Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Extremities”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 469 records · Page 26Linked to original sources
PubMed2005

Prevalence and psychosocial risk factors of upper extremity musculoskeletal pain in industries of Taiwan: a nationwide study.

Prevalence of upper extremity disorders and their associations with psychosocial factors in the workplace have received more attention recently. A national survey of cross-sectional design was performed to determine the prevalence rates of upper extremity disorders among different industries. Trained interviewers administered questionnaires to 17,669 workers and data on musculoskeletal complaints were obtained along with information on risk factors. Overall the 1-year prevalence of neck (14.8%), shoulder (16.6%), and hand (12.4%) disorders were higher than those of the upper back (7.1%) and elbow (8.3%) among those who sought medical treatment due to the complaint. Workers in construction and agriculture-related industries showed a higher prevalence of upper extremity disorders. After multiple logistic regression adjusted for age, education, and employment duration, we found job content, physical working condition, a harmonious interpersonal relationship at the workplace and organizational problems were significant determinants of upper extremity disorders in manufacturing and service industries. Male workers in manufacturing industries showed more concern about physical working conditions while female workers in public administration emphasized problems of job content and interpersonal relationships. We concluded that these factors were major job stressors contributing to musculoskeletal pain of the upper extremity.

Adult↗
PubMed1994

[Fat distribution in Japanese women. Part 2. Fat thickness of extremities and classification of fat distribution of whole body].

The first object of this paper was to follow the previous paper in clarifying the characteristics of the fat distribution on the extremities. The subcutaneous fat thickness was measured at 64 points on the upper extremity and on 129 points on the lower extremity. The difference of the fat distribution between obese subjects and lean subjects was mainly observed on the back of the upper arm and the thigh. The second object of this paper was to clarify the characteristics of the fat distribution on both the trunk and the extremities and to study the factors which contribute to the fat distribution of the whole body. Average subcutaneous fat thickness over the body was 7.8 mm, and the standard deviation was 1.2 mm. Types of fat distribution of the whole body were classified by principal component analysis of average fat thickness in the 8 regions. The first component was the size factor which expressed the amount of fat on the whole body. The second component showed the contrast of fat distribution in the lower extremities and in the breast, abdomen, back and arms. These two components accounted for 90.79% of the variance of fat distribution. Measuring points, which showed high correlation coefficient with the average fat thickness of the whole body, were abdomen, subscapular, back, thigh and side breast.

Adipose Tissue↗
PubMed2000

[A comparison of malignant fibrous histiocytoma of head, neck and extremities].

OBJECTIVE: To compare the epidemiology, local and regional invasion and prognosis of head and neck, malignant fibrous histiocytoma (MFH) and extremity MFH. METHODS: Between January 1, 1972 and December 31, 1993, 173 patients with MFH (71 head and neck, 102 extremities and trunk) were referred to the Cancer Hospital for surgical treatment. They were 101 men and 72 women, with age ranging from 13 to 83 years (median: 45 years). The extent of surgery was classified into radical, wide and local resection. RESULTS: For head and neck, local recurrence of MFH after wide resection was 80.4% (37/46), compared with 36.4% (8/22) after radical surgery (P = 0.000). The five-year survival was 50.79% in all the head and neck patients (74.75% in patients free of local recurrence, 37.74% in patients with local recurrence; P = 0.0181), compared with 70.71% in extremity patients (P = 0.0005). Repeated surgery after recurrence of MFH could cure 40.9% of the head and neck patients and 80.7% of the extremity patients. CONCLUSION: Inadequate resection of head and neck MFH in initial surgery is associated with a high incidence of local recurrence, which is always correlated with worse prognosis. Repeated surgery for recurrent head and neck MFH is not as effective as for recurrent extremity MFH. Therefore, we suggest that the initial surgery for head and neck MFH should be as radical as allowed to avoid a possible local recurrence.

Adolescent↗
PubMed2000

[Injuries of the extremities caused by high energy gunshots and land-mines].

