The Journal of hand surgery
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To examine the contact site of the radiocarpal joint and lengths of carpal ligaments at different forearm rotations in vivo. Rotation of the forearm could exert noteworthy influence on mechanics of the wrist, and understanding how forearm rotation influences wrist mechanics may help treat carpal disorders because wrist position closely relates to forearm rotation. ⋯ Our findings will help elucidate carpal biomechanics during forearm rotation. The findings may inform decisions about how to reduce the load to these carpal ligaments when treating the carpal disorders.
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Comparative Study
Radial collateral ligament injuries of the thumb metacarpophalangeal joint: epidemiology in a military population.
The reasons for variation in the reported incidence rates between thumb metacarpophalangeal joint radial collateral ligament (RCL) and ulnar collateral ligament (UCL) injuries are unclear. Delay in diagnosis of injury to the RCL leads to greater time of patient disability. The purpose of this study was to define the demographics and presentation of patients with RCL injuries in a military health care system. ⋯ In this series, patients sustaining injuries to the RCL were younger and presented later than their counterparts with UCL instability. Close attention to subtle or frank instability presenting as pain in younger patients with axial loading injury mechanisms may allow early diagnosis and appropriate treatment of this injury.
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Comparative Study
Transhemispheric cortical plasticity following contralateral C7 nerve transfer: a rat functional magnetic resonance imaging survival study.
To perform contralateral C7 nerve transfer in a controlled, survival rat functional magnetic resonance imaging model, so as to understand the extent of cortical plasticity after brachial plexus injury and surgical manipulation with this procedure. ⋯ Understanding the cortical changes after nerve injury and repair may lead to specific pharmacologic or behavioral interventions that can improve functional outcomes.
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Randomized Controlled Trial Comparative Study
Upper extremity spasticity in children with cerebral palsy: a randomized, double-blind, placebo-controlled study of the short-term outcomes of treatment with botulinum A toxin.
Botulinum A toxin (BoNT-A) injections are used widely to manage lower extremity spasticity in children with cerebral palsy. However, their use in the upper extremity is less well defined. This randomized, double-blind, placebo-controlled clinical trial evaluated the safety and efficacy of upper extremity intramuscular injections of BoNT-A in a cross-section of children with varying levels of function. ⋯ Children receiving BoNT-A injections demonstrated clinically meaningful short-term improvements in upper extremity function. Injections were well tolerated and safe. In contrast to other studies, study participants underwent multiple injection sessions based on their individual spasticity patterns.
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Randomized Controlled Trial Comparative Study
Effect of low-intensity pulsed ultrasound on bone healing at osteotomy sites after forearm bone shortening.
To test the hypothesis that low-intensity pulsed ultrasound (LIPUS) may accelerate healing at osteotomy sites after forearm bone shortening osteotomies. ⋯ Application of LIPUS shortened the time to cortical union by 27%, and to endosteal union by 18%. Our results indicate that LIPUS accelerated bone healing after we performed forearm bone shortening osteotomies. This may provide earlier return to activity and work for patients undergoing forearm osteotomies.