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Sample records for proximal forearm presenting

  1. Intramuscular myxoid lipoma in the proximal forearm presenting as an olecranon mass with superficial radial nerve palsy: a case report

    Directory of Open Access Journals (Sweden)

    Hildebrand Kevin A

    2011-07-01

    Full Text Available Abstract Background Extremity lipomas may occur in any location, including the proximal forearm. We describe a case of a patient with an intramuscular lipoma presenting as an unusual posterior elbow mass. Case presentation We discuss the case of a 57-year-old Caucasian man who presented with a tender, posterior elbow mass initially diagnosed as chronic olecranon bursitis. A minor sensory disturbance in the distribution of the superficial radial nerve was initially thought to be unrelated, but was likely caused by mass effect from the lipoma. No pre-operative advanced imaging was obtained because the diagnosis was felt to have already been made. At the time of surgery, a fatty mass originating in the volar forearm muscles was found to have breached the dorsal forearm fascia and displaced the olecranon bursa. Tissue diagnosis was made by histopathology as a myxoid lipoma with no aggressive features. Post-operative recovery was uneventful. Conclusion We present a case of an unusual elbow mass presenting with symptoms consistent with chronic olecranon bursitis, a relatively common condition. The only unexplained pre-operative finding was the non-specific finding of a transient superficial radial nerve deficit. We remind clinicians to be cautious when diagnosing soft tissue masses in the extremities when unexplained physical findings are present.

  2. Cast index in predicting outcome of proximal pediatric forearm fractures

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    Hassaan Qaiser Sheikh

    2015-01-01

    Conclusion: Cast index is useful in predicting redisplacement of manipulated distal forearm fractures. We found that in proximal half forearm fractures it is difficult to achieve a CI of <0.8, but increased CI does not predict loss of position in these fractures. We therefore discourage the use of CI in proximal half forearm fractures.

  3. Dual pathology proximal median nerve compression of the forearm.

    LENUS (Irish Health Repository)

    Murphy, Siun M

    2013-12-01

    We report an unusual case of synchronous pathology in the forearm- the coexistence of a large lipoma of the median nerve together with an osteochondroma of the proximal ulna, giving rise to a dual proximal median nerve compression. Proximal median nerve compression neuropathies in the forearm are uncommon compared to the prevalence of distal compression neuropathies (eg Carpal Tunnel Syndrome). Both neural fibrolipomas (Refs. 1,2) and osteochondromas of the proximal ulna (Ref. 3) in isolation are rare but well documented. Unlike that of a distal compression, a proximal compression of the median nerve will often have a definite cause. Neural fibrolipoma, also called fibrolipomatous hamartoma are rare, slow-growing, benign tumours of peripheral nerves, most often occurring in the median nerve of younger patients. To our knowledge, this is the first report of such dual pathology in the same forearm, giving rise to a severe proximal compression of the median nerve. In this case, the nerve was being pushed anteriorly by the osteochondroma, and was being compressed from within by the intraneural lipoma. This unusual case highlights the advantage of preoperative imaging as part of the workup of proximal median nerve compression.

  4. Patient-Reported Outcome of Surgical Treatment of Nerve Entrapments in the Proximal Forearm

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    Birgitta Svernlöv

    2011-01-01

    Full Text Available The outcome of decompression for long-standing symptoms of nerve entrapments in the proximal forearm was investigated in a retrospective study of 205 patients using a self-assessment questionnaire, 45 months after the operation. The questionnaire consisted of visual analogue scale recordings of pre- and postoperative pain during rest and activity, questions about remaining symptoms and appreciation of the result and the Disabilities of Arm, Shoulder and Hand form (DASH. Altogether, 59% of the patients were satisfied, 58% considered themselves improved, and 3% as being entirely relieved of all symptoms. Pain decreased significantly (=0.001. There was a significant correlation between preoperative duration and patient perceived post-operative pain. Preoperative pain was a chief complaint, and pain reduction appears to be the principal gain of the operation. Although the majority of the patients benefited from the operation, a substantial proportion was not satisfied. There is apparently room for improvement of the diagnostic and surgical methods applied in this study.

  5. Treatment of forearm fractures

    National Research Council Canada - National Science Library

    Macintyre, N R; Ilyas, A M; Jupiter, J B

    2009-01-01

    Fractures of the forearm represent common injuries. Understanding the anatomy and function of the radius, ulna, interosseous membrane, proximal and distal radioulnar joints is critical to appropriate management...

  6. Morphology and morphometry of the ulnar head of the pronator teres muscle in relation to median nerve compression at the proximal forearm.

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    Gurses, I A; Altinel, L; Gayretli, O; Akgul, T; Uzun, I; Dikici, F

    2016-12-01

    The pronator syndrome is a rare compression neuropathy of the median nerve. Ulnar head of the pronator teres muscle may cause compression at proximal forearm. Detailed morphologic and morphometric studies on the anatomy of the ulnar head of pronator teres is scarce. We dissected 112 forearms of fresh cadavers. We evaluated the morphology and morphometry of the ulnar head of pronator teres muscle. The average ulnar head width was 16.3±8.2mm. The median nerve passed anterior to the ulnar head at a distance of 50.4±10.7mm from the interepicondylar line. We classified the morphology of the ulnar head into 5 types. In type 1, the ulnar head was fibromuscular in 60 forearms (53.6%). In type 2, it was muscular in 23 forearms (20.5%). In type 3, it was just a fibrotic band in 18 forearms (16.1%). In type 4, it was absent in 9 forearms (8%). In type 5, the ulnar head had two arches in 2 forearms (1.8%). In 80 forearms (71.5%: types 1, 3, and 5), the ulnar head was either fibromuscular or a fibrotic band. Although the pronator syndrome is a rare compression syndrome, the ulnar head of pronator teres is reported as the major cause of entrapment in the majority of the cases. The location of the compression of the median nerve in relation to the ulnar head of pronator teres muscle and the morphology of the ulnar head is important for open or minimally-invasive surgical treatment. Sectional study. Basic science study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  7. Novel Technique for Proximal Bone Anchoring of Penile Prosthesis After Radial Forearm Free Flap Neophallus.

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    Cohen, Andrew J; Bhanvadia, Raj R; Pariser, Joseph J; Hatcher, David M; Gottlieb, Lawrence J; Bales, Gregory T

    2017-07-01

    To describe outcomes of bone anchoring of penile implant in a neophallus with an accompanying video focusing on operative technique and salient tips for surgeons performing these procedures. Penile prosthesis insertion allows individuals with a neophallus to achieve erectile function. Lack of corporal bodies to accommodate cylinders makes anchoring of any prosthesis challenging. Anchoring the device to the pubic bone is one strategy to achieve proximal stabilization. A single-institution, retrospective chart review of 10 neophallus patients undergoing penile prosthesis placement from 2006 to 2015 was done. The pubic symphysis is exposed and corticotomy created for placement of the rear tip extender of the implant using a Stryker TPS bone drill. Anchoring sutures through the corticotomy defect, rear tip, and proximal cylinder seat the implant. The remainder of the implantation procedure mirrors that used in native tissue. The overall perioperative complication rate was 20%, with a mean follow-up of 49 months. Seventy percent of the patients required reoperation, with a mean of 1.4 prosthesis revision surgeries per patient. Primary causes of revision included infection, poor fixation of the rear tip, and prosthesis failure. Despite high revision rates, 80% of the patients have fully functioning prosthesis as of last follow-up. Limitations include retrospective study design and the small patient cohort. Penile prosthesis placement in the neophallus is feasible and effective. A bone-anchored rear tip is an option to provide proximal stabilization. Continued efforts to minimize the need for revisions are ongoing and necessary. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Ultrasonographic diagnostics of pain in the lateral cubital compartment and proximal forearm

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    Anna Dębek

    2012-06-01

    Full Text Available Pain in the lateral compartment of the elbow joint and decreased strength of the extensor muscle constitute a fairly common clinical problem. These symptoms, occurring in such movements as inverting and converting the forearm, pushing, lifting and pulling, mostly affect people who carry out daily activities with an intense use of wrist, e.g. work on computer. Strains in this area often result from persistent overload and degeneration processes of the common extensor tendon and the radial collateral ligament. Similar symptoms resulting from the compression of deep branch of the radial nerve in radial nerve tunnel should be remembered as well. It happens that both conditions occur simultaneously. A proper diagnosis is essential in undertaking an effective treatment. Ultrasonography is a non-invasive method and the application of high-end apparatus with heads of frequencies exceeding 12 MHz allows for a precise evaluation of joint structures, tendons and nerves. In case of the so-called tennis elbow, the examination allows for evaluation of the degree and extent of injury to the radial collateral ligament and common extensor tendon, in addition to the presence of blood vessels in inflicted area. Administration of autologous blood platelets concentrate containing growth factors, used in treatment of tennis elbow, is performed under ultrasound image control conditions. This allows for a precise incision of scar whilst keeping a healthy (unaffected tissue margin to form fine channels enabling the penetration of growth factors. Post-surgery medical check-up allows for the evaluation of treatment effectiveness. In radial nerve tunnel syndrome, the ultrasound examination can reveal abnormalities in the deep branch of the radial nerve and within the anatomical structures adjacent to the nerve in the radial nerve tunnel. Furthermore, the ultrasound examination allows for detection of other articular and extraarticular pathologies, which affect the

  9. The influence of different non-articular proximal forearm orthoses (brace) widths in the wrist extensors muscle activity, range of motion and grip strength in healthy volunteers.

    Science.gov (United States)

    Marcolino, Alexandre Márcio; Fonseca, Marisa de Cássia Registro; Leonardi, Naiara Tais; Barbosa, Rafael Inácio; Neves, Lais Mara Siqueira das; de Jesus Guirro, Rinaldo Roberto

    2016-06-30

    The purpose this study was perform a biomechanical evaluation to compare the influence of commercial models of different non-articular proximal forearm orthoses widths (2.5 cm, 5.5 cm, 7.5 cm and 12.0 cm) in the extensor muscle activation, range of motion and grip strength in healthy subjects. Was analyzed data from extensor carpi radialis, extensor carpi ulnares and extensor digitorum comunis using surface electromyography, simultaneous with a wrist electrogoniometer MiotecTM and a hydraulic dynamometer JamarTM. The sequence of tests with all the commercial orthoses models was randomized. Statistics analyses were performed by linear model with mixed effects. According to our findings the non-articular proximal forearm orthoses (2.5 cm - narrowest) positioned close to lateral epicondyle provided lesser muscle activation on extensor carpi radialis brevis/longus and extensor digitorum comunis, decreased wrist extension and grip strength during submaximal grip task (p< 0.01). A narrow non-articular proximal forearm orthosis positioned close to the lateral epicondyle might decrease the extensor muscle activation and therefore could reduce mechanical stress on its insertion, based on this sample. Clinical studies must be conducted to confirm these findings.

  10. Low Osteoporosis Treatment Initiation Rate in Women after Distal Forearm or Proximal Humerus Fracture: A Healthcare Database Nested Cohort Study.

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    Marie Viprey

    Full Text Available Treatment initiation rates following fragility fractures have often been reported to be low and in recent years numerous programs have been implemented worldwide to increase them. This study aimed at describing osteoporosis (OP treatment initiation in a representative sample of women who were hospitalized for a distal forearm fracture (DFF or proximal humerus fracture (PHF in 2009-2011 in France. The data source was a nationwide sample of 600,000 individuals, extracted from the French National Insurance Healthcare System database. All women aged 50 years and older who were hospitalized for a DFF or PHF between 2009 and 2011 and who had not received any OP treatment in the preceding 12 months were included in a retrospective cohort study. OP treatments initiated during the year following the fracture were analyzed. From 2009 to 2011, 729 women were hospitalized for a DFF or a PHF and 284 were on OP treatment at the time of the fracture occurrence. Among the 445 women who had no prevalent OP treatment, 131 (29.4% received supplementation treatment only (vitamin D and/or calcium and 42 (9.4% received a pharmacologic OP treatment in the year following their fracture. Pharmacological OP treatments included bisphosphonates (n = 21, strontium ranelate (n = 14, hormone replacement therapy (n = 4, or raloxifene (n = 3. General practitioners prescribed 75% of initial OP treatments. Despite the guidelines published in 2006 and the numerous initiatives to promote post-fracture OP treatment, OP treatment initiation rate in women who were hospitalized for a fragility fracture remained low in 2009-2011 in France.

  11. Site-specific advantages in skeletal geometry and strength at the proximal femur and forearm in young female gymnasts.

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    Dowthwaite, Jodi N; Rosenbaum, Paula F; Scerpella, Tamara A

    2012-05-01

    We evaluated site-specific skeletal adaptation to loading during growth, comparing radius (RAD) and femoral neck (FN) DXA scans in young female gymnasts (GYM) and non-gymnasts (NON). Subjects from an ongoing longitudinal study (8-26yr old) underwent annual DXA scans (proximal femur, forearm, total body) and anthropometry, completing maturity and physical activity questionnaires. This cross-sectional analysis used the most recent data meeting the following criteria: gynecological age ≤2.5yr post-menarche; and GYM annual mean gymnastic exposure ≥5.0h/wk in the prior year. Bone geometric and strength indices were derived from scans for 173 subjects (8-17yr old) via hip structural analysis (femoral narrow neck, NN) and similar radius formulae (1/3 and Ultradistal (UD)). Maturity was coded as M1 (Tanner I breast), M2 (pre-menarche, ≥Tanner II breast) or M3 (post-menarche). ANOVA and chi square compared descriptive data. Two factor ANCOVA adjusted for age, height, total body non-bone lean mass and percent body fat; significance was tested for main effects and interactions between gymnastic exposure and maturity. At the distal radius, GYM means were significantly greater than NON means for all variables (padvantages only in M1 and M3; for BMC and buckling ratio, M1 advantages were greatest); 2) 1/3 radius BMC, width, endosteal diameter, cortical cross-sectional area, and section modulus (GYM advantages primarily post-menarche); and 3) UD radius BMC and axial compressive strength (GYM advantages were larger with greater maturity, greatest post-menarche). Maturity-specific comparisons suggested site-specific skeletal adaptation to loading during growth, with greater advantages at the radius versus the proximal femur. At the radius, GYM advantages included greater bone width, cortical cross-sectional area and cortical thickness; in contrast, at the femoral neck, GYM bone tissue cross-sectional area and cortical thickness were greater, but bone width was narrower than

  12. Forearm Fractures in Children

    NARCIS (Netherlands)

    J.W. Colaris (Joost)

    2014-01-01

    markdownabstract__Abstract__ The forearm consists of the radius and ulna which are connected by the proximal and distal radioulnar joints, the interosseous membrane and several muscles. Forearm rotation, consisting of pronation and supination, is a rotatory motion of the radius around the ulna

  13. Proximity and touch sensing using deformable ionic conductors (Conference Presentation)

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    Madden, John D. W.; Dobashi, Yuta; Sarwar, Mirza S.; Preston, Eden C.; Wyss, Justin K. M.; Woehling, Vincent; Nguyen, Tran-Minh-Giao; Plesse, Cedric; Vidal, Frédéric; Naficy, Sina; Spinks, Geoffrey M.

    2017-04-01

    There is increasing interest in creating bendable and stretchable electronic interfaces that can be worn or applied to virtually any surface. The electroactive polymer community is well placed to add value by incorporating sensors and actuators. Recent work has demonstrated transparent dielectric elastomer actuation as well as pressure, stretch or touch sensing. Here we present two alternative forms of sensing. The first uses ionically conductive and stretchable gels as electrodes in capacitive sensors that detect finger proximity. In this case the finger acts as a third electrode, reducing capacitance between the two gel electrodes as it approaches, which can be detected even during bending and stretching. Very light finger touch is readily detected even during deformation of the substrate. Lateral resolution is achieved by creating a sensor array. In the second approach, electrodes placed beneath a salt containing gel are able to detect ion currents generated by the deformation of the gel. In this approach, applied pressure results in ion currents that create a potential difference around the point of contact, leading to a voltage and current in the electrodes without any need for input electrical energy. The mechanism may be related to effects seen in ionomeric polymer metal composites (IPMCs), but with the response in plane rather than through the thickness of the film. Ultimately, these ionically conductive materials that can also be transparent and actuate, have the potential to be used in wearable devices.

  14. Transient forearm conduction block in the median nerve.

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    Watson, Bradley V; Parkes, Anthony W; Brown, John D

    2002-03-01

    We present two cases referred for electrophysiological confirmation of carpal tunnel syndrome (CTS). Initial nerve conduction studies were normal. Approximately 20 min into the examination, both patients developed sensory symptoms and weakness in the distal median nerve territory while the elbow was extended and forearm supinated. Further studies demonstrated complete conduction block across the forearm in the median motor and sensory nerve fibers. When measurable, conduction velocities remained normal or were modestly slow. Complete clinical and electrophysiological recovery occurred within 2 min following forearm pronation, suggesting that dysfunction was probably due to focal transient ischemia. Patients describing increased sensory symptoms during routine electrophysiological assessments for CTS should be investigated to rule out the possibility of a more proximal abnormality. Copyright 2002 Wiley Periodicals, Inc.

  15. Structural properties of 6 forearm ligaments.

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    Werner, Frederick W; Taormina, Jennifer L; Sutton, Levi G; Harley, Brian J

    2011-12-01

    To first determine the structural properties of 6 forearm ligaments and then to create linear and nonlinear analytical models of each ligament from these properties. We nondestructively tested the annular ligament, dorsal and palmar radioulnar ligaments, and the distal, central, and proximal bands of the interosseous ligament from 7 fresh cadaver forearms in a servohydraulic testing apparatus. We performed testing with the bone-ligament-bone constructs positioned corresponding to neutral forearm rotation as well as in 45° of supination and 45° of pronation. Based on a mechanical creep test of each ligament, we computed a linear and nonlinear ligament stiffness value for each ligament. We then compared these computed analytical responses to loading with loading data when each ligament was tested at 1.0 and 0.05 mm/s. We analyzed differences among ligaments and forearm positions using 1-way and 2-way analyses of variance. The stiffnesses for the distal band and the dorsal radioulnar ligament were statistically less when the constructs were positioned in supination compared with neutral forearm rotation. At all forearm positions, the linear stiffness of the central band was greater than that for the distal band of the interosseous ligament, the proximal band of the interosseous ligament, and the dorsal radioulnar and palmar radioulnar ligaments. In neutral forearm rotation, the linear stiffness of the central band was statistically greater than the annular ligament. The experimental loading behavior of each ligament was better modeled by a nonlinear stiffness than a linear one. The central band of the interosseous membrane is the stiffest stabilizing structure of the forearm. Any structure used to replace the central band or other forearm ligaments should demonstrate a nonlinear response to loading. In considering a reconstruction for the forearm, the graft used should have a nonlinear response to loading and be one that is similar to the normal, original ligament

  16. Epidemiology of forearm fractures in adults in Denmark

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Jørgensen, N R; Schwarz, P

    2015-01-01

    National epidemiological studies of forearm fractures are scarce. We examined in- and outpatient rates in Denmark, including anatomical location, surgery, hospitalization ratio, recurrent fractures, and ratio of forearm to hip fractures. This may be useful for triangulation in countries with less....... METHODS: We used national individual patient data on inpatient and outpatient treatment to calculate rates of forearm fractures, taking readmissions into account, with subtables for distal and proximal fractures. We also calculated ratios of forearm to hip fractures that may be useful when imputing...... forearm fracture rates from other administrative sources. In addition, we report the rates of hospital admission and the rates of surgical treatment, allowing readers to extrapolate from the number of admissions or surgical procedures to incidence rates, should their data sources be less comprehensive...

  17. Dynamics of wrist and forearm rotations.

    Science.gov (United States)

    Peaden, Allan W; Charles, Steven K

    2014-08-22

    Human movement generally involves multiple degrees of freedom (DOF) coordinated in a graceful and seemingly effortless manner even though the underlying dynamics are generally complex. Understanding these dynamics is important because it exposes the challenges that the neuromuscular system faces in controlling movement. Despite the importance of wrist and forearm rotations in everyday life, the dynamics of movements involving wrist and forearm rotations are currently unknown. Here we present equations of motion describing the torques required to produce movements combining flexion-extension (FE) and radial-ulnar deviation (RUD) of the wrist and pronation-supination (PS) of the forearm. The total torque is comprised of components required to overcome the effects of inertia, damping, stiffness, and gravity. Using experimentally measured kinematic data and subject-specific impedance parameters (inertia, damping, and stiffness), we evaluated movement torques to test the following hypotheses: the dynamics of wrist and forearm rotations are (1) dominated by stiffness, not inertial or damping effects, (2) significantly coupled through interaction torques due to stiffness and damping (but not inertia), and (3) too complex to be well approximated by a simple, linear model. We found that (1) the dynamics of movements combining the wrist and forearm are similar to wrist rotations in that stiffness dominates over inertial and damping effects (pwrist and forearm are significantly coupled through stiffness, while interactions due to inertia and damping are small, and (3) despite the complexity of the exact equations of motion, the dynamics of wrist and forearm rotations are well approximated by a simple, linear (but still coupled) model (the mean error in predicting torque was less than 1% of the maximum torque). The exact and approximate models are presented for modeling wrist and forearm rotations in future studies. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Elderly with proximal hip fracture present significantly lower levels of 25-hydroxyvitamin D

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    Marcelo Teodoro Ezequiel Guerra

    Full Text Available ABSTRACT OBJECTIVE: To compare serum 25-hydroxyvitamin D (25[OH]D levels, a serum marker of vitamin D3, between patients with and without proximal hip fracture. METHODS: This was a case-control study in which serum samples of 25(OHD were obtained from 110 proximal hip fracture inpatients and 231 control patients without fractures, all over 60 years of age. Levels of 25(OHD lower than or equal to 20 ng/mL were considered deficient; from 21 ng/mL to 29 ng/mL, insufficient; and above 30 ng/mL, sufficient. Sex, age, and ethnicity were considered for association with the study groups and 25(OHD levels. RESULTS: Patients with proximal hip fracture had significantly lower serum 25(OHD levels (21.07 ng/mL than controls (28.59 ng/mL; p = 0.000. Among patients with proximal hip fracture, 54.5% had deficient 25(OHD levels, 27.2% had insufficient levels, and only 18.2% had sufficient levels. In the control group, 30.3% of patients had deficient 25(OHD levels, 30.7% had insufficient levels, and 38.9% had sufficient levels. Female patients had decreased serum 25(OHD levels both in the fracture group and in the control group (19.50 ng/mL vs. 26.94 ng/mL; p = 0.000 when compared with male patients with and without fracture (25.67 ng/mL vs. 33.74 ng/mL; p = 0.017. Regarding age, there was a significant association between 25(OHD levels and risk of fracture only for the age groups 71-75 years and above 80 years. CONCLUSION: Patients with proximal hip fracture had significantly decreased serum 25(OHD levels when compared with the control group. Female patients had significantly lower serum 25(OHD levels in both groups.

  19. Combined Endovascular Treatment with Distal Radial Artery Coil Embolization and Angioplasty in Steal Syndrome Associated with Forearm Dialysis Fistula

    Energy Technology Data Exchange (ETDEWEB)

    Tercan, Fahri, E-mail: ftercan@yahoo.com; Koçyiğit, Ali, E-mail: alkoc@yahoo.com [Pamukkale University, Department of Radiology, School of Medicine (Turkey); Güney, Bünyamin [Muğla Sıtkı Kocman University, Department of Radiology, School of Medicine (Turkey)

    2016-09-15

    PurposeThe present study was performed to define the results of the endovascular treatment with angioplasty and distal radial artery embolization in ischemic steal syndrome associated with forearm arteriovenous accesses.MethodThe cases referred to our interventional radiology unit with symptoms and physical examination findings suggestive of ischemic steal syndrome were retrospectively evaluated first by Doppler ultrasonography, and then by angiography. Cases with proximal artery stenosis were applied angioplasty, and those with steal syndrome underwent coil embolization to distal radial artery.ResultsOf 589 patients who underwent endovascular intervention for dialysis arteriovenous fistulae (AVF)-associated problems, 6 (1.01 %) (5 female, 1 males; mean age 62 (range 41–78) with forearm fistula underwent combined endovascular treatment for steal syndrome. In addition to steal phenomenon, there were stenosis and/or occlusion in proximal radial and/or ulnar artery in 6 patients concurrently. Embolization of distal radial artery and angioplasty to proximal arterial stenoses were performed in all patients. Ischemic symptoms were eliminated in all patients and the AVF were in use at the time of study. In one patient, ischemic symptoms recurring 6 months later were alleviated by repeat angioplasty of ulnar artery.ConclusionIn palmar arch steal syndrome affecting forearm fistulae, combined distal radial embolization and angioplasty is also an effective treatment method in the presence of proximal radial and ulnar arterial stenoses and occlusions.

  20. Avaliação dos resultados do tratamento cirúrgico das fraturas-luxações da extremidade proximal do antebraço no adulto Evaluation of the outcome in fracture-dislocation surgeries in the proximal end of the adult forearm

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    Sérgio Luiz Checchia

    2007-09-01

    Full Text Available OBJETIVO: Avaliar os resultados obtidos no tratamento das fraturas-luxações da extremidade proximal do antebraço (FLEPA, procurando identificar fatores que possam influenciar no prognóstico desse tipo de lesão traumática. MÉTODOS: De outubro de 1994 a dezembro de 2005, 30 pacientes com FLEPA foram submetidos ao tratamento cirúrgico. Em todos os casos, o seguimento ambulatorial mínimo foi de 12 meses. As lesões foram classificadas pelo método de Chick et al. A média de idade foi de 48 anos, com mínima de 25 e máxima de 76 anos. Os mecanismos de trauma foram: queda da própria altura em 17 pacientes (57%, acidentes de via pública em 11 casos (37%, trauma direto em um caso (3% e agressão física em um caso (3%. As fraturas expostas corresponderam a oito casos (27%. Realizou-se a análise estatística pelo teste exato de Fisher para avaliar os seguintes dados: exposição do foco de fratura e resultados; sexo e resultados; mecanismo de trauma e resultados; idade e mecanismo de trauma; sexo e mecanismo de trauma. RESULTADOS: Em 11 casos (37% os resultados foram satisfatórios e em 19 casos (63%, insatisfatórios. Estabeleceu-se apenas relação estatística significativa entre exposição da fratura e resultados. CONCLUSÃO: Os tratamentos das FLEPA têm, em sua maioria, resultados insatisfatórios, principalmente nas fraturas expostas, fato estatisticamente significativo neste estudo. Não foi possível definir outros fatores prognósticos. Encontrou-se tendência a melhores resultados nos pacientes do sexo feminino, nos idosos e nas vítimas de traumas de baixa energia.OBJECTIVE: To evaluate results obtained in the treatment of fracture-dislocation of the proximal end of the forearm (FLEPA, in an attempt at identifying factors that may influence the prognosis of this type of traumatic lesion. METHODS: From October 1994 to December 2005, 30 patients with FLEPA were submitted to surgical treatment. In all cases, minimum office follow

  1. Forearm blood flow measurements using computerized R-wave triggered strain-gauge venous occlusion plethysmography: unilateral vs. bilateral measurements.

    Science.gov (United States)

    Kamper, A M; de Craen, A J; Blauw, G J

    2001-09-01

    The human forearm is a well established model to study local vascular reactivity in humans in vivo, using strain-gauge venous occlusion plethysmography to measure blood flow and changes in blood flow in the forearm. To reduce the intra-individual variability of the forearm blood flow (FBF), it has been advocated that simultaneous measurements of contralateral forearm blood flow is obligatory. Therefore, the use of the calculated forearm ratio (FR) is recommended instead of using the actual FBF. In the present study we compared the intra-individual variability of forearm blood flow measurements and the forearm ratio, by using computerized R-wave triggered strain-gauge venous occlusion plethysmography, to test if bilateral expression of measurements is better than unilateral. Results were obtained in eight volunteers. Intra-arterial infused sodium nitroprusside induced a dose dependent increase in forearm blood flow and a dose dependent increase in the calculated forearm ratio. Intra-arterial infused norepinephrine induced a dose dependent decrease in forearm blood flow and a dose dependent decrease in the calculated forearm ratio. The differences between the variation coefficients of the forearm blood flow measurements and the calculated forearm ratio were different. These results support our hypothesis that by using a computerized, R-wave triggered system for unilateral forearm blood flow measurement is a more reliable outcome than the calculated forearm ratio derived from bilateral measurements.

  2. False aneurysm of the interosseous artery and anterior interosseous syndrome - an unusual complication of penetrating injury of the forearm: a case report

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    Garavaglia Guido

    2009-12-01

    Full Text Available Abstract Background Palsies involving the anterior interosseous nerve (AIN comprise less than 1% of all upper extremity nerve palsies. Objectives This case highlights the potential vascular and neurological hazards of minimal penetrating injury of the proximal forearm and emphasizes the phenomenon of delayed presentation of vascular injuries following seemingly obscure penetrating wounds. Case Report We report a case of a 22-year-old male admitted for a minimal penetrating trauma of the proximal forearm that, some days later, developed an anterior interosseous syndrome. A Duplex study performed immediately after the trauma was normal. Further radiologic investigations i.e. a computer-tomographic-angiography (CTA revealed a false aneurysm of the proximal portion of the interosseous artery (IA. Endovascular management was proposed but a spontaneous rupture dictated surgical revision with simple excision. Complete neurological recovery was documented at 4 months postoperatively. Conclusions/Summary After every penetrating injury of the proximal forearm we propose routinely a detailed neurological and vascular status and a CTA if Duplex evaluation is negative.

  3. Comparison of ultrasound assessment of flow-mediated dilatation in the radial and brachial artery with upper and forearm cuff positions.

    Science.gov (United States)

    Agewall, S; Doughty, R N; Bagg, W; Whalley, G A; Braatvedt, G; Sharpe, N

    2001-01-01

    In the published literature relating to flow-mediated dilatation (FMD), there are substantial differences between centres in terms of normal FMD amongst healthy subjects. This present study attempts to identify the effect of differing methodologies on FMD. High frequency ultrasound was used to measure blood flow and percentage brachial and radial artery dilatation after reactive hyperaemia induced by forearm or upper arm cuff occlusion in 24 healthy subjects, less than 40 years, without known cardiovascular risk factors. FMD of the brachial artery was significantly higher after upper arm occlusion, compared with forearm occlusion, 6.4 (3.3) and 3.9 (2.6)% (P<0.05), respectively. FMD of the radial artery was significantly higher after forearm occlusion, compared with upper arm occlusion, 10.0 (4.6) and 7.9 (3.5)% (P<0.05), respectively. The percentage blood flow increase in the brachial and radial arteries after forearm and upper arm occlusion were similar. After forearm and upper arm occlusion, the radial artery percentage dilatation was greater than the brachial artery. In conclusion dilatation of the brachial artery, after reactive hyperaemia induced by upper arm occlusion, was significantly more pronounced compared with dilatation of the brachial artery after forearm occlusion, despite a similar percentage blood flow increase. The local ischaemia of the brachial artery with a proximal occlusion may explain why the brachial artery dilated more after upper arm occlusion compared with after forearm occlusion. The study has also shown that FMD of the radial artery could be assessed by B-mode ultrasound technique. FMD was greater using the radial artery compared with the brachial artery, suggesting that the radial artery may be a useful way to assess FMD in future clinical studies.

  4. [Bipolar forearm dislocation or floating forearm (a case report)].

    Science.gov (United States)

    Daoudi, A; Elibrahimi, A; Loudiyi, W D; Elmrini, A; Chakour, K; Boutayeb, F

    2009-02-01

    Bipolar dislocation of the forearm or floating forearm is a rare injury. It combines concomitant elbow and wrist dislocation. Only six cases have been reported in the literature. The diagnosis of wrist dislocation may initially be missed and therefore the prognosis will be worse. The authors report a case of a bipolar dislocation with a posterior dislocation of the elbow and a perilunate dislocation of the wrist.

  5. An EMG Keyboard for Forearm Amputees

    Directory of Open Access Journals (Sweden)

    Wenwei Yu

    2003-01-01

    Full Text Available A high-efficiency, easy-to-use input device is not only important for data entry but also for human-computer interaction. To date, there has been little research on input devices with many degrees of freedom (DOF that can be used by the handicapped. This paper presents the development of an electromyography (EMG-based input device for forearm amputees. To overcome the difficulties in analysing EMG and realising high DOF from biosignals, the following were integrated: (1 an online learning method to cope with nonlinearity and the individual difference of EMG signals; (2 a smoothing algorithm to deal with noisy recognition results and transition states; and (3 a modified Huffman coding algorithm to generate the optimal code, taking expected error and input efficiency into consideration. Experiments showed the validity of the system and the possibility for development of a quiet, free-posture (no postural restriction input device with many DOF for users, including forearm amputees.

  6. Proximal Hypospadias

    Science.gov (United States)

    Kraft, Kate H.; Shukla, Aseem R.; Canning, Douglas A.

    2011-01-01

    Hypospadias results from abnormal development of the penis that leaves the urethral meatus proximal to its normal glanular position. Meatal position may be located anywhere along the penile shaft, but more severe forms of hypospadias may have a urethral meatus located at the scrotum or perineum. The spectrum of abnormalities may also include ventral curvature of the penis, a dorsally redundant prepuce, and atrophic corpus spongiosum. Due to the severity of these abnormalities, proximal hypospadias often requires more extensive reconstruction in order to achieve an anatomically and functionally successful result. We review the spectrum of proximal hypospadias etiology, presentation, correction, and possible associated complications. PMID:21516286

  7. Grapevine red blotch-associated virus is Present in Free-Living Vitis spp. Proximal to Cultivated Grapevines.

    Science.gov (United States)

    Perry, Keith L; McLane, Heather; Hyder, Muhammad Z; Dangl, Gerald S; Thompson, Jeremy R; Fuchs, Marc F

    2016-06-01

    Red blotch is an emerging disease of grapevine associated with grapevine red blotch-associated virus (GRBaV). The virus spreads with infected planting stocks but no vector of epidemiological significance has been conclusively identified. A vineyard block of red-blotch-affected Vitis vinifera 'Cabernet franc' clone 214 was observed in California, with a clustering of infected, symptomatic vines focused along one edge of the field proximal to a riparian habitat with free-living Vitis spp. No genetic heterogeneity was observed in a 587-nucleotide region of the GRBaV genome in a population of 44 Cabernet franc clone 214 isolates. By contrast, genetic differences were observed in isolates from other cultivars and clones growing in adjacent blocks. GRBaV was confirmed infecting four free-living vines, two of which were shown to be V. californica × V. vinifera hybrids. The genomes of three free-living GRBaV vine isolates and seven from V. vinifera cultivars were compared; free-living vine isolates were shown to be more similar to each other and a 'Merlot' isolate than to the other cultivated vine isolates. The finding that GRBaV is present in free-living Vitis spp. indicates the virus can be spread by natural (nonhuman-mediated) means, and we hypothesize that in-field spread of GRBaV is occurring.

  8. Treatment of proximal hamstring tendinopathy-related sciatic nerve entrapment: presentation of an ultrasound-guided "Intratissue Percutaneous Electrolysis" application.

    Science.gov (United States)

    Mattiussi, Gabriele; Moreno, Carlos

    2016-01-01

    Proximal Hamstring Tendinopathy-related Sciatic Nerve Entrapment (PHTrSNE) is a neuropathy caused by fibrosis interposed between the semimembranosus tendon and the sciatic nerve, at the level of the ischial tuberosity. Ultrasound-guided Intratissue Percutaneous Electrolysis (US-guided EPI) involves galvanic current transfer within the treatment target tissue (fibrosis) via a needle 0.30 to 0.33 mm in diameter. The galvanic current in a saline solution instantly develops the chemical process of electrolysis, which in turn induces electrochemical ablation of fibrosis. In this article, the interventional procedure is presented in detail, and both the strengths and limits of the technique are discussed. US-guided EPI eliminates the fibrotic accumulation that causes PHTrSNE, without the semimembranosus tendon or the sciatic nerve being directly involved during the procedure. The technique is however of limited use in cases of compression neuropathy. US-guided EPI is a technique that is quick to perform, minimally invasive and does not force the patient to suspend their activities (work or sports) to make the treatment effective. This, coupled to the fact that the technique is generally well-tolerated by patients, supports use of US-guided EPI in the treatment of PHTrSNE.

  9. Non-union in forearm fractures

    National Research Council Canada - National Science Library

    Jayakumar, P; Jupiter, J B

    2014-01-01

    Non-union in forearm fractures is an uncommon but complex problem. This is especially given the unique anatomical structure and function of the forearm, making treatment distinctly different to that of other long bone fractures...

  10. Measurement of forearm oxygen consumption

    DEFF Research Database (Denmark)

    Astrup, A; Simonsen, L; Bülow, J

    1988-01-01

    The classical forearm technique widely used for studies of skeletal muscle metabolism requires arterial cannulation. To avoid arterial puncture it is becoming more common to arterialize blood from a contralateral hand vein by local heating. This modification and the classical method have produced...

  11. X-Ray Exam: Forearm

    Science.gov (United States)

    ... recorded on a computer or special X-ray film. This image shows the soft tissues and bones of the forearm. The X-ray image is black and white. Dense structures that block the passage of the X-ray beam through the body, such as the bones, appear white on the ...

  12. The role of ultrasound and magnetic resonance imaging in the evaluation of the forearm interosseous membrane. A review

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez-Martin, Juan [Infanta Leonor University Hospital, Trauma and Orthopaedics, Shoulder and Elbow Unit, Madrid (Spain); Pretell-Mazzini, Juan [The Children' s Hospital of Philadelphia, Pediatric Orthopaedic Fellow, Division of Orthopaedic Surgery, Philadelphia, PA (United States)

    2011-12-15

    The interosseous membrane of the forearm is an important structure to consider in cases of elbow and forearm trauma; it can be injured after elbow or forearm fractures, leading to longitudinal forearm instability. Diagnosis of interosseous membrane injuries is challenging, and failure in diagnosis may result in poor clinical outcomes and complications. Magnetic resonance imaging and ultrasound have shown to be valuable methods for the evaluation of this important structure. Both techniques have advantages and limitations, and its use should be adapted to each specific clinical scenario. This article presents an up-to-date literature review regarding the use of ultrasound and magnetic resonance imaging in the forearm interosseous membrane evaluation. (orig.)

  13. Intramedullary compression device for proximal ulna fracture.

    Science.gov (United States)

    Hong, Choon Chiet; Han, Fucai; Decruz, Joshua; Pannirselvam, Vinodhkumar; Murphy, Diarmuid

    2015-02-01

    Proximal ulna fractures account for 20% of all proximal forearm fractures. Many treatment options are available for such fractures, such as cast immobilisation, plate and screw fixation, tension band wiring and intramedullary screw fixation, depending on the fracture pattern. Due to the subcutaneous nature of the proximal forearm, it is vulnerable to open injuries over the dorsal aspect of the proximal ulna. This may in turn prove challenging, as it is critical to obtain adequate soft tissue coverage to reduce the risk of implant exposure and bony infections. We herein describe a patient with a Gustillo III-B open fracture of the proximal ulna, treated with minimally invasive intramedullary screw fixation using a 6.0-mm cannulated headless titanium compression screw (FusiFIX, Péronnas, France).

  14. System characterization of RiceWrist-S: a forearm-wrist exoskeleton for upper extremity rehabilitation.

    Science.gov (United States)

    Pehlivan, Ali Utku; Rose, Chad; O'Malley, Marcia K

    2013-06-01

    Rehabilitation of the distal joints of the upper extremities is crucial to restore the ability to perform activities of daily living to patients with neurological lesions resulting from stroke or spinal cord injury. Robotic rehabilitation has been identified as a promising new solution, however, much of the existing technology in this field is focused on the more proximal joints of the upper arm. A recently presented device, the RiceWrist-S, focuses on the rehabilitation of the forearm and wrist, and has undergone a few important design changes. This paper first addresses the design improvements achieved in the recent design iteration, and then presents the system characterization of the new device. We show that the RiceWrist-S has capabilities beyond other existing devices, and exhibits favorable system characteristics as a rehabilitation device, in particular torque output, range of motion, closed loop position performance, and high spatial resolution.

  15. Plexiform schwannoma of the forearm

    Energy Technology Data Exchange (ETDEWEB)

    Katsumi, Keiichi; Ogose, Akira; Hotta, Tetsuo; Hatano, Hiroshi; Kawashima, Hiroyuki; Endo, Naoto [Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Asahimachi 1-751, 951-8510, Niigata (Japan); Umezu, Hajime [Division of Pathology, Niigata University Hospital, Niigata (Japan)

    2003-12-01

    We report a case of plexiform schwannoma located in the flexor muscles of the forearm in the absence of other signs of neurofibromatosis or schwannomatosis. Magnetic resonance examination revealed a multinodular irregular inhomogeneous mass. Some nodules displayed a peripheral, high intensity rim and a central low intensity (target sign) on T2-weighted images. Pre-operative diagnosis of the rare plexiform schwannoma may be possible with careful imaging examination for the target sign. (orig.)

  16. Human mimetic forearm mechanism towards bionic arm.

    Science.gov (United States)

    Seo, Minsang; Kim, Hogyun; Choi, Youngjin

    2017-07-01

    The paper presents a mechanical forearm mechanism to extend the pronation and supination (P/S) movement of the trans-radial amputee when he/she is able to conduct the P/S motion partially with his/her remaining forearm. The P/S motions of the existing prostheses and robotic arms developed till now are completely different from those of the human. When we are to develop the robotic prostheses for the amputees, two important issues should be considered such as cosmetic issue to look like normal arm and motion harmony issue between robotic prosthesis and the amputated living arm. Most prostheses do not realize the human-like P/S motion, but the simple rotational motion at the wrist by using the electric motor. In this paper, the well-known spatial four-bar mechanism is adopted in order to mimic human P/S motion as if the person does, because it is one of the best candidates to describe actual human forearm movement. To obtain the design parameters of the mechanism, first, 3D data of the amputated arm as well as the opposite side non-amputated arm are captured by using MRI (Magnetic Resonance Imaging) and 3D scanner. The design parameters such as link lengths, joint locations, and volumetric shape are determined from the measured data. Second, mathematical analysis is performed to simulate one degree-of-freedom P/S motion realized from the spatial four-bar mechanism, and the simulation results are suggested to confirm whether or not it acts like the relative movement between human ulnar and radius bones. Finally the effectiveness of the proposed mechanism is verified through two ADL (activities of daily living) tests.

  17. Axillary Artery Injury Associated with Proximal Humerus Fracture: A Report of 6 Cases

    Directory of Open Access Journals (Sweden)

    Rinne M. Peters

    2017-01-01

    Full Text Available Proximal humerus fractures are common, but associated injury of the axillary artery is uncommon. The majority of published blunt traumatic axillary artery injuries are associated with anterior glenohumeral dislocation; a few are associated with isolated proximal humerus fractures or fracture-dislocation. Experience within our institution demonstrates that axillary artery injury is often unrecognized on initial presentation owing to palpable peripheral pulses and the absence of ischemia and places the hand at risk of necrosis and amputation if there is prolonged ischemia and the forearm at risk of compartment syndrome after revascularization. Accurate physical examination in combination with a low threshold for Doppler examination or angiography can establish the diagnosis of axillary artery injury. We present 6 cases of axillary artery injury associated with proximal humerus fractures in order to highlight the potential for this vascular injury in the setting of a proximal humerus fracture.

  18. Acute Idiopathic Compartment Syndrome of the Forearm in an Adolescent

    Directory of Open Access Journals (Sweden)

    Smith, Kelley

    2014-11-01

    Full Text Available Acute compartment syndrome (ACS is a condition typically associated with long bone fractures or severe trauma; however, non-traumatic etiologies also occur. We describe a case of an otherwise healthy female pediatric patient presenting with unilateral forearm pain without an inciting injury. Intracompartmental pressures of the forearm were measured and she was diagnosed with idiopathic compartment syndrome. Our goal is to encourage clinicians to consider acute compartment syndrome even in the absence of trauma. [West J Emerg Med. 2015;16(1:158-160.

  19. Florid reactive periostitis of the forearm bones in a child.

    Science.gov (United States)

    Mathew, S E; Madhuri, V; Alexander, M; Walter, N M; Gibikote, S V

    2011-03-01

    Florid reactive periostitis is a pronounced periosteal reaction, usually affecting the hands and feet, for which there is no obvious cause. It is rare in children and in long bones. We report an unusual case of florid reactive periostitis in a ten-year-old girl that involved both bones of the forearm. The lesion resolved over a period of one year, leaving a residual exostosis. She developed a physeal bar in the distal ulna in the region of the lesion at one-year follow-up. This was thought to be a complication of the biopsy procedure and was treated by resection and proximal ulnar lengthening.

  20. Forearm posture and mobility in quadrupedal dinosaurs.

    Science.gov (United States)

    VanBuren, Collin S; Bonnan, Matthew

    2013-01-01

    Quadrupedality evolved four independent times in dinosaurs; however, the constraints associated with these transitions in limb anatomy and function remain poorly understood, in particular the evolution of forearm posture and rotational ability (i.e., active pronation and supination). Results of previous qualitative studies are inconsistent, likely due to an inability to quantitatively assess the likelihood of their conclusions. We attempt to quantify antebrachial posture and mobility using the radius bone because its morphology is distinct between extant sprawled taxa with a limited active pronation ability and parasagittal taxa that have an enhanced ability to actively pronate the manus. We used a sliding semi-landmark, outline-based geometric morphometric approach of the proximal radial head and a measurement of the angle of curvature of the radius in a sample of 189 mammals, 49 dinosaurs, 35 squamates, 16 birds, and 5 crocodilians. Our results of radial head morphology showed that quadrupedal ceratopsians, bipedal non-hadrosaurid ornithopods, and theropods had limited pronation/supination ability, and sauropodomorphs have unique radial head morphology that likely allowed limited rotational ability. However, the curvature of the radius showed that no dinosaurian clade had the ability to cross the radius about the ulna, suggesting parallel antebrachial elements for all quadrupedal dinosaurs. We conclude that the bipedal origins of all quadrupedal dinosaur clades could have allowed for greater disparity in forelimb posture than previously appreciated, and future studies on dinosaur posture should not limit their classifications to the overly simplistic extant dichotomy.

  1. Forearm posture and mobility in quadrupedal dinosaurs.

    Directory of Open Access Journals (Sweden)

    Collin S VanBuren

    Full Text Available Quadrupedality evolved four independent times in dinosaurs; however, the constraints associated with these transitions in limb anatomy and function remain poorly understood, in particular the evolution of forearm posture and rotational ability (i.e., active pronation and supination. Results of previous qualitative studies are inconsistent, likely due to an inability to quantitatively assess the likelihood of their conclusions. We attempt to quantify antebrachial posture and mobility using the radius bone because its morphology is distinct between extant sprawled taxa with a limited active pronation ability and parasagittal taxa that have an enhanced ability to actively pronate the manus. We used a sliding semi-landmark, outline-based geometric morphometric approach of the proximal radial head and a measurement of the angle of curvature of the radius in a sample of 189 mammals, 49 dinosaurs, 35 squamates, 16 birds, and 5 crocodilians. Our results of radial head morphology showed that quadrupedal ceratopsians, bipedal non-hadrosaurid ornithopods, and theropods had limited pronation/supination ability, and sauropodomorphs have unique radial head morphology that likely allowed limited rotational ability. However, the curvature of the radius showed that no dinosaurian clade had the ability to cross the radius about the ulna, suggesting parallel antebrachial elements for all quadrupedal dinosaurs. We conclude that the bipedal origins of all quadrupedal dinosaur clades could have allowed for greater disparity in forelimb posture than previously appreciated, and future studies on dinosaur posture should not limit their classifications to the overly simplistic extant dichotomy.

  2. Chronic exertional compartment syndrome in the forearm of a rower ...

    African Journals Online (AJOL)

    This case report describes chronic exertional compartment syndrome in the forearm of a professional rower. We consider this to be a rare anatomical location for this type of syndrome. Morever, not much is known about its clinical presentation and the subsequent optimal medical management thereof.

  3. Mannitol extravasation during partial nephrectomy leading to forearm compartment syndrome

    Directory of Open Access Journals (Sweden)

    Bradley A. Erickson

    2007-02-01

    Full Text Available We present the first known complication of forearm compartment syndrome after mannitol infusion during partial nephrectomy. We stress the importance of excellent intravenous catheter access and constant visual monitoring of the intravenous catheter site during and after mannitol infusion as ways to prevent this complication. Prompt recognition of compartment syndrome with appropriate intervention can prevent long-term sequelae.

  4. Chronic exertional compartment syndrome in the forearm of a rower

    African Journals Online (AJOL)

    known clinical condition that has been extensively described to date. Conversely, the forearm is affected much less frequently, with only a few cases having been reported in sports such as weightlifting, kayaking and motocross.[1,2] We present a ...

  5. Multiple osteochondromas (MO in the forearm: a 12-year single-centre experience

    Directory of Open Access Journals (Sweden)

    John Ham

    2016-10-01

    Full Text Available Abstract Multiple osteochondromas (MO are a rare autosomal dominant disorder characterized by the presence of osteochondromas located on the long bones and axial skeleton. Patients present with growth disturbances and angular deformities of the long bones as well as limited motion of affected joints. Forearm involvement is found in a considerable number of patients and may vary from the presence of a simple osteochondroma to severe forearm deformities and radial head dislocation. Patients encounter a variety of problems and symptoms e.g., pain, functional impairment, loss of strength and cosmetic concerns. Several surgical procedures are offered from excision of symptomatic osteochondromas to challenging reconstructions of forearm deformities. We describe visualizing, planning and treating these forearm deformities in MO and, in particular, a detailed account of the surgical correction of Masada type I and Masada type II MO forearm deformities.

  6. Forearm metabolism during infusion of adrenaline

    DEFF Research Database (Denmark)

    Simonsen, L; Stefl, B; Bülow, J

    2000-01-01

    Human skeletal muscle metabolism is often investigated by measurements of substrate fluxes across the forearm. To evaluate whether the two forearms give the same metabolic information, nine healthy subjects were studied in the fasted state and during infusion of adrenaline. Both arms were...... catheterized in a cubital vein in the retrograde direction. A femoral artery was catheterized for blood sampling, and a femoral vein for infusion of adrenaline. Forearm blood flow was measured by venous occlusion strain-gauge plethysmography. Forearm subcutaneous adipose tissue blood flow was measured...... by the local 133Xe washout method. Metabolic fluxes were calculated as the product of forearm blood flow and a-v differences of metabolite concentrations. After baseline measurements, adrenaline was infused at a rate of 0.3 nmol kg-1 min-1. No difference in the metabolic information obtained in the fasting...

  7. Forearm Torque and Lifting Strength: Normative Data.

    Science.gov (United States)

    Axelsson, Peter; Fredrikson, Per; Nilsson, Anders; Andersson, Jonny K; Kärrholm, Johan

    2018-02-10

    To establish reference values for new methods designed to quantitatively measure forearm torque and lifting strength and to compare these values with grip strength. A total of 499 volunteers, 262 males and 237 females, aged 15 to 85 (mean, 44) years, were tested for lifting strength and forearm torque with the Kern and Baseline dynamometers. These individuals were also tested for grip strength with a Jamar dynamometer. Standardized procedures were used and information about sex, height, weight, hand dominance, and whether their work involved high or low manual strain was collected. Men had approximately 70% higher forearm torque and lifting strength compared with females. Male subjects aged 26 to 35 years and female subjects aged 36 to 45 years showed highest strength values. In patients with dominant right side, 61% to 78% had a higher or equal strength on this side in the different tests performed. In patients with dominant left side, the corresponding proportions varied between 41% and 65%. There was a high correlation between grip strength and forearm torque and lifting strength. Sex, body height, body weight, and age showed a significant correlation to the strength measurements. In a multiple regression model sex, age (entered as linear and squared) could explain 51% to 63% of the total variances of forearm torque strength and 30% to 36% of lifting strength. Reference values for lifting strength and forearm torque to be used in clinical practice were acquired. Grip strength has a high correlation to forearm torque and lifting strength. Sex, age, and height can be used to predict forearm torque and lifting strength. Prediction equations using these variables were generated. Normative data of forearm torque and lifting strength might improve the quality of assessment of wrist and forearm disorders as well as their treatments. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  8. Open Fracture of the Forearm Bones due to Horse Bite

    Directory of Open Access Journals (Sweden)

    John Ashutosh Santoshi

    2014-01-01

    Full Text Available Introduction: Fractures have been described mainly following falling accidents in horse-related injuries. Horse bites are uncommon accidents. We present a case of open fracture of the forearm due to horse bite. Case Report: A 35-year-old male farm-worker presented to the emergency room with alleged history of horse bite to the right forearm about 2 hours prior to presentation while feeding the horse. There was deformity of the forearm with multiple puncture wounds, deep abrasions and small lacerations on the distal-third of the forearm. Copious irrigation with normal saline was done and he was administered anti-tetanus and post-exposure rabies prophylaxis. Prophylactic antibiotic therapy was commenced. Radiographs revealed fracture of radius and ulna in the mid-shaft region. He underwent emergency wound debridement, and the ulna was stabilised with an intra-medullary square nail. Seventy-two hours later, he underwent re-debridement and conversion osteosynthesis. He had an uneventful recovery and at three-month follow-up, the fractures had healed radiographically in anatomic alignment. At two-year follow-up, he is doing well, is pain free and has a normal range of motion compared to the contralateral side. Conclusion: Horse bites behave as compound fractures however rabies prophylaxis will be needed and careful observation is needed. Early radical debridement, preliminary skeletal stabilisation, re-debridement and conversion osteosynthesis to plate, and antibiotic prophylaxis were the key to the successful management of our patient. Keywords: Horse; animal bite; forearm; open fracture

  9. Versatility of radial forearm free flap for intraoral reconstruction

    Directory of Open Access Journals (Sweden)

    Jeremić Jelena V.

    2015-01-01

    Full Text Available Introduction. The radial forearm free flap has an important role in reconstruction of the oncologic defects in the region of head and neck. Objective. The aim was to present and evaluate clinical experience and results in the radial forearm free transfer for intraoral reconstructions after resections due to malignancies. Methods. This article illustrates the versatility and reliability of forearm single donor site in 21 patients with a variety of intraoral oncologic defects who underwent immediate (19 patients, 90.5% or delayed (2 patients, 9.5% reconstruction using free flaps from the radial forearm. Fascio-cutaneous flaps were used in patients with floor of the mouth (6 cases, buccal mucosa (5 cases, lip (1 case and a retromolar triangle (2 cases defects, or after hemiglossectomy (7 cases. In addition, the palmaris longus tendon was included with the flap in 2 patients that required oral sphincter reconstruction. Results. An overall success rate was 90.5%. Flap failures were detected in two (9.5% patients, in one patient due to late ischemic necrosis, which appeared one week after the surgery, and in another patient due to venous congestion, which could not be salvaged after immediate re-exploration. Two patients required re-exploration due to vein thrombosis. The donor site healed uneventfully in all patients, except one, who had partial loss of skin graft. Conclusion. The radial forearm free flap is, due to multiple advantages, an acceptable method for reconstructions after resection of intraoral malignancies. [Projekat Ministarstva nauke Republike Srbije, br. 41006

  10. Forearm Compartment Syndrome: Evaluation and Management.

    Science.gov (United States)

    Kistler, Justin M; Ilyas, Asif M; Thoder, Joseph J

    2018-02-01

    Compartment syndrome of the forearm is uncommon but can have devastating consequences. Compartment syndrome is a result of osseofascial swelling leading to decreased tissue perfusion and tissue necrosis. There are numerous causes of forearm compartment syndrome and high clinical suspicion must be maintained to avoid permanent disability. The most widely recognized symptoms include pain out of proportion and pain with passive stretch of the wrist and digits. Early diagnosis and decompressive fasciotomy are essential in the treatment of forearm compartment syndrome. Closure of fasciotomy wounds can often be accomplished by primary closure but many patients require additional forms of soft tissue coverage procedures. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. PROXIMAL RADIUS RECONSTRUCTION BY METATARSAL OSTEOCHONDRAL AUTO GRAFT

    Directory of Open Access Journals (Sweden)

    Kammar

    2015-04-01

    Full Text Available 17 Year Old student, Pavan presents with swelling since 8 months. Swelling was diffuse over forearm. Tenderness was present. No local rise of temperature. Range of m ovement at elbow was restricted and painful terminally. No distal neurovascular deficits. X - ray reveale d it to be an a neurysmal bone cyst of proximal right radius. FNAC showed Aneurysmal bone cyst for which curettage and bone grafting was done. Post 6 months tumour recurred with a swelling around upper third of right fo rearm. FNAC and J - needle biopsy showed it to be a neurysmal bone cyst. MRI showed ABC of proximal radius without soft tissue involvement. Excision of proximal third of radius with reconstruction by 3 rd metatarsal and augmented with fib ular graft and stabili zed with dynamic c ompression plate and screws . Tumour specimen was sent for h istopathology a t 2 weeks p ost operatively patient had good range of movements. At present patient has full range of flexion , extension , supination & pronation . He is able to carry out his ADL. In the literature proximal radius reconstruction has been tried in traumatic communited radial head fractures. Here it done for r ecurrent benign tumour like aneurysmal bone cyst, as the base of 3rd metatarsal anatomically coincides with radial head and hence a better radio - capital articulation

  12. Motorcycle racer with unilateral forearm flexor and extensor chronic exertional compartment syndrome.

    Science.gov (United States)

    Winkes, Michiel B; Teijink, Joep A; Scheltinga, Marc R

    2016-04-14

    We discuss a case of a 26-year-old man, a motorcycle racer, who presented with progressive pain, weakness and swelling of his right forearm and loss of power in his index finger, experienced during motor racing. Chronic exertional compartment syndrome (CECS) of both flexor and extensor compartments of his forearm was diagnosed by dynamic intracompartmental muscle pressure measurements. After fasciotomies, all symptoms were resolved and the patient was able to improve on his preinjury racing skills, without any limitations. A literature review and a surgical 'how-to' for correct release of the extensor and deep flexor compartments of the forearm are provided. 2016 BMJ Publishing Group Ltd.

  13. Multiset proximity spaces

    Directory of Open Access Journals (Sweden)

    A. Kandil

    2016-10-01

    Full Text Available A multiset is a collection of objects in which repetition of elements is essential. This paper is an attempt to explore the theoretical aspects of multiset by extending the notions of compact, proximity relation and proximal neighborhood to the multiset context. Examples of new multiset topologies, open multiset cover, compact multiset and many identities involving the concept of multiset have been introduced. Further, an integral examples of multiset proximity relations are obtained. A multiset topology induced by a multiset proximity relation on a multiset M has been presented. Also the concept of multiset δ- neighborhood in the multiset proximity space which furnishes an alternative approach to the study of multiset proximity spaces has been mentioned. Finally, some results on this new approach have been obtained and one of the most important results is: every T4- multiset space is semi-compatible with multiset proximity relation δ on M (Theorem 5.10.

  14. A biomechanical analysis of pronation-supination of the forearm using magnetic resonance imaging; Dynamic changes of the interosseous membrane of the forearm during pronation-supination

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Toshiyasu; Yabe, Yutaka; Horiuchi, Yukio (Keio Univ., Tokyo (Japan). School of Medicine)

    1994-01-01

    A magnetic resonance (MR) study was performed using a 0.5 tesla system to investigate the behavior of the interosseous membrane of the forearm during pronation-supination and to evaluate the influence of pronation-supination loading in the neutral position. The right forearm was examined in twenty volunteers at the proximal fourth part, middle part and distal fourth part of the forearm. Slices were examined at maximum pronation, 45deg pronation, neutral, 45deg supination and at maximum supination. A 0.1 Nm torque in both rotational directions was added in the neutral position. The MR image of the interosseous membrane of the forearm was a thin line with low contrast in the neutral position. The tendinous portion and membranous portions of the interosseous membrane could be differentiated. At maximum pronation and at maximum supination, the interosseous membrane was flexed, caused mainly by the relaxation in the membranous portion. The radius shifted slightly volarly to the ulna at maximum pronation, caused by the incongruity of the distal radioulnar joint. The radius shifted dorsally with pronation loading, and shifted volarly with supination loading. The inelasticity of the membranous portion of the interosseous membrane may be responsible for pronation-supination contracture, while rotational loading may be a cause of the distal radioulnar joint dislocation. These studies suggest that this technique is useful for further in vivo studies of kinesiology. (author).

  15. Open segmental fracture of both bone forearm and dislocation of ipsilateral elbow with extruded middle segment radius

    Directory of Open Access Journals (Sweden)

    Pawan Kumar

    2013-01-01

    Full Text Available Extruded middle segment of radius with open segmental fracture both bone forearm and dislocation of ipsilateral elbow is a rare injury. A 12-year-old child presented to us within 4 hours following fall from tree. The child′s mother was carrying a 12-cm-long extruded soiled segment of radius. The extruded bone was thoroughly washed. The medullary cavity was properly syringed with antiseptic solution. The bone was autoclaved and put in the muscle plane of the distal forearm after debridement of the wound. After 5 days, a 2.5-mm K-wire was introduced by retrograde method into the proximal radius by passing through the extruded segment. Another 2.5-mm K-wire was passed in ulna. The limb was evaluated clinicoradiologically every 2 weeks. The wound was healed by primary intention. At 4 months, the reposed bone appeared less dense radiologically and K-wire seemed to be out of the bone. In the subsequent months, the roentgenograms show remodeling of the extruded fragment. After 20 weeks, the K-wires were removed (first ulnar and then radial. Complete union was achieved with full range of movement except loss of few degrees of extension of elbow and thumb. This case is reported to show a good outcome following successful incorporation of an extruded segment of radius in an open fracture.

  16. Rush nail and management of fracture both bone forearm

    OpenAIRE

    Soumya Ghosh; Arnad Chowdhury; Arunima Chaudhuri; Soma Datta; Debasis Singha Roy; Abhinay Singh

    2014-01-01

    Background: The failure of the conventional nailing of both bone of the forearm poses a potential problem of nail migration and rotational instability, despite the best reduction. Objectives: Rush nail is a very handy, low cost easily available implant. In the present study, we have tried to find out its applicability if used in the closed manner under C-arm control without injurying soft tissues and preserving the periosteal vascularity. Materials and Methods: This prospective study was cond...

  17. Compartmental syndrome of the forearm: report of an unusual case.

    Science.gov (United States)

    Pollock, M S; Morris, S B; Sadeghpour, E

    1984-02-01

    Compartmental syndrome of the forearm is a well-recognized complication of upper extremity injuries. An unusual case of the syndrome is presented, which developed after a "sprained" wrist. The etiology of the syndrome in this case was possibly tearing of anterior compartment muscle fibers when the wrist was forcibly extended in the fall, or a reflex sympathetic arc set up by the wrist trauma. Copyright 2013, SLACK Incorporated.

  18. A Segmental Fracture of Humerus with Ipsilateral Forearm Fracture

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    Ruban Raj Joshi

    2016-12-01

    Full Text Available Introduction: Simultaneous segmental humerus fracture with ipsilateral forearm is an uncommon injury and scarcely mentioned in the literature. Case report: We present a case report on such a complex injury in a 9-year old child after falling down from the first floor of his house while playing. The injury pattern consist of ipsilateral supracondylar fracture humerus with distal humerus  and ipsilateral distal forearm fracture. Open reduction and pinning of the both injuries was obtained. Conclusion: Ipsilateral multiple fractures in children often result from high energy trauma and are associated with complications. Immediate reduction and fixation is required. If satisfactory reduction cannot be achieved by closed technique, open reduction should be considered to avert additional soft tissue injury and forthcoming complications.

  19. Experimental study of forearm compartmental pressures.

    Science.gov (United States)

    Ardolino, Antonella; Zeineh, Nedal; O'Connor, David

    2010-10-01

    Chronic compartment syndrome is well recognized, although it is rare in the forearm. Diagnosis is based on history, clinical examination, and compartment pressure readings. Existing normal pressure ranges for the forearm are based on lower limb measurements. This study aimed to establish normal pre- and post-exercise forearm compartment pressures. Using a Stryker intracompartmental pressure monitor (Stryker, Kalamazoo, MI), 41 volunteers had pressure measurements of the extensor and flexor forearm compartments before and after exercise. Normal ranges were established for pre-exercise extensor compartment (2-27 mm Hg; upper confidence interval [CI] 18.8-25.2 mm Hg), post-exercise extensor compartment (2-24 mm Hg; upper CI 16.8-22.8 mm Hg), pre-exercise flexor compartment (1-19 mm Hg; upper CI 13.3-17.4 mm Hg), and post-exercise flexor compartment (0-19 mm Hg; upper CI 16-21.4 mm Hg) pressures. No significant difference was found between pressures before and after exercise. There was no correlation between whether pressures increased or decreased following exercise. There was a significant gender difference. Normal ranges were 0 to 25.2 mm Hg for the extensor compartment and 0 to 21.4 mm Hg for the flexor compartment. This study has shown a significant difference in normal forearm compartment pressures between genders. A normal reference range of flexor and extensor forearm compartment pressures to aid diagnosis of chronic compartment syndrome has been determined. This might also prove useful in aiding the diagnosis of acute forearm compartment syndrome. Copyright © 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  20. Epidemiology of forearm fractures in adults in Denmark: national age- and gender-specific incidence rates, ratio of forearm to hip fractures, and extent of surgical fracture repair in inpatients and outpatients.

    Science.gov (United States)

    Abrahamsen, B; Jørgensen, N R; Schwarz, P

    2015-01-01

    National epidemiological studies of forearm fractures are scarce. We examined in- and outpatient rates in Denmark, including anatomical location, surgery, hospitalization ratio, recurrent fractures, and ratio of forearm to hip fractures. This may be useful for triangulation in countries with less detailed information. Rates were higher than previously estimated. Despite a significant contribution to the overall burden of osteoporotic, nonvertebral fractures, relatively little information is available about age- and gender-specific incidence rates for many countries including Denmark. We used national individual patient data on inpatient and outpatient treatment to calculate rates of forearm fractures, taking readmissions into account, with subtables for distal and proximal fractures. We also calculated ratios of forearm to hip fractures that may be useful when imputing forearm fracture rates from other administrative sources. In addition, we report the rates of hospital admission and the rates of surgical treatment, allowing readers to extrapolate from the number of admissions or surgical procedures to incidence rates, should their data sources be less comprehensive. Forearm fracture rates were 278 per 100,000 patient years in men aged 50+ and 1,110 per 100,000 in women aged 50+. The female to male incidence rate ratio was 4.0 for the age group 50+ but close to unity in persons aged 40 or under. Two thirds of patients were treated on an outpatient basis with little difference across age and gender strata. Four out of five fractures were treated conservatively. The rate of forearm fractures in Denmark was somewhat higher in both genders than recently imputed from hip fracture rates and were close to the rates previously reported in studies from Norway and Sweden. The rates of forearm fracture in Denmark are higher than previously estimated and very similar to the high risk reported from studies in Norway and Sweden.

  1. Etiology and mechanisms of ulnar and median forearm nerve injuries

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    Puzović Vladimir

    2015-01-01

    Full Text Available Bacgraund/Aim. Most often injuries of brachial plexus and its branches disable the injured from using their arms and/or hands. The aim of this study was to investigate the etiology and mechanisms of median and ulnar forearm nerves injuries. Methods. This retrospective cohort study included 99 patients surgically treated in the Clinic of Neurosurgery, Clinical Center of Serbia, from January 1st, 2000 to December 31st, 2010. All data are obtained from the patients' histories. Results. The majority of the injured patients were male, 81 (81.8%, while only 18 (18.2% were females, both mainly with nerve injuries of the distal forearm - 75 (75.6%. Two injury mechanisms were present, transection in 85 patients and traction and contusion in 14 of the patients. The most frequent etiological factor of nerve injuries was cutting, in 61 of the patients. Nerve injuries are often associated with other injuries. In the studied patients there were 22 vascular injuries, 33 muscle and tendon injuries and 20 bone fractures. Conclusion. The majority of those patients with peripheral nerve injuries are represented in the working age population, which is a major socioeconomic problem. In our study 66 out of 99 patients were between 17 and 40 years old, in the most productive age. The fact that the majority of patients had nerve injuries of the distal forearm and that they are operated within the first 6 months after injury, promises them good functional prognosis.

