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At least 667 records · Page 37Linked to original sources
PubMed1996

Bony injuries of the wrist, forearm, and elbow.

One of the greatest challenges when examining an injured athlete is ensuring that the examination encompasses the whole patient and not just the obvious deformity. Bony injuries of the wrist, forearm, and elbow are uncommon in athletes and when present should always lead to suspicion of possible concomitant soft tissue injury. Mechanisms causing osseous disruption are of fairly high energy and can be quite disabling to the long-term career of the athlete. Appropriate expectations with regard to both treatment and the possible return to sports are critical in providing successful treatment for these often complex injuries. There is no substitute for a careful clinical history and physical examination in not only establishing the diagnosis but ensuring that a complete diagnosis with its subsequent prognostic outcome can be rendered.

Athletic Injuries↗
PubMed1983

Tubular orthoses.

A method of constructing orthoses and other patient devices using nylon tubing and clip-together standard components is described. This permits the rapid assembly of custom orthoses that can be evaluated before prescription in a clinical setting. These orthoses have been successfully used for the control of thoracic spinal flexion, hip abduction, elbow extension, shoulder abduction, cervical spine stabilization and pressure sore relief. Advantages over existing orthoses include reduced weight, improved comfort and cosmesis, low cost and increased speed of provision. Examples of these orthoses are shown, together with details of their structure, function and clinical results.

Adult↗
PubMed2005

Diagnosis and treatment of longitudinal instability of the forearm.

Radio-ulnar dissociation can result from high-injury trauma that the compressive forces traverse the wrist forearm and elbow. This injury can be thought of as an "unhappy triad" of radial head fracture, triangular fibrocartilage complex failure, and a tear of the interosseous membrane. The radius is the primary stabilizer of the forearm with the forearm interosseous membrane enabling load sharing between the radius and the ulna. The central one-third of the interosseous membrane is 3 times stronger than the membranous portion and approaches the strength of the anterior cruciate ligament for determining interosseous membrane injury. Imaging studies with proven diagnostic efficacy include magnetic resonance imaging and ultrasound. Surgical treatment should be considered when circumstances imply longitudinal instability of the forearm. Surgical treatment includes open reduction/internal fixation or prosthetic replacement of the radial head as well as repair of the disrupted triangular fibrocartilage complex. Successful treatment of radioulnar dissociation is predicated on early diagnosis of the condition.

Biomechanical Phenomena↗
PubMed1980

Bilateral elbow dislocations with intra-articular displacement of the medial epicondyles.

Described is a case of bilateral epicondylar entrapment following fracture dislocations of elbows in a 13-year-old girl who fell while performing on parallel bars. Close manipulative reduction was unsuccessful. Open reduction and internal fixation yielded excellent results. Ulnar nerves were not transposed anteriorly as has been recommended by some authors. Long-term follow-up in five previous cases has shown no evidence of tardy ulnar nerve palsy. The need for transposing the ulnar nerve is questioned.

Adolescent↗
PubMed1992

Arthrolysis in the treatment of ankylosis and severe post traumatic stiffness of the elbow.

Between 1977 and 1989 the authors performed arthrolysis on 18 patients with ankylosis or severe post traumatic elbow stiffness. After an analysis of the cases, the operative technique is described and original parameters are proposed to evaluate the consequent results. The validity of arthrolysis as a possible alternative to arthroplasty or arthroprosthesis is confirmed by the 67% positive results.

Adolescent↗
PubMed2002

The radioulnar joint in distal radial fractures.

We searched The Cochrane Library and Medline regarding the radioulnar joint in distal radial fractures and found no randomized or controlled studies. This review presents the descriptive literature by summarizing accepted views and controversies. There is only weak support for the commonly accepted treatments. Current research has shown that distal radial fractures are often associated with ligament injuries not seen on radiographs. These injuries can lead to laxity of the DRU-joint and subsequent worse outcome, which indicates that we must have a complete diagnosis including ligament injuries if we want to understand better the fracture and its sequelae. Randomized studies should be done before advocating surgical treatment of these unforeseen injuries.

