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Ma H, Zhong Z, Zhang Z, Wang Y, Zhu Z, Qiu Y, Li F. [Binocular loupe assisted mini-lateral and medial incisions in lateral position for release of elbow stiffness]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2024; 38:140-144. [PMID: 38385224 PMCID: PMC10882232 DOI: 10.7507/1002-1892.202311017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Objective To analyze the effectiveness of binocular loupe assisted mini-lateral and medial incisions in lateral position for the release of elbow stiffness. Methods The clinical data of 16 patients with elbow stiffness treated with binocular loupe assisted mini-internal and external incisions in lateral position release between January 2021 and December 2022 were retrospectively analyzed. There were 9 males and 7 females, aged from 19 to 57 years, with a median age of 33.5 years. Etiologies included olecranon fracture in 6 cases, elbow dislocation in 4 cases, medial epicondyle fracture in 2 cases, radial head fracture in 4 cases, terrible triad of elbow joint in 2 cases, supracondylar fracture of humerus in 1 case, coronoid process fracture of ulna in 1 case, and humerus fracture in 1 case, with 5 cases presenting a combination of two etiologies. The duration of symptoms ranged from 5 to 60 months, with a median of 8 months. Preoperatively, 12 cases had concomitant ulnar nerve numbness, and 6 cases exhibited ectopic ossification. The preoperative range of motion for elbow flexion and extension was (58.63±22.30)°, the visual analogue scale (VAS) score was 4.3±1.6, and the Mayo score was 71.9±7.5. Incision lengths for both lateral and medial approaches were recorded, as well as the occurrence of complications. Clinical outcomes were evaluated using Mayo scores, VAS scores, and elbow range of motion both preoperatively and postoperatively. Results The lateral incision lengths for all patients ranged from 3.0 to 4.8 cm, with an average of 4.1 cm. The medial incision lengths ranged from 2.4 to 4.2 cm, with an average of 3.0 cm. The follow-up duration ranged from 6 to 19 months and a mean of 9.2 months. At last follow-up, 1 patient reported moderate elbow joint pain, and 3 cases exhibited residual mild ulnar nerve numbness. The other patients had no complications such as new heterotopic ossification and ulnar nerve paralysis, which hindered the movement of elbow joint. At last follow-up, the elbow range of motion was (130.44±9.75)°, the VAS score was 1.1±1.0, and the Mayo score was 99.1±3.8, which significantly improved when compared to the preoperative ones ( t=-12.418, P<0.001; t=6.419, P<0.001; t=-13.330, P<0.001). Conclusion The binocular loupe assisted mini-lateral and medial incisions in lateral position integrated the advantages of traditional open and arthroscopic technique, which demonstrated satisfying safety and effectivity for the release of elbow contracture, but it is not indicated for patients with posterior medial heterolateral heterotopic ossification.
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Affiliation(s)
- Hongru Ma
- Department of Orthopedics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing Jiangsu, 210008, P. R. China
| | - Zhenjia Zhong
- Department of Orthopedics, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong, 510245, P. R. China
| | - Zitao Zhang
- Department of Orthopedics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing Jiangsu, 210008, P. R. China
| | - Yichong Wang
- Department of Orthopedics, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong, 510245, P. R. China
| | - Zezhang Zhu
- Department of Orthopedics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing Jiangsu, 210008, P. R. China
| | - Yong Qiu
- Department of Orthopedics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing Jiangsu, 210008, P. R. China
| | - Fengfeng Li
- Department of Orthopedics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing Jiangsu, 210008, P. R. China
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Fulceri F, Marinelli C, Ghelarducci G, Nucci AM, Poggetti A, Ryskalin L, Gesi M. Early post-surgical rehabilitation and functional outcomes of a traumatic ulnar nerve injury: a pediatric case report. Front Neurol 2024; 15:1351407. [PMID: 38385043 PMCID: PMC10879349 DOI: 10.3389/fneur.2024.1351407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/24/2024] [Indexed: 02/23/2024] Open
Abstract