Hospital records of patients who had extremity injuries caused by high energy gunshots and and land-mines and treated in Sirnak Military Hospital between January 1997 and July 1999 were reviewed retrospectively. Among 236 cases 147 (62.3%) had lower extremity wounds and 89 (37.7%) had upper extremity wounds. The most frequently injured part was hands for the upper extremity and feet for the lower extremity. The most dramatic wounds were caused by stepping on anti personnel mines trapped with anti tank mines. The localization and the extension of the wounds varies with type and power of the gun, the position of the victim at the time of explosion and the distance between the victim and the gun.

Adult↗
PubMed2000

[Changes of blood circulation of the extremity with tibia shaft defects treated with external fixation].

OBJECTIVE: To study external skeletal fixation for long tubular bony defect by end to end compression with lengthening (EECL) and segmental bone transport by lengthening (STBL). METHODS: About 20% - 30% of the original length was resected from the middle shaft of the tibia in 10 goats of 1 - 2 years of age. The bony defect ends were shortened step by step with the sulcated half-ring external fixator. Changes of the blood flow of the distant extremity were measured with pulse-dopplar monitor, reference blood flow, and angiograph. RESULTS: The blood flow of the distant extremity was not affected when bony defect was less than 15% of the original length. Blood circulation disorder would appear in the distant extremity when bony defect ranged from 15% to 20% of the original length. The distant extremity would necrose because of obstruction of blood circulation when bony defect was more than 20% of the original length. CONCLUSIONS: EECL can be recommended if bony defect is less than 15% of the original length. SBTL might be the only feasible way if bony defect is more than 20% of the original length. If bony defect is within 15% and 20%, EECL should be applied with great care while watching the extremity circulation with pulse-Dopplar monitor.

Animals↗
PubMed2002

[Injuries of extremity blood vessels, personal experience and results].

The authors evaluated the results achieved in 47 patients with injuries of the acral vesels where they performed a total of 50 vascular operations during the five-year period from 1998-2001. 21.3% injuries were part of multiple injuries. The mean period of hospitalization was 14.7 days. The 30-day mortality was 6.4% and the morbidity 12.8%. The upper extremity was saved in all instances (100%), the lower extremity in 77.3% of the injured. The reason for high amputations of the lower extremity were most frequently injuries of the popliteal artery associated with skeletal injury and extensive contusion of the soft tissues of the extremity. The authors discuss the optimal diagnostic and therapeutic procedures in injuries of the acral vessels. They emphasize a multidisciplinary approach without delay with early, frequently during the primary operation indicated fasciotomy, to prevent the development of compartment syndrome. The order of operations in concurrent injuries of the acral skeleton depends on the stage of ischaemia, type of injury and solution of the skeletal fractures. This type of injury frequently calls for repeated redressing in the operation theatre with repeated necrectomies of soft tissues to prevent infection which may prove fatal for the extremity. Injuries of the acral vessels should be nowadays treated in specialized departments with a 24-hour diagnostic and therapeutic traumatological service which comprises a highly specialized team of vascular surgeons.

Adolescent↗
PubMed2003

Steal syndrome complicating upper extremity hemoaccess procedures: incidence and risk factors.

