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PubMed1997

[Post-traumatic painful ulnar nerve compression syndrome treated by wrapping the nerve with the vein: preliminary report].

Three cases of post-traumatic painful ulnar nerve compression syndrome are presented. Previous treatment both conservative and surgical (neurolysis) proved unsatisfactory. The method described-wrapping of the nerve with the saphenous vein graft in the area of scarification-gave satisfactory outcome in 2 of 3 operated patients (significant resolution of pain and improvement of sensation) in one year follow-up. In one patient surgery failed. The method presented might be considered in refractory cases of painful nerve compression syndrome due to its entrapment within scarred tissue after injury or previous surgery.

Arm Injuries↗
PubMed2001

[The most common overuse injury syndromes of the upper extremity associated with work activity].

Repetitive use of upper extremities, non-physiological body posture, especially of cervical spine, shoulders, lower arms, and fists are still present in modern technological processes. Innate deformities, weakness of connective tissue, accompanying morbidity (radicular symptoms, neuropathies, superior thoracic aperture syndrome, vasopathies and neuroses) are significant pathogenic overuse syndromes. Other causes of overuse syndromes are non-ergonomic tools, musical instruments, furniture, or keyboards. Lack of training for jobs involving repetitive movements, as well as job dissatisfaction are additional aggravating factors of the overuse syndrome. Polypragmasy with drug and physical therapy, insufficient rehabilitation, and questionable medical prognosis of working capacity are challenges to public health of even in richer societies. This paper describes the most common overuse syndromes of upper extremities. The aetiology of reflex dystrophy syndrome, carpal tunnel, and myofascial painful syndrome are still insufficiently explained. The paper also presents data collected in a group of 40 metal workers exposed to significant shoulder strain. They more often reported pain in the cervical spine than the control group of workers under moderate strain (45% v. 7.5%; P < 0.01), as well as pain in the shoulders (12.5% v. 5.0%) and stiffened hand (22.5%:7.5%). Symptoms were significantly more frequent in the dominant hand. A common diagnosis in a sample of 110 musicians was a change in the shoulder joint, which was more distinct in the right shoulder (10%) than in the left (7%) and comparable in the elbows (8%). The paper proceeds with cases of advanced overuse syndrome in a textile worker and cases of dissimulation in a physician and a guitarist. The paper stresses the importance of quantification of morphological and functional changes in overuse syndromes and discusses the necessity of prevention, education, early diagnosis, pharmacological and physical therapy, and rehabilitation of overuse syndromes.

Adult↗
PubMed1987

Brachial artery injuries associated with posterior elbow dislocation.

Posterior elbow dislocation is rarely associated with brachial arterial injury, occurring in two of 23 patients. A cool pulseless hypesthetic arm associated with swelling at the elbow after a history of a fall on an outstretched arm indicates arterial injury associated with posterior elbow dislocation. Concomitant neurologic and bone injury may occur as well. Arterial repair and stabilization of the elbow is the treatment of choice and should result in a functional extremity.

Adult↗