Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “FOREARM”

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 685 records · Page 38Linked to original sources
PubMed1980

Measurement of bone mineral content (BMC) of the lumbar spine, II. correlation between forearm BMC and lumbar spine BMC.

A comparison between forearm bone mineral content (BMC) and lumbar BMC was made in post-menopausal women. Women without symptoms, women with clinical spinal osteoporosis, and women with prednisone-treated rheumatoid arthritis were studied. A conventional two-dimensional single-photon osteodensitometer was used for measurement of forearm BMC. A new two-dimensional dual-photon osteodensitometer was used for measurement of lumbar BMC. Its radioactive source was 153Gadolinium. The mean lumbar BMC was significantly reduced in women with clinical spinal osteoporosis (P < 0.001). The mean forearm of BMC of those patients was normal. Thus, forearm BMC was a poor indicator of spinal osteopenia. If forearm BMC was used to predict lumbar BMC erroneously high results were obtained in women with clinical spinal osteoporosis, and erroneously low values were obtained in prednisone-treated women with rheumatoid arthritis.

Adult↗
PubMed1998

The total volar forearm musculocutaneous free flap for reconstruction of extended forequarter amputations.

Forequarter amputation is performed for resection of large, invasive tumors of the shoulder girdle region. A substantial defect can usually be closed with local or regional flaps; however, a subset of the forequarter amputation group has emerged at this institution with more complex issues. These patients have extensively more invasive posterior tumors, some with chest wall/rib invasion. Local/regional flaps in these situations are inadequate, and free tissue transfer is the only viable option. The forequarter specimen can sometimes be used as a donor site, thereby eliminating the usual donor site morbidity. Variations of the total forearm free flap have been sparsely described in the literature--the majority being case reports of either pure fasciocutaneous or "filet of forearm" flaps. We report a series of 4 patients treated over a 5 year period at this institution using the previously undescribed total volar forearm musculocutaneous free flap based on the brachial artery and its venae comitantes. This flap includes the entire musculature of the volar forearm with fasciocutaneous extensions on either side of the musculocutaneous unit. All potentially ischemic dorsal musculature is discarded, leaving a flap that has central bulk and a relatively large dimension. The entire flap remains extremely well vascularized, and a substantial surface area of as much as 45 x 25 cm can be attained. A pedicle as long as 20 cm can be dissected as far proximally in the arm as is oncologically safe. A single artery and vein are anastomosed to either the intrathoracic or neck vessels. All four flaps survived completely with uncomplicated wound healing. The total volar forearm musculocutaneous flap is extremely well vascularized and highly reliable. The flap as described provides the ideal combination of large surface area, muscle bulk, and long vascular pedicle. It can be dissected rapidly to minimize ischemic time and could therefore be applicable to traumatic forequarter amputations. It has become the flap of choice for reconstruction of extended oncological forequarter amputation defects.

Adult↗
PubMed1992

Linearity and reliability of the IEMG v torque relationship for the forearm flexors and leg extensors.

The purpose of this investigation was to examine the linearity and reliability of the surface integrated electromyogram (IEMG) v isometric torque relationship for the leg extensors and forearm flexors. Nine men and four women (mean age +/- SD = 22 +/- 2 yr) volunteered for this investigation. Isometric testing was conducted on a Cybex II isokinetic dynamometer with the lever arm at 0.785 rad (45 degrees) below the horizontal plane for the leg extensors and in the vertical plane for the forearm flexors. Bipolar surface electrodes were used to record IEMG values from the vastus lateralis and biceps brachii. To examine test-retest reliability, two test sessions, separated by a minimum of 48 h, were performed. The test-retest linearity of the IEMG v torque relationship ranged from r2 = 0.77 to 0.96 and 0.55 to 0.94 for the forearm flexors and r2 = 0.81 to 0.98 and 0.83 to 0.98 for the leg extensors. The slope values were not significantly different (P > 0.05) between sessions and were correlated (intraclass correlation coefficients) at R = 0.86 (standard error of estimate (SEE) = 5.77 microV.Nm-1, 31% of the mean) and R = 0.97 (SEE = 0.27 microV.Nm-1, 12% of the mean) for the forearm flexors and leg extensors, respectively. The test-retest maximal torque values were 57.73 +/- 22.57 Nm and 58.14 +/- 22.81 Nm (R = 0.99; SEE = 2.39 Nm) for the forearm flexors and 187.79 +/- 55.98 Nm and 195.42 +/- 56.27 Nm (R = 0.96; SEE = 22.62 Nm) for the leg extensors (nonsignificant differences; P > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Complications and outcomes of open pediatric forearm fractures.

