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At least 1,027 records · Page 57Linked to original sources
PubMed2006

Functional outcome of the hand following flexor tendon repair at the 'no man's land'.

PURPOSE: To evaluate the functional outcome of the hand following flexor tendon repair at 'no man's land' using 2 strands of a modified Kessler core suture and combined controlled motion rehabilitation protocol. METHODS: Records of 31 zone-2 flexor tendon injuries in 21 digits of 16 patients between July 2000 and June 2005 were reviewed retrospectively. The injured tendons were repaired within 24 hours using 2 strands of a modified Kessler core suture, reinforced by a continuous circumferential epitendon suture. All patients completed a rehabilitation protocol that included active extension against a rubber band, passive flexion, and controlled passive extension and passive flexion exercises. Functional outcome of the fingers was assessed using the Buck-Gramcko II score. Hand grip strength, rehabilitation period, and rupture rate were also measured. RESULTS: 17 (81%) out of 21 digits in 15 out of 16 patients achieved an excellent-to-good functional grade. The remaining patient with concomitant injuries to 4 (19%) digits attained a poor functional grade, attributable to poor compliance with the rehabilitation protocol. The mean rehabilitation period was 130 days and the mean grip strength was 78% that of the uninjured side. Concomitant digital nerve injury did not adversely affect the final outcome. Only one (4.8%) patient experienced a rupture. CONCLUSION: The surgical method and rehabilitation protocol used for zone-2 flexor tendon injury is safe and results in a reasonably good functional outcome.

Adolescent↗
PubMed1975

Double-blind comparison of alclofenac and aspirin in the treatment of rheumatoid arthritis. Part II: high dosage regime for assessment of analgesic and anti-inflammatory activity.

A double-blind trial was carried out in 76 patients with active rheumatoid arthritis to compare the analgesic and anti-inflammatory activity of 3 g. alclofenac with 4.8 g. aspirin daily over a 6-week period. All patients selected showed reversible inflammatory swelling of the finger joints. Of the 60 patients successfully completing the trial, 30 were treated as out-patients and 30 patients received in-patient treatment for approximately the first 2 weeks. Both groups were analysed separately. Treatment was randomised and patients received the drugs in identical tablet form except for the last 16 patients who were transferred to capsules. Results showed that though the activity potential, morning stiffness, grip strength, joint pain and tenderness improved significantly at the end of the 6-week period, there was no statistical difference between the two drugs. However, functional capacity indicated slight superiority of alclofenac over aspirin at a low level of significance. P.I.P. joint swelling showed that both in-patients and out-patients on alclofenac improved significantly (p less than .001)compared to patients in the aspirin group. Laboratory investigations showed no difference between the two drugs as far as changes in serum proteins, serum transaminase, haemoglobin and E.S.R. levels were concerned. However, serum uric acid levels dropped significantly (.05 greater than p greater than .01) with aspirin. The incidence of side-effects was slightly higher in the aspirin group but a high incidence of skin rash (30% approx.) was recorded with alclofenac tablets. No incidence of skin rash was recorded in patients taking alclofenac capsules, but the number of patients taking capsules was too small to make any prediction. It appears from this study that in active rheumatoid arthritis the analgesic and anti-inflammatory activity of 3 g. alclofenac is equivalent to 4.8 g. aspirin, and alclofenac is superior to aspirin in reducing the inflammatory swelling of rheumatoid joints.

Arthritis, Rheumatoid↗
PubMed1977

A comparative study of flurbiprofen and indomethacin in rheumatoid arthritis.

A double-blind, crossover study was carried out in 30 patients with active, classical or definite rheumatoid arthritis to compare the effect of 200 mg flurbiprofen per day with that of 100 mg indomethacin per day. Patients received, at random, each drug for a period of 2 weeks separated by a weeks' wash-out period on placebo. Assessments were made before the start of the trial and at weekly intervals of pain, morning stiffness, grip strength, articular index, walking time, and finger joint size. Patients' preference for any particular treatment period was recorded at the end of the trial. Laboratory investigations were carried out before and during the trial. Both drugs shows statistically significant improvement over baseline assessments, although there was little difference between the two active treatment periods. More patients preferred the treatment period with flurbiprofen, and this was probably related to the fewer side-effects which were reported with this drug.

