scholarly journals Modified osteotomy for treatment of forearm deformities (Masada IIb) in hereditary multiple osteochondromas: a retrospective review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ge Yan ◽  
Guoxin Nan
Keyword(s):  
Distraction Osteogenesis ◽  
External Fixator ◽  
Wrist Joint ◽  
Elbow Flexion ◽  
Wrist Flexion ◽  
Ilizarov External Fixator ◽  
Multiple Osteochondromas ◽  
Before And After ◽  
Ulnar Lengthening ◽  
Flexion And Extension

Abstract Purpose Approximately 30% of patients with hereditary multiple osteochondromas (HMO) have forearm deformity and dysfunction. The aim of this retrospective study was to review our experience with the surgical treatment of children with HMO and Masada IIb forearm deformities. Methods Data of eight children treated for HMO Masada IIb forearm deformity at our hospital between 2015 and 2019 were collected from the hospital records and retrospectively reviewed. All patients underwent ulnar lengthening by distraction osteogenesis using either the Orthofix or Ilizarov external fixator. Range of movements at the elbow and wrist joints, and forearm supination/pronation, before and after the operation were recorded. Radiographs were evaluated by the Fogel method, and wrist joint function by the Krimmer method. Results Follow-up radiographs showed significant improvement in relative ulnar shortening after treatment (pre-operative 9.23 ± 5.21 mm; post-operative 0.33 ± 4.13 mm). Changes in radial articular angle (pre-operative 33.55° ± 3.88° to 32.78° ± 6.57°) and carpal slip (pre-operative 45.00% ± 19.09%; post-operative 43.13% ± 16.68%) were not significant. Elbow flexion and extension, wrist flexion and extension, ulnar and radial deviation at wrist, and forearm rotation were significantly improved after surgery. Wrist function was graded as excellent in seven patients and as good in one patient. One patient treated with the Ilizarov external fixator had poor radial head reduction. Conclusion Ulnar lengthening with distraction osteogenesis is an effective treatment for HMO Masada IIb deformities. The optimum site for ulnar osteotomy appears to be at the proximal one-third to one-fourth of the ulna.

scholarly journals Modified Osteotomy for Treatment of Forearm Deformities (Masada IIb) in Hereditary Multiple Osteochondromas: A Retrospective Review

2021 ◽  
Author(s):  
Ge Yan ◽  
Guoxin Nan
Keyword(s):  
Distraction Osteogenesis ◽  
External Fixator ◽  
Wrist Joint ◽  
Elbow Flexion ◽  
Wrist Flexion ◽  
Ilizarov External Fixator ◽  
Multiple Osteochondromas ◽  
Before And After ◽  
Ulnar Lengthening ◽  
Flexion And Extension

Abstract Purpose: Approximately 30% of patients with hereditary multiple osteochondromas (HMO) have forearm deformity and dysfunction. The aim of this retrospective study was to review our experience with the surgical treatment of children with HMO and Masada IIb forearm deformities.Methods: Data of eight children treated for HMO Masada IIb forearm deformity at our hospital between 2015 and 2019 were collected from the hospital records and retrospectively reviewed. All patients underwent ulnar lengthening by distraction osteogenesis using either the Orthofix or Ilizarov external fixator. Range of movements at the elbow and wrist joints, and forearm supination/pronation, before and after the operation were recorded. Radiographs were evaluated by the Fogel method, and wrist joint function by the Krimmer method.Results: Follow-up radiographs showed significant improvement in relative ulnar shortening after treatment (pre-operative 9.23 ± 5.21 mm; post-operative 0.33 ± 4.13 mm). Changes in radial articular angle (pre-operative 33.55° ± 3.88° to 32.78° ± 6.57°) and carpal slip (pre-operative 45.00% ± 19.09%; post-operative 43.13% ± 16.68%) were not significant. Elbow flexion and extension, wrist flexion and extension, ulnar and radial deviation at wrist, and forearm rotation were significantly improved after surgery. Wrist function was graded as excellent in seven patients and as good in one patient. One patient treated with the Ilizarov external fixator had poor radial head reduction.Conclusion: Ulnar lengthening with distraction osteogenesis is an effective treatment for HMO Masada IIb deformities. The optimum site for ulnar osteotomy appears to be at the proximal one-third to one-fourth of the ulna.