  2. Ulnar nerve paralysis after forearm bone fracture

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    Carlos Roberto Schwartsmann

    2016-08-01

    Full Text Available ABSTRACT Paralysis or nerve injury associated with fractures of forearm bones fracture is rare and is more common in exposed fractures with large soft-tissue injuries. Ulnar nerve paralysis is a rare condition associated with closed fractures of the forearm. In most cases, the cause of paralysis is nerve contusion, which evolves with neuropraxia. However, nerve lacerations and entrapment at the fracture site always need to be borne in mind. This becomes more important when neuropraxia appears or worsens after reduction of a closed fracture of the forearm has been completed. The importance of diagnosing this injury and differentiating its features lies in the fact that, depending on the type of lesion, different types of management will be chosen.

  3. Ulnar nerve paralysis after forearm bone fracture.

    Science.gov (United States)

    Schwartsmann, Carlos Roberto; Ruschel, Paulo Henrique; Huyer, Rodrigo Guimarães

    2016-01-01

    Paralysis or nerve injury associated with fractures of forearm bones fracture is rare and is more common in exposed fractures with large soft-tissue injuries. Ulnar nerve paralysis is a rare condition associated with closed fractures of the forearm. In most cases, the cause of paralysis is nerve contusion, which evolves with neuropraxia. However, nerve lacerations and entrapment at the fracture site always need to be borne in mind. This becomes more important when neuropraxia appears or worsens after reduction of a closed fracture of the forearm has been completed. The importance of diagnosing this injury and differentiating its features lies in the fact that, depending on the type of lesion, different types of management will be chosen.

  4. Forearm compartment syndrome secondary to leukemic infiltrates.

    Science.gov (United States)

    Trumble, T

    1987-07-01

    A 20-year-old white man with leukemia was recently treated with chemotherapy and was admitted to the Massachusetts General Hospital with a fever and a swollen and painful left forearm that worsened despite intravenous antibiotics. The flexor forearm compartment pressures were elevated; therefore, surgical decompression of the flexor compartments was done. All the wound cultures were negative, and biopsy specimens of tissue showed leukemic infiltrates in the muscle and subcutaneous tissue. Tumor infiltrates may result in increased compartmental pressures, and the treatment of these lesions includes chemotherapy and/or radiation therapy to provide local control of the tumor.

  5. An EMG-CT method using multiple surface electrodes in the forearm.

    Science.gov (United States)

    Nakajima, Yasuhiro; Keeratihattayakorn, Saran; Yoshinari, Satoshi; Tadano, Shigeru

    2014-12-01

    Electromyography computed tomography (EMG-CT) method is proposed for visualizing the individual muscle activities in the human forearm. An EMG conduction model was formulated for reverse-estimation of muscle activities using EMG signals obtained with multi surface electrodes. The optimization process was calculated using sequential quadratic programming by comparing the estimated EMG values from the model with the measured values. The individual muscle activities in the deep region were estimated and used to produce an EMG tomographic image. For validation of the method, isometric contractions of finger muscles were examined for three subjects, applying a flexion load (4.9, 7.4 and 9.8 N) to the proximal interphalangeal joint of the middle finger. EMG signals in the forearm were recorded during the tasks using multiple surface electrodes, which were bound around the subject's forearm. The EMG-CT method illustrates the distribution of muscle activities within the forearm. The change in amplitude and area of activated muscles can be observed. The normalized muscle activities of all three subjects appear to increase monotonically with increases in the load. Kinesiologically, this method was able to estimate individual muscle activation values and could provide a novel tool for studying hand function and development of an examination for evaluating rehabilitation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Methods of physiotherapy after fracture of the distal forearm

    OpenAIRE

    Šaldová, Kateřina

    2014-01-01

    Name: Kateřina Šaldová Bachelor thesis supervisor: Mgr. Eva Svobodová Title: Methods of physiotherapy after fracture of the distal forearm Abstract: The thesis deals with the issue of distal forearm fractures and subsequent physical therapy. The theoretical part contains an anatomical description and the kinematics of the forearm and the hand. The next chapter is about injuries to the skeletal system - fractures and their healing and classification. The part focusing on distal forearm fractur...

  7. Reconstruction of the elbow and forearm for Ewing sarcoma of ulna: A new biological technique.

    Science.gov (United States)

    Puri, Ajay; Gulia, Ashish; Byregowda, Suman; Ramanujan, Vishnu

    2016-01-01

    Primary bone tumors around the elbow represent <1% of all the skeletal tumors. Surgery with or without adjuvant therapy (radiotherapy, chemotherapy) is the treatment of choice for malignant tumors. Reconstruction of the elbow and forearm in malignant tumors is challenging as it involves a complex interplay between multiple joints which need to be stabilized for the optimal functional outcome. We describe a new technique for the reconstruction of the elbow after resection of a proximal ulna tumor with articular radio-ulnar synostosis with the creation of a single bone forearm. We attempted to achieve a mobile elbow and stable wrist joint with the radio-ulnar union at the proximal articular surface of the ulna resulting in a single bone forearm. The procedure involves an oblique osteotomy preserving the olecranon process (after taking adequate margins based on oncological principles) and its articular cartilage along with the attachment of the triceps tendon. Then the radial head was partially denuded of its cartilage using a burr, leaving cartilage only on the volar side, and then fused to the remnant olecranon. Osteosynthesis was done using compression screw and tension band wiring. The advantages of this procedure are that the mobility at wrist and elbow are retained, it requires minimal hardware and allows for primary closure of the wound.

  8. Preoperative assessment of the cancellous bone mineral density of the proximal humerus using CT data

    Energy Technology Data Exchange (ETDEWEB)

    Krappinger, Dietmar; Roth, Tobias; Gschwentner, Martin; Suckert, Armin; Blauth, Michael; Hengg, Clemens; Kralinger, Franz [Innsbruck Medical University, Department of Trauma Surgery and Sports Medicine, Innsbruck (Austria)

    2012-03-15

    Osteoporotic fractures of the proximal humerus show an increasing incidence. Osteoporosis not only influences the fracture risk after low-energy trauma, but also affects the mechanical stability of internal fixation. Preoperative assessment of the local bone quality may be useful in the surgical treatment of patients sustaining these injuries. The aim of the present study was to present a method for the preoperative assessment of the local cancellous bone mineral density (BMD) of the proximal humerus using CT data. In the first part of the study, CT scans of 30 patients with unilateral fractures of the proximal humerus after low-energy trauma were used. The local BMD was assessed on the contralateral uninjured side. All 30 patients additionally underwent dual-emission X-ray absorptiometry (DXA) of the lumbar spine, proximal femur, and forearm of the side of the uninjured proximal humerus within 6 weeks after trauma. Three independent trauma surgeons performed measurements on the uninjured proximal humerus twice with a time interval of 4 weeks in order to assess the inter- and intraobserver reliability of the method. In the second part of the study, the local BMD of 507 patients with either proximal humerus fractures or chronic shoulder instability was assessed by a single trauma surgeon. In both parts, the average HU values in standardized ROIs of the humeral head were automatically calculated after correcting for HU values below the water equivalent. A linear calibration equation was computed for the calculation from HU to BMD using a calibration device (EFP). The intra- and interobserver reliability was high (ICC > 0.95). Correlation coefficients between the local BMD of the proximal humerus and other anatomical sites were between 0.35 (lumbar spine) and 0.64 (forearm). We found a high correlation between the local BMD and age. The BMD in the fracture group was significantly lower than in the instability group. These patients were significantly older and more

  9. Treatment of proximal hamstring tendinopathy-related sciatic nerve entrapment: presentation of an ultrasound-guided “Intratissue Percutaneous Electrolysis” application

    Science.gov (United States)

    Mattiussi, Gabriele; Moreno, Carlos

    2016-01-01

    Summary Background Proximal Hamstring Tendinopathy-related Sciatic Nerve Entrapment (PHTrSNE) is a neuropathy caused by fibrosis interposed between the semimembranosus tendon and the sciatic nerve, at the level of the ischial tuberosity. Methods Ultrasound-guided Intratissue Percutaneous Electrolysis (US-guided EPI) involves galvanic current transfer within the treatment target tissue (fibrosis) via a needle 0.30 to 0.33 mm in diameter. The galvanic current in a saline solution instantly develops the chemical process of electrolysis, which in turn induces electrochemical ablation of fibrosis. In this article, the interventional procedure is presented in detail, and both the strengths and limits of the technique are discussed. Results US-guided EPI eliminates the fibrotic accumulation that causes PHTrSNE, without the semimembranosus tendon or the sciatic nerve being directly involved during the procedure. The technique is however of limited use in cases of compression neuropathy. Conclusion US-guided EPI is a technique that is quick to perform, minimally invasive and does not force the patient to suspend their activities (work or sports) to make the treatment effective. This, coupled to the fact that the technique is generally well-tolerated by patients, supports use of US-guided EPI in the treatment of PHTrSNE. PMID:27900300

  10. Laparoscopic Management of a Proximal Jejunal Gallstone Ileus with Patulous Ampulla and Choledochal Cyst-a Report of Unusual Presentation and a Review.

    Science.gov (United States)

    Narkhede, Rajvilas Anil; Bada, Vijaykumar C; Kona, Lakshmi Kumari

    2017-02-01

    Gallstone ileus is a diagnosis of rarity, and a proximal site of obstruction in a young patient is even rare. Of the three cases in our experience, we found two cases of gallstone ileus (GSI) with typical epidemiology and presentation, one had combination of multiple rare associations. We report such a case, suspected to have gallstone ileus on ultrasound and confirmed diagnosis on computed tomography. Presence of biliary-enteric fistula, old age, and obstructive features, as in typical cases, was a bigger asset for diagnosis, but it was difficult to entertain diagnosis of GSI in young girl in absence of a demonstrable biliary-enteric fistula, with uncommon association of choledochal cyst and sickle cell disease. A very surprising finding, dilated major papilla, could however explain the pathogenesis which has also been reported in the past. Although differential opinions regarding management exist, we decided to follow two-stage surgery as our institute protocol. A minimal access approach has been immensely helpful in accurate diagnosis, and expedative management with early recovery has been proven in the past studies which we agreed with our experience.

  11. Comparative anatomical analyses of the forearm muscles of Cebus libidinosus (Rylands et al. 2000: manipulatory behavior and tool use.

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    Tales Alexandre Aversi-Ferreira

    Full Text Available The present study describes the flexor and extensor muscles in Cebus libidinosus' forearm and compares them with those from humans, chimpanzees and baboons. The data is presented in quantitative anatomical indices for similarity. The capuchin forearm muscles showed important similarities with chimpanzees and humans, particularly those that act on thumb motion and allow certain degree of independence from other hand structures, even though their configuration does not enable a true opposable thumb. The characteristics of Cebus' forearm muscles corroborate the evolutionary convergence towards an adaptive behavior (tool use between Cebus genus and apes.

  12. Biomechanics of Forearm Rotation: Force and Efficiency of Pronator Teres

    Science.gov (United States)

    Ibáñez-Gimeno, Pere; Galtés, Ignasi; Jordana, Xavier; Malgosa, Assumpció; Manyosa, Joan

    2014-01-01

    Biomechanical models are useful to assess the effect of muscular forces on bone structure. Using skeletal remains, we analyze pronator teres rotational efficiency and its force components throughout the entire flexion-extension and pronation-supination ranges by means of a new biomechanical model and 3D imaging techniques, and we explore the relationship between these parameters and skeletal structure. The results show that maximal efficiency is the highest in full elbow flexion and is close to forearm neutral position for each elbow angle. The vertical component of pronator teres force is the highest among all components and is greater in pronation and elbow extension. The radial component becomes negative in pronation and reaches lower values as the elbow flexes. Both components could enhance radial curvature, especially in pronation. The model also enables to calculate efficiency and force components simulating changes in osteometric parameters. An increase of radial curvature improves efficiency and displaces the position where the radial component becomes negative towards the end of pronation. A more proximal location of pronator teres radial enthesis and a larger humeral medial epicondyle increase efficiency and displace the position where this component becomes negative towards forearm neutral position, which enhances radial curvature. Efficiency is also affected by medial epicondylar orientation and carrying angle. Moreover, reaching an object and bringing it close to the face in a close-to-neutral position improve efficiency and entail an equilibrium between the forces affecting the elbow joint stability. When the upper-limb skeleton is used in positions of low efficiency, implying unbalanced force components, it undergoes plastic changes, which improve these parameters. These findings are useful for studies on ergonomics and orthopaedics, and the model could also be applied to fossil primates in order to infer their locomotor form. Moreover, activity

  13. A newly designed intramedullary nail for the treatment of diaphyseal forearm fractures in adults

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    Ibrahim Azboy

    2017-01-01

    Full Text Available Background: The treatment of diaphyseal forearm fractures using open reduction and plate fixation is generally accepted as the best choice in many studies. However, periosteal stripping, haematoma evacuation may result in delayed union, nonunion and infection. Refracture after plate removal is another concern. To overcome these problems intramedullary nails (IM with different designs have been used with various outcomes. However previous IM nails have some shortcomings such is rotational instability and interlocking difficulties. We evaluated the results of newly designed IM nail in the treatment of diaphyseal forearm fractures in adults. Materials and Methods: 32 patients who had been treated with the interlocking IM nail for forearm fractures between 2011 and 2014 were included in this study. There were 23 males and 9 females with mean age of 36 years (range 18-68 years. 22 patients (68.8% had both bone fractures. Nine patients (28.1% had open fractures. The remaining ten patients (31.2% had radius or ulna fractures. Grace and Eversmann rating system was used to assess functional evaluation. Patient reported outcomes were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH questionnaire scores. Results: Union was achieved in all patients. The mean followup was 17 months (range 13 – 28 months. According to the Grace-Eversmann criteria, 27 patients (87.5% had excellent or good results. The mean DASH score was 14 (range 5-36. Overall complication rate was 12.5%. Superficial infection was encountered in two patients. One patient had delayed union, however fracture healed without any additional surgical procedure. One patient who had open grade 3A, comminuted proximal third radius fracture developed radioulnar synostosis. Conclusions: The new design IM interlocking forearm nail provides satisfactory functional and radiological outcomes in the treatment of adult diaphyseal forearm fractures.

  14. Forearm Posture and Mobility in Quadrupedal Dinosaurs

    OpenAIRE

    Dodson, Peter; VanBuren, Collin S.; Bonnan, Matthew

    2013-01-01

    Quadrupedality evolved four independent times in dinosaurs; however, the constraints associated with these transitions in limb anatomy and function remain poorly understood, in particular the evolution of forearm posture and rotational ability (i.e., active pronation and supination). Results of previous qualitative studies are inconsistent, likely due to an inability to quantitatively assess the likelihood of their conclusions. We attempt to quantify antebrachial posture and mobility using th...

  15. Forearm blood flow responses of offspring of hypertensives to an extended stress task.

    Science.gov (United States)

    Ditto, B; Miller, S B

    1989-02-01

    The forearm blood flow and other cardiovascular responses of 10 healthy young men with a parental history of hypertension to an extended laboratory stressor were compared with the responses of 10 age-matched men with normotensive parents. To eliminate the effects of the anticipation of stress on baseline measures, all subjects participated in a separate 1-hour counterbalanced baseline session in which no stress was presented. There were no significant differences between the two groups in resting blood pressure, heart rate, blood volume pulse, forearm blood flow and vascular resistance, and self-report anxiety, although offspring of hypertensive parents exhibited marginally greater (p = 0.08) forearm blood flow at rest. During the stress session, subjects played video games for 1 hour and avoided mild electric shocks depending on performance. Offspring of hypertensive parents exhibited significantly greater heart rate (+19 +/- 6 vs. +3 +/- 2%), forearm blood flow (+52 +/- 14 vs. +9 +/- 4%), and self-report anxiety (+25 +/- 6 vs. +9 +/- 3%) responses to the task. There were no significant group differences in blood pressure response to the task. Significant positive correlations between forearm blood flow and heart rate responses to the task were observed. These findings extend earlier results that suggested healthy young offspring of hypertensive and normotensive parents may exhibit different patterns of hemodynamic response to stress in the absence of differences in resting blood pressure or blood pressure responsiveness to stress.

  16. Timing of forearm deformity correction in a child with multiple hereditary exostosis.

    Science.gov (United States)

    Beutel, Bryan G; Klifto, Christopher S; Chu, Alice

    2014-09-01

    Multiple hereditary exostosis (MHE) can cause progressive skeletal deformities (eg, ulnar shortening, bowing, radial head dislocation) in the upper extremity. Various procedures have been used to correct forearm deformity in children with MHE. The timing of these procedures, however, is controversial. An 11-year-old boy with known MHE presented 7 months after onset of left elbow pain and loss of flexion-extension to 40° to 120°. Radiographs showed a distal ulna osteochondroma, ulnar shortening, bowing, and radial head dislocation. Eighteen months after ulnar osteotomy, radial head reduction, and external fixation, he had motion from 0° to 135°. This case demonstrates that later stage MHE-induced forearm deformities can be successfully surgically corrected. Given possible recurrence during growth, there may be an indication for waiting until the patient is closer to skeletal maturity before proceeding with corrective forearm procedures.

  17. Endoscopic fasciotomy in chronic exertional compartment syndrome of the forearm caused by heavy manual work – case report

    Directory of Open Access Journals (Sweden)

    Wilmink, Beate

    2016-06-01

    Full Text Available Chronic exertional compartment syndrome (CECS of the forearm is a rare condition causing pain, tenderness, swelling, paraesthesia and muscle weakness. It is caused by a critical augmentation of the extracellular pressure of the forearm compartments induced by intensive sport or heavy manual work. This case report describes a 33-year-old demolition worker who presented with chronic exertional compartment syndrome of both forearms induced by severe physical work. The exclusion diagnosis was made based on clinical and electro-physiological examinations. The patient was treated using a minimal-invasive one portal endoscopic fasciotomy. He resumed to full work duties with no recurrence of symptoms during strain caused by heavy lifting and carrying. In conclusion, endoscopic forearm fascial release is a safe, efficient and minimally invasive technique that avoids the disadvantages associated with open decompression in cases of CECS and facilitates an early resumption of work.

  18. Ulnar nerve palsy after closed forearm fracture: a case report

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    Levent Kucuk

    2012-04-01

    Full Text Available Closed double bone forearm fractures are among the most common fractures of childhood. These fractures often heal without problems with closed reduction and casting. The leading complications are known as malunion and compartment syndrome. The reports about nerve injuries related with these fractures are very limited. We present an eight years old boy who admitted to our hospital with ulnar nerve palsy symptomps three months after his initial trauma. His initial trauma was a simple fall which caused radius and ulna fractures. Radiological assessment showed proper union of the fractures. We performed surgical exploration to the ulnar nerve. We found a trapped and damaged nerve in the fracture region. Even though the rate of complications about nerve injuries are extremely rare in forearm fractures, neurologic examinations should be performed before and after the reduction maneuvers. Neurologic examination will be not only a guide for fracture management but also an important point for medicolegal problems. [Hand Microsurg 2012; 1(1.000: 30-32

  19. Prevalence of vitamin D insufficiency in children with forearm fractures.

    Science.gov (United States)

    Saglam, Y; Kizildag, H; Toprak, G; Alp, N B; Yalcinkaya, E Y

    2017-06-01

    This study aimed to determine whether children with distal radius impaction fractures have increased prevalence of 25-hydroxyvitamin D (25(OH) D) insufficiency compared with healthy controls. This is a prospective controlled study. The 30 children who were diagnosed with forearm fracture at the orthopaedic emergency clinic were included in the study and 30 healthy children from the routine paediatric outpatient unit were included as the control group. Peripheric venous 25(OH) D, calcium (Ca), magnesium (Mg), phosphor (P), alkaline phosphatase (ALP) and parathyroid hormone (PTH) of both groups were recorded. The sample size was estimated based on the effect size for a type I error of 5% and power of 80%. Demographic characteristics of the two groups did not differ in terms of weekly physical activity levels and breast milk intake. The mean whole body BMI was similar in both groups of patients. History of previous fracture and 25(OH) D level were significantly lower in the patient group than the control group. In the present study, the prevalence of vitamin D insufficiency or deficiency was higher in patients with forearm impaction type fractures than healthy controls and the baseline levels reported in the literature. In addition, there were no significant differences in serum Ca, Mg, P, ALP and PTH levels between the healthy controls and the patient group.

  20. Microwave Imaging of Human Forearms: Pilot Study and Image Enhancement

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    Colin Gilmore

    2013-01-01

    Full Text Available We present a pilot study using a microwave tomography system in which we image the forearms of 5 adult male and female volunteers between the ages of 30 and 48. Microwave scattering data were collected at 0.8 to 1.2 GHz with 24 transmitting and receiving antennas located in a matching fluid of deionized water and table salt. Inversion of the microwave data was performed with a balanced version of the multiplicative-regularized contrast source inversion algorithm formulated using the finite-element method (FEM-CSI. T1-weighted MRI images of each volunteer’s forearm were also collected in the same plane as the microwave scattering experiment. Initial “blind” imaging results from the utilized inversion algorithm show that the image quality is dependent on the thickness of the arm’s peripheral adipose tissue layer; thicker layers of adipose tissue lead to poorer overall image quality. Due to the exible nature of the FEM-CSI algorithm used, prior information can be readily incorporated into the microwave imaging inversion process. We show that by introducing prior information into the FEM-CSI algorithm the internal anatomical features of all the arms are resolved, significantly improving the images. The prior information was estimated manually from the blind inversions using an ad hoc procedure.

  1. Forearm articular proportions and the antebrachial index in Homo sapiens, Australopithecus afarensis and the great apes.

    Science.gov (United States)

    Williams, Frank L'Engle; Cunningham, Deborah L; Amaral, Lia Q

    2015-12-01

    When hominin bipedality evolved, the forearms were free to adopt nonlocomotor tasks which may have resulted in changes to the articular surfaces of the ulna and the relative lengths of the forearm bones. Similarly, sex differences in forearm proportions may be more likely to emerge in bipeds than in the great apes given the locomotor constraints in Gorilla, Pan and Pongo. To test these assumptions, ulnar articular proportions and the antebrachial index (radius length/ulna length) in Homo sapiens (n=51), Gorilla gorilla (n=88), Pan troglodytes (n=49), Pongo pygmaeus (n=36) and Australopithecus afarensis A.L. 288-1 and A.L. 438-1 are compared. Intercept-adjusted ratios are used to control for size and minimize the effects of allometry. Canonical scores axes show that the proximally broad and elongated trochlear notch with respect to size in H. sapiens and A. afarensis is largely distinct from G. gorilla, P. troglodytes and P. pygmaeus. A cluster analysis of scaled ulnar articular dimensions groups H. sapiens males with A.L. 438-1 ulna length estimates, while one A.L. 288-1 ulna length estimate groups with Pan and another clusters most closely with H. sapiens, G. gorilla and A.L. 438-1. The relatively low antebrachial index characterizing H. sapiens and non-outlier estimates of A.L. 288-1 and A.L. 438-1 differs from those of the great apes. Unique sex differences in H. sapiens suggest a link between bipedality and forearm functional morphology. Copyright © 2015 Elsevier GmbH. All rights reserved.

  2. Presentation

    Directory of Open Access Journals (Sweden)

    Eduardo Vicente

    2013-06-01

    Full Text Available In the present edition of Significação – Scientific Journal for Audiovisual Culture and in the others to follow something new is brought: the presence of thematic dossiers which are to be organized by invited scholars. The appointed subject for the very first one of them was Radio and the invited scholar, Eduardo Vicente, professor at the Graduate Course in Audiovisual and at the Postgraduate Program in Audiovisual Media and Processes of the School of Communication and Arts of the University of São Paulo (ECA-USP. Entitled Radio Beyond Borders the dossier gathers six articles and the intention of reuniting works on the perspectives of usage of such media as much as on the new possibilities of aesthetical experimenting being build up for it, especially considering the new digital technologies and technological convergences. It also intends to present works with original theoretical approach and original reflections able to reset the way we look at what is today already a centennial media. Having broadened the meaning of “beyond borders”, four foreign authors were invited to join the dossier. This is the first time they are being published in this country and so, in all cases, the articles where either written or translated into Portuguese.The dossier begins with “Radio is dead…Long live to the sound”, which is the transcription of a thought provoking lecture given by Armand Balsebre (Autonomous University of Barcelona – one of the most influential authors in the world on the Radio study field. It addresses the challenges such media is to face so that it can become “a new sound media, in the context of a new soundscape or sound-sphere, for the new listeners”. Andrew Dubber (Birmingham City University regarding the challenges posed by a Digital Era argues for a theoretical approach in radio studies which can consider a Media Ecology. The author understands the form and discourse of radio as a negotiation of affordances and

  3. Teaching Strategies for the Forearm Pass in Volleyball

    Science.gov (United States)

    Casebolt, Kevin; Zhang, Peng; Brett, Christine

    2014-01-01

    This article shares teaching strategies for the forearm pass in the game of volleyball and identifies how they will help students improve their performance and development of forearm passing skills. The article also provides an assessment rubric to facilitate student understanding of the skill.

  4. Total phallic reconstruction using radial forearm free flap after iatrogenic penile amputation.

    Science.gov (United States)

    Angulo, J C; Arance, I; Gómez-Llorens, C; Esquinas, C; Gómez-Martín, C; Fernández-Cañamaque, J L

    2017-09-01

    The iatrogenic loss of the penis is a rare situation. We present a challenging case of deferred total penile reconstruction in a genetic male. A 57-year-old man with the loss of the penis due to a penile abscess and necrosis secondary to penile curvature surgery. The reconstruction was performed over several operations using a radial forearm free flap (RFFF) and placement of a customised inflatable prosthesis a year later. During the first operation, the penile abscess was drained, the necrotic residues were debrided and placement of hypogastric drainage. Seven weeks later, phalloplasty was performed with RFFF and a tube-in-tube neourethra was constructed. Multiple microsurgical anastomosis was performed, and the donor site was coated with a skin graft from the thigh of partial thickness. The surgery lasted 10hours and had the complication of hair growth in the neourethra, which required mechanical endoscopic depilation on repeated occasions. The patient regained penile sensitivity. Eighteen months after the phalloplasty, a Zephyr single-body inflatable prosthesis (Geneva, Switzerland) was implanted, using the tunica albuginea of the proximal corpus cavernosum. The patient was satisfied with the aesthetics and urinary and sensory function. Four months later, the patient is gaining confidence to consider penetration. Despite the risk of postoperative complications and the need for multiple operations, phallic reconstruction with RFFF and the placement of a customised prosthetic implant can improve urinary and sexual function secondary to the loss of the penis. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Rush nail and management of fracture both bone forearm

    Directory of Open Access Journals (Sweden)

    Soumya Ghosh

    2014-01-01

    Full Text Available Background: The failure of the conventional nailing of both bone of the forearm poses a potential problem of nail migration and rotational instability, despite the best reduction. Objectives: Rush nail is a very handy, low cost easily available implant. In the present study, we have tried to find out its applicability if used in the closed manner under C-arm control without injurying soft tissues and preserving the periosteal vascularity. Materials and Methods: This prospective study was conducted on thirty adult subjects. Skeletally mature subjects with Gustilo type 1 open and closed fractures without the neurovascular deficit were included. Stainless steel rush nails were used for all patients for both radius and ulnar repair. Patients were followed-up for a minimum of 4 months and maximum of 1.5 years. Results: The mean age of study participants was 37.43 years. Mean time of the union was 14.32 weeks. Average operative time was 67.16 min. No intraoperative complication occurred nor was any nailing converted to some other form of fixation, except in three cases radial nail was introduced by open method through anterior Henry′s approach. Cast support was maintained for a mean of 7.43 weeks, after that forearm brace was applied for a mean period of 6.26 weeks and continued until radiographic union was seen. Three patients showed non-union of radius mostly distal third. They were treated with open reduction and internal fixation with locking plate and bone grafting. One patient had extensor tendon injury. Two patients have superficial infection which cured with antibiotics. One case had delayed union of radius which required bone grafting. Two patients had gross restrictions of wrist movements and pronation-supination movement. Using Anderson criteria 22 patients had satisfactory results (71.33%, three patients had excellent result. Three patients had non-unions (10%. Implant removal was performed in two cases about 14 months post

  6. The passive stiffness of the wrist and forearm

    Science.gov (United States)

    Charles, Steven K.; Zollo, Loredana; Guglielmelli, Eugenio; Hogan, Neville; Krebs, Hermano I.

    2012-01-01

    Because wrist rotation dynamics are dominated by stiffness (Charles SK, Hogan N. J Biomech 44: 614–621, 2011), understanding how humans plan and execute coordinated wrist rotations requires knowledge of the stiffness characteristics of the wrist joint. In the past, the passive stiffness of the wrist joint has been measured in 1 degree of freedom (DOF). Although these 1-DOF measurements inform us of the dynamics the neuromuscular system must overcome to rotate the wrist in pure flexion-extension (FE) or pure radial-ulnar deviation (RUD), the wrist rarely rotates in pure FE or RUD. Instead, understanding natural wrist rotations requires knowledge of wrist stiffness in combinations of FE and RUD. The purpose of this report is to present measurements of passive wrist stiffness throughout the space spanned by FE and RUD. Using a rehabilitation robot designed for the wrist and forearm, we measured the passive stiffness of the wrist joint in 10 subjects in FE, RUD, and combinations. For comparison, we measured the passive stiffness of the forearm (in pronation-supination), as well. Our measurements in pure FE and RUD agreed well with previous 1-DOF measurements. We have linearized the 2-DOF stiffness measurements and present them in the form of stiffness ellipses and as stiffness matrices useful for modeling wrist rotation dynamics. We found that passive wrist stiffness was anisotropic, with greater stiffness in RUD than in FE. We also found that passive wrist stiffness did not align with the anatomical axes of the wrist; the major and minor axes of the stiffness ellipse were rotated with respect to the FE and RUD axes by ∼20°. The direction of least stiffness was between ulnar flexion and radial extension, a direction used in many natural movements (known as the “dart-thrower's motion”), suggesting that the nervous system may take advantage of the direction of least stiffness for common wrist rotations. PMID:22649208

  7. Single portal endoscopic treatment for chronic exertional compartment syndrome of the forearm.

    Science.gov (United States)

    Pozzi, Alessandro; Pivato, Giorgio; Kask, Kristo; Susini, Francesca; Pegoli, Loris

    2014-09-01

    Chronic exertional compartment syndrome of the forearm is an unusual disease not commonly found in the daily practice of a hand surgeon. This condition is quite rare in the general population but occurs more frequently among musicians and athletes, with the highest incidence found in professional motorcycle drivers. It is mainly because of a critical augmentation of the extracellular pressure of the forearm compartments. The diagnosis is mainly clinical, based on stress dynamic tests and intracompartmental pressure measurements. Traditionally, the treatment of this disease has revolved around trigger activity suspension. In the case of professional athletes, this solution cannot be considered and thus the standard surgical treatment consists of an open forearm fasciotomy. This procedure usually requires a lengthy operation period and has a long recovery time before patients can resume their regular activity. Different surgical endoscopic solutions with mini-open techniques have been proposed to shorten this time and reduce the incision size. The aim of this study was to present a new technique for endoscopic-assisted fasciotomy of the forearm in chronic exertional compartment syndrome using a single mini-incision. Four surgical procedures were performed in 3 patients. They were all treated at our center for this condition, and in one case the disease was found on both sides.

  8. Acute forearm compartment syndrome following haemodialysis access fistula puncture in uraemia.

    Science.gov (United States)

    Lin, Chin-Ta; Dai, Niann-Tzyy; Chen, Shyi-Gen; Chang, Shun-Cheng

    2016-10-01

    Acute compartment syndrome is a well-described surgical emergency that requires immediate diagnosis and operative intervention. Vascular access-associated compartment syndrome is rarely reported in haemodialysis patients. The purpose of this article is to document evidence that catheter-related puncture, which results in arteriovenous fistula injury in uraemia, may cause acute forearm compartment syndrome. Between September 2007 and September 2012, five consecutive patients presented to our section with tense swollen forearms with skin blistering, decreased hand sensation and reduced capillary return in the fingers. Their ages ranged from 65 to 81 years (mean 72.8 years). All of the patients underwent emergent exploration after the diagnosis of acute forearm compartment syndrome. The patients' details were reviewed. The time interval between dialysis completion and return to the emergency department ranged from 6 to 9 h (mean 7.4 h). During operation, the bleeding was found to originate from the site of the fistula puncture and was repaired with 9-0 nylon suture under microscopy. After adequate wound care, a reconstructive procedure with a split-thickness skin graft was performed in all of the five patients. There was no vascular or neurological deficit of the forearm or hand within the mean follow-up period of 14.8 months (range 12-18 months). In this series, we report five cases of forearm compartment syndrome in uraemia, secondary to bleeding from a catheter-related puncture of a haemodialysis access fistula. However, there is no case series that focuses upon this specific topic in the present literature. This problem deserves more attention. © 2014 Royal Australasian College of Surgeons.

  9. Forearm Range of Motion in Australovenator wintonensis (Theropoda, Megaraptoridae.

    Directory of Open Access Journals (Sweden)

    Matt A White

    Full Text Available The hypertrophied manual claws and modified manus of megaraptoran theropods represent an unusual morphological adaptation among carnivorous dinosaurs. The skeleton of Australovenator wintonensis from the Cenomanian of Australia is among the most complete of any megaraptorid. It presents the opportunity to examine the range of motion of its forearm and the function of its highly modified manus. This provides the basis for behavioural inferences, and comparison with other Gondwanan theropod groups. Digital models created from computed tomography scans of the holotype reveal a humerus range of motion that is much greater than Allosaurus, Acrocanthosaurus, Tyrannosaurus but similar to that of the dromaeosaurid Bambiraptor. During flexion, the radius was forced distally by the radial condyle of the humerus. This movement is here suggested as a mechanism that forced a medial movement of the wrist. The antebrachium possessed a range of motion that was close to dromaeosaurids; however, the unguals were capable of hyper-extension, in particular manual phalanx I-2, which is a primitive range of motion characteristic seen in allosaurids and Dilophosaurus. During flexion, digits I and II slightly converge and diverge when extended which is accentuated by hyperextension of the digits in particular the unguals. We envision that prey was dispatched by its hands and feet with manual phalanx I-2 playing a dominant role. The range of motion analysis neither confirms nor refutes current phylogenetic hypotheses with regards to the placement of Megaraptoridae; however, we note Australovenator possessed, not only a similar forearm range of motion to some maniraptorans and basal coelurosaurs, but also similarities with Tetanurans (Allosauroids and Dilophosaurus.

  10. Synergistic control of forearm based on accelerometer data and artificial neural networks

    Directory of Open Access Journals (Sweden)

    B. Mijovic

    2008-05-01

    Full Text Available In the present study, we modeled a reaching task as a two-link mechanism. The upper arm and forearm motion trajectories during vertical arm movements were estimated from the measured angular accelerations with dual-axis accelerometers. A data set of reaching synergies from able-bodied individuals was used to train a radial basis function artificial neural network with upper arm/forearm tangential angular accelerations. The trained radial basis function artificial neural network for the specific movements predicted forearm motion from new upper arm trajectories with high correlation (mean, 0.9149-0.941. For all other movements, prediction was low (range, 0.0316-0.8302. Results suggest that the proposed algorithm is successful in generalization over similar motions and subjects. Such networks may be used as a high-level controller that could predict forearm kinematics from voluntary movements of the upper arm. This methodology is suitable for restoring the upper limb functions of individuals with motor disabilities of the forearm, but not of the upper arm. The developed control paradigm is applicable to upper-limb orthotic systems employing functional electrical stimulation. The proposed approach is of great significance particularly for humans with spinal cord injuries in a free-living environment. The implication of a measurement system with dual-axis accelerometers, developed for this study, is further seen in the evaluation of movement during the course of rehabilitation. For this purpose, training-related changes in synergies apparent from movement kinematics during rehabilitation would characterize the extent and the course of recovery. As such, a simple system using this methodology is of particular importance for stroke patients. The results underlie the important issue of upper-limb coordination.

  11. Early postmenopausal diminution of forearm and spinal bone mineral density

    DEFF Research Database (Denmark)

    Bjarnason, K; Hassager, C; Ravn, Pernille

    1995-01-01

    ) and anteroposterior (AP) projections, and in the distal third of the forearm. The postmenopausal diminution of BMD was best described by an exponential fit. The initial rate of postmenopausal diminution of BMD was highest in the most trabecular sites (LAT > AP > forearm), but 10-year diminution was similar at all...... sites (12%-13%, corresponding to about 1.0-1.5 SD), and extrapolation suggested reverse order of the rates of diminution thereafter (forearm > AP > LAT). When bone mineral content of the entire L3 vertebra (tBMC) was measured in vivo, AP tBMC could account for only 67% of the variation in LAT t...

  12. [Anterior compartment syndrome of the forearm caused by exercise: unusual cause of recurrent episodes of acute effort rhabdomyolysis].

    Science.gov (United States)

    Drouet, A; Jaquin, O; Guilloton, L; Dumas, P; Volckmann, P; Ribot, C

    2001-04-01

    An effort-related compartmental syndrome is well known in the leg, but may be present infrequently, acutely or chronically in the anterior compartment of the forearm. We report a case of a 32-year-old man who presented four times after climbing exercises a bilateral compartment of the forearm, unusual because of the observation of rhabdomyolysis, but without irreversible damage. Clinical information and follow-up on two acute and 14 chronic cases were reexamined, showing a homogenous presentation. He refused fasciotomy because he stopped athletic activities. Measurement of intramuscular pressure after exertion was useful for diagnosis. A local effort-related pain must call to mind a chronic compartment syndrome of the forearm, which may risk incurring the acute form, with irreversible lesions of muscle and nerve, and possibly renal failure because of rhabdomyolysis.

  13. Proximal renal tubular acidosis

    Science.gov (United States)

    Renal tubular acidosis - proximal; Type II RTA; RTA - proximal; Renal tubular acidosis type II ... by alkaline substances, mainly bicarbonate. Proximal renal tubular acidosis (Type II RTA) occurs when bicarbonate is not ...

  14. A study of retrograde degeneration of median nerve forearm ...

    African Journals Online (AJOL)

    Mona Mokhtar El Bardawil

    Alexandria University, Department of Physical Medicine, Rheumatology and Rehabilitation, Egypt. Received 16 April 2013; accepted 24 August 2013. Available online 22 October 2013. KEYWORDS. Carpal tunnel syndrome;. Electrodiagnosis;. Forearm median mixed study;. Retrograde degeneration. Abstract Introduction: ...

  15. Does a distal forearm fracture lead to evaluation for osteoporosis? A retrospective cohort study in 147 Danish women

    DEFF Research Database (Denmark)

    Rud, Bo; Greibe, Rasmus; Hyldstrup, Lars

    2005-01-01

    for a densitometry to estimate the prevalence of osteoporosis. From May 1, 2001 to April 30, 2002, 147 women presented with a low-trauma distal forearm fractures. According to the review of hospital records, none of the women was referred for bone densitometry or spine X-rays. One woman had calcium and vitamin D......In postmenopausal women, a low-trauma distal forearm fracture is a risk factor for osteoporosis and future fracture, which indicates osteoporosis follow-up according to prevailing guidelines. We decided to determine how often women over 45 yr presenting with a low-trauma distal forearm fracture...... to a Danish emergency department during a 1-yr period were followed up for osteoporosis. We performed a retrospective review of hospital records and we sent the women and their general practitioners (GPs) questionnaires regarding the follow-up undertaken in primary care. Finally, we invited the women...

  16. Proximal humeral fractures

    OpenAIRE

    Mauro, Craig S.

    2011-01-01

    Proximal humeral fractures may present with many different configurations in patients with varying co-morbities and expectations. As a result, the treating physician must understand the fracture pattern, the quality of the bone, other patient-related factors, and the expanding range of reconstructive options to achieve the best functional outcome and to minimize complications. Current treatment options range from non-operative treatment with physical therapy to fracture fixation using percuta...

  17. Does a distal forearm fracture lead to evaluation for osteoporosis? A retrospective cohort study in 147 Danish women

    DEFF Research Database (Denmark)

    Rud, Bo; Greibe, Rasmus; Hyldstrup, Lars

    2005-01-01

    for a densitometry to estimate the prevalence of osteoporosis. From May 1, 2001 to April 30, 2002, 147 women presented with a low-trauma distal forearm fractures. According to the review of hospital records, none of the women was referred for bone densitometry or spine X-rays. One woman had calcium and vitamin D...... supplementation (CVDS) prescribed and two were recommended to consult their GPs for osteoporosis follow-up. In primary care, 12 women were referred for densitometry or spine X-rays, and 11 women started CVDS after the fracture. Women with risk factors for osteoporosis in addition to the forearm fracture were...... not more likely to be referred for densitometry or spine X-rays (p = 0.10). The prevalence of osteoporosis was 24% among the 79 women who underwent densitometry. Our study demonstrates a low use of available measures to reduce the risk of future fracture in women with a low-trauma distal forearm fracture...

  18. Vascular responses in forearm and calf to contralateral static exercises.

    Science.gov (United States)

    Duprez, D A; Essandoh, L K; Vanhoutte, P M; Shepherd, J T

    1989-02-01

    Ten normal subjects performed a 90-s isometric exercise [20, 30, and 40% of maximal voluntary contraction (MVC) of the flexor muscle of the right index finger or quadriceps muscle of the right leg. Contralateral forearm and calf blood flows (strain gauge plethysmography) and arterial blood pressure (auscultation) were measured simultaneously. Each exercise caused a decrease in forearm vascular resistance and a progressive increase in calf resistance. These changes were greatest with the 40% MVC. With finger exercise at 20 and 40% MVC, the percentage decreases in forearm vascular resistance from control were 12.3 and 22.7%, respectively (P less than 0.01). Similar decreases (9.5 and 24.9%, respectively; P less than 0.01) were noted with exercise of the quadriceps muscle. By contrast, the corresponding increases in calf vascular resistance were greater (P less than 0.01) with quadriceps exercise (13.3 and 55.4%, respectively) than with finger exercise (6.0 and 36.0%). Arrest of the circulation to the exercising muscles just before the exercise ended caused an abrupt increase in forearm vascular resistance and a decrease in calf resistance. These studies provide further evidence of the heterogeneity of responses of forearm and calf resistance vessels to certain cardiovascular stimuli.

  19. In Vivo Estimation of Human Forearm and Wrist Dynamic Properties.

    Science.gov (United States)

    Park, Kyungbin; Chang, Pyung-Hun; Kang, Sang Hoon

    2017-05-01

    It is important to estimate the 3 degree-of-freedom (DOF) impedance of human forearm and wrist (i.e., forearm prono-supination, and wrist flexion-extension and radial-ulnar deviation) in motor control and in the diagnosis of altered mechanical resistance following stroke. There is, however, a lack of methods to characterize 3 DOF impedance. Thus, we developed a reliable and accurate impedance estimation method, the distal internal model based impedance control (dIMBIC)-based method, to characterize the 3 DOF impedance, including cross-coupled terms between DOFs, for the first time. Its accuracy and reliability were experimentally validated using a robot with substantial nonlinear joint friction. The 3 DOF human forearm and wrist impedance of eight healthy subjects was reliably characterized, and its linear behavior was verified. Thus, the dIMBIC-based method can provide us with 3 DOF forearm and wrist impedance regardless of nonlinear robot joint friction. It is expected that, with the proposed method, the 3 DOF impedance estimation can promote motor control studies and complement the diagnosis of altered wrist and forearm resistance post-stroke by providing objective impedance estimates, including cross-coupled terms.

  20. Evaluating protocols for normalizing forearm electromyograms during power grip.

    Science.gov (United States)

    Ngo, Binh P T; Wells, Richard P

    2016-02-01

    Many studies use a reference task of an isometric maximum voluntary power grip task in a mid-pronated forearm posture to normalize their forearm electromyographic (EMG) signal amplitude. Currently there are no recommended protocols to do this. In order to provide guidance on the topic, we examined the EMG amplitude of six forearm muscles (three flexors and three extensors) during twenty different maximal voluntary efforts that included various gripping postures, force and moment exertions and compared them to a frequently used normalization task of exerting a maximum grip force, termed the reference task. 16 participants (8 male and 8 female, aged 18-26) were recruited for this study. Overall, maximal muscle activity was produced during the resisted moment tasks. When contrasted with the reference task, the resisted moment tasks produced EMG activity that was up to 2.8 times higher (pnormalize forearm EMG activity during power gripping prehensile tasks should use resisted flexor and extensor moment tasks to obtain better estimates of the forearm muscles' maximum electrical activation magnitudes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. [Free radial forearm flap in head and neck: our experience].

    Science.gov (United States)

    Tornero, Jordi; Cruz-Toro, Paula; Farré, Anna; Vega-Celiz, Jorge; Skufca, Javier; Nogués, Julio; Maños-Pujol, Manel

    2014-01-01

    Oncologic surgery leads to important defects and sequelae, as well as notable cosmetic and functional alterations. In this aspect reconstructive surgery has an essential role, allowing more radical excision and lower associated functional and cosmetic morbidities. The aim of this study was to present and evaluate the experience and results of the reconstructive microsurgery unit in our centre's ENT department. Retrospective study of procedures performed between 2006 and 2012. A total of 36 cases were reviewed. The primary tumour was found in the oropharynx (58%) in the majority of cases. In 5 cases the procedure was performed for reconstruction and fistula closure (4 pharyngostoma and 1 tracheoesophageal fistula). Failure from total necrosis was 16% (6/36). No associated mortality has been reported. The most common postoperative complications were wound dehiscence in 5 patients and pharyngostoma (fistula) in 5 cases. Prior radiotherapy significantly influenced the increase in the overall incidence of complications (P<05). Reconstructive surgery currently plays an important role in surgery for head and neck cancer. The radial forearm flap is a safe, reliable method for reconstruction of most defects in the ENT field. This type of intervention provides greater autonomy and safety in surgical oncology. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  2. Immediate and delayed effects of forearm kinesio taping on grip strength.

    Science.gov (United States)

    Kouhzad Mohammadi, Hosein; Khademi Kalantari, Khosro; Naeimi, Sedighe Sadat; Pouretezad, Mohammad; Shokri, Esmaeil; Tafazoli, Mojdeh; Dastjerdi, Mahboobeh; Kardooni, Leila

    2014-08-01

    Due to the fundamental role of gripping in most upper limb activities, grip strength promotion is a chief goal in the treatment of patients with upper limb musculoskeletal disorders. Kinesio taping is a novel and effective therapeutic technique believed to facilitate muscle contraction through stimulating mechanoreceptors and increasing the sensory feedback around the taped region. The present study aimed to identify the best region (flexor, extensor and flexor/extensor regions) and time (immediate, 0.5, 1, 1.5, and 2 hours) of forearm Kinesio taping to obtain the maximum improvement in grip strength. In this longitudinal study, 40 healthy men and women (the mean age of 22.3 ± 2.19 years) were selected among students of Shahid Beheshti University of Medical Sciences, Tehran, Iran by simple, nonrandom sampling method. A dynamometer was used to measure grip strength immediately and every 30 minutes during the two hours after I-shaped application of tape (with 50% stretch) to the flexor, extensor, and flexor/extensor forearm muscles. Grip strength was significantly increased in various muscle groups for males (P = 0.002) and females (P = 0.000) of the forearm and at different intervals for males (P = 0.000) and females (P = 0.000). Moreover, in both men and women, tape application to the extensor region provided greater grip strength compared to taping of the flexor and flexor/extensor regions (P = 0.000 for both). Furthermore, the maximum increase in grip strength were 0.5 (10.8% increase, P = 0.001) and 1.5 h (23.9% increase, P = 0.000) after taping in males and females, respectively. Taping the extensor region of forearm is recommended to achieve higher grip strength. Although grip strength increased at a slower pace in females than males, the final values were higher in women.

  3. Immediate and Delayed Effects of Forearm Kinesio Taping on Grip Strength

    Science.gov (United States)

    Kouhzad Mohammadi, Hosein; Khademi Kalantari, Khosro; Naeimi, Sedighe Sadat; Pouretezad, Mohammad; Shokri, Esmaeil; Tafazoli, Mojdeh; Dastjerdi, Mahboobeh; Kardooni, Leila

    2014-01-01

    Background: Due to the fundamental role of gripping in most upper limb activities, grip strength promotion is a chief goal in the treatment of patients with upper limb musculoskeletal disorders. Kinesio taping is a novel and effective therapeutic technique believed to facilitate muscle contraction through stimulating mechanoreceptors and increasing the sensory feedback around the taped region. Objectives: The present study aimed to identify the best region (flexor, extensor and flexor/extensor regions) and time (immediate, 0.5, 1, 1.5, and 2 hours) of forearm Kinesio taping to obtain the maximum improvement in grip strength. Materials and Methods: In this longitudinal study, 40 healthy men and women (the mean age of 22.3 ± 2.19 years) were selected among students of Shahid Beheshti University of Medical Sciences, Tehran, Iran by simple, nonrandom sampling method. A dynamometer was used to measure grip strength immediately and every 30 minutes during the two hours after I-shaped application of tape (with 50% stretch) to the flexor, extensor, and flexor/extensor forearm muscles. Results: Grip strength was significantly increased in various muscle groups for males (P = 0.002) and females (P = 0.000) of the forearm and at different intervals for males (P = 0.000) and females (P = 0.000). Moreover, in both men and women, tape application to the extensor region provided greater grip strength compared to taping of the flexor and flexor/extensor regions (P = 0.000 for both). Furthermore, the maximum increase in grip strength were 0.5 (10.8% increase, P = 0.001) and 1.5 h (23.9% increase, P = 0.000) after taping in males and females, respectively. Conclusions: Taping the extensor region of forearm is recommended to achieve higher grip strength. Although grip strength increased at a slower pace in females than males, the final values were higher in women. PMID:25389492

  4. Supinator Extender (SUE): a pneumatically actuated robot for forearm/wrist rehabilitation after stroke.

    Science.gov (United States)

    Allington, James; Spencer, Steven J; Klein, Julius; Buell, Meghan; Reinkensmeyer, David J; Bobrow, James

    2011-01-01

    The robot described in this paper, SUE (Supinator Extender), adds forearm/wrist rehabilitation functionality to the UCI BONES exoskeleton robot and to the ArmeoSpring rehabilitation device. SUE is a 2-DOF serial chain that can measure and assist forearm supination-pronation and wrist flexion-extension. The large power to weight ratio of pneumatic actuators allows SUE to achieve the forces needed for rehabilitation therapy while remaining lightweight enough to be carried by BONES and ArmeoSpring. Each degree of freedom has a range of 90 degrees, and a nominal torque of 2 ft-lbs. The cylinders are mounted away from the patient's body on the lateral aspect of the arm. This is to prevent the danger of a collision and maximize the workspace of the arm robot. The rotation axis used for supination-pronation is a small bearing just below the subject's wrist. The flexion-extension motion is actuated by a cantilevered pneumatic cylinder, which allows the palm of the hand to remain open. Data are presented that demonstrate the ability of SUE to measure and cancel forearm/wrist passive tone, thereby extending the active range of motion for people with stroke.

  5. Identification of time-varying stiffness, damping, and equilibrium position in human forearm movements.

    Science.gov (United States)

    Konczak, J; Brommann, K; Kalveram, K T

    1999-10-01

    Knowledge of how stiffness, damping, and the equilibrium position of specific limbs change during voluntary motion is important for understanding basic strategies of neuromotor control. Presented here is an algorithm for identifying time-dependent changes in joint stiffness, damping, and equilibrium position of the human forearm. The procedure requires data from only a single trial. The method relies neither on an analysis of the resonant frequency of the arm nor on the presence of an external bias force. Its validity was tested with a simulated forward model of the human forearm. Using the parameter estimations as forward model input, the angular kinematics (model output) were reconstructed and compared to the empirically measured data. Identification of mechanical impedance is based on a least-squares solution of the model equation. As a regularization technique and to improve the temporal resolution of the identification process, a moving temporal window with a variable width was imposed. The method's performance was tested by (a) identifying a priori known hypothetical time-series of stiffness, damping, and equilibrium position, and (b) determining impedance parameters from recorded single-joint forearm movements during a hold and a goal-directed movement task. The method reliably reconstructed the original angular kinematics of the artificial and human data with an average positional error of less than 0.05 rad for movement amplitudes of up to 0.9 rad, and did not yield hypermetric trajectories like previous procedures not accounting for damping.

  6. 3D Measurement of Forearm and Upper Arm during Throwing Motion using Body Mounted Sensor

    Science.gov (United States)

    Koda, Hideharu; Sagawa, Koichi; Kuroshima, Kouta; Tsukamoto, Toshiaki; Urita, Kazutaka; Ishibashi, Yasuyuki

    The aim of this study is to propose the measurement method of three-dimensional (3D) movement of forearm and upper arm during pitching motion of baseball using inertial sensors without serious consideration of sensor installation. Although high accuracy measurement of sports motion is achieved by using optical motion capture system at present, it has some disadvantages such as the calibration of cameras and limitation of measurement place. Whereas the proposed method for 3D measurement of pitching motion using body mounted sensors provides trajectory and orientation of upper arm by the integration of acceleration and angular velocity measured on upper limb. The trajectory of forearm is derived so that the elbow joint axis of forearm corresponds to that of upper arm. Spatial relation between upper limb and sensor system is obtained by performing predetermined movements of upper limb and utilizing angular velocity and gravitational acceleration. The integration error is modified so that the estimated final position, velocity and posture of upper limb agree with the actual ones. The experimental results of the measurement of pitching motion show that trajectories of shoulder, elbow and wrist estimated by the proposed method are highly correlated to those from the motion capture system within the estimation error of about 10 [%].

  7. Epithelioid Sarcoma of the Forearm Arising from Perineural Sheath of Median Nerve Mimicking Carpal Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Hiromasa Fujii

    2009-01-01

    Full Text Available We report here a case of epithelioid sarcoma in the forearm of a 33-year-old male presenting with symptoms and signs of carpal tunnel syndrome originating from the direct involvement of the median nerve. Due to the slow growing of the tumor, the patient noticed the presence of tumor mass in his forearm after several months from the initial onset of the symptoms. Magnetic resonance imaging showed an 8×4 cm mass involving the median nerve in the middle part of the forearm, and histological analysis of the biopsy specimen revealed the diagnosis of epithelioid sarcoma. Radical surgical resection was performed in conjunction with adjuvant chemotherapy. The function of the flexors were restored by the multiple tendon transfers (EIP→FDS; ECRL→FDP; BrR→FPL; EDM→opponens with superficial cutaneous branch of radial nerve transfer to the resected median nerve. The function of the affected hand showed excellent with the DASH disability/symptom score of 22.5, and both the grasp power and sensory of the median nerve area has recovered up to 50% of the normal side. The patient returned to his original vocation and alive with continuous disease free at 3.5-year follow-up since initial treatment.

  8. Forearm bone density in users of Depo-Provera as a contraceptive method.

    Science.gov (United States)

    Bahamondes, L; Perrotti, M; Castro, S; Faúndes, D; Petta, C; Bedone, A

    1999-05-01

    To determine the influence of depot medroxyprogesterone acetate (MPA) on bone mineral density when used as a contraceptive method. Cross-sectional study. Academic tertiary-care hospital. Fifty premenopausal women who had used depot MPA as a contraceptive method for > or =1 year and 50 women who had never used hormonal contraceptive methods. Bone mineral density was evaluated at the midshaft and at the distal radius of the nondominant forearm using single x-ray absorptiometry. Bone mineral density. Bone mineral density at the midshaft of the forearm was lower in depot MPA users than in women who had never used hormonal contraceptive methods, but the difference was not statistically significant. At the distal portion, bone mineral density was significantly lower in the study group. The duration of depot MPA use was not related to bone mineral density. Women > or =35 years of age presented with a lower bone mineral density only at the distal portion of the forearm after the use of depot MPA for > or =1 year. However, this decrease was not related to the duration of depot MPA use. It is not possible to conclude that women who use depot MPA are at risk of osteoporosis.

  9. Ischemic Preconditioning of One Forearm Enhances Static and Dynamic Apnea

    DEFF Research Database (Denmark)

    Kjeld, Thomas; Rasmussen, Mads Reinholdt; Jattu, Timo

    2014-01-01

    INTRODUCTION: Ischemic preconditioning enhances ergometer cycling and swimming performance. We evaluated whether ischemic preconditioning of one forearm (four times for 5 min) also affects static breath hold and underwater swimming, whereas the effect of similar preconditioning on ergometer rowing...... oxygenation decreased from 66% ± 7% to 33% ± 14% (P swimming distance from 110 ± 16 to 119 ± 14 m (P ....05). CONCLUSIONS: We conclude that while the effect of ischemic preconditioning (of one forearm) on ergometer rowing was minimal, probably because of reduced muscle oxygenation during the warm-up, ischemic preconditioning does enhance both static and dynamic apnea, supporting that muscle ischemia is an important...

  10. The developmental spectrum of proximal radioulnar synostosis

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, Alison M. [University of Manitoba, Winnipeg Regional Health Association Program of Genetics and Metabolism, Winnipeg, MB (Canada); University of Manitoba, Department of Paediatrics and Child Health, Winnipeg, MB (Canada); University of Manitoba, Department of Biochemistry and Medical Genetics, Winnipeg, MB (Canada); University of Manitoba, WRHA Program of Genetics and Metabolism, Departments of Paediatrics and Child Health, Biochemistry and Medical Genetics, Winnipeg, MB (Canada); Kibria, Lisa [University of Manitoba, Department of School of Medical Rehabilitation, Winnipeg, MB (Canada); Reed, Martin H. [University of Manitoba, Department of Paediatrics and Child Health, Winnipeg, MB (Canada); University of Manitoba, Department of Biochemistry and Medical Genetics, Winnipeg, MB (Canada); University of Manitoba, Department of Diagnostic Imaging, Winnipeg, MB (Canada)

    2010-01-15

    Proximal radioulnar synostosis is a rare upper limb malformation. The elbow is first identifiable at 35 days (after conception), at which stage the cartilaginous anlagen of the humerus, radius and ulna are continuous. Subsequently, longitudinal segmentation produces separation of the distal radius and ulna. However, temporarily, the proximal ends are united and continue to share a common perichondrium. We investigated the hypothesis that posterior congenital dislocation of the radial head and proximal radioulnar fusion are different clinical manifestations of the same primary developmental abnormality. Records were searched for ''proximal radioulnar fusion/posterior radial head dislocation'' in patients followed at the local Children's Hospital and Rehabilitation Centre for Children. Relevant radiographic, demographic and clinical data were recorded. Ethics approval was obtained through the University Research Ethics Board. In total, 28 patients met the inclusion criteria. The majority of patients (16) had bilateral involvement; eight with posterior dislocation of the radial head only; five had posterior radial head dislocation with radioulnar fusion and two had radioulnar fusion without dislocation. One patient had bilateral proximal radioulnar fusion and posterior dislocation of the left radial head. Nine patients had only left-sided involvement, and three had only right-sided involvement.The degree of proximal fusion varied, with some patients showing 'complete' proximal fusion and others showing fusion that occurred slightly distal to the radial head: 'partially separated.' Associated disorders in our cohort included Poland syndrome (two patients), Cornelia de Lange syndrome, chromosome anomalies (including tetrasomy X) and Cenani Lenz syndactyly. The suggestion of a developmental relationship between posterior dislocation of the radial head and proximal radioulnar fusion is supported by the fact that both anomalies

  11. Reconstruction of scalp defects with the radial forearm free flap

    Science.gov (United States)

    2012-01-01

    Background Advanced and recurrent cutaneous squamous cell carcinoma of the scalp and forehead require aggressive surgical excision often resulting in complex defects requiring reconstruction. This study evaluates various microvascular free flap reconstructions in this patient population, including the rarely utilized radial forearm free flap. Patients and methods A retrospective review of patients undergoing free flap surgeries (n = 47) of the scalp between 1997 and 2011 were included. Patients were divided primarily into two cohorts: a new primary lesion (n = 21) or recurrence (n = 26). Factors examined include patient demographics, indication for surgery, defect, type of flap used, complications (major and minor), and outcomes. Results The patients were primarily male (n = 34), with a mean age of 67 years (25–91). A total of 58 microvascular free flap reconstructions were performed (radial forearm free flap: n = 28, latissimus dorsi: n = 20, rectus abdominis: n = 9, scapula: n = 1). Following reconstruction with a radial forearm free flap, duration of hospitalization was shorter (P = 0.04) and complications rates were similar (P = 0.46). Donor site selection correlated with defect area (P scalp are aggressive and challenging to treat. The radial forearm free flap is an underutilized free flap in the reconstruction of complex scalp defects. PMID:22583845

  12. [Subcutaneous plexiform schwannoma of the forearm. A case report].

    Science.gov (United States)

    Daoudi, A; Znati, K; Elibrahimi, A; Loudiyi, W D; Elmrini, A; Amarti, A R; Chakour, K; Boutayeb, F

    2009-02-01

    Plexiform schwannoma is an exceptional schwannoma subtype. It's a benign nerve sheath tumor. Mainly, it's solitary, asymptomatic and slowly growing nodule that occurs in the subcutis or dermis. Histology gives the diagnosis. The authors report a case of solitary superficial plexiform schwannoma of the right forearm of a patient aged 22. A review of literature is done.

  13. Intramedullary fixation of forearm fractures with new locked nail

    Directory of Open Access Journals (Sweden)

    Himanshu Bansal

    2011-01-01

    Conclusion: This new interlocking nail may be considered as an alternative to plate osteosynthesis for fractures of the forearm in adults. The advantages are benefit of closed reduction, smaller residual scar, reduced cost and early union with allowance of immediate movements.

  14. Plate osteosynthesis of simple forearm fractures : LCP versus DC plates

    NARCIS (Netherlands)

    Stevens, Charles Tjerk; Ten Duis, Henk Jan

    The aim of this study was to compare the time to radiological bony union of simple A-type fractures of the forearm, treated with either a locking compression plate (LCP) or a dynamic compression plate (DCP). For each fracture, the relation between the use of compression and radiological healing time

  15. Primary giant congenital infantile fibrosarcoma of the left forearm.

    Science.gov (United States)

    Duan, S; Zhang, X; Wang, G; Zhong, J; Yang, Z; Jiang, X; Li, J

    2013-09-01

    Infantile fibrosarcoma is a rare soft tissue tumor in the infant, and only a few cases have been reported as congenital. We report a case of congenital infantile fibrosarcoma of the left forearm at birth. An amputation was performed because the tumor was relapsed soon after surgical removal, and associated with anabrosis and bleeding. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  16. Tracking blood vessels in human forearms using visual servoing

    DEFF Research Database (Denmark)

    Savarimuthu, Thiusius Rajeeth; Ellekilde, Lars-Peter; Hansen, Morten

    compensation. By using images taken with near-infrared light to locate the blood vessels in a human forearm and using the same images to detects movements of the arm, this paper shows that it is possible make a robot arm, potentially equipped with a needle for drawing the blood, compensate for the movements...

  17. A study of retrograde degeneration of median nerve forearm ...

    African Journals Online (AJOL)

    Introduction: Carpal tunnel syndrome (CTS) is a disorder of the hand which results from compression of the median nerve within its fibro-osseous tunnel at the wrist. The slowing in the forearm motor conduction velocity suggests the presence of retrograde degeneration. Existing studies conflict regarding a correlation ...

  18. Grip strength after forearm cooling in healthy subjects

    Directory of Open Access Journals (Sweden)

    Pedro Henrique Reis Rabelo

    Full Text Available Abstract Introduction: Muscle strength has shown different responses to the cooling of neuromuscular tissue and its behavior is still unclear. Objective: To verify the behavior of maximum grip strength before and after forearm cooling. Methods: The cooling intervention consisted of immersing the forearm up to the elbow in water cooled to 10° C. Grip strength was assessed using a dynamometer prior to cooling, immediately after immersion, and at 5, 10 and 30 minutes of forearm exposure to ambient temperature (recovery phase concomitantly to measurement of skin surface temperature. The sample consisted of 30 healthy individuals. Results: Grip strength decreased significantly (p < 0.05 between the period prior to cooling and all the time intervals following immersion in ice water. There was also a gradual increase in grip strength during the recovery phase, with significant differences (p < 0.05 between the mean immediately after immersion and means at 5, 15 and 30 minutes after exposure to ambient temperature. Conclusion: The results indicate that immersion in ice water (10ºC for 15 minutes significantly reduced (p < 0.05 grip strength for up to 30 minutes after forearm cooling. Strength also recovered progressively after removal of the cold stimulus. Further research is needed to obtain definitive results regarding the effects of cooling on muscle strength in healthy individuals.

  19. Intramedullary wire fixation for unstable forearm fractures in children.

    Science.gov (United States)

    Altay, Murat; Aktekin, Cem Nuri; Ozkurt, Bülent; Birinci, Bariş; Ozturk, Akif Muhtar; Tabak, A Yalçin

    2006-10-01

    Displaced fractures of the diaphyseal forearm in children are often treated conservatively, but there is relatively high incidence of redisplacement, malunion and consequent limitation of function. This retrospective study was performed to determine means for minimalising the complications of intramedullary Kirschner (K)-wire fixation used in the treatment of unstable, diaphyseal forearm fractures by pointing out those which most frequently occur with this treatment choice. This treatment method was applied in 48 children with a mean age of 10.3 (range, 5-14) years. A limited open reduction to one or both bones was necessary for insertion of the intramedullary wire in 20 (40%) patients. Although 24 complications, such as pin site infection, loss of forearm rotation, superficial branch of radial nerve palsy, delayed union, nonunion, hardware migration, and K-wire penetration to the opposite cortex, were recorded in 18 patients, 46 patients (96%) had excellent or good, 1 patient (2%) had fair and 1 patient (2%) had poor outcome using the grading scheme adapted by Price. Except for the patient in whom the fracture was not united, the average union time was 6.3 weeks in children less than 10 years and 7.8 weeks in those above 10 years of age. Despite these minor complications, percutaneous intramedullary fixation with K-wires and proper technique is an appropriate, effective and safe operation for unstable diaphyseal fractures of the forearm in children who cannot be treated by closed manipulation.

  20. Mobility of the forearm in the raccoon (Procyon lotor), raccoon dog (Nyctereutes procyonoides) and red panda (Ailurus fulgens).

    Science.gov (United States)

    Kamioka, Minao; Sasaki, Motoki; Yamada, Kazutaka; Endo, Hideki; Oishi, Motoharu; Yuhara, Kazutoshi; Tomikawa, Sohei; Sugimoto, Miki; Oshida, Tatsuo; Kondoh, Daisuke; Kitamura, Nobuo

    2017-01-24

    The ranges of pronation/supination of forearms in raccoons, raccoon dogs and red pandas were nondestructively examined. Three carcasses of each species were used for CT analysis, and the left forearms were scanned with a CT scanner in two positions: maximal supination and maximal pronation. Scanning data were reconstructed into three-dimensional images, cross-sectional images were extracted at the position that shows the largest area in the distal part of ulna, and then, the centroids of each cross section of the radius and ulna were detected. CT images of two positions were superimposed, by overlapping the outlines of each ulna, and then, the centroids were connected by lines to measure the angle of rotation, as an index of range of mobility. The measurements in each animal were analyzed, using the Tukey-Kramer method. The average angle of rotation was largest in raccoons and smallest in raccoon dogs, and the difference was significant. In the maximally pronated forearm of all species, the posture was almost equal to the usual grounding position with palms touching the ground. Therefore, the present results demonstrate that the forearms of raccoons can supinate to a greater degree from the grounding position with palms on the ground, as compared with those of raccoon dogs and red pandas.

  1. File list: Oth.Epd.50.AllAg.Forearm_skin [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Oth.Epd.50.AllAg.Forearm_skin hg19 TFs and others Epidermis Forearm skin SRX200046,...SRX200052,SRX200048,SRX200050 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Oth.Epd.50.AllAg.Forearm_skin.bed ...