Adult↗
PubMed1980

[The recent status of vibration hazards among workers at the state forests in Hokkaido (author's transl)].

In order to make clear the recent status of vibration hazards among workers belonging to the national forestry bureau in northern Hokkaido, a special health examination was carried out on 417 chain saw operators and 443 bush cutter operators. The results obtained are as follows: 1. Seven point seven percent of chain saw operators and 5.6% of bush cutter operators were diagnosed as suffering from vibration hazards. Distribution of the cases in chain saw operators was 50% in grade I, 31.2% in grade II and 18.8% in grade III, while in bush cutter operators it was 20% in grade I, 60.0% in grade II and 20.0% in grade III. 2. Six new patients were found in this special health examination. 3. Twenty-two of 76 authorized patients, who had been treated with periodical therapy and prohibited from the operation of vibratory tools until this special health examination, were diagnosed as having recovered their health because of the existance of no symptoms concerning vibration hazards. 4. Pains on pressure of the muscles were complained of at the upper arm, forearm, chest and at the back in 12.4% of chain saw and bush cutter operators. Deformities of the elbow, hand and finger joints were recognized in 12.6% of the workers, and ulnar nerve paralysis was recognized in 1.0% of them. 5. Occupational hearing loss and lumbago were diagnosed in 20.2% and 14.7% of the chain saw and bush cutter workers, respectively.

Adult↗
PubMed2004

Outstanding Scientist of 2004. Joseph K. McLaughlin, PhD: A world leader in implant research.

OBJECTIVE: To describe the key contributions of Dr. Joseph K. McLaughlin, Outstanding Scientist of 2004. METHODS: We review the scientific literature and indicate how epidemiologic research conducted by Dr. McLaughlin has clarified long-term health effects among persons with breast and other medical implants. RESULTS: Dr. Joseph K. McLaughlin has conducted and directed more research into the long-term effects of human implants than any other scientist worldwide. His insights greatly elucidated the long-term health consequences associated with a variety of implanted devices, including silicone and saline breast implants, hip and knee replacements, temporomandibular and finger joint devices, and pacemakers. By initiating and bringing to fruition a series of innovative epidemiologic investigations, Dr. McLaughlin and his colleagues have provided the scientific basis for making judgments about alleged adverse health effects following cosmetic, reconstructive, and reparative implant surgery. CONCLUSIONS: Dr. McLaughlin's seminal investigations have provided reassurance that breast and other implants have not demonstrably increased the risk of cancer or other systemic diseases. The comprehensive and rigorous nature of this research merits his selection as Outstanding Scientist of 2004.

Awards and Prizes↗
PubMed1995

[Case report: rheumatoid arthritis complicated by chronic myelogenous leukemia treated with interferon].

A fifty-six-year old man complained of arthralgia and swelling of both feet, morning stiffness in both hands and finger joints in March 1987, and was treated with non-steroidal anti-inflammatory agents at another hospital. He has been treated for chronic myelogenous leukemia (CML) since May 1990. He was admitted to our hospital in March 1991 because of worsening of his multiple arthralgias, and a diagnosis of rheumatoid arthritis (RA) (Stage I, Class 2) was made on the basis of gait disturbance, arthralgia persisting for more than 6 weeks, the presence of subcutaneous nodules and X-ray findings. CML was confirmed by peripheral blood and bone marrow findings and the presence of the Philadelphia chromosome and bcr gene rearrangement. High fever and dyspnea developed suddenly 3 days after administration of interferon in May 1991. In addition to pneumonia, a leucostasis was suspected and he was treated with high dose steroids and antibiotics. After improvement, the steroids were tapered and he was discharged from hospital in July 1991.

Antineoplastic Agents↗
PubMed1982

Irregularities at the base of the proximal phalanges: false indicator of early rheumatoid arthritis.

