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At least 1,225 records · Page 68Linked to original sources
PubMed1984

Traumatic hemipelvectomy in combination with traumatic amputation of an upper extremity.

This is a report of a 16-year-old survivor of a traumatic hemipelvectomy in combination with an amputation of the upper extremity on the ipsilateral side. The injury was caused when the patient fell under a railroad train. There were associated injuries of the genitourinary tract and the rectum. Factors that contributed to the patient's survival were: 1) the excellent care he received at the scene of the accident by the paramedics of the regional emergency care system; 2) a rapid transportation to the hospital by a life flight helicopter; and 3) a concentrated effort by the general surgery, plastic surgery, and urologic surgery teams in providing vigorous, sustained, and comprehensive preoperative, operative, and postoperative care.

Adolescent↗
PubMed1996

Performance of the 'unaffected' upper extremity of elderly stroke patients.

BACKGROUND AND PURPOSE: The main objective of this study was to compare the sensorimotor performance of the unaffected upper extremity (UE) of elderly stroke patients with that of healthy elderly people. METHODS: The group of stroke patients was composed of 43 hemiplegic/paretic subjects who had had a cerebrovascular accident at least 6 months earlier. They were > or = 60 years old, were right-handed before the stroke, had visual perception within normal limits, and showed no major cognitive impairments. A group of 43 healthy subjects matched for dominance, age, and sex was used for comparison. The main parameters of the performance of the unaffected UE of the stroke subjects and of the same side of the healthy subjects were measured with valid, reliable instruments. Some variables potentially related to the unaffected UE were also measured: affected UE motor function, functional independence, length of time since the stroke, self-perceived health status, activity level, and hand anthropometry. RESULTS: Statistical analyses showed significant deficits in the unaffected UE of hemiplegic/paretic subjects compared with normal subjects with regard to the following parameters: gross manual dexterity, fine manual dexterity, motor coordination, global performance, and kinesthesia (P < .01 to P < .0001). No significant clinical or statistical difference was found for grip strength (P < .81), static and moving two-point discrimination (P = .21 and P = .12), or touch/pressure threshold (P < .91). CONCLUSIONS: Many factors (frequency of use of the unaffected hand, sensorimotor interaction tasks, severity of the deficits in corticifugal projections, and deficits in postural stabilization) could interact to provide the clinical picture obtained in the present study.

Aged↗
PubMed1999

Unilateral variation of the arterial pattern of the human upper extremity with a muscle variation of the hand.

A unilateral variation in the origin and distribution of the arterial pattern of the human upper extremity on the right side is reported on. Apart from its usual branches, the third part of the right axillary artery gave origin to a common branch, the profunda brachii artery and the superior ulnar collateral artery. The right brachial artery, at a point 5.0 cm distal to its origin, bifurcated into the radial and ulnar arteries; their origin was in a position opposite the usual location. The radial artery continued on the medial side of the arm for 2.5 cm and crossed the ulnar artery anteriorly to gain a lateral position in the arm. The inferior ulnar collateral artery arose not from the brachial artery, but from the ulnar artery. A muscle variation was also observed in the right hand, which is compatible with the notion variations within one system of a limb will frequently be accompanied by variations in other systems of the same limb.

Aged↗
PubMed1992

Compressive neuropathies in the upper extremity of athletes.

The physician responsible for the evaluation and treatment of athletes must include nerve compression injury in the differential diagnosis of upper extremity pain and dysfunction. Careful history and physical examination, along with selective objective testing, should be diagnostic. Treatment and prevention methods implemented under the supervision of knowledgeable trainers and coaches may allow for complete resolution of symptoms and, more importantly, prevent recurrence. Adolescents and novice athletes in many sports may be at the highest risk for this type of overuse injury.

Athletic Injuries↗
PubMedDate not supplied

Surgical management of nerve injuries of the upper extremity in children: a 15-year survey.

In a 15-year retrospective study, the results of 37 surgically treated nerve lesions of the upper extremity in 33 children were reviewed after a mean follow-up of 2 years. Children ranged in age from 4 to 15 years. There were 19 ulnar, 12 median, and 6 radial nerve injuries. Discontinuity of the nerve trunk was found in 23 patients operated by interfascicular grafting (18 patients) or epineural suture (5 patients). The other 14 lesions were treated by decompressive external neurolysis. Useful sensory function (S4-S3) assessed at the autonomous zone was restored in 31 patients (84%). Satisfactory motor recovery was achieved in 25 patients (67%). Independent of the type of lesion, the median nerve showed the best ability to regain complete motor and sensory function. In lesions with continuity of the nerve trunk, those affecting the radial nerve had a worse prognosis regarding motor function recovery. Unfavorable prognosis was mainly related to a time interval of more than 1 year between nerve damage and surgery.

