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At least 1,009 records · Page 56Linked to original sources
PubMed1976

Volkmann's ischemic contracture due to soft tissue injury alone.

Fifteen upper extremities, in 14 patients in whom incipient or actual Volkmann's ischemic contracture was present, were seen in a 5 year period. Nine patients were stuporous due to drug overdose and had laid on the extremity; two had received a recent injury of main arterial trunks; two had sudden severe compression; one with chronic myelogenous leukemia had each arm involved at different times in a bizarre autoimmune response causing massive swelling. No patient had a fracture or dislocation. Pain and tenderness, loss of sensibility, resistant muscle contracture, and rock-hard muscle compartments were warning signs. Immediate fasciotomy was done. Useful function was restored when treatment was carried out in the early stages of the ischemia.

Adult↗
PubMed1990

An experience with upper-extremity vascular trauma.

In this 6-year study of 101 limbs requiring surgical intervention for upper-extremity vascular trauma, most patients were male, young, and injured by penetrating objects. Injured vessels included 13 axillary/subclavian, 23 brachial, 40 radial, and 25 ulnar arteries. Concomitant injuries included nerve injury in 50 cases, tendon laceration in 29, and bony fracture in 11. Arterial repair was accomplished by primary repair in 54 limbs, vein graft in 26 limbs, and vein patch in 3 limbs. Seventeen arterial injuries were ligated. Ancillary procedures included 30 nerve or 27 tendon repairs. The limb salvage rate was 99%. No functional deficits were noted in those cases with only a vascular injury. In 64% and 25% of patients with nerve or musculoskeletal injury, respectively, the arm was functionally impaired. Prompt diagnosis and surgical intervention eliminate vascular injury as a factor in upper-extremity limb loss or disability. Functional deficits are the result of nerve or orthopedic injuries.

Adolescent↗
PubMedDate not supplied

Acute plastic bowing deformity: a review of the literature.

An acute plastic bowing deformity (APBD) represents a subtle form of an acute fracture. This entity was not formally recognized until recently when Borden demonstrated the almost imperceptible deformity radiographically. While found in both the adult and pediatric populations, the biomechanical properties of children's bones make them more prone to this injury. In either population, the lack of an obvious cortical defect lends this injury to misdiagnosis, mismanagement, and subsequent complications.

Arm Injuries↗
PubMed2001

Stress fractures of the upper extremity.

Stress fractures are common injuries in the athletic population. Although much of the published literature has focused on lower extremity stress injuries, these injuries also occur in the upper extremities. Stress injuries of bone result from repetitive loads smaller than would be required to cause an acute fracture. As bone is repetitively stressed, it behaves like any solid substance. If deformity occurs within its elastic range, it returns to its original configuration. If stressed into its plastic range, permanent deformity occurs, and microfractures propagate, causing structural failure and complete fracture of the involved bone. High clinical suspicion is required for diagnosis because of historical and physical features can be vague. Plain radiographs are often inconclusive, but bone scans and MR imaging usually help elucidate the diagnosis. Most upper extremity stress injuries will heal with nonoperative management. In rare situations these injuries can progress to nonunion, which requires surgical correction.

Arm Injuries↗
PubMed2003

[Injuries and chronic damages in classic ballet].

From 1994 till 1996 there were examined 219 dancers (male and female) at 8 theatres because of typical injuries and damages. It was elevated an exactly anamnese and physical examination with regard to orthopedic peculiarity. The determined dates were documented on a standardized form and analyzed separately to the respective part of the body. It is an examination with the biggest figures in Europe. The destination is to avoid damages because of enlightenment and timely recognize of reasons. Incorrect training and not recognizing individual anatomical faults could make this job dangerous and emphasize these typical injuries and damages.

Acute Disease↗
PubMed1991

Free groin flaps in microsurgical reconstruction of the extremity.