Fifty posteroanterior hand radiographs from normal adults were reviewed retrospectively to assess the incidence of cortical indistinctness at the base of the proximal phalanges in a normal population. This radiographic change, reported to be an early indicator of rheumatoid arthritis, was seen in at least one site in 10% of the films reviewed. Focal areas of cortical erosion or indistinctness at the bases of the proximal phalanges are not considered to be a reliable sign of early rheumatoid arthritis in the absence of juxtaarticular osteoporosis or changes in the metacarpal heads.

Adolescent↗
PubMed1976

Flexor tendon synovectomy of the hand in rheumatoid arthritis. A follow-up study of 201 operated hands.

A follow-up study of 201 flexor tendon synovectomies of the hand in patients with rheumatoid arthritis is presented. The operations were performed from 1/2-49 years after onset of the disease, and the patients were between 16 and 76 years of age. The follow-up study is based on questionnaires and, in addition, 78% of the patients also had a physical re-examination. The follow-up time spanned 12-78 months. Nearly 70% of the operated hands were subjectively improved; the others were unchanged or worse. The poor results were often caused by progression of arthritis in finger joints. Recurrence of the tenosynovitis was observed in about 37% of the hands, but in very few to such an extent that reoperation has been necessary.

Arthritis, Rheumatoid↗
PubMed1982

Surgical rehabilitation.

There is hardly any other disorder where the possibility of replacing destroyed joints by artificial ones has transformed the functional outcome so decisively as in rheumatoid arthritis. The advances achieved in surgery may even be regarded as the most important result of any research on rheumatoid arthritis as published in recent years. Arthroplastics account for almost half of all interventions in our own statistics which cover almost 6000 operations on patients with this disease. Surgical synovectomies account for more than 40 per cent, and various other techniques are used in only 10 per cent of operations. Indications and contra-indications are discussed first in a more general way, and the need for close collaboration of family doctor, rheumatologist, orthopaedic surgeon and highly qualified therapeutic staff is emphasized. In the following sections the most rewarding methods used for rehabilitation of the upper limbs are described, including pre- and post-surgical management as well as the results to be expected. Subsequently our standard programme for the surgical rehabilitation of the affected joints of the lower limbs is presented. Special reference is made to a new technique for the fixation of the arthroplasty in cases of rheumatoid acetabular protrusion.

Adult↗
PubMed1981

A new thermoplastic casting material. A comparison between plaster of Paris and Hexelite.

Plaster of Paris and Hexelite, a new thermoplastic bandage, were compared in the treatment of 183 patients with malleolar fractures, Colles' fractures or distortions of the finger joints. There were no statistically significant differences between the two types of bandages taking into account the strength of the bandage, the amount of skin damage and the patient's opinion of the bandage. Hexelite is seven times more expensive than plaster of Paris, and, in addition, is more difficult to handle. Hence its use has been discontinued.

Adult↗
PubMed1986

Treatment of multiple enchondromatosis (Ollier's disease) of the hand.

The clinical treatment and results for three hands in two patients with multiple enchondromatosis (Ollier's disease) are presented. Diaphyseal resection (total or subtotal) in 27 phalanges and metacarpals preceded autogenous fibular bone grafting to the defects. All bone grafts subsequently healed and were well incorporated. Hand function and cosmesis were restored satisfactorily in each case. There were no infections or recurrences.

Adolescent↗
PubMedDate not supplied

Management of the upper extremity in juvenile rheumatoid arthritis.

Juvenile rheumatoid arthritis is a multifaceted disease. Average age of onset is 6 years, with peaks between 1 and 4 and between 9 and 14 years. Girls are affected more frequently than boys. Nonsteroidal anti-inflammatory drugs are the standard first line of therapy. Second-line therapy of antirheumatic drugs may be used early for progressive disease. Intra-articular corticosteroid injections should be considered to preserve joint mobility and muscle strength when medical treatment fails to control synovitis or when marked functional impairment exists. Historically, surgery has been a last resort, but in appropriate patients, it should be considered soon after failure of conservative management. However, when possible, reconstructive surgery should be delayed until completion of skeletal growth.

Algorithms↗