Few reports have documented the complications and outcomes of open pediatric forearm fractures. The authors completed of all patients (1987-1999) with open forearm fractures. Sixty-five patients with 65 injured extremities were identified, with an average age of 10.3 years. Fifty-two open fractures were grade I, 12 were grade II, and 1 was grade IIIA. Implants stabilized 40 extremities (62%), which improved alignment but not outcome. Forearms initially stabilized with implants did not undergo additional realignment procedures (0%), compared with 18.5% of forearms without stabilization. Eleven patients (16.9%) experienced complications. Overall, 47 (72%) were classified as having excellent results, 11 (17%) as good, and 7 (11%) as fair. Open pediatric forearm fractures have a high percentage of excellent and good outcomes. Early, thorough surgical débridement produces a low frequency of deep infections, and bony stabilization can be a safe technique, permitting more anatomic alignment and preventing the need for reoperation due to malalignment.

Adolescent↗
PubMed1985

Prejunctional alpha 2-adrenoceptors and norepinephrine release in the forearm of normal humans.

To investigate the prejunctional alpha 2-adrenoceptor-mediated autoinhibitory feedback for norepinephrine (NE) release, we measured the response of forearm blood flow (FAF, mercury in silastic strain gauge plethysmography) and changes of the forearm venous-arterial NE difference (delta VA-NE, deep forearm vein, brachial artery norepinephrine concentration) induced by six intrabrachial artery 5-min infusions of clonidine in 13 normal volunteers. NE spillover into the forearm circulation was estimated as the product of delta VA-NE and FAF after three clonidine infusions. Clonidine caused dose-dependent decreases in FAF with a maximum reduction of FAF after the highest dose of clonidine of 32 +/- 8%, (N = 7, p less than 0.01) indicating postjunctional alpha-adrenergic stimulation. delta VA-NE increased slightly yet calculated norepinephrine spillover remained statistically unchanged after clonidine. The results suggest that auto-inhibitory feedback control of neuronal transmitter release via prejunctional alpha 2-adrenoceptors may not to an important degree modulate norepinephrine release in the forearm vasculature of healthy subjects.

Adult↗
PubMed1986

Comparative effects of propranolol and pindolol on small and large arteries and veins of the forearm circulation in hypertensive man.

Brachial artery diameter (pulsed Doppler method), forearm vascular resistance, and venous tone (plethysmographic method) were studied in 18 patients with sustained essential hypertension. Hemodynamic parameters were reevaluated after 3 months of treatment by propranolol (9 patients) or pindolol (9 patients). For the same decrease in pressure, propranolol decreased heart rate significantly while pindolol did not, indicating the role of intrinsic sympathomimetic activity. After pindolol, forearm vascular resistance and venous tone significantly decreased while brachial artery cross-sectional area significantly increased. After propranolol, forearm vascular resistance and brachial artery cross-sectional area did not change significantly, while forearm venous tone increased markedly. The study shows that, in the long term, pindolol dilates small and large arteries and veins of the forearm circulation whereas Propranolol apparently does not.

Adult↗
PubMed1997

Short-term estrogen augments both nitric oxide-mediated and non-nitric oxide-mediated endothelium-dependent forearm vasodilation in postmenopausal women.

