Hand (New York, N.Y.)
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Hand (New York, N.Y.) · Mar 2012
The epidemiology of upper extremity injuries presenting to the emergency department in the United States.
The epidemiology of upper extremity injuries presenting to emergency departments in the USA is not well studied. The purpose of this investigation was to estimate the incidence rates of upper extremity injuries presenting to emergency departments. ⋯ The NEISS provides estimates of the incidences of upper extremity injuries that may be useful for public health initiatives.
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Hand (New York, N.Y.) · Mar 2012
Endoscopic detection of compressing fascial bands around the ulnar nerve within the FCU.
The aim of this study is to endoscopically evaluate the ulnar nerve proximal and distal to the cubital tunnel after in situ decompression to identify and eventually release fascial bands capable of compressing the ulnar nerve. ⋯ The good results reported after in situ ulnar nerve decompression have questioned the need for endoscopically assisted decompression of the ulnar nerve proximal and distal to the cubital tunnel. Some authors suggest the existence of fascial bands within the flexor carpi ulnaris (FCU) capable of compressing the ulnar nerve. This study would suggest that fibrous bands deep in the FCU capable of compressing the ulnar nerve do not exist. Our satisfactory outcomes would support the perception that extensive decompression of the ulnar nerve beyond the cubital tunnel is not routinely needed.
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Hand (New York, N.Y.) · Mar 2012
Static progressive orthoses for the upper extremity: a comprehensive literature review.
Static progressive orthoses are commonly used in the treatment of stiff joints or joint contractures of the upper extremity, but there are few high-quality studies to support this intervention. In addition, there has not been a recently published review of the current literature describing this treatment technique and the outcomes achieved. The specific purpose of this comprehensive literature review is to investigate the current levels of evidence supporting the use of static progressive orthoses in the treatment of joint stiffness or contracture in clients with orthopedic conditions of the upper extremity. This review will also discuss common diagnoses of patients and outcomes achieved, as well as provide recommendations for future hand therapy practice. ⋯ Although the overall level of evidence is low, the inclusion of static progressive orthoses as an intervention appears to result in positive outcomes, including increased active range of motion, increased grip strength, improved DASH scores, and improved patient satisfaction as well as reduced pain medications during orthotic intervention. The current evidence supports static progressive orthoses as an intervention for patients with upper extremity joint stiffness or contractures due to orthopedic conditions.
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Upper extremity electrical burns are a cause of major morbidity and disability in affected individuals. Anecdotally, we have noted changes in the presentation of cases to our institution. We sought to compare current data on upper extremity electrical burns in children with our previously published historical data. ⋯ Changes in upper extremity electrical burn demographics and etiology since the 1970s may be indicative of effective education and safety campaigns. Consequently, reconstructive requirements have also changed. We hope that similar ongoing efforts in the developing world may bring about comparable positive results.
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Tourniquets are compressive devices that occlude venous and arterial blood flow to limbs and are commonly used in upper limb surgery. With the potential risk of complications, there is some debate as to whether tourniquets should continue to be routinely used. In this review, we first look at the different designs, principles, and practical considerations associated with the use of tourniquets in the upper limb. ⋯ The evidence in the literature suggests that upper limb tourniquets are beneficial in promoting optimum surgical conditions and modern tourniquet use is associated with a low rate of adverse events. With the improvement in knowledge and technology, the incidence of adverse events should continue to decrease. We recommend the use of tourniquets in upper limb surgery where no contraindications exist.