The authors performed free groin flap transplantation in 36 patients with extensive soft-tissue injury of the extremities. In each case, the vascular anatomy of the groin flap was analyzed during the operation. The anatomic classification of the superficial circumflex iliac artery according to its origin was as follows: a common origin with the superficial inferior epigastric artery in 15 cases (39.5 percent); an isolated origin and absent superficial inferior epigastric artery in 14 cases (36.8 percent), a separate origin in three cases (7.9 percent), and an origin from the profunda femoral artery in six cases (15.8 percent). These results are similar to those reported previously. The overall success rate was 72.2 percent. The success rate was better in the upper extremity (100.0 percent) than in the lower extremity (65.5 percent). Free vascularized groin flap transplantation is a suitable procedure for the one-stage reconstruction of severe soft-tissue injury, especially in the upper extremity.

Arm Injuries↗
PubMed1996

Simplified external fixation for primary management of severe musculoskeletal injuries under war and peace time conditions.

This study was undertaken to document whether a basic set of a new unilateral external fixation device could provide sufficient stability in complex musculoskeletal injuries involving upper and lower extremities and in patients with unstable pelvic ring disruptions. The initial clinical evaluation was performed in Sweden (stage 1) followed by field evaluation at the Swedish Field Hospital during the Mogadishu conflict in Somalia (stage 2). In stage 1, there were 90 patients with 116 acute limb injuries and six patients with an unstable pelvic ring disruption. Ninety limb injuries and all six pelvic fractures were primarily stabilized by the external fixation device. The other 26 fractures were managed at the index operation with intramedullary nailing, open reduction, and internal fixation or cast immobilization. Twelve patients had a local pedicle or free vascularized flap for soft tissue coverage. One multiply injured with an open Gustilo IIIB tibial shaft fracture had an early amputation. The basic set provided adequate stabilization for soft tissue recovery in 89 limb injuries (89 of 90), thereby providing optimal conditions for continued management to skeletal consolidation in 88 patients. Hemodynamic stabilization was achieved in all six patients with unstable pelvic fractures. In stage 2, there were 63 patients with war injuries and 33 patients injured in traffic accidents. All were managed under field conditions. The basic set was sufficient for soft tissue recovery in all 96 cases. It is concluded that the rigidity of this device is adequate for stabilization of severe musculoskeletal injuries requiring major surgical procedures. In addition, the simplicity of this device, which allows for only a limited number of possible configurations makes it suitable for inexperienced surgeons working under war or mass-casualty conditions to manage these complex musculoskeletal injuries.

Adolescent↗
PubMed1975

Primary peripheral nerve repair in the hand and upper extremity.

A small consecutive series of primary nerve repairs in civilian injuries demonstrates that normal two-point discrimination and stereognosis can be anticipated not only in digital-nerve injuries but in mixed sensory and motor nerve injuries. Motor return follows and approaches normal in most patients. During the study period, 15 delayed repairs of mixed nerve lacerations were done. Two-point discrimination and stereognosis did not return to normal in any of the patients with mixed-nerve injuries or in one quarter of those with sensory-nerve injuries. Motor return never graded better than 3 on a scale of 0-4. Therefore, this author feels primary repair is superior to secondary repair and that almost all civilian injuries can be made surgically clean by debridement.

Adult↗
PubMed1999

Upper extremity stress fractures in athletes: clinical features of 44 cases.

PURPOSE: To review the clinical features of a large series of active patients with a stress fracture in a non-weight-bearing location of the upper extremity or ribs. DESIGN: Multicenter cross-sectional study. SETTING: Multiple academic medical centers. PARTICIPANTS: 44 patients with a diagnosis of upper extremity or rib stress fracture. MAIN OUTCOME MEASURES: Clinical features according to anatomic location, primary sport, and subdivided according to the nature of the sport-specific skills involved. RESULTS: A diagnosis of stress fracture was made in 44 patients based on history and physical examination, and confirmed by radiography, scintigraphy, magnetic resonance imaging (MRI), computed tomography (CT), or a combination of imaging techniques. Patients were subjectively divided into four categories based on the predominant type of upper extremity activity required for participation in their sport: 1) weight lifter (e.g., football, weight lifting, wrestling); 2) upper extremity weight bearer (e.g., gymnastics, diving, cheerleading); 3) thrower (e.g., pitcher, soccer goalie, javelin); or 4) swinger (e.g., golf, tennis). We noted that all fractures in the weight bearers occurred distal to the elbow, whereas in the throwers most fractures affected the shoulder girdle. Lower rib stress fractures predominated in the swingers group, whereas weight lifters had fractures located throughout the upper extremity. CONCLUSION: Stress fracture should be considered in the differential diagnosis of athletes presenting with upper extremity or rib pain of bony origin that is of insidious onset. Further study of the sport-specific patterns of injury described here may improve our ability to treat and prevent these injuries.