INTRODUCTION: Steal syndrome is a potentially grave complication of upper extremity hemoaccess (HA) in patients with renal failure. To determine the incidence and risk factors for steal in these patients at the St. Boniface Hospital, Winnipeg, a tertiary care centre for vascular surgery and dialysis, we reviewed data from patients requiring hemodialysis between September 1986 and July 2000. PATIENTS AND METHODS: We excluded all venous catheter and lower extremity procedures. There remained 325 upper extremity procedures in 217 patients. Data were collected from the patients' charts or by interview. First by univariate analysis and then by multivariate analysis for independent risk factors, we studied the effect on the development of steal of age, sex, race diabetes mellitus, hypertension, coronary artery disease or cerebrovascular disease, smoking, proximal procedures based on the brachial artery, distal procedures based on the radial artery, the use of prosthetic graft material and the creation of autologous fistulas. RESULTS: The incidence of steal was 6.2%. The significant independent risk factors were diabetes mellitus (odds ratio [OR] 5.00, 95% confidence interval [CI] 1.39-18.08, p = 0.01) and Aboriginal race (OR 3.59, 95% CI 1.07-12.04, p = 0.04). An increasing risk for each year of advancing age at the time of procedure was suggested but was not significant (OR 1.04, 95% CI 1.00-1.09 p = 0.07). CONCLUSIONS: Patients who are diabetic or Aboriginal are at increased risk for steal with upper extremity HA procedures. This knowledge can guide discussion of dialysis options and informed consent. If upper extremity HA procedures are undertaken in patients at risk, they should be closely monitored and early intervention applied if necessary.

Adolescent↗
PubMed2003

Prevalence of lower extremity pain and its association with functionality and quality of life in elderly women in Australia.

OBJECTIVE: To determine the prevalence of self-reported lower extremity pain and the impact on functionality and quality of life in a population based study of elderly women in Western Australia. METHODS: One thousand four hundred eighty-six women, 6.2% of 24,800 women aged over 70 in Perth, were recruited. An index of relative socioeconomic disadvantage (SES) was derived from postcode. Self-reported lower extremity pain at the hip, knee, and foot was collected by questionnaire. The frequency of lower extremity pain was classified into 5 groups. Mobility was measured by the Timed Up and Go Test (TUG). Quality of life was measured using the Medical Outcome Study Short Form 36 (SF-36) summary statistics: physical and mental component scores (PCS and MCS). RESULTS: The prevalence of women reporting any hip, knee, and foot pain was 39%, 52%, and 34% respectively. Fourteen percent experienced pain at all sites whereas 28% had no pain. There was no age difference between the various pain groups. Women with more pain were heavier and had higher BMI scores. At all lower limb sites, women with more frequent pain had reduced mobility and lower quality of life as measured by TUG, PCS, and MCS. For the TUG test, significant determinants in stepwise regression were age, BMI, knee and hip pain. For the SF-36 PCS, significant predictors were age, SES, BMI, and foot, knee, and hip pain. For the SF-36 MCS, SES and foot pain were significant predictors. CONCLUSIONS: Our results confirm the high prevalence of lower extremity pain in elderly women in Australia. Lower extremity pain significantly reduced both physical and mental aspects of the quality of life as well as mobility. In view of the availability of effective interventions to reduce joint pain, more aggressive intervention in the most disabled is indicated.

Activities of Daily Living↗
PubMed2005

[Autologous peripheral blood stem cells transplantation in treatment of 62 cases of lower extremity ischemic disorder].

OBJECTIVE: To observe the clinical efficacy of autologous peripheral blood stem cells (PBSC) transplantation in 62 cases with ischemic lower extremity disorder. METHODS: Totally 62 patients with 34 cases of diabetic foot and 28 cases of various lower extremity ischemic disorders received recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) 450 - 600 microg/d by hypodermic injection for 5 days to mobilize stem cells. On the sixth day, PBSC were collected by COBE 6.1 Spectra Version with an amount of 82 - 148 ml; the number of mononuclear cells (MNC) is (718.2 - 224.6) x 10(9)/L. CD34+ cells were tested. The PBSC were injected into the ischemic lower extremity and foot intramuscularly at 3 cm x 3 cm distance. The clinical and laboratory findings were monitored from first day to 24th week. RESULTS: In 62 patients with PBSC transplantation, free of severe pain was found in 54 cases (87.1%) from 7 to 30 days, improvement of foot cool feeling in 56 patients (90.3%) from 7 to 30 days, improvement of foot ulcer in 16 cases (40.0%) from 4 to 16 weeks. Ankle/brachial index (ABI) increased in 12 cases (34.3%), TcPO2 improved in 26 cases (42.3%). Digital subtraction angiographic scores were performed in 5 patients after 8 - 12 weeks, there was formation of new collateral vessels. No related complication or adverse effect was observed except in 2 patients with diabetic foot and cerebral infarction exacerbation of symptoms during the process of stem cells mobilization in all process. CONCLUSION: Autologous PBSC transplantation might be a safe and effective method for lower extremity ischemic disorder. It could improve the quality of life of many patients as amputation of lower extremity or foot might be avoided.

