Fifteen months after successful surgical treatment, he became fully functional again as an elite taekwondo athlete.

Ageing Cattle: The Use of Radiographic Examinations on Cattle Metapodials from Eketorp Ringfort on the Island of Öland in Sweden.

In this paper conventional X-ray analysis of cattle metapodials is used to study the age structure of slaughtered cattle at Eketorp ringfort on the island of Öland, Sweden. The X-ray analyses suggest that several animals in both phases were slaughtered aged 4-8 years. More oxen/bulls than cows reached the advanced age of over 8 years, yet in phase III more oxen/bulls seem to have been slaughtered between the ages of 2 and 8 years. These differences may reflect a change in demand for meat related to the character of the site. The results also show a correlation between metapodials with a pathology connected to biomechanical stress and older animals. This suggests that male cattle were used both in meat production and as draught animals. Asymmetry in male metatarsals such as distal broadening of the lateral part of the medial trochlea was visible on the X-ray images. The bone element also indicates a denser outer cortex of the medial diaphysis in comparison to the inner medulla. This could be the result of repetitive mechanical stress. Two metatarsals from cows were documented with distal asymmetry indicating that cows were also used as working animals. Bone elements with changes in the articular surfaces were more common in metapodials from cows with an X-ray age of over 3-4 years. These results highlighted the slaughter age difference between oxen/bulls and cows, enabling a better understanding of animal husbandry and the selection of draught cattle at Eketorp ringfort.

Hyperthermia at 434 MHz in the treatment of overuse sport tendinopathies: a randomised controlled clinical trial.

The objective of this randomized study was to compare a thermotherapy system, hyperthermia at 434 MHz and conventional ultrasound in the treatment of overuse sports tendinopathies. The study group consisted of 44 athletes, 33 males and 11 females (age 26 +/- 4.56 years) affected by tendinopathies at lower extremities (patellar or achilles tendons). After elucidation of the kind of trial, 22 patients were randomly assigned to hyperthermia and 22 to ultrasound. The patients received after a pain measurement and ultrasound scanning 12 treatments, 3 times a week for 4 weeks. The same standardized examination was done at the end of treatment and 1 month after the end of treatment. The assessor physician was unaware of the treatment allocation. The patients were asked to rate the ultimate outcome on the base of pain resolution and return to sports activity. Both groups had a significant decrease of symptoms (P<0.001). Hyperthermia, however, demonstrated better effects on the reduction of VAS score and on the subjective overall satisfaction (77 %) of excellent and good results in comparison to the 33 % of ultrasound. In patients with chronic overuse tendinopathies hyperthermia at 434 MHz showed encouraging results, with short-term clinical improvement, safety and no side effects.

[Traumatic finger polyarthrosis in judo athletes: a follow-up study]. / Traumatische Fingerpolyarthrose bei Judo-Sportlern: Eine Verlaufsuntersuchung.

Osteoarthritis is the most common joint disease. In addition to known risk factors e.g. genetics, age and hormonal status it has been suggested that chronic-repetitive micro- and substantial (macro-) injury may play an important pathogenetic role. In a longitudinal case-study we examined Judo-players for clinical and radiological changes of the finger joints over the course of 16 years. All examined 8 players demonstrated soft tissue changes including Heberden nodes and radiological changes typical for osteoarthritis of the finger joints. Changes were symmetrical and were not restricted to joints with tendon ruptures or fractures in the anamnesis. Degenerative changes were progressive and more pronounced in active players. Subjectively, symptoms were usually mild. Extensive Judo seems to be a risk factor for the development of osteoarthritis of the finger joints due to chronic-repetitive micro- and substantial (macro-) injury.

Detection of stress fractures in athletes and nonathletes.

Stress fractures are considered a relatively common athletic injury. Some authors also feel this disorder may be overlooked in many nonathletic patients. Three cases of stress fractures are presented. All had classical clinical pictures; however, two were athletes and one was not. The athletes' stress fractures were suspected early in the disease evolution, confirmed with a bone scan and proper care instituted to prevent extended morbidity. The nonathlete's case was misdiagnosed by another practitioner and allowed to progress to the level of a true fracture. Extended morbidity followed this case. The infrequent report of nonathlete stress fractures in the literature may have played a major role in this oversight. Stress fractures do occur in athletes and nonathletes. The history is the key to making an early diagnosis. Scintigraphy (bone scan) or plain films may be used to confirm the diagnosis and rule out other disorders.