Excitotoxic acid lesions of the primate subthalamic nucleus result in reduced pallidal neuronal activity during active holding

1992 ◽  
Vol 68 (5) ◽  
pp. 1859-1866 ◽  
Author(s):  
I. Hamada ◽  
M. R. DeLong
Keyword(s):  
Subthalamic Nucleus ◽  
Neuronal Activity ◽  
Elbow Flexion ◽  
Ibotenic Acid ◽  
Excitatory Input ◽  
Behavioral Task ◽  
Discharge Rates ◽  
Before And After ◽  
The Mean ◽  
Flexion And Extension

1. To gain a better understanding of the pathophysiology of hemiballismus in primates, and to test directly the hypothesis that the subthalamopallidal projection is excitatory, we studied the effects of lesions of the subthalamic nucleus (STN) on neuronal activity in the globus pallidus (GP) of monkeys during performance of a motor behavioral task. 2. Animals were trained to position and hold a manipulandum to which torque pulses were applied, producing elbow flexion and extension. The activity of neurons in the external (GPe) and internal (GPi) segments of GP was recorded in two monkeys during task performance before and after STN lesions. The STN was lesioned by the fiber-sparing neurotoxins ibotenic acid and/or kainic acid. 3. After lesioning, the firing rate of neurons in both segments of GP, which was measured during the period of holding before torque application, was significantly decreased in both animals. The mean of discharge rates of GPi neurons decreased (P < 0.001) from 69.8 (n = 169, SD = 21.6) to 47.4 spikes/s (n = 180, SD = 22.6) after lesioning. The mean of discharge rates of GPe neurons decreased from 63.6 spikes/s (n = 218, SD = 25.1) before lesions to 41.0 spikes/s (n = 208, SD = 18.1) after lesioning. 4. These results provide further evidence that STN gives rise to a major excitatory input to both segments of the GP and support the hypothesis that dyskinesias result from decreased GPi output.

Learning Transfer from Flexion to Extension Movements: Importance of the Final Position

Motor Control ◽  
1998 ◽  
Vol 2 (3) ◽  
pp. 221-227 ◽  
Author(s):  
Dusko B. Ilic ◽  
Dragan M. Mirkov ◽  
Slobodan Jaric
Keyword(s):  
Elbow Flexion ◽  
Control Group ◽  
Final Position ◽  
Variable Error ◽  
Before And After ◽  
Movement Distance ◽  
Level Of Significance ◽  
Experimental Group ◽  
Flexion And Extension

Nine subjects (experimental group) were tested on rapid elbow flexion and extension movements performed in the same final position, before and after extensive practice of the movements. Nine additional subjects (control group) were also tested, but without any practice between the tests. Comparison of the pretest and posttest results suggested that the experimental group decreased their variable error (i.e., standard deviation of the final movement position) in both practiced (elbow flexion) and nonpracticed (elbow extension) movements. The control group, however, did not improve in either of tested movements. The experimental group demonstrated lower variable error in the nonpracticed elbow extensions than the control group, while the same difference for practiced elbow flexion movements was slightly below the level of significance. The results support the importance of the final position in programming of rapid, self-terminated movements; however, they do not rule out the role of other kinetic and kinematic variables (such as movement distance).

Effect of Wrist Joint Angle on the Examination of Hoffmann's Sign

2021 ◽  
Author(s):  
Guan Shi ◽  
Hai Tang ◽  
Jianlin Shan
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Joint Angle ◽  
Wrist Joint ◽  
Control Group ◽  
Wrist Flexion ◽  
Significant Difference ◽  
Palmar Flexion ◽  
Flexion And Extension

Abstract Objective To study the effect of different wrist flexion and extension angles on the results of Hoffmann’s sign.Methods Thirty-seven patients with cervical spondylotic myelopathy and fifty objectives as control group were examinated at 15° palmar flexion, 0° neutral, 30° back extension, and 60° back extension of the wrist joint to observe Hoffmann's sign.ResultsThe patients with cervical spondylotic myelopathy did not present significantly different results of Hoffmann’s sign at 0° neutral, 30° back extension, and 60° back extension, but significantly different at 15° palmar flexion (P<0.05). In control group, there is no significant difference at 15° palmar flexion, 0° neutral, 30° back extension, but significantly different at 60° back extension (p<0.05).ConclusionThe different angles of wrist flexion and extension present a significant impact on the results of Hoffmann’s sign examination. For the patients with cervical spondylotic myelopathy, it is reliable to test Hoffmann’s sign at 30° wrist back extension.

scholarly journals Older age and multi-joint external fixator are two risk factors of complications in ulnar lengthening in children with hereditary multiple exostosis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Chao Zheng ◽  
Huanli Han ◽  
Yujiang Cao
Keyword(s):  
Risk Factors ◽  
External Fixator ◽  
Elbow Flexion ◽  
Clinical Results ◽  
External Fixators ◽  
Hereditary Multiple Exostosis ◽  
Older Children ◽  
Group A ◽  
Group B ◽  
Ulnar Lengthening