Adult↗
PubMed2005

[Repair of venous trunk injuries without accompanied arterial injuries in extremities].

OBJECTIVE: To research the mechanisms, diagnosis and repair method of venous trunk injuries without accompanied arterial injuries in extremities. METHODS: From January 1993 to June 2002, 12 cases of venous trunks injuries without accompanied arterial injuries in extremities were treated. All the patients were males, their ages ranged from 18 to 35 years. The interval between injury and operation was 30 minutes to 2 hours. The cause of injury was stab wound. Along with the antishock, the injured vessels were mended in 7 cases, end-to-end anastomosis was performed in 5 cases, and the operations were given in the patients with red wounds of the skull, chest or abdomen. RESULTS: One case died of severe cerebral trauma, the other 11 cases obtained primary healing. Doppler ultrasonography showed that the blood vessels were patent. After a follow-up of 1-5 years (2 years and 4 months on average), 8 cases recovered the function and circulation of extremities; and 3 cases accompanied with red injuries of nerves recovered the circulation of extremities, but did not recover the function with sensory disability and dyskinesia. CONCLUSION: Emergent hemostasis, antishock, repair of the injured vessels as soon as possible and treatment of associated injuries are important measures to save patients' life in treating venous trunk injuries without accompanied arterial injuries in extremities.

Adolescent↗
PubMed2005

Lower extremity amputation in Hong Kong.

OBJECTIVE: To evaluate the characteristics and outcome of patients undergoing lower extremity amputation in Hong Kong. DESIGN: Cohort study. SETTING: University teaching hospital, Hong Kong. PARTICIPANTS. One hundred and eighty-four Chinese adults who underwent lower extremity amputation. MAIN OUTCOME MEASURES: Demographic data of the cohort, wound complication and revision amputation rates, prosthesis use, functional ambulation level and institutionalisation at postoperative 6 months, operative mortality, and long-term survival. RESULTS: The majority of patients (83.1%) who underwent lower extremity amputation were aged over 60 years. Vascular occlusive disease was the most common underlying pathology, followed by infection. The wound complication and operative mortality rates were high. Only 43.0% of patients were able to resume community ambulation at 6 months and 40.7% became institutionalised. After high-level amputations, 22.3% managed to use a prosthesis. The median survival after lower extremity amputation was 1008 days. High-level amputation was associated with lower wound complication and revision amputation rates, but an inferior functional outcome and survival compared with foot amputation. CONCLUSIONS: Lower extremity amputation is associated with high morbidity and mortality, especially with high-level amputations. It places a heavy burden of care on patients, their families, the health care system, and society. Appropriate health care planning, provisions, and coordinated efforts at various levels are necessary to improve the situation. Major efforts must also be focused on preventing vascular occlusive disease and diabetes.

Adult↗
PubMed2005

Cortical reorganization associated lower extremity motor recovery as evidenced by functional MRI and diffusion tensor tractography in a stroke patient.

