PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “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
PubMed2001

Multidisciplinary team evaluation of upper extremity injuries in a single visit: the UPPER Program.

Musculoskeletal disorders are the leading cause of disability among people between 18 and 64 years of age. Patients with musculoskeletal injuries of the upper extremities are usually evaluated and treated by an individual physician and therapist. However, for patients who have problems, especially after being treated by a hand surgeon and a certified hand therapist, there are few other management options. A multidisciplinary assessment program for patients with chronic upper limb pain has not been described in the literature. As part of The University of Michigan RERC (Rehabilitation Engineering Research Center), the UPPER Program (UPper extremity Protocol Evaluation in Rehabilitation) was developed to evaluate patients who have disabling upper limb musculoskeletal disorders. At the center of the program is a multidisciplinary team composed of a physiatrist (physical medicine and rehabilitation specialist), occupational therapist, physical therapist, exercise physiologist, vocational counselor and pain psychologist. The UPPER Program elements include a pre-evaluation questionnaire, individual team member assessments and a team meeting. It is followed by a patient appointment with the team physician to review the results and recommendations. The essential details of the program are presented in this article so it can be reproduced elsewhere.

Adolescent↗
PubMed2002

Assessment of upper extremity role functioning in students.

BACKGROUND: Upper extremity symptoms associated with use of computers and other upper extremity activities are common in students. Research on these disorders requires psychometrically sound measures of health-related student role function; no such measure is available currently. METHODS: Based upon input from students and clinicians, we developed a 10-item scale to measure student health-related role function. The measure was administered as part of a survey of 193 undergraduates at one university. A follow-up survey was administered 1 month later. The student health-related role function questionnaire was assessed for internal consistency, ceiling effects, convergent and discriminant validity, and responsiveness to self-reported change in functional status. RESULTS: Eighty-two percent of students who were given the survey completed it and 65% completed a follow-up survey 1 month later. The new measure was reliable (Cronbach's alpha 0.87). Forty-six percent of respondents reported "no difficulty" on all items of the health-related student role function measure while 64% reported "no difficulty" on all items of a generic upper extremity functional status measure. This finding indicates that the new measure was better able to detect functional limitations; it had a less prominent ceiling effect. The new measure had moderately high correlations with measures of symptom severity and pain, documenting convergent validity. It distinguished students who utilized clinician services, medications, or academic accommodation from students who did not utilize these resources, documenting discriminant validity. The measure was responsive to self-perceived change, as demonstrated by a highly significant association (P < 0.0001) between changes in score over a 1-month follow-up and students' perceptions of whether they had improved in functional abilities after the month, deteriorated or remained stable. CONCLUSIONS: The student health-related role functioning measure is reliable, valid and responsive to change. It is an appropriate measure for research on upper extremity symptoms in students.

Arm↗
PubMed2000

Work-related upper extremity musculoskeletal disorders.

Upper extremity musculoskeletal disorders such as DeQuervain's tendonitis, carpal tunnel syndrome, and rotator cuff tendonitis have become increasingly common among working people in the United States. Extensive epidemiological investigation indicates that the adverse ergonomic exposures of force, repetition, vibration and certain postures are risk factors for development of many of these disorders. Assessment of patients with possible work-related upper limb disorders requires eliciting information about the illness, performing an examination about the illness, and obtaining information about adverse ergonomic exposures on and off from work. Treatment can only be successful when exposure to adverse ergonomic risk factors is reduced or eliminated.

Arm↗
PubMed1992

Acute management of thermal and electrical burns of the upper extremity.

Acute management of upper extremity thermal and electrical injuries requires an aggressive treatment protocol which combines meticulous wound care, intensive hand therapy, and early stable wound coverage to salvage upper extremity function. Electrical injuries inflict severe deep-tissue destruction that frequently results in major limb amputation.

Arm Injuries↗
PubMed1997

Management of severe ischemia of the upper extremity.

Ischemia of the upper extremity is unusual, particularly in patients without trauma or iatrogenic injury to the vessels of the arm. Some authors have suggested that ischemia of the upper extremity is one sixth as common as that in the leg. Management of patients with vascular trauma or iatrogenic injury is usually straightforward, with direct repair or vein grafting of the injured vessel. Patients with ischemia from vascular disease, however, present a different set of management problems. These individuals often suffer from systemic medical problems that lead to their vascular disease, which is often very severe and accelerated because of the underlying cause. This article discusses the approach to these patients and options for management.

Arm↗
PubMed2002

Upper extremity deep venous thrombosis.