Adolescent↗
PubMed1998

Evaluation of increases in stature, upper extremity length and hand length in children from school age to the cessation of growth in Ogi County, Japan: a longitudinal study.

Stature, upper extremity length (UEL) and hand length (HL) were measured once yearly in children (171 males and 180 females) in Ogi County, Saga, Japan, from the 1 st grade of primary school (6.5 years of age) for 12 years. Based on the age of growth cessation, the order of growth cessation of stature, UEL and HL was investigated, in addition to the relationship between this order and the measurements obtained at 6.5 years of age. With regard to the order of growth cessation of stature and UEL, growth cessation of UEL occurred earlier than that of stature in 73.68% of males and 71.67% of females, growth cessation occurred simultaneously in 23.98% of males and 25.56% of females, and growth cessation of UEL occurred later than that of stature in 2.34% of males and 2.78% of females. According, growth cessation of UEL occurred earlier than that of stature in most subjects. In males, no significant differences were observed between subjects in whom growth cessation of UEL and HL occurred simultaneously and those in whom growth cessation of UEL occurred later than that of HL. However, in females, significant differences were noted, since the latter case was observed 1.69 times more frequently than the former. Nevertheless, growth cessation of stature, UEL and HL occurred at almost the same age in both males and females when cross-sectional data was used for processing, in agreement with data reported by other researchers. We also investigated whether there was any relationship between stature and UEL at initial examination and the order of growth cessation. No significant relationship was observed. Each measured value at initial examination tended to be large in subjects in whom growth cessation of stature and UEL occurred earlier. In addition, final stature was significantly taller in both males and females in whom growth cessation of stature occurred later compared to those in whom growth cessation occurred earlier.

Anthropometry↗
PubMed2000

Evaluation and management of chronic work-related musculoskeletal disorders of the distal upper extremity.

This clinical review will describe the epidemiology, clinical presentation, and management of the following work-related musculoskeletal disorders (WMSDs) of the distal upper extremity: deQuervain's disease, extensor and flexor forearm tendinitis/tendinosis, lateral and medial epicondylitis, cubital tunnel syndrome, and hand-arm vibration syndrome (HAVS). These conditions were selected for review either because they were among the most common WMSDs among patients attending the New York State Occupational Health Clinics (NYSOHC) network, or because there is strong evidence for work-relatedness in the clinical literature. Work-related carpal tunnel syndrome is discussed in an accompanying paper. In an attempt to provide evidence-based treatment recommendations, literature searches on the treatment of each condition were conducted via Medline for the years 1985-1999. There was a dearth of studies evaluating the efficacy of specific clinical treatments and ergonomic interventions for WMSDs. Therefore, many of the treatment recommendations presented here are based on a consensus of experienced public health-oriented occupational medicine physicians from the NYSOHC network after review of the pertinent literature. A summary table of the clinical features of the disorders is presented as a reference resource.

Arm↗
PubMedDate not supplied

Placement of a retrievable Günther Tulip filter in the superior vena cava for upper extremity deep venous thrombosis.

A retrievable Günther Tulip caval filter (William Cook, Europe) was successfully placed and retrieved in the superior vena cava for upper extremity deep venous thrombosis in a 56-year-old woman. Bilateral subclavian and internal jugular venous thromboses thought secondary to placement of multiple central venous catheters were present. There have been reports of the use of permanent Greenfield filters and a single case report of a temporary filter in the superior vena cava. As far as we are aware this is the first reported placement and successful retrieval of a filter in these circumstances.

Arm↗
PubMed1982

The pectoralis major island flap for coverage in the upper extremity.

From July 1, 1978, to July 1, 1980, 26 patients required pedicle flap coverage for acute skin loss defects in the hand and upper extremity. Eighteen patients had groin or abdominal flap coverage, and the pectoralis major island flap (PMIF) was used in eight patients. The circumstances of injury were approximately the same in both groups, consisting of a gunshot wound or electrical injury in over half of the cases. The PMIF was selected more often in proximal and dorsal injuries of the forearm and wrist and in older patients. Two of 13 groin flaps sustained partial necrosis, but none of the abdominal or PMIF flaps necrosed. The principle advantages of the PMIF in these selected cases was fourfold: (1) an extremity placed in a less dependent, sling-like position, (2) mobility, (3) reliability, and (4) a complete inset into the defect. The chest wall donor site defect, however, must be given some consideration.

Abdomen↗
PubMed1997

Upper-extremity infections in patients seropositive for human immunodeficiency virus.

