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Hand and wrist

Renu Saigal, Alok Chaudhary, Prashant Pathak, Amandeep Singh, Deepak Gupta, M L Tank, Saahil Nohria, Diwanshu Khatana
We describe a case of Spondyloepiphyseal Dysplasia Congenita (SEDc) who presented to our rheumatology clinic with complaints of painful swelling of bilateral elbow, knee, distal and proximal interphalangeal joints (DIP and PIP) of hands and small joints of foot. Patient also complained of restriction during extension of bilateral wrist joint and lateral rotation of neck on both sides. He was also unable to walk without support.
July 2016: Journal of the Association of Physicians of India
Guangtao Xu, Ruibing Su, Junyao Lv, Xiaoping Lai, Xianxian Li, Jiayan Wu, Bo Hu, Long Xu, Ruilin Shen, Jiang Gu, Xiaojun Yu
Specific morphological changes may be absent in some cases of electrocution shocked by the voltage of 220 V or lower. In this study, we attempted to demonstrate that the anterior wrist and medial malleolus were the optimal sites with promising and significant changes in electric death through the hand-to-foot circuit pathway. We established an electric shock rat model and observed histopathologic changes in the anterior wrist and medial malleolus. The results showed that the current intensities in the left anterior wrist and right medial malleolus were remarkably higher than those in the other sites, and the nuclei long/short (L/S) axis ratios of the arterial endotheliocyte and the skeletal muscle cell in these two areas were significantly higher than those in other parts of the body...
October 17, 2016: International Journal of Legal Medicine
Luke Steven Robinson, Mitchell Sarkies, Ted Brown, Lisa O'Brien
BACKGROUND: Injuries sustained to the hand and wrist are common, accounting for 20% of all emergency presentations. The economic burden of these injuries, comprised of direct (medical expenses incurred), indirect (value of lost productivity) and intangible costs, can be extensive and rise sharply with the increase of severity. OBJECTIVE: This paper systematically reviews cost-of-illness studies and health economic evaluations of acute hand and wrist injuries with a particular focus on direct, indirect and intangible costs...
October 1, 2016: Injury
Julio Ramírez, José Iniciarte-Mundo, Andrea Cuervo, Virginia Ruiz-Esquide, M Victoria Hernández, Raimón Sanmartí, Juan D Cañete
OBJECTIVES: To analyse clinical, serological and sonographic differences between rheumatoid arthritis (RA) and polyarticular psoriatic arthritis (PsA) patients on anti-TNF therapy in clinical remission. METHODS: Angiogenic and proinflammatory cytokine serum levels were determined by multiplex ELISA in patients with RA and PsA in clinical remission (DAS28-ESR<2.6), clinically-active RA patients (DAS28>3.2) and healthy controls. Ultrasound (US) scans were made of both wrists and hands...
October 7, 2016: Clinical and Experimental Rheumatology
Jimmy Tat, Aaron M Kociolek, Peter J Keir
The most common finding in carpal tunnel syndrome is fibrosis and thickening of the subsynovial connective tissue (SSCT). While the SSCT mediates tendon gliding in the carpal tunnel, this histopathology suggests excessive shear forces are involved in injury development. Ultrasound is often used to quantify relative motion between the finger flexor tendons and SSCT as an indirect measure of "shear-strain"; however, the underlying mechanical implications of using ultrasound are not well understood. The middle flexor digitorum superficialis (FDS) tendon of 8 cadavers was moved in a combination of 2 wrist postures (neutral, flexed), 3 velocities (5, 10, 15cm/s), and 3 forces (10, 20, 30N) to assess ultrasound-based FDS-SSCT relative displacement while simultaneously quantifying tendon frictional work in the carpal tunnel...
October 6, 2016: Journal of Biomechanics
I Naroura, A Zemirline, C Taleb, F Lebailly, S Facca, J J Hidalgo Díaz, S Collon, P Liverneaux
Three direct volar portals for wrist arthroscopy have been described previously: two radiocarpal and one midcarpal. The aim of this study was to systematically describe four volar arthroscopic portals through minimally invasive incisions using an inside-out approach from known dorsal portals. Four volar arthroscopic wrist portals were studied on six hand specimens using an inside-out technique: a radial radiocarpal approach (RRCA), an ulnar radiocarpal approach (URCA), a radial midcarpal approach (RMCA) and an ulnar midcarpal approach (UMCA)...
