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contractures AND physical therapy

Ryan P Cauley, Sean A Hickey, Charles Scott Hultman, Katie Mathews, Jeremy Goverman
BACKGROUND: Postburn axillary contractures are common and significantly impact quality of life. Simple release combined with split thickness skin grafting necessitates a donor site, requires immobilization, and may result in poor functional outcome. Common methods of adjacent tissue rearrangement are not well designed to treat broad linear contractures. Flaps from the back, flank, or arm can be used, but may come with significant donor site morbidity. We demonstrate the use of the STARplasty, a novel adjacent tissue rearrangement initially developed to treat neosyndactyly, as a useful reconstructive option for the release of Kurtzman type 1 posterior or anterior axillary contractures...
October 17, 2016: Annals of Plastic Surgery
Loreto Lollo, Andreas Grabinsky
BACKGROUND: Acute lower extremity compartment syndrome (CS) is a condition that untreated causes irreversible nerve and muscle ischemia. Treatment by decompression fasciotomy without delay prevents permanent disability. The use of intracompartmental pressure (iCP) measurement in uncertain situations aids in diagnosis of severe leg pain. As an infrequent complication of lower extremity trauma, consequences of CS include chronic pain, nerve injury, and contractures. The purpose of this study was to observe the clinical and functional outcomes for patients with lower extremity CS after fasciotomy...
July 2016: International Journal of Critical Illness and Injury Science
J Vissing
Metabolic myopathies encompass muscle glycogenoses (GSD) and disorders of muscle fat oxidation (FAOD). FAODs and GSDs can be divided into two main clinical phenotypes; those with static symptoms related to fixed muscle weakness and atrophy, and those with dynamic, exercise-related symptoms that are brought about by a deficient supply of ATP. Together with mitochondrial myopathies, metabolic myopathies are unique among muscle diseases, as the limitation in exercise performance is not solely caused by structural damage of muscle, but also or exclusively related to energy deficiency...
October 2016: Revue Neurologique
Minna M Wieck, Donna Nowicki, Kathy A Schall, Chadi Zeinati, Lori K Howell, M Anselmo
BACKGROUND: Intramuscular venous malformations (VMs) are rare, but can be highly symptomatic. There are few reports on outcomes, particularly pain, functional limitations, and muscle contractures. We aimed to compare results of medical management, sclerotherapy, and surgical resection. METHODS: We retrospectively reviewed 45 patients with an extremity or truncal intramuscular VM between June 2005 and June 2015 at a single institution. Outcomes were compared between treatment modalities with ANOVA and χ2 tests...
September 1, 2016: Journal of Pediatric Surgery
Catherine Ball, David Izadi, Liaquat Suleman Verjee, James Chan, Jagdeep Nanchahal
BACKGROUND: Dupuytren's disease is a common fibrotic disorder of the palm characterized by the development of progressive flexion deformities in the digits, leading to significant functional impairment. Surgical excision remains the most common treatment. However, this is only indicated in patients with established contractures rather than those with early disease. Early disease is generally characterized by the presence of palmar nodules with limited or no contracture of the fingers...
2016: BMC Musculoskeletal Disorders
Brittany J Carr, Sherman O Canapp, Debra A Canapp, Lauri-Jo Gamble, David L Dycus
OBJECTIVE: To describe clinical and diagnostic findings as well as management of adhesive capsulitis in dogs. BACKGROUND: Adhesive capsulitis, also known as frozen shoulder, is a syndrome defined by loss of range of motion of the shoulder and may be the end-stage manifestation of several primary conditions. EVIDENTIARY VALUE: This is a case series report of eight dogs with chronic forelimb lameness diagnosed with adhesive capsulitis. METHODS: Medical records (June 1, 2010-September 1, 2015) including, physical examination findings, radiographic findings, magnetic resonance imaging (MRI) findings, arthroscopy findings, and treatment plans were reviewed...
