Cervical spine injuries resulting from water sports.

A retrospective review of 152 cases of cervical spine injury suffered in water sport-related accidents is presented. Water sport accidents were the second most common cause of traumatic quadriplegia among patients treated on the Spinal Injury Service at Rancho Los Amigos Hospital. The mechanics of injury in 80% of the cases involved flexion and/or axial loading forces. A fracture of the body of C5 was seen in two thirds of the cases. The ratio of complete to incomplete cord lesions was approximately 1:1, with anterior cord syndrome being the most commonly observed. Various risk factors are identified.

The Magnuson-Stack procedure for treatment of recurrent glenohumeral dislocations.

The Magnuson-Stack procedure was developed in 1943 as a treatment for recurrent anterior dislocation of the glenohumeral joint. Since that time, very little literature has been published on this procedure. The purpose of our study is to evaluate its efficacy in preventing further dislocations and, also, introduce the Cybex Isokinetic Dynamometer as a quantitative tool in scientifically evaluating total shoulder function. At the Bryn Mawr (Pennsylvania) Hospital from 1971 to 1978, 43 patients underwent a Magnuson-Stack procedure. Twenty-nine returned detailed questionnaires; 26 of these patients returned for clinical and roentgenographic examination by one of the authors, and 18 had their shoulder motion and power quantitatively compared to their contralateral normal arms with the Cybex Isokinetic Dynamometer. Eighty-five percent of shoulders did not dislocate postoperatively; 90% considered their results satisfactory. By gross physical examination, no shoulder atrophy was noted. Strength seemed to equal the uninjured shoulder. Range of motion showed a 10 degrees loss of external rotation as measured with a hand-held goniometer. However, by testing range of motion with the Cybex system, a 25 degrees lack of external rotation was noted. Force values measured at 60 degrees of arc/sec and 180 degrees of arc/sec showed an 18 and 10% deficit, respectively, in external rotation. The authors believe that the Magnuson-Stack procedure has a place in the treatment of recurrent anterior dislocations of the shoulder. Also, the Cybex II isolated joint testing system provides an accurate reproducible method of comparing the postoperative results of all patients treated for dislocation of the shoulder.(ABSTRACT TRUNCATED AT 250 WORDS)

Delayed hypersensitivity reaction of the knee after injection of arthroscopy portals with bupivacaine (marcaine)

The number of arthroscopic procedures performed annually for the management of intraarticular injuries has grown at an exponential rate. Whether done with the patient under general anesthesia or local anesthesia supplemented with intravenous sedation, it is common practice to postoperatively inject each portal as well as the joint with a local anesthetic to provide pain relief in the transition to the recovery room and discharge after outpatient surgery. To our knowledge, no previous reports of localized urticaria and delayed hypersensitivity reaction have been reported in the postarthroscopy setting. We are reporting a case of delayed hypersensitivity reaction and urticaria of the knee that presented after bupivacaine (Marcaine) injection of arthroscopic portals after routine meniscectomy.