PURPOSE: Recovery mechanisms supporting upper extremity motor recovery following stroke are well established, but cortical mechanism associated with lower extremity motor recovery is unknown. The aim of this study was to assess cortical reorganization associated with lower extremity motor recovery in a hemiparetic patient. METHODS: Six control subjects and a 17 year-old woman with left intracerebral hemorrhage due to an arterio-venous malformation rupture were evaluated. The motor function of the paretic (left) hip and knee had recovered slowly to the extent of her being able to overcome gravity for 10 months after the onset of stroke. However, her paretic upper extremity showed no significant motor recovery. Blood oxygenation level dependent (BOLD) functional MRI at 1.5 Tesla was used to determine the acutual location of cortical activation in the predefined regions of interest. Concurrently, Diffusion Tensor Imaging (DTI) in combination with a novel 3D-fiber reconstruction algorithm was utilized to investigate the pattern of the corticospinal pathway connectivity between the areas of the motor stream. All subjects' body parts were secured in the scanner and performed a sequential knee flexion-extension with a predetermined angle of 0-60 degrees at 0.5 Hz. RESULTS: Controls showed anticipated activation in the contralateral sensorimotor cortex (SM1) and the descending corticospinal fibers stemming from motor cortex. In contrast to control normal subjects, the stroke patient showed fMRI activation only in the unaffected (right) primary SM1 during either paretic or nonparetic knee movements. DTT fiber tracing data showed that the corticospinal tract fibers were found only in the unaffected hemisphere but not in the affected hemisphere. CONCLUSIONS: Our results indicate that an ipsilateral motor pathway from the unaffected (right) motor cortex to the paretic (right) leg was present in this patient. This study raises the potential that the contralesional (ipsilateral) SM1 is involved in cortical reorganization associated lower extremity motor recovery in stroke. This study is the first neuroimaging evidence that the combined fMRI and DTI fiber tracing can significantly expand the explanatory power of probing cortical reorganization underlying motor recovery mechanism in stroke.

Adolescent↗
PubMed2006

Lower extremity vein digital photoplethysmography in highly qualified football players and wrestlers.

Modern sport, along with the high technical, tactic and psychological readiness, requires good physical preparation achieved by a big physical load during trainings and competitions. Aim of the investigations was to study lower extremity venous system functional condition during physical load in highly qualified football players and wrestlers. Highly qualified 25 football players and 30 wrestlers, of age 18-25 years, were studied. Olympic, World and Europe champions were included among wrestlers. Lower extremity venous system digital photopletismography (D-PPG) was conducted by apparatus: Rheo Dopplex II of Huntleight Diagnostics. The equipment digitally analyses photopletismoghraphic plots. Significant functional parameters: vein restoration time (VRT) and venous pump function (VP) in deep venous system were reported by the apparatus appropriate software. It included parameter interpretation diagram, defining degree of venous system condition as normal, equivocal or pathological. Target sportsmen were examined in siting position with physical loading pedis. Sportsmen lower extremity vein light transducing change registration associated with the degree of vessel filling was studied by digital photopletismography . The study results showed that vein restoration time (VRT) in football players is two times minor to compare to the one of wrestlers, while venous pump (VP) function is about 1.5 times higher in footballers than in wrestlers. Degree of lower extremity venous system condition according to parameter interpretation diagram program showed normal values only in few cases. Slight deviations were observed only in individuals with recent trauma. Further examination after the appropriate treatment revealed normal values in traumatic subjects. The search also showed that digital photopletismography appears to be effective, simple and financialy available diagnostic method, which should be more frequently applied in lower extremity vein function examinations among sportmen of different kinds as well as in estimation of recovery therapy effectiveness in post-trauma period.

Adolescent↗
PubMed2006

Lymphscintigraphic evaluation of manual lymphatic drainage for lower extremity lymphedema.

To evaluate the effect of manual lymphatic drainage on technetium-99m-labeled dextran (99mTcDx) transport, 16 patients with lymphedema of lower extremities underwent two lymphscintigraphy exams by injecting 99mTcDx intradermally into the first interdigital space of the affected extremity. The first was a control examination at rest followed by an examination which included a manual lymphatic drainage session after the injection of the 99mTcDx. Images were obtained 45 minutes and three hours after the injection of the radioisotope. Extremity volumes were also measured before and after the drainage session. The findings from the examinations were assessed in a quantitative, semiquantitative and qualitative manner and compared without and with drainage. The analyses of the extremities' circumference before and after the drainage by paired t-test revealed a significant decrease. The analyses of the quantitative, semi-quantitative and qualitative evaluations evidenced no significant difference, without or with drainage, within the 45-minute and three-hour periods. Thus, manual lymphatic drainage caused an effective reduction in the circumference of the extremities but did not have a significant effect in the transport of 99mTcDx.