Elbow Joint↗
PubMedDate not supplied

Using therapeutic touch in nursing practice.

This article is an introduction to "therapeutic touch" and its implications for nursing. A case study provides an example of how therapeutic touch was used with an individual who fell from a ladder and injured his elbow. A brief history and assumptions that support the practice of therapeutic touch are discussed. Rogers' Science of Unitary Human Beings, a nursing theory, provides a theoretical basis for therapeutic touch. The method developed by Kunz and Krieger involves four phases and each of these is identified and described. General uses for therapeutic touch are presented and a variety of research studies validate the practice of therapeutic touch in nursing. Resources are provided for those who may be interested in learning more about therapeutic touch.

Holistic Health↗
PubMedDate not supplied

Surgical treatment of partial distal biceps tendon ruptures through a single posterior incision.

The purpose of this study was to describe a novel technique for repair of partial distal biceps tendon ruptures through a single posterior incision. Eight patients with partial distal biceps tendon ruptures had the tear confirmed and repaired through a single posterior incision. All were men. The mean age was 50 years (range, 36-60 years). Postoperatively, immediate active and passive motion was instituted. Seven of eight patients returned to their previous professions. The mean postoperative American Shoulder and Elbow Surgeons elbow score was 96 (range, 89-100). Six of the patients were completely satisfied, and all were much improved. There were no complications. Surgical confirmation and repair of symptomatic partial distal biceps tendon ruptures can be performed through a single posterior incision. The morbidity of the anterior exposure can be avoided and the tendon readily explored and reattached with excellent patient outcomes. The security of repairing the tendon directly into a trough in bone and suturing over cortical bone permits immediate rehabilitation without immobilization in a cast or splint.

Adult↗
PubMed2006

Tendinitis and tendinosis of the elbow, wrist, and hands.

Tendinopathy in the upper extremity continues to be a source of morbidity and disability in the working population despite a benign clinical course. Risk factors include high force, repetition, and awkward positions. An understanding of the pertinent anatomy and pathophysiology should help clinicians in the management of these conditions. Tension overload and shear stress are the two mechanisms most likely responsible for most upper extremity tendinopathies. Clinical presentation includes localized pain and tenderness. Most treatment options have yet to undergo evaluation for efficacy in well-designed clinical trials, yet there is a generally favorable response to nonoperative or conservative management. Cases resistant to conservative treatment may require surgical intervention.

Biomechanical Phenomena↗
PubMed2004

Magnetic resonance imaging of the elbow.

Despite being one of the more commonly injured joints in recreational and elite athletes, diagnosis of soft-tissue injuries of the elbow remains problematic. Although plain radiographs remain the initial mainstay for imaging of the elbow, the superior soft-tissue contrast and direct multiplanar capabilities of magnetic resonance (MR) imaging has afforded the ability to more accurately diagnose the site and extent of soft-tissue pathology, including tendinous injuries and trauma to the static stabilizers. In addition, the ability of MR imaging to noninvasively assess the integrity of the articular cartilage provides for more comprehensive information that was previously unavailable and has prognostic significance in the athlete.

Athletic Injuries↗
PubMedDate not supplied

Surgical treatment of posttraumatic elbow contracture in adolescents.

Thirteen adolescent patients with posttraumatic elbow contractures were treated with open surgical release at an average of 16.2 years of age. When possible, an extensile medial approach to the elbow was used. All patients were treated with 6 weeks of postoperative continuous passive motion in addition to physical therapy and splinting. Eleven patients with >6 months of follow-up were evaluated at an average of 29 months after surgery. Average loss of extension improved from 57 degrees to 15 degrees, and average flexion improved from 109 degrees to 123 degrees. Average total arc of motion improved from 53 degrees to 107 degrees. Complications included one case of wound drainage requiring irrigation and debridement and one case of transient ulnar neuropraxia. One of the 13 patients was unable to tolerate postoperative therapy and showed loss of motion.