Background Peripheral nerve injuries (PNIs) of the upper limb are very common events within the pediatric population, especially following soft tissue trauma and bone fractures. Symptoms of brachial plexus nerve injuries can differ considerably depending on the site and severity of injury. Compared to median and radial nerves, the ulnar nerve (UN) is the most frequently and severely injured nerve of the upper extremity. Indeed, due to its peculiar anatomical path, the UN is known to be particularly vulnerable to traumatic injuries, which result in pain and substantial motor and sensory disabilities of the forearm and hand. Therefore, timely and appropriate postoperative management of UN lesions is crucial to avoid permanent sensorymotor deficits and claw hand deformities leading to lifelong impairments. Nevertheless, the literature regarding the rehabilitation following PNIs is limited and lacks clear evidence regarding a solid treatment algorithm for the management of UN lesions that ensures full functional recovery. Case presentation The patient is a 11-year-old child who experienced left-hand pain, stiffness, and disability secondary to a domestic accident. The traumatic UN lesion occurred about 8 cm proximal to Guyon's canal and it was surgically treated with termino-terminal (end-to-end) neurorrhaphy. One month after surgery, the patient underwent multimodal rehabilitative protocol and both subjective and functional measurements were recorded at baseline (T0) and at 3- (T1) and 5-month (T2) follow-up. At the end of the rehabilitation protocol, the patient achieved substantial reduction in pain and improvement in quality of life. Of considerable interest, the patient regained a complete functional recovery with satisfactory handgrip and pinch functions in addition with a decrease of disability in activities of daily living. Conclusion A timely and intensive rehabilitative intervention done by qualified hand therapist with previous training in the rehabilitation of upper limb neuromuscular disorders is pivotal to achieve a stable and optimal functional recovery of the hand, while preventing the onset of deformities, in patients with peripheral nerve injuries of the upper limb.
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Affiliation(s)
- Federica Fulceri
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Chiara Marinelli
- Center for Rehabilitative Medicine “Sport and Anatomy”, University of Pisa, Pisa, Italy
| | - Giulia Ghelarducci
- Center for Rehabilitative Medicine “Sport and Anatomy”, University of Pisa, Pisa, Italy
| | - Anna Maria Nucci
- Department of Pediatric Orthopedics and Traumatology, Azienda Ospedaliero Universitaria, Meyer Children Hospital, Florence, Italy
| | - Andrea Poggetti
- Hand and Reconstructive Microsurgery Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Larisa Ryskalin
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- Center for Rehabilitative Medicine “Sport and Anatomy”, University of Pisa, Pisa, Italy
| | - Marco Gesi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- Center for Rehabilitative Medicine “Sport and Anatomy”, University of Pisa, Pisa, Italy
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Chang YC, Lay IS, Tu CH, Lee YC. Increased Risk of Coronary Artery Disease in People with Diagnosis of Neuromuscular Disorders: A Nationwide Retrospective Population-Based Case-Control Study. Diagnostics (Basel) 2024; 14:199. [PMID: 38248075 PMCID: PMC10814733 DOI: 10.3390/diagnostics14020199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/03/2024] [Accepted: 01/12/2024] [Indexed: 01/23/2024] Open
Abstract
The existing literature has explored carpal tunnel syndrome (CTS) and determined that it could be a risk for coronary artery disease (CAD), but there has been little research comparing the relevance of CAD with other neuromuscular disorders (NMDs) to CTS. This case-control study explored the association between CTS, stenosing tenosynovitis (ST), and ulnar side NMDs and CAD. The study utilized data from Taiwan's National Health Insurance Research Database, focusing on health insurance claims. Between January 2000 and December 2011, we employed the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes to identify 64,025 CAD patients as the case group. The control group consisted of an equal number of individuals without CAD, matched for age, sex, and index year of CAD. Logistic regression analysis was employed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for each variable. Multivariate analysis, after adjusting for sociodemographic factors and comorbidities, revealed a significantly higher likelihood of a previous diagnosis of CTS in the CAD group compared to the comparison control group. However, neither ST nor the ulnar side NMDs had any statistical significance. These results indicated that median nerve injury, rather than other NMDs, may uniquely serve as a predisposing factor of CAD.
