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https://www.readbyqxmd.com/read/29132790/ulnar-thumb-pulp-reconstruction-using-the-anterograde-homodigital-neurovascular-island-flap
#1
REVIEW
Valeriy Shubinets, River M Elliott
The thumb ulnar pulp is a critical component of key pinch and precision manipulation. Injuries to this area should be reconstructed with robust, sensate tissue that restores bulk and contour. The existing reconstructive options, however, have substantial risks and drawbacks. We describe an anterograde homodigital neurovascular island flap that provides both sensate and durable coverage of the ulnar thumb pulp. The flap uses innervated glabrous tissue, limits donor site morbidity to the thumb and first web space, and does not require microvascular anastomoses or nerve coaptation...
November 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29132379/effects-of-somatosensory-electrical-stimulation-on-motor-function-and-cortical-oscillations
#2
Adelyn P Tu-Chan, Nikhilesh Natraj, Jason Godlove, Gary Abrams, Karunesh Ganguly
BACKGROUND: Few patients recover full hand dexterity after an acquired brain injury such as stroke. Repetitive somatosensory electrical stimulation (SES) is a promising method to promote recovery of hand function. However, studies using SES have largely focused on gross motor function; it remains unclear if it can modulate distal hand functions such as finger individuation. OBJECTIVE: The specific goal of this study was to monitor the effects of SES on individuation as well as on cortical oscillations measured using EEG, with the additional goal of identifying neurophysiological biomarkers...
November 13, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/29067749/combined-brain-and-peripheral-nerve-stimulation-in-chronic-stroke-patients-with-moderate-to-severe-motor-impairment
#3
Isabella S Menezes, Leonardo G Cohen, Eduardo A Mello, André G Machado, Paul Hunter Peckham, Sarah M Anjos, Inara L Siqueira, Juliana Conti, Ela B Plow, Adriana B Conforto
OBJECTIVES: To evaluate effects of somatosensory stimulation in the form of repetitive peripheral nerve sensory stimulation (RPSS) in combination with transcranial direct current stimulation (tDCS), tDCS alone, RPSS alone, or sham RPSS + tDCS as add-on interventions to training of wrist extension with functional electrical stimulation (FES), in chronic stroke patients with moderate to severe upper limb impairments in a crossover design. We hypothesized that the combination of RPSS and tDCS would enhance the effects of FES on active range of movement (ROM) of the paretic wrist to a greater extent than RPSS alone, tDCS alone or sham RPSS + tDCS...
October 25, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29052828/long-term-results-of-primary-repair-of-combined-cuts-on-the-median-and-ulnar-nerves-in-the-forearm
#4
Kemal Özaksar, Hüseyin Günay, Levent Küçük, Erhan Coşkunol
BACKGROUND: The objective of this clinical study was to evaluate sensory and motor functions in the later period following primary repair of combined injuries of the ulnar and median nerves in the forearm at proximal, middle, and distal levels. METHODS: Later period sensory evaluation of ulnar and median combined cuts was performed using two-point discrimination and monofilament tests. On the other hand, motor evaluation was performed by determining dorsal palmar interosseus strength for the ulnar nerve and abductor pollicis brevis muscle strength for the median nerve...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28951097/transfer-of-the-motor-branch-of-the-abductor-digiti-quinti-for-thenar-muscle-reinnervation-in-high-median-nerve-injuries
#5
Jayme Augusto Bertelli, Francisco Soldado, Alfonso Rodrígues-Baeza, Marcos Flávio Ghizoni
PURPOSE: In high median nerve repairs, thenar muscle reinnervation is impossible because of the long distances over which axons must regenerate. To overcome this obstacle, we propose transferring the abductor digiti quinti motor branch (ADQMB) to the thenar branch of the median nerve (TBMN). METHODS: We used 10 embalmed hands for anatomical and histological studies. Thereafter, 5 patients with a high median nerve injury underwent surgical reconstruction within 8 months of their accident and were followed for at least 10 months after surgery (mean, 13...