Adolescent↗
PubMed1984

Sports injuries survey on university students in Hong Kong.

A sports injuries survey was conducted among 1714 students of the Chinese University of Hong Kong. The common sports involved in injuries were Soccer (26%), Basketball (18%), Cycling (11%), Track and field athletics (11%) and Swimming (10%). The lower limb usually took the brunt of the injuries (67%) followed by the upper limb (28%) and spinal injuries were relatively uncommon (3%). The majority of the injuries were mild to moderate and the commonest ones were abrasion (37%), contusion (21%), cramp (20%), sprains (9%), and strains (7%). Of the injuries 80% recovered in less than 10 days and 50% of them were self-treated. However, a significant group of more severe injuries was recorded: fracture, concussion and heat stroke which demanded special medical attention and longer period for recovery. The pattern of treatment was also unique in that traditional Chinese methods of treatment were sought more frequently than special orthopaedic advice. The preventive aspects of sports injuries was not well recognised with only 40% of the students regularly practising warm-up exercises, 18% stretching exercises and 4% using protective aids. More educational programmes and studies were indicated. The set up of a sports injury clinic is recommended with the utilisation of a sports injury reporting system.

Adolescent↗
PubMed1986

The epidemiology of ice hockey injuries.

As part of the injury profylaxes in Denmark a questionnaire investigation was undertaken in 14 randomly chosen ice hockey teams--out of 266 players, 210 answered (79%). The injury incidence per player per 1000 hours was 4.7, i.e. 1.5 in training and 38.0 in match. Half of the injuries were localised to the head (28%) and lower extremities (27%), 19% to the upper extremities and 7% to the back. Of these 48% were contusions. Knee and elbow injuries were of longest duration. The necessity for increased shock absorption in helmets and barriers as well as built-in rotational and collateral stabilizers in the existing knee protectors for injury prophylaxis is stressed.

Adolescent↗
PubMed1986

Upper limb injuries associated with rock climbing.

Four cases of upper limb injuries secondary to rock-climbing or training for rock climbing are presented. All four cases had diagnosis and treatment delayed because of unawareness of the range of injuries seen in high grade rock climbing.

Adult↗
PubMed1996

Injuries in cross-country skiing: a critical appraisal of the literature.

This study comprehensively reviews and critically appraises recent literature on cross-country skiing injuries. Particular attention was paid to the study design when reviewing the literature, thereby producing a measure of internal and external validity. From these data, the factors associated with the aetiology, frequency, site distribution and types of cross-country skiing injuries are examined. The incidence of injury in cross-country skiing is estimated to be between 0.49 and 5.63 per 1000 skier days. The most common injuries are medial collateral ligament sprains of the knee, and ulnar collateral ligament sprains of the thumb. Overuse and cold injuries (e.g. hypothermia and frostbite) appear to be common as well, although the data do not provide an estimate of incidence. Comments in the literature on prevention of these injuries are mainly empirical: they recommend safer equipment, wise choice of terrain and a general increase in skier awareness of ways to prevent injury. However, rigorous studies that adequately evaluate preventive intervention strategies have yet to be conducted. Cross-country skiing is relatively safe and a suitable activity for physical fitness and rehabilitation. In the future, studies employing an analytical design will be required to evaluate the effectiveness of injury prevention intervention strategies.

Arm Injuries↗