STUDIES ON THE REGENERATION OF OSSAL TISSUE. III. INFLUENCE OF POSITIVE AND NEGATIVE ELECTRICITY UPON CALLUS FORMATION IN HUMANS.
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Tendon lacerations at the distal forearm are a common clinical problem. The aim of this study is to investigate whether there is any significant bone loss of the dominant and nondominant forearm due to early passive mobilization in surgically treated patients for acute tendon-artery-nerve clean-cut injuries at the wrist level. Fifty-eight dominant right-handed patients who underwent such an operation were enrolled in this study. Patients were divided into two groups. Patients in group 1 (n=26) were operated on for dominant forearm clean-cut injuries; patients in group 2 (n=29) were operated on for nondominant forearm clean-cut injuries. Bone mineral density (BMD) measurements of ulna and radius were obtained at weeks 1 and 6, and at months 3 and 12 after the operation. Bone mineral density (BMD) of the radius and ulna did not change significantly with time in group 1 (p>0.05). In group 2, BMD measurements were reduced significantly more with time in the mid-diaphysis and distal regions of the ulna and in the ultra-distal region of the radius. Most BMD decreases were observed at month 3 of the study. Eventually, these bone losses were found to be recovered at month 12.
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In a series of 180 transfers of free flaps were in 11 cases on upper extremities applied emergency flaps, both for immediate reconstruction of function and for the replacement and covering of tissue defects. In one case a scapular flap was used simultaneously with the replantation of the forearm. In three cases was applied a forearm flap for the reconstruction of the thumb and of the scalped index finger, and in three cases a central venous flap for traumatic defects of tissues on fingers. These flaps yielded surprisingly good functional results after an injury associated with a loss of dorsal aponeurosis of fingers and with an exposure of IP joints. A toe-to-hand transfer was used in one case for the reconstruction of the thumb. A groin flap and a lateral arm flap were applied for the covering of tissue defects.
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OBJECTIVE: To describe the estimated frequency and types of injuries associated with in-line skates in U.S. children and to compare in-line skating injuries to rollerskating injuries. DESIGN: National case series. SETTING: Emergency departments of hospitals participating in the United States Consumer Product Safety Commission (USCPSC) National Electronic Injury Surveillance System. PATIENTS: Persons with injuries associated with the use of in-line skates or rollerskates reported to the USCPSC in 1992 and 1993. RESULTS: There were an estimated 66,465 injuries associated with in-line skates; the incidence of injury was highest in children 11 and 12 years old. An estimated 40,730 in-line skate injuries involved children < 20 years old. The mean age of injured children was 11.8 years (median, 12 years); 68% were boys. Fractures (45%) were the most common injury; 66% of fractures involved the distal forearm. Five percent had head injuries. Two and one half percent required hospital admission; 90% of children admitted had a fracture and 11% had a head or face injury. There were an estimated 147,928 rollerskating injuries among children < 20 years old; the mean age was 10.5 years (median 10 years) (P < 0.001 vs in-line skates). Thirty-two percent were to boys (P < 0.001 vs in-line skates). Fractures were the most common injury; forearm fractures accounted for 72% (P < 0.001 vs in-line skates). Five percent had head injuries. One and one half percent were admitted to the hospital (P < 0.001 vs in-line skates). In 1993, the injury rate among children for in-line skates was 31/100,000, and the injury rate for rollerskates was 95/100,000. CONCLUSIONS: Injuries associated with in-line skates are highest among preadolescents. Injuries associated with in-line skate use are less common than injuries associated with rollerskate use. Distal forearm fractures are the most common injuries related to both in-line skate and rollerskate use. Exposure data and analysis of the efficacy of protective gear, including wrist guards and helmets, are needed.
The basic role of the shoulder, upper arm, elbow, forearm, and wrist is to place the hand in the appropriate position, so that it can fulfill its function. The upper extremity, especially the wrist and the hand, has a very complex anatomy with a large number of bones, muscles, tendons and nerves. They are essential to work and sport activities and are subject to acute and/or chronic mechanical injuries. This is why overuse injuries are the most common in these regions. They are often characterised by tendinitis, tenosynovitis, tunnel syndromes, or stress fractures. This paper gives an overview of the most common overuse syndromes of the hand, wrist, forearm and elbow, describing their characteristic symptoms and methods of diagnosis and treatment. The syndromes are trigger finger, dorsal radiocarpal impingement syndrome (gymnast's wrist), DeQuervain's disease, tenosynovitis of other dorsal compartments, intersection syndrome (oarsman's wrist), flexor carpi ulnaris tendinitis, flexor carpi radialis tendonitis, humeral epicondylitis (tennis elbow), posterior impingement syndrome of the elbow, medial tension and lateral compression syndrome, stress fracture in the hand, wrist, forearm and elbow, and tunnel syndromes.
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