The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Oct 1999
Comparative Study Clinical TrialClinical results of contralateral C7 root neurotization to the median nerve in brachial plexus injuries with total root avulsions.
This prospective study was carried out to assess motor and sensory recovery after contralateral C7 root to median nerve neurotization in brachial plexus injuries with total root avulsions. The survey was carried out from 1993 to 1995 and the patients were followed up for at least 3 years. There were 96 male patients with ages ranging from 13 to 48 years. ⋯ Furthermore, phrenic nerve to suprascapular nerve and spinal accessory nerve (via a sural nerve graft) to musculocutaneous nerve neurotizations were also carried out to obtain shoulder abduction and elbow flexion. At the 3 year follow-up, most patients had encouraging recovery of sensory function in the hand but motor function of the forearm and hand muscles was rather poor. Acceptable motor function was found in only 50 to 60% of the patients who were younger than 18 years.
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J Hand Surg Eur Vol · Oct 1999
Comparative Study Clinical TrialThe role of magnetic resonance imaging in the management of traction injuries to the adult brachial plexus.
Magnetic resonance imaging (MRI) of the cervical spine and brachial plexus was performed on 26 consecutive patients presenting with traction injuries of the brachial plexus during 1996 and 1997. These included T1 and T2 weighted coronal, sagittal and axial images of the cervical spine and coronal images of the brachial plexus. The results were compared with surgical findings, intraoperative neurophysiology, and subsequent clinical progress. ⋯ It was usually possible to define the level of the injury within the plexus. This study suggests that MR imaging, performed early after traction injury to the brachial plexus, provides useful additional information towards establishing the level of the lesion. It also provides information about injury to the plexus outside the spinal canal.
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J Hand Surg Eur Vol · Jun 1999
Case ReportsCompartment syndrome of the hand following intra-arterial injection of heroin.
We report two cases of compartment syndrome of the hand and forearm, due to intra-arterial injection of heroin, managed by surgical fasciotomies alone. We also review the literature on the management of this condition.
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J Hand Surg Eur Vol · Jun 1999
Case ReportsIrreducible Galeazzi fracture-dislocation due to an avulsion fracture of the fovea of the ulna.
We report a rare case of Galeazzi fracture-dislocation with an irreducible distal radioulnar joint. The cause of the irreducibility was entrapment of a fragment avulsed from the fovea of the ulna. The patient was successfully treated with open reduction and internal fixation of the radius, ulnar styloid process and avulsed fracture at the fovea of the ulna.
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J Hand Surg Eur Vol · Jun 1999
Bone mineral density in the distal radius in a healthy Japanese population and in relation to fractures of the distal radius.
Changes in bone mineral density with age were measured in the distal radius of healthy adults using dual energy X-ray absorptiometry. A total of 2789 healthy women (20-95 years old) and 1255 healthy men (20-87 years old), and 72 women (52-94 years old) and 23 men (51-79 years old) with fractures of the distal radius were assessed. ⋯ In men with fractures of the distal radius, there were no significant differences between bone mineral density and age. In the fracture groups loss of radial inclination after reduction correlated with decreased bone mineral density, but there was no significant regression between bone mineral density and the decrease in radial length or palmar tilt.