Abstract Objectives Hereditary multiple exostosis (HME) often involves forearm deformities. The aim of this study was to present the clinical results of 37 children who underwent ulnar lengthening with two different types of unilateral external fixators and to investigate the risk factors of complications. Methods We evaluated 37 children with forearm deformities caused by HME treated in our hospital from January 2008 to July 2019. The surgical procedures included resection of exostosis, osteotomy of the ulna, and gradual lengthening of the ulna with a unilateral external fixator. According to the type of fixator they received, the children were divided into two groups: group A received monorail fixators and group B received multi-joint fixators. Radiographic and functional parameters were assessed. Complications were recorded. Results All patients were followed-up for an average of 4.6 years (3.0 to 6.5). In both group A and group B, the ulna shortening (US), radial articular angle (RAA), carpal slip (CS), elbow flexion, forearm pronation, supination, and Mayo Elbow Performance Score (MEPS) values improved significantly from preoperatively to postoperatively (p < 0.05). However, the ulnar deviation was observed in 4 cases in group B and no cases in group A. According to logistic regression, the difference was only related to age (p < 0.05) and the type of external fixator (p < 0.05). Conclusions Ulnar lengthening with unilateral external fixation is a safe and effective procedure for the treatment of HME. Regarding complications, deviation of the ulna axis was more likely to occur in older children with multi-joint external fixators.

Use of Mental Imagery to Limit Strength Loss after Immobilization

2003 ◽  
Vol 12 (3) ◽  
pp. 249-258 ◽  
Author(s):  
Johanna Newsom ◽  
Peter Knight ◽  
Ronald Balnave
Keyword(s):  
Grip Strength ◽  
Outcome Measures ◽  
Mental Imagery ◽  
Strength Loss ◽  
Control Group ◽  
Wrist Flexion ◽  
Imagery Group ◽  
Before And After ◽  
Limit Strength ◽  
Flexion And Extension

Objective:To assess whether mental imagery of gripping prevents the loss of grip strength associated with forearm immobilization.Design:Pretest–posttest randomized-group design.Setting:Laboratory.Participants:13 female and 5 male university students, age between 17 and 30 years, randomly assigned into 2 groups—1 control and 1 experimental.Interventions:Both groups had their nondominant forearms immobilized for 10 days. The experimental group undertook three 5-min mental-imagery sessions daily, during which they imagined they were squeezing a rubber ball.Main Outcome Measures:Wrist-flexion and -extension and grip strength before and after immobilization.Results:There was no significant change in wrist-flexion or -extension strength in the mental-imagery group. The control group experienced a significant decrease in wrist-flexion and -extension strength during the period of immobilization (P< .05).Conclusions:Despite study limitations, the results suggest that mental imagery might be useful in preventing the strength loss associated with short-term muscle immobilization

scholarly journals Repeatability of Pressure Force During Elbow Flexion and Extension Before and After Exercise

2009 ◽  
Vol 10 (2) ◽  
Author(s):  
Marek Zatoń ◽  
Ryszard Błacha ◽  
Agnieszka Jastrzębska ◽  
Krzysztof Słonina
Keyword(s):  
Elbow Flexion ◽  
Pressure Force ◽  
Before And After ◽  
Flexion And Extension

Rebalancing the tetraplegic wrist using extensor carpi ulnaris-tenodesis

2012 ◽  
Vol 38 (1) ◽  
pp. 22-28 ◽  
Author(s):  
C. Reinholdt ◽  
J. Fridén
Keyword(s):  
Grip Strength ◽  
Motion Correction ◽  
Wrist Joint ◽  
Cervical Spinal Cord ◽  
Wrist Flexion ◽  
Extensor Carpi Ulnaris ◽  
Flexion Extension ◽  
Cord Injury ◽  
Joint Flexion ◽  
Flexion And Extension

Patients with cervical spinal cord injury and tetraplegia often present with a radial deviation deformity of the wrist owing to impaired active wrist flexion and extension. Tenodesis of the extensor carpi ulnaris can help optimize grip strength. The purpose of the study was to compare reconstruction of the grip with and without extensor carpi ulnaris-tenodesis, as well as evaluating the outcome of the procedure. The grip strength of the group with tenodesis of the extensor carpi ulnaris was twice as strong as of the group without the tenodesis and with similar wrist joint flexion–extension range of motion. Correction of the wrist deformity enables a more ergonomic use of the hand. This may also help prevent shoulder pain, which is common among patients with tetraplegia.