The records of 74 human immunodeficiency virus (HIV)-seropositive patients who were treated for upper-extremity infections were retrospectively reviewed. Intravenous drug use was the most common risk factor for HIV infection as well as the most common cause of the infection necessitating admission. These patients were admitted a total of 97 times for the treatment of 89 different infections and underwent 120 surgical procedures. Twenty-six infections (29%) required more than 1 operation, and 11 (12%) resulted in amputation. Twenty-seven patients who met criteria for the diagnosis of acquired immunodeficiency syndrome (AIDS) were found to be no more likely than their HIV-seropositive counterparts to be readmitted for the same diagnosis, to be treated for more than 1 infection, or to require more than 1 operation or amputation to eradicate their infection. Patients with AIDS were significantly more likely to present with spontaneous onset of infection in the absence of penetrating injury than were those who were HIV seropositive.

Adolescent↗
PubMed2000

Upper extremity disorders in women.

Carpal tunnel syndrome, Colles' fracture, and osteoarthritis of the basilar joint of the thumb are only three of the many upper extremity conditions that preferentially affect women. With more and more women entering the workplace, these conditions become more disruptive of patients' lifestyles and even may be increasing in incidence. Orthopaedic surgeons traditionally have focused on the surgical treatment of patients with these conditions, but it is becoming increasingly clear that surgeons also must focus on delineating pathophysiology to better identify those individuals at risk and help prevent these potentially disabling disorders.

Carpal Tunnel Syndrome↗
PubMed2001

Test/retest reliability and inter-rater agreement of the Quality of Upper Extremities Skills Test (QUEST) for older children with acquired brain injuries.

Test/retest reliability and inter-rater agreement was established on the Quality of Upper Extremities Skills Test (QUEST) for 16 children between 6 and 16 years of age who had an acquired brain injury. Performance on the QUEST was videotaped for the purpose of scoring, and some modifications were made to the administration and scoring of the assessment. Intra-class correlation indicated high agreement for test/retest reliability (0.90 to 0.95), and inter-rater reliability (0.84 to 0.94) across all subtests. The findings are discussed in terms of ongoing test refinements and the extension of the original age range and diagnostic group for which the test was designed.

Activities of Daily Living↗
PubMed1990

Use of omental pedicle for treatment of Buerger's disease affecting the upper extremities. A modified technique.

We present a report of a 58-year-old male patient who suffered from Buerger's disease of the upper extremities verified by microscopy and angiography. Despite medical treatment and repeated thoracic sympathectomy he developed gangrene at the tip of his right thumb and index finger. Pedicled omentum was prepared through midline laparatomy, placed through subcostal incision to the subcutaneous space of the forearm and affected fingers. Rest pain disappeared by the fifth day after surgery. The omental pedicle was ligated six weeks post-operatively and the extremity mobilized. The thumb healed well. The index finger required amputation because of continuing infection. Five years postoperatively the patient has a good functioning hand in which the transferred omentum has retained its viability.

Angiography↗
PubMed1996

Neural blockade for upper-extremity pain.

Carefully performed and interpreted neural blockade can be a useful adjunct in both the diagnosis and treatment of painful syndromes of the upper extremity. Pain is a very difficult entity to quantify and diagnose specifically because of its subjective nature, vast differences between patients and their response to pain, and largely because of our inexact understanding of its physiology. Best results of block therapy require thorough understanding of these complexities and limitations, and a rational, careful examination of the data it provides.

Arm↗
PubMed1998

Three-phase bone scan and dynamic vascular scintigraphy in algoneurodystrophy of the upper extremity.

UNLABELLED: Algoneurodystrophy (AND) is a complex disorder with a wide spectrum of clinical presentations. Patients referred for a work-up of unilateral upper extremity AND were reviewed, and 50 patients were enrolled with sufficient documentation on history, causal event, clinical stage, and final outcome. There were 27 females, 23 males, mean age 44 years. The affected area was: shoulder 5, arm 3, elbow 3, wrist 26 and hand 13. Main precipitating events were fracture, contusion, or prior surgery. Three-phase bone scintigraphy was performed followed by a 2-phase vascular scintigraphy on another day. Typical periarticular uptake on the delayed bone scan was used to diagnose AND. Staging was done with the dynamic phase of the vascular scan. The clinicians diagnosed 30 patients positive for AND, 14 negative, and 6 equivocal. Bone scintigraphy yielded 25 positive, 20 negative, and 5 equivocal scans, i.e. sensitivity 73% and specificity 86%. Of the positive bone scans, 21 had all 3 phases positive, and 16 were concordant on vascular scintigraphy. The remaining 5 vascular scans classified 3 patients in transition (stage I-->II) and 2 in stage II. In other words, in 24% of patients vascular scintigraphy indicated restaging. CONCLUSION: dynamic bone scintigraphy is an accurate method to diagnose AND. Vascular scintigraphy changed AND stage in one quarter of the patients. Therefore, a combination of both studies is indicated in the work-up and treatment monitoring of AND.

Adult↗