Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Bones of Upper Extremity”

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 73 records · Page 4Linked to original sources
PubMed1975

Bone and soft tissue abnormalities of the upper extremity in diabetes mellitus.

Roentgenographic evidence of bone and soft tissue abnormalities may be noted in the upper extremities of diabetics. Major shoulder changes, typically associated with peripheral neuropathy, include humeral head deformity due to bone resorption, joint space narrowing, subchondral cysts and sclerosis, subluxation, and juxtra-articular soft tissue bone fragments. Charcot-type joints, characterized by severe joint destruction, sclerosis, multiple bone fragments, and soft tissue swelling may occur. Diabetic neuropathy can produce flexion contractures of the hand. Abnormalities not necessarily associated with clinical neuropathy include cystic bone changes, cortical bone erosions, soft tissue calcification (calcific tendinitis), and vascular calcification.

Aged↗
PubMed1991

Monobloc resection of the upper extremity of the leg for bone tumor with distal vascular reconstruction.

A patient with juxtacortical osteosarcoma of the upper extremity of the left tibia which encased the popliteal neurovascular bundle was treated by monobloc resection of the superior extremity of the tibia and the tibial nerve. The knee joint was replaced by a Guepar prosthetic knee. Arterial and venous continuity was reestablished by a double bypass using the contralateral greater saphenous vein. One year later the patient had good lower limb function and was free of local or general disease. This observation confirms that preservation of lower limb function is possible using reconstruction techniques of bone, nerves, and vessels in sarcoma of the musculoskeletal system.

Adult↗
PubMed1994

Immediate internal fixation for open fractures of the long bones of the upper and lower extremities.

Immediate open reduction with internal fixation was performed on 66 open fractures (54 patients) of the long bones in the upper or lower extremity, including one clavicle. Using the classification system of Gustilo, there were 13 (20%) type I, 30 (45%) type II, 11 (16%) type IIIA, six (9%) type IIIB, and six (9%) type IIIC soft tissue injuries. Thirty-two patients had associated major multiple trauma. Eighty-eight percent of the patients had good functional results using a modification of Katenjian's criteria. There were three late deep infections (4.5%), all at the sites of type III fractures. The nonunions occurred in four open fractures (6.1%). We conclude that, if a complete and timely debridement can be accomplished, immediate internal fixation of open fractures allows for improvement in ultimate function and a decrease in mortality in patients with multiple trauma. This procedure should be performed in selected patients who have type III open fractures, with careful attention to the general status of the patient and the severity of the soft tissue wound at the fracture site.

Adolescent↗
PubMed2006

Loading modalities and bone structures at nonweight-bearing upper extremity and weight-bearing lower extremity: a pQCT study of adult female athletes.

This cross-sectional study of adult female athletes assessed whether the apparent loading-related differences in bone structure are primarily associated with the loading type or the muscle performance-related joint moments. Several structural variables at shaft sites of the tibia, radius and humerus, and distal sites of the tibia and radius were measured with peripheral quantitative computed tomography (pQCT) among 113 female national level athletes (representing hurdling, volleyball, soccer, racket-sports and swimming) and their 30 nonathletic referents. For the weight-bearing lower extremities, the loading modalities of the above sports were classified into high-impact (hurdling, volleyball), odd-impact (soccer, racket-sports) and repetitive, nonimpact (swimming) loadings; and for the nonweight-bearing upper extremities into high magnitude (functional weightlifting in hurdling and soccer), impact (volleyball, racket-sports) and repetitive, nonimpact (swimming) loadings. As expected, athletes' bone mass was substantially higher at loaded bone sites compared with the nonathletic referents, but more pertinently to the locomotive perspective, the loading-induced additional bone mass seemed to be used to build mechanically strong and appropriate bone structures. Compared with controls, the weight-bearing bone structures of female athletes (swimmers excluded) were characterized by larger diaphysis, thicker cortices and somewhat denser trabecular bone. The athletes' bones at the nonweight-bearing upper extremity were generally larger in cross-sectional area. The estimated indices of joint moment (muscle force x estimated lever arm) were explained from 29% to 50%, and the loading modalities from 8% to 25%, of the variance in most bone variables (P < 0.05) of the tibia (shaft and distal site). In contrast to the weight-bearing tibia, only the estimated joint moment was positively associated (P < 0.05) with the structural characteristics of the radius and humerus, accounting for 6% to 26% of the variance in bone variables of the shafts of these bones. Such association was not observed at the distal radius. In conclusion, at the weight-bearing lower extremity, the strong bone structure of the female athletes was attributable to muscle performance-related estimated joint moments and impact loading modality. At the shaft sites of the nonweight-bearing upper extremity, the strong bone structure was mainly attributable to the estimated joint moments. Thus, different loading history and other features of loading seemed to govern the skeletal adaptation at the upper and lower extremity.