Estrogen is known to improve in the short term the impaired endothelium-dependent vasodilating responses in postmenopausal women, which may account in part for the beneficial cardiovascular effects of the female hormone. Endothelium-dependent vasodilation is achieved by combined effects of endothelium-derived prostacyclin, nitric oxide (NO), and hyperpolarizing factor. In this study, we investigated our hypothesis that short-term estrogen improves both NO-mediated and non-NO-mediated endothelium-dependent vasodilation in postmenopausal women. The study included 12 postmenopausal women (aged 64 +/- 3 years). The forearm blood flow was measured by strain-gauge plethysmography. The forearm vascular responses to the endothelium-dependent vasodilators, acetylcholine and substance P, were examined before and after intravenous administration of conjugated estrogen and subsequently after intraarterial infusion of NG-monomethyl-L-arginine (L-NMMA), an inhibitor of NO synthesis. Short-term estrogen augmented the forearm vasodilating responses to both acetylcholine and substance P. The treatment with L-NMMA almost abolished the augmented response to acetylcholine but did not affect that to substance P. The forearm vascular response to sodium nitroprusside was unchanged by the estrogen administration. These results indicate that estrogen augments (in the short-term) both NO-mediated and non-NO-mediated endothelium-dependent forearm vasodilation in postmenopausal women. Thus the beneficial effect of estrogen on endothelial vasodilator function appears to extend to non-NO-dependent mechanism(s).

Aged↗
PubMed2001

Prelaminating the fascial radial forearm flap by using tissue-engineered mucosa: improvement of donor and recipient sites.

In reconstructive surgery, prelamination of free flaps using split-thickness skin is an established technique to avoid the creation of a considerable defect at the donor site, for example, in the case of a radial forearm flap. For oral and maxillofacial surgery, this technique is less than optimal for the recipient site because the transferred skin is inadequate to form a lining in the oral cavity. To create mucosa-lined free flaps, prelamination using pieces of split-thickness mucosa has been performed. However, the availability of donor sites for harvesting mucosa is limited. The present study combines a tissue-engineering technique with free flap surgery to create mucosa-lined flaps with the intention of improving the tissue quality at the recipient site and decreasing donor-site morbidity. On five patients undergoing resection of squamous cell carcinoma of the oral cavity, the radial forearm flap was prelaminated with a tissue-engineered mucosa graft to reconstruct intraoral defects. Using 10 x 5 mm biopsies of healthy mucosa, keratinocytes were cultured for 12 days and seeded onto collagen membranes (4.5 x 9 cm). After 3 days, the mucosal keratinocyte collagen membrane was implanted subcutaneously at the left or right lower forearm to prelaminate the fascial radial forearm flap. One week later, resection of the squamous cell carcinoma was performed, and the free fascial radial forearm flap pre- laminated with tissue-engineered mucosa was transplanted into the defect and was microvascularly anastomosed. Resection defects up to a size of 5 x 8 cm were covered. In four patients, the graft healed without complications. In one patient, an abscess developed in the resection cavity without jeopardizing the flap. During the postoperative healing period, the membrane detached and a vulnerable pale-pink, glassy hyperproliferative wound surface was observed. This surface developed into normal-appearing healthy mucosa after 3 to 4 weeks. In the postoperative follow-up period, such functions as mouth opening and closing and speech attested to the success of the tissue-engineering technique for flap prelamination.

Aged↗
PubMed2006

Acceptance of angulation in the non-operative treatment of paediatric forearm fractures.

Forearm fractures are the most common injury in paediatric traumatology. The unique properties of the juvenile skeleton make it possible to cope well with traumatic deformities such as angulation, apposition and displacement. While we make use of these properties, the exact mechanism and degree of healing remains obscure. Different types of forearm fractures require specific treatment options, each with its limitations. A meta-analysis of recent literature was carried out, and together with the opinions of 18 international experts an effort was made to provide insight into the limits of acceptance of angular deformation in the non-operative treatment of paediatric forearm fractures. With this information we constructed graphs (age versus angulation) for each of the eight types of paediatric forearm fractures. In the absence of proper trials, it is our opinion that the presented Isala graphs can provide useful support in the decision-making process of acceptance of angular deformities in paediatric forearm fractures.

Adolescent↗
PubMed2003

Reversed forearm island flap supplied by the septocutaneous perforator of the radial artery: anatomical basis and clinical applications.

