Archives of physical medicine and rehabilitation
-
In a retrospective study of 277 adult patients consecutively hospitalized for burns over a five-year period (1975-1979) patients' characteristics, circumstances of burn injury and prevalence of established predisposing factors were determined. The average age was 44.5 years, 78% were black and 62% were men. Average extent of burn was 19.7% body surface area. ⋯ The most common predisposing factors were alcohol and drug abuse, physical and mental illness and advanced age. Mortality rate was 12.6%. This study emphasizes the urgent need for effective burn prevention programs in which all health professionals should play an important role.
-
Arch Phys Med Rehabil · Nov 1985
Synoviorthesis with colloidal 32P chromic phosphate for hemophilic arthropathy: clinical follow-up.
Thirty-one synoviortheses were performed in 22 joints of 14 hemophilic patients (aged 12 to 28 years) with chronic synovitis and for whom "conventional treatments" were considered ineffective. Except for patients with inhibitors, conventional treatments included three to six months of adequate prophylactic therapy with the missing coagulation factors, intensive physiotherapy and, when indicated, antiinflammatory agents and orthosis. Colloidal 32P chromic phosphate was injected intraarticularly in doses of 1.0 mCi for knees and of 0.5 mCi for the other joints. ⋯ However, in three of the four patients synoviorthesis had to be repeated after two to four years for recurrence of synovitis. Extraarticular escape of radioactivity was monitored 62 times for 17 synoviortheses in 12 patients; extraarticular counts never exceeded 4% of the intraarticular counts. Chromosome aberrations were found not to be increased after treatment in the seven patients in whom adequate analysis could be done.
-
Arch Phys Med Rehabil · Oct 1985
Case ReportsAcquired isolated axillary neuropathy: an unusual complication of quadriplegia.
This report describes a rare case of acquired axillary neuropathy in a 17-year-old C-5 quadriplegic man who developed right axillary neuropathy after sleeping for six hours in a far-right lateral decubitus position. Two days after the onset of shoulder weakness, his shoulder abduction strength was found to have decreased 1 1/2 grades from measurements made 2 weeks before. ⋯ Six and one-half months later, after strengthening exercises and shoulder joint support to prevent subluxation, the patient recovered deltoid strength and upper extremity function beyond that seen at the onset of the axillary neuropathy. This case emphasizes the importance of proper body positioning of spinal cord injured (SCI) patients to prevent peripheral nerve compression and further disability.
-
Arch Phys Med Rehabil · Sep 1985
Case ReportsCalcitonin therapy in prolonged immobilization hypercalcemia.
During the course of hospitalization for comprehensive rehabilitation, an 11-year-old boy with a C4-C5 spinal cord injury developed hypercalcemia which persisted for 131 days. The total serum calcium was closely monitored during six treatment periods during which calcitonin was administered. The response to calcitonin was variable and limited by the occurrence of the escape phenomenon. ⋯ A review of the pathophysiology of immobilization hypercalcemia indicates that increased bone resorption is primarily responsible for the disorder. Both calcitonin and glucocorticoids are potent inhibitors of bone resorption, and glucocorticoids can prevent escape from calcitonin's calcium-lowering effect. We suggest that combination therapy with calcitonin and glucocorticoids be utilized in severe hypercalcemia in order to take advantage of the rapid effect of calcitonin and the more sustained effect of glucocorticoids.
-
Arch Phys Med Rehabil · Aug 1985
Case ReportsUlnar nerve compression by heterotopic ossification in a head-injured patient.
Although heterotopic ossification (HO) at the elbow is a frequent occurrence following head injury, nerve compression by heterotopic bone is quite rare. We report the case of a 22-year-old woman with head injury and well-documented HO at the left elbow who developed signs and symptoms of an ulnar neuropathy four months after her original injury. Electrodiagnostic studies confirmed the presence of a severe ulnar nerve lesion at the level of the elbow. Anterior transposition of the left ulnar nerve showed the nerve to have been compressed by heterotopic bone.