2016: Frontiers in Veterinary Science
Daisuke Sotobayashi, Hirohisa Kawahata, Natsuki Anada, Toshio Ogihara, Ryuichi Morishita, Motokuni Aoki
BACKGROUND: Limited range of motion (ROM) as a result of joint contracture in treatment associated with joint immobilization or motor paralysis is a critical issue. However, its molecular mechanism has not been fully clarified and a therapeutic approach is not yet established. METHODS: In the present study, we investigated its molecular mechanism, focusing on the role of a transcription factor, hypoxia inducible factor-1 (HIF-1), which regulates the expression of connective tissue growth factor (CTGF) and vascular endothelial growth factor (VEGF), and evaluated the possibility of molecular therapy to inhibit HIF-1 activation by ribbon-type decoy oligonucleotides (ODNs) for HIF-1 using immobilized knee animal models...
August 2016: Journal of Gene Medicine
Travis G O'Brien, Robert J Spinner, Andrea J Boon
INTRODUCTION: Neuromuscular choristomas (NMCs) are rare benign peripheral nerve lesions in which skeletal muscle tissue is admixed with nerve fascicles. METHODS: We describe a case of sciatic nerve NMC presenting with unilateral limb hypoplasia, monoparesis, and equinovarus contracture in a pediatric patient. We outline the unique clinical presentation and diagnostic work-up for our patient, including electromyographic and imaging studies. RESULTS: MRI revealed fusiform enlargement of the sciatic nerve, <50% intralesional fat, and signal characteristics similar to those of muscle tissue...
October 2016: Muscle & Nerve
Elsa G Shapiro, Kyle Rudser, Alia Ahmed, Robert D Steiner, Kathleen A Delaney, Brianna Yund, Kelly King, Alicia Kunin-Batson, Julie Eisengart, Chester B Whitley
OBJECTIVES: The behavioral, adaptive and quality of life characteristics of attenuated mucopolysaccharidosis type II (MPS II) have not been well studied. Understanding changes over time in the attenuated phenotype may assist in helping achieve better outcomes in long-term function. This longitudinal study investigates these outcomes in relation to age, somatic disease burden, and IQ. Specifically, somatic disease burden is a major challenge for these patients, even with treatment with enzyme replacement therapy...
June 2016: Molecular Genetics and Metabolism Reports
Merisa Piper, Isabella Guajardo, Keith Denkler, Hani Sbitany
BACKGROUND: Axillary web syndrome (AWS) is a poorly understood but common cause of significant morbidity after axillary lymph node dissection for breast cancer. It is characterized by painful scar tissue formation and contracture extending from the axilla down the medial arm which limits shoulder and arm mobility. We sought to gain a better understanding of its pathophysiology and available treatments. Additionally, we present our preliminary experience with 2 novel treatment methods: (1) percutaneous needle cord disruption with fat grafting, (2) Xiaflex injection to the cording...
May 2016: Annals of Plastic Surgery
Eun Jung Sung, Min Ho Chun, Ja Young Hong, Kyung Hee Do
OBJECTIVE: To assess the effectiveness of the resting foot splint to prevent ankle contracture. METHODS: We performed a randomized controlled trial in 33 patients with brain injury with ankle dorsiflexor weakness (muscle power ≤grade 2). Both groups continued conventional customized physical therapy, but the patients in the foot splint group were advised to wear a resting foot splint for more than 12 hours per day for 3 weeks. The data were assessed before and 3 weeks after the study...
February 2016: Annals of Rehabilitation Medicine
Shkurta Rrecaj, Hajrie Hysenaj, Merita Martinaj, Ardiana Murtezani, Dafina Ibrahimi-Kacuri, Bekim Haxhiu, Zene Buja
OBJECTIVE: Burn injuries in hands are much more complex and the appearance of contractures is a common complication. Hand burn injuries often result in limited functionality, flexion and extension of fingers and present a major hindrance in rehabilitation. The aim of physical therapy and splinting after hand burn injury is to maintain mobility, prevent the development of the contracture and to promote the functionality of hand and good cosmetic results. The purpose of this study is to presents our experience of 38 children with hand burn injuries, admitted and treated at the Department of Plastic Surgery, UCCK-Pristina, Kosovo, during the years 2012-2015...
December 2015: Materia Socio-medica
Małgorzata Miller, Marta Banach
We describe a case of a 54-year-old woman reporting weakness of the right upper limb, preceded by a period of severe pain in the right shoulder. Despite several orthopedic consultations and two cycles of physical therapy, the symptoms deteriorated over a period of 6 months, and progressive paresis of the extensor muscles of the upper limb and elbow flexion contracture were observed. On the basis of the clinical presentation and results of medical tests including an electrophysiological study that showed axonal damage to the long thoracic nerve, axillary nerve, and posterior interosseous nerve, neuralgic amyotrophy was diagnosed...