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Affiliation(s)
- Yi-Chuan Chang
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung 404328, Taiwan;
- Department of Chinese Medicine, China Medical University Beigang Hospital, Yunlin 651012, Taiwan;
| | - Ing-Shiow Lay
- Department of Chinese Medicine, China Medical University Beigang Hospital, Yunlin 651012, Taiwan;
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung 404328, Taiwan
| | - Cheng-Hao Tu
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung 404328, Taiwan;
| | - Yu-Chen Lee
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung 404328, Taiwan;
- School of Chinese Medicine, China Medical University, Taichung 404328, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404328, Taiwan
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Siriwittayakorn W, Fongsri W, Watatham K, Atthakorn W. The Isolated Motor Branch of the Ulnar Nerve Injury During Open Carpal Tunnel Release. Cureus 2023; 15:e43601. [PMID: 37719604 PMCID: PMC10504059 DOI: 10.7759/cureus.43601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 09/19/2023] Open
Abstract
A 76-year-old woman underwent open carpal tunnel release (OCTR). She had sudden sharp shooting pain in her hand, in the mid-palmar area, during the operation. She was then unable to abduct or adduct her thumb and fingers after surgery. She had no sensation impairment of the ulnar digit. The nerve conduction study confirmed a complete transection of the motor branch of the ulnar nerve (MUN). The MUN was repaired, and the patient recovered her intrinsic hand muscle function two years after the operation. The mechanism of injury, related anatomy and potentially dangerous area, clinical findings, management, and prevention are discussed.
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Affiliation(s)
| | - Warangkana Fongsri
- Faculty of Medicine, Department of Orthopaedics, Prince of Songkhla University, Songkhla, THA
| | - Kraisong Watatham
- Faculty of Medicine, Department of Orthopaedics, Prince of Songkhla University, Songkhla, THA
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Muacevic A, Adler JR, Aljohani S, Qutub L, Alghamdi MF, Kutub L, Kutub H. Ulnar Nerve Injury Following Open Carpal Tunnel Release: A Case Report. Cureus 2022; 14:e32477. [PMID: 36644096 PMCID: PMC9835856 DOI: 10.7759/cureus.32477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
Carpal tunnel syndrome (CTS) is one of the most common peripheral nerve diseases. It is managed medically and if not, resolved by surgical procedure. Decompression of the carpal tunnel is considered the definitive treatment. There are multiple complications after this procedure, which can be classified into three categories: (I) persistent, (II) recurrent, or (III) new symptoms, and ulnar nerve palsy after decompression of the carpal tunnel is a rare complication. In this study, we present a case of carpal tunnel decompression, which was complicated by ulnar nerve palsy, which exacerbated a pre-existing chronic ulnar nerve injury. We also explore the possible causes that may have led to this outcome.
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Sun J, Shan J, Meng L, Liu T, Wang E, Jia G. Rotation of both X- and Y-axes is a predictive confounder of ulnar nerve injury and open reduction in pediatric lateral flexion supracondylar humeral fractures: A retrospective cohort study. Front Pediatr 2022; 10:962521. [PMID: 36268037 PMCID: PMC9577068 DOI: 10.3389/fped.2022.962521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/28/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Rotation of the distal fragment often occurs in flexion-type supracondylar humerus fractures (SCHFs), potentially leading to ulnar nerve injury (UNI) and open reduction. We analyzed the correlation between the rotations and UNI or open reduction and then assessed the risk factors associated with these rotations. METHODS Data of Wilkins type III lateral flexion SCHFs were collected over a 10-year time period (1 January 2012 to 31 December 2021) in Children's Hospital of Fudan University Anhui Hospital. We defined the rotation of the distal fragment on the coordinate axis as two types, IIIA (X-axis rotation) and IIIB (the rotation of both X- and Y-axes) on X-ray radiography. Demographic data, the incidence of the two-type rotation, odds ratios (ORs) of UNI and open reduction, and risk factors of the rotation of both X- and Y-axes were analyzed. RESULTS Totally, 152 patients were found (50 with IIIA vs. 102 IIIB). The UNI rate was 13%, and the open reduction rate was 22%. The UNI rate of the IIIB was five-fold higher than that of the IIIA [OR, 5.143; 95% confidence interval (CI), 1.414-23.125; p = 0.019], and the open reduction rate of the IIIB was nearly five-fold higher than that of the IIIA (OR, 4.729, 95%CI, 1.584-14.495; p = 0.003). In these two types, patients with UNI had a higher risk of open reduction than those without UNI (OR, 9.816; 95%CI, 3.503-27.508; p = 0.001). In the multiple regression analysis, a high level of fracture was identified as a risk factor for the rotation of both X- and Y-axes. CONCLUSION Type IIIB lateral flexion-type SCHFs have higher rates of UNI and open reduction, and a high level of fracture is a risk factor associated with this type.