Upper extremity deep venous thrombosis (UEDVT) makes up approximately 1-4% of all episodes of deep venous thrombosis (DVT). Risk factors for UEDVT include central venous catheterization, strenuous upper extremity exercise or anatomic abnormalities causing venous compression, inherited thrombophilia, and acquired hypercoagulable states including pregnancy, oral contraceptive use, and cancer. Unexplained or recurrent UEDVT should prompt a search for inherited hypercoagulable states or underlying malignancy. Clinical presentations include arm, neck, and shoulder pain; edema; skin discoloration; tenderness; and venous distension. Because UEDVT is frequently asymptomatic until complications ensue, a high index of suspicion is required for patients with one or more risk factors for thrombosis. Pulmonary embolism and post-thrombotic syndrome are the most common sequelae of UEDVT. Early detection and treatment of UEDVT decrease complications, morbidity, and mortality. Compressive ultrasonography is an effective and economical means of confirming the clinical diagnosis in most patients. Traditional anticoagulant therapy of UEDVT is giving way to a multimodal approach involving transcatheter thrombolytic therapy followed by a minimum of 3 months of warfarin sodium anticoagulant therapy, venous decompression as needed, and balloon angioplasty with stenting for treatment of residual stricture. Low-dose anticoagulant therapy can safely and effectively mitigate the increased risk of UEDVT associated with the use of central venous catheters.

Arm↗
PubMed2002

Upper extremity arterial disease.

Upper extremity arterial disease is much less common than lower extremity involvement and typically presents as arm claudication, Raynaud's syndrome, rest pain, ischemic ulcerations, or gangrene. The disease can reflect an underlying systemic disorder. In addition to clinical examination, diagnostic studies include noninvasive vascular studies, serologic, immunologic, and hematologic studies (when indicated), and selective arteriography. Atherosclerotic disease is the most common cause of large vessel obstruction, but it can also cause small vessel obstruction by atheromatous embolization or thromboembolism. Treatment varies from pharmacological therapy for vasospastic and vasculitic syndromes to operative approaches for endarterectomy or bypass of focal lesions. Angioplasty and stent techniques also can provide an effective treatment option.

Arm↗
PubMed1995

Upper extremity venous thrombosis.

Upper extremity venous thrombosis is unusual, but the occurrence rate is increasing. Nurses must be aware of the predisposing factors for thrombosis, diagnostic modalities, treatment options, and follow-up treatment for these patients. Nurses are responsible for patient evaluation, education, and monitoring for side effects of therapy.

Arm↗
PubMed1990

Upper extremity burn contractures.

Upper extremity burn contractures are a major challenge to the reconstructive surgeon. Despite increasing sophistication in the overall management of acute thermal injuries, contractures still occur and are the most common cause of skin contracture in the hand. Reconstructive options for axillary, antecubital, wrist, metacarpophalangeal joint, and interdigital web contractures are discussed, with special emphasis on the techniques and advantages of local flap reconstruction.

Arm↗
PubMed1986

Contralateral therapy in upper extremity rehabilitation.

Evaluation of upper extremity function after an elective surgery with emphasis on the possible effect of contralateral therapy was done in 20 patients. This study was designed to test the postulate that range of motion exercises and work to muscle groups of one upper extremity has a beneficial effect on the analogous muscle groups in an immobilized, post-surgical contralateral extremity. Analysis of results show a small, but consistent, effect on range of motion measurements. However, strength measurements were shown to be markedly increased in the group receiving contralateral therapy to the normal extremity, as compared to the normal control group. Significant indirect training occurs by a cross-over phenomenon. Rehabilitation programs can be individually designed to enhance recovery of specific motor groups by utilizing contralateral therapy and cross-education principles. Further work is now underway to further elucidate specific clinical applications.

Adult↗
PubMed1990

Controlled tissue expansion of a groin flap for upper extremity reconstruction.

A large upper extremity defect in an 8-year-old girl was resurfaced with an expanded groin flap. Tissue expansion allowed complete coverage of the defect while minimizing the donor deformity. Pretransfer expansion of pedicled flaps offers an alternative to free-flap reconstruction of complex upper extremity defects. This is especially valuable in the pediatric patient, in whom donor-site morbidity can be significant.

Child↗
PubMed2002

[Replantation in the complete amputation of the upper extremity].

Trauma of the upper extremity can be a cause of significant morbidity and disability to otherwise productive people. Wounded extremity can be saved by replantation of the amputated parts. Replantation of traumatic amputations can be performed with reasonable success at a regional medical center when experienced surgeons, appropriate and experienced equipment, and skilled ancillary care are available. Successful replantation significantly reduces the morbidity of upper extremity amputations. We presented one case that, 9 year-old, was bridged to our hospital because of total arm amputation after sustained during use of a lawn mover. His arm was saved by urgency surgery.