September 23, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28947332/polish-version-of-the-patient-rated-ulnar-nerve-evaluation-in-preoperative-patients-translation-and-psychometric-testing
#6
Mateusz Koziej, Marek Trybus, Anna Mydłowska, Katarzyna Piątek, Marta Banach, Mateusz Hołda
STUDY DESIGN: Cross-sectional design. INTRODUCTION: This study examined the translated English to Polish version of the Patient-Rated Ulnar Nerve Evaluation (PRUNE) for its internal consistency, test-retest reliability, and construct validity. METHODS: During the first assessment validity testing, a total of 39 consecutive patients with cubital tunnel syndrome completed the PRUNE, Michigan Hand Outcome Questionnaire, Disabilities of the Arm, Shoulder, and Hand questionnaire, and Patient Evaluation Measure in conjunction with the grip and key pinch tests and pain score (by Visual Analogue Scale)...
September 22, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28803691/effectiveness-of-lavendula-stoechas-essential-oil-in-treatment-of-mild-to-moderate-carpal-tunnel-syndrome-a-randomized-controlled-trial
#7
Bina Eftekharsadat, Peyman Roomizadeh, Shervin Torabi, Fariba Heshmati-Afshar, Fatemeh Jahanjoo, Arash Babaei-Ghazani
STUDY DESIGN: Randomized controlled trial. INTRODUCTION: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity. To date, no previous study has evaluated the efficacy of topical Lavendula stoechas (Lavender) oil in CTS patients. PURPOSE OF THE STUDY: To investigate the effectiveness of topical Lavender essential oil in pain intensity, isometric pinch strength, electrophysiological features, and functional status of patients with mild to moderate CTS...
August 10, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28760122/comparison-of-two-medial-epicondylectomy-techniques-in-cubital-tunnel-syndrome
#8
Meriç Çırpar, Cem Seyfi Özüak, Birhan Oktaş, İbrahim Deniz Canbeyli
OBJECTIVES: This study aims to compare partial medial epicondylectomy (PMe) and distal medial epicondylectomy (DMe) techniques in terms of sensory and motor improvements, functional results and complications. PATIENTS AND METHODS: The study included a total of 59 cubital tunnel syndrome patients (37 males, 22 females; mean age 42.3 years; range 23 to 80 years). Of the patients, DMe was applied on 30 and PMe was applied on 29. Patients were evaluated with Wilson Krout scores, Semmes-Weinstein Monofilament (SWM) test, and grip and pinch strength measurements preoperatively and at postoperative third, sixth, and 12th months...
August 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/28720007/extensor-pollicis-brevis-spiral-tenodesis-for-combined-metacarpophalangeal-instability-and-trapeziometacarpal-arthritis
#9
Mark Henry
BACKGROUND: In more advanced stages of trapeziometacarpal arthritis, the thumb metacarpal may develop an adduction contracture, leading to secondary hyperextension instability of the metacarpophalangeal joint. Following trapeziometacarpal arthroplasty, uncorrected substantial metacarpophalangeal hyperextension may contribute to ongoing Z-collapse deformity, weakness of pinch and grip, and patient perception of diminished function. METHODS: We prospectively analyzed a consecutive case series of 55 trapeziometacarpal arthroplasty patients (mean age, 60 years; 7 males) who received simultaneous extensor pollicis brevis spiral tenodesis for thumb metacarpophalangeal hyperextension of at least 50°...
March 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28716587/botulinum-neurotoxin-a-promotes-functional-recovery-after-peripheral-nerve-injury-by-increasing-regeneration-of-myelinated-fibers
#10
Stefano Cobianchi, Jessica Jaramillo, Siro Luvisetto, Flaminia Pavone, Xavier Navarro
The injection of safe doses of botulinum neurotoxin A (BoNT/A) have been reported to be useful for the treatment of neuropathic pain, but it is still unknown how functional recovery is induced after peripheral nerve injury. We evaluated the effects of intranerve application of BoNT/A, on regeneration and sensorimotor functional recovery in partial and complete peripheral nerve injuries in the mouse. After sciatic nerve crush (SNC) and intranerve delivery of BoNT/A (15pg), axonal regeneration was measured by nerve pinch test at different days...
