PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Bones of Upper Extremity”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
PubMed1991

Callotasis lengthening in the upper extremity: indications, techniques, and pitfalls.

Bone lengthening through callotasis has been performed in 12 bones of the upper extremity in eight patients. Diagnoses included congenital amputations, phocomelia, radial agenesis, traumatic amputations, and infected fracture with bone loss. Nine of the 12 procedures resulted in complete consolidation of the transport gap with new bone without need for bone graft. One patient died of unrelated illness before completion of treatment but demonstrated early consolidation of the gap. In two cases bone graft was required. Complications included one superficial pin tract infection and one case of premature cessation of lengthening because of hand deviation. Early experience with this technique indicates that it is effective in the management of bone defects in the upper extremity. It appears that in most cases a half-frame lengthening device, rather than a more complex circular frame, can be used in the non-weight-bearing upper extremity. Adequate control of the distal segment, appropriate choice of location for corticotomy, and gentle handling of the bone and periosteum can improve results and minimize complications.

Adult↗
PubMed2006

Bone graft substitutes in the upper extremity.

The development of effective bone graft substitutes is one of the most important innovations in musculoskeletal surgery. Bone graft substitutes provide an osteoconductive scaffolding similar to those of autogenous bone. They eliminate donor site morbidity,decrease operative time and complexity and treatment costs, and improve patient satisfaction. Osteoinductive and osteogenic elements may be added to further stimulate and enhance healing and incorporation of the scaffolding substance into the adjacent bone. Bone graft substitutes have proven effective in the spine and larger long bones of the extremities. The continuing development of bone graft substitutes, evaluation of their efficacy relative to autogenous bone grafts and to each other, and their use in the hand and wrist are emerging fields.

Arm Bones↗
PubMed2004

The relations among upper-extremity loading characteristics and bone mineral density changes in young women.

The relations among the reaction forces engendered during an upper-extremity dynamic impact-loading exercise (DILE) program and bone mineral density adaptations (DeltaBMD) in the radius were investigated in 24 healthy premenopausal women (mean age = 29 +/- 6 years). Subjects performed DILE 36 cycles/day, 3 days/week for 24 weeks. The exercised arm was allocated randomly to either the dominant or the nondominant limb. In addition, subjects were assigned randomly into either damped or nondamped treatment arms to examine the effects of both higher- and lower-magnitude loading prescriptions. Measurements including anthropometrics, self-reported physical activity levels, hand-grip strength, radial BMD (DEXA, Hologic QDR1500, MA) at the ultradistal radius (UD), distal 1/3 radius (DR), and total distal radius (TOTAL), and exercise-related loading characteristics (impact load, loading rate, and impulse) were recorded at baseline and at 6 months. Simple linear regression models were used to fit the regional BMD changes to the reaction force, changes in hand-grip strength (DeltaGRIP), and changes in body weight (DeltaBW). Findings demonstrated that the damping condition utilized during DILE influenced the relations between loading events and BMD changes. Specifically, none of the reaction-force characteristics significantly predicted changes in BMD in participants performing DILE using the damped condition, whereas, in the nondamped condition, impact load accounted for 58% of the variance in BMD change at DR and 66% of the variance in BMD change at TOTAL. Thresholds of 345 and 285 N of impact force to promote BMD increases at DR and TOTAL, respectively, were obtained from the regression models in the nondamped group. Impulse was also an independent predictor of BMD changes at TOTAL, accounting for 56% of the variance. Neither DeltaGRIP nor DeltaBW significantly predicted DeltaBMD at any radial site. These findings, in young adult women, parallel previous reports identifying significant, regionally specific relations among external loading events and BMD changes in both animal and human models.

Adult↗
PubMed1992

Mixed sclerosing bone dystrophy presenting with upper extremity deformities. A case report and review of the literature.

We present a detailed study of a 59-year-old white woman with mixed sclerosing bone dystrophy: the rare occurrence of two or more sclerosing bone dysplasias in a single subject. She exhibited features of osteopoikilosis, osteopathia striata and melorheostosis. The symptoms were primarily the result of the melorheostosis lesions which were distributed within the C6 sclerotome. This is an unusual case of mixed sclerosing bone dystrophy in that the upper extremity was the main site of involvement, instead of the usual symmetrical involvement of all limbs. The patient developed a recalcitrant lateral epicondylitis in the un-involved contralateral elbow that required surgical treatment.

Female↗
PubMed2004

Bone-forming tumors of the upper extremity and Ewing's sarcoma.

This article presents an overview of bone-forming tumors that occur in the upper extremity. Osteoid osteoma, osteoblastoma, osteosarcoma, and Ewing's sarcoma are covered. Each tumor type is described, and suggestions are made for diagnostic workup and differential diagnosis. Locations in the upper extremity where each tumor typically occurs are given. Preferred treatment regimens and incidence of recurrence are also presented.