Amputation, Traumatic↗
PubMed1996

Congenital Deformities of the Upper Extremity.

Congenital deformities of the upper extremity are rare. They are often associated with other, more severe disorders of the cardiovascular, craniofacial, neurologic, and musculoskeletal systems. Most upper-extremity congenital anomalies are minor and cause no functional deficits, and surgical reconstruction is therefore unnecessary. If a severe cosmetic deformity is present or there is significant functional compromise, surgical treatment is indicated. The authors review the common congenital deformities of the upper extremity and offer treatment recommendations.

Journal Article↗
PubMed1988

Growth and predictions of growth in the upper extremity.

Teleroentgenograms of the upper extremity in 244 children (123 boys and 121 girls) were made at six-month intervals from the age of seven to the time of skeletal maturity. Lengths were measured to determine the growth remaining at both growth plates of the humerus, radius, and ulna. The subjects were healthy, well nourished, middle-class Americans, mostly of northwest European descent. After the age of seven, the proportion between the upper and lower arms does not change appreciably. The humerus is 18 per cent of standing height in girls at the age of seven and 19 per cent at the age of fifteen. In boys, the humerus is 18 per cent of standing height at the age of seven and 20 per cent at the age of seventeen. The length of the radius is 13 per cent of standing height in girls at the age of seven, increasing to 14 per cent by skeletal maturity. In boys, the length of the radius increases from 14 per cent of standing height at the age of seven to 15 per cent at skeletal maturity. From the age of seven to skeletal maturity, the humerus grows approximately 1.2 centimeters in girls and 1.3 centimeters in boys each year. In girls, the ulna grows approximately 1.0 centimeter and the radius, 0.9 centimeter each year after the age of seven. In boys, the ulna grows approximately 1.1 centimeters and the radius, approximately 1.0 centimeter each year from the age of seven to skeletal maturity. Based on these data, accurate predictions of growth and of growth discrepancy in the upper extremity can be made, and the time at which to perform equalization procedures can be determined more precisely.

Adolescent↗
PubMed1992

Upper extremity symptoms in supermarket workers.

Upper extremity symptoms in supermarket workers, particularly those who performed checking using laser scanners, were evaluated using a questionnaire administered by trained interviewers to 124 supermarket workers. Summary indices of exposure (short-term and long-term) as well as indices of past personal illnesses and personal activities were employed. Outcome data were summarized by four composite symptom indices. Chi square and logistic regression analyses demonstrated that hours of checking work in the preceding 2 weeks and cumulative weighted years of work were associated with adverse upper extremity symptoms. Symptoms involved both the proximal and distal parts of the upper extremities.

Adult↗
PubMed2007

Volumetric evaluation of upper extremities in 250 healthy persons.

BACKGROUND AND PURPOSE: Upper extremity oedema frequently occurs as a complication of several diseases. The aim of this study was to establish normative data for upper extremity volumes with a modified water displacement method. These data were used to develop predictive formulas helpful in detecting abnormal swelling. SUBJECTS AND METHODS: Upper extremities of 250 healthy subjects (138 men and 112 women) were measured by water displacement. RESULTS: A mean difference of 3.0% (3.2%) between right and left arm (forearm) was found. Intra-class correlation coefficients were 0.99 for intra-rater and inter-rater reliabilities. Coefficient of variation was 0.23%. To predict the premorbid volume of an oedematous arm, prediction formulas were constructed. DISCUSSION AND CONCLUSION: Water displacement as used in this study is a highly reliable technique for volume measurement of upper extremities. This technique was applied to gather normative data for upper extremity volumes. We suggest that this technique can be used in daily clinical practice for the evaluation of upper extremity oedema or atrophy caused by various diseases as well as for volume monitoring. Prediction formulas can be used to define abnormal swelling.

Adolescent↗
PubMed1993

A practical guide to diagnostic imaging of the upper extremity.

Imaging of the upper extremities can be challenging and rewarding. Newer imaging modalities, including MRI and CT, have greatly expanded the ability of the radiologist to define soft-tissue abnormalities in the wrist, especially triangular fibrocartilage tears and carpal and radioulnar instability. MRI of the shoulder has almost replaced the arthrogram for diagnosing rotator cuff tears. The plain film, however, remains the mainstay of bone imaging and is the most efficacious first step in the diagnostic work-up. The radionuclide scan, although nonspecific, may provide a map for the radiologist to locate occult lesions. Dialogue between the surgeon and radiologist is essential to effective upper extremity evaluations. The radiologist can maximize his or her effectiveness by performing a brief history and physical examination of the patient.

Arm Injuries↗