  2. File list: ALL.Epd.10.AllAg.Forearm_skin [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Epd.10.AllAg.Forearm_skin hg19 All antigens Epidermis Forearm skin SRX200046,SR...X200052,SRX200048,SRX200044,SRX200038,SRX200036,SRX200042,SRX200050 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Epd.10.AllAg.Forearm_skin.bed ...

  3. File list: His.Epd.05.AllAg.Forearm_skin [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Epd.05.AllAg.Forearm_skin hg19 Histone Epidermis Forearm skin SRX200044,SRX2000...42,SRX200038,SRX200036 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Epd.05.AllAg.Forearm_skin.bed ...

  4. File list: ALL.Epd.20.AllAg.Forearm_skin [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Epd.20.AllAg.Forearm_skin hg19 All antigens Epidermis Forearm skin SRX200048,SR...X200036,SRX200052,SRX200038,SRX200044,SRX200042,SRX200050,SRX200046 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Epd.20.AllAg.Forearm_skin.bed ...

  5. File list: His.Epd.20.AllAg.Forearm_skin [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Epd.20.AllAg.Forearm_skin hg19 Histone Epidermis Forearm skin SRX200036,SRX2000...38,SRX200044,SRX200042 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Epd.20.AllAg.Forearm_skin.bed ...

  6. File list: Oth.Epd.20.AllAg.Forearm_skin [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Oth.Epd.20.AllAg.Forearm_skin hg19 TFs and others Epidermis Forearm skin SRX200048,...SRX200052,SRX200050,SRX200046 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Oth.Epd.20.AllAg.Forearm_skin.bed ...

  7. File list: His.Epd.50.AllAg.Forearm_skin [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Epd.50.AllAg.Forearm_skin hg19 Histone Epidermis Forearm skin SRX200042,SRX2000...44,SRX200036,SRX200038 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Epd.50.AllAg.Forearm_skin.bed ...

  8. File list: ALL.Epd.05.AllAg.Forearm_skin [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Epd.05.AllAg.Forearm_skin hg19 All antigens Epidermis Forearm skin SRX200046,SR...X200052,SRX200048,SRX200044,SRX200042,SRX200038,SRX200036,SRX200050 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Epd.05.AllAg.Forearm_skin.bed ...

  9. File list: ALL.Epd.50.AllAg.Forearm_skin [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Epd.50.AllAg.Forearm_skin hg19 All antigens Epidermis Forearm skin SRX200046,SR...X200052,SRX200048,SRX200042,SRX200044,SRX200036,SRX200038,SRX200050 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Epd.50.AllAg.Forearm_skin.bed ...

  10. File list: Oth.Epd.05.AllAg.Forearm_skin [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Oth.Epd.05.AllAg.Forearm_skin hg19 TFs and others Epidermis Forearm skin SRX200046,...SRX200052,SRX200048,SRX200050 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Oth.Epd.05.AllAg.Forearm_skin.bed ...

  11. File list: His.Epd.10.AllAg.Forearm_skin [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Epd.10.AllAg.Forearm_skin hg19 Histone Epidermis Forearm skin SRX200044,SRX2000...38,SRX200036,SRX200042 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Epd.10.AllAg.Forearm_skin.bed ...

  12. Childhood Forearm Breaks Resulting from Mild Trauma May Indicate Bone Deficits

    Science.gov (United States)

    ... 2014 X-ray image of a child’s forearm fracture. Photo credit: eORIF LLC. Children who break their forearm after just a mild ... weaker bones and reduced bone quality compared to children without fractures. Their forearm bones could take less pressure before ...

  13. File list: Oth.Epd.10.AllAg.Forearm_skin [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Oth.Epd.10.AllAg.Forearm_skin hg19 TFs and others Epidermis Forearm skin SRX200046,...SRX200052,SRX200048,SRX200050 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Oth.Epd.10.AllAg.Forearm_skin.bed ...

  14. Reduction in ulnar pressure distribution when walking with forearm crutches with a novel cuff design: Cross-sectional intervention study on the biomechanical efficacy of an ulnar recess.

    Science.gov (United States)

    Molteni, Pascal; Hügle, Thomas; Hügle, Maria; Nüesch, Corina; Mündermann, Annegret

    2018-01-01

    Walking with crutches is an effective way of reducing the load on the lower extremity and is often indicated after injury or surgery. However, walking with forearm crutches with conventional cuffs can trigger symptoms including tenosynovitis in the biceps tendon, ulnar neuropraxia at the wrist, pain, or skin hematoma. The purpose of this study was to test the hypothesis that a crutch cuff design with an ulnar recess reduces ulnar pressure during walking with forearm crutches. The pressure distribution between the forearm and crutch cuff was measured in 15 healthy participants for crutch walking with conventional and novel cuffs, respectively. Relative peak pressure in the proximal medial region compared to the overall peak pressure was reduced by 8.6% when walking with crutches with the novel cuff design compared to conventional cuffs (p < 0.001). Relative peak pressure in the distal intermediate and lateral regions were increased by 3.3% and 3.7% for the novel compared with conventional cuffs, respectively (p < 0.001 for both). Hence, the novel crutch cuffs shifted regions of high pressure away from the proximal ulnar region towards more distal regions that are covered by more soft tissue.

  15. Aneurysmal Bone Cysts of the Hand, Wrist, and Forearm.

    Science.gov (United States)

    Crowe, Matthew M; Houdek, Matthew T; Moran, Steven L; Kakar, Sanjeev

    2015-10-01

    To determine the outcomes of surgical management of aneurysmal bone cysts (ABCs) in the hand, wrist, and forearm. The medical records of 11 patients undergoing surgical treatment of ABCs distal to the elbow from 1994 to 2011 with at least 12 months follow-up were reviewed retrospectively. Mean follow-up was 29 months (range, 13-56 months). There were 7 males and 4 females. Four lesions presented in the radius, 3 in the ulna, 2 in the metacarpals, and 2 in the phalanges. Ten patients underwent wide unroofing and intralesional curettage with 9 undergoing associated high-speed burring. Multiple chemical and thermal adjuvants were used. One patient underwent en bloc resection with reconstruction. There was 1 recurrence in a periphyseal lesion in a 2-year-old boy treated with curettage, burring, and adjuvant chemotherapy. Ten patients incorporated the bone graft and healed without further surgery. One patient required revision bone grafting. The diagnosis of ABC should remain in the differential diagnosis for cystic lesions in the upper extremity in pediatric and adult patients. Low recurrence has been obtained predominantly with intralesional curettage and high-speed burring with and without chemical and thermal adjuvant therapy. Appropriate healing has been obtained with both allograft and autograft reconstructions. Periarticular and periphyseal lesions remain challenging and provide the highest chance for incomplete resection and recurrence. Follow-up with plain radiographs did not lead to any delay in diagnosis of recurrence in any case. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  16. Proximal Probes Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Proximal Probes Facility consists of laboratories for microscopy, spectroscopy, and probing of nanostructured materials and their functional properties. At the...

  17. Nonunion of forearm fracture: a rare instance in a toddler

    Directory of Open Access Journals (Sweden)

    Saini Pramod

    2012-12-01

    Full Text Available 【Abstract】 When compared to adults, pediatric frac-tures unite readily and nonunion is quite rare. Nonunion is often associated with open fractures, operative interventions, infection, pediatric osteogenesis imperfecta and neurofibromatosis. There are only a few studies and reports mentioning nonunion following conservative ma-nagement of closed pediatric fractures. We report here a case of an eighteen-month-old child who developed non-union following treatment of fracture of both forearm bones with cast and was successfully treated with plating. To the best of our knowledge, this is the youngest reported case of nonunion following conservative management of closed diaphyseal pediatric fracture. Key words: Forearm; Fractures, bone; Child

  18. Increased sympathetic tone in forearm subcutaneous tissue in primary hypothyroidism

    DEFF Research Database (Denmark)

    Vagn Nielsen, H; Hasselström, K; Feldt-Rasmussen, U

    1987-01-01

    Sympathetic reflex regulation of subcutaneous blood flow (SBF) in the forearm was studied in eight patients with primary hypothyroidism. Diastolic arterial pressure was greater than or equal to 95 mmHg in five patients. SBF was determined by local clearance of Na99mTcO4. Sympathetic vasoconstrict......Sympathetic reflex regulation of subcutaneous blood flow (SBF) in the forearm was studied in eight patients with primary hypothyroidism. Diastolic arterial pressure was greater than or equal to 95 mmHg in five patients. SBF was determined by local clearance of Na99mTcO4. Sympathetic.......02)). In conclusion sympathetic vasoconstrictor activity in adipose tissue is markedly increased in primary hypothyroidism. Sympathetic tone and arterial pressure are reduced during treatment....

  19. Avaliação da apresentação de sinais e sintomas de impacto femoroacetabular após epifisiólise do fêmur proximal Evaluation of presentation of signs and symptoms of femoroacetabular impingement after epiphysiolysis of the proximal femur

    Directory of Open Access Journals (Sweden)

    Fábio Peng Krüger

    2011-04-01

    Full Text Available OBJETIVO: Neste trabalho, procuramos avaliar se existe relação entre o grau de deslizamento da epifisiólise femoral proximal (EFP e a presença de impacto femoroacetabular (IFA. Ainda, analisou-se o arco de movimento do quadril (ADM em relação ao IFA, além de revisar a literatura sobre o assunto. MÉTODO: Foram analisados 19 casos de EFP em 15 pacientes tratados cirurgicamente com epifisiodese in situ com um parafuso canulado, com seguimento médio de 27 meses. Realizou-se a análise do grau de deslizamento da EFP pelos ângulos epimetafisário (âEM e coloepifisário (âCE da radiografia em perfil, dos sinais de impacto radiográficos na incidência anteroposterior, dos sintomas clínicos e do ADM do quadril. RESULTADOS: Evidenciou-se que o grau de deslizamento da EFP (através do âEM apresenta relação inversa estatisticamente significante com a presença de IFA no período médio de seguimento deste estudo. Ou seja, os pacientes que demonstraram um quadro sintomático de IFA apresentaram graus menores de deslizamento. Isso pode ser explicado pelo fato que o tipo de impacto que ocorre na EFP (came de inclusão ou de impacção depende do grau de deslizamento, e estes se apresentam de forma e cronologia diferentes. O ADM do quadril não apresentou relação com o IFA. CONCLUSÃO: Há relação entre o grau de deslizamento e a presença de IFA clínicoradiológica após EFP.OBJECTIVES: In this study, we sought to evaluate whether there is any relationship between the degree of epiphysiolysis of the proximal femur (EPF and the presence of femoroacetabular impingement (FAI. Hip range of motion (ROM was also analyzed in relation to FAI, and the literature on this topic was reviewed. METHODS: Nineteen cases of EPF in fifteen patients who had been treated surgically by means of in situ epiphysiodesis with a cannulated screw were evaluated. The mean follow-up was 27 months. The degree of EPF was analyzed using the epimetaphyseal and neck

  20. The utility of clinical ultrasonography in identifying distal forearm fractures in the pediatric emergency department.

    Science.gov (United States)

    Galletebeitia Laka, Iratxe; Samson, Frederic; Gorostiza, Inigo; Gonzalez, Andrés; Gonzalez, Carlos

    2017-10-13

    The aim of this study is to evaluate the utility of Point-Of-Care Ultrasound (POCUS) for diagnosing distal forearm fractures in pediatric emergency departments (ED). A prospective observational study was carried out in children aged younger than 15 years attended in an ED with an indication of radiography because of a suspected distal forearm fracture. The POCUS was performed considering cortical irregularity or disruption compatible with fracture. Then, the radiography was requested and the patient was evaluated by an ED traumatologist. Both tests were blinded to each other. The radiograph was considered to be the reference diagnostic test. Diagnostic validation tests were performed. A total of 115 patients [mean age: 9.1 (SD: 3.1) years; 50.4% males] were included, with 57 of these presenting fractures: 42 (73.7%) single bone fractures and 15 (26.3%) combined fractures of the radius and ulna. As such, 72 fractures were detected (prevalence 31.3%). The sensitivity and specificity of POCUS for detecting fractures were 94.4% [95% confidence interval (CI): 86.4-98.5] and 96.8% (95% CI: 92.8-99.0), respectively. The positive and negative predictive values were 93.2% (95% CI: 84.7-97.7) and 97.5% (95% CI: 93.6-99.3), respectively. POCUS enables the clinical diagnosis of distal forearm fractures in ED. In addition, this is a highly accurate technique that can be applied easily by the ED pediatrician. As such, its inclusion as part of the physical examination could improve the accuracy of the clinical diagnosis and the global management of the patient.

  1. The Etiology and Treatment of the Softened Phallus after the Radial Forearm Osteocutaneous Free Flap Phalloplasty

    Directory of Open Access Journals (Sweden)

    Seok-Kwun Kim

    2012-07-01

    Full Text Available BackgroundThe radial forearm osteocutaneous free flap is considered to be the standard technique for penile construction. One year after their operation, most patients experience a softened phallus, so that they suffer from difficulties in sexual intercourse. In this report, we present our experience with phalloplasty by radial forearm osteocutaneous free flap, as well as an evaluation of the etiology and treatment of the softened phallus.MethodsBetween March 2005 and February 2010, 58 patients underwent phalloplasty by radial forearm osteocutaneous free flap. Most of their neophallus had been softened subjectively and among them, 12 patients who wanted correction were investigated. We performed repetitive fat injection, artificial dermis grafting, silicone rod insertion, and rib bone with cartilaginous tip graft. Physical examination, plain radiograph, computed tomography, bone scintigraphy, and satisfaction scores were investigated.ResultsMost of the participants' penises have been softened after phalloplasty, and the skin elasticity had been also decreased. On plain radiograph, the distal end of the bone was self-rounded; however, the bone shape of the neophallus had no significant interval changes or resorption. Computed tomography showed equivocal density of cortical bone. On bone scintigraphy, the bone metabolism was active at 3 months postoperatively, and remained active 9 years postoperatively.ConclusionsThe use of a rib bone with cartilaginous tip graft could be an option for improvement of the softened phallus. Silicon rod insertion is also worth considering for rigidity of the softened phallus. Decreased rigidity due to soft tissue atrophy could be alleviated with repeated fat injection and artificial dermis grafting.

  2. The epidemiology of forearm nerve injuries--a retrospective study.

    Science.gov (United States)

    Rasulić, Lukas; Puzović, Vladimir; Rotim, Krešimir; Jovanović, Milan; Samardžić, Miroslav; Živković, Bojana; Savić, Andrija

    2015-03-01

    The aim of this study was to investigate the mechanisms and etiologic factors of forearm nerve injuries. This retrospective survey included all patients treated surgically in Clinical Department of Neurosurgery, Clinical Center of Serbia, from January 1, 2000 to December 31, 2010. All relevant data were collected from medical records. Statistical procedures were done using the PASW 18 statistical package. Our study included 104 patients that underwent surgery after forearm nerve injury. The majority of admitted patients were male (n = 84; 80.8%) and only 20 (19.2%) were female. Ulnar nerve injury predominated with 70 cases, followed by median nerve with 54 (51.9%) cases and radial nerve with only 5 cases. Transection was the dominant mechanism of injury and it occurred in 84.6% of cases. Injury by a sharp object was the most frequent etiologic factor and it occurred in 62 (59.6%) patients, while traffic accident and gunshot injuries were the least common etiologic factor of forearm nerve injury, occurring in 7 (6.7%) and 6 (5.8%) cases, respectively. Associated injuries of muscles and tendons, bones and blood vessels occurred in 20 (19.2%), 16 (15.4%) and 15 (14.4%) patients, respectively. The etiology and mechanism of peripheral nerve injury are of great importance when choosing the right course of treatment in each individual patient because timing and type of treatment are closely related to these factors.

  3. An Exoskeleton Robot for Human Forearm and Wrist Motion Assist

    Science.gov (United States)

    Ranathunga Arachchilage Ruwan Chandra Gopura; Kiguchi, Kazuo

    The exoskeleton robot is worn by the human operator as an orthotic device. Its joints and links correspond to those of the human body. The same system operated in different modes can be used for different fundamental applications; a human-amplifier, haptic interface, rehabilitation device and assistive device sharing a portion of the external load with the operator. We have been developing exoskeleton robots for assisting the motion of physically weak individuals such as elderly or slightly disabled in daily life. In this paper, we propose a three degree of freedom (3DOF) exoskeleton robot (W-EXOS) for the forearm pronation/ supination motion, wrist flexion/extension motion and ulnar/radial deviation. The paper describes the wrist anatomy toward the development of the exoskeleton robot, the hardware design of the exoskeleton robot and EMG-based control method. The skin surface electromyographic (EMG) signals of muscles in forearm of the exoskeletons' user and the hand force/forearm torque are used as input information for the controller. By applying the skin surface EMG signals as main input signals to the controller, automatic control of the robot can be realized without manipulating any other equipment. Fuzzy control method has been applied to realize the natural and flexible motion assist. Experiments have been performed to evaluate the proposed exoskeleton robot and its control method.

  4. Fashioning reversed axial pattern forearm tissues in different challenging conditions of the forearm territory as a reliable substitute for free tissue transfer.

    Science.gov (United States)

    El-Shazly, M

    2012-01-01

    Traumatic tissue defects, chronic ulcerations, burn contractures and post-oncological excisions are the main problems affecting the hand and forearm areas. This work addresses the question of whether reversed axial island flaps from the forearm area could be applicable to any form of soft tissue defects in the territory of the forearm, and whether they could be considered reliable substitutes for free tissue transfer. Thirteen patients who sought surgical treatment for soft tissue defects of the hand, wrist, and distal forearm regions were included in this evaluation report. The patients complained of four different etiologies, and their resultant tissue defects were managed by reversed radial forearm flap in eight cases and by the ulnar variety of the reversed forearm flap in another five cases. Selection of the flap option depended on the site of the pathology, size and thickness of the resultant defect, special needs of the defect, vascular limitations, and the like-tissue reconstruction objective. All flaps survived well with no complications. Both donor and recipient sites healed successfully. The selected flaps were ideal in their specific application. Harvesting reversed forearm flaps does not require high surgical skills or special equipment, venous congestion is less significant than with free flaps, and the patients do not need intensive immediate postoperative care and supervision. This is an easy and reliable technique requiring short operating time, and initiation of early physiotherapy is permitted, making forearm flaps reliable substitutes for free flap applications with all the associated complications.

  5. A synchronous incidence of eccrine porocarcinoma of the forearm and facial squamous cell carcinoma: A case report.

    Science.gov (United States)

    Ramasenderan, Nandinii; Shahir, Hasliza; Omar, Siti Zarqah

    2017-12-08

    Cutaneous appendageal tumor can differentiate towards or arise from either pilosebaceous apparatus or the eccrine sweat glands. Appendageal tumors are relatively rare, their clinical appearance is non-specific, and the vast majority are not diagnosed until after excision. Eccrine porocarcinoma (EP), also known as malignant eccrine poroma is a rare adnexal tumor arising from the intraepithelial ductal parts of the sweat gland. We presented a 65-year-old, Asian, female with medical co-morbids, who came with both a facial squamous cell carcinoma and a long-standing lesion over her left forearm. Histopathological finding of the left forearm demonstrated eccrine porocarcinoma. Mohs micrographic surgery is the mainstay treatment of cutaneous carcinoma. It is important to rule out associated syndromes in patient who present with multiple cutaneous appendageal tumors. Copyright © 2017. Published by Elsevier Ltd.

  6. Dietary sodium intake modulates systemic but not forearm norepinephrine release.

    Science.gov (United States)

    Stein, C M; Nelson, R; Brown, M; He, H; Wood, M; Wood, A J

    1995-10-01

    Sodium intake has profound effects on systemic and renal sympathetic activity, but its effects on sympathetic activity in skeletal muscle vascular beds, a site at which local regulatory mechanisms could alter vascular tone directly, are unclear. To determine the effect of dietary sodium intake on basal and isoproterenol-stimulated systemic and forearm norepinephrine kinetics, we studied seven healthy male volunteers twice, 4 weeks apart, while they were receiving a low-sodium (10 mmol sodium/24 hours) diet and a high-sodium diet (250 mmol sodium/24 hours). Forearm blood flow, measured by plethysmography, and systemic and forearm norepinephrine spillover, measured by radioisotope dilution, were determined before and after intra-arterial infusion of 60 and 400 ng/min isoproterenol. Baseline (before isoproterenol) systemic norepinephrine spillover was higher when subjects received the low-sodium diet (448.1 +/- 55.7 ng/min) compared with the high-sodium diet (269.7 +/- 42.7 ng/min; p < 0.05). In contrast, sodium intake did not affect local forearm norepinephrine spillover, either at baseline (low-sodium diet, 2.05 +/- 0.48 ng/min versus high-sodium diet, 2.63 +/- 0.79 ng/min; p = 0.50) or after stimulation with isoproterenol in doses of 60 ng/min (low-sodium diet, 8.84 +/- 2.2 ng/min versus high-sodium diet, 6.1 +/- 1.9 ng/min; p = 0.38) or 400 ng/min (low-sodium diet, 16.4 +/- 4.5 ng/min versus high-sodium diet, 16.7 +/- 2.5 ng/min; p = 0.93). Under conditions of low sodium intake, systemic norepinephrine spillover was increased but forearm norepinephrine spillover was not, suggesting that alteration in sodium intake may produce a differential effect on norepinephrine spillover in different tissues but that decreased local sympathetic activity in skeletal muscle is not the likely mechanism by which a low-sodium diet may lower blood pressure or attenuate stress-induced pressor responses.

  7. Elastic robust intramedullary nailing for forearm fracture in children

    Directory of Open Access Journals (Sweden)

    Wasem, Jürgen

    2006-01-01

    Full Text Available Background: Forearm fractures are the most common fractures in children (23% of all fractures. Basically there are two treatment options available for diaphyseal forearm fractures in children: closed reduction with cast immobilisation (conservative therapy and the elastic stable intramedullary nailing (ESIN. Treatment decision is influenced by the doctor's estimation of fracture instability. Stable fractures can be treated conservatively whereas instable forearm shaft fractures can be treated according the following three treatment strategies: 1. conservative therapy in an outpatient setting 2. conservative therapy in the operating room in attendance to change to ESIN in case that no stabilisation can be achieved with cast immobilisation 3. immediate treatment with ESIN in the operating room. Objectives: Aim of this Health Technology Assessment (HTA report is to assess and report the published evidence concerning effectiveness and cost-effectiveness of ESIN as a treatment option for diaphyseal forearm fractures in children and to identify future research need. Important parameters for the assessment of effectiveness are objective parameters (axis deviation, losses of motion, and numbers of reductions in case of redislocations and subjective parameters (pain or impairment in quality of life. Furthermore, a health economic evaluation shall be done which refers to the costs of the different therapy strategies. Methods: An extensive, systematic literature search in medical, economic, and HTA literature databases was performed. Relevant data were extracted and synthesised. Results: Three cohort studies and seven case series have been identified. Controlled clinical studies, systematic reviews and/or HTA reports that gave evidence to answer the own study question have not been found. The identified studies partly differed in respect of defined indication for ESIN, study population and treatment strategies. For that reason comparability of results was

  8. EVALUATION OF RESULTS IN FRACTURES OF BOTH BONES FOREARM TREATED WITH DYNAMIC COMPRESSION PLATING

    Directory of Open Access Journals (Sweden)

    Sindhuja G

    2017-06-01

    Full Text Available BACKGROUND The anatomical alignment of the bones, the length, the radial bow, and axis should be restored for a good functional outcome. Conservative treatment has resulted in malunion, non-union, synostosis and ultimately poor functional outcome. Internal fixation helps in perfect reduction of fracture fragments in anatomical position by rigid fixation and early mobilisation, the normal functions of the hand can be re-achieved at the earliest. This study has been taken up to evaluate the results of open reduction and internal fixation of the fractures of BBFA with DCP in adults and its advantages and complications. In this study, the rate and time taken for union, the complication, the functional results in terms of forearm rotation and wrist and elbow movements are evaluated. MATERIALS AND METHODS This study includes treatment of 20 cases of fracture of both bones of forearm by open reduction and internal fixation with 3.5 mm DCP from August 2013 to August 2015 at Department of Orthopaedics at Konaseema Institute of Medical Sciences, Amalapuram. Follow-up was done up to September 2015. This is a prospective time bound study. Sample size - 20 patients. Inclusion Criteria- 1. Simple fractures. 2. Open fractures-Gustilo and Anderson type I and type II. 3. Age criteria = 15 to 70 years, both males and females. Exclusion Criteria- 1. Age criteria 0 to 14 years & > 70 years. 2. Radiologically proven segmental fractures and isolated forearm bone fractures. 3. Pathological fracture. 4. Gustilo and Anderson type III. 5. Patient not willing for surgery. 6. Patient unfit for surgery. RESULTS The present study consists of 20 cases of fracture both bones of the forearm. All the cases were openly reduced and internally fixed with 3.5 mm DCP. The study period was from August 2013 to September 2015. The age of these patients ranged from 15-70 years with fracture being most common in 3 rd decade and an average age of 31 years. CONCLUSION Use of separate

  9. Ununited diaphyseal forearm fractures with segmental defects: plate fixation and autogenous cancellous bone-grafting.

    Science.gov (United States)

    Ring, David; Allende, Christian; Jafarnia, Koroush; Allende, Bartolome T; Jupiter, Jesse B

    2004-11-01

    With current techniques of plate-and-screw fixation, diaphyseal nonunions of the radius and ulna are unusual. The few reports that have been published have discussed the use of structural corticocancellous bone grafts for the treatment of atrophic nonunions that are associated with osseous defects. We reviewed the rate of union and the functional results in association with the use of plate-and-screw fixation and autogenous cancellous (nonstructural) bone grafts. Thirty-five patients with an atrophic ununited diaphyseal fracture of the forearm were treated with 3.5-mm plate-and-screw fixation and autogenous cancellous bone-grafting. A segmental osseous defect with an average size of 2.2 cm (range, 1 to 6 cm) was present in each patient. Twenty of the original fractures had been open. Eleven patients had had treatment of a deep infection before referral to us. The nonunion involved both forearm bones in eight patients, the radius alone in sixteen patients, and the ulna alone in eleven patients. The atrophic nonunion was associated with an open fracture in twenty patients, suboptimal fixation in twenty-two, a fracture-dislocation of the forearm in nine, and infection in eleven. All fractures healed without additional intervention within six months. Two patients had a subsequent Darrach resection of the distal part of the ulna for the treatment of arthrosis of the distal radioulnar joint. After an average duration of follow-up of forty-three months, the final arc of motion averaged 121 degrees in the forearm, 131 degrees at the elbow, and 137 degrees at the wrist, with an average grip strength of 83% compared with that of the contralateral limb. According to the system of Anderson and colleagues, five patients had an excellent result, eighteen had a satisfactory result, eleven had an unsatisfactory result (because of elbow stiffness related to associated elbow injuries in three and because of wrist stiffness in eight), and one had a poor result (because of malunion

  10. Necrotising fasciitis causing compartment syndrome of the forearm and septic shock due to Vibrio vulnificus: a case report.

    Science.gov (United States)

    Leechavengvongs, Somsak; Jidpugdeebodin, Suwanee; Milindankura, Samaniya

    2006-01-01

    Compartment syndrome caused by necrotising fasciitis has rarely been described. We report a case of systemic Vibrio vulnificus necrotising fasciitis presented with compartmental syndrome of the forearm and septic shock. The patient was treated with systemic antibiotic treatment and urgent surgical decompression followed by multiple necrotic tissue debridements. The patient recovered with some limited motion of the hand function. Prompt recognition and immediate treatment with antibiotics and surgical intervention are essential.

  11. An Unusual Metastasis of a Transglottic Squamous Cell Carcinoma to the Forearm

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    Abdullah Dafir Albeyatti

    2013-01-01

    Full Text Available Introduction. Each year around 2,200 people in the UK are diagnosed with laryngeal SCC (Office of National Statistics 2009. Compared to pharyngeal carcinoma, it is a highly curable disease with a survival rate of around 60% for all stages and all forms of treatment. Case Presentation. We present the case of a 60-year-old man with a previously treated T4 N2c transglottic squamous cell carcinoma (SCC, who developed an isolated swelling in the extensor compartment of his right forearm at 6 months after radical laryngectomy with bilateral neck dissection. Fine needle aspiration of the forearm lesion revealed SCC consistent with a metastasis from the laryngeal primary. MRI revealed that the lesion was confined to the muscle. Initial staging CT showed no distant metastases or signs of advanced disease, including no evidence of axillary nodal involvement. Conclusion. This case is therefore unusual, as one of only 2 cases reported in the scientific literature of isolated distant muscular metastasis from a laryngeal squamous cell carcinoma. We conclude that any muscular swelling, in the setting of previous head and neck malignancy, should be treated with a high degree of suspicion for metastasis and investigated promptly.

  12. [Elastic stable intramedullary nailing (ESIN) in the treatment of both-bone forearm fractures in the child: about 87 cases].

    Science.gov (United States)

    Andaloussi, Saad; Amine Oukhouya, Mohamed; Alaoui, Othmane; Atarraf, Karima; Chater, Lamiae; Afifi, My Abderrahmane

    2017-01-01

    This study aims to describe the complications of elastic stable intramedullary nailing (ESIN) in the treatment of both-bone forearm diaphyseal fractures in the child. Between January 2009 and December 2013, 87 children with both-bone forearm diaphyseal fractures were treated by elastic stable intramedullary nailing with Métaizeau nails. 76 boys and 11 girls, with an average age of 12 years, were enrolled in the study. Nailing was promptly performed in 50 cases and after secondary displacement during plaster-cast treatment in the other cases. Both bones were nailed in all cases. All patients underwent systematic plaster immobilization for a period of about one month. On average, nails were removed after about 6 months. Functional outcomes were studied over a mean follow-up period of 10 months. Complications were marked by 14 superficial infections (14 cases), osteitis associated with material (2 cases), refracture (3 cases), pseudarthrosis (3 cases), delayed fracture consolidation (2 cases) and proximal radioulnar synostosis (1 case). Although intramedullary nailing ideally is an osteosynthesis technique suitable for the treatment of fractures in children, it is more invasive than orthopaedic treatment.Indications for treatment should remain within well-established limits.

  13. MR imaging of the major nerves about the elbow: cadaveric study examining the effect of flexion and extension of the elbow and pronation and supination of the forearm

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Sook; Yeh, Lee Ren; Trudell, D.; Resnick, D. [Department of Radiology (114), Veterans Administration Medical Center, San Diego, CA (United States)

    1998-08-01

    Magnetic resonance (MR) imaging provides useful information in the evaluation of peripheral nerves. Recent advances in MR imaging allow for detailed depiction of the soft tissue structures of the elbow joint. Three major nerves are present about the elbow. Six cadaveric elbows were imaged to depict the normal anatomy of these nerves and to determine the best plane and position of the elbow for optimal visualization of each nerve. Axial images of the elbow in full extension with the forearm in supination allow identification of all major nerves. Axial images with the elbow in full flexion allow accurate assessment of the cubital tunnel and the ulner nerve. Axial images of the elbow in full extension with the forearm in pronation are helpful for assessment of the median and radial nerves in the forearm. (orig.) With 11 figs., 20 refs.

  14. Vascularized proximal fibular epiphyseal transfer for Bayne and Klug type III radial longitudinal deficiency in children.

    Science.gov (United States)

    Yang, Jiantao; Qin, Bengang; Li, Ping; Fu, Guo; Xiang, Jianping; Gu, Liqiang

    2015-01-01

    Treatment of Bayne and Klug type III radial longitudinal deficiency with fibular epiphyseal transplantation in children has had limited success to date. The purpose of this investigation was to review the authors' results of microvascular epiphyseal transplantation for radial longitudinal deficiency. Between 2007 and 2009, four children with a mean age of 4.3 years (range, 3.3 to 5.8 years) who had a type III radial longitudinal deficiency underwent microsurgical reconstruction of the distal radius with vascularized proximal fibular transplantation, including the physis, partial superior tibiofibular joint, and a variable length of the diaphysis. All of the grafts were supplied by the inferior lateral genicular artery. In all patients, the range of motion of the digits, wrist, forearm, and elbow; the length of the forearm; and the deviation of the wrist were evaluated. The mean duration of follow-up was 42 months (range, 24 to 65 months). All four transfers survived and united with the host bone within 3 months postoperatively. An average correction of 28 degrees in the hand-forearm angle was obtained. Forearm length was 67.9 percent that of the normal side on average at the final follow-up. The overall range of wrist motion was approximately 55 percent that of the contralateral extremity. No major complications were observed. Vascularized proximal fibular epiphyseal transfer, based on the inferior lateral genicular artery, is a technically feasible method for treatment of type III radial longitudinal deficiency, which maintains hand-forearm alignment, provides excellent function, and minimizes the length discrepancy between the distal radius and ulna. Therapeutic, IV.

  15. Pediatric Hereditary Angioedema as a Cause of Acute Compartment Syndrome of the Hand and Forearm: A Case Report.

    Science.gov (United States)

    Venditto, Chelsea; Jager, Zachary; LoGiudice, John; Matloub, Hani

    2017-05-01

    Compartment syndrome of the upper extremity is a surgical emergency that, when left untreated, can have dire consequences. Its causes are numerous, one of which is the uncommon entity hereditary angioedema, an autosomal dominant disease resulting in edema in a variety of potential locations, including the extremities. This is only the second time hereditary angioedema has been mentioned in the literature as a cause of compartment syndrome. We present a case of hereditary angioedema leading to hand and forearm compartment syndrome in a 13-year-old pediatric patient. Diagnosis of hereditary angioedema was made by our Rheumatology colleagues with physical exam and a thorough history, and confirmed by laboratory studies. Our patient presented with compartment syndrome of the hand and forearm and underwent hand and volar forearm fasciotomies. She was subsequently worked up for hereditary angioedema with laboratory results confirming the diagnosis. She was discharged after a 5-day hospitalization with prophylactic C1-inhibitor therapy. Hereditary angioedema is a rare but known cause of compartment syndrome of the upper extremity, and must be considered when patients present with compartment syndrome of unknown etiology. This disease can be diagnosed by laboratory studies and symptoms can be controlled with medical therapy.

  16. A Rare Case of a 15-Year-Old Boy with Two Accessory Nipples: One in the Forearm and One in the Milk Line

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    Alexander J. Tauchen

    2015-01-01

    Full Text Available A 15-year-old male presented for evaluation of a volar forearm mass that he noticed four years before. The mass was not painful and his main concern was cosmesis. The mass was two centimeters in diameter with a pinpoint central sinus and scant drainage. After excision, the pathology report noted pilosebaceous units and smooth muscle bundles, consistent with an accessory nipple. In addition, the patient had another accessory nipple in the “milk line” on his torso. While accessory nipples and breast tissue have been reported in numerous locations throughout the body, this is the first reported case of an accessory nipple on the forearm.

  17. A Regularized Algorithm for the Proximal Split Feasibility Problem

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    Zhangsong Yao

    2014-01-01

    Full Text Available The proximal split feasibility problem has been studied. A regularized method has been presented for solving the proximal split feasibility problem. Strong convergence theorem is given.

  18. Prevalence of and referred pain from myofascial trigger points in the forearm muscles in patients with lateral epicondylalgia.

    Science.gov (United States)

    Fernández-Carnero, Josué; Fernández-de-Las-Peñas, César; de la Llave-Rincón, Ana Isabel; Ge, Hong-You; Arendt-Nielsen, Lars

    2007-05-01

    Referred pain and pain characteristics evoked from the extensor carpi radialis brevis, extensor carpi radialis longus, extensor digitorum communis, and brachioradialis muscles was investigated in 20 patients with lateral epicondylalgia (LE) and 20-matched controls. Both groups were examined for the presence of myofascial trigger points (TrPs) in a blinded fashion. The quality and location of the evoked referred pain, and the pressure pain threshold (PPT) at the lateral epicondyle on the right upper extremity (symptomatic side in patients, and dominant-side on controls) were recorded. Several lateral elbow pain parameters were also evaluated. Within the patient group, the elicited referred pain by manual exploration of 13 out of 20 (65%) extensor carpi radialis brevis muscles, 12/20 (70%) extensor carpi radialis longus muscles, 10/20 (50%) brachioradialis muscles, and 5/20 (25%) extensor digitorum communis muscles, shares similar pain patterns as their habitual lateral elbow and forearm pain. The mean number of muscles with TrPs for each patient was 2.9 [95% confidence interval (CI) 1,4] of which 2 (95% CI 1,3) were active, and 0.9 (95% CI 0,2) were latent TrPs. Control participants only had latent TrPs (mean: 0.4; 95% CI 0,2). TrP occurrence between the 2 groups was significantly different for active TrPs (Platent TrPs (P>0.05). The referred pain pattern was larger in patients than in controls, with pain referral to the lateral epicondyle (proximally) and to the dorso-lateral aspect of the forearm in the patients, and confined to the dorso-lateral aspect of the forearm in the controls. Patients with LE showed a significant (Pactive TrPs (rs=-0.5; P=0.02): the greater the number of active TrPs, the lower the PPT at the lateral epicondyle. Our results suggest that in patients with LE, the evoked referred pain and its sensory characteristics shared similar patterns as their habitual elbow and forearm pain, consistent with active TrPs. Lower PPT and larger referred

  19. SURGICAL METHODS FOR TREATMENT OF DIAPHYSIAL FRACTURES OF FOREARM IN CHILDREN

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    R. R. Khodjayev

    2011-01-01

    Full Text Available Treatment of diaphyseal fractures of the forearm: among children is an urgent and complex issue. Results of treatment of closed fractures of the forearm in 43 children who have used surgical treatment using the existing (open reduction, intramedullary fixation combined with external fixation by Ilizarov ring of the two towers methods. The main principles of treatment of forearm fractures in children the correct mapping of one fragments, their reliable fixation, early adequate functional load.

  20. Endoscopic Fascia Release for Forearm Chronic Exertional Compartment Syndrome: Case Report and Surgical Technique

    National Research Council Canada - National Science Library

    Miller, Elizabeth A; Cobb, Anna L; Cobb, Tyson K

    Background: Chronic exertional compartment syndrome (CECS) of the forearm is traditionally treated with open compartment release requiring large incisions that can result in less than optimal esthetic results...

  1. Electromyographic analysis of forearm muscles in professional and amateur golfers.

    Science.gov (United States)

    Farber, Adam J; Smith, J Steve; Kvitne, Ronald S; Mohr, Karen J; Shin, Steven S

    2009-02-01

    No fine-wire electromyography studies have been performed to compare the activity of forearm muscles in professional golfers versus amateur golfers. The fine-wire electromyographic activity of forearm muscles differs between professional and amateur golfers during the different phases of the golf swing. Controlled laboratory study. Ten male right-handed amateur golfers and 10 male right-handed professional golfers without history of elbow symptoms were tested with fine-wire electromyographic electrodes inserted into the flexor carpi radialis, pronator teres, flexor carpi ulnaris, and extensor carpi radialis brevis muscles of both forearms. Electromyographic data were synchronized with video data, and the muscle activity was expressed as a percentage of maximum manual muscle test activity for each phase of the golf swing. Compared with professional golfers, amateur golfers had more muscle activity in the pronator teres of the trail arm (right arm in a right-handed golfer) in the forward swing phase (120.9% maximum manual muscle test vs 57.4% maximum manual muscle test; P = .04) and a trend toward increased activity in the acceleration phase (104.8% maximum manual muscle test vs 53.1% maximum manual muscle test; P = .08). In contrast, professional golfers had more muscle activity in the pronator teres of the lead arm (left arm in a right-handed golfer) in the acceleration phase (88.1% maximum manual muscle test vs 36.3% maximum manual muscle test; P = .03) and a trend toward increased activity in the early follow-through phase (58.1% maximum manual muscle test vs 28.8% maximum manual muscle test; P = .06). Pronator teres muscle activity in the golf swing differs significantly between professional and amateur golfers. Exercises with an emphasis on stretching and strengthening of the pronator teres may be useful in treating and/or preventing medial epicondylitis in amateur golfers.

  2. The single-bout forearm critical force test: a new method to establish forearm aerobic metabolic exercise intensity and capacity.

    Science.gov (United States)

    Kellawan, J Mikhail; Tschakovsky, Michael E

    2014-01-01

    No non-invasive test exists for forearm exercise that allows identification of power-time relationship parameters (W', critical power) and thereby identification of the heavy-severe exercise intensity boundary and scaling of aerobic metabolic exercise intensity. The aim of this study was to develop a maximal effort handgrip exercise test to estimate forearm critical force (fCF; force analog of power) and establish its repeatability and validity. Ten healthy males (20-43 years) completed two maximal effort rhythmic handgrip exercise tests (repeated maximal voluntary contractions (MVC); 1 s contraction-2 s relaxation for 600 s) on separate days. Exercise intensity was quantified via peak contraction force and contraction impulse. There was no systematic difference between test 1 and 2 for fCF(peak) force (p = 0.11) or fCF(impulse) (p = 0.76). Typical error was small for both fCF(peak force) (15.3 N, 5.5%) and fCF(impulse) (15.7 N ⋅ s, 6.8%), and test re-test correlations were strong (fCF(peak force), r = 0.91, ICC = 0.94, pfCF(peak force). TTE predicted by W' showed good agreement with actual TTE during the TTE tests (r = 0.97, ICC = 0.97, PMVC did not predict fCF(peak force) (p = 0.37), fCF(impulse) (p = 0.49) or W' (p = 0.15). In conclusion, the poor relationship between MVC and fCF or W' illustrates the serious limitation of MVC in identifying metabolism-based exercise intensity zones. The maximal effort handgrip exercise test provides repeatable and valid estimates of fCF and should be used to normalize forearm aerobic metabolic exercise intensity instead of MVC.

  3. A comparative analysis of sonographic interpretation of peripheral nerves in the anterior compartment of the forearm between an experienced and novice interpreter.

    Science.gov (United States)

    Hung, Laurie Y; Lucaciu, Octavian C; Soave, David M

    2012-01-01

    This article describes a pilot study that compares the ability of a novice interpreter and an experienced interpreter to interpret ultrasound images of peripheral nerves in the anterior compartment of the forearm. Twenty subjects between 18 and 50 years of age were included. A student was taken through tutorials in which she was guided through identification of the peripheral nerves of the anterior forearm. After the tutorials, the experienced interpreter traced the subjects' ulnar nerve and artery neurovascular bundle proximally in the anterior compartment of the forearm until just before it separated into the artery and nerve. Here the distance between the median and ulnar nerve was measured by the investigators. The Bland and Altman design and paired t tests were used to compare the agreement between the results of the two investigators. The Bland and Altman analysis reveals that the difference between two sets of measurements (experienced investigator vs. student) is calculated to be 0.08 mm ± 0.22 mm for the left arm and 0.16 mm ± 0.43 mm for the right arm. A paired t test revealed that there is no significant difference in the measurements obtained by the two investigators (left arm: p = .12; right arm: p = .10). These results suggest that the measurements of the two investigators may be interchangeable. This pilot study shows that after tutorials combining dissection and sonographic interpretation, the ability of a novice interpreter to identify ultrasonographic images of peripheral nerves in the anterior compartment of the forearm is comparable to that of an experienced interpreter.

  4. Total Lip Reconstruction with Tendinofasciocutaneous Radial Forearm Flap

    Directory of Open Access Journals (Sweden)

    Eldad Silberstein

    2014-01-01

    Full Text Available Introduction. Squamous cell carcinoma is a common tumour of lower lip. Small defects created by surgical resection may be readily reconstructed by linear closure or with local flaps. However, large tumours resection often results with microstomia and oral incompetence, drooling, and speech incomprehension. The goal of this study is to describe our experience with composite free radial forearm-palmaris longus tendon flap for total or near total lower lip reconstruction. Patients and Methods. This procedure was used in 5 patients with 80–100% lip defect resulting from Squamous cell carcinoma. Patients’ age ranged from 46 to 82 years. They are three male patients and two female. In 3 cases chin skin was reconstructed as well and in one case a 5 cm segment of mandible was reconstructed using radius bone. In one case where palmaris longus was missing hemi-flexor carpi radialis tendon was used instead. All patients tolerated the procedure well. Results. All flaps totally survived. No patient suffered from drooling. All patients regained normal diet and normal speech. Cosmetic result was fair to good in all patients accept one. Conclusion. We conclude that tendino-fasciocutaneous radial forearm flap for total lower lip reconstruction is safe. Functional and aesthetic result approaches reconstructive goals.

  5. Experimental forearm immobilization in humans induces cold and mechanical hyperalgesia.

    Science.gov (United States)

    Terkelsen, Astrid J; Bach, Flemming W; Jensen, Troels S

    2008-08-01

    Complex regional pain syndrome is a painful condition of unknown etiology. Clinical and experimental observations suggest that limb immobilization may induce symptoms and signs characteristic of complex regional pain syndrome. This study examined the effect of forearm immobilization on regional sensory and autonomic functions in healthy subjects. Thermal and mechanical sensitivity, skin temperature, and vasoconstrictor responses were measured in 30 healthy subjects before and 0, 3, and 28 days after scaphoid cast immobilization. Fifteen subjects served as nonimmobilized controls. At cast removal, 27 subjects experienced pain at joint movement. Cast immobilization induced cold hyperalgesia in glabrous and hairy skin on the immobilized hand and induced significant skin temperature differences between the control and the immobilized hand at cast removal and after 3 days. Immobilization also reduced pain threshold at skin fold testing at all time points after cast removal. All measures except pain threshold at skin fold testing were normalized after 28 days. Immobilization did not affect thermal detection, heat pain, and pressure pain thresholds; resting skin perfusion; or vasoconstrictor responses induced by mental stress or deep inspirations. Four weeks of forearm immobilization caused transient changes in skin temperature, mechanosensitivity, and thermosensitivity, without alteration in the sympathetically mediated vascular tone.

  6. Capacitive proximity sensor

    Science.gov (United States)

    Kronberg, James W.

    1994-01-01

    A proximity sensor based on a closed field circuit. The circuit comprises a ring oscillator using a symmetrical array of plates that creates an oscillating displacement current. The displacement current varies as a function of the proximity of objects to the plate array. Preferably the plates are in the form of a group of three pair of symmetric plates having a common center, arranged in a hexagonal pattern with opposing plates linked as a pair. The sensor produces logic level pulses suitable for interfacing with a computer or process controller. The proximity sensor can be incorporated into a load cell, a differential pressure gauge, or a device for measuring the consistency of a characteristic of a material where a variation in the consistency causes the dielectric constant of the material to change.

  7. Neighborhoods and manageable proximity

    Directory of Open Access Journals (Sweden)

    Stavros Stavrides

    2011-08-01

    Full Text Available The theatricality of urban encounters is above all a theatricality of distances which allow for the encounter. The absolute “strangeness” of the crowd (Simmel 1997: 74 expressed, in its purest form, in the absolute proximity of a crowded subway train, does not generally allow for any movements of approach, but only for nervous hostile reactions and submissive hypnotic gestures. Neither forced intersections in the course of pedestrians or vehicles, nor the instantaneous crossing of distances by the technology of live broadcasting and remote control give birth to places of encounter. In the forced proximity of the metropolitan crowd which haunted the city of the 19th and 20th century, as well as in the forced proximity of the tele-presence which haunts the dystopic prospect of the future “omnipolis” (Virilio 1997: 74, the necessary distance, which is the stage of an encounter between different instances of otherness, is dissipated.

  8. Design of Wrist Gimbal: a forearm and wrist exoskeleton for stroke rehabilitation.

    Science.gov (United States)

    Martinez, John A; Ng, Paul; Lu, Son; Campagna, McKenzie S; Celik, Ozkan

    2013-06-01

    In this paper, we present design, implementation and specifications of the Wrist Gimbal, a three degree-of-freedom (DOF) exoskeleton developed for forearm and wrist rehabilitation. Wrist Gimbal has three active DOF, corresponding to pronation/supination, flexion/extension and adduction/abduction joints. We mainly focused on a robust, safe and practical device design to facilitate clinical implementation, testing and acceptance. Robustness and mechanical rigidity was achieved by implementing two bearing supports for each of the pronation/supination and adduction/abduction axes. Rubber hard stops for each axis, an emergency stop button and software measures ensured safe operation. An arm rest with padding and straps, a handle with adjustable distal distance and height and a large inner volume contribute to ease of use, of patient attachment and to comfort. We present the specifications of Wrist Gimbal in comparison with similar devices in the literature and example data collected from a healthy subject.

  9. Hypertrophic non-union of a pathological forearm fracture secondary to multiple myeloma: a case report

    Directory of Open Access Journals (Sweden)

    Okoro Tosan

    2010-04-01

    Full Text Available Abstract Skeletal lesions in multiple myeloma are predominantly lytic and when non-union of pathological fractures occur it is typically atrophic. We report a lady of 61 years of age with myeloma who presented with a pathological fracture through an ulnar myeloma deposit. The fracture was immobilised initially then irradiated. Nine months later she re-presented with marked forearm pain particularly on rotation. Radiographs demonstrated a hypertrophic non-union of a pathological fracture with a typical elephant's hoof appearance. The fracture was immobilised using an ulnar nail. Whilst non-unions in metastatic malignancy are typically atrophic, just occasionally hypertrophic non-unions can occur. Management principles remain the same with stabilisation of the entire bone and early mobilisation being appropriate.

  10. Promoting proximal formative assessment with relational discourse

    Science.gov (United States)

    Scherr, Rachel E.; Close, Hunter G.; McKagan, Sarah B.

    2012-02-01

    The practice of proximal formative assessment - the continual, responsive attention to students' developing understanding as it is expressed in real time - depends on students' sharing their ideas with instructors and on teachers' attending to them. Rogerian psychology presents an account of the conditions under which proximal formative assessment may be promoted or inhibited: (1) Normal classroom conditions, characterized by evaluation and attention to learning targets, may present threats to students' sense of their own competence and value, causing them to conceal their ideas and reducing the potential for proximal formative assessment. (2) In contrast, discourse patterns characterized by positive anticipation and attention to learner ideas increase the potential for proximal formative assessment and promote self-directed learning. We present an analysis methodology based on these principles and demonstrate its utility for understanding episodes of university physics instruction.

  11. Atrofia muscular proximal familiar

    Directory of Open Access Journals (Sweden)

    José Antonio Levy

    1962-09-01

    Full Text Available Os autores relatam dois casos de atrofia muscular proximal familiar, moléstia caracterizada por déficit motor e atrofias musculares de distribuição proximal, secundárias a lesão de neurônios periféricos. Assim, como em outros casos descritos na literatura, foi feito inicialmente o diagnóstico de distrofia muscular progressiva. O diagnóstico correto foi conseguido com auxílio da eletromiografia e da biopsia muscular.

  12. Angular malalignment as cause of limitation of forearm rotation: an analysis of prospectively collected data of both-bone forearm fractures in children.

    Science.gov (United States)

    Colaris, Joost; Reijman, Max; Allema, Jan Hein; de Vries, Mark; Biter, Ulas; Bloem, Rolf; van de Ven, Cees; Verhaar, Jan

    2014-06-01

    Although limitation of pronation/supination following both-bone forearm fractures in children is often attributed to an angular malunion, no clinical study has compared pronation/supination and angular malalignment of the same child by analysis of prospectively collected clinical data. The purpose of this trial is to explore whether limitation of pronation/supination can be predicted by the degree of angular malalignment in children who sustained a both-bone forearm fracture. In four Dutch hospitals, children aged ≤16 years with a both-bone forearm fracture were prospectively followed up consecutive children for 6-9 months. At the final follow-up, pronation/supination and angular malunion on radiographs were determined. Between January 2006 and August 2010, a total of 410 children were prospectively followed up, of which 393 children were included for analysis in this study. The mean age of the children was 8.0 (±3.5) years, of which 63% were male and 40% fractured their dominant arm. The mean time to final examination was 219 (±51) days. Children with a metaphyseal both-bone fracture of the distal forearm with an angular malalignment of ≤15° had a 9-13% chance of developing a clinically relevant limitation (i.e., children with an angular malalignment of ≥16° had a 60% chance. Children with diaphyseal both-bone forearm fractures with ≤5° of angular malalignment had a 13% chance of developing a clinically relevant limitation, which showed no significant increase with a further increase of angular malalignment. Children who sustained a both-bone forearm fracture localised in the distal metaphysis have a higher chance of developing a clinically relevant limitation of forearm rotation in case of a more severe angular malalignment, while children with a diaphyseal both-bone forearm fracture had a moderate chance of limitation, irrespective of the severity of the angular malalignment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Does computer use pose an occupational hazard for forearm pain; from the NUDATA study

    DEFF Research Database (Denmark)

    Kryger, Ann Isabel; Andersen, JH; Lassen, C. F.

    2003-01-01

    AIMS: To determine the occurrence of pain conditions and disorders in the forearm and to evaluate risk factors for forearm pain in a cohort of computer workers. METHODS: A total of 6943 participants with a wide range of computer use and work tasks were studied. At baseline and at one year follow ...

  14. Effects of a Ginkgo biloba extract on forearm haemodynamics in healthy volunteers

    DEFF Research Database (Denmark)

    Mehlsen, J; Drabaek, H; Wiinberg, N

    2002-01-01

    -gauge plethysmography. Blood pressure was measured by standard sphygmomanometry, and forearm vascular resistance (FVR) was derived. Measurements were made at baseline and after 3, 6, 9 and 12 weeks of treatment. Forearm blood flow was significantly higher during active treatment after 3 and 6 weeks as compared...

  15. Evaluation of donor site function and morbidity of the fasciocutaneous radial forearm flap

    NARCIS (Netherlands)

    de Bree, Remco; Hartley, Chris; Smeele, Ludwig E.; Kuik, Dirk J.; Quak, Jasper J.; Leemans, C. René

    2004-01-01

    To assess the results of the use of the free radial forearm flap in terms of objective morbidity and subjective patient response. The donor sites were examined from 37 patients who underwent reconstruction with a free fasciocutaneous radial forearm flap in the head and neck after ablative tumor

  16. Microvascular filtration is increased in the forearms of patients with breast cancer-related lymphedema

    DEFF Research Database (Denmark)

    Jensen, Mads Radmer; Simonsen, Lene; Karlsmark, Tonny

    2013-01-01

    -enhanced ultrasound; venous occlusion strain-gauge plethysmography; lower-body negative pressure; noninvasive blood pressure measurements; and skin (99m)Tc-pertechnetate clearance technique. Measurements were performed bilaterally and simultaneously in the forearms, enabling use of the nonedematous forearm...

  17. Effect of specific resistance training on forearm pain and work disability in industrial technicians: cluster randomised controlled trial

    DEFF Research Database (Denmark)

    Andersen, Lars Louis; Jakobsen, Markus D; Pedersen, Mogens Theisen

    2012-01-01

    To determine the effect of specific resistance training on forearm pain and work disability in industrial technicians.......To determine the effect of specific resistance training on forearm pain and work disability in industrial technicians....

  18. [Experimental proximal carpectomy. Biodynamics].

    Science.gov (United States)

    Kuhlmann, J N

    1992-01-01

    Proximal carpectomy was performed in 10 fresh cadavre wrists. Dynamic x-rays were taken and the forces necessary to obtain different movements before and after the operation were measured. Comparison of these parameters clearly defines the advantages and limitations of carpectomy and indicates the reasons.

  19. Proximate Analysis of Coal

    Science.gov (United States)

    Donahue, Craig J.; Rais, Elizabeth A.

    2009-01-01

    This lab experiment illustrates the use of thermogravimetric analysis (TGA) to perform proximate analysis on a series of coal samples of different rank. Peat and coke are also examined. A total of four exercises are described. These are dry exercises as students interpret previously recorded scans. The weight percent moisture, volatile matter,…

  20. Proximal Tibial Bone Graft

    Science.gov (United States)

    ... the Big Toe Ailments of the Smaller Toes Diabetic Foot Treatments Currently selected Injections and other Procedures Treatments ... from which the bone was taken if the foot/ankle surgeries done at the same time allow for it. ... problems after a PTBG include infection, fracture of the proximal tibia and pain related ...

  1. An unusual presentation of anetoderma: a case report

    Directory of Open Access Journals (Sweden)

    Aghaei Shahin

    2004-08-01

    Full Text Available Abstract Background Anetoderma is a benign condition with focal loss of dermal elastic tissue resulting in localized areas of flaccid or herniated saclike skin. Currently, anetoderma is classified as either primary (idiopathic, or secondary anetoderma (which is associated with a variety of skin conditions, penicillamine use, or neonatal prematurity. Lesions appear on the upper arms, trunk, and thighs. Case presentation We report a 14-year-old boy, which was noticed to have had multiple, white, non-pruritic areas on the acral sites of upper and lower extremities for two years. In physical examination, the patient had normal mental development. Skin lesions consisted of scattered, white to skin-colored papules, less than 1 cm in diameter, and with central protrusion, with distribution on dorsal part of the index finger, forearms, distal portion of thighs and calves. Lesions were detected neither on the trunk nor the proximal areas of extremities. There are no sensory changes associated with the lesions. Otherwise, his general health was good. He did not have any medication consumption history. Family history was negative. Laboratory examinations were within normal limits. Skin biopsy from one of his lesions was done, that confirmed the diagnosis of anetoderma. Conclusions In summary, we report a case of anetoderma on unusual sites of the skin. We could not find similar reports of anetoderma developing on distal extremities without involvement of the upper trunk and proximal arms, in the medical literature.

  2. An Unusual Presenting Symptom of Graves’ Disease: Myalgia

    Science.gov (United States)

    Papanikolaou, N.; Perros, P.

    2013-01-01

    A 50-year-old female patient presented with severe myalgia involving her proximal muscles for 3–4 weeks. She also reported mild thyrotoxic symptoms over the same time period. Examination revealed mild thyrotoxicosis, a moderate diffuse goiter and no eye signs. The clinical picture was dominated by muscle pain and tenderness involving mainly her proximal arms and legs, her calves and her fingers, requiring opiate analgesia. Muscle power and tendon reflexes were normal. Laboratory evaluation revealed undetectable serum thyroid stimulating hormone (TSH) with raised FT4, FT3 and positive TSH receptor antibodies. Treatment with carbimazole was started. Additional laboratory investigations were negative (inflammatory markers, creatine kinase and antibodies to antinuclear antibodies, gastric parietal cell, smooth muscle, mitochondrial, dsDNA, centromere, extractable nuclear antigen (ENA) ribonucleoprotein, ENA Sm, ENA Ro, ENA Anti-La, ENA Scl70, ENA Jo-1, anti-CCP and rheumatoid factor). Further assessment in the rheumatology clinic confirmed there was no small joint tenderness or loss of range of movement of her limbs, but widespread and profound muscle tenderness of the common extensors of the forearms, biceps, trapezius, calves and thighs. She was treated symptomatically with analgesic medication and continued on carbimazole. A month later she was euthyroid and her myalgia had resolved. Hyperthyroidism has a profound effect on skeletal muscle and often leads to myopathy. Severe myalgia in association with Graves’ disease is rare and resolves with the restoration of euthyroidism. PMID:24783030

  3. Functional Outcomes After Both Bone Forearm Fractures in Adults.

    Science.gov (United States)

    Thayer, Mary K; Vaidya, Rahul; Langfitt, Maxwell; Carroll, Eben A; Cannada, Lisa K

    2015-01-01

    The purpose of this study was to evaluate midterm outcomes after both bone forearm fractures. A retrospective review of patients treated with open reduction and internal fixation (ORIF) at three level 1 trauma centers was completed. Eligible patients were sent three questionnaires: Disabilities of the Arm, Shoulder and Hand (DASH), Short Form-12 (SF-12), and questions about postinjury experience. Twenty-nine patients with an average age of 45 years returned the materials. The forms were completed an average of 60 months after ORIF. The mean DASH was 22 for all respondents. Twenty-one subjects participated in physical therapy (72%). Eight patients (28%) screened positive for posttraumatic stress disorder (PTSD). The mean SF-12 physical component score was 39 and the SF-12 mental component score was 40, both of which were lower than the non-PTSD group, indicating a lower subjective level of health (p < .05). The data suggest that, years after surgery, patients have decreased functional outcomes.

  4. Forearm diaphyseal fractures in children: intramedullary Kirschner's wire fixation treatment.

    Science.gov (United States)

    Mahecha-Toro, M; Vergara-Amador, E; González Ramírez, M

    Diaphyseal fractures of the forearm comprise 6%-10% of all fractures in children. The treatment depends on the age and type of displacement, and conservative and surgical management with fixation of intramedullary nails, among other techniques, is valid. The aim is to show the radiological and functional outcomes, and complications of intramedullary fixation with Kirschner nails in children. A retrospective descriptive case series of patients treated with intramedullary fixation of forearm fractures. The radiological and functional results, and complications are correlated. Of the 117 patients operated, 59 met the inclusion criteria. The average age was 10 years. Eighty-four point seven percent were males and the left side was the most affected (62.7%). In 88.1% both bones were fractured and 11 cases had open fractures. An open reduction was performed in 72.8% of the cases, the main indications for this being instability, failed reduction and refracture. There were 52 excellent outcomes, 2 good, and 4 regular and 1 bad. There were 13.5% minor complications. This study shows that intramedullary fixation with Kirschner nails in radius and ulna diaphysis fractures in children is a safe, low-cost procedure and offers adequate short and medium term functional outcomes, with a low prevalence of serious complications with only 6 cases of non-consolidation and refracture. Larger preoperative angulations in the anteroposterior and lateral planes, and lateral postoperative angulations, could be considered predictors of less satisfactory functional results. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Optical Myography: Detecting Finger Movements by Looking at the Forearm

    Directory of Open Access Journals (Sweden)

    Christian eNissler

    2016-04-01

    Full Text Available One of the crucial problems found in the scientific community of assistive / rehabilitation robotics nowadays is that of automatically detecting what a disabled subject (for instance, a hand amputee wants to do, exactly when she wants to do it and strictly for the time she wants to do it. This problem, commonly called intent detection, has traditionally been tackled using surface electromyography, a technique which suffers from a number of drawbacks, including the changes in the signal induced by sweat and muscle fatigue. With the advent of realistic, physically plausible augmented- and virtual-reality environments for rehabilitation, this approach does not suffice anymore. In this paper we explore a novel method to solve the problem, that we call Optical Myography (OMG. The idea is to visually inspect the human forearm (or stump to reconstruct what fingers are moving and to what extent. In a psychophysical experiment involving ten intact subjects, we used visual fiducial markers (AprilTags and a standard web-camera to visualize the deformations of the surface of the forearm, which then were mapped to the intended finger motions. As ground truth, a visual stimulus was used, avoiding the need for finger sensors (force/position sensors, datagloves, etc.. Two machine-learning approaches, a linear and a non-linear one, were comparatively tested in settings of increasing realism. The results indicate an average error in the range of 0.05 to 0.22 (root mean square error normalized over the signal range, in line with similar results obtained with more mature techniques such as electromyography. If further successfully tested in the large, this approach could lead to vision-based intent detection of amputees, with the main application of letting such disabled persons dexterously and reliably interact in an augmented- / virtual-reality setup.

  6. The single-bout forearm critical force test: a new method to establish forearm aerobic metabolic exercise intensity and capacity.

    Directory of Open Access Journals (Sweden)

    J Mikhail Kellawan

    Full Text Available No non-invasive test exists for forearm exercise that allows identification of power-time relationship parameters (W', critical power and thereby identification of the heavy-severe exercise intensity boundary and scaling of aerobic metabolic exercise intensity. The aim of this study was to develop a maximal effort handgrip exercise test to estimate forearm critical force (fCF; force analog of power and establish its repeatability and validity. Ten healthy males (20-43 years completed two maximal effort rhythmic handgrip exercise tests (repeated maximal voluntary contractions (MVC; 1 s contraction-2 s relaxation for 600 s on separate days. Exercise intensity was quantified via peak contraction force and contraction impulse. There was no systematic difference between test 1 and 2 for fCF(peak force (p = 0.11 or fCF(impulse (p = 0.76. Typical error was small for both fCF(peak force (15.3 N, 5.5% and fCF(impulse (15.7 N ⋅ s, 6.8%, and test re-test correlations were strong (fCF(peak force, r = 0.91, ICC = 0.94, pfCF(peak force. TTE predicted by W' showed good agreement with actual TTE during the TTE tests (r = 0.97, ICC = 0.97, P<0.01; typical error 0.98 min, 12%; regression fit slope = 0.99 and y intercept not different from 0, p = 0.31. MVC did not predict fCF(peak force (p = 0.37, fCF(impulse (p = 0.49 or W' (p = 0.15. In conclusion, the poor relationship between MVC and fCF or W' illustrates the serious limitation of MVC in identifying metabolism-based exercise intensity zones. The maximal effort handgrip exercise test provides repeatable and valid estimates of fCF and should be used to normalize forearm aerobic metabolic exercise intensity instead of MVC.

  7. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi

    2015-01-01

    -displaced femoral neck fractures and prosthesis for displaced among the elderly; and sliding hip screw for stabile- and intramedullary nails for unstable- and sub-trochanteric fractures) but they are based on a variety of criteria and definitions - and often leave wide space for the individual surgeons' subjective...... guidelines for hip fracture surgery and discuss a method for future pathway/guideline implementation and evaluation. METHODS: By a PubMed search in March 2015 six studies of surgical treatment pathways covering all types of proximal femoral fractures with publication after 1995 were identified. Also we...... searched the homepages of the national heath authorities and national orthopedic societies in West Europe and found 11 national or regional (in case of no national) guidelines including any type of proximal femoral fracture surgery. RESULTS: Pathway consensus is outspread (internal fixation for un...

  8. Scaling of Primate Forearm Muscle Architecture as It Relates to Locomotion and Posture.

    Science.gov (United States)

    Leischner, Carissa L; Crouch, Michael; Allen, Kari L; Marchi, Damiano; Pastor, Francisco; Hartstone-Rose, Adam

    2018-03-01

    It has been previously proposed that distal humerus morphology may reflect the locomotor pattern and substrate preferred by different primates. However, relationships between these behaviors and the morphological capabilities of muscles originating on these osteological structures have not been fully explored. Here, we present data about forearm muscle architecture in a sample of 44 primate species (N = 55 specimens): 9 strepsirrhines, 15 platyrrhines, and 20 catarrhines. The sample includes all major locomotor and substrate use groups. We isolated each antebrachial muscle and categorized them into functional groups: wrist and digital extensors and flexors, antebrachial mm. that do not cross the wrist, and functional combinations thereof. Muscle mass, physiological cross-sectional area (PCSA), reduced PCSA (RPCSA), and fiber length (FL) are examined in the context of higher taxonomic group, as well as locomotor/postural and substrate preferences. Results show that muscle masses, PCSA, and RPCSA scale with positive allometry while FL scales with isometry indicating that larger primates have relatively stronger, but neither faster nor more flexible, forearms across the sample. When accounting for variation in body size, we found no statistically significant difference in architecture among higher taxonomic groups or locomotor/postural groups. However, we found that arboreal primates have significantly greater FL than terrestrial ones, suggesting that these species are adapted for greater speed and/or flexibility in the trees. These data may affect our interpretation of the mechanisms for variation in humeral morphology and provide information for refining biomechanical models of joint stress and movement in extant and fossil primates. Anat Rec, 301:484-495, 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

  9. Forearm Trajectory Measurement during Pitching Motion using an Elbow-mounted Sensor

    Science.gov (United States)

    Sagawa, Koichi; Abo, Shuko; Tsukamoto, Toshiaki; Kondo, Izumi

    This paper describes a measurement method of three-dimensional (3D) forearm movement during pitching motion using an elbow-mounted sensor (3D sensor). The 3D sensor comprises accelerometers of two kinds with dynamic range of 4 [G] and 100 [G], and two kinds of gyroscopes with dynamic range of 300 [deg/s] and 4000 [deg/s], respectively, because the sensors used in measurement of sports activities require a wide dynamic range. The 3D sensor, attached on the forearm, measures 3D acceleration and angular velocity. The 3D trajectory of the forearm is estimated through double integration of the measured acceleration, which is transformed from the acceleration based on the system of moving coordinate on the forearm to that on the fixed system of coordinates. Because the estimated trajectory of the forearm is affected by the numerical integration of the measured data including errors, the 3D trajectory error is reduced by determining the position and posture of the forearm at the end of the pitching motion. Results of the pitching experiment show that the 3D trajectory and angle of the forearm estimated by the 3D sensor agree with those measured from a video camera image with an error margin of around 10 %.

