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At least 991 records · Page 55Linked to original sources
PubMed1986

Computerised axial tomography in traction injuries of the brachial plexus.

Severe traction injuries may damage the brachial plexus at any level from the spinal cord to the axillary outlet. Investigation aims to determine the level of the injury for each of the nerves, trunks or cords, with particular reference to obtaining firm evidence of any intradural (pre-ganglionic) damage. We report the results of computerised axial tomography of the cervical spine in comparison with conventional myelography and with surgical exploration of the plexus. CT scanning with contrast enhancement greatly improves diagnostic accuracy, particularly at C5 and C6 root levels.

Acute Disease↗
PubMed1988

Obstetric traction injuries of the brachial plexus. Natural history, indications for surgical repair and results.

Of a consecutive series of 70 babies with obstetric traction injury to the brachial plexus we were able to review 40 who had had only conservative treatment. We found that if recovery in the upper roots had not started by three months of age then, at follow-up there was a significant residual functional deficit. In a further 22 babies who showed no recovery of the upper roots by three months, exploration and sural nerve grafting were performed; 20 of these children were reviewed at one year. Good recovery of the deltoid was seen in 80% and of the biceps in 55%, while 25% had good external rotation at the shoulder. We conclude that if there is disruption of the upper roots with no sign of recovery at three months, grafting of these roots provides the best chance of useful recovery.

Birth Injuries↗
PubMed2006

Sonography of brachial plexus traction injuries.

OBJECTIVE: Our purpose was to evaluate the feasibility of sonography in identifying nerve abnormalities in patients with traction injury of the brachial plexus. CONCLUSION: Sonography of the brachial plexus was technically feasible, although the entire brachial plexus could not be evaluated. Sonography appears to be a useful bedside imaging technique for assessing brachial plexus injury. The potential of sonography as a complementary diagnostic tool in the evaluation of these patients warrants further investigation.

Adult↗
PubMed1981

Sonography of the low-lying placenta: value of Trendelenburg and traction scans.

In later stages of pregnancy, acoustic shadowing from a fetal head may obscure the termination of a low-lying placenta and prevent sonographic imaging of the internal cervical os. The evaluation of a marginal or partial placenta previa in this setting may be difficult. Placing the mother in Trendelenburg position and applying gentle upward traction on the fetal head allows amniotic fluid to cover the lower uterine segments. This provides an acoustic window to visualize the relation of the termination of the placenta to the internal os. This technique was evaluated prospectively in a series of 217 patients and was successful in 49 of 50 patients in whom conventional studies failed to image the termination of the placenta or the region of the internal os.

Evaluation Studies as Topic↗
PubMedDate not supplied

[Nerve transfer in traction injuries of the brachial plexus].

BACKGROUND: The aim of this study was to analyze the results of nerve transfer to the musculocutaneous and axillary nerves, using some technical modalities such as intercostal, spinal accessory or intraplexal transfer, and on the basis of the results to try to clarify the most common controversies concerning these operations. METHODS: The study included 82 patients with brachial plexus traction injuries, who were operated on using various techniques of nerve transfer. The follow-up period was at least two years. The analysis of biceps and deltoid muscles recovery was performed according to the type of the donor nerve. RESULTS: The corresponding rates of recovery for the musculocutaneous and axillary nerves were 46.7% and 68.1% in intercostal nerve transfer, 71.4% and 75% in accessory nerve transfer, 93.1% and 88.8% in nerve transfer of the brachial plexus collateral branches, and 55.5% and 60% in classical intraplexal nerve transfer, respectively. Comparative statistical analysis demonstrated significantly better final outcome and quality of recovery in regional nerve transfers in comparison to the other methods. CONCLUSION: Our findings suggest that nerve transfer of collateral branches, where possible, (such as in cases with upper or extended upper brachial plexus palsy) might be a method of choice, offering better results and quality of recovery.

Adolescent↗
PubMed1992

Nerve transfer in brachial plexus traction injuries.

Brachial plexus palsy due to traction injury, especially spinal nerve-root avulsion, represents a severe handicap for the patient. Despite recent progress in diagnosis and microsurgical repair, the prognosis in such cases remains unfavorable. Nerve transfer is the only possibility for repair in cases of spinal nerve-root avulsion. This technique was analyzed in 37 patients with 64 reinnervation procedures of the musculocutaneous and/or axillary nerve using upper intercostal, spinal accessory, and regional nerves as donors. The most favorable results, with an 83.8% overall rate of useful functional recovery, were obtained in patients with upper brachial plexus palsy in which regional donor nerves, such as the medial pectoral, thoracodorsal, long thoracic, and subscapular nerves, had been used. The overall rates of recovery for the spinal accessory and upper intercostal nerves were 64.3% and 55.5%, respectively, which are significantly lower. The authors evaluate the results of nerve transfer and analyze different donor nerves as factors influencing the prognosis of surgical repair.