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Affiliation(s)
- Jun Sun
- Children's Hospital of Anhui Province, Hefei, China
| | - Jing Shan
- Children's Hospital of Anhui Province, Hefei, China
| | - Lian Meng
- Children's Hospital of Anhui Province, Hefei, China
| | - Tianjing Liu
- Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Enbo Wang
- Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Guoqiang Jia
- Children's Hospital of Anhui Province, Hefei, China
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Ding W, Li X, Pan J, Zhang P, Yin S, Zhou X, Li J, Wang L, Wang X, Dong J. Repair Method for Complete High Ulnar Nerve Injury Based on Nerve Magnified Regeneration. Ther Clin Risk Manag 2020; 16:155-168. [PMID: 32184608 PMCID: PMC7060778 DOI: 10.2147/tcrm.s237851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/18/2020] [Indexed: 12/04/2022] Open
Abstract
PURPOSE Complete high ulnar nerve injury can cause serious sequelae, including residual sensation and loss of movement and especially dysfunction of the intrinsic muscles of the hand. As a solution to treat complete high ulnar nerve injury, we proposed a new repair method for ulnar nerve injury based on nerve-magnified regeneration. METHODS Twenty-two patients with complete division of the ulnar nerve at a high level who were treated from May 2013 to December 2016 were divided into two groups. The proposed repair method for complete high ulnar nerve injury was performed in group I (11 patients), while the traditional repair method, ie, repair of the original injury site of the ulnar nerve, was used in group II (11 patients). RESULTS The results showed no significant difference in the mean sensory scores assigned by the Highet-Zachary scheme (the Highet Scale) between the two groups. The mean Highet Scale score of muscle strength for the first dorsal interosseus muscle was significantly better in group I than that in group II (p=0.010). In group I, 10 of 11 patients were graded as M4 or M5. Grip strength, pinch strength, and the Disabilities of the Arm, Shoulder, and Hand (DASH) score were significantly better in group I than those in group II (p<0.01). CONCLUSION Therefore, this method for complete high ulnar nerve injury based on nerve-magnified regeneration can shorten the path of motor nerve regeneration, effectively reduce atrophy of the intrinsic muscles of the hand, and provide better hand function.
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Affiliation(s)
- Wenquan Ding
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
| | - Xueyuan Li
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
| | - Jiadong Pan
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
| | - Peixun Zhang
- Department of Trauma Orthopedics, Peking University People’s Hospital, Beijing100044, People’s Republic of China
| | - Shanqing Yin
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
| | - Xianting Zhou
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
| | - Junjie Li
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
| | - Liping Wang
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
- School of Pharmacy and Medical Sciences, and UniSA Cancer Research Institute, University of South Australia, Adelaide, SA5001, Australia
| | - Xin Wang
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
| | - Jianghui Dong
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
- School of Pharmacy and Medical Sciences, and UniSA Cancer Research Institute, University of South Australia, Adelaide, SA5001, Australia
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Cloete D, Lahri S. Ulnar Nerve Injury and Froment's Test: A Case Report. Cureus 2019; 11:e6335. [PMID: 31929954 PMCID: PMC6952870 DOI: 10.7759/cureus.6335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Traumatic, peripheral nerve injuries can be easily missed in the emergency department. The attending physician needs to maintain a high index of suspicion when reviewing patients with extremity injuries. We present a case of a stable, 28-year-old male sustaining penetrating trauma to his right forearm with resultant, isolated ulnar nerve transection. Clinical findings and related anatomy are discussed pertaining to this patient's injury, with specific reference to Froment's test. This is a useful clinical adjunct when reviewing potential ulnar nerve injuries, demonstrating disruption of specific motor innervation to the thumb when such pathology exists. As a result, compensatory hyperflexion occurs with attempted thumb adduction, due to intact median nerve innervation of flexor pollicis longus. Early recognition of this pathology, whether isolated or concomitant, allows for early appropriate referral and improved patient outcomes.