  10. Prospective clinical evaluation of a novel anatomic cuff for forearm crutches in patients with osteoarthritis.

    Science.gov (United States)

    Hügle, Thomas; Arnieri, Ansgar; Bünter, Margerita; Schären, Stefan; Mündermann, Annegret

    2017-03-14

    The use of forearm crutches has been associated with pain and neuropraxia along the ulnar bone. Whilst anatomic grips have improved comfort of crutch walking, to date anatomic forearm cuffs have not been clinically evaluated. The aim of this clinical pilot study was to determine if the use of forearm crutches with anatomic cuffs reduces pain and increases comfort and function in long-term users of forearm crutches during a 4-week period. Prospective study in ten patients suffering from end-stage osteoarthritis of the lower extremity. All participants were long-term users of conventional forearm crutches. Participants used forearm crutches with an anatomically shaped cuff for 4-weeks. General health was assessed using the SF-36, and the crutches were evaluated using a newly developed questionnaire focusing on symptoms along the forearm. Pain and paresthesia along the forearms decreased by 3.3 points (95% confidence interval difference (CI): [-5.0; -1.6], p = .004) and 3.5 points (95%CI: [-5.1; -1.9], p = .002), respectively, after using the crutches with the new anatomic cuff for 4 weeks. Comfort and sense of security of crutch use increased by 3.0 points (95%CI: [1.3; 4.7], p = .007) and 2.4 points (95%CI: [0.7; 4.1], p = .024). Cross-correlation analysis revealed correlations among items in the same item category and no correlations between items of different item categories of the new questionnaires. An anatomically shaped cuff increases comfort of forearm crutches. Further research should confirm long-term clinical improvement. This study was registered retrospectively in ISRCTN (TRN: ISRCTN 11135150 ) on 14/02/2017.

  11. Endovascular Proximal Forearm Arteriovenous Fistula for Hemodialysis Access: Results of the Prospective, Multicenter Novel Endovascular Access Trial (NEAT).

    Science.gov (United States)

    Lok, Charmaine E; Rajan, Dheeraj K; Clement, Jason; Kiaii, Mercedeh; Sidhu, Ravi; Thomson, Ken; Buldo, George; Dipchand, Christine; Moist, Louise; Sasal, Joanna

    2017-10-01

    Hemodialysis arteriovenous fistulas (AVFs) are suboptimally used primarily due to problems with maturation, early thrombosis, and patient nonacceptance. An endovascular approach to fistula creation without open surgery offers another hemodialysis vascular access option. Prospective, single-arm, multicenter study (Novel Endovascular Access Trial [NEAT]). Consecutive adult non-dialysis-dependent and dialysis-dependent patients referred for vascular access creation at 9 centers in Canada, Australia, and New Zealand. Using catheter-based endovascular technology and radiofrequency energy, an anastomosis was created between target vessels, resulting in an endovascular AVF (endoAVF). Safety, efficacy, functional usability, and patency end points. Safety as percentage of device-related serious adverse events; efficacy as percentage of endoAVFs physiologically suitable (brachial artery flow ≥ 500mL/min, vein diameter ≥ 4mm) for dialysis within 3 months; functional usability of endoAVFs to provide prescribed dialysis via 2-needle cannulation; primary and cumulative endoAVF patencies per standardized definitions. 80 patients were enrolled (20 roll-in and 60 participants in the full analysis set; the latter are reported). EndoAVFs were created in 98% of participants; 8% had a serious procedure-related adverse event (2% device related). 87% were physiologically suitable for dialysis (eg, mean brachial artery flow, 918mL/min; endoAVF vein diameter, 5.2mm [cephalic vein]). EndoAVF functional usability was 64% in participants who received dialysis. 12-month primary and cumulative patencies were 69% and 84%, respectively. Due to the unique anatomy and vessels used to create endoAVFs, this was a single-arm study without a surgical comparator. An endoAVF can be reliably created using a radiofrequency magnetic catheter-based system, without open surgery and with minimal complications. The endoAVF can be successfully used for hemodialysis and demonstrated high 12-month cumulative patencies. It may be a viable alternative option for achieving AVFs for hemodialysis patients in need of vascular access. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Initial diagnosis of HIV/AIDS in a 56-year-old man with non-healing forearm lesion.

    Science.gov (United States)

    Zapata, Heidi J; Villanueva, Merceditas; Shenoi, Sheela

    2013-11-18

    A 56-year-old Hispanic man with no significant medical problems presented with a 2-month history of a non-healing right forearm lesion that progressed despite several courses of empiric antibiotics. The patient underwent incision and drainage. Warthin-Starry stain with immunohistochemistry testing diagnosed bacillary angiomatosis secondary to Bartonella quintana. Subsequently, the patient was diagnosed with HIV, with a CD4 count of 68 cells/mm(3), and a HIV viral load of 47, 914 copies/mL. The patient was treated with doxycycline and started on antiretroviral therapy. The lesion has resolved and he has had no recurrence after 16 months of treatment.

  13. Acute dietary nitrate supplementation does not augment submaximal forearm exercise hyperemia in healthy young men

    National Research Council Canada - National Science Library

    Kim, Jin-Kwang; Moore, David J; Maurer, David G; Kim-Shapiro, Daniel B; Basu, Swati; Flanagan, Michael P; Skulas-Ray, Ann C; Kris-Etherton, Penny; Proctor, David N

    2015-01-01

    ... on exercising limb blood flow in humans. We hypothesized that acute dietary nitrate supplementation from beetroot juice would augment the increases in forearm blood flow, as well as the progressive dilation of the brachial artery...

  14. Local forearm and whole-body respiratory quotient in humans after an oral glucose load

    DEFF Research Database (Denmark)

    Simonsen, L; Bülow, J; Madsen, J

    1993-01-01

    the glucose load and had not returned to baseline level at the end of the experiment. Whole-body respiratory quotient (RQ) was, on average, 0.80 (SD 0.05) in the baseline condition and increased to a maximum of 0.91 (0.03) and then decreased to baseline level at the end of the experiment. The local forearm.......17) to 0.63 (0.17) 30 min after the glucose load (P experiments emphasize several methodological problems in the measurement of local forearm RQ. The whole-body RQ......The effects of an oral glucose load of 75 g on the local forearm and whole-body energy thermogenesis were measured in normal subjects during the 4 h after the glucose intake. Simultaneous assessment of substrate metabolism in the forearm was performed. Energy expenditure (EE) increased after...

  15. Forearm Pronation Osteotomy for Supination Contracture Secondary to Obstetrical Brachial Plexus Palsy: A Retrospective Cohort Study.

    Science.gov (United States)

    Gladstein, Aharon Z; Sachleben, Brant; Ho, Emily S; Anthony, Alison; Clarke, Howard M; Hopyan, Sevan

    2017-09-01

    Obstetrical brachial plexus palsy can lead to fixed forearm supination contracture. Fixed supination may lead to functional deficits as the affected hand cannot be positioned optimally for activities on a desk such as writing and typing, or for using tools including utensils, which require a neutral or pronated forearm. Forearm pronation osteotomy has been used to address this problem, although the functional benefit over nonoperative management has not been clearly defined. Potentially deleterious consequences on hand function that requires supination or fine motor skills are also uncertain. Patients with fixed forearm supination contracture were selected from our institutional brachial plexus database. Those who underwent both bone forearm rotational osteotomy were analyzed for age at time of surgery, preoperative forearm resting position, active and passive supination and pronation, and preoperative function assessed by the brachial plexus outcome measure (BPOM) and active movement scale (AMS). Preoperative results were compared with values obtained at follow-up at least 12 months postoperatively. A matched cohort of children with fixed forearm supination contracture that were treated nonoperatively and followed for at least 12 months, was also selected. For this group, forearm resting position, movement, AMS, and BPOM scores were analyzed at a baseline clinic visit and the most recent follow-up. Changes in forearm resting position, AMS, and BPOM activity scale scores were then compared between groups. Records were obtained for 14 cases and 10 controls. Study groups were similar with respect to resting forearm position, hand function, and time from initial to final evaluation. Groups differed with respect to age and active supination. We observed a statistically significant change in resting position among operative patients compared with their preoperative status and compared with controls. Hand-specific AMS score did not change significantly in the operative

  16. Diaphyseal Fractures of the Forearm in Adults, Plating Or Intramedullary Nailing Is a Better Option for the Treatment?

    Directory of Open Access Journals (Sweden)

    Tabet A. Al-Sadek

    2016-11-01

    Full Text Available BACKGROUND: Fractures of the radius and ulna occupy a large field of the modern traumatology. Therefore, these fractures are a major subject in modern orthopaedics and traumatology. The study of the mechanisms of the trauma, and the pathophysiological changes that occur are of great importance for the development of ever more efficient and varied ways of the treatment and prophylactics of this type of fracture. AIM: The aim of this paper was to study the pattern of the diaphyseal fractures of the forearm in adults, to decide the modalities of surgical management, to observe the period of fracture healing clinically and radiologically, as well to study the rehabilitation of the patients. MATERIAL AND METHODS: The present study included 45 cases of diaphyseal fractures of both bones forearm in adults presenting to the orthopaedic outpatient department. For all the patients a detailed history was taken. A thorough clinical examination was carried out, required X-rays were taken, and initial treatment was given and admitted as in all patients. After careful pre-operative planning and evaluation for anaesthetic fitness, patients were operated for the fractures of both bone forearms. Twenty-three cases with 46 fractures were treated by open reduction and rigid fixation with DCP & Semi-tubular plates and 22 cases with 44 fractures were treated by closed reduction and fixation with “Talwarkar” intramedullary square nails. RESULTS: United results were found in 100% of plating group vs. 86% in the nailing group. Delayed and non-union results were found in 9% of the nailing group only. Average time to union in weeks was 9.4 weeks in the plating group vs. 10.2 weeks in the nailing group. CONCLUSION: Open reduction and internal fixation with compression plates with strict adherence to surgical technique is the gold standard method of treatment in both bones forearm fractures with excellent results than closed reduction, internal fixation with

  17. The effect of wrist orthoses on forearm muscle activity.

    Science.gov (United States)

    Johansson, Lena; Björing, Gunnar; Hägg, Göran M

    2004-03-01

    A general hypothesis is that a wrist orthosis reduces the wrist extensor muscle load. The aim of this study was to investigate the effects of a completely stiff wrist orthosis (SO) and a commercially available wrist orthosis (CO) on flexor and extensor electromyographic (EMG)-activity in a standardised intermittent gripping task and during standardised manual work tasks. Surface EMG from two forearm flexor and two extensor muscles was recorded. The target grip forces were 5%, 20% and 40% of maximal voluntary contraction (MVC). During the grip contraction phase CO had no effect on the EMG-readings. SO resulted in higher EMG activity than when gripping with CO and with no orthosis (NO), especially when gripping with 40% MVC. During the relaxation phase neither CO nor SO had any effect on the extensors. For the flexors the SO gave higher EMG-readings than when gripping with CO and NO, especially at 40% MVC. In conclusion the wrist orthoses tested did not reduce the EMG-activity from the flexors or the extensors during gripping or manual tasks.

  18. Chronic compartment syndrome of the forearm in competitive motor cyclists: a report of two cases.

    Science.gov (United States)

    Goubier, J N; Saillant, G

    2003-01-01

    Exertional compartment syndrome of the forearm is rare. However, it should be considered in cases of a painful forearm during motorcycle racing. Pressure measurements of all compartments during exercises that simulate the actions of racing confirm the diagnosis. An exertional electromyography may be useful to reveal a nerve compression associated with the compartment syndrome. Fasciotomy of the affected compartments allows relief of symptoms and return to previous activities in all cases.

  19. Forearm Muscle Volumes Can Be Accurately Quantified From High Resolution Magnetic Resonance Imaging (MRI)

    OpenAIRE

    Eng, Carolyn M.; Abrams, Geoff D.; Smallwood, Laura R.; Lieber, Richard L.; Ward, Samuel R.

    2007-01-01

    Upper extremity musculoskeletal modeling is becoming increasingly sophisticated, creating a growing need for subject-specific muscle size parameters. One method for determining subject-specific muscle volume is magnetic resonance imaging (MRI). The purpose of this study was to determine the validity of MRI-derived muscle volumes in the human forearm across a variety of muscle sizes and shapes. Seventeen cadaveric forearms were scanned using a fast spoiled gradient echo pulse sequence with hig...

  20. Surgical trainees neuropraxia? An unusual case of compression of the lateral cutaneous nerve of the forearm.

    LENUS (Irish Health Repository)

    Seoighe, D M

    2010-09-01

    Compression of the lateral cutaneous nerve of the forearm is an uncommon diagnosis but has been associated with strenuous upper limb activity. We report the unique case of a 32-year-old male orthopaedic trainee who suffered this nerve palsy as a result of prolonged elbow extension and forearm pronation while the single assistant during a hip resurfacing procedure. Conservative measures were sufficient for sensory recovery to be clinically detectable after 12 weeks.

  1. The importance of the deep volar compartment in crush injuries of the forearm.

    Science.gov (United States)

    Allen, M J; Steingold, R F; Kotecha, M; Barnes, M

    1985-01-01

    Two cases are described of blunt injury to the forearm in the absence of bone injury, resulting in an acute deep volar compartment syndrome. The importance of the deep flexor compartment of the forearm is noted. The diagnostic pitfalls and the use of intra-compartmental monitoring are discussed. We emphasize that all such cases must be admitted and carefully studied as a matter of routine. If operation is undertaken, both the superficial and deep volar compartments must be adequately decompressed.

  2. Recovery of forearm occluded trajectory in Kinect using a wrist-mounted Inertial Measurement Unit.

    Science.gov (United States)

    Jatesiktat, Prayook; Wei Tech Ang

    2017-07-01

    Kinect sensor is a successful device that lets 3D human motion capture be used in a general residential setting. This work aims to fulfill some missing capabilities in Kinect, which are forearm orientation estimation and forearm tracking in occlusion. By using a wrist-mounted Inertial Measurement Unit and Kinect's built-in skeleton tracking, we have developed a fusion procedure that improves the upper limb motion tracking without adding too many obtrusive devices to the user.

  3. Surgical trainees neuropraxia? An unusual case of compression of the lateral cutaneous nerve of the forearm.

    Science.gov (United States)

    Seoighe, D M; Baker, J F; Mulhall, K J

    2010-09-01

    Compression of the lateral cutaneous nerve of the forearm is an uncommon diagnosis but has been associated with strenuous upper limb activity. We report the unique case of a 32-year-old male orthopaedic trainee who suffered this nerve palsy as a result of prolonged elbow extension and forearm pronation while the single assistant during a hip resurfacing procedure. Conservative measures were sufficient for sensory recovery to be clinically detectable after 12 weeks. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  4. Comparison of hybrid fixation versus dual intramedullary nailing fixation for forearm fractures in older children: Case-control study.

    Science.gov (United States)

    Feng, Yongzeng; Shui, Xiaolong; Wang, Jianshun; Cai, Leyi; Wang, Gang; Hong, Jianjun

    2016-06-01

    The aim of the present study was to compare the clinical outcomes of hybrid fixation using elastic stable intramedullary nailing (ESIN) for the radius and plate screw fixation for the ulna (Hybrid group) with dual ESIN fixation (D-ESIN group) for both-bone forearm fractures in children between 10 and 16 years of age. Fifty patients with both-bone forearm fractures (28 patients in the Hybrid group and 22 patients in the D-ESIN group) were reviewed. Functional outcomes were evaluated according to the criteria of Price et al. Radiological results were assessed by fracture union at three and six months and bone union time. Postoperative complications were also recorded. The times of fluoroscopy intraoperatively and duration of immobilization postoperatively were significantly lower in the Hybrid group (P < 0.05). The union rate of the ulna at three months postoperatively in the hybrid group was significantly higher than that in the D-ESIN group (P < 0.05). The average time of bone union was significantly shorter in the hybrid group than that in the D-ESIN group (P < 0.05). There were no differences according to the satisfactory rate and degree, the major and minor complications between the groups. Hybrid fixation is superior in terms of the times of fluoroscopy intraoperatively, duration of immobilization postoperatively, delayed union rate of the ulna and the average time of bone union. Therefore, hybrid fixation is an alternative treatment for both-bone forearm fractures in children between 10 and 16 years of age. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Outcome of Both Bone Forearm Fracture Fixation in Children by Rush Nails.

    Science.gov (United States)

    Dwivedi, R; Joshi, R; Panthi, S; Byanjankar, S; Shrestha, R

    2015-01-01

    Forearm fractures are common upper limb injuries among children and usually treated non-operatively. Failure of non-operative treatment, open injuries and multiple fractures are the indications for surgery in paediatric both bone forearm fractures. Intramedullary nailing is considered as minimally invasive procedure with excellent to fair outcomes but it is not free of complications. We reviewed the results and evaluated the outcomes of IM fixation of forearm fractures in children by Rush nails to understand the risks and complications associated with these procedures. A retrospective crossectional study of all paediatric patients treated for diaphyseal forearm fractures for period of five years in a tertiary care setup. Complications were classified according to modified Clavien-Dindo complication classification system. Outcomes were graded depending upon complication grade along with range of motion of forearm. A total of 25 patients were included in the study. Mean time for fracture union was 10.56 weeks. Outcomes were excellent in 16 (64%), good in 7 (28%), fair in 2 (8%) patients and no poor outcome was noted. Ten minor complications were seen. Fixation of paediatric forearm fractures by intramedullary Rush nail is minimally invasive procedure and outcomes are excellent to fair with acceptable complication rates.

  6. Personal identification based on skin texture features from the forearm and multi-modal imaging.

    Science.gov (United States)

    Bianconi, F; Chirikhina, E; Smeraldi, F; Bontozoglou, C; Xiao, P

    2017-08-01

    We investigate the use of skin texture features from the inner forearm as a means for personal identification. The forearm offers a number of potential advantages in that it is a fairly accessible area, and, compared with other zones such as fingertips, is less exposed to the elements and more shielded from wear. We extract and combine skin textural features from two imaging devices (optical and capacitive) with the aim of discriminating between different individuals. Skin texture images from 43 subjects were acquired from three different body parts (back of the hand, forearm and palm); testing used the two sensors either separately or in combination. Skin texture features from the forearm proved effective for discriminating between different individuals with overall recognition accuracy approaching 96%. We found that skin texture features from the forearm are highly individual-specific and therefore suitable for personal identification. Interestingly, forearm skin texture features yielded significantly better accuracy compared to the skin of the back of the hand and of the palm of the same subjects. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. [Disorders of sex development and proximal hypospadias].

    Science.gov (United States)

    Oswald, J

    2016-01-01

    Children with ambiguous genitalia due to different chromosome or gonadal sex are a particular challenge concerning the diagnostic and therapeutic implications. Proximal hypospadias patients with normal gonadal development should be distinguished from children with DSD (disorders of sex development) to guarantee normal gender identity and the best possible surgical therapy. This paper focuses on the terminology, embryology, and pathophysiology of the different manifestations of DSD. The state of knowledge about this disease pattern with particular emphasis on proximal hypospadias based on national and international scientific discussions is presented. The different clinical pictures as well as therapeutic options of DSD with a special focus on recent literature and giving particular attention to patients with proximal hypospadias are presented. Because of the complexity of patients suffering from disorders of sex development an interdisciplinary DSD healthcare team including a paediatric endocrinologist as well as paediatric urologist should be provided. These specialists enable an accurate diagnosis in severe hypospadias patients without reference to DSD diseases patterns.

  8. Some Properties of Fuzzy Soft Proximity Spaces

    Science.gov (United States)

    Demir, İzzettin; Özbakır, Oya Bedre

    2015-01-01

    We study the fuzzy soft proximity spaces in Katsaras's sense. First, we show how a fuzzy soft topology is derived from a fuzzy soft proximity. Also, we define the notion of fuzzy soft δ-neighborhood in the fuzzy soft proximity space which offers an alternative approach to the study of fuzzy soft proximity spaces. Later, we obtain the initial fuzzy soft proximity determined by a family of fuzzy soft proximities. Finally, we investigate relationship between fuzzy soft proximities and proximities. PMID:25793224

  9. PROXIMITY MANAGEMENT IN CRISIS CONDITIONS

    Directory of Open Access Journals (Sweden)

    Ion Dorin BUMBENECI

    2010-01-01

    Full Text Available The purpose of this study is to evaluate the level of assimilation for the terms "Proximity Management" and "Proximity Manager", both in the specialized literature and in practice. The study has two parts: the theoretical research of the two terms, and an evaluation of the use of Proximity management in 32 companies in Gorj, Romania. The object of the evaluation resides in 27 companies with less than 50 employees and 5 companies with more than 50 employees.

  10. Forearm muscle oxygenation during sustained isometric contractions in rock climbers

    Directory of Open Access Journals (Sweden)

    Jan Kodejška

    2016-02-01

    Full Text Available Background. Bouldering and lead climbing are divergent disciplines of the sport of rock climbing. Bouldering moves are short and powerful, whilst sport climbing is longer and require a greater degree of endurance. Aim. The aim of this study was to compare forearm muscle oxygenation during sustained isometric contraction between lead climbers (LC and boulderers (BO. Methods. Eight BO and twelve LC completed maximal finger flexor strength test and sustained contractions to exhaustion at 60% of maximum voluntary contraction (MVC. Differences between BO and LC in maximal strength, time to exhaustion, force time integral (FTI, and tissue oxygenation (SmO2 were assessed by t-test for independent samples. Results. LC showed significantly lower level of average tissue oxygenation (BO 38.9% SmO2, s = 7.4; LC 28.7% SmO2, s = 7.1 and maximal tissue deoxygenation (BO 25.6% SmO2, s = 8.2; LC 13.5% SmO2, s = 8.5. LC demonstrated significantly lower finger flexor strength (519 N, s = 72 than BO (621 N, s = 142. LC sustained a longer time of contraction (not significantly (BO 52.2 s, s = 11.5; LC 60.6 s, s = 13 and achieved a similar value of FTI (BO 17421 Ns, s = 4291; LO 17476 Ns, s = 5036 in the endurance test. Conclusions. The results showed lower deoxygenation during sustained contraction in BO than LC despite similar FTI, indicating different local metabolic pathways in both groups.

  11. The non-operative resin treatment of proximal caries lesions.

    Science.gov (United States)

    Ekstrand, Kim; Martignon, Stefania; Bakhshandeh, Azam; Ricketts, David N J

    2012-11-01

    Epidemiological data show that the prevalence of caries on proximal surfaces in need of operative treatment is very high around the world, both in the primary and the permanent dentition. This article presents two new treatment methods: proximal sealing and proximal infiltration. The indications are progressing proximal caries lesions, radiographically with a depth around the enamel-dentine junction. A small number of studies regarding the effect of sealing and infiltration on proximal caries versus the use of fluoride varnish, placebo treatment and flossing instructions have been carried out. About half of the studies disclose a not significant difference between test and control treatment. In the other half, the therapeutic effect is significant and corresponds to about 30% reduction in lesion progression. However, longitudinal studies of longer duration are lacking. Proximal sealing and proximal infiltration may have a place in the treatment of non-cavitated proximal lesions. Proximal caries is a problem in both primary and permanent dentitions. Proximal sealants or lesion infiltration are possible treatments.

  12. Industrial Computed Tomography using Proximal Algorithm

    KAUST Repository

    Zang, Guangming

    2016-04-14

    In this thesis, we present ProxiSART, a flexible proximal framework for robust 3D cone beam tomographic reconstruction based on the Simultaneous Algebraic Reconstruction Technique (SART). We derive the proximal operator for the SART algorithm and use it for minimizing the data term in a proximal algorithm. We show the flexibility of the framework by plugging in different powerful regularizers, and show its robustness in achieving better reconstruction results in the presence of noise and using fewer projections. We compare our framework to state-of-the-art methods and existing popular software tomography reconstruction packages, on both synthetic and real datasets, and show superior reconstruction quality, especially from noisy data and a small number of projections.

  13. 9__43 - 50__Tijjani_Proximate

    African Journals Online (AJOL)

    User

    Sena et al., 1998). In Nigeria, the plant is commonly consumed by the Hausa speaking communities as a spice and a sauce (Ibrahim et al., 2012). However, during preparation the leaves and stem are not carefully separated before processing of food. Thus, the present study was aimed at evaluating the proximate, minerals ...

  14. Forearm Fixation is Not Necessary in the Treatment of Pediatric Floating Elbow.

    Science.gov (United States)

    Blumberg, Todd J; Bremjit, Prashoban; Bompadre, Viviana; Steinman, Suzanne

    2018-02-01

    Ipsilateral supracondylar humerus and forearm fractures in the pediatric population are an uncommon injury associated with high-energy trauma. Current literature suggests a high rate of compartmental syndrome with this fracture pattern and recommends surgical stabilization of both injuries. We investigate whether surgical treatment of the supracondylar fracture with closed reduction of the forearm fracture and placement into a noncircumferential cast may be an appropriate treatment. Retrospective clinical and radiographic review of 47 patients (22 male, 25 female; mean age 6 y) with modified Gartland type 2 or type 3 supracondylar humerus fracture requiring surgical stabilization and an ipsilateral forearm fracture from a single institution over 78 months. Forty-seven pediatric "floating elbow" cases that had operative management of the supracondylar fracture were identified. A total of 21/47 (45%) had displaced forearm fractures that required closed manipulation. Of these, 17/21 (81%) underwent closed reduction of the displaced forearm fracture(s) and were placed into a noncircumferential cast or splint. No patients lost reduction or required remanipulation of either fracture. No patients developed signs of elevated compartment pressures. All patients went on to radiographic union without secondary procedures. We demonstrate that a supracondylar humerus fracture with an ipsilateral forearm fracture can be safely managed with operative stabilization of the supracondylar humerus fracture alone. Simultaneous closed reduction of the ipsilateral displaced forearm fracture and use of noncircumferential immobilization postoperatively is safe and was not associated with the development of elevated compartment pressures or need for remanipulation. Previous studies that relate a high rate of compartment syndrome with this injury pattern may be misguided, as method of postoperative immobilization may be a more significant factor in the development of elevated compartment

  15. Outcome of Both Bone Forearm Fracture Fixation in Children by Rush Nails

    Directory of Open Access Journals (Sweden)

    Rajeev Dwivedi

    2016-10-01

    Full Text Available Introduction: Forearm fractures are common upper limb injuries among children and usually treated non-operatively. Failure of non-operative treatment, open injuries and multiple fractures are the indications for surgery in paediatric both bone forearm fractures. Intramedullary nailing is considered as minimally invasive procedure with excellent to fair outcomes but it is not free of complications. We reviewed the results and evaluated the outcomes of IM xation of forearm fractures in children by Rush nails to understand the risks and complications associated with these procedures.  Methods: A retrospective crossectional study of all paediatric patients treated for diaphyseal forearm fractures for period of ve years in a tertiary care setup. Complications were classi ed according to modied Clavien-Dindo complication classication system. Outcomes were graded depending upon complication grade along with range of motion of forearm. Results: A total of 25 patients were included in the study. Mean time for fracture union was 10.56 weeks. Outcomes were excellent in 16 (64%, good in 7 (28%, fair in 2 (8% patients and no poor outcome was noted. Ten minor complications were seen.  Conclusion: Fixation of paediatric forearm fractures by intramedullary Rush nail is minimally invasive procedure and outcomes are excellent to fair with acceptable complication rates. Keywords: complication; forearm fractures; intramedullary nailing; outcome; paediatrics; Rush nail.

  16. Human eccrine hamartoma of the forearm-antebrachial organ of the ringtailed lemur (Lemur catta). A possible phylogenetic relationship?

    Science.gov (United States)

    Kopera, D; Soyer, H P; Kerl, H

    1994-06-01

    A 31-year-old woman presented with a clinically otherwise unsuspicious area of profuse sweating on her right forearm. Without triggering agents, sweating attacks producing a clear, serous fluid were observed daily. Histopathologic examination of a biopsy specimen showed hyperplastic eccrine glands with pale, stippled cytoplasm characteristic of eccrine hamartoma. No explanation, however, has been given for the fact that several authors observed eccrine hamartomas in the same anatomical location. Adolescent lemurs of the species catta (ringtailed lemur) are equipped with a pair of antebrachial cutaneous glands located on the volar surface of the wrist. They exude a clear secretion enabling them to "brachial branch mark" their territories. Histopathologic findings in the ringtailed lemur's antebrachial organ show characteristics of both apocrine and eccrine glands. In contrast to normal apocrine glands, however, the antebrachial organs of ringtailed lemurs reach the epidermis directly and are not connected to hair follicles. According to the "biogenetic law" of Ernst Haeckel, stating that ontogeny has to be seen as a short and incomplete repetition of phylogeny, a human fetus passes all evolutional stages from a single cell via amphibians and mammals to a human being. Thus, the antebrachial organ of the ringtailed lemur may be the "phylogenetic explanation" for eccrine hamartomas of the forearm in humans. The histopathologic findings of the antebrachial organ and of eccrine hamartomas are in accordance with this hypothesis.

  17. Deep Soft Tissue Leiomyoma of Forearm: A Case Report and Review of Literature.

    Science.gov (United States)

    Bommireddy, Babulreddy; Gurram, Vijay

    2016-06-01

    Leiomyomas are benign tumours of smooth-muscle origin representing 4.4% of all benign soft-tissue neoplasms. They are classified as cutaneous, vascular and leiomyomas of deep soft tissues. Leiomyomas rarely occur in extremities and are more common in the lower limb than in the upper extremity. Deep soft tissue leiomyomas are even rare with a very few reported cases so far in the literature. A 25-year-old female presented to us with an atraumatic slowly enlarging mass in the right forearm from 6 months with mild erosion of cortex of radius. She was otherwise healthy, MRI revealed a soft tissue lesion involving the interosseous space, isointense on T1, slightly hyperintense on T2 and hyperintense on STIR images. The tumour was excised intoto. The case is presented due to its rarity and the risk of tumor misdiagnosis. It should be considered in the differential diagnosis of any solitary painful slow growing mass of the extremities. If adequate margins are obtained recurrence of this tumour is very rare.

  18. Inexact proximal Newton methods for self-concordant functions

    DEFF Research Database (Denmark)

    Li, Jinchao; Andersen, Martin Skovgaard; Vandenberghe, Lieven

    2016-01-01

    with an application to L1-regularized covariance selection, in which prior constraints on the sparsity pattern of the inverse covariance matrix are imposed. In the numerical experiments the proximal Newton steps are computed by an accelerated proximal gradient method, and multifrontal algorithms for positive definite......We analyze the proximal Newton method for minimizing a sum of a self-concordant function and a convex function with an inexpensive proximal operator. We present new results on the global and local convergence of the method when inexact search directions are used. The method is illustrated...

  19. Design of a three-dimensional hand/forearm model to apply computational fluid dynamics

    Directory of Open Access Journals (Sweden)

    Daniel Almeida Marinho

    2010-04-01

    Full Text Available The purpose of this study was to develop a three-dimensional digital model of a human hand and forearm to apply Computational Fluid Dynamics to propulsion analysis in swimming. Computer tomography scans of the hand and forearm of an Olympic swimmer were applied. The data were converted, using image processing techniques, into relevant coordinate input, which could be used in Computational Fluid Dynamics software. From that analysis, it was possible to verify an almost perfect agreement between the true human segment and the digital model. This technique could be used as a means to overcome the difficulties in developing a true three-dimensional model of a specific segment of the human body. Additionally, it could be used to improve the use of Computational Fluid Dynamics generally in sports and specifically in swimming studies, decreasing the gap between the experimental and the computational data.O objetivo do presente estudo foi desenvolver um modelo digital tridimensional de uma mão e um antebraço humano para aplicar a Dinâmica Computacional de Fluidos ao estudo da propulsão em natação. Foram aplicados procedimentos computorizados de tomografia axial na mão e antebraço de um nadador Olímpico. Através de técnicas de processamento de imagem, os dados foram convertidos em coordenadas tridimensionais, que podem ser utilizadas em programas de simulação computacional. Através dos resultados encontrados, foi possível verificar uma semelhança quase perfeita entre o segmento humano e o modelo digital. Esta técnica pode ser utilizada como uma forma de ultrapassar as dificuldades em desenvolver um modelo digital tridimensional de um segmento específico do corpo humano. Complementarmente, pode ser bastante útil na melhoria da utilização da Dinâmica Computacional de Fluidos no Desporto, de uma forma geral, e, mais especificamente, nos estudos em natação, diminuindo a diferença entre a investigação experimental e a investiga

  20. Quantifying forearm and wrist joint power during unconstrained movements in healthy individuals.

    Science.gov (United States)

    Flores, Diana Castillo; Laurendeau, Simon; Teasdale, Normand; Simoneau, Martin

    2014-11-17

    Wrist movement-related injuries account for a large number of repetitive motion injuries. Remarkably little, if any, empirical data exist to quantify the impact of neuromuscular disorders affecting the wrist or to validate the effectiveness of rehabilitation training programs on wrist functions. The aim of this project was to develop a biomechanical model for quantifying wrist and forearm kinetics during unconstrained movements, to assess its reliability and to determine its sensitivity. Twenty healthy subjects with no history of upper arm and wrist pain volunteered for the experiment. To evaluate the reliability of the data, we quantified their forearm and wrist kinetics on two different days (minimum and maximum number of days between experimental sessions were 1 and 4 days respectively). To measure forearm and wrist kinetics, an apparatus was built to offer rotational inertia during forearm and wrist movements. An inertial measurement unit was located near the top of the device measuring its angular position along the frontal and sagittal planes. We used a mathematical model to infer forearm and wrist torque. Thereafter, we calculated the product of torque and angular velocity to determine forearm and wrist power. Results revealed that for 75% of the power and torque measurements the ICC was greater than 0.75 (range: 0.77 - 0.83). Torque and power measurements for adduction movements, however, were less reliable (i.e., ICC of 0.60 and 0.47, respectively) across testing sessions. The biomechanical model was robust to small measurement errors, and the power peaks between the first and second testing session were not different indicating that there was no systematic bias (i.e., motor performance improvement) between testing sessions. The biomechanical model can be used to assess the effectiveness of rehabilitation programs, document the progression of athletes or conduct research-oriented testing of maximum forearm and wrist kinetic capacities. Nonetheless

  1. Internal fixation of proximal humerus fractures using the T2-proximal humeral nail.

    Science.gov (United States)

    Popescu, Dragos; Fernandez-Valencia, Jenaro A; Rios, Moisés; Cuñé, Jordi; Domingo, Anna; Prat, Salvi

    2009-09-01

    Surgical management of proximal humerus fractures remains controversial and there is an increasing interest in intramedullary nailing. Created to improve previous designs, the T2-proximal humeral nail (PHN) (Stryker) has been recently released, and the English literature lacks a series evaluating its results. We present a clinical prospective study evaluating this implant for proximal humeral fractures. We evaluated the functional and radiological results and possible complications. Twenty-nine patients with displaced fractures of the proximal humerus were treated with this nail. One patient was lost right after surgery and excluded from the assessment. Eighteen patients were older than 70 years. There were 21 fractures of the proximal part of the humerus and 7 fractures that also involved the shaft; 15 of the fractures were two-part fractures (surgical neck), 5 were three-part fractures, and 1 was a four-part fracture. All fractures healed in a mean period of 2.7 months. There was one delayed union that healed in 4 months. One case of avascular necrosis of the humeral head was observed (a four-part fracture), but remained asymptomatic and did not require further treatment. In one case a back-out of one proximal screw was observed. A final evaluation with a minimum 1 year follow-up was performed by an independent observer; in 18 patients, the mean Constant score was 65.7 or 76.1% with the adjustment of age and gender; in 19 patients, the mean Oxford Shoulder Score was 21.7. The results obtained with the T2-PHN nail indicate that it represents a safe and reliable method in the treatment of two- and three-part fractures of the proximal humerus. The proximal fixation mechanism diminishes the rate of back-out of the screws, a frequent complication described in the literature. Better functional results were obtained from the patients younger than 70 years, but these were not statistically significant.

  2. Isokinetic profile of wrist and forearm strength in elite female junior tennis players.

    Science.gov (United States)

    Ellenbecker, T S; Roetert, E P; Riewald, S

    2006-05-01

    In tennis, injuries to the elbow and wrist occur secondary to the repetitive nature of play and are seen at increasingly young ages. Isokinetic testing can be used to determine muscular strength levels, but dominant/non-dominant and agonist/antagonist relations are needed for meaningful interpretation of the results. To determine whether there are laterality differences in wrist extension/flexion (E/F) and forearm supination/pronation (S/P) strength in elite female tennis players. 32 elite female tennis players (age 12 to 16 years) with no history of upper extremity injury underwent bilateral isokinetic testing using a Cybex 6000 dynamometer. Peak torque and single repetition work values for wrist E/F and forearm S/P were measured at speeds of 90 degrees/s and 210 degrees/s, with random determination of the starting extremity. Repeated measures analysis of variance was used to determine differences between extremities for peak torque and single repetition work values. Significantly greater (pwrist E/F and forearm pronation strength was measured at both testing speeds. Significantly less (pwrist E/F and forearm pronation strength is common and normal in young elite level female tennis players. These strength relations indicate sport specific muscular adaptations in the dominant tennis playing extremity. The results of this study can guide clinicians who work with young athletes from this population. Restoring greater dominant side wrist and forearm strength is indicated after an injury to the dominant upper extremity in such players.

  3. Clinical Application of a Pedicled Forearm Flap in the Reconstruction After Oral Cancer Resection.

    Science.gov (United States)

    Zhao, Xiaoqiang; Zhang, Youmei; Fu, Shuai; Zhang, Changbin; Li, Ming; Wu, Yong

    2017-05-01

    To investigate the clinical application of a pedicled forearm flap in the reconstruction of soft tissue defects after oral cancer resection. A retrospective analysis was performed on 31 patients with oral cancer in the Affiliated Stomatology Hospital of Kunming Medical University. The patients underwent repair of soft tissue defects, resulting from oral cancer resection, using a pedicled forearm flap. Patients were followed up for 3 months to 3 years to observe the survival rate of the pedicled forearm flap and the recovery of the patient's appearance and oral function. The pedicled forearm flap survived in 30 patients (96.77%), and 3 patients showed flap vascular crisis (9.67%; 2 patients were successfully rescued). The articulation, chewing, and swallowing function of the patients were improved after surgery. The pedicled forearm flap has advantages in terms of color and texture, its moderate thickness, long vascular pedicle, good blood supply, and strong infection resistance. It has a high survival rate and is an excellent skin-muscle flap suited to the repair of soft tissue defects after oral cancer resection.

  4. [Endoscopic aponeurotomy for chronic exertional compartmental syndrome of the forearm: report of 41 cases].

    Science.gov (United States)

    Fontes, D; Clement, R; Roure, P

    2003-08-01

    Chronic exertional compartment syndrome of the forearm is probably underdiagnosed as a cause of forearm pain in the sportsman. Its pathological basis is a critical elevation of extracellular pressure. The clinical diagnosis is confirmed by measurements of intracompartmental pressures. We described a reliable original method of endoscopically assisted superficial fasciotomy for treating chronic exertional compartment syndrome of the forearm. The goal of the study is the physiological and clinical validation of this technique. Retrospective cohort study after the anatomical assessment of the feasibility of our endoscopically assisted fasciotomy. Review of 41 forearm decompressions in 25 patients (23 sportsmen and 2 musicians). Follow-up of 6 months to 9 years. Eighty-eight percent reported an excellent or good outcome with significant reduction of pain during exercise. Three patients noted the return of their compartment syndrome and this was confirmed by new measurements of intramuscular pressure. Two of them underwent fasciectomy with excision of a hypertrophic scar of the superficial aponevrosis to good effect. Two hematomas and 2 lateral epicondylitis with no adverse effect on the final result. Endoscopically assisted fasciotomy is a reliable technique for reducing pain in chronic compartment exertional syndromes. It allows the large majority of patients to return to sports. It is our first choice indication in young sportsmen for syndromes of the forearm (anterior and/or posterior compartment). The limit of the technique is the current knowledge of collagenic tissues pathology as a cause of recurrence with hypertrophic aponevrotic scars.

  5. Muscle fatigue in relation to forearm pain and tenderness among professional computer users

    Directory of Open Access Journals (Sweden)

    Kryger Ann I

    2007-12-01

    Full Text Available Abstract Background To examine the hypothesis that forearm pain with palpation tenderness in computer users is associated with increased extensor muscle fatigue. Methods Eighteen persons with pain and moderate to severe palpation tenderness in the extensor muscle group of the right forearm and twenty gender and age matched referents without such complaints were enrolled from the Danish NUDATA study of neck and upper extremity disorders among technical assistants and machine technicians. Fatigue of the right forearm extensor muscles was assessed by muscle twitch forces in response to low frequency (2 Hz percutaneous electrical stimulation. Twitch forces were measured before, immediately after and 15 minutes into recovery of an extensor isometric wrist extension for ten minutes at 15 % Maximal Voluntary Contraction (MVC. Results The average MVC wrist extension force and baseline stimulated twitch forces were equal in the case and the referent group. After the fatiguing contraction, a decrease in muscle average twitch force was seen in both groups, but the decrease was largest in the referent group: 27% (95% CI 17–37 versus 9% (95% CI -2 to 20. This difference in twitch force response was not explained by differences in the MVC or body mass index. Conclusion Computer users with forearm pain and moderate to severe palpation tenderness had diminished forearm extensor muscle fatigue response. Additional studies are necessary to determine whether this result reflects an adaptive response to exposure without any pathophysiological significance, or represents a part of a causal pathway leading to pain.

  6. Predicted vitamin D status during pregnancy in relation to offspring forearm fractures in childhood

    DEFF Research Database (Denmark)

    Petersen, Sesilje B.; Strøm, Marin; Maslova, Ekaterina

    2015-01-01

    In a prospective cohort study, the association between maternal vitamin D status during pregnancy and offspring forearm fractures during childhood and adolescence was analysed in 30 132 mother and child pairs recruited to the Danish National Birth Cohort between 1996 and 2002. Data on characteris......In a prospective cohort study, the association between maternal vitamin D status during pregnancy and offspring forearm fractures during childhood and adolescence was analysed in 30 132 mother and child pairs recruited to the Danish National Birth Cohort between 1996 and 2002. Data...... on characteristics, dietary factors and lifestyle factors were collected on several occasions during pregnancy. We analysed the association between predicted vitamin D status, based on a subsample with 25-hydroxyvitamin D (25(OH)D) biomarker measurements (n 1497) from gestation week 25, and first-time forearm...... and supplementary vitamin D intake, tanning bed use and outdoor physical activity) in pregnancy and offspring forearm fractures. Likewise, measured 25(OH)D, tanning bed use and dietary vitamin D intake were not associated with offspring forearm fractures. In mid-pregnancy, 91 % of the women reported intake...

  7. Functional results of dynamic splinting after transmetacarpal, wrist, and distal forearm replantation.

    Science.gov (United States)

    Scheker, L R; Chesher, S P; Netscher, D T; Julliard, K N; O'Neill, W L

    1995-10-01

    The results of replantation at the wrist and distal forearm are reported to be better than at the metacarpal level, in part because the latter involve direct injury to the intrinsic muscles. This study evaluates a new post-operative protocol for replantation at the metacarpal, wrist and distal forearm levels. 3 days after replantation, the patient was placed in a dynamic crane outrigger splint with MP joint control, compensating for intrinsic muscle function loss. From 4 to 12 weeks, an anticlaw splint alternated with the outrigger splint. After 12 weeks, a dynamic wrist extension orthosis was added to the anti-claw splint. 11 patients (four replantations at the transmetacarpal level, three at the wrist and four in the distal forearm) had this protocol between 1988 and 1993. For distal forearm replantation, TAM of fingers averaged 216 degrees, grip strength 42 lb, and pinch strength 7.2 lb with 75% good or excellent results. For wrist replantations, TAM of fingers averaged 243 degrees, grip strength 37 lb and pinch strength 10.6 lb with 100% good or excellent results. For transmetacarpal replantations, TAM of fingers averaged 189 degrees, grip strength 37 lb and pinch strength 5.6 lb, with 75% good and excellent results. Early protected mobilization, as described here, preserves tendon gliding, muscle strength and excursion. Our results support this protocol for wrist and distal forearm replantation and especially for transmetacarpal replantation, the results of which tend to be poor according to the medical literature.

  8. Staphylococcal diaphyseal subacute osteomyelitis of the ulna in a child: an unusual cause of post-traumatic forearm swelling.

    LENUS (Irish Health Repository)

    Kearns, S R

    2004-01-01

    Paediatric subacute osteomyelitis (SAO) presents a diagnostic and therapeutic challenge to clinicians. Typically located in the metaphysis of long bones, diaphyseal SAO of the upper limb is rare. We present the case of a three-year-old girl referred to our fracture clinic as an occult fracture following trauma to her forearm with normal initial radiographs. Follow-up radiographs one week later showed cortical erosion of the distal ulna, while a subsequent MRI scan showed soft tissue swelling with an area of high signal in the distal ulna. A limited biopsy diagnosed staphylococcal subacute osteomyelitis of the ulna. The patient responded to high dose antibiotic therapy and made a full recovery. We present this case to highlight the high index of suspicion required to diagnose and appropriately manage this insidious condition, which may easily be confused with any number of benign and malignant bony lesions and provide a review of the relevant literature.

  9. The utility of dual-energy X-ray absorptiometry, calcaneal quantitative ultrasound, and fracture risk indices (FRAX® and Osteoporosis Risk Assessment Instrument) for the identification of women with distal forearm or hip fractures: A pilot study.

    Science.gov (United States)

    Esmaeilzadeh, Sina; Cesme, Fatih; Oral, Aydan; Yaliman, Ayse; Sindel, Dilsad

    2016-08-01

    Dual-energy X-ray absorptiometry (DXA) is considered the "gold standard" in predicting osteoporotic fractures. Calcaneal quantitative ultrasound (QUS) variables are also known to predict fractures. Fracture risk assessment tools may also guide us for the detection of individuals at high risk for fractures. The aim of this case-control study was to evaluate the utility of DXA bone mineral density (BMD), calcaneal QUS parameters, FRAX® (Fracture Risk Assessment Tool), and Osteoporosis Risk Assessment Instrument (ORAI) for the discrimination of women with distal forearm or hip fractures. This case-control study included 20 women with a distal forearm fracture and 18 women with a hip fracture as cases and 76 age-matched women served as controls. BMD at the spine, proximal femur, and radius was measured using DXA and acoustic parameters of bone were obtained using a calcaneal QUS device. FRAX® 10-year probability of fracture and ORAI scores were also calculated in all participants. Receiver operating characteristic (ROC) analysis was used to assess fracture discriminatory power of all the tools. While all DXA BMD, and QUS variables and FRAX® fracture probabilities demonstrated significant areas under the ROC curves for the discrimination of hip-fractured women and those without, only 33% radius BMD, broadband ultrasound attenuation (BUA), and FRAX® major osteoporotic fracture probability calculated without BMD showed significant discriminatory power for distal forearm fractures. It can be concluded that QUS variables, particularly BUA, and FRAX® major osteoporotic fracture probability without BMD are good candidates for the identification of both hip and distal forearm fractures.

  10. Influence of the renin-angiotensin system on human forearm blood flow

    DEFF Research Database (Denmark)

    Stadeager, C; Hesse, B; Henriksen, O

    1990-01-01

    Although angiotensin II is a potent vasoconstrictor agent in all tissues, including the human forearm, equivocal effects on forearm blood flow (FBF) have been found after angiotensin blockade. In 13 healthy Na(+)-depleted subjects FBF was measured by the 133Xe washout technique; subcutaneous...... and muscle blood flows were determined separately. FBF was measured during supine rest, after the arm was lowered, and during lower body negative pressure (LBNP). The measurements were repeated during intra-arterial saralasin infusion in six subjects and after intravenous administration of enalapril in seven....... It is concluded that, in the human forearm, angiotensin II is not necessary for sympathetic vasoconstrictor reflexes but may, through a central effect, have some influence on arteriolar tone at rest....

  11. Muscle fatigue in relation to forearm pain and tenderness among professional computer users

    DEFF Research Database (Denmark)

    Thomsen, GF; Johnson, PW; Svendsen, Susanne Wulff

    2007-01-01

    ABSTRACT: BACKGROUND: To examine the hypothesis that forearm pain with palpation tenderness in computer users is associated with increased extensor muscle fatigue. METHODS: Eighteen persons with pain and moderate to severe palpation tenderness in the extensor muscle group of the right forearm...... and twenty gender and age matched referents without such complaints were enrolled from the Danish NUDATA study of neck and upper extremity disorders among technical assistants and machine technicians. Fatigue of the right forearm extensor muscles was assessed by muscle twitch forces in response to low...... stimulated twitch forces were equal in the case and the referent group. After the fatiguing contraction, a decrease in muscle average twitch force was seen in both groups, but the decrease was largest in the referent group: 27% (95% CI 17-37) versus 9% (95% CI -2 to 20). This difference in twitch force...

  12. Medical thermography (digital infrared thermal imaging - DITI) in paediatric forearm fractures - A pilot study.

    Science.gov (United States)

    Ćurković, S; Antabak, A; Halužan, D; Luetić, T; Prlić, I; Šiško, J

    2015-11-01

    Trauma is the most common cause of hospitalisation in children, and forearm fractures comprise 35% of all paediatric fractures. One-third of forearm fractures are distal forearm fractures, which are the most common fractures in the paediatric population. This type of fracture represents an everyday problem for the paediatric surgeon. The three phases of fracture healing in paediatric trauma are associated with skin temperature changes that can be measured and then compared with standard plain radiographs of visible callus formation, and eventually these methods can be used in everyday practice. Thermographic assessment of temperature distribution within the examined tissues enables a quick, non-contact, non-invasive measurement of their temperature. Medical thermography is used as a screening method in other parts of medicine, but the use of this method in traumatology has still not been researched. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Use of anti-osteoporotic drugs in central Norway after a forearm fracture

    DEFF Research Database (Denmark)

    Hoff, Mari; Skurtveit, Svetlana; Meyer, Haakon E

    2015-01-01

    , or ≥ 4 different drugs were associated with AOD use. PURPOSE: The primary aim of this study was to examine time trends in prevalence and incidence of AOD use the first year after a forearm fracture from 2005-2012. Further, secondary aims were to investigate if gender, the number of drugs used before......UNLABELLED: Use of anti-osteoporotic drugs (AOD) the first year after a forearm fracture in central Norway was low in the period 2005-2012. Women with fractures used more AOD compared to the general population only in 2006, 2007, and 2011. Female gender, age ≥ 60 years, use of glucocorticosteroids...... 2005 and 2012. AOD were defined as bisphosphonates, teriparatide, denosumab, and raloxifene. Prevalence and incidence were calculated, and prevalent use among women with forearm fracture was compared with the population in Nord-Trøndelag and Norway. Age-adjusted Poisson regression analyses for time...

  14. Isolated Proximal Tibiofibular Dislocation during Soccer

    Directory of Open Access Journals (Sweden)

    Casey Chiu

    2015-01-01

    Full Text Available Proximal tibiofibular dislocations are rarely encountered in the Emergency Department (ED. We present a case involving a man presenting to the ED with left knee pain after making a sharp left turn on the soccer field. His physical exam was only remarkable for tenderness over the lateral fibular head. His X-rays showed subtle abnormalities of the tibiofibular joint. The dislocation was reduced and the patient was discharged from the ED with orthopedic follow-up.

  15. Level of Agreement Between Forearm and Upper Arm Blood Pressure Measurements in Patients With Large Arm Circumference.

    Science.gov (United States)

    Watson, Sheri; Aguas, Marita; Colegrove, Pat; Foisy, Nancy; Jondahl, Bonnie; Anastas, Zoe

    2017-02-01

    The purpose of the study was to determine if forearm blood pressures (BPs) measured in three different locations agree with the recommended upper arm location for noninvasive BP measurement. A method-comparison design was used. In a convenience sample of postanesthesia care unit patients with large upper arm circumference, BP's were obtained in three different forearm locations (lower forearm, middle forearm, and upper forearm) and compared to upper arm BP using an automated BP measuring device. The level of agreement (bias ± precision) between each forearm location and the upper arm BP was calculated using standard formulas. Acceptable levels of agreement based on expert opinion were set a priori at bias and precision values of less than ±5 mm Hg (bias) and ±8 mm Hg (precision). Forty-eight postanesthesia patients participated in the study. Bias and precision values were found to exceed the acceptable level of agreement for all but one of the systolic and diastolic BP comparisons in the three forearm BP locations. Fifty-six percent of all patients studied had one or more BP difference of at least 10 mm Hg in each of the three forearm locations, with 10% having one or more differences of at least 20 mm Hg. The differences in forearm BP measurements observed in this study indicate that the clinical practice of using a forearm BP with a regular-sized BP cuff in place of a larger sized BP cuff placed on the upper arm in postanesthesia care unit patients with large arm circumferences is inappropriate. The BPs obtained at the forearm location are not equivalent to the BPs obtained at the upper arm location. Copyright © 2015 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  16. Quantifying forearm muscle activity during wrist and finger movements by means of multi-channel electromyography.

    Directory of Open Access Journals (Sweden)

    Marco Gazzoni

    Full Text Available The study of hand and finger movement is an important topic with applications in prosthetics, rehabilitation, and ergonomics. Surface electromyography (sEMG is the gold standard for the analysis of muscle activation. Previous studies investigated the optimal electrode number and positioning on the forearm to obtain information representative of muscle activation and robust to movements. However, the sEMG spatial distribution on the forearm during hand and finger movements and its changes due to different hand positions has never been quantified. The aim of this work is to quantify 1 the spatial localization of surface EMG activity of distinct forearm muscles during dynamic free movements of wrist and single fingers and 2 the effect of hand position on sEMG activity distribution. The subjects performed cyclic dynamic tasks involving the wrist and the fingers. The wrist tasks and the hand opening/closing task were performed with the hand in prone and neutral positions. A sensorized glove was used for kinematics recording. sEMG signals were acquired from the forearm muscles using a grid of 112 electrodes integrated into a stretchable textile sleeve. The areas of sEMG activity have been identified by a segmentation technique after a data dimensionality reduction step based on Non Negative Matrix Factorization applied to the EMG envelopes. The results show that 1 it is possible to identify distinct areas of sEMG activity on the forearm for different fingers; 2 hand position influences sEMG activity level and spatial distribution. This work gives new quantitative information about sEMG activity distribution on the forearm in healthy subjects and provides a basis for future works on the identification of optimal electrode configuration for sEMG based control of prostheses, exoskeletons, or orthoses. An example of use of this information for the optimization of the detection system for the estimation of joint kinematics from sEMG is reported.

  17. Quantifying Forearm Muscle Activity during Wrist and Finger Movements by Means of Multi-Channel Electromyography

    Science.gov (United States)

    Gazzoni, Marco; Celadon, Nicolò; Mastrapasqua, Davide; Paleari, Marco; Margaria, Valentina; Ariano, Paolo

    2014-01-01

    The study of hand and finger movement is an important topic with applications in prosthetics, rehabilitation, and ergonomics. Surface electromyography (sEMG) is the gold standard for the analysis of muscle activation. Previous studies investigated the optimal electrode number and positioning on the forearm to obtain information representative of muscle activation and robust to movements. However, the sEMG spatial distribution on the forearm during hand and finger movements and its changes due to different hand positions has never been quantified. The aim of this work is to quantify 1) the spatial localization of surface EMG activity of distinct forearm muscles during dynamic free movements of wrist and single fingers and 2) the effect of hand position on sEMG activity distribution. The subjects performed cyclic dynamic tasks involving the wrist and the fingers. The wrist tasks and the hand opening/closing task were performed with the hand in prone and neutral positions. A sensorized glove was used for kinematics recording. sEMG signals were acquired from the forearm muscles using a grid of 112 electrodes integrated into a stretchable textile sleeve. The areas of sEMG activity have been identified by a segmentation technique after a data dimensionality reduction step based on Non Negative Matrix Factorization applied to the EMG envelopes. The results show that 1) it is possible to identify distinct areas of sEMG activity on the forearm for different fingers; 2) hand position influences sEMG activity level and spatial distribution. This work gives new quantitative information about sEMG activity distribution on the forearm in healthy subjects and provides a basis for future works on the identification of optimal electrode configuration for sEMG based control of prostheses, exoskeletons, or orthoses. An example of use of this information for the optimization of the detection system for the estimation of joint kinematics from sEMG is reported. PMID:25289669

  18. Screw elastic intramedullary nail for the management of adult forearm fractures

    Directory of Open Access Journals (Sweden)

    Wasudeo Gadegone

    2012-01-01

    Full Text Available Background: The failure of the conventional nailing of both forearm bones or isolated fractures of radius and ulna pose a potential problem of nail migration and rotational instability, despite the best reduction. The purpose of this paper is to evaluate the results of screw elastic intramedullary nail for the treatment of adult diaphyseal fractures of both forearm bones, which effectively addresses the problems associated with the conventional nailing systems for the forearm fractures. Materials and Methods: Seventy-six adults with forearm fractures (radius and ulna or isolated fracture of the single bone were retrospectively evaluated. Fifty males and 26 females with the mean age of 38 years (range, 18-70 years underwent closed reduction and screw intramedullary nail fixation. Ten patients required limited open reduction. The fractures were classified according to the AO/OTA system. The average followup was 12 months (range, 6 to 18 months. Results: The mean surgical time was 45 minutes (35 to 65 minutes. The meantime to union was 14 weeks (10-21 weeks. The results were graded as excellent in 50, good in 18 patients, and acceptable in eight patients, using the criteria of Grace and Eversman. We had superficial infection in three cases, one case of delayed infection, painful bursa in two cases, delayed union in two cases, malunion with dislocation of the DRUJ in two cases, injury to the extensor tendon of the thumb in one case, and one case of incomplete radioulnar synostosis. Conclusion: Closed reduction and internal fixation of forearm fractures by screw intramedullary nails reestablishes the near normal relationship of the fractured fragments. Screw intramedullary nail effectively controls both rotatory forces and the migration of the nail. It produces excellent clinical results in isolated fractures of either bones, as well as both bones of the forearm in adults.

  19. Biomechanic comparison of 3 tendon transfers for supination of the forearm.

    Science.gov (United States)

    Cheema, Tahseen A; Firoozbakhsh, Keikhosrow; De Carvalho, Alex F; Mercer, Deana

    2006-12-01

    Flexion-pronation of the hand and the forearm is a common deformity when the upper extremity is affected by cerebral palsy. Solutions used to improve the pronation deformity and increase supination include transfer of the flexor carpi ulnaris to the extensor carpi radialis brevis, pronator teres rerouting, and brachioradialis rerouting. The purpose of this study was to compare the biomechanic efficacy of these 3 tendon transfers in simulated supination in cadaveric forearms. Ten fresh-frozen adult cadaveric above-elbow upper extremities were used. In each specimen the 3 tendon transfers were performed sequentially in random order and were loaded in increments of 4 N (1 lb) to a maximum of 36 N (8 lb). Measurements were recorded from the starting point of 90 degrees of pronation. Statistical analysis of the data included the Student t test with the Bonferoni correction. For all transfers, supination increased in a nonlinear manner as the load was increased in a nonlinear manner. For the flexor carpi ulnaris transfer, the forearm reached its neutral position at a load of 9 N (2 lb). The forearm continued to rotate to up to 84 degrees of supination with 36 N (8 lb) of load. With the brachioradialis transfer, the forearm reached its neutral position at 13 N (3 lb) of load and continued to rotate to up to 33 degrees of supination with 36 N of load. With the pronator teres transfer, the forearm never reached the neutral position. Under a maximum load of 36 N, only 55 degrees of rotation from full pronation was obtained. Transfer of the flexor carpi ulnaris to the extensor carpi radialis brevis proved to be the most effective transfer for producing supination in cadavers. The brachioradialis transfer was second best. The pronator teres rerouting was the least effective transfer in effecting simulated supination in this experiment.

  20. Low complication rate of elastic stable intramedullary nailing (ESIN) of pediatric forearm fractures

    Science.gov (United States)

    Kruppa, Christiane; Bunge, Pamela; Schildhauer, Thomas A.; Dudda, Marcel

    2017-01-01

    Abstract Elastic stable intramedullary nailing (ESIN) has been established as state of the art treatment for forearm fractures in children, if operative stabilization is required. Their use has been expanded to single bone shaft fractures, and also more complex injuries such as Monteggia fractures or Monteggia-like lesions. A wide range of complications has been reported in the literature, up to 70% in certain investigations. The purpose of this study was to assess the complication rate after ESIN treatment of forearm fractures in children and adolescents in a representative cohort of patients from a level 1 trauma center in Germany. Between 2000 and 2015, we retrospectively analyzed all patients, up to the age of 16 years, with forearm fractures, who were operatively treated using ESIN in our department of general and trauma surgery. The main outcome measurements were the rates of postoperative complications after ESIN such as re-fracture, malunion, nonunion, tendon lesion, wound infection, and limited range of motion. In all, 201 consecutive patients with 202 forearm fractures were included in this study. Age averaged 9.7 years (range 3–16 years). Fifteen (7.4%) fractures were open. Fractures were 82.2% diaphyseal both-bone forearm fractures. Follow-up averaged 10.2 months (range 0.7–176.3 months). Complications were 10 re-fractures, 2 malunions, 3 extensor pollicis longus tendon ruptures, 1 superficial wound infection, and 2 limited range of motions. Fourteen (6.9%) children required a secondary operative intervention for their complication. Time to implant removal averaged 3.8 months (range 0.4–16.3 months). Elastic stable intramedullary nailing is a minimally invasive and reliable technique with a low complication rate. Both-bone forearm fractures and single bone fractures, and also Monteggia and Monteggia-equivalent fractures can be successfully treated with this method. As a major complication, re-fractures are frequently seen, even with ESIN in situ

  1. Bedside Ultrasound vs X-Ray for the Diagnosis of Forearm Fractures in Children.

    Science.gov (United States)

    Rowlands, Rachel; Rippey, James; Tie, Sing; Flynn, James

    2017-02-01

    Painful forearm injuries after a fall occur frequently in children. X-ray study is currently the gold standard investigation. Ultrasound (US) is a potential alternative that avoids exposure to ionizing radiation and may be less painful than x-ray study; and familiarity and skill with US is increasing among emergency physicians. The primary aim of this study was to determine if a cohort of physicians with little or no previous experience with US could, after a short training program, safely exclude forearm fractures in children. Secondary aims were to compare any pain or discomfort associated with clinical examination, US, and x-ray study and to determine the acceptability of US as a diagnostic tool to parents and patients. A prospective, nonrandomized, interventional diagnostic study was performed on children between the ages of 0 and 16 years who had a suspected fracture of the forearm. US scanning was performed by a group of physicians, most with little or no previous US experience. After the brief training program, a group of pediatric emergency physicians could diagnose forearm fractures in children with a sensitivity of 91.5% and a specificity of 87.6%. Pain associated with US was no better or worse than pain associated with x-ray study. Patients and parents preferred US over x-ray study as an investigation modality for suspected forearm fractures. A group of pediatric emergency physicians with limited previous experience could, after a short training program, diagnose forearm fractures in children. Pain associated with US was no better or worse than pain associated with x-ray study. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  2. Maternal dietary patterns during pregnancy in relation to offspring forearm fractures

    DEFF Research Database (Denmark)

    Petersen, Sesilje Elise Bondo; Rasmussen, Morten Arendt; Olsen, Sjurdur F

    2015-01-01

    .01-1.23) of fractures, and there was a borderline significant positive trend (p = 0.06). The other dietary patterns showed no associations and neither did supplementary analyses of macro- and micronutrients or single food groups, except for the intake of artificially sweetened soft drinks, which was positively...... associated with offspring forearm fractures (p = 0.02). In the large prospective DNBC high mid-pregnancy consumption of Western diet and artificially sweetened soft drinks, respectively, indicated positive associations with offspring forearm fractures, which provides interesting hypotheses for future...

  3. Resistance exercise with different volumes: blood pressure response and forearm blood flow in the hypertensive elderly

    Directory of Open Access Journals (Sweden)

    Brito AF

    2014-12-01

    Full Text Available Aline de Freitas Brito,1 Caio Victor Coutinho de Oliveira,2 Maria do Socorro Brasileiro-Santos,1 Amilton da Cruz Santos1 1Physical Education Department, 2Research Laboratory for Physical Training Applied to Performance and Health, Federal University of Paraíba, João Pessoa, Brazil Background: The purpose of this study was to evaluate the effect of two sessions of resistance exercise with different volumes on post-exercise hypotension, forearm blood flow, and forearm vascular resistance in hypertensive elderly subjects.Methods: The study was conducted with ten hypertensive elderly (65±3 years, 28.7±3 kg/m2 subjected to three experimental sessions, ie, a control session, exercise with a set (S1, and exercise with three sets (S3. For each session, the subjects were evaluated before and after intervention. In the pre-intervention period, blood pressure, forearm blood flow, and forearm vascular resistance were measured after 10 minutes of rest in the supine position. Thereafter, the subjects were taken to the gym to perform their exercise sessions or remained at rest during the same time period. Both S1 and S3 comprised a set of ten repetitions of ten exercises, with an interval of 90 seconds between exercises. Subsequently, the measurements were again performed at 10, 30, 50, 70, and 90 minutes of recovery (post-intervention in the supine position.Results: Post-exercise hypotension was greater in S3 than in S1 (systolic blood pressure, −26.5±4.2 mmHg versus −17.9±4.7 mmHg; diastolic blood pressure, −13.8±4.9 mmHg versus −7.7±5 mmHg, P<0.05. Similarly, forearm blood flow and forearm vascular resistance changed significantly in both sessions with an increase and decrease, respectively, that was more evident in S3 than in S1 (P<0.05.Conclusion: Resistance exercises with higher volume were more effective in causing post-exercise hypotension, being accompanied by an increase in forearm blood flow and a reduction of forearm vascular

  4. Recovery of nerve injury-induced alexia for Braille using forearm anaesthesia.

    Science.gov (United States)

    Björkman, Anders; Rosén, Birgitta; Lundborg, Göran

    2008-04-16

    Nerve injuries in the upper extremity may severely affect hand function. Cutaneous forearm anaesthesia has been shown to improve hand sensation in nerve-injured patients. A blind man who lost his Braille reading capability after an axillary plexus injury was treated with temporary cutaneous forearm anaesthesia. After treatment sensory functions of the hand improved and the patient regained his Braille reading capability. The mechanism behind the improvement is likely unmasking of inhibited or silent neurons, but after repeated treatment sessions at increasing intervals the improvement has remained at 1-year follow-up, implying a structural change in the somatosensory cortex.

  5. Effects of a Ginkgo biloba extract on forearm haemodynamics in healthy volunteers

    DEFF Research Database (Denmark)

    Mehlsen, J; Drabaek, H; Wiinberg, N

    2002-01-01

    The aim was to validate possible vasodilating effects of a Ginkgo biloba extract with a secondary aim of finding a pharmacodynamic signal relating to the active component of these extracts. We studied the effect of G. biloba extract on forearm haemodynamics in 16 healthy subjects (nine females......, seven males) with a median age of 32 years (range: 21-47). The study was conducted as a randomized, double-blinded cross-over design using oral treatment with G. biloba extract (Gibidyl Forte(R) t.i.d. or placebo for 6 weeks. Forearm blood flow and venous capacity were measured by strain...

  6. Computer modeling and numerical analysis of the prosthesis to fix the forearm fractures

    Directory of Open Access Journals (Sweden)

    Oleksandr F. Dashchenko

    2015-06-01

    Full Text Available The forearm fractures constitute about 15% of all fractures of the limb segments. The most common they are among athletes and people involved in a traffic accidents or military actions. The relevance of design and numerical analysis of structures for fixing broken bones is determined with certain imperfections and insufficient research of orthopedic devices’ fixation rod. The study is devoted to important problems of modern traumatology: scientific substantiation and development of fixing holder design; development of methods to determine the forearm fractures locking structure strength and rigidity characteristics for the treatment success.