2015: Przegla̧d Lekarski
Laura S Humphries, Essie Kueberuwa, Maureen Beederman, Lawrence J Gottlieb
BACKGROUND: This study reviewed a single center's 14-year experience with surgical treatment of chronic, severe hidradenitis suppurativa (HS) through wide excision technique and healing by secondary intention. METHODS: All patients who underwent wide excision of HS between 2000 and 2014 and allowed to heal by secondary intention were included. Wound care consisted of topical antimicrobials and hydrotherapy. Physical therapy was initiated for joint contracture prevention...
April 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Ivan Blažeković, Ervina Bilić, Marija Žagar, Branimir Anić
Complex regional pain syndrome (CRPS) represents a state of constant and often disabling pain, affecting one region (usually hand) and often occurs after a trauma whose severity does not correlate with the level of pain. The older term for this condition of chronic pain associated with motor and autonomic symptoms is reflex sympathetic dystrophy or causalgia. The aim of this review, based on contemporary literature, is to show the epidemiology and etiology, proposed pathophysiological mechanisms, method of diagnosis and treatment options, prevention and mitigation of this under-recognized disease...
September 2015: Lijec̆nic̆ki Vjesnik
Miriam Byrne, Michelle O'Donnell, Lisa Fitzgerald, Odhran P Shelley
INTRODUCTION: Fat transfer is increasingly used as part of our reconstructive armamentarium to address the challenges encountered in secondary burn reconstruction. The aim of this study was to review our experience with autologous fat transfer in relation to hand function, scarring and cosmesis, in patients undergoing secondary reconstruction after burns. METHOD: Retrospective analysis of burn patients (2010-2013) who underwent autologous fat transfer to improve scarring, contour deformity and/or scar contracture was performed...
March 2016: Burns: Journal of the International Society for Burn Injuries
Joseph J Ruzbarsky, David Scher, Emily Dodwell
PURPOSE OF REVIEW: The present review includes the most up-to-date literature on the causes, epidemiology, diagnosis, and treatment of toe walking. RECENT FINDINGS: The prevalence of toe walking at age 5.5 years is 2% in normally developing children, and 41% in children with a neuropsychiatric diagnosis or developmental delays. A recent systematic review concluded that there is good evidence for casting and surgery in the treatment of idiopathic toe walking, with only surgery providing long-term results beyond 1 year...
February 2016: Current Opinion in Pediatrics
Kyle Bradford Jones, Benjamin Wilson, Dean Weedon, Deborah Bilder
Cerebral palsy (CP) is a group of disorders that primarily affect motor function. This developmental disability is becoming more common in adults as life expectancy increases for individuals with CP. Many physical, medical, mental, and behavioral health conditions are associated with CP, and assistance should be provided to patients with CP to optimize function, when available. These comorbidities include intellectual disabilities, seizures, muscle contractures, abnormal gait, osteoporosis, communication disorders, malnutrition, sleep disorders, and mental health disorders, such as depression and anxiety...
December 2015: FP Essentials
B Hohendorff, F Biber, H Sauer, C Ries, C Spies, J Franke
OBJECTIVE: Correction of residual flexion deformity of the proximal interphalangeal (PIP) joint after excision of diseased connective tissue in Dupuytren's contracture by stepwise arthrolysis. INDICATIONS: Flexion deformity of the PIP joint of 20° or more after excision of the diseased connective tissue in Dupuytren's contracture. CONTRAINDICATIONS: Joint deformities, osteoarthrosis, intrinsic muscle contracture, instability of the PIP joint...
February 2016: Operative Orthopädie und Traumatologie
Tyler S Pidgeon, Jose M Ramirez, Jonathan R Schiller
Spasticity is a common manifestation of many neurological conditions including multiple sclerosis, stroke, cerebral palsy, traumatic brain injury, and spinal cord injuries. Management of spasticity seeks to reduce its burden on patients and to limit secondary complications. Non-operative interventions including stretching/splinting, postural management, physical therapy/strengthening, anti-spasticity medications, and botulinum toxin injections may help patients with spasticity. Surgical management of these conditions, however, is often necessary to improve quality of life and prevent complications...
December 2015: Rhode Island Medical Journal
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