September 17, 2017: Neuroscience
https://www.readbyqxmd.com/read/28689390/usefulness-of-end-to-side-bridging-anastomosis-of-sural-nerve-to-tibial-nerve-an-experimental-research
#11
Soner Civi, Emre Durdag, Murat Hamit Aytar, Ozgur Kardes, Figen Kaymaz, Sukru Aykol
OBJECTIVE: Repair of sensorial nerve defect is an important issue on peripheric nerve surgery. The aim of the present study was to determine the effects of sensory-motor nerve bridging on the denervated dermatomal area, in rats with sensory nerve defects, using a neural cell adhesion molecule (NCAM). METHODS: We compared the efficacy of end-to-side (ETS) coaptation of the tibial nerve for sural nerve defect repair, in 32 Sprague-Dawley rats. Rats were assigned to 1 of 4 groups: group A was the sham operated group, group B rats had sural nerves sectioned and buried in neighboring muscles, group C experienced nerve sectioning and end-to-end (ETE) anastomosis, and group D had sural nerves sectioned and ETS anastomosis was performed using atibial nerve bridge...
July 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28655474/quantification-of-hand-function-by-power-grip-and-pinch-strength-force-measurements-in-ulnar-nerve-lesion-simulated-by-ulnar-nerve-block
#12
Nikolaus Johannes Wachter, Martin Mentzel, Gert D Krischak, Joachim Gülke
INTRODUCTION: In the assessment of hand and upper limb function, grip strength is of the major importance. The measurement by dynamometers has been established. PURPOSE OF THE STUDY: In this study, the effect of a simulated ulnar nerve lesion on different grip force measurements was evaluated. METHODS: In 25 healthy volunteers, grip force measurement was done by the JAMAR dynamometer (Fabrication Enterprises Inc, Irvington, NY) for power grip and by a pinch strength dynamometer for tip pinch strength, tripod grip, and key pinch strength...
June 24, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28648328/functional-outcomes-of-thumb-trapeziometacarpal-arthrodesis-with-a-locked-plate-versus-ligament-reconstruction-and-tendon-interposition
#13
K J Hippensteel, Ryan Calfee, Agnes Z Dardas, Richard Gelberman, Daniel Osei, Lindley Wall
PURPOSE: To compare standardized functional and patient-reported early outcomes following trapeziometacarpal arthrodesis (TMA) using a locking cage plate construct with trapezial excision, ligament reconstruction, and tendon interposition (LRTI). METHODS: This prospective cohort enrolled 50 consecutive patients with trapeziometacarpal osteoarthritis undergoing TMA or LRTI. Demographic data, objective measurements, Sollerman function testing, and patient-reported outcomes were collected before surgery and at various time intervals up to 12 months after surgery...
September 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28604191/establishing-a-new-appropriate-intramuscular-injection-site-in-the-deltoid-muscle
#14
Yukari Nakajima, Kanae Mukai, Kana Takaoka, Toshiko Hirose, Keiko Morishita, Takuya Yamamoto, Yuka Yoshida, Tamae Urai, Toshio Nakatani
It is becoming increasingly important for clinicians to identify a safer intramuscular (IM) injection site in the deltoid muscle because of possible complications following the vaccine administration of IM injections. We herein examined 4 original IM sites located on the perpendicular line through the mid-acromion to establish a safer IM injection site. Thirty healthy volunteers participated in this study and the distances from our 4 IM sites to some anatomical landmarks on their left arms were measured. Ultrasonography (US) was also performed to measure the thickness of the deltoid muscle and identify the posterior circumflex humeral artery (PCHA) along the course of the axillary nerve...
September 2, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28549364/-an-option-to-restore-ulnar-intrinsic-muscles-when-the-anterior-interosseus-nerve-is-not-available
#15
G A González-Trevizo
BACKGROUND: The peripheral nerve injuries are devastating for the patient; the classic reconstructive options are the Nerve Graft and Tendon Transfers. Lately the Nerve Transfers are being used more and more broadly. They are an excellent option on early injuries and when the motor plate is still alive. The advantages are numerous, because the functional recovery is much better. METHODS AND RESULTS: We report the case of a patient who sustained and injury on the median and ulnar nerve, so the EDQ and ECU branches were used to restore the Ulnar Intrinsic Function...
