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At least 865 records · Page 48Linked to original sources
PubMed1996

Congenital disorders of the hand and upper extremity.

This article summarizes normal formation and growth of the upper limb as a basis for understanding malformation. Shoulder anomalies, including Sprengel's undescended scapula, clavicle pseudarthrosis, cleidocraniodystostosis, and Poland's syndrome, are presented. Classification and examples of limb malformations are discussed as well as neuromuscular disorders, such as obstetric brachial plexopathy, cerebral palsy, and arthrogryposis. The author hopes that this article provides a basic understanding of the evaluation necessary for appropriate counseling and referrals for treatment of the child with hand and upper extremity congenital deformities.

Arm↗
PubMed1988

Extravasations of radiographic contrast material in the upper extremity.

Five significant extravasations of radiographic contrast material in the upper extremity were treated with early surgical drainage in an attempt to prevent extensive skin necrosis. Four of the five patients underwent operation within 6 hours of the extravasations, and all of these patients had excellent functional and cosmetic results without any evidence of skin necrosis. One patient who had a poor result did not undergo operation until 20 hours after a severe extravasation to the dorsum of the right hand. Most small-volume, less-extensive extravasations can be satisfactorily managed conservatively. Our clinical experience indicates that large subcutaneous extravasations of radiographic contrast material (volume more than 20 ml) should be surgically drained within 6 hours to prevent extensive damage to tissue.

Adult↗
PubMed1984

Sports injuries to the upper extremity. How to recognize and deal with some common problems.

Upper extremity syndromes caused by a single stress or by repetitive microtrauma occur in a variety of sports. The throwing motion, long-distance swimming, bowling, golf, gymnastics, basketball, volleyball, and field events can repetitively stress the hand, wrist, elbow, and shoulder. The biomechanical evaluation of racquet handling, throwing, and swimming motions has progressed considerably, and the future looks promising for better identification and prevention of sports injuries due to stress. These insights will help the physician more adequately understand and treat athletic injuries. As for the present, we must recognize athletic injuries for what they are--debilitating single or repetitive trauma to active persons who want a rapid return to their sport. The goal of both the injured athlete and the treating physician must be 100% recovery; compromise in treatment is not warranted. To achieve the best results, the physician should emphasize to the athlete, coach, and parent that healing is a matter of time.

Arm Injuries↗
PubMedDate not supplied

Early upper-extremity prosthetic fit in patients with burns.

Patients with upper-extremity amputations necessitated by burn injury have frequently faced delays in prosthetic fit. At the Regional Medical Center, Memphis, Tennessee, seven patients required amputations because of burns. These injuries were electrical in four cases, thermal and crush in one case, thermal in one case, and steam and crush in one case. Five patients had below-elbow amputations, one had a bilateral below-elbow amputation, and one had a bilateral above-elbow amputation. All patients were fitted with prostheses within 30 days of the last definitive surgery on the amputated extremity. All patients continued to wear a prosthesis and no patient exhibited skin breakdown. Patients returned to independence with self care within 2 weeks and to preamputation activities within an average of 2.5 months.

Adolescent↗
PubMed1978

Rollover injuries of the upper extremity.

Eleven patients were treated for rollover injuries of the upper extremities from 1971 to 1976 resulting from the rollover accidents of off-road vehicles in rough terrain. Injuries to the volar surfaces of the extremity were most common, but injury to the extensor surfaces seemed to be more severe. Soft-tissue injuries predominated as did injury to the nondominant hand. The majority of patients returned to their original jobs after sometimes prolonged recovery and rehabilitation. A redesign of the rollover cage with interior hand holds could reduce the frequency and severity of these novel injuries.

Accidents↗
PubMed1986

Detection of cumulative trauma disorders of upper extremities in the workplace.