Absorptiometry, Photon↗
PubMed1992

Reconstruction of the bones and joints of the upper extremity by vascularized free fibular graft: report of 46 cases.

The vascularized free fibular graft was applied in reconstructing bone and joint structures of the upper extremity in 46 cases between August, 1977 and December, 1989. Among these, 30 were grafts of the fibular shaft and 16 were grafts of the fibular head. There were 19 bony defects after trauma or osteomyelitis, 18 bony or articular defects after resection of tumors, five congenital deformities or defects, and four replacements for fibrous dysplasia. The longest grafted fibula was 22 cm and the shortest, 5 cm. Thirty-one cases were followed for more than two years, and these were evaluated for functional ability in daily living, roentgenologic appearance, and 99mTc scan during follow-up. The results revealed quite sufficient functional restoration, solid bone healing, and adequate blood supply, in most cases. The vascularized free fibular head graft appears to be an ideal procedure for the reconstruction of defects of the lower end of the radius or the upper humerus, including the humeral head. The stability of the reconstructed wrist or shoulder joint was maintained by suturing the lateral collateral ligament, the palmar collateral ligament around the wrist, or by passing the long head of the biceps brachii through the grafted fibula at the shoulder. Methods for fixation of the fibular shaft to the recipient bone and the selection of vessels for anastomoses, both in the graft and at the recipient site, are discussed. The importance of postoperative functional exercise is emphasized.

Adult↗
PubMed2005

[Operative strategies in the treatment of upper limb fractures in polytraumatized patients].

BACKGROUND: Optimal timing of operative treatment of upper extremity long bone fractures in polytraumatized patients depends on the type and location of the fractures, as well as on the cardiorespiratory stability of the patient, and should be early in diaphyseal fractures in order to optimize intensive care treatment. The timing of surgery in cases of upper limb fractures is secondary to life-saving therapies. The same applies to stabilization of fractures of the lower limbs, including fractures of the femur and tibial shaft. METHODS: The recommended operative procedure for adult polytraumatized patients with closed or open humeral shaft fractures of grade I or II is intramedullary nailing or plating. For closed or open lower arm fractures of grade I or II, plating is the best procedure, or alternatively nailing. For upper extremity epi- or metaphyseal fractures plating is preferred. Specific fracture situations require specific operative treatments, for example traction band for olecranon fractures, external fixation for distal radial multi-fragmentary fractures. The external fixator may be the optimal approach in grade III open fractures of the upper extremity long bones. The main difference in paediatric fractures is not the timing of the procedure, but the selection of the technique, which has to respect the epiphyseal growth plates. RESULTS: Additional vessel injuries require quick diagnosis and early vessel reconstruction in the presence of cardiopulmonary stability. Open fractures should have a higher therapeutic priority if they are associated with vessel/nerve lesions. The strategy in additional nerve injuries depends on the type of lesion. Nerve decompression should take place together with fracture stabilization; necessary nerve reconstruction should be performed secondarily. The primary phase should be limited to fracture fixation. If the fracture is combined with a compartment syndrome, decompression by fasciotomy together with fracture fixation ensuring cardiopulmonary stability has be performed. CONCLUSION: Amputations at the upper extremity in polytraumatized patients are only occasionally indicated in very severe injuries. In injuries involving total amputation, depending on the condition of the limb, immediate reattachment should be attempted if the cardiorespiratory situation of the patient is stable.

Arm Injuries↗
PubMed1978

Method of bone fixation in reattachment of amputations in the upper extremities.

The object of secure bone fixation in the reattachment of amputated fingers is early motion. The use of specially designed screws and Kirschner wires is essential for this objective. This becomes even more important in the reattachment of fingers than the upper arm or forearm. If there should be non-union of the bone, an autologous bone graft should be applied as a secondary procedure.

Adolescent↗
PubMed1979

Free vascularized bone grafts in surgery of the upper extremity.

Free vascularized fibular grafts were employed in five patients with segmental bone defects following trauma or resection of tumors of the upper extremity with excellent results in three patients and satisfactory results in two. No donor site morbidity was experienced. A comparison with rib and iliac crest grafts indicates that the fibula is more suitable for reconstruction of long bone defects. The advantages of this technique are stability without sacrificing viability and a shorter immobilization period with more rapid incorporation and hypertrophy of the graft. The disadvantages are prolonged operating time, difficulty in assessing patency of anastamoses in the immediate postoperative period, and sacrifice of a major vessel in the lower extremity.

Adult↗