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Affiliation(s)
- David Cloete
- Emergency Medicine, University of Stellenbosch, Cape Town, ZAF
| | - Sa'ad Lahri
- Emergency Medicine, Tygerberg Hospital, Cape Town, ZAF
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Abstract
BACKGROUND Sparse documentation of Galeazzi fracture with associated nerve injury exists in the medical literature. The purpose of this report is to review the available literature in regard to incidence, nerve injury type, treatment strategies, and expected outcomes. METHODS We present a classic Galeazzi fracture dislocation with associated complete ulnar nerve transection injury at the level of the wrist. After rigid internal bony stabilization, allograft nerve repair was performed. The patient's presentation, operative management, recovery, and a thorough literature review are discussed. RESULTS Fracture union was attained with near full wrist and elbow range of motion. Despite lack of ulnar nerve function return, the patient was able to resume manual labor occupation. CONCLUSIONS Despite its close proximity to the dislocating distal radioulnar joint (DRUJ), thorough review reveals rare associated ulnar nerve palsy. If there is suspicion for nerve injury in the setting of open DRUJ dislocation, the nerve should be explored to identify possible entrapment or transection. Literature supports likely return of nerve function in cases of intact nerve; however, management of nerve transection remains debatable.
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Affiliation(s)
- Paul Roettges
- University of Arizona College of Medicine, Tucson, USA,Paul Roettges, University of Arizona College of Medicine, 1501 N. Campbell Avenue, Tucson, AZ 85724-5018, USA.
| | - Tolga Turker
- University of Arizona College of Medicine, Tucson, USA
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Rostami HR, Khayatzadeh Mahany M, Yarmohammadi N. Feasibility of the modified constraint-induced movement therapy in patients with median and ulnar nerve injuries: a single-subject A-B-A design. Clin Rehabil 2014; 29:277-84. [PMID: 25009201 DOI: 10.1177/0269215514542357] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The present study aimed to determine feasibility and efficacy of the modified constraint-induced movement therapy on upper limb function in patients with median and ulnar nerve injuries. DESIGN Single subject, A1-B-A2 design. SETTING Occupational therapy outpatient clinic. SUBJECTS A convenience sample including three patients with median and ulnar nerve injuries. INTERVENTIONS Modified constraint-induced movement therapy as follows: an intensive practice with affected hand for one hour daily, five days per week, for four weeks while the healthy hand was immobilised using a splint during waking hours. MAIN MEASURES Semmes-Weinstein monofilaments, Box and block test, and Disabilities of the arm, shoulder, and hand questionnaire. A blinded assessor administered the assessments in a random order across sessions, six times for the baseline phase (A1), four times for the intervention phase (B), and four times for the withdrawal phase (A2). RESULTS Touch perception did not occur after the intervention phase at the pulp of the index and little fingers. Manual dexterity and motor ability significantly improved (Box and block change scores exceeded the minimal detectable change of 5.5 blocks), as well performance in activities of daily living during real life (Disabilities of the arm, shoulder, and hand questionnaire change scores exceeded the clinically important change value of 20.9 points). These improvements maintained and even enhanced during the withdrawal phase. CONCLUSIONS Modified constraint-induced movement therapy is a feasible and useful adjunct to rehabilitation of the patients with median and ulnar nerve injuries that warrants further research.
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Affiliation(s)
- Hamid Reza Rostami
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Khayatzadeh Mahany
- Department of Occupational Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Poduval M, Kanagasabai R, Abraham VT, Marimuthu C. Unusual presentation of a radial neck fracture in a child. Indian J Orthop 2013; 47:204-6. [PMID: 23682185 PMCID: PMC3654473 DOI: 10.4103/0019-5413.108923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Fracture of the radial neck are uncommon injuries. In children, they may present as radial neck fractures, a components of forearm fracture dislocations, or as isolated fracture dislocations. Here, we present an unusual and previously undescribed variant of radial neck fracture with dislocation of the radial head to the medial side and ulnar nerve injury. The fracture dislocation was openly reduced and fixed with a small fragment plate. The fracture healed with some loss of rotational movements. At short followup of 6 months patient had useful elbow function but ulnar nerve did not recover.
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Affiliation(s)
- Murali Poduval
- Department of Orthopaedics, Jawaharlal Institute of Post Graduate Medical Education and Research, Kalapet, Puducherry, India,Address for correspondence: Dr. Murali Poduval, Department of Orthopaedics, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry - 605 006, India. E-mail:
| | - R Kanagasabai
- Department of Orthopaedics Pondicherry, Institute of Medical Sciences, Kalapet, Puducherry, India
| | | | - Chandrasekharan Marimuthu
- Department of Orthopaedics, Jawaharlal Institute of Post Graduate Medical Education and Research, Kalapet, Puducherry, India
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