Accessory Nerve↗
PubMed1999

Role of pin traction in wound closure.

This study examined the role of pin traction in wound closure. Forty patients comprised the study population. Wounds treated were on legs, thighs, and forearms. Kirschner wires were passed around margins of the wound and interconnected with stainless steel wires, which were gradually tightened to approximate the wound edges to healing. Final results were excellent in 18 (45%), good in 13 (32.%), fair in 5 (12.%), and poor in 4 (1%) patients. The main complication was cutting through the wires. The results were unsatisfactory in old, scarred, and large wounds.

Adolescent↗
PubMed1992

[Relationship between bladder trigone and bladder neck induced by traction of an indwelling balloon catheter with a spring balance and parameters of cystometrogram].

Sensation of the bladder trigone and bladder neck induced by traction of an indwelling balloon catheter with a spring balance and cystometry was evaluated in 393 males and 106 females. Male patients with an average age of 56.9 +/- 15.9 (mean +/- standard deviation) years old (range 17 to 88 years) were divided into 7 groups as follows: 19 patients without any micturitional disturbance, uregency and chronic prostatitis (11 patients), benign prostate hypertrophy (BPH) (131 patients), cervical or thoracic cord compression disorders (67 patients), lumbar vertebral disorders (114 patients), other peripheral nerve disorders associated with diabetes mellitus, post operative status of rectum cancer and others (27 patients) and brain diseases (24 patients). Female patients with an average age of 55.2 +/- 15.5 years old (range 17 to 88 years) were divided into 6 groups as follows: 24 patients without any neurological problems, urgency (7 patients), cervical or thoracic cord compression disorders (11 patients), lumbar vertebral disorders (37 patients), other peripheral nerve disorders (18 patients) and brain diseases (9 patients). The observed sensation, first desire to void (FDV) and maximum cystometric capacity (MCC) were evaluated statistically in relation to clinical factors (e.g. disease group, generation and patterns of cystometrogram). The correlation between the sensation and FDV or MCC in these patients were assessed by linear regression analysis. Sensation of normal males was 334.2 +/- 159.7 g on the average and correlated well with FDV (r = 0.88, y = 375x - 189.4). Sensation of normal females was 373.3 +/- 199.5 g on the average. However, there was no correlation (r = 0.35) between sensation and FDV in females. In males, the means of sensation obtained in patients with other peripheral nerve disorders (557.3 +/- 314.5 g) was significantly larger than the means of normal subjects (p less than 0.001), and patients with uregency and chronic prostatitis (236.4 +/- 148.3 g, p less than 0.01), BPH (424.1 +/- 215.6 g, p less than 0.001), cervical or thoracic cord compression disorders (349.0 +/- 229.5 g p less than 0.001), lumbar vertebral disorders (349.7 +/- 201.7 g, p less than 0.001) or brain diseases (490.6 +/- 305.0 g, p less than 0.05). Furthermore, the differences in the means of sensation between BPH and lumbar vertebral disorders (p less than 0.05) or brain diseases (p less than 0.05) were statistically significant.(ABSTRACT TRUNCATED AT 400 WORDS)

Catheterization↗
PubMedDate not supplied

[Retinitis pigmentosa and vitreo-macular traction syndrome. An anatomo-clinical and histopathological study apropos of a case].

PURPOSE: A case of congenital epiretinal membrane associated with retinitis pigmentosa is reported. PATIENT: A 30 year old man with retinitis pigmentosa was operated for a vitreomacular traction syndrome. The epiretinal membrane removed during surgical procedure was analyzed in electronic microscopy. RESULTS: Visual acuity, 6 months after the intervention: improve at 20/400, because of amblyopia. The study in electronic microscopy reveals many fibroblasts in an abundant collagenic tissue without glial cells. DISCUSSION: The observation of such an epiretinal membrane is unusual during retinitis pigmentosa. Its origin is probably congenital and the vitreous may play some role in its evolution. The systematic examination of the vitreoretinal interface represents an important element of the surveillance of retinitis pigmentosa.

Adult↗
PubMed1999

The experience to use a modified en bloc excision technique in vitrectomy for diabetic traction retinal detachment.

Modified en bloc excision is a technique in which all posterior hyaloid is excised except the portions essential for membrane dissection. Then, bimanual dissection techniques allow excision of retained fibrovascular membrane "en bloc" with hyaloid. In a consecutive series of 16 eyes with diabetic traction retinal detachment treated with this technique, visual acuity of 5/200 or better was obtained in 11 (69%) of the cases, and complete macula reattachment was noted in 14 (87%) of 16 eyes. The final visual acuity was improved in 12 (75%) cases. While this surgical technique allows a higher rate of anatomic success and less postoperative morbidity, visual results remain limited by irreversible alteration in retinal function.

Adult↗
PubMed2000

[Vitrectomy for diabetic macular edema associated with hyaloid posterior traction].