The cutaneous perforators of the radial artery adjacent to the superficial branch of the radial nerve and the lateral antebrachial cutaneous nerve were investigated, and the vascular anatomical features of the reversed forearm island flap supplied by those accompanying perforators were documented. Ten fresh cadavers were systemically injected with lead oxide, gelatin, and water. Twenty forearms were then dissected, and an overall map of the cutaneous vasculature and source vessels was constructed. The accompanying arteries were observed to lie along the lateral antebrachial cutaneous nerve and the superficial branch of the radial nerve and to nourish the skin through cutaneous branches. Vascular communication among these cutaneous vessels was evaluated, to determine the cutaneous vascular territory of the radial forearm flap. This anatomical information facilitates flap design in the forearm region. Clinical experience regarding the usefulness of the reversed forearm island flap for hand reconstruction for a series of five patients is presented.

Adult↗
PubMed2002

Four-year gain in bone mineral in girls with and without past forearm fractures: a DXA study. Dual energy X-ray absorptiometry.

We have previously shown that girls with a recent distal forearm fracture have weaker skeletons than girls who have never fractured. This could be a transient or persistent phenomenon. The present study was undertaken to determine whether the bone mineral content (BMC) of girls with previous distal forearm fractures remains lower 4 years postfracture or if catch-up gain has occurred. We report baseline and follow-up dual energy X-ray absorptiometry (DXA) results for 163 girls: 81 girls from the original control group who remained free of fracture (group 1) and 82 girls from the original group with distal forearm fractures (group 2). In data adjusted for bone area, height, weight, and pubertal status, group 2 girls had 3.5-8.5% less BMC at the total body, lumbar spine, ultradistal radius, and hip trochanter than group 1 at baseline, and 2.4-5.7% less BMC at these sites at follow-up. Even girls from group 2 who did not experience another fracture after baseline (n = 58) did not display greater BMC at follow-up compared with baseline values at any site, indicating that the decreased BMC at the time of fracture had persisted. In group 2, the relative gain in BMC after adjusting for the initial BMC and current bone area, height, weight, and pubertal stage was less than or similar to, but not greater than that of group 1 (ratio [95% CI]: total body, 0.985 [0.972-0.998]; lumbar spine, 0.961 [0.935-0.987]; ultradistal radius, 0.968 [0.939-0.998]; hip trochanter, 0.955 [0.923-0.988]; femoral neck, 0.981 [0.956-1.007]; and 33% radius 0.999 [0.977-1.021]). These findings indicate that girls with distal forearm fractures do not improve their gain of BMC. We conclude that girls who have sustained a distal forearm fracture maintain their lower BMC at most sites for at least 4 years.

Absorptiometry, Photon↗
PubMed2005

Does a distal forearm fracture lead to evaluation for osteoporosis? A retrospective cohort study in 147 Danish women.

In postmenopausal women, a low-trauma distal forearm fracture is a risk factor for osteoporosis and future fracture, which indicates osteoporosis follow-up according to prevailing guidelines. We decided to determine how often women over 45 yr presenting with a low-trauma distal forearm fracture to a Danish emergency department during a 1-yr period were followed up for osteoporosis. We performed a retrospective review of hospital records and we sent the women and their general practitioners (GPs) questionnaires regarding the follow-up undertaken in primary care. Finally, we invited the women for a densitometry to estimate the prevalence of osteoporosis. From May 1, 2001 to April 30, 2002, 147 women presented with a low-trauma distal forearm fractures. According to the review of hospital records, none of the women was referred for bone densitometry or spine X-rays. One woman had calcium and vitamin D supplementation (CVDS) prescribed and two were recommended to consult their GPs for osteoporosis follow-up. In primary care, 12 women were referred for densitometry or spine X-rays, and 11 women started CVDS after the fracture. Women with risk factors for osteoporosis in addition to the forearm fracture were not more likely to be referred for densitometry or spine X-rays (p = 0.10). The prevalence of osteoporosis was 24% among the 79 women who underwent densitometry. Our study demonstrates a low use of available measures to reduce the risk of future fracture in women with a low-trauma distal forearm fracture, and it emphasizes the need to decide on a local level how to provide osteoporosis follow-up for women with fragility fractures.