June 2016: Hand Surgery and Rehabilitation
Bethel C A Osuagwu, Leslie Wallace, Mathew Fraser, Aleksandra Vuckovic
OBJECTIVE: To compare neurological and functional outcomes between two groups of hospitalised patients with subacute tetraplegia. APPROACH: Seven patients received 20 sessions of brain computer interface (BCI) controlled functional electrical stimulation (FES) while five patients received the same number of sessions of passive FES for both hands. The neurological assessment measures were event related desynchronization (ERD) during movement attempt, Somatosensory evoked potential (SSEP) of the ulnar and median nerve; assessment of hand function involved the range of motion (ROM) of wrist and manual muscle test...
October 14, 2016: Journal of Neural Engineering
Elisabet Rodby-Bousquet, Ginny Paleg, Jackie Casey, Alicja Wizert, Roslyn Livingstone
BACKGROUND: There is a lack of understanding of the factors that influence independent mobility and participation in meaningful activities. The purpose of this study was to analyse physical factors influencing independent use of manual and power wheelchairs in a total population of children with cerebral palsy (CP). METHODS: A cross-sectional study based on the most recent examination of all children with CP, born 2002-2013, reported into the Swedish cerebral palsy registry (CPUP), from January 2012 to June 2014...
October 10, 2016: BMC Pediatrics
Oskar C Aszmann, Ivan Vujaklija, Aidan D Roche, Stefan Salminger, Malvina Herceg, Agnes Sturma, Laura A Hruby, Anna Pittermann, Christian Hofer, Sebastian Amsuess, Dario Farina
Critical soft tissue injuries may lead to a non-functional and insensate limb. In these cases standard reconstructive techniques will not suffice to provide a useful outcome, and solutions outside the biological arena must be considered and offered to these patients. We propose a concept which, after all reconstructive options have been exhausted, involves an elective amputation along with a bionic substitution, implementing an actuated prosthetic hand via a structured tech-neuro-rehabilitation program. Here, three patients are presented in whom this concept has been successfully applied after mutilating hand injuries...
October 10, 2016: Scientific Reports
Guangliang Zhang, Jihui Ju, Guangzhe Jin, Linfeng Tang, Yi Fu, Ruixing Hou
PURPOSE: The purpose of this study was to explore effective strategies of replantation or revascularization for the treatment of hand degloving injuries. METHODS: Ten patients who had received replantation or revascularization surgery for hand degloving injury between 2002 and 2014 were included for this study. The average age at the time of surgery was 34.5 years (range 18-49 years). There were nine left and one right hand replantations. The cause of injury was an industrial machine press in all of them...
September 19, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Gintare Kaliniene, Ruta Ustinaviciene, Lina Skemiene, Vidmantas Vaiciulis, Paulius Vasilavicius
BACKGROUND: Information technologies in occupational activities have been developing very rapid. Epidemiological studies have shown that musculoskeletal disorders are widely prevalent among employees working with a computer. The aim of this study was to evaluate the prevalence of musculoskeletal pain in various anatomical areas and its associations with individual, ergonomic, and psychosocial factors among computer workers of the public sector in Kaunas County, Lithuania. METHODS: The investigation consisting of two parts - questionnaire study (Nordic Musculoskeletal Questionnaire and Copenhagen Psychosocial Questionnaire) and direct observation (evaluation of work ergonomics using the Rapid Upper Limb Assessment [RULA]) - was carried out in three randomly selected public sector companies of Kaunas County...
October 7, 2016: BMC Musculoskeletal Disorders
Maurício Vieira de Pádua Maia, Vinícius Ynoe de Moraes, João Baptista Gomes Dos Santos, Flávio Faloppa, João Carlos Belloti
INTRODUCTION: Minimal important difference (MID) score is an important measure for surgical clinical research and impacts on treatment decisions. Our approach considered patient satisfaction as the relevant anchor criteria. The aims of this study were: determine after surgery MID for three relevant questionnaires: Disabilities of the Arm, Shoulder and Hand (DASH), Michigan Hand Questionnaire (MHQ), and Short Form 12 (SF-12); and assess the correlation between these scores and patient reported satisfaction...