Adult↗
PubMed2006

The most common anatomical sites of arterial injury in the extremities: a review of 75 angiographically-proven cases.

The incidence of vascular injury has increased worldwide. In an attempt to quantitate the specific arteries most commonly involved in the extremities, we reviewed 75 patients with extremity trauma who were evaluated with angiography (DSA, digital subtraction angiography). The majority of these injuries were related to motor vehicle accidents (93.3%). The mean age of these patients was 28.16 +/- 11.14 years, 94.7% of these patients being male. The ratio of upper to lower extremity arterial trauma was 12 to 86. A total of 99 arterial injuries were detected angiographically. Simultaneous injuries to two and three extremity arteries were identified in 13.3% and 9.3% of patients respectively. The most common arteries injured were the anterior tibial, femoral, peroneal, and popliteal arteries. Associated fractures were present in 86.7% of patients. These data may prove useful to the clinician who evaluates post-traumatic injuries of the extremities.

Accidents, Traffic↗
PubMed2006

Microsurgery within reconstructive surgery of extremities.

Reconstructive surgery of extremities is an object of a special attention of surgeons. Vessel and nerve damages, deficiency of soft tissue, bone, associated with infection results in a complete loss of extremity function, it also raises a question of amputation. The goal of the study was to improve the role of microsurgery in reconstructive surgery of limbs. We operated on 294 patients with various diseases and damages of extremities: pathology of nerves, vessels, tissue loss. An original method of treatment of large simultaneous functional defects of limbs has been used. Good functional and aesthetic results were obtained. Results of reconstructive operations on extremities might be improved by using of microsurgery methods. Microsurgery is deemed as a method of choice for extremities' reconstructive surgery as far as outcomes achieved through application of microsurgical technique significantly surpass the outcomes obtained through the use of routine surgical methods.

Extremities↗
PubMed2006

Twice-weekly complete decongestive physical therapy in the management of secondary lymphedema of the lower extremities.

BACKGROUND AND PURPOSE: This case report describes the physical therapist examination, evaluation, and intervention for a patient with bilateral lower-extremity lymphedema who received complete decongestive physical therapy 2 days per week instead of the recommended daily frequency. CASE DESCRIPTION: The patient was a 55-year-old woman who developed bilateral lower-extremity grade II lymphedema 3 years after surgery and radiation for cervical cancer. She had impairments in hip and knee flexion range of motion and functional limitations in transfers, gait, and activities of daily living. Intervention. A twice-weekly intervention program was implemented consisting of education in skin care, manual lymph techniques, compression, and exercise. OUTCOMES: Outcomes related to the lymphedema were measured using the sum of the circumference of each limb. At discharge, the patient had reductions in lymphedema of 9% for the left lower extremity and 10% for the right lower extremity. Her hip flexion range of motion increased from 95 degrees to 110 degrees, and her knee flexion range of motion increased from 95 degrees to 130 degrees. She had resumed all premorbid activities and was independent in self-management. DISCUSSION: Twice-weekly management of lymphedema using a program of skin care, manual lymph techniques, compression, and exercise was followed by reduction of the impairments and functional limitations in a patient with bilateral lower-extremity lymphedema.

Female↗
PubMed1983

Concentrations of cefazolin sodium in ischemic extremities.

Patients with ischemic extremities were administered 2 g of cefazolin sodium (CEZ) intravenously from the unaffected extremity. Blood samples were periodically taken from both affected and unaffected extremities and concentrations of CEZ in both samples were compared. No statistically significant difference was observed in the concentration of CEZ in affected and unaffected extremities, which suggested that systematic administration of CEZ has satisfactory effects on ischemic extremities.

Adult↗