The vitreomacular relationship has been demonstrated to play a role in the physiopathology of the diabetic macular edema. We review the functional and anatomic results of vitrectomy performed on four eyes of three patients with diabetic cystoid macular edema unresolved by photocoagulation. The preoperative visual acuity was "finger counting" at one meter to 1/20. After surgery, for three eyes, the visual acuity raised between 2/10 and 4/10. There was no change for one eye, which presented a subretinal fibrosis. The macular edema resolved in three eyes and improved in one eye. The mean postoperative follow-up is 13 months. The vitrectomy may be effective in cases of diabetic macular traction and edema without posterior vitreous detachment.

Aged↗
PubMed2000

Reduction of skiing-related anterior shoulder dislocation using Kocher's method without traction.

We evaluated the use of Kocher's original method (without humeral traction) for reduction of acute anterior glenohumeral dislocation in 28 alpine skiers and snowboarders at a single ski area during the 1995-1996 ski season. In all cases, reduction was begun within 1 hour of the acute injury. The Kocher method alone was successful in 23 (82%) patients. Of the patients having a successful reduction by means of the original Kocher technique, the mean reduction time was less than 5 minutes, and 9 (39%) of the reductions were achieved in less than 1 minute. Only 1 patient experienced discomfort significant enough to require analgesia, and no patients required sedation. The complication rate was minimal, with 1 patient developing hyperesthesia in the axillary nerve distribution; no fractures of the humerus or glenoid resulted from the reduction technique.

Adolescent↗
PubMed1975

Traction release of subretinal fluid.

The purpose of this investigation was to establish whether the hazards of drainage of subretinal fluid could be reduced. The technique employed utilizes a three-pronged circular grid with a central aperture, 1 mm in diameter. This rigid grid engages the sclera perpendicularly and can be satisfactorily controlled with one hand. Traction with this device elevates the scleral wall to a variable degree depending upon the rigidity of the sclera and the intraocular tension. This scleral elevation allows the point of penetration of the subretinal space to be further removed from the plane of the detached retina than normally would be achieved by conventional techniques. The data presented illustrates the advantages of this approach in terms of reducing the risk of retinal penetration, inadvertent vitreous release, and failure to penetrate the subretinal space in the drainage maneuver. It is suggested that this technique adds an additional safety feature to this problem area of retinal detachment surgery.

Drainage↗
PubMed2002

[Correlation of the (rotation) traction force with the pressure in the nucleus pulposus in multiple segments of the cervical vertebra].

OBJECTIVE: To study the correlation between cervical (rotation) traction force and the pressure in the cervical nucleus pulposus based on an examination of multiple segments of the cervical vertebra. METHODS: The data obtained from our observation were processed by the exponential model, and the changes in the pressure reduction (P) in the cervical nucleus pulposus were analyzed. RESULTS: When stretching followed by rotation was imposed on the cervical vertebra, an increase of P was first observed due to the stretching before a reduction in P caused by the rotation. The P of C(3-4) segments was constantly greater than that of C(5-6) segments, while the changes in P of C(4-5) followed different patterns. CONCLUSION: Changes of P in each segment of the cervical vertebra are similar in response to the load force, and there is no correlation of monotonic increase or decrease between the changes of P and the location of the cervical vertebra.

Cervical Vertebrae↗
PubMedDate not supplied

Skeletal pin traction: guidelines on postoperative care and support.

Orthopaedic pins and wires have been used to apply skeletal traction for many years, and there has been an increase in the use of external fixators (Santy, 2000; Sims and Saleh, 2000). Multiple pins are frequently used and, as such, create potential portals for infection. Infection rates for these pins are reported to be as high as 85 per cent (Sims and Saleh, 2000). However, pin-site management practices are diverse, contradictory and lack consistency.

Bandages↗
PubMed1992

Microvillus form of focal anchorage in human Chang liver cells rounded by antiporter activation: scanning electron microscopy profiles and evidence of traction origin.

Na+/H+ antiporter activation in human Chang liver cells produces a flat-to-round (FTR) change in cell shape with gross reduction in cell profile area. Scanning electron microscopy (SEM) vividly displays a third phenomenon, viz., the development of focal microvillus anchors. Reduction in cell profile area concomitant with the development of this microvillus form of focal anchorage is quantitated by on-line image analysis during SEM examination. The reduction in profile area is corroborated by spectrophotometric digitization in light microscopy. Transmission electron microscopy (TEM) of rounded cells shows large endocytic channels and endosomes consistent with the observation of internalization of fluoresceinated-dextrans (FDx) of a diverse range of sizes, from 4,400 to 2,000,000 molecular weight, with cell rounding. Concomitant endocytosis of this magnitude indicates massive plasma membrane internalizations which could explain the very considerable profile area reduction and suggest that the microvillus anchors are probably traction processes. Antiporter mediated rounding (AMR) provides a highly reproducible and simple model for the production of anchoring microvilli ('filopodia') whereby they can be further explored.

Carrier Proteins↗