Absorptiometry, Photon↗
PubMed2002

[The Essex-Lopresti forearm fracture (case report)].

The radial head fracture associated with dislocation in the distal end of the ulna and tear of interosseous membrane of the forearm with a subsequent proximal migration of the radial shaft is a relatively rare injury. For the first time it was described by Essex-Lopresti in 1951. Our report presents one case together with an analysis of available literature relating to the diagnosis and treatment. A man, 69 years old, hurt his right elbow and forearm in a fall on the outstretched arm. There was a 2 x 1 cm excoriation on the lateral portion of the elbow and a dominating pain and limitation of the range of motion of the right elbow and wrist. The radiograph of the elbow, forearm and wrist showed a dislocated comminuted fracture of the radial head, dorsal subluxation of the ulnar and proximal displacement of radius. The condition was assessed as Essex-Lopresti fracture of the forearm indicated for surgery. The four-fragment fracture of the radial head did not allow reconstruction and therefore the head was resected. Subsequently the distal radio-ulnar joint was revised from dorsal approach with a K-wire inserted transversally. In order to prevent proximal displacement of the radius a K-wire was inserted in the medullary cavity of the radius close to the distal end of the humerus with the elbow in 90 degrees flexion and slight supination. The wounds were sutured and plaster of Paris applied extending across the elbow up to the metacarpal heads. After 6 weeks the plaster fixation and K-wires were removed. Full weight bearing was permitted 4 months after the surgery. Ten months after the surgery the patient was without complaints. Flexion in the elbow ranged between 0-5-130 degrees, pronation-supination was limited by 10 degrees in both extreme positions. The ulnar head became prominent on the dorsal side, dorsiflextion and ulnar duction in the wrist were limited to 10 degrees. The radiograph of the wrist showed and evident proximal displacement of the radius, the dorsally subluxated ulnar head overhung by 7 mm. Our case has confirmed that a mere extirpation of the head with a subsequent stabilization and transfixation of the proximal end of the radius and transfixation of the distal radio-ulnar joint cannot prevent after the extraction of wires a proximal displacement of the radius and development of the "plus variant" resulting in the limitation of both the range of motion of the wrist and the pronation-supination movement of the forearm.

Aged↗
PubMed1990

Variability and reproducibility of arterial and venous circulation parameters in the forearm and calf measured at one-week intervals.

In 12 healthy men aged 22 to 29 years the variability of basal arterial blood flow, maximal arterial blood flow as induced by a 5-min arterial occlusion, vascular resistances, total venous capacity and venous emptying rate and the reproducibility of the measurements were studied in both the upper and lower limbs 3 times at one week's interval under strictly standardised conditions using an automatic venous occlusion plethysmograph. Means, medians, standard errors, and standard deviations were virtually identical or very similar without any statistically significant difference between the 3 study occasions; this implies that valid comparisons can be made when measurements are repeated at several days' interval provided measuring conditions are rigorously standardised. Basal and maximal arterial blood flows and venous emptying rates per 100 ml of tissue were significantly higher (p less than 0.05-p less than 0.001) in the forearm than in the calf. Variability of basal blood flow in terms of standard deviations and in terms of coefficients of variation computed from duplicate determinations were significantly higher than for the other parameters and significantly more elevated in the forearm than in the calf. Variability of maximal arterial blood flow and venous emptying rate also tended to be higher in the forearm than in the leg. The high variability and low reproducibility of basal arterial flow measurements are apparently due to a high degree of random biological variability in particular concerning the forearm vascular bed which makes the forearm basal blood flow poorly suitable for studying effects of interventions in cardiovascular control.

Adult↗
PubMed1992

Subclinical injuries in lacerations to the forearm and hand.