Adolescent↗
PubMed2000

A myoelectrically controlled shoulder-elbow orthosis for unrecovered brachial plexus injury.

Two myoelectrically controlled battery powered shoulder-elbow orthoses manufactured individually for two traumatic unilateral brachial plexus injury cases are reported. The first case was 24 years old and the other was 6 years old. Both patients had undergone unsuccessful microsurgical nerve repair procedures leaving them with elbow and shoulder paralysis and some residual hand motion. Manufactured orthoses were made of lightweight thermoplastic polyethylene. They stabilised the affected shoulder joint in the neutral position. Elbow extension and flexion were activated by a myoelectrically controlled battery powered orthosis, and the active range of motion of the elbow was between 60 and 140 degrees. These orthoses achieved elbow motions at a speed of 16 degrees per second. The rehabilitation time was 3 months in both patients. The older patient was rehabilitated using a 1 kg mass, and the younger one with 0.5 kg mass, throughout the full range of active elbow motions. After 21 months it was found, in both cases, that the orthotic treatment had been successful and that the patients had been given the ability to engage in two-handed activities of daily living.

Accidents, Traffic↗
PubMed2004

Myofibroblast numbers are elevated in human elbow capsules after trauma.

Elbow contractures, a frequent problem after injury, can be treated by excision of the joint capsule. However, the underlying changes in the joint capsule are poorly understood. Based on skin healing work, we examined the hypotheses that myofibroblast numbers and expression of a myofibroblast marker alpha-smooth muscle actin, are elevated in patients with posttraumatic joint contractures. Anterior capsules were obtained from six patients who had operative release of posttraumatic contractures greater than 5 months after injury and six elbows of organ donors free of contractures. Immunohistochemical studies revealed that myofibroblast numbers and percentage of total cells that were myofibroblasts were significantly elevated in the joint capsules from patients with contractures (326 +/- 61 cells per field, 36% +/- 4% total cells) when compared with similar tissues of the organ donors (69 +/- 41 cells per field, 9% +/- 4% total cells). Western blot analysis showed that protein levels of alpha-smooth muscle actin were significantly elevated in patients with posttraumatic joint contractures. However, analysis with reverse transcription-polymerase chain reaction determined that messenger ribonucleic acid levels for smooth muscle actin normalized to the housekeeping gene glyceraldehyde-3-phosphate dehydrogenase were not significantly different between the two groups. An association between increased numbers of myofibroblasts and posttraumatic joint contractures has been established in the human elbow capsule. Additional work is required to determine whether myofibroblast regulators may be targets for adjuvant therapies of posttraumatic contractures.

Adult↗
PubMedDate not supplied

Upper extremity wringer injury.

A clinical survey of 92 upper extremity wringer injuries over the past four years at the Bexar County Hospital are presented. Our treatment regimen and results are outlined. Complex injuries occurred infrequently (7%). No vascular insufficiency developed and no fasciotomies were required. We are of the opinion that hospitalization is necessary in all but a small number of selected cases. Close observation is necessary to prevent edema progression and further tissue loss. Ninety-two upper extremity compression injuries secondary to washing machine wringers were reviewed. Seventy-six percent of the injuries occurred in persons under 10 years of age. Extremity distribution was equal. Injury occurred below the elbow in 72% of the extremities. Soft tissue injury was manifested by swelling and tenderness in 96%. Twenty-one percent had no violation of the skin. Major avulsion, such as third degree skin loss, crush injury, dislocation, and tendon avulsion, occurred in 8%. The treatment regimen consisted of surgical preparation with Betadine, compressing dressing, and elevation. Observation of the involved extremity is made every hour for development of vascular insufficiency. Fractures and other major injuries were treated as indicated. No fasciotomy was required. No vascular insufficiency developed. SKin slough was present in 16 of 92 extremities and skin graft was required in 5 of the 16. Results of treatment reveal 87% with no functional impairment of the involved extremity. Varying degrees of impairment are present in 6% of the injured extremities with all localized to the major avulsion group of injuries.

Accidents, Home↗