American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Sep 2009
Case ReportsThe role of high-resolution ultrasound in the diagnosis of a traumatic neuroma in an injured median nerve.
Since the development of high-resolution ultrasound, its role in the diagnosis of peripheral nerve lesions has steadily increased. We present the case of a 42-yr-old woman who experienced consistent numbness over the left hand and fingers after cutting the wrist in a suicide attempt and subsequent tendon and median nerve repair and a period of rehabilitation. ⋯ Postoperatively, the patient's symptoms improved significantly. This case suggests that high-resolution ultrasound may be superior to electrodiagnostic studies for the diagnosis of traumatic neuroma.
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Am J Phys Med Rehabil · Aug 2009
Nerve injury in patients after hip and knee arthroplasties and knee arthroscopy.
To examine the reporting of lower limb neuropathy within 90 days of surgery for patients undergoing hip arthroplasty, knee arthroplasty, or knee arthroscopy. ⋯ Nerve injuries after hip and knee arthroplasty and knee arthroscopy were rare in a large population of patients younger than 65 yrs. Although the overall rates were low, there was an increased occurrence of nerve injuries in the diabetic population. This information is useful when counseling patients and benchmarking surgical complication rates.
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Am J Phys Med Rehabil · Aug 2009
Separating deployment-related traumatic brain injury and posttraumatic stress disorder in veterans: preliminary findings from the Veterans Affairs traumatic brain injury screening program.
Traumatic brain injury in returning Iraq and Afghanistan combat veterans has been the subject of numerous articles by the popular press and congressional inquires. Recent research has questioned the accuracy of the traumatic brain injury diagnosis in veterans with depression and/or posttraumatic stress disorder and the validity of the Veterans Affairs traumatic brain injury screening tool to identify traumatic brain injury in returning combat veterans. ⋯ Veterans who screen positive for mild traumatic brain injury by the Veterans Affairs traumatic brain injury screening tool have high rates of posttraumatic stress disorder, which suggests that interdisciplinary rehabilitation teams need to include mental health professionals with expertise in posttraumatic stress disorder. Because both traumatic brain injury and posttraumatic stress disorder are defined, in part, by the same events and the same self-reported symptoms, the Veterans Affairs traumatic brain injury screening tool does not distinguish between these two commonly reported diagnoses in Operation Enduring Freedom/Operation Iraqi Freedom combat veterans.
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Am J Phys Med Rehabil · Jul 2009
Case ReportsPressure ulcers in spinal cord injury: an unusual site and etiology.
Case series of pressure ulcers in patients with spinal cord injury after inappropriate and prolonged application of graduated compression stockings are presented. Three adult patients with spinal cord injury were fitted with graduated compression stockings in the acute phase to prevent thromboembolism. Acute hospital staff did not monitor the skin for potential pressure ulcer because of the graduated compression stockings. ⋯ The manufacturers of graduated compression stockings did not include information about the need to monitor patients with sensory impairment for pressure ulcers. It is suggested that the manufacturers of graduated compression stockings include information about the need to monitor patients with sensory impairment for skin breakdown. When graduated compression stockings are applied to patients with sensory impairment, including spinal cord injury, staff needs to be vigilant for pressure ulcers occurring at the extremes of the graduated compression stockings, in addition to the more common areas where pressure ulcers occur.
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Am J Phys Med Rehabil · Jun 2009
Preliminary clinical prediction rule for identifying patients with ankylosing spondylitis who are likely to respond to an exercise program: a pilot study.
The aim of this study was to develop a preliminary clinical prediction rule to identify the potential predictors for identifying patients presenting with ankylosing spondylitis who are likely to respond to a specific exercise program. ⋯ The present preliminary clinical prediction rule provides the potential to identify patients with ankylosing spondylitis who are likely to experience short-term follow-up success with a specific exercise program. Future studies are necessary to validate the clinical prediction rule.