Arm↗
PubMed2005

Muscle strength is a determinant of bone mineral content in the hemiparetic upper extremity: implications for stroke rehabilitation.

Individuals with stroke have a high incidence of bone fractures and approximately 30% of these fractures occur in the upper extremity. The high risk of falls and the decline in bone and muscle health make the chronic stroke population particularly prone to upper extremity fractures. This was the first study to investigate the bone mineral content (BMC), bone mineral density (BMD), and soft tissue composition of the upper extremities and their relationship to stroke-related impairments in ambulatory individuals with chronic stroke (onset >1 year). Dual-energy X-ray absorptiometry (DXA) was used to acquire total body scans on 56 (22 women) community-dwelling individuals (>or=50 years of age) with chronic stroke. BMC (g) and BMD (g/cm2), lean mass (g), and fat mass (g) for each arm were derived from the total body scans. The paretic upper extremity was evaluated for muscle strength (hand-held dynamometry), impairment of motor function (Fugl-Meyer motor assessment), spasticity (Modified Ashworth Scale), and amount of use of the paretic arm in daily activities (Motor Activity Log). Results showed that the paretic arm had significantly lower BMC (13.8%, P<0.001), BMD (4.5%, P<0.001), and lean mass (9.0%, P<0.001) but higher fat mass (6.3%, P=0.028) than the non-paretic arm. Multiple regression analysis showed that lean mass in the paretic arm, height, and muscle strength were significant predictors (R2=0.810, P<0.001) of the paretic arm BMC. Height, muscle strength, and gender were significant predictors (R2=0.822, P<0.001) of lean mass in the paretic arm. These results highlight the potential of muscle strengthening to promote bone health of the paretic arm in individuals with chronic stroke.

Adipose Tissue↗
PubMed1999

Dynamic injury tolerances for long bones of the female upper extremity.

This paper presents the dynamic injury tolerances for the female humerus and forearm derived from dynamic 3-point bending tests using 22 female cadaver upper extremities. Twelve female humeri were tested at an average strain rate of 3.7+/-1.3%/s. The strain rates were chosen to be representative of those observed during upper extremity interaction with frontal and side airbags. The average moment to failure when mass scaled for the 5th centile female was 128+/-19 Nm. Using data from the in situ strain gauges during the drop tests and geometric properties obtained from pretest CT scans, an average dynamic elastic modulus for the female humerus was found to be 24.4+/-3.9 GPa. The injury tolerance for the forearm was determined from 10 female forearms tested at an average strain rate of 3.94+/-2.0%/s. Using 3 matched forearm pairs, it was determined that the forearm is 21% stronger in the supinated position (92+/-5 Nm) versus the pronated position (75+/-7 Nm). Two distinct fracture patterns were seen for the pronated and supinated groups. In the supinated position the average difference in fracture time between the radius and ulna was a negligible 0.4+/-0.3 ms. However, the pronated tests yielded an average difference in fracture time of 3.6+/-1.2 ms, with the ulna breaking before the radius in every test. This trend implies that in the pronated position, the ulna and radius are loaded independently, while in the supinated position the ulna and radius are loaded together as a combined structure. To produce a conservative injury criterion, a total of 7 female forearms were tested in the pronated position, which resulted in the forearm injury criterion of 58+/-12 Nm when scaled for the 5th centile female. It is anticipated that these data will provide injury reference values for the female forearm during driver air bag loading, and the female humerus during side air bag loading.

Air Bags↗
PubMed1987

Upper extremity reconstruction by vascularized bone transfers: results and complications.

Twenty-one cases of vascularized fibula transfer for upper limb reconstruction are reviewed. Recipient sites included the humerus in 11 patients, radius in five, ulna in three, and clavicle in two. Overall, primary bone union occurred in 15 patients (71.4%), and eventual union was achieved in 17 patients (81%). Two of the patients in whom there was failure to unite are minimally symptomatic, with stable fibrous nonunions. The most favorable results were achieved in cases of forearm bone reconstruction (100% union) and for long-bone reconstruction after tumor resection (83% union).

Adolescent↗
PubMed1986

Electrical stimulation applied to bone and nerve injuries in the upper extremity.

In conclusion, electrical stimulation of bone has advanced from the laboratory to clinical reality. Despite the lack of good double-blind clinical studies, it is impossible to ignore the excellent results reported from numerous multicenter trials. Doubts and controversies will and should continue. Electrical stimulation has a definite place in the treatment of scaphoid nonunion as well as other failures of osteogenic biology in the upper extremity. The future may realize the enormous potential of electrical stimulation in areas of nerve repair, wound healings, or osteoporosis. The hand surgeon may soon be operating in the age of biophysics where he or she can charge by the kilowatt hour. Yet one should not become a mere technician, but understand the basic science of what one is doing and, above all, maintain a balanced and critical approach.

Arm Injuries↗