Surveillance for musculoskeletal disorders of the upper extremity in industry is in its infancy. Research efforts to elucidate the causal factors of these disorders often rely on either the analysis of existing medical records, worker compensation records (passive surveillance), or the surveying of workers with questionnaire and physical examination (active surveillance). The use of either type of data for routine surveillance presents several difficulties illustrated with the results presented in this paper. The analysis of existing records is generally less costly but the reliability of the data is difficult to assess. Standardized questionnaire and physical examinations can be as sensitive as the use of unusually thorough existing occupational medical records; however, it is unclear whether the additional cost of an active surveillance system will deter the routine use of such systems.

Arm↗
PubMed2005

HyperIgEaemia in patients with juvenile muscular atrophy of the distal upper extremity (Hirayama disease).

BACKGROUND: Juvenile muscular atrophy of the distal upper extremity (Hirayama disease) is characterised by anterior horn cell loss in the lower cervical cord, presumably caused by anterior displacement of the dural sac during neck flexion. A recent report suggests that atopy and IgE may contribute to anterior horn damage. OBJECTIVE: To investigate whether IgE is a contributing factor in Hirayama disease. METHODS: Serum total IgE and allergen specific IgE were examined in 20 consecutive patients, and their correlations with clinical profiles investigated. RESULTS: Past or present history of allergy/atopy was found in only four patients (20%), but serum IgE was raised in 14 (70%). Patients with hyperIgEaemia had more severe clinical disabilities than those without (p = 0.01). In patients whose history of Hirayama disease was less than five years, serum total IgE was higher than in those with the disease for five years or more (p = 0.05). CONCLUSIONS: The results suggest that hyperIgEaemia is often associated with Hirayama disease and can facilitate its pathophysiology, particularly in the early phases of the disease. HyperIgEaemia does not appear to involve the anterior horn cells primarily.

Adolescent↗
PubMed1976

Fluorescein angiography especially of the upper extremities.

The technique used in sequential fluorescein angiography of the upper extremities is described. The sensitivity and reproducibility of the method are exemplified and discussed in regard to its applicability in diagnosis of organic arterial obliterations, e.g. in Raynaud's phenomenon as well as to its usefulness in evaluation of reconstructive arterial surgery and medical treatment with respectively thrombolytic (Brinase, Astra) and microhaemorheologic agents (Venoruton, Zyma; Arwin, Knoll) or those with an influence on systemic haemodynamic factors as in induced hypertension. The importance of standardized experimental conditions is emphasized, particularly with reference to vasodilatation. The method represents a new possibility of obtaining clinically a functional over-all information on the nutritional blood flow of rather extensive skin areas. Also, it can illustrate the interaction between macro- and microcirculation. Segmental macrovascular occlusions without concomitant damage of the corresponding terminal vascular area mainly cause a prolongation of the fluorescence appearance time. Obstruction of the microvascular blood flow reveals itself as more definite changes in the fluorescence pattern of the affected skin areas.

Adult↗
PubMed1988

Management of the spastic upper extremity in the neurologically impaired adult.

Spasticity that interferes with upper extremity function is common in adults following stroke, brain injury, or anoxia. During the period of neurologic recovery definitive surgical procedures are avoided. Techniques to temporarily reduce spasticity include the implantation of a MicroPort reservoir and catheter for repeated branchial plexus blocks and phenol nerve blocks, which provide longer lasting relief of noxious muscle tone. Percutaneous blocks of the musculocutaneous and recurrent median nerves and motor point blocks of the pectoralis major, the brachioradialis, and forearm flexor muscles are easily performed at bedside. The motor branch of the ulnar nerve can be injected surgically with phenol to diminish intrinsic spasticity. When neurologic recovery has plateaued, hand placement can be improved in many patients following proximal release of the brachioradialis muscle and lengthening of the biceps and branchialis tendons. Hand function is enhanced by fractional lengthening of spastic wrist and finger flexors. Intrinsic spasticity must be addressed at the same time by phenol block or intrinic release. When extensor function is lacking, a tenodesis of the wrist extensors is helpful. The thumb-in-palm deformity requires proximal release of the thenar muscles as well as lengthening of the flexor pollicis longus. Contracture releases in the nonfunctional arm improve hygiene and ease care.