  7. Fractures of the proximal humerus

    DEFF Research Database (Denmark)

    Brorson, Stig

    2013-01-01

    . The bandages were further supported by splints made of wood or coarse grass. Healing was expected in forty days. Different fracture patterns have been discussed and classified since Ancient Greece. Current classification of proximal humeral fractures mainly relies on the classifications proposed by Charles......, classification of proximal humeral fractures remains a challenge for the conduct, reporting, and interpretation of clinical trials. The evidence for the benefits of surgery in complex fractures of the proximal humerus is weak. In three systematic reviews I studied the outcome after locking plate osteosynthesis......Fractures of the proximal humerus have been diagnosed and managed since the earliest known surgical texts. For more than four millennia the preferred treatment was forceful traction, closed reduction, and immobilization with linen soaked in combinations of oil, honey, alum, wine, or cerate...

  8. Incidence of Connected Consciousness after Tracheal Intubation A Prospective, International, Multicenter Cohort Study of the Isolated Forearm Technique

    NARCIS (Netherlands)

    Sanders, Robert D.; Gaskell, Amy; Raz, Aeyal; Winders, Joel; Stevanovic, Ana; Rossaint, Rolf; Boncyk, Christina; Defresne, Aline; Tran, Gabriel; Tasbihgou, Seth; Meier, Sascha; Vlisides, Phillip E.; Fardous, Hussein; Hess, Aaron; Bauer, Rebecca M.; Absalom, Anthony; Mashour, George A.; Bonhomme, Vincent; Coburn, Mark; Sleigh, Jamie

    Background: The isolated forearm technique allows assessment of consciousness of the external world (connected consciousness) through a verbal command to move the hand (of a tourniquet-isolated arm) during intended general anesthesia. Previous isolated forearm technique data suggest that the

  9. Transverse Carpal Ligament and Forearm Fascia Release for the Treatment of Carpal Tunnel Syndrome Change the Entrance Angle of Flexor Tendons to the A1 Pulley: The Relationship between Carpal Tunnel Surgery and Trigger Finger Occurence

    Directory of Open Access Journals (Sweden)

    Nazım Karalezli

    2013-01-01

    Full Text Available Purpose. The appearance of trigger finger after decompression of the carpal tunnel without a preexisting symptom has been reported in a few articles. Although, the cause is not clear yet, the loss of pulley action of the transverse carpal ligament has been accused mostly. In this study, we planned a biomechanical approach to fresh cadavers. Methods. The study was performed on 10 fresh amputees of the arm. The angles were measured with (1 the transverse carpal ligament and the distal forearm fascia intact, (2 only the transverse carpal ligament incised, (3 the distal forearm fascia incised to the point 3 cm proximal from the most proximal part of the transverse carpal ligament in addition to the transverse carpal ligament. The changes between the angles produced at all three conditions were compared to each other. Results. We saw that the entrance angle increased in all of five fingers in an increasing manner from procedure 1 to 3, and it was seen that the maximal increase is detected in the middle finger from procedure 1 to procedure 2 and the minimal increase is detected in little finger. Discussion. Our results support that transverse carpal ligament and forearm fascia release may be a predisposing factor for the development of trigger finger by the effect of changing the enterance angle to the A1 pulley and consequently increase the friction in this anatomic area. Clinical Relevance. This study is a cadaveric study which is directly investigating the effect of a transverse carpal ligament release on the enterance angle of flexor tendons to A1 pulleys in the hand.

  10. Midshaft humeral fracture following a proximal humeral fracture: a case report

    National Research Council Canada - National Science Library

    Jayaseelan, Dhinu J; Post, Andrew A; Ruggirello, Leah D; Sault, Josiah D

    2014-01-01

    ... of rehabilitation of a proximal humerus fracture. A 63-year-old female recreational tennis player presented to physical therapy, progressing well following a proximal humeral fracture, sustained 18 weeks prior...

  11. Bilateral myofascial trigger points in the forearm muscles in patients with chronic unilateral lateral epicondylalgia: a blinded, controlled study.

    Science.gov (United States)

    Fernández-Carnero, Josué; Fernández-de-las-Peñas, César; de la Llave-Rincón, Ana Isabel; Ge, Hong-You; Arendt-Nielsen, Lars

    2008-01-01

    The aim of the present study was to investigate the presence of active and latent muscle trigger points (TrPs) in the forearm musculature on both affected and unaffected sides in patients with lateral epicondylalgia (LE) and healthy controls. Twenty-five patients with LE and 20 healthy matched controls participated. Both groups were examined for the presence of TrPs in the extensor carpi radialis brevis, extensor carpi radialis longus, extensor digitorum communis, and brachioradialis muscles in a blinded fashion. TrPs were identified in both affected and unaffected sides within the patient group. In the control group, TrPs were explored around the dominant side. Pressure pain thresholds (PPTs) were assessed on both affected and unaffected arms. In the patient group, the number of active muscle TrPs in the affected side was 3.1 [95% confidence interval (CI): 2.8-3.4], whereas in the unaffected arm, only latent TrPs were found (mean: 2.2; 95% CI: 1.8-2.6). Active TrPs were only located on the affected side (Platent TrPs in the dominant arm was 0.4 (95% CI: 0.0-0.7), which was significantly lower than the number of latent TrPs in the unaffected arm (Platent muscle TrPs in the forearm musculature were associated with the unaffected side in the patient group as compared with the dominant arm in healthy controls: extensor carpi radialis brevis [odds ratio (OR)=66 (95% CI: 9.9-48.8)], extensor carpi radialis longus [OR=16 (95% CI: 3.7-29.6)], brachioradialis [OR=2.6 (95% CI: 0.3-27.1)], and extensor digitorum communis [OR=0.5 (95% CI: 0.4-0.8)]. PPTs were lower around the affected side than around the unaffected arm in patients (mean+/-SD: 274.5+/-90.4 KPa vs. 465.4+/-140.7 KPa; Pactive TrPs (mean+/-SD: 244+/-70.4 KPa) was significantly lower (PLatent TrPs are present in forearm muscles on the unaffected side in patients with LE where active TrPs contribute to the pain on the affected arm. The presence of latent TrPs on the unaffected side in unilateral LE may be related

  12. The infrastructure of psychological proximity

    DEFF Research Database (Denmark)

    Nickelsen, Niels Christian Mossfeldt

    2015-01-01

    ). The experience of psychological proximity between patient and nurse is provided through confidence, continuity and the practical set-up. This constitutes an important enactment of skillfulness, which may render telemedicine a convincing health service in the future. Methodology: The study draws on a pilot...... (Langstrup & Winthereik 2008). This study contributes by showing the infrastructure of psychological proximity, which is provided by way of device, confidence, continuity and accountability....

  13. Odds ratios for hip- and lower forearm fracture using peripheral bone densitometry; a case-control study of postmenopausal women

    DEFF Research Database (Denmark)

    Saleh, M M A; Jørgensen, H L; Lauritzen, J B

    2002-01-01

    concern when using peripheral densitometry is the poor correlation with the central measurements. The main aim of this study is, therefore, to assess the possibility of expressing ultrasound measurements at the heel and bone mineral density (BMD) measured at the distal forearm as fracture odds ratios...... rather than an absolute measure of bone mass. METHODS: A total of 76 women with lower forearm fracture, 47 women with hip fracture and 231 age-matched women (controls) were included. All had broadband ultrasound attenuation (BUA) and speed of sound (SOS) measured at the heel using the DTU-one ultrasound...... scanner as well as BMD measured by dual X-ray absorptiometry on the DTX-200 at the distal forearm. RESULTS: BUA, SOS and BMD at the distal forearm were all significantly lower in fracture patients compared with their respective control groups. The odds ratio for lower forearm fracture was 3.1 (95% CI: 1...

  14. Bone density of the arm and forearm as an age indicator in specimens of stranded striped dolphins (Stenella coeruleoalba).

    Science.gov (United States)

    Guglielmini, Carlo; Zotti, Alessandro; Bernardini, Daniele; Pietra, Marco; Podestá, Michela; Cozzi, Bruno

    2002-07-01

    The age of odontocetes living in the wild is determined mainly by analysis of dentine layers in sections of the teeth. We examined a series of specimens from striped dolphins (Stenella coeruleoalba, Meyen, 1833) that had stranded along the Italian coast of the Mediterranean sea. The present study analyzes and describes bone density in the arm and forearm of the stranded specimens, and correlates the data with total body length of the animal and age as determined by the number of dentine layers in sections of the teeth. According to our model, age can be predicted on the basis of bone density and total body length of the stranded animal. This is the first study to use bone density as a biological parameter to understand the wear and tear of life in the sea. The results suggest that bone density is a new tool for recording age in wild odontocetes. Copyright 2002 Wiley-Liss, Inc.

  15. Spontaneous Healing of a Pediatric Scaphoid Proximal Pole Fracture Nonunion.

    Science.gov (United States)

    Rupani, Neal; Riley, Nicholas; McNab, Ian

    2018-02-01

    Background  Scaphoid fractures in the pediatric population are rare. The majority of nondisplaced fractures tend to unite; however, there is an increased risk of nonunion in proximal pole fractures. Limited evidence exists in their outcomes, owing to the scarcity of the fracture pattern. Case Description  A 13-year-old boy who presented late after developing a traumatic proximal pole scaphoid fracture developed nonunion. He was treated conservatively owing to it being asymptomatic and developed union at 18 months. Literature Review  No previous case of proximal pole pediatric scaphoid fractures with established nonunion that has developed union with conservative management has been described. Clinical Relevance  The authors highlight a unique case of an established proximal pole scaphoid nonunion in a child progressing to union with nonoperative intervention. Owing to its rarity and difficulty in obtaining research, we recommend consideration of nonoperative management of asymptomatic nondisplaced proximal pole fractures in children.

  16. Risk factors for persistent elbow, forearm and hand pain among computer workers

    DEFF Research Database (Denmark)

    Lassen, C. F.; Mikkelsen, S.; Kryger, Ann Isabel

    2005-01-01

    OBJECTIVES: This study examined the influence of work-related and personal factors on the prognosis of "severe" elbow, forearm, and wrist-hand pain among computer users. METHODS: In a 1-year follow-up study of 6943 computer users, 673 (10%) participants reported "quite a lot" or more trouble due ...

  17. Pain, wheal and flare in human forearm skin induced by bradykinin and 5-hydroxytryptamine

    DEFF Research Database (Denmark)

    Jensen, Kai; Tuxen, C; Pedersen-Bjergaard, U

    1990-01-01

    Pain was induced in 19 healthy individuals by double-blind injections into the forearm skin of 0.05 ml of physiological saline with or without active substances added. Bradykinin (0.5 nmol), 5-hydroxytryptamine (0.5 nmol) and a mixture of the two substances in half dosage (0.25 nmol + 0.25 nmol) ...

  18. Clinical quiz: Lesion on forearm after visit to Iraq | Foster | South ...

    African Journals Online (AJOL)

    ... visit to the Middle East. He attends the local travel clinic for booster vaccines and asks about a lesion on his right forearm (See attached photo). It started as a small papule that developed an erythematous halo. He has no symptoms but is concerned about it expanding. South African Family Practice Vol. 49 (2) 2007: pp. 46 ...

  19. Diagnostic power of the non-ischaemic forearm exercise test in detecting glycogenosis type V

    NARCIS (Netherlands)

    Hogrel, J.Y.; Bogaart, F. van den; Ledoux, I.; Ollivier, G.; Petit, F.; Koujah, N.; Behin, A.; Stojkovic, T.; Eymard, B.; Voermans, N.C.; Laforet, P.

    2015-01-01

    BACKGROUND AND PURPOSE: This was a retrospective study to assess the diagnostic value of the non-ischaemic forearm exercise test in detecting McArdle's disease. METHODS: The study is a retrospective diagnostic study over 15 years (1999-2013) on a referred sample of patients suffering from exercise

  20. The diagnostic value of hyperammonaemia induced by the non-ischaemic forearm exercise test

    NARCIS (Netherlands)

    Hogrel, J.Y.; Janssen, J.B.E.; Ledoux, I.; Ollivier, G.; Behin, A.; Stojkovic, T.; Eymard, B.; Voermans, N.C.; Laforet, P.

    2017-01-01

    AIMS: The non-ischaemic forearm exercise test (NIFET) is used as a diagnostic tool for the screening of patients with exercise intolerance and for the diagnosis of various metabolic muscle disorders. The production of lactate and ammonia are generally analysed to guide the diagnosis. The aim of this

  1. Water filtration of the forearm in short- and long-term diabetes mellitus

    DEFF Research Database (Denmark)

    Poulsen, H L; Nielsen, S L

    1976-01-01

    Blood flow and capillary filtration coefficient (CFC) were measured by strain-gauge plethysmography on the upper and lower third of the forearm in 9 normal subjects and 29 well regulated patients with diabetes mellitus of varying duration (less than 10 years, 10 to 20 years, and more than 20 years...

  2. Prolonged local forearm hyperinsulinemia induces sustained enhancement of nitric oxide-dependent vasodilation in healthy subjects

    DEFF Research Database (Denmark)

    Hermann, Thomas S; Ihlemann, Nikolaj; Dominguez, Helena

    2005-01-01

    vasodilatation was studied during intra-arterial infusion of serotonin and sodium nitroprusside (SNP), respectively. Forearm blood flow was measured by plethysmography. Intra-arterial insulin was infused for 240 min at a constant rate and blood flow was measured hourly during stimulation of endothelium...

  3. Neuromechanical control of the forearm muscles during gripping with sudden flexion and extension wrist perturbations.

    Science.gov (United States)

    Holmes, Michael W R; Tat, Jimmy; Keir, Peter J

    2015-01-01

    The purpose of this study was to investigate how gripping modulates forearm muscle co-contraction prior to and during sudden wrist perturbations. Ten males performed a sub-maximal gripping task (no grip, 5% and 10% of maximum) while a perturbation forced wrist flexion or extension. Wrist joint angles and activity from 11 muscles were used to determine forearm co-contraction and muscle contributions to wrist joint stiffness. Co-contraction increased in all pairs as grip force increased (from no grip to 10% grip), corresponding to a 36% increase in overall wrist joint stiffness. Inclusion of individual muscle contributions to wrist joint stiffness enhanced the understanding of forearm co-contraction. The extensor carpi radialis longus (ECRL) and brevis had the largest stiffness contributions (34.5 ± 1.3% and 20.5 ± 2.3%, respectively), yet muscle pairs including ECRL produced the lowest co-contraction. The muscles contributing most to wrist stiffness were consistent across conditions (ECRL for extensors; Flexor Digitorum Superficialis for flexors), suggesting enhanced contributions rather than muscular redistribution. This work provides investigation of the neuromuscular response to wrist perturbations and gripping demands by considering both co-contraction and muscle contributions to joint stiffness. Individual muscle stiffness contributions can be used to enhance the understanding of forearm muscle control during complex tasks.

  4. A new method for measuring forearm rotation using a modified finger goniometer.

    Science.gov (United States)

    Szekeres, Mike; MacDermid, Joy C; Rooney, Joanne

    2015-01-01

    In this manuscript, the authors describe the challenges with measuring forearm range of motion, and propose a new method for obtaining this measurement. Pros, cons, and future research directions are discussed.--Victoria Priganc, PhD, OTR, CHT, CLT, Practice Forum Editor. Copyright © 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  5. 78 FR 68907 - Agency Information Collection (Elbow and Forearm Conditions Disability Benefits Questionnaire...

    Science.gov (United States)

    2013-11-15

    ... review and comment. The PRA submission describes the nature of the information collection and its... examination and/or receiving private medical evidence that may potentially be sufficient for rating purposes... the results of medical examinations and related to the claimant's diagnosis of an elbow or forearm...

  6. Ultrasound for Distal Forearm Fracture : A Systematic Review and Diagnostic Meta-Analysis

    NARCIS (Netherlands)

    Douma-den Hamer, Djoke; Blanker, Marco H; Edens, Mireille A; Buijteweg, Lonneke N; Boomsma, Martijn F; van Helden, Sven H; Mauritz, Gert-Jan

    2016-01-01

    Study Objective To determine the diagnostic accuracy of ultrasound for detecting distal forearm fractures. Methods A systematic review and diagnostic meta-analysis was performed according to the PRISMA statement. We searched MEDLINE, Web of Science and the Cochrane Library from inception to

  7. Experiences of the High-Velocity Firearm Injuries at the Forearm and Hand

    Directory of Open Access Journals (Sweden)

    Yakup Çil

    2017-09-01

    Full Text Available Objective: Weapon injuries have been increasing due to use of weapons widespread. This study aims to describe our experiences with high-velocity firearm injuries to the forearm and the hand. Material and Methods: Seven patients who had high - velocity firearm injuries to the forearm and the hand were included in this study that was conducted between 2010 and 2015. All patients were male, and their mean age was 25 years (range, 21-33 years. On the average, patients were operated on within the first eight hours (range, 6–12 hours. There were two forearm injuries and five hand injuries. Revascularization could not be performed for two finger injuries, and the digits were amputated. Two forearm and three hand vascular injuries that needed microvascular anastomosis were operated on using interposition vein grafts. Vein grafts were obtained from saphenous veins in two patients and from dorsal foot veins in three patients. Results: No microvascular complications were seen in the early or late follow-up periods. Phalanx fractures were seen in all hand injuries. On the average, patients were operated on three times (range: two-five in the follow-up period. Conclusion: In firearm injuries, microvascular repair should be performed out of injury zones; surgeons should not hesitate to use interpositional vein graft for microvascular repair, and physical rehabilitations of patients should be started in the early follow-up period.

  8. Treatment Results Of Diaphyseal Forearm Fractures With Dynamique Compression Plate A Retrospective study of 156 Cases.

    Directory of Open Access Journals (Sweden)

    Hassan BOUSSAKRI

    2016-03-01

    Full Text Available This retrospective study addresses a series of 156 cases of forearm fractures. These 156 cases were managed in the trauma-orthopedic department (B4 of Fez University Hospital, Morocco, from May 2008 till January 2013. The purpose of this study is to analyze epidemiological and clinical factors of diaphyseal forearm fractures and the results of their treatment with dynamic compression plate (DCP, as well as the complications and therapeutic errors of this surgical technique. The frequency of hospitalization in the trauma-orthopedic department was 3,96%. Ages ranged between 16 and 83, the average age was 32. 132 patients were male (85%. 90% were managed at the day of trauma. Traffic accidents were the most frequent cause in 52% patients. The fracture was in the left forearm in 65% of patients. 53% of fracture lines were in the middle third of the forearm. 38 fractures were open, and 30 were admitted for polytrauma. Osteosynthesis was performed with dynamic compression plate for all patients. In comparison with the literature, our series shows the predominance of young male patients, with traffic accidents being the cause. Osteosynthesis with dynamic compression plate remains the treatment of choice that provides satisfactory results if the accuracy in this technique was respected.

  9. Fracture of the distal forearm : epidemiological developments in the period 1971-1995

    NARCIS (Netherlands)

    Oskam, J; Kingma, J; Klasen, HJ

    This study describes longterm epidemiological trends of 8361 distal forearm fractures out of 256431 trauma patients (3 per cent) treated in a Dutch university hospital. The mean incidence rate across the whole lifespan was 42 per 10000 inhabitants. The general picture was that the incidence rate

  10. A Magnetoencephalographic Study of Sensorimotor Activity Differences during Unilateral and Bilateral Forearm Movements

    Science.gov (United States)

    Nakagawa, Kei

    2010-01-01

    This study compared activation of the sensorimotor area using magnetoencephalography after unilateral and bilateral movements. Thirteen healthy individuals and a patient with mild hemiplegia performed unilateral and bilateral forearm pronation movements. Among healthy participants, there were no significant differences in motor-evoked field during…

  11. Cut-off values of distal forearm bone density for the diagnosis of ...

    African Journals Online (AJOL)

    2011-09-15

    Sep 15, 2011 ... Original Research: Cut-off values of distal forearm bone density for the diagnosis of central osteoporosis. 79. 2012 Volume 17 No 2. JEMDSA remain significantly higher.11 Furthermore, in addition to an increased life expectancy (osteoporosis risk factor), lifestyle behaviours generally associated with.

  12. The Effect of Movement Imagery Training on Learning Forearm Pass in Volleyball

    Science.gov (United States)

    Ay, Khitam Mousa; Halaweh, Rami Saleh; Al-Taieb, Mohammad Abu

    2013-01-01

    This study investigates the effect of movement imagery on learning the forearm pass in volleyball. Twenty four mail students from Physical Education Factuly at Jordan University (19 ± 0.5) years of age. After Completed the Movement Imagery Questionnaire-Revised (MIQ-R; Hall & Martin, 1997) the subjects randomly divided into two groups,…

  13. Impairment and employment issues after nerve repair in the hand and forearm

    NARCIS (Netherlands)

    Meiners, PM; Coert, JH; Robinson, PH; Meek, MF

    2005-01-01

    Purpose. To evaluate retrospectively subjective impairments, experienced disabilities, job and leisure restrictions and job changes in patients at least 2 years after repair of a peripheral nerve injury in the forearm, wrist or hand. Methods. Between January 1997 and January 2000, 125 patients were

  14. The plate fixation in the treatment of complex forearm open fractures

    Directory of Open Access Journals (Sweden)

    Meric Ugurlar

    2017-04-01

    Conclusion: In high nergy traumas of the upper extremity associated with complex injuries and Type-IIIC forearm fractures, severity of soft tissue injuries determined the functional results in patients, demonstrating it is possible to achieve a safe and efficient fixation with immediate plate-screw osteosynthesis. [Hand Microsurg 2017; 6(1.000: 1-8

  15. Design of a Model of Forearm Bone Fractures for Educational Purposes

    Science.gov (United States)

    Jastaniah, Saddig; Hamdan, Abdulrahman; Alhadrami, Abdullah; Almatrafi, Talal; Arif, Ahmed; Almalki, Hassan

    2016-01-01

    This work explores a new approach to demonstrate possible forearm fractures in humans as an educating means for student radiographers. The Design of abnormal bones are not normally available as phantoms; the manufacturer usually produces normal human musculoskeletal models for educational purposes. Hence fractures and abnormalities are usually…

  16. Pronation and supination after forearm fractures in children: Reliability of visual estimation and conventional goniometry measurement.

    Science.gov (United States)

    Colaris, Joost; van der Linden, Marleen; Selles, Ruud; Coene, Napoleon; Allema, Jan Hein; Verhaar, Jan

    2010-06-01

    Forearm fractures are common amongst children and often result in limited rotational function. In daily practice, pronation and supination of the arm are often visually estimated or measured using a conventional goniometer. The aim of this study was to compare the reliability of these two methods in paediatric patients who had previously sustained a forearm fracture. Intra- and interrater reliability of visual estimation and conventional goniometry were determined in 47 children who had previously sustained a forearm fracture. Intra- and interrater reliability of visual estimation and conventional goniometry was fair to excellent, with intraclass correlation coefficients (ICCs) ranging between 0.75 and 0.94. In addition, the overall goniometer data consistently showed lower smallest detectable differences (SDDs) compared to the visual estimation data, also indicating better reliability for the goniometer method. A conventional goniometer is an easy, fast and reliable method to determine the pronation and supination in a child who had sustained a forearm fracture. If an uncooperative child hinders the measurement, visual estimation is a good second choice. Measurements are more reliable when repeated by the same professional. Copyright 2010 Elsevier Ltd. All rights reserved.

  17. Blood flow in skin, subcutaneous adipose tissue and skeletal muscle in the forearm of normal man during an oral glucose load

    DEFF Research Database (Denmark)

    Bülow, J; Astrup, A; Christensen, N J

    1987-01-01

    Blood flow to the forearm, and the subcutaneous tissue and skin in the forearm were measured by strain gauge plethysmography, 133Xe-elimination and Laser Doppler flowmetry during an oral glucose load (I g glucose kg-1 lean body mass) and during control conditions. The forearm blood flow remained...

  18. Residual upper arm motor function primes innervation of paretic forearm muscles in chronic stroke after Brain-Machine Interface (BMI) training

    NARCIS (Netherlands)

    Curado, M.R.; Garcia Cossio, E.; Brötz, D.; Agostini, M.; Cho, W.; Brasil, F.L.; Yilmaz, O.; Liberati, G.; Lepski, G.; Birbaumer, N.; Ramos-Murguialday, A.

    2015-01-01

    Background Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may

  19. Comparison of skin test reactivity to histamine on back and forearm in young children.

    Science.gov (United States)

    Yuenyongviwat, Araya; Koonrangsesomboon, Duangrachanee; Sangsupawanich, Pasuree

    2012-12-01

    Skin responses to standardized positive and negative controls are important in the interpretation of a skin prick tests (SPT). However, this information in young children is lacking. We aimed to determine skin reactivity and compare the skin responses to these controls on the upper back and forearm in young children. SPTs for histamine hydrochloride 1 mg/ml (positive control) and 50% glycerol-saline (negative control) were performed on the upper back and forearm of children aged 6-25 months who came to the well-child clinic at Songklanagarind Hospital. SPTs to common allergens (cow's milk, soybean, egg white and house dust mite) were also evaluated. A total of 133 children with a mean age of 12.4 months were enrolled in the study. Seventy-five children (56.4%) were male. The results from the upper back and the forearm of the histamine-induced mean wheal diameter + standard deviation (SD) were 4.74+1.37 mm and 3.86+1.82mm (p responses to histamine on the upper back and the forearm were 18.47 +/- 4.28 mm and 16.37 +/- 5.50 mm (p wheal (0.57+1.17 vs. 0.34+0.89 mm, p = 0.007) and flare (4.57 +/- 3.04 mm vs. 3.34 +/- 1.91 mm, p wheal and flare responses to standardized positive and negative controls in young children. The upper back is more reactive than the forearm and is the preferred SPT site in young-aged children.

  20. Acute changes in forearm venous volume and tone using radionuclide plethysmography

    Energy Technology Data Exchange (ETDEWEB)

    Manyari, D.E.; Malkinson, T.J.; Robinson, V.; Smith, E.R.; Cooper, K.E.

    1988-10-01

    In this investigation blood pool scintigraphy was validated as a method to study acute changes in human forearm veins. Changes in regional forearm vascular volume (capacity) and the occluding pressure-volume (P-V) relationship induced by sublingual nifedipine (NIF) and nitroglycerin (GTN) were recorded in 16 patients with simultaneous data collection by the radionuclide and the mercury-in-rubber strain-gauge techniques. The standard error of estimate (Syx) between successive control measurements using the radionuclide method was 3.1% compared with 3.2% for the strain-gauge method. The venous P-V curves were highly reproducible using both techniques. Strain gauge and radionuclide measurements of acute changes in forearm venous volume correlated well (r = 0.86; Syx = 7%, n = 156). After 20 mg of NIF or 0.6 mg of GTN, mean heart rate increased from 71 +/- 10 to 77 +/- 9 and from 68 +/- 10 to 75 +/- 11 beats/min, respectively, and group systolic blood pressure decreased from 128 +/- 22 to 120 +/- 19 and from 136 +/- 18 to 126 +/- 23 mmHg, respectively (P less than 0.05). At venous occluding pressures of 0 and 30 mmHg, the forearm vascular volume did not change after NIF (2 +/- 4 and -1 +/- 4%; P greater than 0.05), whereas it increased after GTN (8 +/- 5 and 12 +/- 7%; P less than 0.001). The forearm venous P-V relationship did not change after NIF, whereas a significant rightward shift (venodilation, with an increase in unstressed volume) occurred after GTN.

  1. Psychophysical Evaluation of the Capability for Phantom Limb Movement in Forearm Amputees.

    Science.gov (United States)

    Kawashima, Noritaka; Mita, Tomoki

    2016-01-01

    A phantom limb is the sensation that an amputated limb is still attached to the body and is moving together with other body parts. Phantom limb phenomenon is often described on the basis of the patient's subjective sense, for example as represented using a visual analog scale (VAS). The aim of this study was to propose a novel quantification method for behavioral aspect of phantom limb by psychophysics. Twelve unilateral forearm amputees were asked to perform phantom wrist motion with various motion frequencies (60, 80, 100, 120, 140, 160, 180, 200, 220, 240% of preferred speed). The attainment of phantom limb motion in each session was rated by the VAS ranging from 0 (hard) to 10 (easy). The relationship between the VAS and motion frequency was mathematically fitted by quadric function, and the value of shift and the degree of steepness were obtained as evaluation variables for the phantom limb movement. In order to test whether the proposed method can reasonably quantify the characteristics of phantom limb motion, we compared the variables among three different phantom limb movement conditions: (1) unilateral (phantom only), (2) bimanual, and (3) bimanual wrist movement with mirror reflection-induced visual feedback (MVF). While VAS rating showed a larger extent of inter- and intra-subject variability, the relationship of the VAS in response to motion frequency could be fitted by quadric curve, and the obtained parameters based on quadric function well characterize task-dependent changes in phantom limb movement. The present results suggest the potential usefulness of psychophysical evaluation as a validate assessment tool of phantom limb condition.

  2. Psychophysical Evaluation of the Capability for Phantom Limb Movement in Forearm Amputees.

    Directory of Open Access Journals (Sweden)

    Noritaka Kawashima

    Full Text Available A phantom limb is the sensation that an amputated limb is still attached to the body and is moving together with other body parts. Phantom limb phenomenon is often described on the basis of the patient's subjective sense, for example as represented using a visual analog scale (VAS. The aim of this study was to propose a novel quantification method for behavioral aspect of phantom limb by psychophysics. Twelve unilateral forearm amputees were asked to perform phantom wrist motion with various motion frequencies (60, 80, 100, 120, 140, 160, 180, 200, 220, 240% of preferred speed. The attainment of phantom limb motion in each session was rated by the VAS ranging from 0 (hard to 10 (easy. The relationship between the VAS and motion frequency was mathematically fitted by quadric function, and the value of shift and the degree of steepness were obtained as evaluation variables for the phantom limb movement. In order to test whether the proposed method can reasonably quantify the characteristics of phantom limb motion, we compared the variables among three different phantom limb movement conditions: (1 unilateral (phantom only, (2 bimanual, and (3 bimanual wrist movement with mirror reflection-induced visual feedback (MVF. While VAS rating showed a larger extent of inter- and intra-subject variability, the relationship of the VAS in response to motion frequency could be fitted by quadric curve, and the obtained parameters based on quadric function well characterize task-dependent changes in phantom limb movement. The present results suggest the potential usefulness of psychophysical evaluation as a validate assessment tool of phantom limb condition.

  3. Vascular branches from cutaneous nerve of the forearm and hand: application to better understanding raynaud's disease.

    Science.gov (United States)

    Umemoto, K; Ohmichi, M; Ohmichi, Y; Yakura, T; Hammer, N; Mizuno, D; Naito, M; Nakano, T

    2017-09-29

    Cutaneous nerves have branches called vascular branches (VBs) that reach arteries. VBs are thought to be involved in arterial constriction, and this is the rationale for periarterial sympathectomy as a treatment option for Raynaud's disease. However, the branching patterns and distribution areas of the VBs remain largely unclear. The aim of the present study was to investigate the anatomical structures of the VBs of the cutaneous nerves. Forty hands and forearms were examined to assess the branching patterns and distribution areas of the VBs of the superficial branch of the radial nerve (SBRN), the lateral antebrachial cutaneous nerve (LACN), the medial antebrachial cutaneous nerve (MACN), and the palmar cutaneous branch of the ulnar nerve (PCUN). VBs reaching the radial and ulnar arteries were observed in all specimens. The branching patterns were classified into six types. The mean distance between the radial styloid process and the point where the VBs reached the radial artery was 34.3 ± 4.8 mm in the SBRN and 38.5 ± 15.8 mm in the LACN. The mean distance between the ulnar styloid process and the point where the VBs reached the ulnar artery was 60.3 ± 25.9 mm in the MACN and 43.8 ± 26.0 mm in the PCUN. This study showed that the VBs of the cutaneous nerves have diverse branching patterns. The VBs of the SBRN had a more limited distribution areas than those of the other nerves. Clin. Anat., 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  4. [Arthroscopic fracture management in proximal humeral fractures].

    Science.gov (United States)

    Lill, H; Katthagen, C; Jensen, G; Voigt, C

    2013-04-01

    Arthroscopy has become increasingly more established in the treatment of proximal humeral fractures. In addition to the known advantages of minimally invasive surgery fracture and implant positioning can be optimized and controlled arthroscopically and relevant intra-articular concomitant pathologies (e.g. biceps tendon complex and rotator cuff) can be diagnosed and treated. Arthroscopic techniques have proven to be advantageous in the treatment of various entities of greater tuberosity fractures, lesser tuberosity fractures (suture bridging technique) and subcapital humeral fractures (arthroscopic nailing). This article presents an overview on innovative arthroscopic modalities for treating proximal humeral fractures, describes the surgical techniques and the advantages compared to open procedures as well as initial clinical results.

  5. SINA: A test system for proximity fuses

    Science.gov (United States)

    Ruizenaar, M. G. A.

    1989-04-01

    SINA, a signal generator that can be used for testing proximity fuses, is described. The circuitry of proximity fuses is presented; the output signal of the RF circuit results from a mixing of the emitted signal and received signal that is Doppler shifted in frequency by the relative motion of the fuse with respect to the reflecting target of surface. With SINA, digitized and stored target and clutter signals (previously measured) can be transformed to Doppler signals, for example during a real flight. SINA can be used for testing fuse circuitry, for example in the verification of results of computer simulations of the low frequency Doppler signal processing. The software of SINA and its use are explained.

  6. Management of Proximal Third Arm Replantation

    Directory of Open Access Journals (Sweden)

    Süleyman Taş

    2017-12-01

    Full Text Available Notwithstanding the recent success in major limb replantation achieved through the advancements in microsurgical techniques, the viability of the extremity is still relatively low at the transhumeral level following a replantation. There are no exact guidelines for deciding whether to undertake a stump repair or a replantation in such amputations at the proximal level. However, a highly motivated patient with realistic expectations and protected shoulder function can be a candidate to undergo replantation. The replanted arm may help the uninjured arm in daily activities. In this report we present the case of a 47-year-old man whose arm was amputated at proximal third level by an asphalt machine and successfully replanted together with the encountered problems and their solutions. The roadmap followed in this rare case may be a guide for hand surgeons.

  7. Proximal collagenous gastroenteritides:

    DEFF Research Database (Denmark)

    Nielsen, Ole Haagen; Riis, Lene Buhl; Danese, Silvio

    2014-01-01

    a systematic review of collagenous gastritis, collagenous sprue, and a combination thereof. METHOD: The search yielded 117 studies which were suitable for inclusion in the systematic review. Excluding repeated cases, 89 case reports and 28 case series were reported, whereas no prospective studies...... of these disorders is presented. The prognosis of both collagenous gastritis and sprue seems not to be as dismal as considered previously. Data point to involvement of immune or autoimmune mechanisms potentially driven by luminal antigens initiating the fibroinflammatory condition. CONCLUSIONS: To reach...

  8. [Correlation between the lengths of the long bones of the forearm and the fibula with body height in our population].

    Science.gov (United States)

    Marinković, Nadica; Vilić, Jasenka Vasić

    2012-05-01

    The task of a forensic examiner during exhumation of skeletal remains is to calculate antemortem height of a person whose skeletal remains were found. Anthropological investigations which provided formulae for calculating ante-mortem body height date back from XIX or from the first half of XX centuries. The most commonly used formulae are those of Trotter-Gleser, which were used to investigate skeletal remains from the World War II. Those investigations were conducted on skeletal remains of various ages and degrees of decay. Our experience with exhumation have shown that the present formulae do not deliver reliable values of antemortem height. The aim of this study was to investigate if there is a correlation of the length of long bones of leg and forearm with body height within our population and to establish the formulae for calculating ante-mortem body height within our population based on the obtained values. The lengths of ulna, radius, fibula and tibia were determined precisely by measuring bones on living individuals using a digital X-ray system. The height of individuals whose bones were measured was determined using an anthropometer. The highest degree of correlation between bone length and body height was found for tibia in males (r = 0.859, p population the length of long bones of the forearm and the leg are characterized by various degree of correlation with body height. The formulae that we set, make less distinction between the measured and the calculated body height as compared with the Trotter-Gleser formulae. We do hope that their implementation will facilitate identification of sceletal remains in our population.

  9. The basis and functional role of the late EMG activity in human forearm muscles following wrist displacement.

    Science.gov (United States)

    Goodin, D S; Aminoff, M J

    1992-08-28

    The present paper examines the hypothesis that the long latency EMG activity produced by muscle stretch is the result of long loop reflex pathways involved in the control of limb stiffness. We recorded the cerebral responses and late EMG activity in agonist and antagonist muscles following sudden stretch of the wrist extensor muscles under 4 experimental conditions in 11 subjects. In each experiment subjects held their right wrist extended isometrically against a constant force of 2.3 N and a trial was begun with a step increase in the force from 2.3 N to 18.4 N, to stretch the extensor muscle. In the first and second experiments the force change occurred unpredictably and subjects had to either oppose the perturbation (Unpredictable Oppose) or relax the forearm muscles once the increase in force was detected (Unpredictable Let-Go). In the third and fourth experiments the force change occurred predictably when subjects pressed a thumb switch with the left hand to cause it. As before, subjects were instructed to either oppose the perturbation (Predictable Oppose) or relax the forearm muscles (Predictable Let-Go). Responses were recorded from the flexor and extensor carpi radialis muscles and from the scalp. When the perturbing force occurred unpredictably, early latency EMG activity (the MI response) was seen in the stretched extensor muscle, and longer latency EMG activity was seen simultaneously in both extensor and flexor muscles. When the force change occurred predictably the late EMG activity was considerably attenuated, especially in the Predictable Let-Go condition. Cerebral responses similarly depended upon the predictability of the perturbation.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Cubesat Proximity Operations Demonstration (CPOD)

    Science.gov (United States)

    Villa, Marco; Martinez, Andres; Petro, Andrew

    2015-01-01

    The CubeSat Proximity Operations Demonstration (CPOD) project will demonstrate rendezvous, proximity operations and docking (RPOD) using two 3-unit (3U) CubeSats. Each CubeSat is a satellite with the dimensions 4 inches x 4 inches x 13 inches (10 centimeters x 10 centimeters x 33 centimeters) and weighing approximately 11 pounds (5 kilograms). This flight demonstration will validate and characterize many new miniature low-power proximity operations technologies applicable to future missions. This mission will advance the state of the art in nanosatellite attitude determination,navigation and control systems, in addition to demonstrating relative navigation capabilities.The two CPOD satellites are scheduled to be launched together to low-Earth orbit no earlier than Dec. 1, 2015.

  11. The effect of topically applied tissue expanders on radial forearm skin pliability: a prospective self-controlled study.

    Science.gov (United States)

    Chung, Jeffson; Bonaparte, James P; Odell, Michael; Corsten, Martin

    2014-04-16

    The use of pre-operatively applied topical tissue expansion tapes have previously demonstrated increased rates of primary closure of radial forearm free flap donor sites. This is associated with a reduced cost of care as well as improved cosmetic appearance of the donor site. Unfortunately, little is known about the biomechanical changes these tapes cause in the forearm skin. This study tested the hypothesis that the use of topically applied tissue expansion tapes will result in an increase in forearm skin pliability in patients undergoing radial forearm free flap surgery. Twenty-four patients scheduled for head and neck surgery requiring a radial forearm free flap were enrolled in this prospective self-controlled observational study. DynaClose tissue expansion tapes (registered Canica Design Inc, Almonte, Canada) were applied across the forearm one week pre-operatively. Immediately prior to surgery, the skin pliability of the dorsal and volar forearm sites were measured with the Cutometer MPA 580 (registered Courage-Khazaka Electronic GmbH, Cologne, Germany) on both the treatment and contralateral (control) arms. Paired t-tests were used to compare treatment to control at both sites, with p definition of clinical significance.

  12. A cadaver study into the number of fasciotomies required to decompress the anterior compartment in forearm compartment syndrome.

    Science.gov (United States)

    Benamran, Lionel; Masquelet, Alain Charles

    2017-11-27

    There is no typical approach for decompression of forearm compartment syndrome, due to contradictory considerations regarding the characteristics of forearm anterior compartment deep fascia. The main purpose of this study was to determine how many fasciae should be opened to fully decompress the forearm anterior compartment. Further, the compliance of the deep anterior compartment was also investigated, to strengthen our results. An experimental study of a laboratory model of acute forearm compartment syndrome was performed. A deep forearm injection of egg white was undertaken to create an acute forearm compartment syndrome in sixteen non-embalmed human forearms from six male and two female donors. The pressure in the superficial and deep anterior compartments was recorded four times, both before and after each fasciotomy and the compliance of the deep anterior compartment was calculated for each step. The first incision of the superficial lamina of the deep fascia was not sufficient to decrease the elevated compartment pressure in the superficial and deep anterior compartments. Whereas the pressures decreased to near-baseline levels, following the fasciotomy of the intermuscular septum observed posterior to the flexor carpi radialis. The last incision of the deep lamina of the deep anterior fascia had no noticeable impact. These observations supported the hypothesis of high compliance of the deep anterior compartment. Two successive incisions were necessary to decompress the anterior compartment: the incision of the superficial lamina of the deep fascia and the incision of the intermuscular septum.

  13. Proximity of Practice

    DEFF Research Database (Denmark)

    Ren, Carina Bregnholm; Gyimóthy, Szilvia; Jensen, Martin Trandberg

    2014-01-01

    There is a widespread acknowledgement among European policy-makers that higher education may potentially contribute to enhancing competitiveness of tourism. This has led to a sheer explosion of specific measures encouraging knowledge transfer with the private sector. Despite the importance...... of knowledge flow processes, the role of universities and students has been little researched or linked to the understanding of innovation defectiveness in tourism. Followed by a critical review of knowledge transfer and learning processes in generic development and tourism literature, the chapter presents...... an illustrative case from an innovation course on a Danish Master program in tourism. The case describes and discusses challenges in working with, creating and implementing innovation through student-practitioner collaboration. It is argued that successful innovation is not solely, as previously argued...

  14. Sweating responses to isometric hand-grip exercise and forearm muscle metaboreflex in prepubertal children and elderly.

    Science.gov (United States)

    Amano, Tatsuro; Kai, Seiko; Nakajima, Michi; Ichinose-Kuwahara, Tomoko; Gerrett, Nicola; Kondo, Narihiko; Inoue, Yoshimitsu

    2017-02-01

    What is the central question of this study? Non-thermal factors (e.g. muscle metaboreflex) contribute to the sweating response during exercise. Although it is well recognized that the sweating responses caused by core temperature elevation in prepubertal children and the elderly are attenuated compared with young adults, it is unknown whether non-thermal sweating is also attenuated in these populations. What is the main finding and its importance? The non-thermal sweating response during isometric hand-grip exercise and isolated muscle metaboreflex were attenuated in prepubertal children compared with young adults in a non-uniform manner over the body, but only during the muscle metaboreflex in the elderly. This may explain the maturation- and ageing-related decline of sweating during exercise. The purpose of the present study was to investigate sweating responses to isometric hand-grip (IH) exercise and muscle metaboreflex in prepubertal children and the elderly. In hot conditions (ambient temperature, 35°C; relative humidity, 45%), 13 healthy young adults, 10 prepubertal children and 10 elderly subjects (aged 20.4 ± 1.2, 11.4 ± 0.5 and 63.5 ± 3.1 years, respectively) repeated a three hand-grip exercise protocol that consisted of 1 min IH exercise at 15, 30 or 45% of maximal voluntary contraction (MVC) followed by 2 min postexercise forearm occlusion. Local sweat rates (SRs) on the forehead, chest, forearm, thigh and palm were continuously measured (ventilated capsule method). The forehead SR in prepubertal children during IH exercise at 45% MVC was significantly lower than that of young adults (0.26 ± 0.22 and 0.08 ± 0.15 mg cm-2  min-1 for young adults and children, respectively; P elderly at any exercise intensities. The SR on the chest (0.22 ± 0.22 and -0.01 ± 0.05 mg cm-2  min-1 for young adults and children, respectively), forearm (0.14 ± 0.12 and 0.03 ± 0.04 mg cm-2  min-1 ) and thigh (0.13 ± 0.10 and 0.02 ± 0

  15. Relationships between metacarpal morphometry, fore-arm and vertebral bone density and fractures in post-menopausal women

    Energy Technology Data Exchange (ETDEWEB)

    Wishart, J.M.; Horowitz, M.; Bochner, M.; Need, A.G.; Nordin, B.E.C. (Royal Adelaide Hospital, SA (Australia))

    1993-05-01

    The relationships between metacarpal morphometric, vertebral and forearm density measurement and the prevalence of vertebral and peripheral fractures were examined in 239 postmenopausal women (median age 63, range 32-84 years). Metacarpal cortical area/total area ratio (CA/TA) was measured with needle calipers forearm mineral density (FMD) by single photon absorptiometry and vertebral mineral density (VMD) by single energy quantitative computed tomography. The authors suggest that metacarpal morphometry, which is widely available at relatively low cost, yields cross-sectional information about bone density and fracture risk, comparable with that obtained by forearm and vertebral densitometry. (Author).

  16. Surface Electromyography of the Forearm Musculature During the Windmill Softball Pitch.

    Science.gov (United States)

    Remaley, D Trey; Fincham, Bryce; McCullough, Bryan; Davis, Kirk; Nofsinger, Charles; Armstrong, Charles; Stausmire, Julie M

    2015-01-01

    Previous studies investigating the windmill softball pitch have focused primarily on shoulder musculature and function, collecting limited data on elbow and forearm musculature. Little information is available in the literature regarding the forearm. This study documents forearm muscle electromyographic (EMG) activity that has not been previously published. Elbow and upper extremity overuse injuries are on the rise in fast-pitch softball pitchers. This study attempts to describe forearm muscle activity in softball pitchers during the windmill softball pitch. Overuse injuries can be prevented if a better understanding of mechanics is defined. Descriptive laboratory study. Surface EMG and high-speed videography was used to study forearm muscle activation patterns during the windmill softball pitch on 10 female collegiate-level pitchers. Maximum voluntary isometric contraction of each muscle was used as a normalizing value. Each subject was tested during a single laboratory session per pitcher. Data included peak muscle activation, average muscle activation, and time to peak activation for 6 pitch types: fastball, changeup, riseball, curveball, screwball, and dropball. During the first 4 phases, muscle activity (seen as signal strength on the EMG recordings) was limited and static in nature. The greatest activation occurred in phases 5 and 6, with increased signal strength, evidence of stretch-shortening cycle, and different muscle characteristics with each pitch style. These 2 phases of the windmill pitch are where the arm is placed in the 6 o'clock position and then at release of the ball. The flexor carpi ulnaris signal strength was significantly greater than the other forearm flexors. Timing of phases 1 through 5 was successively shorter for each pitch. There was a secondary pattern of activation in the flexor carpi ulnaris in phase 4 for all pitches except the fastball and riseball. During the 6 pitches, the greatest muscular activity was in phases 5 and 6

  17. A spontaneous pre-anastomotic occlusion does not necessarily impair forearm native dialysis fistulas: echo-Doppler, 3D MR angiographic and digital subtraction angiographic imaging.

    Science.gov (United States)

    Verbeeck, N; Pillet, J C; Prospert, E; McLntyre, D; Lamy, S

    2013-01-01

    Renal transplantation is the choice treatment of end-stage renal disease. When it is not indicated or not immediately feasible, hemodialysis must be performed, preferably via a native arteriovenous fistula in the forearm. A pre-anastomotic occlusion of this type of fistula is often accompanied by a thrombosis of its draining vein. In some instances, the venous segment may remain permeable thanks to the development of arterial collateral pathways and may even allow efficient dialysis without any clinical syndrome of distal steal. We present the echo-Doppler, magnetic and angiographic characteristics of three of these collateralized shunts that have remained functional, in one of the cases following a percutaneous dilation.

  18. SHORT COMMUNICATION PROXIMATE COMPOSITION, MINERAL ...

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    SHORT COMMUNICATION. PROXIMATE COMPOSITION, MINERAL CONTENT AND ANTINUTRITIONAL. FACTORS OF SOME CAPSICUM (Capsicum annum) VARIETIES GROWN IN. ETHIOPIA. Esayas K.1, Shimelis A.2, Ashebir F.3, Negussie R.3, Tilahun B.4 and Gulelat D.4*. 1Hawassa University, Department of Food ...

  19. Management of posttraumatic proximal interphalangeal joint contracture.

    Science.gov (United States)

    Houshian, Shirzad; Jing, Shan Shan; Chikkamuniyappa, Chandrasekar; Kazemian, Gholam Hussein; Emami-Moghaddam-Tehrani, Mohammad

    2013-08-01

    Chronic flexion contracture of the proximal interphalangeal (PIP) joint presents a common yet challenging problem to hand surgeons. Over the years, multiple treatment modalities have been described for this problem, producing limited results. Nonoperative treatment using serial casting and splints should be tried before attempting open surgical release, which should be done in selected patients. The use of external fixation for treating PIP contracture has been encouraging and can be a useful alterative. This review provides an update on the current management of PIP joint contractures and presents a flowchart of treatment to aid decision making. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  20. Transverse Stress Fracture of the Proximal Patella

    Science.gov (United States)

    Atsumi, Satoru; Arai, Yuji; Kato, Ko; Nishimura, Akinobu; Nakazora, Shigeto; Nakagawa, Shuji; Ikoma, Kazuya; Fujiwara, Hiroyoshi; Sudo, Akihiro; Kubo, Toshikazu

    2016-01-01

    Abstract Among stress fractures associated with sports activities, patellar stress fracture is rare. Regarding patella stress fractures, so far only distal transverse or lateral longitudinal fractures have been reported, but there are no reports of transverse fractures occurring in the proximal patella. We describe an extremely rare case of transverse stress fracture of proximal patella in a 9-year-old athlete. A 9-year old boy, who participated in sports (sprints and Kendo) presented with left knee pain without any external injury. In plain radiographs, a fracture line was observed in the proximal 1/3 of the left patella, and a patella stress fracture was diagnosed. For treatment, because 7 months of conservative therapy showed no improvement, internal fixation was carried out using Acutrak screws, and bone union was thus achieved. Three months after the operation, he was able to return to his previous level of athletic sports activity. Regarding the mechanism of onset, it is believed that the causes are longitudinal traction force and patellofemoral contact pressure. On the other hand, the contact region of the patella with the femur changes with the flexion angle of the knee. In the current case, the fracture occurred at a site where the patella was in contact with the femur at a flexion angle of >90°, so it is believed that it occurred as a clinical condition from being subjected to repeated longitudinal traction force and patellofemoral contact pressure at a flexion angle of >90°, during the sports activities of sprints and Kendo. The nonunion of the transverse stress fracture of his proximal patella was successfully treated with internal fixation using Acutrak screws. PMID:26871789

  1. Association between polymorphisms of apolipoprotein E, bone mineral density of the lower forearm, quantitative ultrasound of the calcaneus and osteoporotic fractures in postmenopausal women with hip or lower forearm fracture

    DEFF Research Database (Denmark)

    Sennels, Henriette Pia; Sand, J C; Madsen, B

    2003-01-01

    are contradictory. The aim of this study was to examine the association between polymorphisms of APOE, BMD of the lower forearm, quantitative ultrasound of the calcaneus and osteoporotic fractures in a population of postmenopausal women with hip or lower forearm fractures admitted to a department of orthopaedic...... surgery and age-matched controls from the population register. The APOE genotypes of 327 women were studied: 73 with lower forearm fractures, 43 with hip fractures and 211 age-matched controls. The participants were not receiving antiosteoporotic treatment. Polymerase chain reaction restriction fragment....... In conclusion, this study showed no association between bone mass parameters (BMD, speed of sound (SOS), broadband ultrasound attenuation (BUA)), hip or lower forearm fracture and APOE genotypes in a population of postmenopausal women and age-matched controls....

  2. Inexact proximal Newton methods for self-concordant functions

    DEFF Research Database (Denmark)

    Li, Jinchao; Andersen, Martin Skovgaard; Vandenberghe, Lieven

    2016-01-01

    We analyze the proximal Newton method for minimizing a sum of a self-concordant function and a convex function with an inexpensive proximal operator. We present new results on the global and local convergence of the method when inexact search directions are used. The method is illustrated...... matrices with chordal sparsity patterns are used to evaluate gradients and matrix-vector products with the Hessian of the smooth component of the objective....

  3. Pathological fractures of the proximal humerus treated with a proximal humeral locking plate and bone cement.

    Science.gov (United States)

    Siegel, H J; Lopez-Ben, R; Mann, J P; Ponce, B A

    2010-05-01

    Bone loss secondary to primary or metastatic lesions of the proximal humerus remains a challenging surgical problem. Options include preservation of the joint with stabilisation using internal fixation or resection of the tumour with prosthetic replacement. Resection of the proximal humerus often includes the greater tuberosity and adjacent diaphysis, which may result in poor function secondary to loss of the rotator cuff and/or deltoid function. Preservation of the joint with internal fixation may reduce the time in hospital and peri-operative morbidity compared with joint replacement, and result in a better functional outcome. We included 32 patients with pathological fractures of the proximal humerus in this study. Functional and radiological assessments were performed. At a mean follow-up of 17.6 months (8 to 61) there was no radiological evidence of failure of fixation. The mean revised musculoskeletal Tumour Society functional score was 94.6% (86% to 99%). There was recurrent tumour requiring further surgery in four patients (12.5%). Of the 22 patients who were employed prior to presentation all returned to work without restrictions. The use of a locking plate combined with augmentation with cement extends the indications for salvage of the proximal humerus with good function in patients with pathological and impending pathological fractures.

  4. Mechanical design of EFW Exo II: A hybrid exoskeleton for elbow-forearm-wrist rehabilitation.

    Science.gov (United States)

    Bian, Hui; Chen, Ziye; Wang, Hao; Zhao, Tieshi

    2017-07-01

    The use of rehabilitation exoskeleton has become an important means for the treatment of stroke patients. A hybrid exoskeleton named EFW Exo II is developed for the motor function rehabilitation of elbow, forearm and wrist. The EFW Exo II is based on a parallel 2-URR/RRS mechanism and a serial R mechanism. It could fit both left and right arms for the symmetrical and open structure, and the distance between the elbow and wrist could automatically adjust for different forearm length. Details of the mechanical design are introduced. Brushless DC servo motors with planetary gear reducer are used as the actuators of the exoskeleton. Gear drive and belt drive are used for power transmission. A three dimensional force sensor is mounted in the handle to regulate the interaction between the exoskeleton and patient. The EFW Exo II can realize rehabilitation exercise for each joint and the ranges of motion meet the rehabilitation demands of daily living.

  5. Estimation of height of an individual from forearm length on the population of Eastern India

    Directory of Open Access Journals (Sweden)

    Biswa Bhusan Mohanty1, Divya Agrawal1, Kunal Mishra2, Pusparaj Samantsinghar2, Prafulla Kumar Chinara1

    2013-08-01

    Full Text Available Height is a fundamental unit to assess growth and nutrition, for calculating body surface area and predicting pulmonary function in a person. But measurement of height may be hindered by muscle weakness, joint & spinal deformity. So, some alternative method should be there to measure height of a person in these cases. Also, when dismembered human fragments are encountered in scenes of mass disaster, the height of a person is to be calculated for identification. Estimation of stature from skeletal fragments is of great interest in forensic science. The aim of the current study is to find out a regression equation that could calculate the height of a person precisely and reproducibly from forearm length. 300 stu-dents (M = 206, F = 94 aged 18-25 years, who had no disability, were studied at SCB Medical College, Cuttack. Height & forearm lengths were measured. Prediction equation for height was de-rived using linear equation method.

  6. Characteristics and effectiveness of vasodilatory and pressor compensation for reduced relaxation time during rhythmic forearm contractions.

    Science.gov (United States)

    Bentley, Robert F; Poitras, Veronica J; Hong, Terrence; Tschakovsky, Michael E

    2017-06-01

    What is the central question of this study? Reduced relaxation time between contractions in exercise requires increased vasodilatation and/or pressor response to prevent hypoperfusion and potential compromise to exercise tolerance. However, it remains unknown whether and to what extent local vasodilatation and/or systemic pressor compensation occurs and whether the efficacy of compensation is exercise intensity dependent. What is the main finding and its importance? We demonstrate that in a forearm exercise model vasodilatory but not pressor compensation occurs and is adequate to prevent hypoperfusion below but not above ∼40% peak work rate. Inadequate compensation occurs with exercise still well inside the submaximal domain, despite a vasodilatory reserve, and compromises exercise performance. During muscle contraction in rhythmic exercise, muscle blood flow is significantly impeded by microvascular compression. The purpose of this study was to establish the nature and magnitude of vasodilatory and/or pressor compensatory responses during forearm exercise in the face of an increased duration of mechanical microvascular compression, and whether the effectiveness of such compensation was exercise intensity dependent. Seven healthy males (21.0 ± 1.8 years old) completed progressive forearm exercise (24.5 N every 3 min; 2 s contraction-4 s relaxation duty cycle) in two conditions: control (CON), 2 s 100 mmHg forearm cuff inflation during contraction; and impedance (IMP), extension of cuff inflation 2 s beyond contraction. Forearm blood flow (in millilitres per minute); brachial artery Doppler and echo ultrasound), mean arterial blood pressure (in millimetres of mercury; finger photoplethysmography) and exercising forearm venous effluent (antecubital vein catheter) measurements revealed an exercise intensity-dependent compensatory vasodilatation effectiveness whereby increased vasodilatation fully protected forearm blood flow up to the 30% exercise

  7. Results of Closed Intramedullary Nailing using Talwarkar Square Nail in Adult Forearm Fractures

    Directory of Open Access Journals (Sweden)

    Nadeem A Lil

    2012-07-01

    Full Text Available The aim of the study was to evaluate results of closed intramedullary nailing using Talwarkar square nails in adult forearm fractures. We prospectively evaluated 34 patients with both bone forearm fractures. The average time to union was 12.8 (SD +3.2 weeks with cast support for a mean of 8.2 weeks. Union was achieved in 31 out of 34 patients. Using the Grace and Eversmann rating system, 17 patients were excellent, 10 were good, and 4 had an acceptable result. Three patients had non-unions, 2 for the radius and one for the ulna. There were two cases of superficial infection, one subject had olecranon bursitis, and one case of radio-ulnar synostosis. Complication rates associated with the use of square nails were lower compared to plate osteosynthesis and locked intramedullary nails. To control rotation post- operatively, there is a need for application of an above-elbow cast after nailing.

  8. Chronic exertional compartment syndrome of the forearm: a case series of 12 patients treated with fasciotomy.

    Science.gov (United States)

    Brown, J S; Wheeler, P C; Boyd, K T; Barnes, M R; Allen, M J

    2011-06-01

    Chronic exertional compartment syndrome of the forearm is rare in the published literature. We report the outcome of a series of 12 patients treated with fasciotomy over a 14 year period. All patients underwent dynamic intra-compartmental pressure testing using a slit catheter technique before surgery. Raised intra-compartmental pressures on exercise, typical symptoms and the absence of other diagnoses were criteria for offering surgical intervention. The superficial flexor, deep flexor and extensor compartments were released. Median follow-up was 9.5 years (range 7 months to 12 years). Median patient-reported percentage improvement after surgery was 88% (range 0%-100%). Median time to return to full activity was 9 weeks. Eleven out of 12 patients were satisfied, very satisfied or extremely satisfied with the outcome of surgery. Fasciotomy can be an effective treatment for chronic exertional compartment syndrome of the forearm.

  9. Low-dose lidocaine intravenous regional anesthesia for forearm fractures in children.

    Science.gov (United States)

    Juliano, P J; Mazur, J M; Cummings, R J; McCluskey, W P

    1992-01-01

    Intravenous (i.v.) regional anesthesia with low-dose lidocaine (1 mg/kg) lidocaine 1% diluted to 0.125% vol) provided safe and effective anesthesia for closed reductions of pediatric forearm fractures in outpatients. This procedure was prospectively evaluated in 44 children at The Nemours Children's Clinic, Jacksonville, Florida. Forty-three of 44 patients achieved adequate anesthesia (minimal or no pain on closed reduction). No significant complications were noted. Both patients and physicians were satisfied with the procedure. Patient pain was objectively assessed with visual pain charts in the preanesthesic, immediate postanesthetic, and postreduction time periods. The technique was both safe and effective in providing pain relief for reduction of forearm fractures in children.

  10. Development of a novel pediatric forearm fracture treatment: simulation, prototype and evaluation

    Directory of Open Access Journals (Sweden)

    El-Shaffey Hala

    2017-09-01

    Full Text Available A treatment gap exists for moderately displaced pediatric distal forearm fractures (DFF, which carry a potential risk of improper reduction when treated conservatively. Currently, no standard method for the correction of the initial reduction of pediatric DFF is available. A novel closed reduction method has been proposed to correct and maintain a successful reduction throughout the healing process. This study further develops this novel cast system and evaluates its mechanical behavior through the design, construction, and testing of a biomechanical CAD model and pediatric forearm phantom. Initial results support the novel system as an improved treatment for pediatric fractures. Both the CAD model and tissue phantom indicate the ability of the system to manipulate a 15° fracture, with 0-1° of residual angulation.

  11. Thermogenic response to epinephrine in the forearm and abdominal subcutaneous adipose tissue

    DEFF Research Database (Denmark)

    Simonsen, L; Bülow, J; Madsen, J

    1992-01-01

    Whole body energy expenditure, thermogenic and metabolic changes in the forearm, and intercellular glucose concentrations in subcutaneous adipose tissue on the abdomen determined by microdialysis were measured during epinephrine infusion in healthy subjects. After a control period, epinephrine......-1 and increased to 0.586 +/- 0.445 and 0.760 +/- 0.534 mumol.100 g-1 x min-1 (P subcutaneous adipose tissue on the abdomen was equal to the arterial concentration in the basal period but did not increase as much during infusion of epinephrine......, indicating glucose uptake in adipose tissue in this condition. If it is assumed that forearm skeletal muscle is representative for the average skeletal muscle, it can be calculated that on average 40% of the enhanced whole body oxygen uptake induced by infusion of epinephrine is taking place in skeletal...

  12. Thermogenic response to adrenaline during restricted blood flow in the forearm

    DEFF Research Database (Denmark)

    Simonsen, L; Stefl, B; Christensen, N J

    1999-01-01

    To elucidate the underlying mechanism behind the thermogenic effect of adrenaline in human skeletal muscle, nine healthy subjects were studied during intravenous infusion of adrenaline. Restriction of blood flow to one forearm was obtained by external compression of the brachial artery, to separate...... a direct metabolic effect of adrenaline from an effect dependent on increased blood flow. The other arm served as the control arm. In the control arm, the forearm blood flow increased 4.7-fold (from 2.0 +/- 0.3 to 9.3 +/- 1.5 mL 100 g(-1) min(-1), P adrenaline infusion. Adrenaline...... not increase (baseline period: 5.6 +/- 2.3 micromol 100 g(-1) min(-1), adrenaline period: 6.1 +/- 2.1 micromol 100 g(-1) min(-1), P = 0.54). The experimental design and the difficulties in interpretation of the result are discussed. The results give evidence for the hypothesis that the vascular system plays...

  13. [The radio-ulnar unit. Its functional importance in fractures of both bones of the forearm].

    Science.gov (United States)

    Kapandji, A

    1998-01-01

    The forearm has been composed of two bones since our very old ancestor Ichthyostega, which settled on dry land 300 million years ago. The fish fins, transformed into legs, already comprised two bones, which only became useful much later. This "frame", composed of 2 bones rotating around a longitudinal axis, is the most "practical" mechanical solution to allow longitudinal rotation of the distal extremity, but this rectangle must be pliable in a diagonal plane by means of the two conjoint radioulnar joints and a flexible hinge, the interosseous membrane. This system can only function when certain conditions are respected: strict alignment of the axes and simultaneous functioning of the two joints, maintenance of the "coordinated" shape of the two bones, an intact system of union of the two bones and coaptation of the joints. These anatomical and functional devices may be compromised by many pathological conditions, which is why the pronation-supination function of the forearm is so important and so vulnerable.

  14. Use of anti-osteoporotic drugs in central Norway after a forearm fracture

    DEFF Research Database (Denmark)

    Hoff, Mari; Skurtveit, Svetlana; Meyer, Haakon E

    2015-01-01

    trends and odds ratio for treatment with AOD was estimated. Adherence was defined as medication possession ratio ≥ 80 %. RESULTS: The first year after the fracture, 11.2 % of the women and 2.7 % of the men were prevalent users, while 5.1 % and 1.2 %, respectively, were incident users of AOD......UNLABELLED: Use of anti-osteoporotic drugs (AOD) the first year after a forearm fracture in central Norway was low in the period 2005-2012. Women with fractures used more AOD compared to the general population only in 2006, 2007, and 2011. Female gender, age ≥ 60 years, use of glucocorticosteroids......, or ≥ 4 different drugs were associated with AOD use. PURPOSE: The primary aim of this study was to examine time trends in prevalence and incidence of AOD use the first year after a forearm fracture from 2005-2012. Further, secondary aims were to investigate if gender, the number of drugs used before...

  15. Immediate effects of forearm elastic and nonelastic taping on wrist flexor muscle and grip strength of normal adults.

    Science.gov (United States)

    Cha, Hyun-Gyu; Kim, Myoung-Kwon; Shin, Young-Jun

    2016-10-01

    [Purpose] The purpose of this study was to examine the effects of forearm elastic taping on grip and wrist flexor muscle strength. [Subjects and Methods] This was a single-blind, crossover study. This study selected 40 healthy subjects with no history of orthopedic disorders and was conducted after consent to participate was obtained. Grip and wrist flexor muscle strength of subjects were assessed by a handheld dynamometer and a Commander Muscle Tester, respectively, with forearm elastic taping or nonelastic taping. [Results] After application of forearm elastic taping, grip strength and wrist flexor muscle strength significantly increased compared with the nonelastic taping group. [Conclusion] Application of forearm elastic taping is considered to have positive effects on improving wrist and grip strength.

  16. Diminished insulin-mediated forearm blood flow and muscle glucose uptake in young men with low birth weight

    DEFF Research Database (Denmark)

    Sonne, M P; Højbjerre, L; Alibegovic, A C

    2009-01-01

    with venous occlusion plethysmography and intra-arterial infusions of adenosine and acetylcholine, before and during a hyperinsulinemic isoglycemic clamp. RESULTS: Forearm blood flow response to systemic hyperinsulinemia was diminished in LBW compared to controls (p

  17. Local forearm and whole-body respiratory quotient in humans after an oral glucose load: methodological problems

    DEFF Research Database (Denmark)

    Simonsen, L; Bülow, J; Madsen, Jan Lysgård

    1993-01-01

    the glucose load and had not returned to baseline level at the end of the experiment. Whole-body respiratory quotient (RQ) was, on average, 0.80 (SD 0.05) in the baseline condition and increased to a maximum of 0.91 (0.03) and then decreased to baseline level at the end of the experiment. The local forearm.......17) to 0.63 (0.17) 30 min after the glucose load (P experiments emphasize several methodological problems in the measurement of local forearm RQ. The whole-body RQ......The effects of an oral glucose load of 75 g on the local forearm and whole-body energy thermogenesis were measured in normal subjects during the 4 h after the glucose intake. Simultaneous assessment of substrate metabolism in the forearm was performed. Energy expenditure (EE) increased after...