2016: SICOT-J
Serena Bugatti, Laura Bogliolo, Barbara Vitolo, Antonio Manzo, Carlomaurizio Montecucco, Roberto Caporali
BACKGROUND: Autoantibodies such as anti-citrullinated protein antibodies (ACPA) are major risk factors for articular bone destruction from the earliest phases of rheumatoid arthritis (RA). The aim of the current study was to determine whether RA-associated autoantibodies also impact on systemic bone loss in patients with early disease. METHODS: Systemic bone mineral density (BMD) was measured in the lumbar spine and the hip in 155 consecutive treatment-naïve patients with early RA (median symptom duration 13 weeks)...
October 6, 2016: Arthritis Research & Therapy
Christos I Ioannou, Shinichi Furuya, Eckart Altenmüller
Five musicians suffering from focal dystonia participated in a pilot study that examined the feasibility of an experimental protocol designed to assess musicians' motor performance under stress. Electrocardiography, free cortisol levels, and subjective assessments were used to monitor alterations of the hypothalamic-pituitary-adrenal axis. As measures of motor outcome, temporal variability of finger movements and muscular cocontraction of the wrist flexor and extensor were assessed. Findings suggest that the specific experimental design could be successfully applied...
August 11, 2016: Journal of Motor Behavior
Won-Taek Oh, Yun-Rak Choi, Ho-Jung Kang, Il-Hyun Koh, Kyung-Han Lim
PURPOSE: To compare union rates and clinical and radiological outcomes of arthroscopic-assisted reduction and fixation with those of open reduction and fixation in patients with trans-scaphoid perilunate fracture dislocations. METHODS: This retrospective study included consecutive patients with trans-scaphoid PLFDs who underwent arthroscopic-assisted reduction and fixation (group A) or open reduction and fixation (group O), and who were followed up for a minimum of 2 years between May 2005 and March 2013...
October 1, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Wilfried Mau
New studies increase the evidence, that different applications of physical therapy are effective. In patients with rheumatoid arthritis (RA) physiotherapy of the hands improve strength, joint mobility and activity without increased risk of pain nor inflammation. A theory-based physiotherapy of the hands shows clinical effectiveness and cost-utility. In patients with spondyloarthritides supervised group exercise training is more effective than home exercise programs. Compared with biologics only combined exercise training and tumour necrosis factor alpha inhibitor therapy improve mobility and disease activity more effectively...
September 2016: Deutsche Medizinische Wochenschrift
Max Stuelcken, Daniel Mellifont, Adam Gorman, Mark Sayers
The wrist/hand complex forms the crucial final link in the kinetic chain between the body and the racquet and therefore has a number of important roles in the production of all tennis strokes. However, the internal and external loads that are created at the wrist during these strokes have the potential to contribute to pain and injury. Therefore, the purposes of this narrative review are to (1) determine the extent of the problem of wrist pain/injury in tennis players, (2) identify bony and soft tissue structures of the wrist that are susceptible to damage as a result of tennis play and (3) explore factors that may influence the development of wrist pain/injury in tennis players...
October 3, 2016: Sports Medicine
Michiko Nishiyama, Masako Sonobe, Kazuhiro Watanabe
In this paper, we present a pulse pressure waveform sensor that does not constrain a wearer's daily activity; the sensor uses hetero-core fiber optics. Hetero-core fiber sensors have been found to be sensitive to moderate bending. To detect minute pulse pressure changes from the radial artery at the wrist, we devised a fiber sensor arrangement using three-point bending supports. We analyzed and evaluated the measurement validity using wavelet transformation, which is well-suited for biological signal processing...
September 1, 2016: Biomedical Optics Express
Clifton Meals, Nathan J Castro, David Moss
Background: The aim was to test the null hypothesis that splint material, thickness, or longitudinal ridging does not affect the strength of a wrist splint. Methods: Ten splints were made according to each of 7 different splint designs (resulting in 7 groups of 10 splints each). All splints were the same length and were molded to approximate the contour of the volar hand, wrist, and forearm with the wrist in neutral. Three groups consisted of plaster splints of different thicknesses (8, 10, and 12 ply). Three additional groups included splints of the same thicknesses but with a longitudinal ridge...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
Michael B Gottschalk, Maxim Danilevich, Hilton P Gottschalk
Background: Carpal coalition and metacarpal synostosis are uncommon congenital anomalies of the carpus and hand. Methods: A comprehensive review of the literature was performed to help guide surgical and non-surgical treatment of carpal coalition and metacarpal synostosis. Results: The embryology, epidemiology, medical and surgical management, and associated outcomes are detailed. Conclusions: Most patients with these disorders will likely benefit from conservative measures. Surgery should be considered in patients with pain and limitations in wrist and hand function...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
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