This report describes the incidence and severity of subclinical injuries to underlying structures in lacerations to the hand and forearm. One hundred consecutive hand and forearm lacerations that penetrated the full thickness of subcutaneous tissue were studied prospectively. Lacerations were explored under either biceps or forearm tourniquets. Injuries, treatment, tourniquet time, causative agent and complications were recorded. In all, 97 patients sustained 100 lacerations. A total of 49 deep injuries were discovered, none of which was detected clinically before exploration. Of these, 33 were tendon lacerations; 21 tendons, including three flexor tendons, were repaired. Nineteen patients required treatment in a volar slab for at least 3 weeks. Five patients of 49 returning for review developed wound infection. No patient developed significant problems related to the tourniquet, which was inflated for a mean time of 4.9 min. There is a high incidence of subclinical injury in full-thickness lacerations of the forearm and hand. These should be explored under tourniquet, which should minimize complications such as wound infection and delayed tendon rupture.

Forearm↗
PubMed1993

The lateral arm/proximal forearm flap.

The classic lateral arm flap is constrained by limited skin availability, thick subcutaneous tissue, a short vascular pedicle, and inconsistent sensory innervation. We report modifications of the lateral arm flap which increase its skin availability, provide thin sensate skin, and extend the overall reach of the flap. The vascular anatomy of the lateral arm/proximal forearm flap was studied in 10 fresh anatomic specimens. The posterior radial collateral artery communicated with a rich vascular plexus that extended well into the proximal forearm. This plexus is also fed by communicating branches from the radial recurrent artery. Fifteen lateral arm/proximal forearm flaps have been utilized for various upper and lower extremity reconstructions and three penile constructions. All flaps survived, and there was primary healing of all wounds. Three are presented which demonstrate the versatility of the lateral arm/proximal forearm flap.

Adult↗
PubMedDate not supplied

Decompression of forearm compartment syndromes.

The diagnosis of forearm compartment syndrome by clinical findings alone has been difficult and inconsistent. This study was designed to assist in the diagnosis and treatment of forearm compartment syndromes. We evaluated several forearm incisions and determined their effectiveness by measuring compartment pressures using the wick catheter. The wick catheter is a simple, safe, and effective means of determining forearm compartment pressures. Preoperative and intraoperative measurements of the dorsal as well as the volar compartment pressures should be performed. Volar fasciotomy is effective in decompressing the volar compartment and may be effective in lowering the dorsal compartment pressure as well. Dorsal fasciotomy should be performed when that pressure remains elevated following volar decompression. The curvilinear volar and volar-ulnar incisions were equally effective in lowering compartment pressures experimentally, but the curved incision allowed beteer exposure to nerves and vessels and is preferred.

Adult↗
PubMed2002

Osteoporosis intervention following distal forearm fractures: a missed opportunity?

BACKGROUND: Fractures are a manifestation of osteoporosis, but therapeutic interventions to reduce the risk of recurrent fractures are not widespread. OBJECTIVE: To identify predictors of osteoporosis treatment in postmenopausal women following distal forearm fracture. METHODS: This population-based retrospective cohort study included all postmenopausal women, 45 years or older, residing in Olmsted County, Minnesota, who sustained a distal forearm fracture due to minimal trauma (a fall from standing height or under) in 1993 to 1997. Complete medical records were reviewed for each subject and Cox proportional hazards regression was used to evaluate the relationship of baseline demographic and clinical characteristics to therapeutic interventions for osteoporosis within 12 months following the fracture. RESULTS: A total of 343 women with a mean age of 70.5 years had a minimal trauma distal forearm fracture. Within 12 months, 83% had seen a nonorthopedic physician. Of these, 17% had a pharmacologic osteoporosis intervention and the 12-month actuarially estimated cumulative incidence of any intervention was 18% (95% confidence interval [CI], 14%-22%). In a multivariate analysis, treatment was more likely to be offered to those with a prior diagnosis of osteoporosis (relative risk [RR], 2.08; 95% CI, 1.21-3.58), previous distal forearm fracture (RR, 2.38; 95% CI, 1.30-4.34), or history of cigarette smoking (RR, 1.86; 95% CI, 1.11-3.12). CONCLUSIONS: Effective osteoporosis interventions are underutilized among postmenopausal women who experience an osteoporotic fracture. Further work is needed to overcome barriers to optimal osteoporosis management in these women who are at high risk for future complications of osteoporosis.

Cohort Studies↗