  18. Tachyphylaxis of human forearm vascular responses does not occur rapidly after exposure to isoproterenol.

    Science.gov (United States)

    Stein, C M; Nelson, R; Deegan, R; He, H; Inagami, T; Frazer, M; Badr, K F; Wood, M; Wood, A J

    1995-06-01

    In vitro and limited in vivo data suggest that rapid desensitization of beta-adrenoceptor responses occurs after exposure to agonist. Tachyphylaxis to a beta-adrenoceptor agonist would represent a potentially important mechanism for the short-term regulation of vascular tone. The effects of a 4-hour infusion of 400 ng/min intra-arterial isoproterenol on forearm blood flow and presynaptic beta-adrenoceptor-mediated norepinephrine release were determined in eight healthy volunteers. Intra-arterial isoproterenol at 400 ng/min resulted in a significant increase in forearm blood flow in all eight subjects at all time points, with no evidence of tachyphylaxis. In fact, forearm blood flow after 4 hours of the isoproterenol infusion (22.8 +/- 3.3 mL/100 mL per minute) was significantly greater than after 7 minutes (14.6 +/- 2.8 mL/100 mL per minute), 15 minutes (15.4 +/- 2.4 mL/100 mL per minute), and 30 minutes (17.4 +/- 3.0 mL/100 mL per minute) of the infusion (P < .05). Similarly, presynaptic beta-adrenoceptor responses showed no evidence of tachyphylaxis, so forearm norepinephrine spillover values after 7 minutes (6.6 +/- 0.94 ng/min), 15 minutes (7.6 +/- 1.5 ng/min), and 4 hours (8.8 +/- 1.1 ng/min) of isoproterenol infusion were increased and similar. Minimal systemic effects were observed, and there was no evidence of tolerance, there being no difference in heart rate after 7 minutes (70.7 +/- 2.7 beats per minute) and 4 hours (72.2 +/- 3.6 beats per minute) of isoproterenol infusion.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Forearm Flexor Muscles in Children with Cerebral Palsy Are Weak, Thin and Stiff

    Directory of Open Access Journals (Sweden)

    Eva Pontén

    2017-04-01

    Full Text Available Children with cerebral palsy (CP often develop reduced passive range of motion with age. The determining factor underlying this process is believed to be progressive development of contracture in skeletal muscle that likely changes the biomechanics of the joints. Consequently, to identify the underlying mechanisms, we modeled the mechanical characteristics of the forearm flexors acting across the wrist joint. We investigated skeletal muscle strength (Grippit® and passive stiffness and viscosity of the forearm flexors in 15 typically developing (TD children (10 boys/5 girls, mean age 12 years, range 8–18 yrs and nine children with CP Nine children (6 boys/3 girls, mean age 11 ± 3 years (yrs, range 7–15 yrs using the NeuroFlexor® apparatus. The muscle stiffness we estimate and report is the instantaneous mechanical response of the tissue that is independent of reflex activity. Furthermore, we assessed cross-sectional area of the flexor carpi radialis (FCR muscle using ultrasound. Age and body weight did not differ significantly between the two groups. Children with CP had a significantly weaker (−65%, p < 0.01 grip and had smaller cross-sectional area (−43%, p < 0.01 of the FCR muscle. Passive stiffness of the forearm muscles in children with CP was increased 2-fold (p < 0.05 whereas viscosity did not differ significantly between CP and TD children. FCR cross-sectional area correlated to age (R2 = 0.58, p < 0.01, body weight (R2 = 0.92, p < 0.0001 and grip strength (R2 = 0.82, p < 0.0001 in TD children but only to grip strength (R2 = 0.60, p < 0.05 in children with CP. We conclude that children with CP have weaker, thinner, and stiffer forearm flexors as compared to typically developing children.

  20. Skin and muscle components of forearm blood flow in directly heated resting man.

    Science.gov (United States)

    Detry, J.-M. R.; Brengelmann, G. L.; Rowell, L. B.; Wyss, C.

    1972-01-01

    Changes in forearm muscle blood flow (FMBF) during direct whole-body heating were measured in 17 normal subjects using three different methods. We conclude that FMBF is not increased by direct whole-body heating. Since renal and splanchnic blood flow fall 30% under these conditions, maximal total skin blood flow in 12 previously studied subjects can be estimated from the rise in cardiac output to be 7.6 L/min (3.0-11.1 L/min).

  1. Topical Retinol Restores Type I Collagen Production in Photoaged Forearm Skin within Four Weeks

    Directory of Open Access Journals (Sweden)

    Min Sun

    2016-09-01

    Full Text Available Production of type I collagen (COL1, the major structural protein of the skin, declines during aging, leading to skin thinning and becoming fragile, which increases the risk of bruising and wound healing disorders in the elderly. Topical treatments that can restore COL1 synthesis and ultimately COL1 content in aged skin hold promise to improve skin health. Much effort has been spent on developing agents that can safely and effectively enhance COL1 synthesis in aged skin. However, how fast and to what extent COL1 production in aged skin can be enhanced by a topical treatment remains unclear. Herein, we investigated a four-week topical retinol (ROL treatment. A one-day occlusion of ROL (0.4% or vehicle was applied on photoaged forearms of elderly (>65 years old subjects once a week for four weeks. Vehicle was also applied on forearms of young (23–33 years subjects in the same manner. Skin samples were obtained one week after the last treatment and analyzed for COL1 synthesis. We found that the ROL treatment increased the level of COL1 mRNA (2.3-fold and proCOL1 protein (1.8-fold in photoaged forearms to levels similar to that of young forearms within four weeks. Our study proves the concept that reduced COL1 production in aged skin can be readily restored. In addition, our study provides an evidence-based foundation for developing COL1-enhancing topical agents, and establishes a reliable and practical efficacy test for evaluating such agents.

  2. Transient compartment syndrome of the forearm resulting from venous congestion from a tourniquet.

    Science.gov (United States)

    O'Neil, D; Sheppard, J E

    1989-09-01

    A case of transient compartment syndrome of the forearm resulting from faulty tourniquet function is described. The patient was followed with serial compartmental pressure measurements. Signs and symptoms subsided within a few hours of limb elevation. Thus, conservative care in the early stages may be therapeutic. Early recognition of tourniquet malfunction, systematic assessment of the source of engorgement, and prompt correction can avoid this post-operative complication.

  3. Chronic exertional compartment syndrome of the forearm: a case series of 12 patients treated with fasciotomy

    OpenAIRE

    Brown, J S; Wheeler, P C; Boyd, K T; Barnes, M R; Allen, M J

    2011-01-01

    Chronic exertional compartment syndrome of the forearm is rare in the published literature. We report the outcome of a series of 12 patients treated with fasciotomy over a 14 year period. All patients underwent dynamic intra-compartmental pressure testing using a slit catheter technique before surgery. Raised intra-compartmental pressures on exercise, typical symptoms and the absence of other diagnoses were criteria for offering surgical intervention. The superficial flexor, deep flexor and e...

  4. Non-contact strain measurement in the mouse forearm loading model using digital image correlation (DIC).

    Science.gov (United States)

    Begonia, Mark T; Dallas, Mark; Vizcarra, Bruno; Liu, Ying; Johnson, Mark L; Thiagarajan, Ganesh

    2015-12-01

    This study investigates the use of a non-contact method known as digital image correlation (DIC) to measure strains in the mouse forearm during axial compressive loading. A two camera system was adapted to analyze the medial and lateral forearm displacements simultaneously, and the derived DIC strain measurements were compared to strain gage readings from both the ulna and radius. Factors such as region-of-interest (ROI) location, lens magnification, noise, and out-of-plane motion were examined to determine their influence on the DIC strain measurements. We confirmed that our DIC system can differentiate ROI locations since it detected higher average strains in the ulna compared to the radius and detected compressive strains on medial bone surfaces vs. tensile strains on lateral bone surfaces. Interestingly, the DIC method also captured heterogeneity in surface strain fields which are not detectable by strain gage based methods. A separate analysis of the noise intrinsic to the DIC system also revealed that the noise constituted less than 4.5% of all DIC strain measurements. Furthermore, finite element (FE) simulations of the forearm showed that out-of-plane motion was not a significant factor that influenced DIC measurements. Finally, we observed that average DIC strain measurements can be up to 1.5-2 times greater than average strain gage readings on the medial bone surfaces. These findings suggest that strain experienced in the mouse forearm model by loading is better captured through DIC as opposed to strain gages, which as a result of being glued to the bone surface artificially stiffen the bone and lead to an underestimation of the strain response. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Immediate effects of forearm elastic and nonelastic taping on wrist flexor muscle and grip strength of normal adults

    OpenAIRE

    Cha, Hyun-Gyu; Kim, Myoung-Kwon; Shin, Young-Jun

    2016-01-01

    [Purpose] The purpose of this study was to examine the effects of forearm elastic taping on grip and wrist flexor muscle strength. [Subjects and Methods] This was a single-blind, crossover study. This study selected 40 healthy subjects with no history of orthopedic disorders and was conducted after consent to participate was obtained. Grip and wrist flexor muscle strength of subjects were assessed by a handheld dynamometer and a Commander Muscle Tester, respectively, with forearm elastic tapi...

  6. The effect of topically applied tissue expanders on radial forearm skin pliability: a prospective self-controlled study

    OpenAIRE

    Chung, Jeffson; Bonaparte, James P; Odell, Michael; Corsten, Martin

    2014-01-01

    Background The use of pre-operatively applied topical tissue expansion tapes have previously demonstrated increased rates of primary closure of radial forearm free flap donor sites. This is associated with a reduced cost of care as well as improved cosmetic appearance of the donor site. Unfortunately, little is known about the biomechanical changes these tapes cause in the forearm skin. This study tested the hypothesis that the use of topically applied tissue expansion tapes will result in an...

  7. Mobility of the forearm in the raccoon (Procyon lotor), raccoon dog (Nyctereutes procyonoides) and red panda (Ailurus fulgens)

    OpenAIRE

    KAMIOKA, Minao; SASAKI, Motoki; YAMADA, Kazutaka; ENDO, Hideki; OISHI, Motoharu; YUHARA, Kazutoshi; TOMIKAWA, Sohei; SUGIMOTO, Miki; OSHIDA, Tatsuo; KONDOH, Daisuke; KITAMURA, Nobuo; 佐々木, 基樹; 押田, 龍夫; 近藤, 大輔; 北村, 延夫

    2017-01-01

    The ranges of pronation/supination of forearms in raccoons, raccoon dogs and red pandas were nondestructively examined. Three carcasses of each species were used for CT analysis, and the left forearms were scanned with a CT scanner in two positions: maximal supination and maximal pronation. Scanning data were reconstructed into three-dimensional images, cross-sectional images were extracted at the position that shows the largest area in the distal part of ulna, and then, the centroids of each...

  8. Rectal temperature, distal sweat rate, and forearm blood flow following mild exercise at two phases of the circadian cycle.

    Science.gov (United States)

    Waterhouse, Jim; Aizawa, Seika; Nevill, Alan; Edwards, Benjamin; Weinert, Dietmar; Atkinson, Greg; Reilly, Thomas

    2007-01-01

    Changes in rectal temperature during mild exercise in the middle of the rising (11:00 h) and falling (23:00 h) phases of the circadian rhythm of resting core temperature have been compared. Seven healthy males were studied at rest, while exercising on a cycle ergometer (60 min at 80 W), and during the first 30 min of recovery. Rectal temperature, forearm blood flow, and forearm sweat rate were measured at 1 min intervals throughout. During exercise, there were significant time-of-day differences in the profiles of all three variables, and in the thresholds for increases in forearm blood flow and sweating. Forearm blood flow and sweat rate were recruited more rapidly and to a greater extent with evening exercise, and rectal temperature rose less. Analysis of covariance, with rectal temperature as the covariate, indicated the associations between it and forearm blood flow or sweating were significantly different (ptimes of day. There were also significant (ptime-of-day effects for forearm blood flow and sweating that were independent of rectal temperature. During recovery, rectal temperature fell more quickly in the late evening than late morning. Forearm blood flow and sweating also showed time-of-day differences, but these did not co-vary with rectal temperature. Control of rectal temperature during exercise and recovery appears to be more effective in the late evening than late morning, and differences in forearm blood flow and sweating, as well as factors independent of these two variables, contribute to this difference. The results support our "heat-gain/heat-loss modes" hypothesis.

  9. A comparison of intervention and conservative treatment for angulated fractures of the distal forearm in children (AFIC): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Adrian, Miriam; Wachtlin, Daniel; Kronfeld, Kai; Sommerfeldt, Dirk; Wessel, Lucas M

    2015-09-30

    Angulated fractures of the distal forearm are very frequent lesions in childhood. Currently, there are no standard guidelines on whether these children should be treated conservatively with a cast; with reduction and a cast; or with reduction, pinning and a cast under anesthesia. Minor prospective and retrospective studies have shown that the distal physis of the forearm possesses high remodeling capacity leading to reliable correction of malalignment. The aim of this trial is to answer the question about whether operative and conservative treatment show equivocal results. This is a prospective, multinational, multicenter, randomized, observer-blinded, actively controlled, parallel group trial, with 24 months of observation. The primary objective of this trial is to assess whether or not the long-term functional outcome in remodeling patients is inferior to patients receiving closed reduction and K-wire pinning. The trial should include 742 patients with acute fracture. The patients will be included in 30 medical centers in Germany, Switzerland and Austria. All patients 5 to 11 years of age presenting at the emergency department with an angulated distal fracture of the forearm will be randomized online after informed consent. The primary endpoint is the Cooney Score after 24 months. The secondary endpoint is the grade of radiological displacement at 12/24 months. Therapy of angulated fractures is a matter of intensive debate. Primary manipulation and pinning under general anesthesia is recommended in order to avoid malalignment. No major study has proven the advantage of manipulation and pinning over immobilization alone. Should remodeling appear to be a safe alternative, manipulation under general anesthesia, K-wire pinning and removal of pins could be avoided, thus sparing significant costs. DRKS00004874 , 30 October 2013.

  10. Diffusion-tensor MRI reveals the complex muscle architecture of the human forearm.

    Science.gov (United States)

    Froeling, Martijn; Nederveen, Aart J; Heijtel, Dennis F R; Lataster, Arno; Bos, Clemens; Nicolay, Klaas; Maas, Mario; Drost, Maarten R; Strijkers, Gustav J

    2012-07-01

    To design a time-efficient patient-friendly clinical diffusion tensor MRI protocol and postprocessing tool to study the complex muscle architecture of the human forearm. The 15-minute examination was done using a 3 T system and consisted of: T(1) -weighted imaging, dual echo gradient echo imaging, single-shot spin-echo echo-planar imaging (EPI) diffusion tensor MRI. Postprocessing comprised of signal-to-noise improvement by a Rician noise suppression algorithm, image registration to correct for motion and eddy currents, and correction of susceptibility-induced deformations using magnetic field inhomogeneity maps. Per muscle one to five regions of interest were used for fiber tractography seeding. To validate our approach, the reconstructions of individual muscles from the in vivo scans were compared to photographs of those dissected from a human cadaver forearm. Postprocessing proved essential to allow muscle segmentation based on combined T(1) -weighted and diffusion tensor data. The protocol can be applied more generally to study human muscle architecture in other parts of the body. The proposed protocol was able to visualize the muscle architecture of the human forearm in great detail and showed excellent agreement with the dissected cadaver muscles. Copyright © 2012 Wiley Periodicals, Inc.

  11. EFFECT OF USING WRIST ORTHOSES ON FOREARM FLEXOR AND EXTENSOR MUSCLE ACTIVATION.

    Science.gov (United States)

    Novais Van Petten, Adriana Maria Valladão; Ávila, Antônio Ferreira

    2010-01-01

    To investigate the effect of using wrist immobilization orthoses made from different materials, on activation of the flexor and extensor musculature of the forearm while performing specific tasks. Twenty-six adults, with an average age of 26.2 years, underwent the Jebsen-Taylor functional hand test and the grip strength test (Jamar(®) dynamometer) under three conditions: free hand, wearing a composite orthosis and wearing a thermoplastic orthosis. The tests were carried out using the dominant hand only. During the tests, surface electrodes were attached to the flexor and extensor muscles of the forearm to record the muscle electrical activity. The results obtained under the three conditions were compared and analyzed using the Wilcoxon statistical test. Significant differences in muscle activation were found between using the free hand and using any of the orthoses. There was no significant difference in muscle activation between the two types of orthosis. A decrease in activity of the extensor muscles of the forearm was observed during all the tasks, as well as an increase in activation of the flexor muscles with the use of the orthoses. These results are important for defining whether an orthosis should be prescribed during the rehabilitation process for a wide range of disorders, such as tendinitis of the flexors and extensors of the wrist and fingers, as well as for predicting the length of time for which these devices should be used.

  12. Forearm Skin Blood Flow After Kinesiology Taping in Healthy Soccer Players: An Exploratory Investigation.

    Science.gov (United States)

    Woodward, Kirsty A; Unnithan, Vish; Hopkins, Nicola D

    2015-10-01

    Kinesiology tape (KT) has become popular among athletes for both injury prevention and rehabilitation due to its reported therapeutic effects, including facilitation of lymphatic flow and enhanced peripheral blood flow. However, evidence to support such claims is insufficient. To determine whether KT improves skin blood flow (SkBF) responses in young, elite soccer players. Randomized crossover study. Research laboratory. Thirteen healthy, elite, adolescent male soccer players (age = 14.7 ± 0.6 years). Participants completed 2 experimental trials; during trial 1, the volar aspect of the dominant forearm was taped. Forearm SkBF was measured within the taped area and 3 cm lateral to the taped area. During trial 2, no tape was applied to either site. Both trials were performed within 7 days. Baseline and maximal thermally (42°C) stimulated SkBF responses were assessed using laser Doppler flowmetry. Continuously measured SkBF and derived mean arterial pressure obtained at 5-minute intervals were used to calculate cutaneous vascular conductance (CVC), the primary outcome measure. No differences were observed for baseline SkBF or CVC between trials or measurement sites. After local heating, no differences were evident for SkBF or CVC between trials or measurement sites. Our findings suggest that, in healthy, trained adolescent males, KT was not associated with increased forearm SkBF.

  13. Forearm muscle oxidative capacity index predicts sport rock-climbing performance.

    Science.gov (United States)

    Fryer, Simon; Stoner, Lee; Stone, K; Giles, D; Sveen, Joakim; Garrido, Inma; España-Romero, Vanesa

    2016-08-01

    Rock-climbing performance is largely dependent on the endurance of the forearm flexors. Recently, it was reported that forearm flexor endurance in elite climbers is independent of the ability to regulate conduit artery (brachial) blood flow, suggesting that endurance is not primarily dependent on the ability of the brachial artery to deliver oxygen, but rather the ability of the muscle to perfuse and use oxygen, i.e., skeletal muscle oxidative capacity. The aim of the study was to determine whether an index of oxidative capacity in the flexor digitorum profundus (FDP) predicts the best sport climbing red-point grade within the last 6 months. Participants consisted of 46 sport climbers with a range of abilities. Using near-infrared spectroscopy, the oxidative capacity index of the FDP was assessed by calculating the half-time for tissue oxygen resaturation (O2HTR) following 3-5 min of ischemia. Linear regression, adjusted for age, sex, BMI, and training experience, revealed a 1-s decrease in O2HTR was associated with an increase in red-point grade by 0.65 (95 % CI 0.35-0.94, Adj R (2)  = 0.53). Considering a grade of 0.4 separated the top four competitors in the 2015 International Federation Sport Climbing World Cup, this finding suggests that forearm flexor oxidative capacity index is an important determinant of rock-climbing performance.

  14. Supinated forearm is correlated with the onset of medial epicondylitis in professional slalom water-skiers

    Science.gov (United States)

    Rosa, Donato; Di Donato, Sigismondo Luca; Balato, Giovanni; D’Addona, Alessio; Schonauer, Fabrizio

    2016-01-01

    Summary Background prolonged and laborious activities involving wrists and forearms has been long associated with the onset of epicondylitis. Slalom water-skiing can be included in this category. The purpose of the study is to analyse the correlation between the pronated or supinated position of forearms during water-skiing practice and the presence respectively of lateral and medial epicondylitis. Methods sixty-six pro and semi-pro slalom water-skiers were enrolled in the study. A questionnaire was submitted to each athlete. Diagnosis of lateral or medial epicondylitis was made through anamnesis and clinical exam by an expert orthopaedic surgeon. Chi-squared were performed for categorical variables, and Mann-Whitney U test for continuous ones. Results from 116 upper limbs examined, we observed 15 (12.9%) cases of lateral epicondylitis, 30 (25.9%) cases of medial epicondylitis, 10 (8.6%) were affected by both lateral and medial epicondylitis. Lateral and medial epicondylitis were associated (95% C.I.=2,489–26,355; P=slalom water-skiing can be considered a high-risk sport for epicondylitis. In slalom water-skiers there is a correlation between development of lateral and medial epicondylitis in the same upper limb. Supinated position of forearms is strongly associated with the diagnosis of medial epicondylitis. PMID:27331043

  15. Forearm Skin Blood Flow After Kinesiology Taping in Healthy Soccer Players: An Exploratory Investigation

    Science.gov (United States)

    Woodward, Kirsty A.; Unnithan, Vish; Hopkins, Nicola D.

    2015-01-01

    Context Kinesiology tape (KT) has become popular among athletes for both injury prevention and rehabilitation due to its reported therapeutic effects, including facilitation of lymphatic flow and enhanced peripheral blood flow. However, evidence to support such claims is insufficient. Objective To determine whether KT improves skin blood flow (SkBF) responses in young, elite soccer players. Design Randomized crossover study. Setting Research laboratory. Patients or Other Participants Thirteen healthy, elite, adolescent male soccer players (age = 14.7 ± 0.6 years). Intervention(s) Participants completed 2 experimental trials; during trial 1, the volar aspect of the dominant forearm was taped. Forearm SkBF was measured within the taped area and 3 cm lateral to the taped area. During trial 2, no tape was applied to either site. Both trials were performed within 7 days. Main Outcome Measure(s) Baseline and maximal thermally (42°C) stimulated SkBF responses were assessed using laser Doppler flowmetry. Continuously measured SkBF and derived mean arterial pressure obtained at 5-minute intervals were used to calculate cutaneous vascular conductance (CVC), the primary outcome measure. Results No differences were observed for baseline SkBF or CVC between trials or measurement sites. After local heating, no differences were evident for SkBF or CVC between trials or measurement sites. Conclusions Our findings suggest that, in healthy, trained adolescent males, KT was not associated with increased forearm SkBF. PMID:26445024

  16. The Etiology and Treatment of the Softened Phallus after the Radial Forearm Osteocutaneous Free Flap Phalloplasty

    Directory of Open Access Journals (Sweden)

    Seok-Kwun Kim

    2012-07-01

    Full Text Available Background The radial forearm osteocutaneous free flap is considered to be the standardtechnique for penile construction. One year after their operation, most patients experience asoftened phallus, so that they suffer from difficulties in sexual intercourse. In this report, wepresent our experience with phalloplasty by radial forearm osteocutaneous free flap, as wellas an evaluation of the etiology and treatment of the softened phallus.Methods Between March 2005 and February 2010, 58 patients underwent phalloplastyby radial forearm osteocutaneous free flap. Most of their neophallus had been softenedsubjectively and among them, 12 patients who wanted correction were investigated. Weperformed repetitive fat injection, artificial dermis grafting, silicone rod insertion, and rib bonewith cartilaginous tip graft. Physical examination, plain radiograph, computed tomography,bone scintigraphy, and satisfaction scores were investigated.Results Most of the participants’ penises have been softened after phalloplasty, and the skinelasticity had been also decreased. On plain radiograph, the distal end of the bone was self-rounded;however, the bone shape of the neophallus had no significant interval changes or resorption.Computed tomography showed equivocal density of cortical bone. On bone scintigraphy, the bonemetabolism was active at 3 months postoperatively, and remained active 9 years postoperatively.Conclusions The use of a rib bone with cartilaginous tip graft could be an option for improvementof the softened phallus. Silicon rod insertion is also worth considering for rigidity of the softenedphallus. Decreased rigidity due to soft tissue atrophy could be alleviated with repeated fat injectionand artificial dermis grafting.

  17. Is wrist splint more effective than forearm band for lateral epicondylitis?

    Science.gov (United States)

    Meissner, Arturo; Vives, María Ignacia; Román, Javier; Meissner, Arturo

    2017-12-28

    Lateral epicondylitis is a common cause of lateral elbow pain. There are many treatments able to improvement symptoms, including orthotic devices. The main available orthosis are wrist splint and forearm band. However, it is not clear which one constitutes the best alternative for symptomatic treatment. To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We identified three systematic reviews including four studies overall, all of them randomized trials. With this evidence, we concluded there might be no difference in global measure of improvement and pain free grip strength between the forearm band and wrist splint, and it is not clear whether using a wrist splint decreases pain in comparison with a forearm band, because the certainty of the evidence is very low.

  18. Elastic stable intramedullary nailing in paediatric forearm fractures: the rate of open reduction and complications.

    Science.gov (United States)

    Makki, Daoud; Matar, Hosam E; Webb, Mark; Wright, David M; James, Leroy A; Ricketts, David M

    2017-09-01

    The aim of this study was to evaluate the rate of open reduction and complications of elastic stable intramedullary nailing (ESIN) in treating unstable diaphyseal forearm fractures in children. We performed a retrospective review of a consecutive series of 102 paediatric patients with a mean age of 9 years (range: 7-14 years) who underwent ESIN of unstable closed forearm fractures at three different centres. Closed reduction of one or both bones was achieved in 68 (67%) patients and open reduction was required in 34 (33%) patients. The rate of open reduction in single-bone fractures (52.2%) was significantly higher than that in both-bone fractures (27.8%) (P=0.04, Fisher's exact test). All the fractures united within 3 months. There were six refractures following nail removal. Five patients had superficial wound infections. Seven patients developed neuropraxia of the sensory branch of the radial nerve. All resolved spontaneously within 3 months of the surgery. ESIN is an effective technique in treating unstable diaphyseal forearm fractures. The need for open reduction should be decided promptly following failed attempts of closed reduction. Single-bone fractures are more likely to require open reduction than both-bone fractures. The radius should be reduced and stabilized first. If open reduction is required, this should be performed through a volar approach rather than a dorsal one.

  19. [A case of proximal type epithelioid sarcoma of the perineum].

    Science.gov (United States)

    Murashima, Takaya; Kamibeppu, Toyoharu; Hiromasa, Tukino; Mukai, Syoichiro; Kamoto, Toshiyuki

    2013-11-01

    Epithelioid sarcomas are rare soft tissue neoplasms which occur more often in young people. They tend to relapse, metastatize and show poor prognosis. Proximal-type epithelioid sarcomas arise from the more proximal part of body and are more malignant than distal-type epithelioid sarcomas. We present a case of proximal-type epithelioid sarcoma which occurred in the perineum. A 24-year-old male visited our hospital with the chief complaint of pain in the perineum. Computed tomography and magnetic resonance imaging showed a tumor 30×23×17 mm in diameter in the perineal region. The tumor was excised regionally and the pathological examination with immunohistochemical staining revealed that the tumor was proximal-type epithelioid sarcoma. The patient is free of recurrence and metastasis one year after local excision.

  20. Photoactivated In Vivo Proximity Labeling.

    Science.gov (United States)

    Beck, David B; Bonasio, Roberto

    2017-06-19

    Identification of molecular interactions is paramount to understanding how cells function. Most available technologies rely on co-purification of a protein of interest and its binding partners. Therefore, they are limited in their ability to detect low-affinity interactions and cannot be applied to proteins that localize to difficult-to-solubilize cellular compartments. In vivo proximity labeling (IPL) overcomes these obstacles by covalently tagging proteins and RNAs based on their proximity in vivo to a protein of interest. In IPL, a heterobifunctional probe comprising a photoactivatable moiety and biotin is recruited by a monomeric streptavidin tag fused to a protein of interest. Following UV irradiation, candidate interacting proteins and RNAs are covalently biotinylated with tight spatial and temporal control and subsequently recovered using biotin as an affinity handle. Here, we describe experimental protocols to discover novel protein-protein and protein-RNA interactions using IPL. © 2017 by John Wiley & Sons, Inc. Copyright © 2017 John Wiley & Sons, Inc.

  1. The Effects of Forearm Support on Upper Body for People in Front of Monitor: A Meta-Analysis.

    Science.gov (United States)

    Lyu, Jingtong; Wu, Xiaojing; Duan, Xin; Xiang, Zhou

    2015-01-01

    With the ever-growing number of people who work at visual display terminals, the work-related musculoskeletal disorders of the upper body are believed to be an important problem all over the world. The forearm support, which can keep the forearm and wrist in biomechanical posture, is a possible protective factor of the development of upper body syndrome. This meta-analysis examines the efficacy of forearm support in reducing upper body syndrome. The Cochrane Library, EMBASE, Ovid, ScienceDirect, SpringerLink, Google Scholar, CNKI database, and Wanfang database were searched from inception until May 29, 2013. Relevant studies were included after the screening of title, abstract, and the full text. Impact of bias was assessed independently by 2 authors. Four studies that met all the inclusion criteria were included finally. The combined results based on all studies suggested that statistically the forearm support had a nonsignificant effect on upper body syndrome (odds ratio [OR] = 0.70, 95% confidence interval [CI]: 0.49, 1.02). The result of subgroup analysis suggested that forearm support has a significant effect on neck or shoulder syndrome (OR = 0.70, 95% CI: 0.43, 1.14) and the effect on upper extremity syndrome (OR = 0.76, 95% CI: 0.49, 1.19) is not significant. This meta-analysis suggested that the forearm support had statistically nonsignificant effect on preventing upper body syndrome on the whole.

  2. Prox-1 Automated Proximity Operations

    Science.gov (United States)

    2016-01-13

    on demonstrating the functionality required to meet minimum mission success criteria. The minimum mission includes on- orbit spacecraft checkout of...also includes deployment of LightSail-B from the P-POD, and imaging of LightSail-B for 20 minutes as it recedes from Prox-1. small satellite ; proximity...criteria. The minimum mission includes on- orbit spacecraft checkout of all spacecraft subsystems, including flight qualification of the following new

  3. Blood flow in the forearm in patients with Rheumatoid arthritis and healthy subjects under local thermotherapy

    Directory of Open Access Journals (Sweden)

    C. Mucha

    2002-02-01

    Full Text Available Objectives: Muscle blood flow in the forearm of patients with rheuma-toid arthritis and healthy volunteers following treatment with temperature increasingarm baths, mudpacks and short- or decimeter-wave diathermy was studied in thisinvestigation. The aim of the study was to find out the difference of reactive hyperemia between the different temperature methods as well as the influence on theconsensual reaction. Subjects: Eighty patients with rheumatoid arthritis, stage 3 according toSteinbrocker, as well as 80 healthy human subjects had been assigned numerically in the four therapy- and controlgroups. Patients with diseases influencing the peripheral blood flow were excluded. Design: Blood flow was measured by venous occlusion plethysmography in both forearms with the subjects lyingsupine. The application of the local heat therapies had been excluded on the left forearm. The forearm blood flow wasmonitored before heat therapy, directly after as well as in two further 10 minutes intervals. An analysis of variancewas used to determine the influence on blood flow of the response to the heat therapies in patients with rheumatoidarthritis and healthy subjects.Results: Under homogeneous starting conditions and a statistically uniformed high blood flow in rest the reactive values of blood flow on the left-hand side of application and the right consensual side showed high significant differencesbetween all methods of therapy. Differences between the patients and the healthy subjects only showed tendencies withpartially lower reactions, concerning the patients with rheumatoid arthritis. All methods of heat therapy caused a statistically provable consensual reaction that turned out smaller after diathermic methods. Here the post therapeuticreaction of the blood flow on the side of application was also lower or rather shorter. Conclusion: Greater differences of the blood flow in rest between the patients with rheumatoid arthritis and healthysubjects

  4. The inter-rater reliability of the modified finger goniometer for measuring forearm rotation.

    Science.gov (United States)

    Szekeres, Mike; MacDermid, Joy C; Birmingham, Trevor; Grewal, Ruby

    2016-01-01

    Prospective cohort study. To compare the inter-rater reliability of using a modified finger goniometer (MFG) for the measurement of isolated forearm rotation for patients with distal radius fractures to the currently accepted technique for isolated forearm measurement. The currently accepted method of forearm measurement requires the assessor to visually estimate vertical for the stationary arm and placement of the moveable arm while placing a straight edge along a curved surface. Inter-rater reliability may be limited as assessors may estimate the placement of the goniometer arms differently depending on their experience, posture, and even their positioning relative to the patient. Rather than continue to place a straight edge on a round surface, we evaluate a new technique using an MFG for measuring isolated forearm rotation. Patients with clinically healed distal radius fractures were enrolled in the study. Measurement of active forearm pronation and supination was recorded using 2 separate measurement techniques. These measurements were taken by 2 separate hand therapists with more than 10 years of clinical experience in a tertiary care setting at the beginning and end of hand therapy sessions for 3 consecutive weekly visits. Intraclass correlation coefficients (ICCs), standard error of measurement, and minimal detectable change were calculated for each technique. The point estimates for the MFG method demonstrated a slightly higher ICC than the standard method for pronation (0.86 vs 0.82). For supination, both measurement techniques displayed equally high pooled ICCs (0.95). The standard error of measurements for the MFG were 2.1 for pronation and 1.2 for supination compared with 2.9 (pronation) and 1.2 (supination) for the standard technique. These translate into 90% minimal detectable changes of 5° and 3° for the MFG pronation/supination compared with 7° (pronation) and 3° (supination) for the standard technique, respectively. Although the point

  5. Bicarbonate secretion by rabbit proximal colon.

    Science.gov (United States)

    Sullivan, S K; Smith, P L

    1986-10-01

    Stripped segments of proximal colon (1-6 cm distal to the ampulla caecalis coli) were studied in vitro in Ussing chambers under short-circuit conditions using the pH-stat technique. With glucose and HCO3-CO2 present in the serosal bathing solution only, proximal colon alkalinizes the luminal bathing solution at a rate of 2.1 +/- 0.2 mu eq X h-1 X cm-2 (n = 36). With HCO3-CO2 present in the luminal bathing solution alone, proximal colon does not significantly acidify or alkalinize the serosal bathing solution. Addition of glucose (10 mM) to the luminal bathing solution abolished luminal alkalinization. Removal of HCO3 and CO2 from the serosal bathing solution or replacement of O2 with N2 also abolished luminal alkalinization. Acetazolamide (0.1 mM) added to both bathing solutions did not alter the rate of luminal alkalinization. Ion-replacement studies revealed that the alkalinization process was highly dependent on the presence of Na in the bathing solutions and much less dependent on the presence of Cl. Furthermore, ouabain (0.1 mM) significantly reduced luminal alkalinization. As in rabbit ileum, serosal epinephrine (0.1 mM) did not alter luminal alkalinization but increased serosal alkalinization by a Na-dependent mechanism. These results suggest that luminal alkalinization results from a Na-dependent, active transcellular HCO3 transport process and that a Na-dependent HCO3 absorptive process is activated by adrenergic stimuli.

  6. The effect of forearm posture on wrist flexion in computer workers with chronic upper extremity musculoskeletal disorders

    Directory of Open Access Journals (Sweden)

    Thompson R Terry

    2008-04-01

    Full Text Available Abstract Background Occupational computer use has been associated with upper extremity musculoskeletal disorders (UEMSDs, but the etiology and pathophysiology of some of these disorders are poorly understood. Various theories attribute the symptoms to biomechanical and/or psychosocial stressors. The results of several clinical studies suggest that elevated antagonist muscle tension may be a biomechanical stress factor. Affected computer users often exhibit limited wrist range of motion, particularly wrist flexion, which has been attributed to increased extensor muscle tension, rather than to pain symptoms. Recreational or domestic activities requiring extremes of wrist flexion may produce injurious stress on the wrist joint and muscles, the symptoms of which are then exacerbated by computer use. As these activities may involve a variety of forearm postures, we examined whether changes in forearm posture have an effect on pain reports during wrist flexion, or whether pain would have a limiting effect on flexion angle. Methods We measured maximum active wrist flexion using a goniometer with the forearm supported in the prone, neutral, and supine postures. Data was obtained from 5 subjects with UEMSDs attributed to computer use and from 13 control subjects. Results The UEMSD group exhibited significantly restricted wrist flexion compared to the control group in both wrists at all forearm postures with the exception of the non-dominant wrist with the forearm prone. In both groups, maximum active wrist flexion decreased at the supine forearm posture compared to the prone posture. No UEMSD subjects reported an increase in pain symptoms during testing. Conclusion The UEMSD group exhibited reduced wrist flexion compared to controls that did not appear to be pain related. A supine forearm posture reduced wrist flexion in both groups, but the reduction was approximately 100% greater in the UEMSD group. The effect of a supine forearm posture on wrist

  7. PROXIMATE AND ELEMENTAL COMPOSITION OF WHITE GRUBS

    African Journals Online (AJOL)

    DR. AMINU

    PROXIMATE AND ELEMENTAL COMPOSITION OF WHITE GRUBS. 1 Alhassan, A. J. 1M .S. Sule, 1J. ... ABSTRACT. This study determined the proximate and mineral element composition of whole white grubs using standard methods of analysis. Proximate ... days, before pulverized to powder and kept in plastic container.

  8. Optical proximity correction: a first look at manufacturability

    Science.gov (United States)

    Liebmann, Lars W.; Grenon, Brian J.; Lavin, Mark A.; Schomody, Stephen; Zell, Thomas

    1994-12-01

    The feasibility of large scale optical proximity correction with a focus on mask manufacturability is demonstrated on the support and logic gates of a leading edge 64 Mb DRAM chip. Analysis of post reactive ion etch SEM data of the 500 - 600 nm, DUV exposed gates indicates two major contributors to across chip line width variation: first order proximity, that is, the minimum spacing to the nearest neighboring structure, and local area density or pattern loading. Data presented show a very long range (approximately equals 1 mm) impact of pattern density on post reactive ion etch line widths, favoring optical proximity correction approaches that are not based on biasing patterns to compensate for these effects. In this project, pattern density induced effects were alleviated by homogenizing the pattern loading across the chip to approximately 50% instead of biasing the gate structures to compensate for pattern density differences. Proximity induced effects were compensated for with a one- dimensional, single parameter (distance to nearest neighbor), four bucket proximity correction routine with a strong focus on mask manufacturability. Even though the unbiased 64 Mb DRAM gate level challenges mask makers with 480 MB of MEBES data, the optical proximity corrected mask posed no substantial post-processing, writing, or inspection problems in IBM's Burlington, Vermont maskhouse. A very significant 80% reduction in post reactive ion etch across chip line width variation was achieved with this corrected mask.

  9. Psychological responses to the proximity of climate change

    Science.gov (United States)

    Brügger, Adrian; Dessai, Suraje; Devine-Wright, Patrick; Morton, Thomas A.; Pidgeon, Nicholas F.

    2015-12-01

    A frequent suggestion to increase individuals' willingness to take action on climate change and to support relevant policies is to highlight its proximal consequences, that is, those that are close in space and time. But previous studies that have tested this proximizing approach have not revealed the expected positive effects on individual action and support for addressing climate change. We present three lines of psychological reasoning that provide compelling arguments as to why highlighting proximal impacts of climate change might not be as effective a way to increase individual mitigation and adaptation efforts as is often assumed. Our contextualization of the proximizing approach within established psychological research suggests that, depending on the particular theoretical perspective one takes on this issue, and on specific individual characteristics suggested by these perspectives, proximizing can bring about the intended positive effects, can have no (visible) effect or can even backfire. Thus, the effects of proximizing are much more complex than is commonly assumed. Revealing this complexity contributes to a refined theoretical understanding of the role that psychological distance plays in the context of climate change and opens up further avenues for future research and for interventions.

  10. A comparison of conventional intraoral radiography and computer imaging techniques for the detection of proximal surface calculus

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Byung Cheol [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Chonnam National University, Kwangju (Korea, Republic of)

    1994-02-15

    The present results indicates that the sensitivity for the proximal calculus was high, but there are different sensitivities among the observer. More study should be done to determine that digitized image can be clinical applicable to detecting the proximal calculus.

  11. Demonstration of automated proximity and docking technology

    Science.gov (United States)

    Anderson, Robert L.; Tsugawa, Roy K.; Bryan, Thomas C.

    1991-01-01

    Automated spacecraft docking operations are being performed using a full scale motion based simulator and an optical sensor. This presentation will discuss the work in progress at TRW and MSFC facilities to study the problem of automated proximity and docking operations. The docking sensor used in the MSFC Optical Sensor and simulation runs are performed using the MSFC Flat Floor Facility. The control algorithms and six degrees of freedom (6DOF) simulation software were developed at TRW and integrated into the MSFC facility. Key issues being studied are the quantification of docking sensor requirements and operational constraints necessary to perform automated docking maneuvers, control algorithms capable of performing automated docking in the presence of sensitive and noisy sensor data, and sensor technologies for automated proximity and docking operations. As part of this study the MSFC sensor characteristics were analyzed and modeled so that off line simulation runs can be performed for control algorithm testing. Our goal is to develop and demonstrate full 6DOF docking capabilities with actual sensors on the MSFC motion based simulator. We present findings from actual docking simulation runs which show sensor and control loop performance as well as problem areas which require close attention. The evolution of various control algorithms using both phase plane and Clohessy-Wiltshire techniques are discussed. In addition, 6DOF target acquisition and control strategies are described.

  12. Laparoscopic proximal gastrectomy with oblique jejunogastrostomy.

    Science.gov (United States)

    Tanaka, Kimitaka; Ebihara, Yuma; Kurashima, Yo; Nakanishi, Yoshitsugu; Asano, Toshimichi; Noji, Takehiro; Murakami, Soichi; Nakamura, Toru; Tsuchikawa, Takahiro; Okamura, Keisuke; Shichinohe, Toshiaki; Hirano, Satoshi

    2017-05-10

    Proximal early gastric cancer is a good indication for totally laparoscopic proximal gastrectomy (TLPG) with double-tract reconstruction (DTR). However, when most of the dietary intake passes through the escape route of the jejunum, the functional benefits of proximal gastrectomy might be similar to those after total gastrectomy. Our DTR procedure was improved for easy passage through the remnant stomach. The purposes of this study were to present a novel technique for intracorporeal DTR using linear staplers after TLPG and to investigate surgical outcomes. DTR was performed using linear staplers only. A side-to-side jejunogastrostomy with twisting of both the remnant stomach and the anal jejunum was performed for the purpose of passing meals through the remnant stomach (an oblique jejunogastrostomy technique). The ten patients who underwent TLPG with DTR from January 2011 to August 2016 in Hokkaido University Hospital were retrospectively reviewed. Their clinicopathological characteristics and surgical and postoperative outcomes were collected and analyzed. The median duration of operation was 285 (range 146-440) min. No patients required blood transfusions. The number of dissected lymph nodes was 32 (range 22-56). There were no intraoperative complications, and no cases were converted to open surgery. All the patients were pT1N0M0 stage IA. No anastomotic leakage or complications were detected. Postoperative gastrography after reconstruction showed that contrast medium flowed mainly to the remnant stomach. The average percentage body weight loss was 14.0 ± 7.1% at 10 months. The average percentage decrease in serum hemoglobin was 5.4 ± 10.4% at 12 months. This novel technique for intracorporeal DTR provided a considerable advantage by the passage of dietary intake to the remnant stomach after LPG.

  13. Volkmann's ischemia. A volar compartment syndrome of the forearm.

    Science.gov (United States)

    Eaton, R G; Green, W T

    1975-01-01

    In a series of 19 patients with Volkmann's iscemia, 63 per cent had suffered skeletal trauma, whereas 38 per cent had received non-skeletal trauma. Non-specific trauma may trigger an ischemia-edema cycle, producing increased intracompartmental pressure. This cycle, if unrelieved, can involve all of the muscles in the compartment, via cyclic propagation and reinforcement of arterial spasm. The volar compartmental syndrome is not an all or none phenomenon. Localized ischemia may trigger a gradually spreading arterial spasm which results in slowly progressive clinical changes as late as 3-4 months after onset. Decompression not only of the compartment but of each individual muscle which shows evidence of vascular compromise, may reverse this destructive cycle even as late as 3-4 months but it should be performed promptly with the onset of symptoms, when its effect is rapid and dramatic. Induration of the compartment is pathognomonic of the compartmental syndrome. As long as it is present, benefit can be expected from decompression procedures. Regeneration of necrotic ischemic muscle is possible following restoration of circulation.

  14. Finger Proximal Interphalangeal Joint Dislocation.

    Science.gov (United States)

    Ramponi, Denise; Cerepani, Mary Jo

    2015-01-01

    Finger dislocations are common injuries that are often managed by emergency nurse practitioners. A systematic physical examination following these injuries is imperative to avoid complications. Radiographic views, including the anteroposterior, lateral, and oblique views, are imperative to evaluate these finger dislocations. A dorsal dislocation of the proximal interphalangeal (PIP) joint is the most common finger dislocation type often easily reduced. A volar PIP dislocation can often be difficult to reduce and may result in finger deformity. Finger dislocations should be reduced promptly. Referral to an orthopedic hand specialist is required if the dislocation is unable to be reduced or if the finger joint is unstable following reduction attempts.

  15. Equilibrium properties of proximity effect

    Energy Technology Data Exchange (ETDEWEB)

    Esteve, D.; Pothier, H.; Gueron, S.; Birge, N.O.; Devoret, M.

    1996-12-31

    The proximity effect in diffusive normal-superconducting (NS) nano-structures is described by the Usadel equations for the electron pair correlations. We show that these equations obey a variational principle with a potential which generalizes the Ginzburg-Landau energy functional. We discuss simple examples of NS circuits using this formalism. In order to test the theoretical predictions of the Usadel equations, we have measured the density of states as a function of energy on a long N wire in contact with a S wire at one end, at different distances from the NS interface. (authors). 12 refs.

  16. Complications and radiographic outcome of children's both-bone diaphyseal forearm fractures after invasive and non-invasive treatment.

    Science.gov (United States)

    Sinikumpu, Juha-Jaakko; Lautamo, Anu; Pokka, Tytti; Serlo, Willy

    2013-04-01

    The incidence of paediatric forearm fractures and their invasive operative treatment is increasing. Evidence supporting increased interest in internal fixation of forearm fractures has been controversial. We studied radiographic outcome and complications of both-bone diaphyseal middle-third forearm fractures according to the type of treatment. The purpose of the study was to determine if there is an advantage in invasive treatment over non-invasive treatment that supports the increasing trend towards invasive surgery. All children and adolescents (forearm fractures in a geographic area with 86,000 children in 2000-2009 were included. There were 168 patients. The types of primary fractures and their malalignment and displacement rates were analysed. The fractures were classified as 'severe' or 'mild' according to radiographic findings. Radiographic fracture healing and alignment and the rate of complications were compared as regards invasive versus non-invasive surgery. Just over a third of all patients suffered from some complication during follow-up. The overall complication rate was highest in the non-invasive treatment group (58%) and lowest in the intramedullary nailing group (24%) (P compartmental syndrome were not problems in the study population despite the type of treatment. We found that the complication rate of diaphyseal forearm fractures was twice as common after non-invasive than after invasive treatment. The need of re-reduction after non-invasive treatment was remarkable. Nevertheless, bone healing was equally good despite the treatment. We conclude that intramedullary fixation of both-bone forearm fractures is a good mode of primary treatment of mild and severe middle-third diaphyseal both-bone forearm fractures. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Inter-individual difference in the effect of mirror reflection-induced visual feedback on phantom limb awareness in forearm amputees.

    Science.gov (United States)

    Kawashima, Noritaka; Mita, Tomoki; Yoshikawa, Masahiro

    2013-01-01

    To test whether the phantom limb awareness could be altered by observing mirror reflection-induced visual feedback (MVF) in unilateral forearm amputees. Ten unilateral forearm amputees were asked to perform bilateral (intact and phantom) synchronous wrist motions with and without MVF. During wrist motion, electromyographic activities in the extensor digitorum longus (EDL) and flexor carpi radialis muscles (FCR) were recorded with bipolar electrodes. Degree of wrist range of motion (ROM) was also recorded by electrogoniometry attached to the wrist joint of intact side. Subjects were asked to answer the degree of attainment of phantom limb motion using a visual analog scale (VAS: ranging from 0 (hard) to 10 (easy)). VAS and ROM were significantly increased by utilizing MVF, and the extent of an enhancement of the VAS and wrist ROM was positively correlated (r = 0.72, pphantom limb awareness, MVF has a potential to enhance phantom limb awareness, in case those who has a difficulty for the phantom limb motion. The present result suggests that the motor command to the missing limb can be re-activated by an appropriate therapeutic strategy such as mirror therapy.

  18. Ontogeny of rabbit proximal tubule urea permeability

    Science.gov (United States)

    QUIGLEY, RAYMOND; LISEC, AMBER; BAUM, MICHEL

    2014-01-01

    Urea transport in the proximal tubule is passive and is dependent on the epithelial permeability. The present study examined the maturation of urea permeability (Purea) in in vitro perfused proximal convoluted tubules (PCT) and basolateral membrane vesicles (BLMV) from rabbit renal cortex. Urea transport was lower in neonatal than adult PCT at both 37 and 25°C. The PCT Purea was also lower in the neonates than the adults (37°C: 45.4 ± 10.8 vs. 88.5 ± 15.2 × 10−6 cm/s, P 0.05). The activation energy for PCT Purea was not different between the neonatal and adult groups. BLMV Purea was determined by measuring vesicle shrinkage, due to efflux of urea, using a stop-flow instrument. Neonatal BLMV Purea was not different from adult BLMV Purea at 37°C [1.14 ± 0.05 × 10−6 vs. 1.25 ± 0.05 × 10−6 cm/s; P = not significant (NS)] or 25°C (0.94 ± 0.06 vs. 1.05 ± 0.10 × 10−6 cm/s; P = NS). There was no effect of 250 μM phloretin, an inhibitor of the urea transporter, on Purea in either adult or neonatal BLMV. The activation energy for urea diffusion was also identical in the neonatal and adult BLMV. These findings in the BLMV are in contrast to the brush-border membrane vesicles (BBMV) where we have previously demonstrated that urea transport is lower in the neonate than the adult. Urea transport is lower in the neonatal proximal tubule than the adult. This is due to a lower rate of apical membrane urea transport, whereas basolateral urea transport is the same in neonates and adults. The lower Purea in neonatal proximal tubules may play a role in overall urea excretion and in developing and maintaining a high medullary urea concentration and thus in the ability to concentrate the urine during renal maturation. PMID:11353675

  19. Proximate composition and basic phytochemical assessment of two ...

    African Journals Online (AJOL)

    Administrator

    The nut of the yellow variety had terpenoids and steroids present in it while the nut of the red variety had alkaloids present. Statistical analyses carried out showed that there were no significant differences (p≤0.05) between the two varieties based on their proximate composition. INTRODUCTION. Terminalia catappa is ...

  20. No impaired hemoglobin oxygenation in forearm muscles of patients with chronic CRPS-1.

    Science.gov (United States)

    Brunnekreef, Jaap J J; Oosterhof, Jan; Wolff, André P; Crul, Ben J P; Wilder-Smith, Oliver H G; Oostendorp, Rob A B

    2009-01-01

    Physiotherapy is considered an important treatment option in patients with upper limb complex regional pain syndrome type-1 (CRPS-1). In case of chronic CRPS-1, exercise therapy of the affected limb forms an important part of the physiotherapeutic program. We investigated whether muscle loading in chronic CRPS-1 patients is associated with impairments in muscle circulation of the forearm of the affected limb. Thirty patients with chronic CRPS-1 unilaterally affecting their upper limbs, and 30 age-matched and sex-matched control participants were included in this study. Local muscle blood flow and hemoglobin oxygenation were measured by near infrared spectroscopy within the muscles of the forearm at rest, after 1-minute isometric handgrip exercises, and after arterial occlusion. Main outcome parameters were: local muscle blood flow, O2 consumption (mVO2), and postischemic reoxygenation (ReOx). We found no differences in baseline muscle blood flow, mVO2, and ReOx between the affected CRPS-1, unaffected CRPS-1, and control arms. After exercise, mVO2 of the affected CRPS-1 arms was not different from the clinically unaffected CRPS-1 arms. Furthermore, in comparison with the control arms, unaffected CRPS-1 arms showed no difference in mVO2 or ReOx. Muscle loading does not seems to be related to impairments in muscle oxygen uptake in forearm muscles of upper limbs affected by chronic CRPS-1. Our results suggest that exercise therapy can be safely used in physiotherapeutic training programs for chronic CRPS-1 of the upper limb.

  1. Forearm Muscle Volumes Can Be Accurately Quantified From High Resolution Magnetic Resonance Imaging (MRI)

    Science.gov (United States)

    Eng, Carolyn M.; Abrams, Geoff D.; Smallwood, Laura R.; Lieber, Richard L.; Ward, Samuel R.

    2007-01-01

    Upper extremity musculoskeletal modeling is becoming increasingly sophisticated, creating a growing need for subject-specific muscle size parameters. One method for determining subject-specific muscle volume is magnetic resonance imaging (MRI). The purpose of this study was to determine the validity of MRI-derived muscle volumes in the human forearm across a variety of muscle sizes and shapes. Seventeen cadaveric forearms were scanned using a fast spoiled gradient echo pulse sequence with high isotropic spatial resolution (1 mm3 voxels) on a 3T MR system. Pronator teres (PT), extensor carpi radialis brevis (ECRB), extensor pollicis longus (EPL), flexor carpi ulnaris (FCU), and brachioradialis (BR) muscles were manually segmented allowing volume to be calculated. Forearms were then dissected, muscles isolated, and muscle masses obtained, which allowed computation of muscle volume. Intraclass correlation coefficients (ICC2,1) and absolute volume differences were used to compare measurement methods. There was excellent agreement between the anatomical and MRI-derived muscle volumes (ICC = 0.97, relative error = 12.8%) when all 43 muscles were considered together. When individual muscles were considered, there was excellent agreement between measurement methods for PT (ICC = 0.97, relative error = 8.4%), ECRB (ICC = 0.93, relative error = 7.7%), and FCU (ICC = 0.91, relative error = 9.8%), and fair agreement for EPL (ICC = 0.68, relative error = 21.6%) and BR (ICC = 0.93, relative error = 17.2%). Thus, while MRI-based measurements of muscle volume produce relatively small errors in some muscles, muscles with high surface area-to-volume ratios may predispose them to segmentation error, and, therefore, the accuracy of these measurements may be unacceptable. PMID:17521657

  2. Muscle geometry affects accuracy of forearm volume determination by magnetic resonance imaging (MRI).

    Science.gov (United States)

    Eng, Carolyn M; Abrams, Geoff D; Smallwood, Laura R; Lieber, Richard L; Ward, Samuel R

    2007-01-01

    Upper extremity musculoskeletal modeling is becoming increasingly sophisticated, creating a growing need for subject-specific muscle size parameters. One method for determining subject-specific muscle volume is magnetic resonance imaging (MRI). The purpose of this study was to determine the validity of MRI-derived muscle volumes in the human forearm across a variety of muscle sizes and shapes. Seventeen cadaveric forearms were scanned using a fast-spoiled gradient echo pulse sequence with high isotropic spatial resolution (1mm(3) voxels) on a 3T MR system. Pronator teres (PT), extensor carpi radialis brevis (ECRB), extensor pollicis longus (EPL), flexor carpi ulnaris (FCU), and brachioradialis (BR) muscles were manually segmented allowing volume to be calculated. Forearms were then dissected, muscles isolated, and muscle masses obtained, which allowed computation of muscle volume. Intraclass correlation coefficients (ICC(2,1)) and absolute volume differences were used to compare measurement methods. There was excellent agreement between the anatomical and MRI-derived muscle volumes (ICC = 0.97, relative error = 12.8%) when all 43 muscles were considered together. When individual muscles were considered, there was excellent agreement between measurement methods for PT (ICC = 0.97, relative error = 8.4%), ECRB (ICC = 0.93, relative error = 7.7%), and FCU (ICC = 0.91, relative error = 9.8%), and fair agreement for EPL (ICC = 0.68, relative error = 21.6%) and BR (ICC = 0.93, relative error = 17.2%). Thus, while MRI-based measurements of muscle volume produce relatively small errors in some muscles, muscles with high surface area-to-volume ratios may predispose them to segmentation error, and, therefore, the accuracy of these measurements may be unacceptable.

  3. Risk factors for fractures of the distal forearm: a population-based case-control study.

    Science.gov (United States)

    Mallmin, H; Ljunghall, S; Persson, I; Bergström, R

    1994-11-01

    To evaluate the risk factors for early osteoporosis in consecutive patients with fracture of the distal forearm, a population-based case-control study was carried out using postal questionnaires supplemented by interviews when necessary. All men and women between the ages of 40 and 80 years who were resident in the County of Uppsala (population 265,000) and who sustained a fracture of the distal forearm during a defined 12-month period were initially included. Of 427 cases, 385 (90.2%) replied. Those with previous fragility fractures were excluded, leaving 367 patients in the study (mean age 61.9 +/- 10.6 years): 302 women (mean age 62.8 +/- 10.1 years) and 65 men (mean age 57.5 +/- 11.8 years). For each patient an age- and sex-matched control without previous fragility fractures was selected from the population register. The questionnaire concerned heredity, diseases and medications, general health, tobacco smoking and physical activity. Reproductive variables and postmenopausal hormone replacement therapy were analyzed extensively. In neither sex were any significant, consistent differences found with regard to chronic diseases, medications, physical activity or smoking. In females heredity for fractures (odds ratio, OR = 1.46) was associated with an increased risk. Nulliparous women had an increased risk of forearm fractures (OR = 1.72) while late menopause (OR = 0.95) and postmenopausal oestrogen therapy > 2 years (OR = 0.44) appeared to be protective. It is concluded that lifestyle factors did not discriminate between fracture patients and controls in this strict population-based investigation, suggesting that in affluent Western societies, with their high fracture rate, most individuals have an osteoporosis-prone way of life.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Are frequent radiographs necessary in the management of closed forearm fractures in children?

    Science.gov (United States)

    Bochang, Chen; Katz, Kalman; Weigl, Daniel; Jie, Yang; Zhigang, Wang; Bar-On, Elhanan

    2008-06-01

    A prospective pooled case series was used to assess the value of frequent radiographic examinations during treatment of closed forearm fractures in children from major university pediatric medical centers in Israel and China. The sample consisted of 202 consecutive children (mean age 7 years; range 3-12 years) with closed forearm fractures treated nonoperatively. Children with open, growth-plate fractures or fractures associated with dislocation of the nearby joint (i.e., monteggia fractures) were excluded. In 28 children who had torus fractures, radiographic examination was performed at the time of cast removal, 3 weeks after the start of treatment. In 63 children who had stable fractures that did not require reduction (undisplaced or minimally displaced, complete or greenstick), radiographic examination was performed 1 week after the start of treatment and again at cast removal 4-6 weeks later. In the remaining 111 children with complete, displaced, or greenstick fractures (all with angulation of more than 15 degrees ) who underwent closed reduction, an additional X-ray was taken 2 weeks after cast placement. All children (except those with torus fractures) were followed clinically, without further radiographic examination, for 3 months after cast removal. Radiographs at cast removal showed good union in all stable fractures, indicating that additional X-rays on cast removal would have had no added value. In the children with unstable fractures, only 9 showed redisplacement with angulation of more than 15 degrees on repeated X-rays during the first 2 weeks after cast placement. All 9 underwent successful re-reduction. On clinical evaluation 3 months after cast removal, all patients in the sample had full range of elbow and forearm motion. Repeated fracture did not occur in any of the patients. On the basis of these results, radiographs are recommended 2 weeks after cast placement for greenstick or complete fractures. At the time of cast removal, if clinical

  5. Effect of sport training on forearm bone sites in female handball and soccer players.

    Science.gov (United States)

    Boshnjaku, Arben; Dimauro, Ivan; Krasniqi, Ermira; Grazioli, Elisa; Tschan, Harald; Migliaccio, Silvia; DI Luigi, Luigi; Caporossi, Daniela

    2016-12-01

    The objective of this study was to evaluate the bone mineral density (BMD) and Z-score of a skeletal region, considered as weight-bearing site in trained handball players (HP), but as non-weight-bearing site in trained soccer players (SP). The bone health status of the same site was also analyzed in an untrained group (CG). BMD and Z-score at distal forearm regions (dominant, D; non-dominant, ND) were evaluated in 30 female HP and in 30 female SP, who have been training for 7.7±3.8 years, 17 hours per week, as well as in 30 females CG. Playing handball was associated with higher BMD of the skeleton at both measured sites than in CG. Also in comparison with SP, HPs' arms showed a significant increase in BMD. On the other hand, female SP have been reported to exhibit an enhanced ND arm BMD compared with controls. The benefits of exercise appeared to be significantly improved only in SP sub-group who started sport activity before or at menarche. These athletes showed at ND forearm a BMD 4% greater than those SP who started later, reaching a BMD of 11.6% higher than CG, a value similar to the corresponding in HP sub-group. Moreover, their D arm BMD was 7.1% higher compared with CG. This study indicates that, compared with non-trained subjects, long-term high-impact sport participation is associated with an higher bone health state, especially if the playing careers were started before or at menarche. This effect was observed at level of both forearms in HP, which are considered as weight-bearing sites for this discipline but also on the same skeletal regions of SP, which are not directly loaded by sport-related regular training.

  6. Comparison of Hybrid Fixation to Dual Plating for Both-Bone Forearm Fractures in Older Children.

    Science.gov (United States)

    Cai, Leyi; Wang, Jianshun; Du, Shenghu; Zhu, Shaoyu; Wang, Te; Lu, Di; Chen, Hua

    When operative stabilization of forearm fractures in older children is necessary, the optimal method of fixation is controversial. This study compared the radiographic and functional outcomes of dual plating to a hybrid fixation construct with elastic intramedullary nailing of the radius and plate fixation of the ulna of forearm fractures in children aged between 10 and 16 years. Nineteen patients were treated using a hybrid fixation construct and 13 patients were treated with dual plating fixation. The 2 groups were compared retrospectively according to perioperative data and patient outcome measures. The hybrid fixation construct group had 19, with a mean age of 13.3 years (range, 10-16 years) and the dual plate group had 13 patients, with a mean age of 12.9 years (range, 10-16 years). Groups were similar for sex, arm injured, and fracture location. Duration of surgery and tourniquet use was significantly shorter in the hybrid fixation construct group. There was no significant difference in either time to union or Price scores for function evaluation between the 2 groups. Complication rates were also similar between groups, with 1 ulna delayed unions, 1 superficial infection at entry of nail in hybrid fixation construct group, and 1 ulna delayed unions in the dual plating group. Hybrid fixation, using open reduction and internal fixation with a plate-and-screw construct on the ulna and closed reduction and elastic intramedullary fixation of the ulna, is an acceptable method for treating both-bone diaphyseal forearm fractures in skeletally immature patients aged 10-16 years.

  7. Local and remote thermoregulatory changes affect NIRS measurement in forearm muscles.

    Science.gov (United States)

    Messere, Alessandro; Roatta, Silvestro

    2015-11-01

    Near infrared spectroscopy (NIRS) assessment in skeletal muscle is potentially affected by circulatory changes occurring in superficial tissues. The aim of this study was to separately assess the interference from skin microcirculation and large vein blood flow by investigating the effect of selective local and remote warming-induced vasodilation, respectively. Blood volume and oxygenation changes were investigated in the forearm muscles of healthy subjects in two experimental series (ES) during selective forearm (ES1, n = 12) or hand warming (ES2, n = 10). In ES1, the response to muscle contraction (10 s, 70 % MVC) and occlusion before and after warming was also investigated, while in ES2 two NIRS probes were expressly positioned over a visible vein and over a vein-free area. Local warming increased the modified Beer-Lambert (BL) blood volume indicator, tHb, by 5.3 ± 3.6 µmol/L cm to an extent comparable to post-contraction hyperemia (6.8 ± 2.9 µmol/L cm, p < 0.01). Remote warming increased skin blood flow at the hand and tHb at both forearm sites (on average: 5.4 ± 4.8 µmol/L cm, p < 0.01). Conversely, indicators of blood volume and oxygenation, based on spatially resolved spectroscopy (SRS), were not affected by any of the warming stimuli. These results demonstrate for the first time that: (1) blood drained by superficial veins may affect BL measurement; (2) it is difficult to exclude veins from the measurement by simple visual inspection of the cutaneous surface; (3) SRS effectively rejects artifacts from superficial hemodynamic changes in both cutaneous microcirculation and large veins. These results bear implications to conditions in which thermoregulatory adjustments cannot be excluded.

  8. 6D.02: GHRELIN RESTORES NITRIC OXIDE AVAILABILITY IN THE FOREARM MICROCIRCULATION OF ESSENTIAL HYPERTENSIVE PATIENTS.

    Science.gov (United States)

    Virdis, A; Duranti, E; Lorenzini, G; Taddei, S

    2015-06-01

    Essential hypertensive patients (EH) are characterized by endothelial dysfunction caused by a reduced nitric oxide (NO) availability due to reactive oxygen species excess and low-grade inflammatory condition. Ghrelin is a recently identified growth hormone-releasing peptide, with recognized cardiovascular actions. Possible effects on endothelial dysfunction have been never investigated in EH. In this study we evaluated whether exogenous ghrelin can improve endothelial dysfunction in the forearm microcirculation of untreated mild-moderate EH. In 9 EH (51.8 ± 8.1 yrs) and 9 normotensive subjects (NS, 50.5 ± 3.5 yrs), we studied the forearm blood flow (FBF, strain-gauge plethysmography) response to intrabrachial acetylcholine (ACh, 0.15-15 mg/100 ml/min) with and without NO synthase blockade by L-NMMA (100 μg/100 ml/min), or the antioxidant vitamin (Vit) C (8 mg/100 ml/min). The protocol was repeated under exogenous ghrelin intra-arterial infusion (200 ng/min, 30' pre-infusion). In NS, the maximal vasodilation (VD) to ACh (480 ± 20%) was inhibited by L-NMMA (292 ± 22, -39 ± 7%; P Ghrelin failed to modify these vascular responses. In EH, VD to ACh was blunted vs NS (337 ± 45%; P Ghrelin, while not modifying the basal FBF, it increased (P ghrelin infusion (486 ± 45%). In EH ghrelin significantly (P sodium nitroprusside was similar between EH and NS and not affected by ghrelin. Exogenous ghrelin is able to increase endothelial dysfunction by restoring NO availability in the forearm microcirculation of EH, an effect probably determined by antioxidant and/or anti-inflammatory activities.

  9. Effect of repeated forearm muscle cooling on the adaptation of skeletal muscle metabolism in humans

    Science.gov (United States)

    Wakabayashi, Hitoshi; Nishimura, Takayuki; Wijayanto, Titis; Watanuki, Shigeki; Tochihara, Yutaka

    2017-07-01

    This study aimed to investigate the effect of repeated cooling of forearm muscle on adaptation in skeletal muscle metabolism. It is hypothesized that repeated decreases of muscle temperature would increase the oxygen consumption in hypothermic skeletal muscle. Sixteen healthy males participated in this study. Their right forearm muscles were locally cooled to 25 °C by cooling pads attached to the skin. This local cooling was repeated eight times on separate days for eight participants (experimental group), whereas eight controls received no cold exposure. To evaluate adaptation in skeletal muscle metabolism, a local cooling test was conducted before and after the repeated cooling period. Change in oxy-hemoglobin content in the flexor digitorum at rest and during a 25-s isometric handgrip (10% maximal voluntary construction) was measured using near-infrared spectroscopy at every 2 °C reduction in forearm muscle temperature. The arterial blood flow was occluded for 15 s by upper arm cuff inflation at rest and during the isometric handgrip. The oxygen consumption in the flexor digitorum muscle was evaluated by a slope of the oxy-hemoglobin change during the arterial occlusion. In the experimental group, resting oxygen consumption in skeletal muscle did not show any difference between pre- and post-intervention, whereas muscle oxygen consumption during the isometric handgrip was significantly higher in post-intervention than in pre-test from thermoneutral baseline to 31 °C muscle temperature ( P < 0.05). This result indicated that repeated local muscle cooling might facilitate oxidative metabolism in the skeletal muscle. In summary, skeletal muscle metabolism during submaximal isometric handgrip was facilitated after repeated local muscle cooling.