November 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28430708/the-somatosensory-evoked-potential-in-reaction-time-is-gated-and-elicited-earlier-when-the-motor-response-to-a-somatosensory-cue-is-faster
#16
Koichi Hiraoka, Chisato Kori, Kana Sato
The aim of this study was to investigate whether the somatosensory-evoked potential (SEP) is gated and elicited earlier when a motor response to a somatosensory stimulus is faster. In healthy humans, the left index finger and thumb were pinched in response to a somatosensory stimulus administered over the left median nerve. The SEP elicited by this stimulus when producing a fast motor response was compared with that when producing a slow motor response. The amplitudes of N18 and frontal P40 when producing a fast motor response were smaller than those when producing a slow motor response...
May 24, 2017: Neuroreport
https://www.readbyqxmd.com/read/28412189/mean-5-year-follow-up-for-suture-button-suspensionplasty-in-the-treatment-of-thumb-carpometacarpal-joint-osteoarthritis
#17
Jeffrey Yao, Andre Eu-Jin Cheah
PURPOSE: Suture button suspensionplasty (SBS) has been used to treat thumb carpometacarpal joint osteoarthritis (CMC joint OA). Although promising short-term outcomes have been reported, no outcomes beyond 4 years have been published. The aim of this article is to report intermediate outcomes of SBS. METHODS: We reviewed the charts of 14 patients who underwent 16 SBS procedures for symptomatic thumb CMC joint OA. We recorded demographic data, preoperative Eaton stage, length of follow-up, Quick-Disabilities of the Arm, Shoulder, and Hand questionnaire scores, as well as pinch strength, grip strength, range of motion, and metacarpal subsidence...
July 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28411350/acute-appendicitis-somatosensory-disturbances-head-zones-and-the-differential-diagnosis-of-anterior-cutaneous-nerve-entrapment-syndrome-acnes
#18
Rudi M H Roumen, Wouter Vening, Rosanne Wouda, Marc M Scheltinga
BACKGROUND: Anterior cutaneous nerve entrapment syndrome (ACNES) is a neuropathic abdominal wall pain syndrome typically characterized by locally altered skin sensations. On the other hand, visceral disease may also be associated with similar painful and altered skin sensations ("Head zones"). Aim of the study was to determine if patients with acute appendicitis demonstrated somatosensory disturbances in the corresponding right lower quadrant Head zone. METHODS: The presence of somatosensory disturbances such as hyperalgesia, hypoesthesia, altered cool perception, or positive pinch test was determined in 100 patients before and after an appendectomy...
June 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28400666/limited-incision-carpal-tunnel-release
#19
Sunil Gaba, Sandeep Bhogesha, Onkar Singh
BACKGROUND: Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy. Limited incision techniques for carpal tunnel release are gaining popularity. The main advantages of these techniques are less scar load, less pillar pain, shorter recovery, and return-to-work time. However, the completeness of release, and risk of neurovascular injury are always a concern. We devised a method of limited incision release with two mini-incisions and use of nasal speculum and a probe...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28383292/corticomotor-excitability-effects-of-peripheral-nerve-electrical-stimulation-to-the-paretic-arm-in-stroke
#20
RANDOMIZED CONTROLLED TRIAL
Hao Liu, Stephanie S Y Au-Yeung
OBJECTIVE: This study aimed to examine the corticomotor excitability changes after peripheral nerve electrical stimulation (PNS) on the stroke-impaired arm. DESIGN: This randomized cross-over study included 32 subjects with chronic stroke. They received a 1-hr PNS or placebo PNS by random order to the ulnar and radial nerves of the paretic arm in separate sessions. The primary outcome was excitability of the corticospinal projections for the contralateral first dorsal interosseous hand muscle in terms of slope of the recruitment curve, peak motor-evoked potential amplitude, and duration of the cortical silent period, measured with transcranial magnetic stimulation on both cerebral hemispheres...
October 2017: American Journal of Physical Medicine & Rehabilitation
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