Adult↗
PubMed1985

Upper extremity dyskinesis: a case report.

A case is presented demonstrating upper extremity dyskinesis. Dyskinesia is a kinesiopathology of both hyper and hypomobility. Hyper and hypomobility of the spine are discussed and the theory of this extremity dyskinesia is examined. The necessity for a thorough and complete biomechanical evaluation is emphasized before successful treatment can be initiated.

Adult↗
PubMed1975

[Phlebography of the upper extremity (author's transl)].

Various modifications of phlebography of the upper extremity are described. Evaluation of 95 pathological phlebograms proves the importance of phlebographic early diagnosis in the Paget-Schrötter syndrome, in traumatic and iatrogenic vein lesions. A phlebographic delimitation of obstructed drainage, caused by tumors, from scarred stenosing is only seldom possible.

Arm↗
PubMedDate not supplied

Determining the cause of upper extremity complaints in the workplace.

Occupational musculoskeletal disorders of the upper extremity have been termed cumulative trauma disorders (CTDs) and are considered to result from repetitive job function. Determination of work-relatedness of CTDs has far-reaching consequences. The physician equipped with objective, scientific knowledge is less likely to encourage disability or stress the workers' compensation system.

Arm Injuries↗
PubMed2003

Mechanical energy and power flow of the upper extremity in manual wheelchair propulsion.

OBJECTIVE: To investigate the characteristics of mechanical energy and power flow of the upper limb during wheelchair propulsion. DESIGN: Mechanical energy and power flow of segments were calculated. BACKGROUND: Very few studies have taken into account the mechanical energy and power flow of the musculoskeletal system during wheelchair propulsion. Mechanical energy and power flow have proven to be useful tools for investigating locomotion disorders during human gait. METHODS: Twelve healthy male adults (mean age, 23.5 years) were recruited for this study. Three-dimensional kinematic and kinetic data of the upper extremity were collected during wheelchair propulsion using a Hi-Res Expert Vision system and an instrumented wheel, respectively. RESULTS: During the initiation of the propulsion phase, joint power is generated in the upper arm or is transferred from the trunk downward to the forearm and hand to propel the wheel forward. During terminal propulsion, joint power is transferred upward to the trunk from the forearm and upper arm. The rate of change of mechanical energy and power flow for the forearm and hand have similar patterns, but the upper arm values differ. CONCLUSIONS: Joint power plays an important role in energy transfer as well as the energy generated and absorbed by muscles spanning the joints during wheelchair propulsion. RELEVANCE: Energy and power flow information during wheelchair propulsion allows us to gain a better understanding of the coordination of the movement by the musculoskeletal system.

Adult↗
PubMed1990

Comparison of sympathetic neurons in orofacial and upper extremity nerves: implications for causalgia.

This study compared nerves of the orofacial region with nerves frequently associated with causalgia to determine if there is a significant difference in the proportion of sympathetic neurons within these nerves, which may account for the lower incidence of orofacial causalgia. Three orofacial and two upper extremity nerves were examined. Each nerve was transected and labeled with horseradish peroxidase to identify the cell bodies of neurons contributing axons to the nerve. The study included two trials per nerve, for a total of 10 trials in eight cats. The trigeminal and dorsal root ganglia, containing sensory neurons (SN), and the stellate, middle, and superior cervical ganglia, containing postganglionic sympathetic neurons (PGSN), were sectioned and reacted with tetramethyl benzidine to visualize the labeled neurons. The total number of labeled PGSN and SN were counted and the ratio (PGSN:SN) determined for each of the five nerves. The average PGSN:SN ratio from upper extremity nerves (0.40) is 2 1/2 times greater than the ratio determined for branches of the trigeminal nerve (0.16). The lower proportion of sympathetic neurons within the trigeminal nerves provides an anatomic explanation for the lower incidence of orofacial causalgia consistent with the currently accepted etiology.

Animals↗