  10. Proteomics of Primary Cilia by Proximity Labeling.

    Science.gov (United States)

    Mick, David U; Rodrigues, Rachel B; Leib, Ryan D; Adams, Christopher M; Chien, Allis S; Gygi, Steven P; Nachury, Maxence V

    2015-11-23

    While cilia are recognized as important signaling organelles, the extent of ciliary functions remains unknown because of difficulties in cataloguing proteins from mammalian primary cilia. We present a method that readily captures rapid snapshots of the ciliary proteome by selectively biotinylating ciliary proteins using a cilia-targeted proximity labeling enzyme (cilia-APEX). Besides identifying known ciliary proteins, cilia-APEX uncovered several ciliary signaling molecules. The kinases PKA, AMPK, and LKB1 were validated as bona fide ciliary proteins and PKA was found to regulate Hedgehog signaling in primary cilia. Furthermore, proteomics profiling of Ift27/Bbs19 mutant cilia correctly detected BBSome accumulation inside Ift27(-/-) cilia and revealed that β-arrestin 2 and the viral receptor CAR are candidate cargoes of the BBSome. This work demonstrates that proximity labeling can be applied to proteomics of non-membrane-enclosed organelles and suggests that proteomics profiling of cilia will enable a rapid and powerful characterization of ciliopathies. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Primary Solitary Fibrous Tumor of the Forearm With Frequent Late-Onset Recurrence in the Pleura.

    Science.gov (United States)

    Yamamoto, Yoko; Kanzaki, Ryu; Inoue, Masayoshi; Okumura, Meinoshin

    2017-08-01

    Solitary fibrous tumor (SFT) is a relatively rare form of mesenchymal tumor that generally has a benign clinical course. However, SFTs have malignant potential. We report the case of a 36-year-old man with local relapse and frequent late-onset pleural metastasis of primary SFT of the forearm. Pleural metastasis was first seen 11 years after the initial operation. During a 17-year period, he underwent 5 surgical resections. He has been free of disease for 61 months since the most recent operation. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Thermogenic response to epinephrine in the forearm and abdominal subcutaneous adipose tissue

    DEFF Research Database (Denmark)

    Simonsen, L; Bülow, J; Madsen, Jan Lysgård

    1992-01-01

    was infused at rates of 0.2 and 0.4 nmol.kg-1 x min-1. Whole body resting energy expenditure was 4.36 +/- 0.56 (SD) kJ/min. Energy expenditure increased to 5.14 +/- 0.74 and 5.46 +/- 0.79 kJ/min, respectively (P exchange ratio was 0.80 +/- 0......Whole body energy expenditure, thermogenic and metabolic changes in the forearm, and intercellular glucose concentrations in subcutaneous adipose tissue on the abdomen determined by microdialysis were measured during epinephrine infusion in healthy subjects. After a control period, epinephrine...

  13. A case of primary extracranial meningioma of the forearm with bone invasion

    Energy Technology Data Exchange (ETDEWEB)

    Murata, Hideki [Self-Defense Force Fuji Hospital, Division of Orthopaedic Surgery, Oyama-cho, Sunto-gun, Shizuoka (Japan); Takahashi, Mitsuru; Takagi, Tatsuya; Katagiri, Hirohisa [Shizuoka Cancer Center Hospital, Division of Orthopaedic Oncology, Nagaizumi-cho, Sunto-gun, Shizuoka (Japan); Ito, Ichiro [Shizuoka Cancer Center Hospital, Division of Pathology, Nagaizumi-cho, Sunto-gun, Shizuoka (Japan); Ishida, Tsuyoshi [Kohnodai Hospital, Department of Pathology and Laboratory Medicine, National Center of Neurology and Psychiatry, Ichikawa, Chiba (Japan)

    2007-06-15

    We report here a rare case of primary extracranial meningioma in a 73-year-old woman with an asymptomatic mass located in the left distal-dorsal forearm. MRI revealed the lesion to be poorly circumscribed and unclear, with iso-signal intensity to muscle on T1 and with a relatively high signal intensity on T2-weighted imaging. The histopathology of the specimen from incision biopsy was typical of meningioma, showing bland spindle cell proliferation with a whorling pattern. Immunohistochemically, the tumor cells were positive for epithelial membrane antigen and vimentin, and negative for S-100 expression. (orig.)

  14. Development of proprioceptive acuity in typically developing children: normative data on forearm position sense

    Directory of Open Access Journals (Sweden)

    Jessica Mae Holst-Wolf

    2016-08-01

    Full Text Available This study mapped the development of proprioception in healthy, typically developing children by objectively measuring forearm position sense acuity. We assessed position sense acuity in a cross-sectional sample of 308 children (5-17 y/o; M/F = 127/181 and a reference group of 26 healthy adults (18-25 y/o; M/F = 12/14 using a body-scalable bimanual manipulandum that allowed forearm flexion/extension in the horizontal plane. The non-dominant forearm was passively displaced to one of three target positions. Then participants actively matched the target limb position with their dominant forearm. Each of three positions was matched five times. Position error (PE, calculated as the mean difference between the angular positions of the matching and reference arms, measured position sense bias or systematic error. The respective standard deviation (SDPdiff indicated position sense precision or random error. The main results are as follows: First, systematic error, measured as PE, did not change significantly from early childhood to late adolescence (Median PE at 90º target: -2.85º in early childhood; -2.28º in adolescence; 1.30º in adults. Second, response variability as measured by SDPdiff significantly decreased with age (Median SDPdiff at 90º target: 9.66º in early childhood; 5.30º in late adolescence; 3.97º in adults. The data of this large cross-sectional sample of children document that proprioceptive development in typically developing children is characterized as an age-related improvement in precision, not as a development or change in bias. In other words, it is the reliability of the perceptual response that improves between early childhood and adulthood. This study provides normative data against which position sense acuity in pediatric patient populations can be compared. The underlying neurophysiological processes that could explain the observed proprioceptive development include changes in the tuning of muscle spindles at the

  15. Long-term evaluation of donor-site morbidity after radial forearm flap phalloplasty for transsexual men.

    Science.gov (United States)

    Van Caenegem, Eva; Verhaeghe, Evelien; Taes, Youri; Wierckx, Katrien; Toye, Kaatje; Goemaere, Stefan; Zmierczak, Hans-Georg; Hoebeke, Piet; Monstrey, Stan; T'Sjoen, Guy

    2013-06-01

    Phalloplasty using the radial forearm flap is currently the most frequently used technique to create the neophallus in transsexual men (formerly described as female-to-male transsexual persons). Although it is considered the gold standard, its main disadvantage is the eventual donor-site morbidity in a young, healthy patient population. The study aims to examine the long-term effects of radial forearm flap phalloplasty in transsexual men and to evaluate aesthetic outcome, scar acceptance, bone health, and daily functioning. Scars were evaluated with the patient and observer scar assessment scale, the Vancouver Scar Scale, and self-reported satisfaction. Bone health was assessed using dual X-ray absorptiometry and peripheral quantitative computed tomography, and daily functioning using a physical activity questionnaire (Baecke). These measurements were compared with 44 age-matched control women. This is a cross-sectional study of 44 transsexual, a median of 7 years after radial forearm flap phalloplasty, recruited from the Center for Sexology and Gender Problems at the Ghent University Hospital, Belgium. We observed no functional limitations on daily life activities, a pain-free and rather aesthetic scar, and unaffected bone health a median of 7 years after radial foreram flap phalloplasty. Over 75% of transsexual men were either satisfied or neutral with the appearance of the scar. Transsexual men, despite scarring the forearm, consider the radial forearm flap phalloplasty as worthwhile. © 2013 International Society for Sexual Medicine.

  16. [Reconstruction of plantar regions with free radial forearm flaps after frostbite of both feet--case report and literature review].

    Science.gov (United States)

    Molski, Marek

    2002-01-01

    Treatment of 49 year old male with frostbite of feet is presented. The treatment included reconstruction of plantar surfaces in the both feet. Necrotic tissues were excised seven weeks after the injury and the wounds were split skin grafted. Two staged reconstruction with free neurovascular radial forearm flaps was carried out 15 and 20 weeks after the frostbite. The both flaps healed without complications. The patient recovered touch sensibility in the flap skin after 6 months and than he was able to walk. He returned to his professional job. 12 years after the reconstruction the patient can move freely using orthopedic shoes. His full weight bearing time amounts to 3 hours per day. In case of longer trips he takes elbow crouches with him just for assecuration. Pain and touch sensibility is very good and evenly distributed. 2PD on the plantar surfaces is similar and amounts to 12-15 mm. Meticulous feet care decreased hyperkeratosis thus preventing pressure sore and ulceration. No complications were observed in the donor site.

  17. A New Approach for Human Forearm Motion Assist by Actuated Artificial Joint-An Inner Skeleton Robot

    Science.gov (United States)

    Kundu, Subrata Kumar; Kiguchi, Kazuo; Teramoto, Kenbu

    In order to help the physical activities of the elderly or physically disabled persons, we propose a new concept of a power-assist inner skeleton robot (i.e., actuated artificial joint) that is supposed to assist the human daily life motion from inside of the human body. This paper presents an implantable 2 degree of freedom (DOF) inner skeleton robot that is designed to assist human elbow flexion-extension motion and forearm supination-pronation motion for daily life activities. We have developed a prototype of the inner skeleton robot that is supposed to assist the motion from inside of the body and act as an actuated artificial joint. The proposed system is controlled based on the activation patterns of the electromyogram (EMG) signals of the user's muscles by applying fuzzy-neuro control method. A joint actuator with angular position sensor is designed for the inner skeleton robot and a T-Mechanism is proposed to keep the bone arrangement similar to the normal human articulation after the elbow arthroplasty. The effectiveness of the proposed system has been evaluated by experiment.

  18. Complications in proximal humeral fractures.

    Science.gov (United States)

    Calori, Giorgio Maria; Colombo, Massimiliano; Bucci, Miguel Simon; Fadigati, Piero; Colombo, Alessandra Ines Maria; Mazzola, Simone; Cefalo, Vittorio; Mazza, Emilio

    2016-10-01

    Necrosis of the humeral head, infections and non-unions are among the most dangerous and difficult-to-treat complications of proximal humeral fractures. The aim of this work was to analyse in detail non-unions and post-traumatic bone defects and to suggest an algorithm of care. Treatment options are based not only on the radiological frame, but also according to a detailed analysis of the patient, who is classified using a risk factor analysis. This method enables the surgeon to choose the most suitable treatment for the patient, thereby facilitating return of function in the shortest possible time. The treatment of such serious complications requires the surgeon to be knowledgeable about the following possible solutions: increased mechanical stability; biological stimulation; and reconstructive techniques in two steps, with application of biotechnologies and prosthetic substitution. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Mental practice maintains range of motion despite forearm immobilization: a pilot study in healthy persons.

    Science.gov (United States)

    Frenkel, Marie O; Herzig, Daniela S; Gebhard, Florian; Mayer, Jan; Becker, Clemens; Einsiedel, Thomas

    2014-03-01

    To determine whether mental practice of wrist movements during forearm immobilization maintains range of motion. Randomized controlled trial. Eighteen healthy young men aged between 20 and 30 years were assigned to either a control or a mental practice group. Both groups were immobilized with a circular forearm cast for 3 weeks to simulate a distal radial fracture. The mental practice group received 1 × 60-min, followed by 3 × 30-min, sessions of supervised mental practice. Consecutively, they were asked to perform 15 min/day of self-guided imagery sessions, during which they mentally exercised motion sequences of the immobilized joint. The training program followed the Mental Gait Training procedure. The control group did no training. Wrist movement was measured with a goniometer before and after immobilization. Mental practice preserved dorsal extension and ulnar abduction. The sedentary control group showed due to this variables a significant decrease after cast removal. There was no significant change in palmar flexion and radial abduction in either group. Despite the study limitations, these results suggest that mental practice may be useful in preventing loss of hand function associated with mid-term immobilization. Because of the expected clinical benefits, the low cost and simple application of the intervention, the effects of mental practice in orthopedic rehabilitation of the upper extremity warrant further study.

  20. Andreas Vesalius' 500th anniversary: the initiation of hand and forearm myology.

    Science.gov (United States)

    Brinkman, R J; Hage, J J

    2015-11-01

    Andreas Vesalius (1515-1564) was the first to market an illustrated text on the freshly dissected muscular anatomy of the human hand and forearm when he published his De Fabrica Corporis Humani Libri Septem, in 1543. To commemorate his 500th birthday, we searched the second of seven books composing De Fabrica, the annotated woodcut illustrations of De Fabrica, the Tabulae Sex, and Epitome, and an eyewitness report of a public dissection by Vesalius for references to the morphology and functions of these muscles. We found Vesalius to have recognized all currently distinguished muscles except the palmaris brevis and he noted occasional absence of some muscles. Generally, he limited the origin and insertion to bones, largely disregarding attachments to membranes and fascia. Functionally, he recorded the muscles as having a single vector and operating on only one joint. We conclude that Vesalius was nearly completely correct about the anatomy of the muscles of the forearm, but much less accurate about their function. 5. © The Author(s) 2015.

  1. Noninvasive measurement of postocclusive parameters in human forearm blood by near infrared spectroscopy

    Science.gov (United States)

    Rao, K. Prahlad; Radhakrishnan, S.; Reddy, M. Ramasubba

    2005-04-01

    Near infrared (NIR) light in the wavelength range from 700 to 900 nm can pass through skin, bone and other tissues relatively easily. As a result, NIR techniques allow a noninvasive assessment of hemoglobin saturation for a wide range of applications, such as in the study of muscle metabolism, the diagnosis of vascular disorders, brain imaging, and breast cancer detection. Near infrared Spectroscopy (NIRS) is an effective tool to measure the hemoglobin concentration in the tissues, which can discriminate optically the oxy- and deoxy- hemoglobin species because of their different near-infrared absorption spectra. We have developed an NIRS probe consisting of a laser diode of 830 nm wavelength and a PIN photodiode in reflectance mode. We have selected a set of healthy volunteers (mean age 30, range 26-40 years) for the study. The probe is placed on forearm of each subject and the backscattered light intensity is measured by occluding the blood flow at 210, 110 and 85 mmHg pressures. Recovery time, peak time and time after 50% release of the cuff pressure are determined from the optical densities during the post occlusive state of forearm. These parameters are useful for determining the transient increase in blood flow after the release of blood occlusion. Clinically, the functional aspects of blood flow in the limbs could be evaluated noninvasively by NIRS.

  2. Suprafascial Harvest of the Radial Forearm Free Flap Decreases the Risk of Postoperative Tendon Exposure.

    Science.gov (United States)

    Shonka, David C; Kohli, Nikita V; Milam, Benjamin M; Jameson, Mark J

    2017-03-01

    To determine if suprafascial harvest of the radial forearm free flap improves postoperative donor site outcomes compared to subfascial harvest. Retrospective chart review. Forty-six patients underwent reconstruction of a head and neck defect with a radial forearm free flap (RFFF). Subfascial harvest of the RFFF was performed in 25 (53%) patients and suprafascial harvest performed in 22 (47%) patients. All donor sites were covered with a split thickness skin graft and a bolster that remained in place for 6 days. Postoperative tendon exposure at the donor site occurred in 5 (20%) of the patients in the subfascial group and in 0 (0%) of the patients in the suprafascial group ( P = .05; Fisher's exact test). Average tourniquet time was 117 minutes in the subfascial group and 102 minutes in the suprafascial group. Hematoma formation occurred at the donor site in 2 (8%) and 1 (5%) patients in the subfascial and suprafascial groups, respectively. There were no complete or partial flap losses in either group. Suprafascial harvest of the RFFF decreases the risk of postoperative tendon exposure. The suprafascial harvest technique does not increase harvest time or donor site complications, nor does it negatively impact flap vascularity.

  3. Measurements of wrist and forearm positions and movements: effect of, and compensation for, goniometer crosstalk.

    Science.gov (United States)

    Hansson, G-A; Balogh, I; Ohlsson, K; Skerfving, S

    2004-06-01

    Flexible biaxial goniometers are extensively used for measuring wrist positions and movements. However, they display an inherent crosstalk error. The aim was to evaluate the effect, of this error, on summary measures used for characterizing manual work. A goniometer and a torsiometer were combined into one device. An algorithm that effectively compensated for crosstalk was developed. Recordings from 25 women, performing five worktasks, were analyzed, both with and without compensation for crosstalk. The errors in the 10th, 50th and 90th percentiles of the flexion/extension distributions were small, on average <1 degrees. The ulnar/radial deviation distributions were weakly dependent on forearm position. The flexion/extension velocity measures were, for the 50th and 90th percentiles, as well as the mean velocity, consistently underestimated by, on average, 3.9%. For ulnar/radial deviation, the velocity errors were less consistent. Mean power frequency, which is a measure of repetitiveness, was insensitive (error <1%) to crosstalk. The forearm supination/pronation angular distributions were wider, and the velocities higher, than for the wrists. Considering wrist/hand exposure in epidemiologic studies, as well as for establishing and surveillance of exposure limits for prevention of work-related upper extremity musculoskeletal disorders, the crosstalk error can, when considering other errors and sources to variation, be disregarded.

  4. Diaphyseal forearm fractures, 20 years after surgical treatment. Is there still an indication for percutaneous fixation?

    Science.gov (United States)

    Fernández-Marín, M R; Hidalgo-Pérez, M; Arias-Rodríguez, G; García-Mendoza, A; Prada-Chamorro, E; Domecq-Fernández de Bobadilla, G

    2018-01-03

    This is a retrospective study of 98 diaphyseal forearm fractures in adults, treated by a percutaneous technique with intramedullar Kirchner wires. We reviewed 64 patients with 98 forearm fractures with a radiographic follow-up, assessing the presence of pseudarthrosis or delayed bone union and evaluating functional outcomes with the Anderson and the Disability of the Arm, Shoulder and Hand scale. Clinical and radiological bone union was achieved in an average of 12 weeks. We obtained 77% of excellent and good results following Anderson's scale. There were 4 cases of pseudarthrosis and 6 cases of delayed bone union. This surgical technique provides several advantages, such as a low incidence of complications and a total absence of infections, refractures and iatrogenic neurovascular injuries. It allows a lower hospital stay and a shortening of the surgery time compared with other techniques such as plates and intramedullary nails, that have similar results, in terms of bone union and functional outcomes, as we have verified from the published literature. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Short-term after-effect of forearm cast removal in children.

    Science.gov (United States)

    Katz, Kalman; Weigl, Daniel; Becker, Tal; Attias, Joseph; Bar-On, Elhanan

    2011-05-01

    To investigate the sensation in the hand after forearm cast removal in children. The study group included 33 consecutive children who were treated nonoperatively for a forearm fracture at our center over a 1-year period. The children were asked to report any sensation in the ipsilateral hand after cast removal, and the findings were analyzed against background and fracture-related data. The patients ranged in age from 6 to 14 years (median 10.00 years). Seventeen had been immobilized in an above-elbow cast and the remainder in a below-elbow cast. All children treated with an above-elbow cast complained that after cast removal, the hand on that side felt limp, and they had to hold it with the contralateral hand. By contrast, only one child treated with a below-elbow cast reported this sensation (p = 0.0001, Fisher exact test). Orthopedic surgeons and rehabilitation unit staff should be aware of the possibility of a very short-term sensation of drooping and weakness of the hand after removal of an above-elbow cast in children and prepare the child and parents accordingly in order to lessen unnecessary anxiety.

  6. Rereduction for Redisplacement of Both-Bone Forearm Shaft Fractures in Children.

    Science.gov (United States)

    Eismann, Emily A; Parikh, Shital N; Jain, Viral V

    2016-06-01

    There is a high rate of redisplacement after closed reduction and cast treatment of displaced both-bone forearm shaft fractures in children. Little evidence is available on the efficacy of rereduction of these redisplaced fractures. This study evaluates the impact of rereduction on radiographic outcomes and compares the cost to surgical stabilization. This retrospective study included 31 children (mean age, 6.3 y; 18 boys) treated with rereduction for redisplacement of a displaced both-bone forearm shaft fracture between 2008 and 2013. Angulation was measured on anteroposterior and lateral radiographs of the radius and ulna at injury, after reduction, at redisplacement, after rereduction, and at fracture union. Average procedure costs for rereduction and surgical stabilization were calculated. Initial reduction decreased apex volar angulation (initially >20 degrees) of both bones to a median of ≤2 degrees. After an average of 15 days (range, 4 to 35 d), apex volar angulation of the radius worsened to 9 degrees, and apex ulnar angulation worsened to >10 degrees for both bones. For every 5 days after initial reduction, apex ulnar angulation of the radius worsened by 4 degrees. Rereduction reduced apex ulnar and volar angulation of both bones to fractures after redisplacement following initial closed reduction had satisfactory radiographic outcomes and is a safe, effective, and less expensive option than surgical stabilization. Level IV-therapeutic.

  7. Differential axillary nerve block for hand or forearm soft-tissue surgery.

    Science.gov (United States)

    Kii, Natsumi; Yamauchi, Masanori; Takahashi, Kazunobu; Yamakage, Michiaki; Wada, Takuro

    2014-08-01

    This study determined the effective concentration of ropivacaine required to produce the type of differential block known as sensory block with mobilization, for adequate analgesia after forearm or hand soft tissue surgery by axillary brachial plexus block. Forty-four patients were enrolled, and ultrasound-guided axillary nerve block with nerve stimulation was achieved using 16 mL of ropivacaine in total. Postoperative analgesia and sensory/motor function, side effects, the use of rescue analgesics, and the patient satisfaction score were evaluated 24 h after surgery. The effective concentration of nerve block was calculated by probit analysis. Eighteen patients achieved differential block and were sufficiently satisfied with the block, which was significantly better than the patient satisfaction obtained with incomplete differential block. The maximum effective concentration of 6 mL of ropivacaine needed for differential block was calculated as 0.1285 %, which meant that 71 % of the patients experienced both sensory block and maintenance of motor function. This analysis showed that 16 ml of 0.1285 % ropivacaine is suitable for achieving differential block in ultrasound-guided axillary nerve block for hand and forearm surgery.

  8. Renal proximal tubule angiotensin AT1A receptors regulate blood pressure

    OpenAIRE

    Li, Huiping; Weatherford, Eric T.; Davis, Deborah R.; Keen, Henry L.; Grobe, Justin L.; Daugherty, Alan; Cassis, Lisa A.; Allen, Andrew M.; Sigmund, Curt D.

    2011-01-01

    All components of the renin angiotensin system necessary for ANG II generation and action have been reported to be present in renal proximal convoluted tubules. Given the close relationship between renal sodium handling and blood pressure regulation, we hypothesized that modulating the action of ANG II specifically in the renal proximal tubules would alter the chronic level of blood pressure. To test this, we used a proximal tubule-specific, androgen-dependent, promoter construct (KAP2) to ge...

  9. Proximity sensor technology for manipulator end effectors

    Science.gov (United States)

    Johnston, A. R.

    1975-01-01

    Optical proximity sensing techniques which could be used to help control the critical grasping phase of a remote manipulation are described. The proximity sensors described use a triangulation geometry to detect a surface located in a pre-determined region. The design of the proximity sensors themselves is discussed, as well as their application to manipulator control with a local control loop, and possibilities for future development are discussed.

  10. Rehabilitation and Prevention of Proximal Hamstring Tendinopathy.

    Science.gov (United States)

    Beatty, Nicholas R; Félix, Ioonna; Hettler, Jessica; Moley, Peter J; Wyss, James F

    Proximal hamstring tendinopathy (PHT) comprises a small but significant portion of hamstring injuries in athletes, especially runners. PHT is a chronic condition that is clinically diagnosed but can be supported with imaging. The main presenting complaint is pain in the lower gluteal or ischial region that may or may not radiate along the hamstrings in the posterior thigh. There is little scientific evidence on which to base the rehabilitation management of PHT. Treatment is almost always conservative, with a focus on activity modification, addressing contributing biomechanical deficiencies, effective tendon loading including eccentric training, and ultrasound-guided interventional procedures which may facilitate rehabilitation. Surgery is limited to recalcitrant cases or those involving concomitant high-grade musculotendinous pathology. The keys to PHT management include early and accurate diagnosis, optimal rehabilitation to allow for a safe return to preinjury activity level, and preventative strategies to reduce risk of reinjury.

  11. Proximate composition and antinutrient content of pumpkin ...

    African Journals Online (AJOL)

    Proximate composition and antinutrient content of pumpkin ( Cucurbita pepo ) and sorghum ( Sorghum bicolor ) flour blends fermented with Lactobacillus plantarum , Aspergillus niger and Bacillus subtilis.

  12. Efficient Indoor Proximity and Separation Detection for Location Fingerprinting

    DEFF Research Database (Denmark)

    Kjærgaard, Mikkel Baun; Treu, Georg; Ruppel, Peter

    2008-01-01

    Detecting proximity and separation among mobile targets is a basic mechanism for many location-based services (LBSs) and requires continuous positioning and tracking. However, realizing both mechanisms for indoor usage is still a major challenge. Positioning methods like GPS cannot be applied there......, and for distance calculations the particular building topology has to be taken into account. To address these challenges, this paper presents a novel approach for indoor proximity and separation detection, which uses location fingerprinting for indoor positioning of targets and walking distances for modeling...

  13. Arthroscopic-assisted removal of proximal tibia locking plates

    Directory of Open Access Journals (Sweden)

    Gille Justus

    2012-05-01

    Full Text Available Abstract We present a new technique to remove plates from the proximal tibia arthroscopic-assisted with all advantages of the minimally invasive surgery and the possibility to treat concomitant intraarticular pathologies. The initial results (n = 7 are promising with an increase of the Lysholm score in all cases studied [preop. median 78 (range 32–100, postop. median 89 (range 60–100]. In conclusion, arthroscopic-assisted hardware removal at the proximal tibia is feasible and may provide patients with all the benefits of minimal-invasive hardware removal. The described technique can be recommended for all surgeons familiar with arthroscopic surgery.

  14. Specifics of proximal caries and their diagnostics in posterior teeth

    Directory of Open Access Journals (Sweden)

    Wojcik-Checinska Ilona

    2015-06-01

    Full Text Available Proximal surfaces are the second in turn after the occlusal surfaces, as being the most exposed places to the carious process. The specificity of changes and location makes the diagnostic of approximal cavities difficult. The aim of the study was to collect information on possibilities of detection, monitoring and assessment of carious lesions located on proximal surfaces, starting from the early stage. On the base of current literature, chosen methods of diagnosis, from conventional, to advanced technologies were presented. Current literature also suggests that none of the diagnostic methods exclude the possibility of misdiagnosis of proximal caries. Therefore, during the diagnosing of doubtful cases, it is advisable to employ several methods of assessment, with simultaneous individual appraisal of caries risk factors, such as oral hygiene, frequency of eating sweets or the number of active caries foci.

  15. Case report of LCP pediatric hip osteosynthesis of a proximal ...

    African Journals Online (AJOL)

    We present a case report demonstrating the experience of the department of pediatric orthopaedics of the University Orthopedic Hospital at Sofia Medical University in the treatment of an intertrochanteric proximal femoral fracture in a child with osteopetrosis. We performed open fracture reduction with stable 120° LCP ...

  16. Oscillations in the proximal intratubular pressure: a mathematical model

    DEFF Research Database (Denmark)

    Holstein-Rathlou, N H; Leyssac, P P

    1987-01-01

    This study presents a dynamic continuous time model of the regulation of the renal proximal intratubular pressure in the rat. The model integrates a functional model of the glomerulus, a tubular model, a feedback model, and an afferent arteriolar model. The model has one equilibrium solution for ...

  17. Proximal femoral nail: a minimally invasive treatment for ...

    African Journals Online (AJOL)

    Materials and Methods: In our study patients who presented to department of orthopaedics, Katuri Medical College between January 2013 and December 2014, with intertrochanteric fractures were included and treated with Proximal Femoral Nail. Total of 82 patients were included in the study. Medically unfit patients and ...

  18. Studies on the proximate composition, functional properties and ...

    African Journals Online (AJOL)

    The present study produced full fat and defatted flours from matured ackee apple arils and evaluated the proximate composition and the effect of pH and salt concentrations on some of the functional properties of the full fat flour and the defatted flour. Matured ackee apple arils were oven-dried at 60 oC and milled to obtain ...

  19. Dislocation of the proximal tibiofibular joint, do not miss it

    NARCIS (Netherlands)

    van Wulfften Palthe, A.F.Y.; Musters, L.; Sonnega, R.J.A.; van der Sluijs, J.A.

    2015-01-01

    We present a case of a 45-year-old woman with a right proximal tibiofibular dislocation she sustained after a fall during roller skating. Anteroposterior and lateral radiographs confirmed the diagnosis; there were no other injuries. The dislocation was reduced by direct manipulation after

  20. Proximal tibiofibular dislocation: a case report and review of literature

    NARCIS (Netherlands)

    Nieuwe Weme, R. A.; Somford, M. P.; Schepers, T.

    2014-01-01

    An isolated dislocation of the proximal tibiofibular joint is uncommon. The mechanism of this injury is usually sports related. We present a case where initial X-rays did not show the tibiofibular joint dislocation conclusively. It was diagnosed after comparative bilateral AP X-rays of the knees

  1. Outcome of plate osteosynthesis in the management of proximal ...

    African Journals Online (AJOL)

    Background: This paper reports the aetiology, presentation and management of proximal humeral fractures (PHF) in our setup. Objective: To ... Five of thirty two operated cases (15%) developed significant shoulder joint stiffness. ... There is need for arthroplasty in those with severe injury, particularly those with osteoporosis.

  2. Proximity focusing RICH detector based on multilayer silica aerogel radiator

    CERN Document Server

    De Leo, R; Bellunato, T; Calvi, M; Cisbani, E; Cusanno, F; Garibaldi, F; Lagamba, L; Marra, M; Marrone, S; Matteuzzi, C; Musico, P; Nappi, E; Perego, D L; Torrioli, S; Vilardi, I

    2010-01-01

    The performance of a proximity focusing Ring Imaging Cherenkov detector equipped with a radiator of silica aerogel is presented. The aerogel tile used is a monolith with variable index of refraction. Cherenkov photons are detected with high granularity by eight Hamamatsu H9500 flat panel multi anode phototubes.

  3. Sequential Proximal Tibial Stress Fractures associated with Prolonged usage of Methotrexate and Corticosteroids: A Case Report

    Directory of Open Access Journals (Sweden)

    Tan TJL

    2015-11-01

    Full Text Available Stress fractures of the proximal tibia metaphysis are rare in the elderly. We present a case of a 65-year old male who developed sequential proximal tibia stress fractures associated with prolonged usage of methotrexate and prednisolone within a span of 18 months. Magnetic Resonance Imaging revealed an incomplete stress fracture involving the medial proximal tibial region. The patient was treated with stemmed total knee arthroplasty (TKA bilaterally. Stress fractures should be considered in patients with atypical knee pain who have a history of methotrexate and prednisolone usage. TKA is an effective treatment in stress fractures of the proximal tibia.

  4. Functional outcome following proximal humeral interlocking system plating for displaced proximal humeral fractures

    OpenAIRE

    Thyagarajan David; Haridas Samarth; Jones Denise; Dent Colin; Evans Richard; Williams Rhys

    2009-01-01

    Aim: To assess the functional outcome following internal fixation with the PHILOS (proximal humeral interlocking system) for displaced proximal humeral fractures. Patients and Methods: We reviewed 30 consecutive patients treated surgically with the proximal humeral locking plate for a displaced proximal humeral fracture. Functional outcome was determined using the American Shoulder and Elbow Society (ASES) score and Constant Murley score. Results: Average age of the patients was 58 years...

  5. Best Proximity Points for a New Class of Generalized Proximal Mappings

    Directory of Open Access Journals (Sweden)

    Tayyab Kamran

    2017-03-01

    Full Text Available The best proximity points are usually used to find the optimal approximate solution of the operator equation Tx = x, when T has no fixed point. In this paper, we prove some best proximity point theorems for nonself multivalued operators, following the foot steps of Basha and Shahzad [Best proximity point theorems for generalized proximal contractions, Fixed Point Theory Appl., 2012, 2012:42].

  6. Correction of Misclassifications Using a Proximity-Based Estimation Method

    Directory of Open Access Journals (Sweden)

    Shmulevich Ilya

    2004-01-01

    Full Text Available An estimation method for correcting misclassifications in signal and image processing is presented. The method is based on the use of context-based (temporal or spatial information in a sliding-window fashion. The classes can be purely nominal, that is, an ordering of the classes is not required. The method employs nonlinear operations based on class proximities defined by a proximity matrix. Two case studies are presented. In the first, the proposed method is applied to one-dimensional signals for processing data that are obtained by a musical key-finding algorithm. In the second, the estimation method is applied to two-dimensional signals for correction of misclassifications in images. In the first case study, the proximity matrix employed by the estimation method follows directly from music perception studies, whereas in the second case study, the optimal proximity matrix is obtained with genetic algorithms as the learning rule in a training-based optimization framework. Simulation results are presented in both case studies and the degree of improvement in classification accuracy that is obtained by the proposed method is assessed statistically using Kappa analysis.

  7. Preliminary phytochemical screening, proximate and elemental ...

    African Journals Online (AJOL)

    The seed powder of Moringa oleifera was analysed for its phytochemical, proximate and elemental composition using Folin-Denis spectrophotometric method, gravimetric method and energy dispersing X-ray fluorescence (EDXRF) transmission emission technique respectively. The seed powder had the following proximate ...

  8. Bimalleolar ankle fracture with proximal fibular fracture

    NARCIS (Netherlands)

    Colenbrander, R. J.; Struijs, P. A. A.; Ultee, J. M.

    2005-01-01

    A 56-year-old female patient suffered a bimalleolar ankle fracture with an additional proximal fibular fracture. This is an unusual fracture type, seldom reported in literature. It was operatively treated by open reduction and internal fixation of the lateral malleolar fracture. The proximal fibular

  9. Grouping by Proximity in Haptic Contour Detection

    Science.gov (United States)

    Overvliet, Krista E.; Krampe, Ralf Th.; Wagemans, Johan

    2013-01-01

    We investigated the applicability of the Gestalt principle of perceptual grouping by proximity in the haptic modality. To do so, we investigated the influence of element proximity on haptic contour detection. In the course of four sessions ten participants performed a haptic contour detection task in which they freely explored a haptic random dot display that contained a contour in 50% of the trials. A contour was defined by a higher density of elements (raised dots), relative to the background surface. Proximity of the contour elements as well as the average proximity of background elements was systematically varied. We hypothesized that if proximity of contour elements influences haptic contour detection, detection will be more likely when contour elements are in closer proximity. This should be irrespective of the ratio with the proximity of the background elements. Results showed indeed that the closer the contour elements were, the higher the detection rates. Moreover, this was the case independent of the contour/background ratio. We conclude that the Gestalt law of proximity applies to haptic contour detection. PMID:23762364

  10. Proximate analysis on four edible mushrooms ADEDAYO ...

    African Journals Online (AJOL)

    Michael Horsfall

    Vol. 15 (1) 9 - 11. Full-text Available Online at www.bioline.org.br/ja. Proximate analysis on four edible mushrooms. ADEDAYO, MAJEKODUNMI RACHEL. Nigerian Stored Product Research Institute, P.M.B.3032, Kano. ABSTRACT: Proximate study was conducted on four edible mushrooms commonly found in farmlands in.

  11. Proximate Sources of Collective Teacher Efficacy

    Science.gov (United States)

    Adams, Curt M.; Forsyth, Patrick B.

    2006-01-01

    Purpose: Recent scholarship has augmented Bandura's theory underlying efficacy formation by pointing to more proximate sources of efficacy information involved in forming collective teacher efficacy. These proximate sources of efficacy information theoretically shape a teacher's perception of the teaching context, operationalizing the difficulty…

  12. Phytochemical screening, proximate analysis and anticonvulsant ...

    African Journals Online (AJOL)

    Spigelia anthelmia is used traditionally in Southern Nigeria for the treatment of infant convulsion and epilepsy. This study investigated the phytochemical constituents, proximate analysis and anticonvulsant effect of the methanolic extract of Spigelia anthelmia. Phytochemical evaluation and proximate analysis was carried ...

  13. Comparison of bone densitometry of the phalanges, distal forearm and axial skeleton in early postmenopausal women participating in the EPIC Study

    DEFF Research Database (Denmark)

    Ravn, Pernille; Overgaard, K; Huang, C

    1996-01-01

    We present baseline bone densitometry from the Early Postmenopausal Interventional Cohort study (EPIC, sponsored by Merck, Sharp & Dohme) for the first time, in which 1609 women from England, Oregon, Hawaii and Denmark are participating to investigate the efficacy of daily oral alendronate...... forearm. In a random subgroup of 308 women, aged 45-60 years, on average 6 years since menopause (YSM), bone densitometry was measured once at baseline by RA of the phalanges besides the mandatory measurements by DXA. Bone densitometry was furthermore measured by SXA at the Danish site (89 women). Sixty......-eight of the women had duplicate measurements performed within 1-3 weeks to evaluate the short-term precision error (CV%). One hundred and one healthy premenopausal women, aged 25-48 years, were recruited at the Danish and Hawaiian sites to establish a reference group. The precision error was 1.5% for RA...

  14. Maternal Dietary Patterns during Pregnancy in Relation to Offspring Forearm Fractures: Prospective Study from the Danish National Birth Cohort

    Directory of Open Access Journals (Sweden)

    Sesilje B. Petersen

    2015-04-01

    Full Text Available Limited evidence exists for an association between maternal diet during pregnancy and offspring bone health. In a prospective study, we examined the association between dietary patterns in mid-pregnancy and offspring forearm fractures. In total, 101,042 pregnancies were recruited to the Danish National Birth Cohort (DNBC during 1996–2002. Maternal diet was collected by a food frequency questionnaire. Associations were analyzed between seven dietary patterns extracted by principal component analysis and offspring first occurrence of any forearm fracture diagnosis, extracted from the Danish National Patient Register, between time of birth and end of follow-up (<16 year (n = 53,922. In multivariable Cox regression models, offspring of mothers in the fourth vs. first quintile of the Western pattern had a significant increased risk (Hazard ratio, 95% confidence interval: 1.11, 1.01–1.23 of fractures, and there was a borderline significant positive trend (p = 0.06. The other dietary patterns showed no associations and neither did supplementary analyses of macro- and micronutrients or single food groups, except for the intake of artificially sweetened soft drinks, which was positively associated with offspring forearm fractures (p = 0.02. In the large prospective DNBC high mid-pregnancy consumption of Western diet and artificially sweetened soft drinks, respectively, indicated positive associations with offspring forearm fractures, which provides interesting hypotheses for future research.

  15. Effectiveness of Occupational Therapy Interventions for Adults With Musculoskeletal Conditions of the Forearm, Wrist, and Hand: A Systematic Review

    OpenAIRE

    Roll, Shawn C.; Hardison, Mark E.

    2016-01-01

    A review of 59 articles published between 2006 and July 2014 on the effect of occupational therapy interventions on functional outcomes for adults with musculoskeletal disorders of the forearm, wrist, and hand found that the strongest evidence supports postsurgical early active motion protocols and splinting for various conditions.

  16. Conversion to below-elbow cast after 3 weeks is safe for diaphyseal both-bone forearm fractures in children

    NARCIS (Netherlands)

    J.W. Colaris (Joost); J.H. Allema (Jan Hein); L.U. Biter (L. Ulas); M. Reijman (Max); C.P. van de Ven (Cees); M.R.D. Vries; R.M. Bloem (Rolf); A.J.H. Kerver (Albert J.H.); J.A.N. Verhaar (Jan)

    2013-01-01

    textabstractBackground It is unclear whether it is safe to convert above-elbow cast (AEC) to below-elbow cast (BEC) in a child who has sustained a displaced diaphyseal both-bone forearm fracture that is stable after reduction. In this multicenter study, we wanted to answer the question: does early

  17. Cognitive capacity: no association with recovery of sensibility by Semmes Weinstein test score after peripheral nerve injury of the forearm

    NARCIS (Netherlands)

    Boender, Z. J.; Ultee, J.; Hovius, S. E. R.

    2010-01-01

    In the recovery process of sensibility after repair of a peripheral nerve injury of the forearm, not only age but also surgical repair techniques are of importance. If regenerating axons are misdirected, reorganisation or other adaptic processes are needed at the level of the somatosensory brain

  18. Re-displacement of stable distal both-bone forearm fractures in children: a randomised controlled multicentre trial.

    Science.gov (United States)

    Colaris, Joost W; Allema, Jan Hein; Biter, L Ulas; de Vries, Mark R; van de Ven, Cees P; Bloem, Rolf M; Kerver, Albert J H; Reijman, Max; Verhaar, Jan A N

    2013-04-01

    Displaced metaphyseal both-bone fractures of the distal forearm are generally reduced and stabilised by an above-elbow cast (AEC) with or without additional pinning. The purpose of this study was to find out if re-displacement of a reduced stable metaphyseal both-bone fracture of the distal forearm in a child could be prevented by stabilisation with Kirschner wires. Consecutive children aged fracture of the distal forearm (n = 128) that was stable after reduction were randomised to AEC with or without percutaneous fixation with Kirschner wires. The primary outcome was re-displacement of the fracture. A total of 67 children were allocated to fracture reduction and AEC and 61 to reduction of the fracture, fixation with Kirschner wires and AEC. The follow-up rate was 96% with a mean follow-up of 7.1 months. Fractures treated with additional pinning showed less re-displacement (8% vs. 45%), less limitation of pronation and supination (mean limitation 6.9 (± 9.4)° vs. 14.3 (± 13.6)°) but more complications (14 vs. 1). Pinning of apparent stable both-bone fractures of the distal forearm in children might reduce fracture re-displacement. The frequently seen complications of pinning might be reduced by a proper surgical technique. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. ANALYSIS OF FAILURES AND COMPLICATIONS FOLLOWING TREATMENT OF DIAPHYSEAL FOREARM FRACTURES IN CHILDREN USING FLEXIBLE INTRAMEDULLARY NAILING

    Directory of Open Access Journals (Sweden)

    A. A. Korobeinikov

    2016-01-01

    Full Text Available Introduction. Currently flexible intramedullary nailing (FIN is the method of choice for treatment of diaphyseal forearm fractures in children.Purpose of the study: to perform a quantitative and qualitative analysis of failures and complications encountered in treatment of children with diaphyseal forearm fractures using FIN fixation.Materials and methods. The study included 55 consecutive continuous cases of diaphyseal forearm fractures in children operated by FIN fixation from October 2011 till October 2014. Follow up period covered timeframe from admission until implant removal but no less than 6 months. The authors studied age, gender, fracture pattern, surgical technique features, length of hospital stay, frequency of outpatient examinations, healing period, x-ray data and all complications.Results. Complications during treatment were reported in 10 patients. Two patients demonstrated two complications. In two cases a surgical procedure was required to address the complications. Early postoperative complications were observed in two cases (neuropathy of superficial branch of radial nerve. In other cases patients developed complications at outpatient stage starting one to six months after the surgery which did not impact the final outcome.Conclusion. Despite various complications observed following FIN fixation of diaphyseal forearm fractures in children, their severity and frequency had no impact on the final outcome in the authors’ case series. Majority of issues were related to violations in surgical technique and adverse fracture pattern.

  20. Effect of a new hand-forearm splint on grip strength, pain, and function in patients with tennis elbow.

    Science.gov (United States)

    Najafi, Mozhgan; Arazpour, Mokhtar; Aminian, Gholamreza; Curran, Sarah; Madani, Seyed Pezhman; Hutchins, Stephen W

    2016-06-01

    While the effectiveness of orthoses prescribed for tennis elbow has been reported in several studies, the effect of how they may limit movements which aggravate this condition has not yet been explored. The purpose of this study was to evaluate the effect of a new spiral hand-forearm splint that restricts the movement of the wrist and forearm, on grip strength, pain, and function in patients with tennis elbow. Quasi-experimental design. A total of 15 patients with tennis elbow (mean age 43 years) took part in this study. The amount of pain, grip force, and function were compared using a visual analog scale, Jamar dynamometer, and the Disability of the Arm, Shoulder, and Hand questionnaire, respectively. This was performed at baseline and repeated after 4 weeks of splint use. Active motion of the forearm was measured by a goniometer. The spiral splint significantly relieved pain and improved function and grip force in patients after 4 weeks of application (P splint design had a positive effect on the treatment of tennis elbow symptoms which included pain, grip strength, and function. Restriction of rotational movement (e.g. reduction of the supination and pronation of forearm) may have played the main role in this. This new splint design may be considered as a new approach in the conservative treatment and rehabilitation of patients with tennis elbow. © The International Society for Prosthetics and Orthotics 2015.

  1. Virtual Reality Anatomy: Is It Comparable with Traditional Methods in the Teaching of Human Forearm Musculoskeletal Anatomy?

    Science.gov (United States)

    Codd, Anthony M.; Choudhury, Bipasha

    2011-01-01

    The use of cadavers to teach anatomy is well established, but limitations with this approach have led to the introduction of alternative teaching methods. One such method is the use of three-dimensional virtual reality computer models. An interactive, three-dimensional computer model of human forearm anterior compartment musculoskeletal anatomy…

  2. Intercostal and forearm muscle deoxygenation during respiratory fatigue in patients with heart failure: potential role of a respiratory muscle metaboreflex.

    Science.gov (United States)

    Moreno, A M; Castro, R R T; Silva, B M; Villacorta, H; Sant'Anna Junior, M; Nóbrega, A C L

    2014-11-01

    The purpose of this study was to determine the effect of respiratory muscle fatigue on intercostal and forearm muscle perfusion and oxygenation in patients with heart failure. Five clinically stable heart failure patients with respiratory muscle weakness (age, 66 ± 12 years; left ventricle ejection fraction, 34 ± 3%) and nine matched healthy controls underwent a respiratory muscle fatigue protocol, breathing against a fixed resistance at 60% of their maximal inspiratory pressure for as long as they could sustain the predetermined inspiratory pressure. Intercostal and forearm muscle blood volume and oxygenation were continuously monitored by near-infrared spectroscopy with transducers placed on the seventh left intercostal space and the left forearm. Data were compared by two-way ANOVA and Bonferroni correction. Respiratory fatigue occurred at 5.1 ± 1.3 min in heart failure patients and at 9.3 ± 1.4 min in controls (P0.05). Respiratory fatigue in heart failure reduced intercostal and forearm muscle blood volume (Pmuscles (heart failure, -4.5 ± 0.5%; controls, +0.5 ± 0.8%; Pfatigue in patients with heart failure causes an oxygen demand/delivery mismatch in respiratory muscles, probably leading to a reflex reduction in peripheral limb muscle perfusion, featuring a respiratory metaboreflex.

  3. Factors determining outcome of corrective osteotomy for malunited paediatric forearm fractures: A systematic review and meta-analysis

    NARCIS (Netherlands)

    K.C. Roth (Kasper C.); M.M.J. Walenkamp (Monique); Van Geenen, R.C.I. (R. C.I.); M. Reijman (Max); J.A.N. Verhaar (Jan); J.W. Colaris (Joost)

    2017-01-01

    textabstractThe aim of this study was to identify predictors of a superior functional outcome after corrective osteotomy for paediatric malunited radius and both-bone forearm fractures. We performed a systematic review and meta-analysis of individual participant data, searching databases up to 1

  4. Successful reconstruction of irradiated anterior skull base defect using the dual flap technique involving local pericranial flap and radial forearm free flap.

    Science.gov (United States)

    Yeo, In Sung; Kim, Se-Hyuk; Park, Myong Chul; Lim, Hyoseob; Kim, Joo Hyoung; Lee, Il Jae

    2014-07-01

    Skull base reconstruction presents a challenging therapeutic problem requiring a multispecialty surgical approach and close cooperation between the neurosurgeon, head and neck surgeon, as well as plastic and reconstructive surgeon during all stages of treatment. The principal goal of skull base reconstruction is to separate the intracranial space from the nasopharyngeal and oropharyngeal cavities, creating support for the brain and providing a water-tight barrier against cerebrospinal fluid leakage and ascending infection. We present a case involving a 58-year-old man with anterior skull base defects (2.5 cm × 3 cm) secondary to the removal of olfactory neuroblastoma. The patient received conventional radiation therapy at 6000 cGy in 30 fractions approximately a month before tumor removal. The patient had radiation therapy before surgery and was planned to have postoperative radiation therapy, which would lead to a higher complication rate of reconstruction. Artificial dura was used for the packing of the dural defect, which was also suspected to increase the complication rate of reconstruction. For these reasons, we chose to apply the dual flap technique, which uses both local pericranial flap and de-epithelized radial forearm free flap for anterior skull base defect to promote wound healing. During 28 months of follow-up after coverage of the anterior skull base defect, the dual flap survived completely, as confirmed through follow-up magnetic resonance imaging. The patient was free of cerebrospinal fluid leakage, meningitis, and abscess, and there was minimal donor-site morbidity of the radial forearm free flap. Reconstruction of anterior skull base defects using the dual flap technique is safe, reliable, and associated with low morbidity, and it is ideal for irradiated wounds and low-volume defects.

  5. A restrained-torque-based motion instructor: forearm flexion/extension-driving exoskeleton

    Science.gov (United States)

    Nishimura, Takuya; Nomura, Yoshihiko; Sakamoto, Ryota

    2013-01-01

    When learning complicated movements by ourselves, we encounter such problems as a self-rightness. The self-rightness results in a lack of detail and objectivity, and it may cause to miss essences and even twist the essences. Thus, we sometimes fall into the habits of doing inappropriate motions. To solve these problems or to alleviate the problems as could as possible, we have been developed mechanical man-machine human interfaces to support us learning such motions as cultural gestures and sports form. One of the promising interfaces is a wearable exoskeleton mechanical system. As of the first try, we have made a prototype of a 2-link 1-DOF rotational elbow joint interface that is applied for teaching extension-flexion operations with forearms and have found its potential abilities for teaching the initiating and continuing flection motion of the elbow.

  6. Wrist and forearm posture from typing on split and vertically inclined computer keyboards.

    Science.gov (United States)

    Marklin, R W; Simoneau, G G; Monroe, J F

    1999-12-01

    A study was conducted on 90 experienced office workers to determine how commercially available alternative computer keyboards affected wrist and forearm posture. The alternative keyboards tested had the QWERTY layout of keys and were of three designs: split fixed angle, split adjustable angle, and vertically inclined (tilted or tented). When set up correctly, commercially available split keyboards reduced mean ulnar deviation of the right and left wrists from 12 degrees to within 5 degrees of a neutral position compared with a conventional keyboard. The finding that split keyboards place the wrist closer to a neutral posture in the radial/ulnar plane substantially reduces one occupational risk factor of work-related musculoskeletal disorders (WMSDs): ulnar deviation of the wrist. Applications of this research include commercially available computer keyboard designs that typists can use and ergonomists can recommend to their clients in order to minimize wrist ulnar deviation from typing.

  7. Hormonal replacement therapy reduces forearm fracture incidence in recent postmenopausal women

    DEFF Research Database (Denmark)

    Mosekilde, Leif; Beck-Nielsen, H.; Sørensen, O.H.

    2000-01-01

    OBJECTIVES: To study the fracture reducing potential of hormonal replacement therapy (HRT) in recent postmenopausal women in a primary preventive scenario. METHODS: Prospective controlled comprehensive cohort trial: 2016 healthy women aged 45-58 years, from three to 24 months past last menstrual...... bleeding were recruited from a random sample of the background population. Mean age was 50. 8+/-2.8 years, and the number of person years followed was 9335.3. There were two main study arms: a randomised arm (randomised to HRT; n=502, or not; n=504) and a non-randomised arm (on HRT; n=221, or not; n=789...... by own choice). First line HRT was oral sequential oestradiol/norethisterone in women with intact uterus and oral continuous oestradiol in hysterectomised women. RESULTS: After five years, a total of 156 fractures were sustained by 140 women. There were 51 forearm fractures in 51 women. By intention...

  8. Symptoms of neck, shoulder, forearms, and hands: a cohort study among computer office workers in Sudan.

    Science.gov (United States)

    Eltayeb, Shahla M; Staal, J Bart; Khamis, Amar H; de Bie, Rob A

    2011-01-01

    Complaints of the arms, neck, and shoulders in general and computer-related disorders in particular affect many office workers in economically developed countries. However, with the increased use of computer systems in developing countries, the associated musculoskeletal symptoms and risk factors are yet to be investigated. The study investigates the relationship between work-related physical and psychosocial characteristics and symptoms of the arms, neck, and shoulders in an African economically developed worksite. A prospective cohort study with 1-year follow-up was conducted. Data were used from 250 computer office workers in Khartoum, Sudan. Data were collected using the Arabic version of the Maastricht Upper Extremity Questionnaire. Prevalence rates for symptoms were calculated and the categories of risk factors being evaluated consisted of physical, psychological, and individual risk factors. Multivariable logistic regression analysis was used to identify risk factors associated with complaints that were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). The 1-year follow-up prevalence rate was 0.63 (95% CI: 0.58-0.70) for neck symptoms, 0.56 (95% CI: 0.45-0.66) for shoulder symptoms, and 0.46 (95% CI: 0.42-0.59) for symptoms of the forearms/hands. Three main risk factors were significantly associated with the presence of symptoms: (1) time pressure [OR: 1.31 (1.00 to 1.90) P=0.05], (2) task difficulty [OR: 1.85 (1.73 to 1.99) P=0.03], and (3) previous history of symptoms [OR: 4.62 (2.20 to 9.35) P=0.01]. The targeted office workers in Sudan are reporting symptoms in the neck, shoulders, and forearms. Work-related psychological factors predicted more significantly the presence of symptoms in the targeted population.

  9. Sclerotherapy of Diffuse and Infiltrative Venous Malformations of the Hand and Distal Forearm

    Energy Technology Data Exchange (ETDEWEB)

    Guevara, Carlos J., E-mail: guevarac@mir.wustl.edu; Gonzalez-Araiza, Guillermo; Kim, Seung K.; Sheybani, Elizabeth; Darcy, Michael D. [Washington University School of Medicine, Mallinckrodt Institute of Radiology (United States)

    2016-05-15

    PurposeVenous malformations (VM) involving the hand and forearm often lead to chronic pain and dysfunction, and the threshold for treatment is high due to the risk of nerve and skin damage, functional deterioration and compartment syndrome. The purpose of this study is to demonstrate that sclerotherapy of diffuse and infiltrative VM of the hand is a safe and effective therapy.Materials and MethodsA retrospective review of all patients with diffuse and infiltrative VM of the hand and forearm treated with sclerotherapy from 2001 to 2014 was conducted. All VM were diagnosed during the clinical visit by a combination of physical examination and imaging. Sclerotherapy was performed under imaging guidance using ethanol and/or sodium tetradecyl sulfate foam. Clinical notes were reviewed for signs of treatment response and complications, including skin blistering and nerve injury.ResultsSeventeen patients underwent a total of 40 sclerotherapy procedures. Patients were treated for pain (76 %), swelling (29 %) or paresthesias (6 %). Treatments utilized ethanol (70 %), sodium tetradecyl sulfate foam (22.5 %) or a combination of these (7.5 %). Twenty-four percent of patients had complete resolution of symptoms, 24 % had partial relief of symptoms without need for further intervention, and 35 % had some improvement after initial treatment but required additional treatments. Two skin complications were noted, both of which resolved. No motor or sensory loss was reported.ConclusionSclerotherapy is a safe and effective therapy for VM of the hand with over 83 % of patients experiencing relief.

  10. Association of Obesity with Forearm Fractures, Bone Mineral Density and Fracture Risk (FRAX® During Postmenopausal Period

    Directory of Open Access Journals (Sweden)

    Erkan Mesci

    2016-08-01

    Full Text Available Objective: The aim of this study was to investigate the association among obesity with bone mineral density (BMD and subsequent fracture risk among postmenopausal women with a previous forearm fracture. Materials and Methods: The study enrolled obese (n=40 and normal-weight (n=40 postmenopausal women who had a previous forearm fracture. BMD measurements were obtained using a GE-LUNAR DPX dual energy X-ray absorptiometry scan for all subjects. FRAX® fracture risk scores were calculated taking into account former fractures and current risk factors of the subjects. Both groups were compared with respect to their BMD values, T scores, FRAX® risk scores and frequency of previous fractures. Results: No difference was observed between groups with regard to mean age, mean age of menopause onset and mean serum calcium, phosphorus and alkaline phosphatase levels (p>0.05 for all. Statistically, obese patients showed highly significantly greater mean BMD values at lumbar spine (L1-L4 and femoral neck in comparison to subjects with normal body weight (p=0.000 for all. Obese patients had a lower 10-year probability of a major osteoporotic fracture on average as determined by FRAX® fracture risk score compared to that in normal-weight subjects (p<0.05. Also, obese group had a lower 10-year probability of a hip fracture versus normal-weight subjects (p<0.01. Both groups were found to have a similar frequency of previous fractures. Conclusion: Although obese patients in this study had greater BMD values and lower FRAX® risk scores, the probability of subsequent fractures predicted for the obese group was not lower when compared to that predicted for normal-weight group. It should be kept in mind that obesity may not necessarily be protective against fractures and treatment algorithms based solely on BMD might be inadequate to predict future fracture risk.

  11. Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Training

    Science.gov (United States)

    Curado, Marco Rocha; Cossio, Eliana Garcia; Broetz, Doris; Agostini, Manuel; Cho, Woosang; Brasil, Fabricio Lima; Yilmaz, Oezge; Liberati, Giulia; Lepski, Guilherme

    2015-01-01

    Background Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies. Methods Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity. Results Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (parm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, parm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their recruitment

  12. Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI Training.

    Directory of Open Access Journals (Sweden)

    Marco Rocha Curado

    Full Text Available Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies.Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16. In the sham group (n = 16 orthosis movements were random. Motor function was evaluated with electromyography (EMG of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA scores. Patients performed distinct upper arm (e.g., shoulder flexion and hand movements (finger extensions. Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC was used to test inter-session reliability of facilitation of forearm EMG activity.Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001. Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001, but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001.Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in

  13. Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Training.

    Science.gov (United States)

    Curado, Marco Rocha; Cossio, Eliana Garcia; Broetz, Doris; Agostini, Manuel; Cho, Woosang; Brasil, Fabricio Lima; Yilmaz, Oezge; Liberati, Giulia; Lepski, Guilherme; Birbaumer, Niels; Ramos-Murguialday, Ander

    2015-01-01

    Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies. Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity. Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001). Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their

  14. A pilot study of a modified radiographic technique for detecting early proximal cavities.

    Science.gov (United States)

    Akbari, M; Zarch, H H; Movagharipour, F; Ahrari, F

    2013-01-01

    Diagnosing the necessity of cavity preparation in demineralized proximal areas has been considered as a challenge in restorative treatment planning. The purpose of this study was to investigate the clinical performance of a modified radiographic technique for the detection of proximal cavities. The sample consisted of 44 proximal surfaces in 38 dental students. The patients had radiolucent proximal lesions restricted to the inner half of enamel or the outer third of dentine in bitewing radiographs, and there was doubt regarding the presence or absence of cavities in the approximal areas. The suspected surfaces were then examined by secondary bitewing radiographs which were taken after pressing radiopaque material into the proximal areas. Finally, orthodontic elastic separators were placed in the contact areas to provide enough space for direct visual and tactile examination, thus detecting any proximal cavity (reference standard). The sensitivity, specificity and accuracy of the modified bitewing radiography were calculated against the reference standard. Overall, 7 surfaces presented caries cavities according to the reference standard. All proximal radiolucencies observed in the inner half of enamel and 46% of those extended to the outer third of dentine were not cavitated when evaluated by direct visual and tactile examination. The sensitivity, specificity and accuracy of bitewing radiography with opaque material for detecting proximal cavities (n = 7) were 86, 100 and 98%, respectively. The tested radiographic technique displayed good validity in this pilot study for detecting proximal cavities in posterior teeth and should be further investigated. © 2013 S. Karger AG, Basel.

  15. Influence of aging and menopause in determining vertebral and distal forearm bone loss in adult healthy women.

    Science.gov (United States)

    Luisetto, G; Zangari, M; Tizian, L; Nardi, A; Ramazzina, E; Adami, S; Galuppo, P

    1993-07-01

    In order to assess the relative influence of aging and menopause in determining the decrease of bone mass in adult women, two groups of normal subjects were examined in this retrospective, cross-sectional study. In group A, bone mineral density (BMD) was evaluated at spine (L2-L4) by dual X-ray absorptiometry (DXA) (Hologic QDR-1000); in group B, BMD was measured at the distal forearm by single photon absorptiometry (SPA) (Osteometer DT 100). Both groups were further divided into two subgroups: A1 and B1 included women with the same postmenopausal, but different chronological age; A2 and B2 included women with the same chronological, but different postmenopausal age. BMD and BMI-corrected BMD (cBMD) were plotted versus age and years since menopause, respectively. Mathematical analysis of the correlation curves between BMD and chronological age showed that the decrease of BMD is very similar at spine and forearm, and is better fitted by a quadratic function. Age-related fractional bone diminution shows a progressive increase with aging (at spine: -0.38%/year at 45 years, -0.81%/year at 50, -1.3%/year at 55 and -1.9%/year at 60. At forearm: -0.5%/year at 50 years, -1.1%/year at 55 and -1.68%/year at 60). On the other hand, menopause-related BMD decrement is very evident during the first year since menopause (at spine: -8.1%/year; at forearm: -3.4%/year), and progressively decreases, according to a logarithmic function. Ten years later, yearly diminution of BMD is below 1%/year and 0.4%/year at spine and forearm, respectively. At this time, age contributes to determine bone loss for 2/3 and menopause for 1/3.

  16. Intercostal and forearm muscle deoxygenation during respiratory fatigue in patients with heart failure: potential role of a respiratory muscle metaboreflex

    Directory of Open Access Journals (Sweden)

    A.M. Moreno

    2014-11-01

    Full Text Available The purpose of this study was to determine the effect of respiratory muscle fatigue on intercostal and forearm muscle perfusion and oxygenation in patients with heart failure. Five clinically stable heart failure patients with respiratory muscle weakness (age, 66±12 years; left ventricle ejection fraction, 34±3% and nine matched healthy controls underwent a respiratory muscle fatigue protocol, breathing against a fixed resistance at 60% of their maximal inspiratory pressure for as long as they could sustain the predetermined inspiratory pressure. Intercostal and forearm muscle blood volume and oxygenation were continuously monitored by near-infrared spectroscopy with transducers placed on the seventh left intercostal space and the left forearm. Data were compared by two-way ANOVA and Bonferroni correction. Respiratory fatigue occurred at 5.1±1.3 min in heart failure patients and at 9.3±1.4 min in controls (P0.05. Respiratory fatigue in heart failure reduced intercostal and forearm muscle blood volume (P<0.05 along with decreased tissue oxygenation both in intercostal (heart failure, -2.6±1.6%; controls, +1.6±0.5%; P<0.05 and in forearm muscles (heart failure, -4.5±0.5%; controls, +0.5±0.8%; P<0.05. These results suggest that respiratory fatigue in patients with heart failure causes an oxygen demand/delivery mismatch in respiratory muscles, probably leading to a reflex reduction in peripheral limb muscle perfusion, featuring a respiratory metaboreflex.

  17. Proximal Alternating Direction Method with Relaxed Proximal Parameters for the Least Squares Covariance Adjustment Problem

    Directory of Open Access Journals (Sweden)

    Minghua Xu

    2014-01-01

    Full Text Available We consider the problem of seeking a symmetric positive semidefinite matrix in a closed convex set to approximate a given matrix. This problem may arise in several areas of numerical linear algebra or come from finance industry or statistics and thus has many applications. For solving this class of matrix optimization problems, many methods have been proposed in the literature. The proximal alternating direction method is one of those methods which can be easily applied to solve these matrix optimization problems. Generally, the proximal parameters of the proximal alternating direction method are greater than zero. In this paper, we conclude that the restriction on the proximal parameters can be relaxed for solving this kind of matrix optimization problems. Numerical experiments also show that the proximal alternating direction method with the relaxed proximal parameters is convergent and generally has a better performance than the classical proximal alternating direction method.

  18. Design and Kinematic Evaluation of a Novel Joint-Specific Play Controller: Application for Wrist and Forearm Therapy.

    Science.gov (United States)

    Crisco, Joseph J; Schwartz, Joel B; Wilcox, Bethany; Costa, Laura; Kerman, Karen

    2015-07-01

    The wrist extensors and flexors are profoundly affected in most children with hemiparetic cerebral palsy (CP) and are the major target of physical therapists' and occupational therapists' efforts to restore useful hand functions. A limitation of any therapeutic or exercise program can be the level of the child's engagement or adherence. The proposed approach capitalizes on the primary learning avenue for children: toy play. This study aimed to develop and evaluate the measurement accuracy of innovative, motion-specific play controllers that are engaging rehabilitative devices for enhancing therapy and promoting neural plasticity and functional recovery in children with CP. Design objectives of the play controller included a cost-effective, home-based supplement to physical therapy, the ability to calibrate the controller so that play can be accomplished with any active range of motion, and the capability of logging play activity and wrist motion over week-long periods. Accuracy of the play controller in measuring wrist flexion-extension was evaluated in 6 children who were developing in a typical manner, using optical motion capture of the wrist and forearm as the gold standard. The error of the play controller was estimated at approximately 5 degrees in both maximum wrist flexion and extension. Measurements were taken during a laboratory session, with children without CP, and no toy or computer game was interfaced with the play controller. Therefore, the potential engagement of the proposed approach for therapy remains to be evaluated. This study presented the concept, development, and wrist tracking accuracy of an inexpensive approach to extremity therapy that may have a health benefit for children with hemiparesis, and potentially for patients of any age with a wide range of extremity neuromotor impairments. © 2015 American Physical Therapy Association.

  19. The Life Saving Effects of Hospital Proximity

    DEFF Research Database (Denmark)

    Bertoli, Paola; Grembi, Veronica

    We assess the lifesaving effect of hospital proximity using data on fatality rates of road-traffic accidents. While most of the literature on this topic is based on changes in distance to the nearest hospital triggered by hospital closures and use OLS estimates, our identification comes from......) increases the fatality rate by 13.84% on the sample average. This is equal to a 0.92 additional death per every 100 accidents. We show that OLS estimates provide a downward biased measure of the real effect of hospital proximity because they do not fully solve spatial sorting problems. Proximity matters...

  20. Inter-individual difference in the effect of mirror reflection-induced visual feedback on phantom limb awareness in forearm amputees.

    Directory of Open Access Journals (Sweden)

    Noritaka Kawashima

    Full Text Available OBJECTIVE: To test whether the phantom limb awareness could be altered by observing mirror reflection-induced visual feedback (MVF in unilateral forearm amputees. METHODS: Ten unilateral forearm amputees were asked to perform bilateral (intact and phantom synchronous wrist motions with and without MVF. During wrist motion, electromyographic activities in the extensor digitorum longus (EDL and flexor carpi radialis muscles (FCR were recorded with bipolar electrodes. Degree of wrist range of motion (ROM was also recorded by electrogoniometry attached to the wrist joint of intact side. Subjects were asked to answer the degree of attainment of phantom limb motion using a visual analog scale (VAS: ranging from 0 (hard to 10 (easy. RESULTS: VAS and ROM were significantly increased by utilizing MVF, and the extent of an enhancement of the VAS and wrist ROM was positively correlated (r = 0.72, p<0.05. Although FCR EMG activity also showed significant enhancement by MVF, this was not correlated with the changes of VAS and ROM. Interestingly, while we found negative correlation between EDL EMG activity and wrist ROM, MVF generally affected to be increasing both EDL EMG and ROM. CONCLUSIONS: Although there was larger extent of variability in the effect of MVF on phantom limb awareness, MVF has a potential to enhance phantom limb awareness, in case those who has a difficulty for the phantom limb motion. The present result suggests that the motor command to the missing limb can be re-activated by an appropriate therapeutic strategy such as mirror therapy.

  1. Assessment of pepper spray product potency in Asian and Caucasian forearm skin using transepidermal water loss, skin temperature and reflectance colorimetry.