THE THREE-DIMENSIONAL MOVEMENT CORRELATIONS BETWEEN ELBOW AND WRIST JOINT AND ANTHROPOMETRIC DETERMINANTS

2018 ◽  
Vol 18 (02) ◽  
pp. 1850013 ◽  
Author(s):  
WEI WANG ◽  
DONGMEI WANG ◽  
CHENGHUI LAI
Keyword(s):  
Multiple Regression ◽  
Wrist Joint ◽  
Three Dimensional ◽  
Elbow Flexion ◽  
Wrist Flexion ◽  
Factors Affecting ◽  
Bivariate Correlation ◽  
Flexion Extension ◽  
Joint Motions ◽  
The Relationship

This study aimed to investigate three-dimensional (3D) kinematic characteristics of elbow and wrist motions, the relationship between them, and the anthropometric factors affecting them. Using motion capture system, this study measured and calculated the 3D angles of elbow flexion/extension, elbow pronation/supination, wrist flexion/extension, and wrist adduction/abduction of 40 healthy young adults. The study measured nine anthropometric variables and used unpaired [Formula: see text]-tests to assess gender difference. Also, bivariate correlation tests and step-wise multiple regression analyses were performed between joint ranges and anthropometric variables, as well as different joint motions. Results showed two opposite patterns occurred during elbow flexion/extension. The study found a correlation between the range of elbow flexion/extension and the range of elbow pronation/supination that occurred during elbow flexion/extension. Additionally, the study tested joint correlations between the four joint motions. Finally, the study established bivariate and multiple regression relationships between range of elbow motions and anthropometric factors. This research presented an unrecognized pattern of 3D elbow flexion/extension, and associations between various anthropometric factors and different joint motions. These findings can contribute to the design of orthosis of upper extremities and the rehabilitation of joint mobility.

scholarly journals Improved Outside-In Suture through the Joint Capsule to Repair the Palmer I-B Triangular Fibrocartilage Complex Superficial Injury

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Tonglong Xu ◽  
Xiaoyun Pan ◽  
Jingyi Mi
Keyword(s):  
Wrist Joint ◽  
Joint Capsule ◽  
Triangular Fibrocartilage Complex ◽  
Type I ◽  
Dash Score ◽  
Wrist Flexion ◽  
Joint Function ◽  
Triangular Fibrocartilage ◽  
Flexion And Extension

Background. The treatment of type I-B triangular fibrocartilage complex superficial injury is always a challenge to orthopedists. The traditional outside-in suture method often causes a risk of nervous irritation. We designed a modified outside-in suture through the joint capsule to repair the Palmer I-B triangular fibrocartilage complex superficial injury. Methods. From December 2014 to December 2018, we retrospectively collected the medical records of 18 patients in our hospital who used the modified outside-in suture through the joint capsule to repair type I-B triangular fibrocartilage complex superficial injury. Among them, there were 12 males and 6 females, with an average age of 36.2 years. There were 6 cases on the left side and 12 cases on the right side. Record the healing time of all patients after surgery and the occurrence of related complications, and record the pain visual analogue scale (VAS), grip strength, wrist flexion and extension, radioulnar deviation and forearm rotation range of motion, modified Mayo wrist joint function score, and disability of arm-shoulder-hand (DASH) score before operation and at the last follow-up. Results. One patient was lost to follow-up, and a total of 17 patients received the final follow-up. Patients were followed up for 24 to 36 months, with an average of 29.6 ± 3.0 months. No wound infection, nerve damage, or irritation occurred after the operation. At the last follow-up, 15 cases of wrist pain disappeared completely, and 2 cases had mild discomfort during exercise. At the last follow-up, VAS decreased from 3.8 ± 0.7 points before operation to 0.8 ± 0.7 points ( P < 0.05 ); grip strength increased from 15.1 ± 3.1  kg before operation to 23.2 ± 1.5  kg ( P < 0.05 ); wrist flexion and extension, radioulnar deflection, and forearm rotational mobility increased from 116.3 ± 2.2 °, 37.0 ± 3.5 °, and 141.6 ± 2.2 ° before operation to 117.2 ± 2.5 ° ( P < 0.05 ), 38.9 ± 3.0 ° ( P < 0.05 ), and 142.4 ± 1.9 ° ( P < 0.05 ), respectively; the modified Mayo wrist joint function score increased from 66.1 ± 3.6 points to 82.5 ± 3.9 points ( P < 0.05 ), of which 10 cases were excellent, 5 cases were good, 2 cases were fair, and the excellent and good rate was 88.2%; DASH score improved from 37.0 ± 5.7 points preoperatively to 8.0 ± 2.5 points ( P < 0.05 ). Conclusion. The modified outside-in suture through the joint capsule to repair the superficial injury of Palmer I-B triangular fibrocartilage complex has a good clinical effect and is worthy of clinical widespread promotion.

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