    Science.gov (United States)

    Pershing, Lynn K; Reilly, Christopher A; Corlett, Judy L; Crouch, Dennis J

    2006-01-01

    Historically, pepper spray product potency has been established using a taste test evaluation. A taste test is subjective and may not be appropriate for assessing pepper potency in skin. The current study evaluated chemically diverse pepper sprays in human forearm skin using three objective, noninvasive parameters: transepidermal water loss, skin surface temperature and erythema, as a means for assessing dermal pharmacology, toxicology and product potency. Five commercial pepper spray products containing various capsaicinoid analogs at various concentrations were evaluated in duplicate on volar forearms of six Caucasians and six Asians using a 10 min exposure. Mean surface skin temperature, transepidermal water loss results were highly variable and therefore did not demonstrate dose responsive behavior to increasing capsaicinoid concentrations. Erythema, as measured by increases in a* (reflected light in the red-to-green color spectrum) of the L*a*b* uniform color scale, was superior among parameters evaluated in discriminating pepper spray potency and correlated well with the relative and total capsaicinoid concentration in the products. Products containing greater than 16 mg ml(-1) capsaicinoid concentration produced greater erythema responses in Caucasians than Asians. Asians responded greater to the synthetic analog, nonivamide, than to mixtures of capsaicinoids, while Caucasians responded equally to both capsaicinoid analogs. Thus, pepper spray product potency in human skin reflects the total capsaicinoid concentration, the specific capsaicin analog(s) present, and the race of the individual exposed. The finding that the reflectance colorimeter a* scale can differentiate these parameters in skin will have a significant impact on evaluating the use and efficacy of pepper spray products in humans. 2005 John Wiley & Sons, Ltd.

  2. Proximity to coast is linked to climate change belief.

    Science.gov (United States)

    Milfont, Taciano L; Evans, Laurel; Sibley, Chris G; Ries, Jan; Cunningham, Andrew

    2014-01-01

    Psychologists have examined the many psychological barriers to both climate change belief and concern. One barrier is the belief that climate change is too uncertain, and likely to happen in distant places and times, to people unlike oneself. Related to this perceived psychological distance of climate change, studies have shown that direct experience of the effects of climate change increases climate change concern. The present study examined the relationship between physical proximity to the coastline and climate change belief, as proximity may be related to experiencing or anticipating the effects of climate change such as sea-level rise. We show, in a national probability sample of 5,815 New Zealanders, that people living in closer proximity to the shoreline expressed greater belief that climate change is real and greater support for government regulation of carbon emissions. This proximity effect held when adjusting for height above sea level and regional poverty. The model also included individual differences in respondents' sex, age, education, political orientation, and wealth. The results indicate that physical place plays a role in the psychological acceptance of climate change, perhaps because the effects of climate change become more concrete and local.

  3. Proximity to coast is linked to climate change belief.

    Directory of Open Access Journals (Sweden)

    Taciano L Milfont

    Full Text Available Psychologists have examined the many psychological barriers to both climate change belief and concern. One barrier is the belief that climate change is too uncertain, and likely to happen in distant places and times, to people unlike oneself. Related to this perceived psychological distance of climate change, studies have shown that direct experience of the effects of climate change increases climate change concern. The present study examined the relationship between physical proximity to the coastline and climate change belief, as proximity may be related to experiencing or anticipating the effects of climate change such as sea-level rise. We show, in a national probability sample of 5,815 New Zealanders, that people living in closer proximity to the shoreline expressed greater belief that climate change is real and greater support for government regulation of carbon emissions. This proximity effect held when adjusting for height above sea level and regional poverty. The model also included individual differences in respondents' sex, age, education, political orientation, and wealth. The results indicate that physical place plays a role in the psychological acceptance of climate change, perhaps because the effects of climate change become more concrete and local.

  4. Open reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate. Surgical technique.

    Science.gov (United States)

    Konrad, G; Bayer, J; Hepp, P; Voigt, C; Oestern, H; Kääb, M; Luo, C; Plecko, M; Wendt, K; Köstler, W; Südkamp, N

    2010-03-01

    The treatment of unstable displaced proximal humeral fractures, especially in the elderly, remains controversial. The objective of the present prospective, multicenter, observational study was to evaluate the functional outcome and the complication rate after open reduction and internal fixation of proximal humeral fractures with use of a locking proximal humeral plate. One hundred and eighty-seven patients (mean age, 62.9 +/- 15.7 years) with an acute proximal humeral fracture were managed with open reduction and internal fixation with a locking proximal humeral plate. At the three-month, six month,and one-year follow-up examinations, 165 (88%), 158 (84%), and 155 (83%) of the 187 patients were assessed with regard to pain, shoulder mobility, and strength. The Constant score was determined at each interval, and the Disabilities of the Arm, Shoulder and Hand (DASH) score was determined for the injured and contralateral extremities at the time of the one-year follow-up. Between three months and one year, the mean range of motion and the mean Constant score for the injured shoulders improved substantially. Twelve months after surgery, the mean Constant score for the injured side was 70.6 +/- 13.7 points, corresponding to 85.1% +/- 14.0% of the score for the contralateral side. The mean DASH score at the time of the one-year follow-up was 15.2 +/- 16.8 points. Sixty-two complications were encountered in fifty-two (34%) of 155 patients at the time of the one-year follow-up. Twenty-five complications (40%) were related to incorrect surgical technique and were present at the end of the operative procedure. The most common complication, noted in twenty-one (14%) of 155 patients, was intraoperative screw perforation of the humeral head. Twenty-nine patients (19%) had an unplanned second operation within twelve months after the fracture. Surgical treatment of displaced proximal humeral fractures with use of the locking proximal humeral plate that was evaluated in the

  5. Disruption of the proximal tibiofibular joint in the setting of multi-ligament knee injury

    Energy Technology Data Exchange (ETDEWEB)

    Porrino, Jack A. [University of Washington, Department of Radiology, 4245 Roosevelt Way NE, Box 354755, Seattle, WA (United States)

    2015-08-15

    Instability of the proximal tibiofibular joint is a relatively uncommon condition when in isolation; however, instability of the proximal tibiofibular joint is far more frequent in those presenting with a severe multi-ligament injury of the knee. If this joint is left unstable, repair of a co-existent injury of the posterolateral corner may fail, regardless of the proficiency of the technique. We present two patients with disruption of the proximal tibiofibular joint, including the MRI appearance, who initially presented to our hospital for management of significant polytrauma, as well as multi-ligament injury of the ipsilateral knee. (orig.)

  6. Proximity and Collaboration in European Nanotechnology

    NARCIS (Netherlands)

    Cunningham, S.W.; Werker, C.

    2011-01-01

    Collaborations are particularly important for the development and deployment of technology. We analyze the influence of organizational, technological and geographical proximity on European nanotechnology collaborations with the help of a publication dataset and additional geographical information.

  7. Ammonia transport in the proximal tubule.

    Science.gov (United States)

    Hamm, L L; Simon, E E

    1990-01-01

    The transport of ammonia in the proximal tubule is a complex interaction of a number of processes. Ammonia transport in the proximal tubule is clearly bidirectional; ammonia is secreted into the early proximal tubule lumen, but later in the proximal tubule, efflux out of the lumen may result in net ammonia reabsorption. Two mechanisms of ammonia transport have clearly been established: NH3 diffusion and NH4+ transport on the Na(+)-H+ exchanger. The relative contribution of these pathways to ammonia transport is still unsettled. Other pathways for ammonia transport, particularly NH4+ efflux out of the lumen, may be important as well. A variety of factors may modulate ammonia transport: plasma, cell and luminal pH, luminal flow rate, luminal potassium, and angiotensin II. Each of these factors also alters ammonia production rates and in most circumstances, ammonia transport appears to follow ammonia production rates.

  8. Proximate composition and cholesterol concentrations of ...

    African Journals Online (AJOL)

    STORAGESEVER

    2009-05-18

    DWB) for raw and fried samples, respectively, but decreased to 295.20 ... Key words: Rhynchophorus phoenicis, Oryctes monoceros, proximate composition, cholesterol, heat treatment. INTRODUCTION. Insects have played ...

  9. COMPARATIVE ANALYSIS OF PROXIMATE COMPOSITIONS OF ...

    African Journals Online (AJOL)

    Babatunde Emmanuel

    2011-10-06

    Oct 6, 2011 ... Fish allows for protein improved nutrition in that it has a high biological value in terms of high ... marine algae upon which the fish feed [11]. ... Proximate composition of catfish Clarias gariepinus and Tarpon atlanticus were.

  10. Phytochemical screening, proximate analysis and acute toxicity ...

    African Journals Online (AJOL)

    Phytochemical screening, proximate analysis and acute toxicity studies were carried out on the leaf extract of Cola lepidota, in accordance with established standard procedures. The proximate analysis reveals a moisture content of 27.43 ± 3.11 % w/w, total ash value 9.32 ± 0.27 % w/w, acid insoluble ash 3.12 ± 1.05 % w/w ...

  11. Proximate, Mineral and Phytochemical Composition of Dioscorea ...

    African Journals Online (AJOL)

    ADOWIE PERE

    ABSTRACT: Proximate, mineral and phytochemical composition of Dioscorea dumetorum tubers was investigated using standard procedures. Proximate analysis included in g% dry weight: crude protein (6.44 ± 0.32), crude fat (0.75 ± 0.04), crude fibre (15.00 ± 0.56), total ash. (3.45 ± 0.20) and a moisture content of 70.04 ...

  12. Painful Spastic Hip Dislocation: Proximal Femoral Resection

    OpenAIRE

    Albiñana, Javier; Gonzalez-Moran, Gaspar

    2002-01-01

    The dislocated hip in a non-ambulatory child with spastic paresis tends to be a painful interference to sleep, sitting upright, and perineal care. Proximal femoral resection-interposition arthroplasty is one method of treatment for this condition. We reviewed eight hips, two bilateral cases, with a mean follow-up of 30 months. Clinical improvement was observed in all except one case, with respect to pain relief and sitting tolerance. Some proximal migration was observed in three cases, despit...

  13. Proximity sensor system development. CRADA final report

    Energy Technology Data Exchange (ETDEWEB)

    Haley, D.C. [Oak Ridge National Lab., TN (United States); Pigoski, T.M. [Merrit Systems, Inc. (United States)

    1998-01-01

    Lockheed Martin Energy Research Corporation (LMERC) and Merritt Systems, Inc. (MSI) entered into a Cooperative Research and Development Agreement (CRADA) for the development and demonstration of a compact, modular proximity sensing system suitable for application to a wide class of manipulator systems operated in support of environmental restoration and waste management activities. In teleoperated modes, proximity sensing provides the manipulator operator continuous information regarding the proximity of the manipulator to objects in the workspace. In teleoperated and robotic modes, proximity sensing provides added safety through the implementation of active whole arm collision avoidance capabilities. Oak Ridge National Laboratory (ORNL), managed by LMERC for the United States Department of Energy (DOE), has developed an application specific integrated circuit (ASIC) design for the electronics required to support a modular whole arm proximity sensing system based on the use of capacitive sensors developed at Sandia National Laboratories. The use of ASIC technology greatly reduces the size of the electronics required to support the selected sensor types allowing deployment of many small sensor nodes over a large area of the manipulator surface to provide maximum sensor coverage. The ASIC design also provides a communication interface to support sensor commands from and sensor data transmission to a distributed processing system which allows modular implementation and operation of the sensor system. MSI is a commercial small business specializing in proximity sensing systems based upon infrared and acoustic sensors.

  14. Transformations through Proximity Flying: A Phenomenological Investigation

    Science.gov (United States)

    Holmbom, Maria; Brymer, Eric; Schweitzer, Robert D.

    2017-01-01

    Participation in extreme sports has been linked to personal transformations in everyday life. Descriptions of lived experience resulting from transformative experiences are limited. Proximity flying, a relatively new discipline involving BASE jumping with a wingsuit where participants fly close to solid structures, is arguably one of the most extreme of extreme sports. The aim of this paper, part of a larger phenomenological study on the lived experience of proximity flying, is to explicate the ways in which participating in proximity flying influences the everyday lives of participants. Interpretative phenomenological analysis was used to explicate the lived experience of six proximity pilots. An analysis of interview transcripts revealed three significant themes describing the lived experience of participants. First, experiences of change were described as positive and skills developed through proximity flying were transferable into everyday life. Second, transformative experiences were considered fundamental to participants’ perspectives on life. Third, experience of transformation influenced their sense of personal identity and facilitated flourishing in other aspects of everyday life. Participants were clear that their experiences in proximity flying facilitated a profound process of transformation which manifest as changes in everyday capabilities and behaviors, values and sense of identity. PMID:29104552

  15. Proximal spinal muscular atrophy: current orthopedic perspective

    Directory of Open Access Journals (Sweden)

    Haaker G

    2013-11-01

    Full Text Available Gerrit Haaker, Albert Fujak Department of Orthopaedic Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany Abstract: Spinal muscular atrophy (SMA is a hereditary neuromuscular disease of lower motor neurons that is caused by a defective "survival motor neuron" (SMN protein that is mainly associated with proximal progressive muscle weakness and atrophy. Although SMA involves a wide range of disease severity and a high mortality and morbidity rate, recent advances in multidisciplinary supportive care have enhanced quality of life and life expectancy. Active research for possible treatment options has become possible since the disease-causing gene defect was identified in 1995. Nevertheless, a causal therapy is not available at present, and therapeutic management of SMA remains challenging; the prolonged survival is increasing, especially orthopedic, respiratory and nutritive problems. This review focuses on orthopedic management of the disease, with discussion of key aspects that include scoliosis, muscular contractures, hip joint disorders, fractures, technical devices, and a comparative approach of conservative and surgical treatment. Also emphasized are associated complications including respiratory involvement, perioperative care and anesthesia, nutrition problems, and rehabilitation. The SMA disease course can be greatly improved with adequate therapy with established orthopedic procedures in a multidisciplinary therapeutic approach. Keywords: spinal muscular atrophy, scoliosis, contractures, fractures, lung function, treatment, rehabilitation, surgery, ventilation, nutrition, perioperative management

  16. Treatment of three- and four-part proximal humeral fractures with locking proximal humerus plate.

    Science.gov (United States)

    Sun, Jing-Cheng; Li, Yu-Lin; Ning, Guang-Zhi; Wu, Qiang; Feng, Shi-Qing

    2013-08-01

    The purpose of this study was to evaluate the effectiveness and complications of the locking proximal humerus plate to treat proximal humerus fractures. A retrospective clinical trial. Department of Orthopaedics, Tianjin Medical University General Hospital. Sixty-eight consecutive patients with three- or four-part fractures of the proximal humerus were treated with locking proximal humerus plates. The deltopectoral anterolateral acromial approach was used to the proximal humerus; open reduction and locking proximal humerus plate were applied. Constant Score was used to measure the shoulder functional recovery, and Visual Analog Scale (VAS) was used to measure subjective evaluation of pain. The radiology was observed. After average 26.7 months, the average Constant Score was 72.6 ± 13.2 points and the average VAS was 1.2 ± 0.8 points. All the complications such as screw perforation into the glenohumeral joint, screws loosening, soft tissue infections, avascular necrosis and delayed union occurred in eight cases (11.8 %). The effectiveness of the locking proximal humerus plate was similar to other published literatures on treating fractures of the proximal humerus; however, a lower complications rate in short follow-up time was observed in this study. It may potentially provide a favorable option for treating three- or four-part fractures of the proximal humerus. Dealing with each particular fracture pattern, surgeons should have a decision of appropriate way to internal fixation.

  17. Bilateral trampoline fracture of the proximal tibia in a child

    Directory of Open Access Journals (Sweden)

    Enrico B Arkink, MD

    2017-12-01

    Full Text Available Trampoline fractures are transversely oriented impaction fractures of the proximal tibia sustained by young children jumping on a trampoline. Unaware of the mechanism of this specific nontraumatic fracture, physicians may fail to detect these fractures on plain radiographs, as radiological findings may be very subtle. In this case report, we present a rare case of bilateral trampoline fractures with an explanation of the trauma mechanism.

  18. Convex programming with fast proximal and linear operators

    OpenAIRE

    Wytock, Matt; Wang, Po-Wei; Kolter, J. Zico

    2015-01-01

    We present Epsilon, a system for general convex programming using fast linear and proximal operators. As with existing convex programming frameworks, users specify convex optimization problems using a natural grammar for mathematical expressions, composing functions in a way that is guaranteed to be convex by the rules of disciplined convex programming. Given such an input, the Epsilon compiler transforms the optimization problem into a mathematically equivalent form consisting only of functi...

  19. Position of arm and forearm, and elbow flexion during performance of the sculling technique: Technical recommendation versus actual performance

    Directory of Open Access Journals (Sweden)

    Lara Elena Gomes

    2014-03-01

    Full Text Available Sculling motion is a swimming technique executed in a vertical position with the head above the water's surface and, based on the technical recommendation, should be performed maintaining an elbow flexion angle of 90°, arms kept stationary while the forearms move. In order to verify if this recommendation is indeed realistic, the aim of this study was to describe the elbow flexion angle ant its angular velocity, linear speed and range of motion of the shoulder, elbow and wrist during the sculling motion. Data were calculated using three-dimensional kinematic process from underwater video images of ten athletes of synchronized swimming. The results indicate that the arm is relatively stationary and the forearm moves, which agrees with the technical recommendation. However, the elbow flexes and extends, which contradicts the technical recommendation. These findings should be considered when this action is practiced, especially in synchronized swimming, in which sculling motion is a fundamental technique.

  20. Complications and outcomes of diaphyseal forearm fracture intramedullary nailing: a comparison of pediatric and adolescent age groups.

    Science.gov (United States)

    Martus, Jeffrey E; Preston, Ryan K; Schoenecker, Jonathan G; Lovejoy, Steven A; Green, Neil E; Mencio, Gregory A

    2013-09-01

    Flexible intramedullary nailing (IMN) has become a popular technique for the management of unstable or open forearm fractures. Recent publications have suggested an increased incidence of delayed union and poor outcomes in older children and adolescents. The objective of this study was to review forearm fractures treated with IMN, comparing the rate of complications and outcomes between the 2 age groups. Our hypothesis was that IMN is an effective technique with a similar rate of complications in both age groups. An Institutional Review Board-approved retrospective review was conducted of pediatric forearm fractures treated from 1998 to 2008 at a single institution. Over the study time period, 4161 pediatric forearm fractures were managed nonoperatively (92%) and 353 were treated operatively with plate, cross-pin, or intramedullary fixation (8%). Patients with inadequate follow-up, cross-pin, or plate fixation were excluded. Medical records were reviewed for indications and complications. Complications were graded with a modification of the Clavien-Dindo classification. Outcomes were judged by a new grading system. A total of 205 forearm fractures treated with IMN in 203 patients were identified. The mean age was 9.7 years (range, 1.7 to 16.2 y) and mean follow-up was 42 weeks. Operative indications were failure of closed treatment in 165 (80%) and open fracture in 40 (20%). Mean time from injury to IMN was 5.9 days (range, 0 to 25 d). Single bone IMN was performed in 40 of 185 both bone fractures (26%); there were 20 single-bone forearm fractures treated with IMN. Open reduction was required in 61/165 (37%) of closed fractures. Asymptomatic delayed union (grade 1 complication) was observed in 9 fractures (4%). More severe complications were noted in 17% (grade 2 to 4 complications). Postoperative compartment syndrome occurred in 3 isolated forearm fractures with a significant younger mean age (6.0 vs. 10 y, P=0.031). Overall, complications were significantly more

  1. The value of postoperative anticoagulants to improve flap survival in the free radial forearm flap: A systematic review and retrospective multicenter analysis.

    NARCIS (Netherlands)

    Swartz, Justin E.; Aarts, Mark; Swart, Karin M A; Disa, Joseph J; Gerressen, Marcus; Kuo, Yur Ren; Wax, Mark K; Grolman, Wilko; Braunius, Weibel W

    2015-01-01

    BACKGROUND: Free radial forearm flap (FRFF) reconstruction is a valuable technique in head and neck surgery, that allows closure of large defects while striving to maintain functionality. Anticoagulative drugs are often administered to improve flap survival, although evidence regarding effectiveness

  2. Low-frequency and low-intensity ultrasound irradiation to the forearm improves an index of arterial stiffness in subjects with type 2 diabetes and hypertension

    Directory of Open Access Journals (Sweden)

    Katsunori Nonogaki

    2017-09-01

    Conclusions: The low-frequency and low-intensity ultrasound irradiation to the forearm for 10 min might be useful as a preventive application for arterial stiffness in subjects with type 2 diabetes and hypertension.

  3. Proximity ligation in situ assay for monitoring the global DNA methylation in cells

    National Research Council Canada - National Science Library

    Hervouet, Eric; Hulin, Philippe; Vallette, François M; Cartron, Pierre-François

    2011-01-01

    .... We here present the development of the detection of protein-protein interactions via the adaptation of the proximity ligation in situ technology to evaluate the DNA methylation status in cells since...

  4. Repeated cycles of electrical stimulation decrease vasoconstriction and axon-reflex vasodilation to noradrenaline in the human forearm

    Science.gov (United States)

    Drummond, Peter D

    2007-01-01

    What is already known about this subject Repeated cycles of electrical stimulation inhibit cutaneous vasoconstriction to noradrenaline, but the mechanism is unknown. Investigating this is important because peripheral electrical stimulation is useful for pain modulation and appears to assist cutaneous wound healing. What this study adds Intermittent, brief electrical stimulation of the forearm over a 10-day period inhibited vasoconstriction and axon-reflex vasodilation to noradrenaline, but did not affect vasoconstriction to vasopressin or axon-reflex vasodilation to histamine. Thus, electrical stimulation may evoke a specific reduction in responsiveness to noradrenaline. Aim To investigate whether desensitization to the vasomotor effects of noradrenaline is a specific effect of electrical stimulation. Methods Three sites on the forearm of 10 healthy volunteers were stimulated with 0.2 mA direct current for 2 min twice daily for 10 days. Noradrenaline and histamine were then displaced from ring-shaped iontophoresis chambers into two of the pretreated sites and two untreated sites on the contralateral forearm. Axon-reflex vasodilation was measured from the centre of the ring described by the iontophoresis chamber with a laser Doppler flowmeter. One or two days later, noradrenaline and vasopressin were introduced into pretreated and untreated sites by iontophoresis, and vasoconstriction at sites of administration was measured in the heated forearm. Results The pretreatment blocked vasoconstriction to noradrenaline [median increase in flow 1%, interquartile range (IR) −41 to 52%; median decrease at the untreated site 53%, IR. −70 to −10%; P noradrenaline was diminished at the pretreated site (median increase in flow 33%, IR 2–321%; untreated site 247%, IR 31–1087%; P noradrenaline. Repeated cycles of electrical stimulation may downregulate neural and vascular responses to noradrenaline by repetitively activating cutaneous sympathetic nerve fibres. PMID

  5. The Correlation Between the OTA/AO Classification System and Compartment Syndrome in Both Bone Forearm Fractures.

    Science.gov (United States)

    Auld, Thomas S; Hwang, John S; Stekas, Nicholas; Gibson, Peter D; Sirkin, Michael S; Reilly, Mark C; Adams, Mark R

    2017-11-01

    To evaluate the efficacy of using the Orthopaedic Trauma Association (OTA/AO) classification for both bone forearm fractures in predicting compartment syndrome. Retrospective cohort. Level 1 Academic Trauma Center. One hundred fifty-one patients 18 years of age and older, with both bone forearm fractures diagnosed from 2001 to 2016 were categorized based on the OTA/AO classification. Patients with both bone fractures caused by gunshot wounds were excluded. The endpoint for our study was whether forearm fasciotomies were performed based on the presence of compartment syndrome. Of a total of 151 both bone forearm fractures, 15% underwent fasciotomy. Six of 80 (7.5%) grouped 22-A3, 8 of 44 (18%) grouped 22-B3, and 9 of 27 (33%) grouped 22-C underwent fasciotomies for compartment syndrome (P = 0.004). The relative risks of developing compartment syndrome for group 22-B3 versus 22-A3 was 2.42 (P = 0.08), 22-C versus 22-B3 was 1.83 (P = 0.15), and 22-C versus 22-A3 was 4.44 (P = 0.002). There is a significant correlation between the OTA/AO classification and the need for fasciotomies, with group C fractures representing the highest risk. Clinicians can use this information to have a higher index of suspicion for compartment syndrome based on OTA/AO classification to help minimize the risk of a missed diagnosis. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

  6. [Stiffness of rotation of the forearm associated with contraction of the membrana interossea antebrachii (animal experiments) (author's transl)].

    Science.gov (United States)

    Küsswetter, W

    1982-01-01

    In 18 adult cats a wedge osteotomy in the middle of the radial shaft was performed and stabilized with plate fixation in 10 degrees axial deviation. After different times of survival forearm specimens were obtained. In a motion-simulator the elongation pattern of the interosseous membrane during pronation and supination was measured with strain gauges. Remarkable changes of the normal elongation pattern could be observed according to the deviation of the radius.

  7. Which factors affect limitation of pronation/supination after forearm fractures in children? A prospective multicentre study.

    Science.gov (United States)

    Colaris, Joost W; Allema, Jan Hein; Reijman, Max; de Vries, Mark R; Ulas Biter, L; Bloem, Rolf M; van de Ven, Cees P; Verhaar, Jan A N

    2014-04-01

    Both-bone forearm fractures in children frequently result in a limitation of pronation/supination, which hinders daily activities. The purpose of this prospective multicentre study was to investigate which clinical factors are related to the limitation of pronation/supination in children with a both-bone forearm fracture. In four Dutch hospitals, consecutive children (fracture were included. Children were followed up for 6-9 months and data from questionnaires, physical examination and X-rays were collected. Univariate and multivariate logistic regression analyses were used to assess the relationship between limitation of pronation/supination (≥20°) and several clinical factors. A group of 410 children with both-bone forearm fractures were included, of which 10 children missed the final examination (follow-up rate of 97.6%). We found that a re-fracture (odds ratio (OR) 11.7, 95% confidence interval (CI) 1.2; 118.5), a fracture in the diaphysis (OR 3.3, 95% CI 1.4; 7.9) and less physiotherapy during follow-up (OR 0.90, 95% CI 0.82; 0.98) were independently associated with a limitation of pronation/supination of 20° or more. These findings imply that a re-fracture and a diaphyseal located fracture were associated independently of each other with a limitation of pronation/supination in children with a both-bone forearm fracture. Furthermore, in children with severe limitation extensive physiotherapy is associated with better functional outcome. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Nanocrystal Bioassembly: Asymmetry, Proximity, and Enzymatic Manipulation

    Energy Technology Data Exchange (ETDEWEB)

    Claridge, Shelley A. [Univ. of California, Berkeley, CA (United States)

    2008-05-01

    Research at the interface between biomolecules and inorganic nanocrystals has resulted in a great number of new discoveries. In part this arises from the synergistic duality of the system: biomolecules may act as self-assembly agents for organizing inorganic nanocrystals into functional materials; alternatively, nanocrystals may act as microscopic or spectroscopic labels for elucidating the behavior of complex biomolecular systems. However, success in either of these functions relies heavily uponthe ability to control the conjugation and assembly processes.In the work presented here, we first design a branched DNA scaffold which allows hybridization of DNA-nanocrystal monoconjugates to form discrete assemblies. Importantly, the asymmetry of the branched scaffold allows the formation of asymmetric2assemblies of nanocrystals. In the context of a self-assembled device, this can be considered a step toward the ability to engineer functionally distinct inputs and outputs.Next we develop an anion-exchange high performance liquid chromatography purification method which allows large gold nanocrystals attached to single strands of very short DNA to be purified. When two such complementary conjugates are hybridized, the large nanocrystals are brought into close proximity, allowing their plasmon resonances to couple. Such plasmon-coupled constructs are of interest both as optical interconnects for nanoscale devices and as `plasmon ruler? biomolecular probes.We then present an enzymatic ligation strategy for creating multi-nanoparticle building blocks for self-assembly. In constructing a nanoscale device, such a strategy would allow pre-assembly and purification of components; these constructs can also act as multi-label probes of single-stranded DNA conformational dynamics. Finally we demonstrate a simple proof-of-concept of a nanoparticle analog of the polymerase chain reaction.

  9. Modified folding radial forearm flap in soft palate and tonsillar fossa reconstruction.

    Science.gov (United States)

    Kang, Hyun Gu; Park, Myong Chul; Lim, Hyoseob; Kim, Joo Hyoung; Lee, Il Jae

    2013-03-01

    Wide excision of cancer arising from the tonsillar fossa and soft palate has several functional sequelae (e.g., speech, swallowing, chewing, and breathing) that require surgical restoration of the pharyngeo-palatal structure and optimal velopharyngeal function. For this purpose, several kinds of surgical procedures have been introduced. Our method to reconstruct the tonsillar fossa and soft palate entails folding the flaps and reconstructions at the same time as the oral and nasal planes, with some modifications.Patient 1 was a 64-year-old man with left soft palate cancer. After wide excision of the tumor, the defect size of the nasal floor was 3 × 3 cm, and that of soft palate and tonsillar fossa was 8 × 5 cm. Patient 2 was a 49-year-old man with left tonsil cancer. The defect size of the nasal floor was 3 × 3 cm, and that of left lateral wall of the tonsillar fossa was 8 × 3 cm. For reconstruction of oral, nasal, and tonsillar plane, we designed the flap fit to the defect site, especially cutting of the edge of the square plane of the flap to a round shape.Both patients achieved good functional recovery without surgical complications. The average speech intelligibility score in the 2 patients was 10. Swallowing functional score was 4 in both patients. Creative reconstruction with modified radial forearm free flap for tonsillar and soft palate area makes it possible to restore velopharyngeal function to levels close to the preoperative condition.

  10. The diagnostic value of hyperammonaemia induced by the non-ischaemic forearm exercise test.

    Science.gov (United States)

    Hogrel, Jean-Yves; Janssen, Jorien B E; Ledoux, Isabelle; Ollivier, Gwenn; Béhin, Anthony; Stojkovic, Tanya; Eymard, Bruno; Voermans, Nicol C; Laforet, Pascal

    2017-10-01

    The non-ischaemic forearm exercise test (NIFET) is used as a diagnostic tool for the screening of patients with exercise intolerance and for the diagnosis of various metabolic muscle disorders. The production of lactate and ammonia are generally analysed to guide the diagnosis. The aim of this retrospective study was to determine the level of ammonia rise, which can be suggestive of a muscle disease. This retrospective study involved 1440 patients who underwent NIFET. The clinical files of the patients with hyperammonaemia were methodically studied. Normal values were derived from 60 healthy controls. 110 patients with hyperammonaemia were detected. They were classified as either having mild (between 94 and 141 µmol/L) or severe (more than 141 µmol/L) hyperammonaemia. Their diagnosis was studied with respect to the increase in lactate induced by the NIFET. Severe postexercise hyperammonaemia, even in the presence of a normal lactate response, is strongly suggestive of a muscle glycogen storage disease. Mild hyperammonaemia in the absence of other abnormalities is most likely non-specific and not indicative of a muscle disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Functional outcomes and quality of life after total laryngectomy with noncircumferential radial forearm free tissue transfer.

    Science.gov (United States)

    Graville, Donna J; Palmer, Andrew D; Chambers, Christine M; Ottenstein, Lauren; Whalen, Breanne; Andersen, Peter E; Wax, Mark K; Cohen, James I

    2017-11-01

    The purpose of this study was to compare long-term functional and quality of life (QOL) outcomes after total laryngectomy with primary closure and those who underwent reconstruction with noncircumferential radial free forearm tissue transfer (RFFTT). Sixty-seven patients were identified by chart review and underwent long-term follow-up using QOL surveys and standardized interviews. The RFFTT group had significantly higher rates of chemotherapy, gastric tube (G-tube) at surgery, and postoperative stricture. At follow-up, most patients (88%) had a tracheoesophageal prosthesis (TEP) and were using it as their primary communication method. Diet and swallowing outcomes were comparable and no one had a G-tube. Device life and TEP complications did not differ significantly. Only voice-related QOL differed significantly between the RFFTT group and those who had undergone total laryngectomy without adjuvant treatment. Despite more extensive treatment, the reconstructed group achieved comparable outcomes to those who had undergone total laryngectomy with adjuvant treatment. © 2017 Wiley Periodicals, Inc.

  12. Wearable Sensors for eLearning of Manual Tasks: Using Forearm EMG in Hand Hygiene Training.

    Science.gov (United States)

    Kutafina, Ekaterina; Laukamp, David; Bettermann, Ralf; Schroeder, Ulrik; Jonas, Stephan M

    2016-08-03

    In this paper, we propose a novel approach to eLearning that makes use of smart wearable sensors. Traditional eLearning supports the remote and mobile learning of mostly theoretical knowledge. Here we discuss the possibilities of eLearning to support the training of manual skills. We employ forearm armbands with inertial measurement units and surface electromyography sensors to detect and analyse the user's hand motions and evaluate their performance. Hand hygiene is chosen as the example activity, as it is a highly standardized manual task that is often not properly executed. The World Health Organization guidelines on hand hygiene are taken as a model of the optimal hygiene procedure, due to their algorithmic structure. Gesture recognition procedures based on artificial neural networks and hidden Markov modeling were developed, achieving recognition rates of 98 . 30 % ( ± 1 . 26 % ) for individual gestures. Our approach is shown to be promising for further research and application in the mobile eLearning of manual skills.

  13. Wearable Sensors for eLearning of Manual Tasks: Using Forearm EMG in Hand Hygiene Training

    Directory of Open Access Journals (Sweden)

    Ekaterina Kutafina

    2016-08-01

    Full Text Available In this paper, we propose a novel approach to eLearning that makes use of smart wearable sensors. Traditional eLearning supports the remote and mobile learning of mostly theoretical knowledge. Here we discuss the possibilities of eLearning to support the training of manual skills. We employ forearm armbands with inertial measurement units and surface electromyography sensors to detect and analyse the user’s hand motions and evaluate their performance. Hand hygiene is chosen as the example activity, as it is a highly standardized manual task that is often not properly executed. The World Health Organization guidelines on hand hygiene are taken as a model of the optimal hygiene procedure, due to their algorithmic structure. Gesture recognition procedures based on artificial neural networks and hidden Markov modeling were developed, achieving recognition rates of 98 . 30 % ( ± 1 . 26 % for individual gestures. Our approach is shown to be promising for further research and application in the mobile eLearning of manual skills.

  14. The Application of Memetic Algorithms for Forearm Crutch Design: A Case Study

    Directory of Open Access Journals (Sweden)

    Teresa Wu

    2011-01-01

    Full Text Available Product design has normally been performed by teams, each with expertise in a specific discipline such as material, structural, and electrical systems. Traditionally, each team would use its member's experience and knowledge to develop the design sequentially. Collaborative design decisions explore the use of optimization methods to solve the design problem incorporating a number of disciplines simultaneously. It is known that such optimized product design is superior to the design found by optimizing each discipline sequentially due to the fact that it enables the exploitation of the interactions between the disciplines. In this paper, a bi-level decentralized framework based on Memetic Algorithm (MA is proposed for collaborative design decision making using forearm crutch as the case. Two major decisions are considered: the weight and the strength. We introduce two design agents for each of the decisions. At the system level, one additional agent termed facilitator agent is created. Its main function is to locate the optimal solution for the system objective function which is derived from the Pareto concept. Thus to Pareto optimum for both weight and strength is obtained. It is demonstrated that the proposed model can converge to Pareto solutions.

  15. The impact of exercise training on the diameter dilator response to forearm ischaemia in healthy men.

    Science.gov (United States)

    Thijssen, D H J; Tinken, T M; Hopkins, N; Dawson, E A; Cable, N T; Green, D J

    2011-04-01

    Recent studies found differences between groups in the rate of diameter increase following the flow-mediated dilation (FMD). Whilst exercise training alters the magnitude of the FMD, little is known about the impact of exercise training on the rate of diameter increase. The aim of this study is to examine post-cuff deflation changes in brachial artery diameter following 5 min forearm ischaemia every 2 weeks across 8-weeks of a handgrip exercise training regimen. Post-deflation changes in brachial artery diameter following 5-min of ischaemia were examined before, after and every 2-weeks across an 8-week handgrip training programme in healthy young men (n = 11) using echo-Doppler. The magnitude of dilation increased at week 2-4-6, but returned towards baseline values at week 8 (anova: P = 8.001). The time-to-peak diameter (42 ± 15s) demonstrated a significant prolongation at week 4 (77 ± 32s), but returned towards baseline values at weeks 6 and 8 (anova: P < 0.001). The rate of diameter increase did not differ across the intervention. Exercise training in healthy subjects is initially characterized by a larger dilation. Since the rate of dilation did not change, a longer time-to-peak dilation was necessary to achieve the increase in magnitude of dilation. As exercise training continues, the timing and magnitude of the peak diameter response returns to near baseline levels.

  16. Development and Control of a Robotic Exoskeleton for Shoulder, Elbow and Forearm Movement Assistance

    Directory of Open Access Journals (Sweden)

    Mohammad Habibur Rahman

    2012-01-01

    Full Text Available World health organization reports, annually more than 15 million people worldwide suffer a stroke and cardiovascular disease, among which 85% of stroke patients incur acute arm impairment, and 40% of victims are chronically impaired or permanently disabled. This results a burden on the families, communities and to the country as well. Rehabilitation programs are the main way to promote functional recovery in these individuals. Since the number of such cases is constantly growing and that the duration of treatment is long, an intelligent robot could significantly contribute to the success of these programs. We therefore developed a new 5DoFs robotic exoskeleton named MARSE-5 (motion assistive robotic-exoskeleton for superior extremity that supposed to be worn on the lateral side of upper arm to rehabilitate and ease the shoulder, elbow and forearm movements. This paper focused on the design, modeling, development and control of the proposed MARSE-5. To control the exoskeleton, a nonlinear sliding mode control (SMC technique was employed. In experiments, trajectory tracking that corresponds to typical passive rehabilitation exercises was carried out. Experimental results reveal that the controller is able to maneuver the MARSE-5 efficiently to track the desired trajectories.

  17. Study of clutter origin in in-vivo epi-optoacoustic imaging of human forearms

    Science.gov (United States)

    Preisser, Stefan; Held, Gerrit; Akarçay, Hidayet G.; Jaeger, Michael; Frenz, Martin

    2016-09-01

    Epi-optoacoustic (OA) imaging offers flexible clinical diagnostics of the human body when the irradiation optic is attached to or directly integrated into the acoustic probe. Epi-OA images, however, encounter clutter that deteriorates contrast and significantly limits imaging depth. This study elaborates clutter origin in clinical epi-optoacoustic imaging using a linear array probe for scanning the human forearm. We demonstrate that the clutter strength strongly varies with the imaging location but stays stable over time, indicating that clutter is caused by anatomical structures. OA transients which are generated by strong optical absorbers located at the irradiation spot were identified to be the main source of clutter. These transients obscure deep in-plane OA signals when detected by the transducer either directly or after being acoustically scattered in the imaging plane. In addition, OA transients generated in the skin below the probe result in acoustic reverberations, which cause problems in image interpretation and limit imaging depth. Understanding clutter origin allows a better interpretation of clinical OA imaging, helps to design clutter compensation techniques and raises the prospect of contrast optimization via the design of the irradiation geometry.

  18. FRAX fracture risk in women with a recent fracture of the distal forearm

    DEFF Research Database (Denmark)

    Egsmose, Emilie Lund; Birkvig, Mette; Buhl, Thora

    2015-01-01

    The Fracture Risk Assessment Tool (FRAX) has been developed by the World Health Organization to evaluate the 10-year risk of a hip fracture and a major osteoporotic fracture. We examined the agreement between fracture risk calculated with and without femoral neck bone mineral density (BMD......) in individual patients and the impact of BMD measurement side. Bilateral femoral neck BMD results obtained by dual-energy X-ray absorptiometry and clinical risk factor data from 140 women (age 66 ± 8 years) with a recent distal forearm fracture were used for FRAX analyses. Discrepancies between pairs of risk...... of a major fracture and a hip fracture based on the lowest femoral neck BMD value was 23.8 ± 21.4 % and 7.6 ± 8.3 %, respectively. For major fracture risk assessed without versus with the lowest BMD value, lower and upper LoA were -12.3 and 21.1 percentage points (pp) (bias 4.4 pp, p 

  19. Is it reliable to measure the forearm blood pressure in children?

    Directory of Open Access Journals (Sweden)

    Amar M Taksande

    2015-01-01

    Full Text Available Background: When the upper arm (UA is inaccessible or a standard-sized blood pressure (BP cuff is unavailable, some healthcare workers use the forearm (FA to measure BP with a mercury sphygmomanometer. Objective: The objective was to determine the accuracy of BP measurement in the arm and FA. Design: Prospective, randomized study. Setting: Department of Pediatrics, JNMC, Sawangi (Meghe Participants: A total of 72 children aged 5-15 years. Measurements: Mercury and Automatic (OMRON Tokyo, 108-0075 Japan BP measurements were recorded from the arm and FA at 2 min intervals. Results: In our study, 72 children of both sexes were enrolled. The mean age of the children was 10.13 ± 2.82 years, and 48% were females. Pearson′s correlation coefficient between FA and UA systolic BP (SBP measured by mercury was 0.782, and for diastolic BP (DBP it was 0.824. Similarly, Pearson′s correlation coefficient between FA and UA SBP measured with an automated device (OMRON was 0.843, and for DBP it was 0.846. The average readings for the SBP and DBP were higher in the FA than in the UA by approximately 3 mmHg. There was a statistically significant difference in both SBP and DBP. Conclusions: The FA is an acceptable method of BP monitoring when the UA cannot be accessed. The pressure from FA is probably higher than it would be from UA.

  20. Plasma ATP concentration and venous oxygen content in the forearm during dynamic handgrip exercise

    Directory of Open Access Journals (Sweden)

    Askew Christopher D

    2009-12-01

    Full Text Available Abstract Background It has been proposed that adenosine triphosphate (ATP released from red blood cells (RBCs may contribute to the tight coupling between blood flow and oxygen demand in contracting skeletal muscle. To determine whether ATP may contribute to the vasodilatory response to exercise in the forearm, we measured arterialised and venous plasma ATP concentration and venous oxygen content in 10 healthy young males at rest, and at 30 and 180 seconds during dynamic handgrip exercise at 45% of maximum voluntary contraction (MVC. Results Venous plasma ATP concentration was elevated above rest after 30 seconds of exercise (P Conclusions Collectively these results indicate that ATP in the plasma originated from the muscle microcirculation, and are consistent with the notion that deoxygenation of the blood perfusing the muscle acts as a stimulus for ATP release. That ATP concentration was elevated just 30 seconds after the onset of exercise also suggests that ATP may be a contributing factor to the blood flow response in the transition from rest to steady state exercise.

  1. Locking plate fixation for proximal humerus fractures.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2012-02-01

    Locking plates are increasingly used to surgically treat proximal humerus fractures. Knowledge of the bone quality of the proximal humerus is important. Studies have shown the medial and dorsal aspects of the proximal humeral head to have the highest bone strength, and this should be exploited by fixation techniques, particularly in elderly patients with osteoporosis. The goals of surgery for proximal humeral fractures should involve minimal soft tissue dissection and achieve anatomic reduction of the head complex with sufficient stability to allow for early shoulder mobilization. This article reviews various treatment options, in particular locking plate fixation. Locking plate fixation is associated with a high complication rate, such as avascular necrosis (7.9%), screw cutout (11.6%), and revision surgery (13.7%). These complications are frequently due to the varus deformation of the humeral head. Strategic screw placement in the humeral head would minimize the possibility of loss of fracture reduction and potential hardware complications. Locking plate fixation is a good surgical option for the management of proximal humerus fractures. Complications can be avoided by using better bone stock and by careful screw placement in the humeral head.

  2. The effects of posture on abnormalities of forearm venous tone in women with pregnancy-induced hypertension.

    Science.gov (United States)

    Stainer, K; Pickles, C; Cowley, A J

    1987-09-01

    1. Forearm venous tone was measured in the left lateral supine position and in response to passive leg elevation in a group of women with pregnancy-induced hypertension and compared with a group of normotensive pregnant women and a group of non-pregnant women. 2. The women with pregnancy-induced hypertension were venoconstricted in the supine position compared with the normal pregnant women (P less than 0.002). There was no difference in forearm venous tone between the women with pregnancy-induced hypertension and the non-pregnant women. 3. In response to passive leg elevation the women with pregnancy-induced hypertension venodilated (P less than 0.002) whereas there was no change in forearm venous tone in the normotensive pregnant women and the non-pregnant women. There was no change in blood pressure in any of the women after 35 min of leg elevation. 4. These results demonstrate that the abnormal venous vasoconstriction that occurs in women with pregnancy-induced hypertension in the supine position is corrected by passive leg elevation, a manoeuvre which leads to an increase in central blood volume.

  3. Intra-session and inter-day reliability of forearm surface EMG during varying hand grip forces.

    Science.gov (United States)

    Hashemi Oskouei, Alireza; Paulin, Michael G; Carman, Allan B

    2013-02-01

    Surface electromyography (EMG) is widely used to evaluate forearm muscle function and predict hand grip forces; however, there is a lack of literature on its intra-session and inter-day reliability. The aim of this study was to determine reliability of surface EMG of finger and wrist flexor muscles across varying grip forces. Surface EMG was measured from six forearm flexor muscles of 23 healthy adults. Eleven of these subjects undertook inter-day test-retest. Six repetitions of five randomized isometric grip forces between 0% and 80% of maximum force (MVC) were recorded and normalized to MVC. Intra- and inter-day reliability were calculated through the intraclass correlation coefficient (ICC) and standard error of measurement (SEM). Normalized EMG produced excellent intra-session ICC of 0.90 when repeated measurements were averaged. Intra-session SEM was low at low grip forces, however, corresponding normalized SEM was high (23-45%) due to the small magnitude of EMG signals. This may limit the ability to evaluate finer forearm muscle function and hand grip forces in daily tasks. Combining EMG of functionally related muscles improved intra-session SEM, improving within-subject reliability without taking multiple measurements. Removing and replacing electrodes inter-day produced poor ICC (ICC < 0.50) but did not substantially affect SEM. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Systemic vascular function, measured with forearm flow mediated dilatation, in acute and stable cerebrovascular disease: a case-control study

    Directory of Open Access Journals (Sweden)

    Blacker David

    2010-10-01

    Full Text Available Abstract Background Acute ischaemic stroke is associated with alteration in systemic markers of vascular function. We measured forearm vascular function (using forearm flow mediated dilatation to clarify whether recent acute ischaemic stroke/TIA is associated with impaired systemic vascular function. Methods Prospective case control study enrolling 17 patients with recent acute ischaemic stroke/TIA and 17 sex matched controls with stroke more than two years previously. Forearm vascular function was measured using flow medicated dilatation (FMD. Results Flow mediated dilatation was 6.0 ± 1.1% in acute stroke/TIA patients and 4.7 ± 1.0% among control subjects (p = 0.18. The mean paired difference in FMD between subjects with recent acute stroke and controls was 1.25% (95% CI -0.65, 3.14; p = 0.18. Endothelium independent dilatation was measured in six pairs of participants and was similar in acute stroke/TIA patients (22.6 ± 4.3% and control subjects (19.1 ± 2.6%; p = 0.43. Conclusions Despite the small size of this study, these data indicate that recent acute stroke is not necessarily associated with a clinically important reduction in FMD.

  5. Proximal Limb Weakness Reverting After CSF Diversion In Intracranial Hypertension

    Directory of Open Access Journals (Sweden)

    Sinha S

    2005-01-01

    Full Text Available We report about two young girls who developed progressive visual failure secondary to increased intracranial pressure and had significant proximal muscle weakness of limbs. Patients with elevated intracranial pressure (ICP may present with "false localizing signs", besides having headache, vomiting and papilledema. Radicular pain as a manifestation of raised ICP is rare and motor weakness attributable to polyradiculopathy is exceptional. Two patients with increased intracranial pressure without lateralizing signs′ had singnificant muscle weakness. Clinical evaluation and laboratory tests did not disclose any other cause for weakness. Following theco-peritoneal shunt, in both patients, there was variable recovery of vision but the proximal weakness and symptoms of elevated ICP improved rapidly. Recognition of this uncommon manifestation of raised ICP may obviate the need for unnecessary investigation and reduce morbidity due to weakness by CSF diversion procedure.

  6. Indications for computed tomography (CT-) diagnostics in proximal humeral fractures

    DEFF Research Database (Denmark)

    Bahrs, Christian; Rolauffs, Bernd; Südkamp, Norbert P

    2009-01-01

    diagnostics depending on the fractured parts. METHODS: In a prospective diagnostic study in two level 1 trauma centers, 44 patients with proximal humeral fractures were diagnosed with conventional X-rays (22 AP + axillary views, 22 AP + scapular Y-views) and CT (multi-planar reconstruction (MPR) and maximum...... a significantly better assessment of the relevant structures than conventional diagnostics (p X-rays with AP view and a high-quality axillary view are useful for primary diagnostics of the fracture......--independently of the number of fractured parts--when the proximal humerus and the shoulder joint are not presented with sufficient X-ray-quality to establish a treatment plan....

  7. Synostosis of proximal phalangeal bases for loss of distal metacarpal

    Directory of Open Access Journals (Sweden)

    Pankaj Jindal

    2016-01-01

    Full Text Available A finger rendered unstable due to loss of metacarpal head can be stabilized by creating a synostosis at the base of the proximal phalanx of the affected finger with the adjacent normal finger. A cortico cancellous graft bridges the two adjacent proximal phalanges at their bases which are temporarily stabilized with an external fixator. The procedure can be done for, recurrence of giant cell tumor of metacarpal and for traumatic metacarpal loss. The procedure and long term follow up of one patient is presented who had giant cell tumor. This option should be considered before offering ray amputation. There is no micro vascular surgery involved, nor is there any donor site morbidity. The graft heals well without any absorption. The affected finger shows excellent function in the long term followup.

  8. Hand proximity facilitates spatial discrimination of auditory tones

    Directory of Open Access Journals (Sweden)

    Philip eTseng

    2014-06-01

    Full Text Available The effect of hand proximity on vision and visual attention has been well documented. In this study we tested whether such effect(s would also be present in the auditory modality. With hands placed either near or away from the audio sources, participants performed an auditory-spatial discrimination (Exp 1: left or right side, pitch discrimination (Exp 2: high, med, or low tone, and spatial-plus-pitch (Exp 3: left or right; high, med, or low discrimination task. In Exp 1, when hands were away from the audio source, participants consistently responded faster with their right hand regardless of stimulus location. This right hand advantage, however, disappeared in the hands-near condition because of a significant improvement in left hand’s reaction time. No effect of hand proximity was found in Exp 2 or 3, where a choice reaction time task requiring pitch discrimination was used. Together, these results suggest that the effect of hand proximity is not exclusive to vision alone, but is also present in audition, though in a much weaker form. Most important, these findings provide evidence from auditory attention that supports the multimodal account originally raised by Reed et al. in 2006.

  9. Correlation between social proximity and mobility similarity.

    Science.gov (United States)

    Fan, Chao; Liu, Yiding; Huang, Junming; Rong, Zhihai; Zhou, Tao

    2017-09-20

    Human behaviors exhibit ubiquitous correlations in many aspects, such as individual and collective levels, temporal and spatial dimensions, content, social and geographical layers. With rich Internet data of online behaviors becoming available, it attracts academic interests to explore human mobility similarity from the perspective of social network proximity. Existent analysis shows a strong correlation between online social proximity and offline mobility similarity, namely, mobile records between friends are significantly more similar than between strangers, and those between friends with common neighbors are even more similar. We argue the importance of the number and diversity of common friends, with a counter intuitive finding that the number of common friends has no positive impact on mobility similarity while the diversity plays a key role, disagreeing with previous studies. Our analysis provides a novel view for better understanding the coupling between human online and offline behaviors, and will help model and predict human behaviors based on social proximity.

  10. Infiltrating/sealing proximal caries lesions

    DEFF Research Database (Denmark)

    Martignon, S; Ekstrand, K R; Gomez, J

    2012-01-01

    This randomized split-mouth controlled clinical trial aimed at assessing the therapeutic effects of infiltration vs. sealing for controlling caries progression on proximal surfaces. Out of 90 adult students/patients assessed at university clinics and agreeing to participate, 39, each with 3...... differences in lesion progression between infiltration and placebo (P = 0.0012) and between sealing and placebo (P = 0.0269). The study showed that infiltration and sealing are significantly better than placebo treatment for controlling caries progression on proximal lesions. No significant difference...... proximal lesions identified radiographically around the enamel-dentin junction to the outer third of the dentin, were included. Lesions were randomly allocated for treatment to test-A (Infiltration: ICON-pre-product; DMG), test-B (Sealing: Prime-Bond-NT; Dentsply), or control-C (Placebo). Primary outcome...

  11. Knowledge networks in the Dutch aviation industry: The proximity paradox

    NARCIS (Netherlands)

    Broekel, T.; Boschma, R.A.

    2012-01-01

    The importance of geographical proximity for interaction and knowledge sharing has been discussed extensively in recent years. There is increasing consensus that geographical proximity is just one out of many types of proximities that might be relevant. We argue that proximity may be a crucial

  12. Neural mechanisms influencing interlimb coordination during locomotion in humans: presynaptic modulation of forearm H-reflexes during leg cycling.

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Nakajima

    Full Text Available Presynaptic inhibition of transmission between Ia afferent terminals and alpha motoneurons (Ia PSI is a major control mechanism associated with soleus H-reflex modulation during human locomotion. Rhythmic arm cycling suppresses soleus H-reflex amplitude by increasing segmental Ia PSI. There is a reciprocal organization in the human nervous system such that arm cycling modulates H-reflexes in leg muscles and leg cycling modulates H-reflexes in forearm muscles. However, comparatively little is known about mechanisms subserving the effects from leg to arm. Using a conditioning-test (C-T stimulation paradigm, the purpose of this study was to test the hypothesis that changes in Ia PSI underlie the modulation of H-reflexes in forearm flexor muscles during leg cycling. Subjects performed leg cycling and static activation while H-reflexes were evoked in forearm flexor muscles. H-reflexes were conditioned with either electrical stimuli to the radial nerve (to increase Ia PSI; C-T interval  = 20 ms or to the superficial radial (SR nerve (to reduce Ia PSI; C-T interval  = 37-47 ms. While stationary, H-reflex amplitudes were significantly suppressed by radial nerve conditioning and facilitated by SR nerve conditioning. Leg cycling suppressed H-reflex amplitudes and the amount of this suppression was increased with radial nerve conditioning. SR conditioning stimulation removed the suppression of H-reflex amplitude resulting from leg cycling. Interestingly, these effects and interactions on H-reflex amplitudes were observed with subthreshold conditioning stimulus intensities (radial n., ∼0.6×MT; SR n., ∼ perceptual threshold that did not have clear post synaptic effects. That is, did not evoke reflexes in the surface EMG of forearm flexor muscles. We conclude that the interaction between leg cycling and somatosensory conditioning of forearm H-reflex amplitudes is mediated by modulation of Ia PSI pathways. Overall our results support a

  13. Electromyographic and Motion Capture Analysis of the Elbow and Forearm in the Overhead Football Throw

    Science.gov (United States)

    Smith, Jarrod; Winnier, Scott; Douglas, Lonnie; Ostrander, Roger V.; Anz, Adam William; Andrews, James R.

    2017-01-01

    Objectives: Muscle activation patterns and the kinetics of overhead throwing have been well described in the baseball athlete but not in the football athlete. Injury patterns vary between these two populations. The purpose of this controlled laboratory study was to describe the muscle activation patterns of the elbow and forearm during the overhead football throw. A better understanding of muscle activation patterns and kinetics will help clinicians understand the difference in injury between these two populations, with an objective of preventing injury in both groups. The hypothesis was that the unique grip and obligatory pronation upon ball release will cause the elbow and forearm muscles to have a unique activation pattern during the overhead football throw. Methods: IRB approval was obtained. Electromyographic (EMG) and motion capture data was collected on eight male quarterbacks. An EMG direct transmission system measuring at 1200 Hz with 9 surface electrodes was used to collect EMG data, with signals normalized to maximal voluntary contraction values for each subject. EMG sensors were placed on the biceps, triceps, brachialis, brachioradialis, anconeus, extensor digitorum communis, flexor digitorum superficialis, pronator teres, and pronator quadratus. A 13 camera motion capture system measuring at 240 Hz with a full body marker set of 39 retro-reflective 9mm markers was used to capture motion data. The throwing motion was divided into four event segments: early cocking, late cocking, acceleration, and follow through. Results: All athletes had NCAA experience and were aged 18-30 years old. The anconeus (26.9%, 36.3%, 57.6%, and 105.8% MVCs), extensor digitorum communis (22.7%, 28.0%, 31.0%, and 42.8% MVCs), and flexor digitorum superficialis (19.4%, 39.3%, 22.3%, and 104.7% MVCs) had high levels of activity throughout all phases of the football throw. The brachioradialis (56.8%MVC) and anconeus (57.6%MVC) were the most active muscles during the acceleration

  14. Selective use of hand and forearm muscles during bone screw insertion: a natural torque meter.

    Science.gov (United States)

    Barros, Sérgio Estelita; Janson, Guilherme; Chiqueto, Kelly; Ferreira, Eduardo Silveira; Janson, Marcos

    2012-11-01

    To compare the maximum torque produced by different muscle groups and its influence on mini-implant insertion torque and fracture prevention. Eighty-seven professionals were evaluated for the maximum torque produced on a screwdriver by a combined action between the thumb and index finger (maximum digital torque [MDT]) and by the forearm supination movement (maximum brachial torque [MBT]). Ninety mini-implants distributed among 9 different diameters were fractured to determine the fracture torque (FT). The fracture resistance index (FRI) was obtained from: FRI_MDT = FT/MDT and FRI_MBT = FT/MBT. Analysis of variance and t tests were used to compare the groups. The MDT was smaller than the MBT, and the 2 measurements were smaller in female subjects. The FT increased for each 0.1-mm increment in diameter. The FRI_MDT was greater than FRI_MBT for all diameters. An FRI_MDT greater than 1 was found when the diameter was greater than or equal to 1.5 mm. An FRI_MBT greater than 1 occurred with diameters equal to or greater than 1.7 mm for female subjects and 1.8 mm for male subjects. The digital torque was 42% smaller than the brachial torque, and it was mechanically safer and biologically more compatible, allowing the prevention of the fracture of mini-implants with a diameter 1.5 mm or thicker owing to an insertion torque limitation at 15 N-cm. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Long-term vascular, motor, and sensory donor site outcomes after ulnar forearm flap harvest.

    Science.gov (United States)

    Brown, Emile N; Chaudhry, Arif; Mithani, Suhail K; Bluebond-Langner, Rachel O; Feiner, Jeffrey M; Shaffer, Cynthia K; Call, Diana; Rodriguez, Eduardo D

    2014-02-01

    Use of the ulnar forearm flap (UFF) is limited by concerns for ulnar nerve injury and impaired perfusion in the donor extremity. Twenty UFFs were performed over a 6-year period. All patients underwent postoperative bilateral upper extremity arterial duplex studies. A subset of postoperative patients (n = 10) also had bilateral upper extremity sensory and motor evaluations, and functional evaluation via the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH). Motor function was tested by digital and key grip dynamometry. Ulnar nerve sensation was tested by evaluation of one- and two-point perceived pressure thresholds and two-point discrimination using the Pressure-Specified Sensory Device (Sensory Management Services, LLC, Baltimore, MD). All UFFs were viable postoperatively. Mean follow-up was 28.8 months for vascular studies and 45.3 months for motor, sensory, and QuickDASH evaluations. Although mid and distal radial artery flow velocities were significantly higher in donor versus control extremities evaluated at less than 1 year postoperatively, there was no significant difference in extremities evaluated at later time points. Digital pressures, grip strength, key pinch strength, and ulnar sensation were equivalent between donor and control extremities. The mean QuickDASH score was 17.4 ± 23.8. The UFF can be harvested reliably and long-term follow-up shows no evidence of impaired vascular, motor, or sensory function in the donor extremity. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  16. Polyurethane versus silicone catheters for central venous port devices implanted at the forearm.

    Science.gov (United States)

    Wildgruber, Moritz; Lueg, Claudia; Borgmeyer, Sebastian; Karimov, Ilham; Braun, Ulrike; Kiechle, Marion; Meier, Reinhard; Koehler, Michael; Ettl, Johannes; Berger, Hermann

    2016-05-01

    We aimed to analyse short and long-term complications of polyurethane (PU) versus silicone catheters used in totally implantable venous-access ports (TIVAPs) implanted at the forearm. Retrospective analysis of 698 consecutively implanted TIVAPs was performed. Primary end-points were defined as rates of major complications associated with either type of central venous port catheter. Technical success rate, device service interval as well as minor complications not requiring port explantation were defined as secondary end-points. A total of 698 port devices were implanted in 681 patients, 396 equipped with a PU catheter, 302 with a silicone catheter. The technical success rate was 99.9% with no major periprocedural complications. During follow-up a total of 211 complications in 146 patients were observed (1.0/1000 catheter days), 183 occurred associated with PU catheters (1.8/100 catheter days), 28 (0.3/1000 catheter days) with silicone catheters (log rank test p Catheter-related bloodstream infections as well as thrombotic complications occurred significantly more frequently with PU catheters, while silicone catheters exhibited a trend towards a higher rate of mechanical failure such as disconnection or catheter rupture. Major complications requiring explantation of the device occurred more frequently with PU-based catheters (10.6%) compared to silicone catheter carrying ports (4.6%, log rank test p catheters are more susceptible to catheter-related infections and exhibit a higher thrombogenicity, compared to silicone catheters. Silicone catheters instead exhibit a trend towards decreased mechanical stability. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Endoscopic decompression for chronic compartment syndrome of the forearm in motocross racers.

    Science.gov (United States)

    Jans, Christophe; Peersman, Geert; Peersman, Benjamin; Van Den Langenbergh, Tom; Valk, Jody; Richart, Tom

    2015-09-01

    Sporting activities that involve repetitive stress to muscle compartments can elicit chronic exertional compartment syndrome. Its occurrence in the lower leg muscle compartments is most common, but other locations are less well known and the pathophysiology is not completely understood. In motocross racers, chronic exertional compartment syndrome can occur in the muscles of the lower arm. Currently, the only accepted treatment of correctly diagnosed chronic exertional compartment syndrome is surgical release of the fascia, which successfully relieves pain and allows patients to return to full activity. Open decompression is considered as the gold standard of treatment. This clinical paper describes our new endoscopic technique and investigates the functional outcome after surgery. We report on a series of 154 chronic exertional compartment syndromes afflicted motocross racers treated with an endoscopic release of the lower arm muscles. An MRI scan before and after strenuous exercise of the hand flexors (repetitive grip until exhaustion for 15 min) was performed to confirm the clinical diagnosis of chronic exertional compartment syndrome. Symptom severity before and after surgery was assessed using a visual analogue scale. Preoperative symptom severity scores were 1.1 ± 0.3 before exercise and 7.4 ± 1.5 after exercise. Post-operatively, these were 1.0 ± 0.2 and 1.7 ± 0.9. The pre- versus post-operative symptom scores after exercise were significantly different (p compartment of the forearms of motocross racers diagnosed with chronic exertional compartment syndrome is a valuable treatment option, with mild post-operative pain and fast recovery.

  18. Radionuclide assessment of peripheral hemodynamics: a new technique for measurement of forearm blood volume and flow

    Energy Technology Data Exchange (ETDEWEB)

    Todo, Y.; Tanimoto, M.; Yamamoto, T.; Iwasaki, T.

    1986-02-01

    A new peripheral hemodynamic measurement system using /sup 99m/Tc-labeled red blood cells has been developed. This method was carried out on 22 normal subjects, 29 with coronary artery disease, and two with dilated cardiomyopathy. Peripheral hemodynamic indices obtained from this method included forearm blood volume (FBV), venous capacity (FVC), venous capacity index (VCI), blood flow (FBF), and vascular resistance (FVR), and were compared with the central hemodynamic parameters of left ventricular filling pressure (LVFP), cardiac output (CO), and total systemic vascular resistance (TSVR) obtained with an invasive technique. The normal values were FBV 8.54 +/- 2.04 ml/100 ml; FVC 4.54 +/- 1.23 ml/100 ml; VCI 65.5 +/- 3.8%; FBF 4.26 +/- 0.56 ml/100 ml/min; and FVR 20.9 +/- 4.4 mmHg/ml/100 ml/min. These values were in good agreement with the values reported using conventional plethysmography. The 16 patients with congestive heart failure (NYHA Class II or III) showed significantly lower FBV, FVC, and FBF values and significantly higher VCI and FVR values than the healthy subjects. Capacitance vessel parameters (FBV, FVC, and VCI) and LVFP, FBF and CO, and FVR and TSVR each showed significant correlation; reproducibility was also good. The advantages of this method are (a) the detector does not come in contact with the region being measured; (b) it is possible to ascertain the absolute quantity of blood in the tissue; (c) extravasation of the plasma component can be ignored; and (d) data processing is simple.

  19. Directional tuning of human forearm muscle afferents during voluntary wrist movements

    Science.gov (United States)

    Jones, Kelvin E; Wessberg, Johan; Vallbo, Åke B

    2001-01-01

    Single unit activity was recorded with the microneurography technique from sixteen spindle afferents and one Golgi tendon organ afferent originating from the forearm extensor muscles. Impulse rates were studied while subjects performed unobstructed aiming movements at the wrist in eight different directions 45 deg apart. In addition, similar imposed movements were performed while the subject was instructed to remain relaxed. Movement amplitudes were about 5 deg and the speed 10–30 deg s−1. Joint movements were translated to movements of a cursor on a monitor to provide visual feedback. Individual spindle afferents modulated their activity over a number of targets, i.e. were broadly tuned, during these aiming movements. The preferred direction for a spindle afferent was the same during both passive and active movements, indicating that the fusimotor effects associated with active contractions had little or no effect on the direction of tuning. The direction of tuning of individual spindle afferents could be predicted from the biomechanically inferred length changes of the parent muscle. Thus spindle afferents responded as stretch receptors, i.e. impulse rates increased with lengthening and decreased with shortening, in active as well as passive movements. Spindles from muscles, which continuously counteracted gravity exhibited a stretch response and directional tuning during the phase of movement alone whereas their position sensitivity was poor. In contrast, spindle afferents from the muscles that had no or minimal antigravity role were directionally tuned during both the dynamic and the static phase of the aiming task and their position sensitivity was substantially higher. In spite of the limited data base from three extensor muscles it could be demonstrated that wrist joint position was remarkably well encoded in the ensemble muscle spindle data. In some cases the ensemble muscle spindle data encoded the instantaneous trajectory of movement as well. PMID

  20. Different rates of forearm bone loss in healthy women with early or late menopause.

    Science.gov (United States)

    Luisetto, G; Zangari, M; Bottega, F; Peccolo, F; Galuppo, P; Nardi, A; Ziliotto, D

    1995-01-01

    The aim of this study was to evaluate whether healthy women with early or late menopause have different rates of age- and menopause-related bone loss, and whether premature menopause really represents a risk factor for osteopenia. Healthy women aged from 27 to 84 years (n = 2204), with no history of fractures, were divided into two groups according to their age at menopause (AAM): group A with AAM or = 50 years. Bone mineral density (BMD) was measured in the distal non-dominant forearm by single-photon absorptiometry. Group B had a significantly lower average BMD than group A (group A, 0.430 +/- 0.074 g/cm2; group B, 0.419 +/- 0.081; p = 0.003); however, the average age of group A was significantly lower, and weight and height were significantly higher. When women older than 50 years of age were divided into five age-matched subgroups, BMD was significantly lower in women with AAM < or = 43 years up to 60 years; after that age this difference disappeared and, in the oldest subgroups, BMD was significantly lower in group B than in group A. Independent variables such as age, AAM and body mass index (BMI) explain about 30% of the variation of BMD, using a multiple linear regression analysis. In both groups age and BMI weighted more than AAM in determining BMD. When BMD was plotted versus either chronological age or years since menopause, women with late menopause showed a significantly faster bone loss than those with early menopause.(ABSTRACT TRUNCATED AT 250 WORDS)