scholarly journals LIMBS REAMPUTATIONS IN MILITARY PERSONNEL INJURED IN THE AREA OF THE ANTITERRORIST OPERATION IN EAST UKRAINE

2018 ◽  
pp. 5-10
Author(s):  
A.A. Bespalenko ◽  
A.A. Buryanov ◽  
Ie. V. Tsema ◽  
A.V. Dinets
Keyword(s):  
Linear Regression ◽  
Lower Extremity ◽  
Upper Extremity ◽  
Upper Limb ◽  
Military Personnel ◽  
Study Groups ◽  
Armed Conflicts ◽  
Lower Limbs ◽  
Significant Difference ◽  
Hybrid War

The aim – to identify and analyze causes for reamputations in military personnel with limb amputations due to ATO in East Ukraine. Patients and methods. All military personnel of the AFU within ATO was eligible for the study with diagnosis of limb amputations in the period from 01.06.2014 to 30.06.2016, and which were treated in hospitals of the Ministry of Defense of Ukraine. Among 7091 patients with injuries, 152 patients with limb amputations were identified. Results and discussion. Out of 152 patients, 25 (16%) underwent limbs reamputation, whereas 127 (84%) patients underwent amputation once. Patients in the study groups did not differ in age. Amputation was performed on the upper limb in 41 (32%) in the group of patients with amputations, which is significantly higher as compared to 2 (8%) patients in the reamputation group (p = 0.014). Analyses the level of amputations of the upper extremity showed no difference in the parameters. In 23 (92%) patients in the group with reamputation amputation of the lower limbs were diagnosed significantly more often as compared to 86 (68%) patients in the amputation group (p = 0.014). Analyses of the level of amputation of the lower extremity revealed that almost 3 times more often amputation was performed at the level of the ankle in the group of patients with reputations - 8 (32%) patients, as compared to 15 (12%) patients in the amputation group (p = 0.03). However, linear regression did not show a significant difference of these parameters in reamputations. Amputation of one upper extremity in the reamputation group was diagnosed 7 times less frequent - 1(4%) patient less often than in the amputation group - 37(29%) patients (p = 0.005). Conclusions: The results of the study of the injured in a hybrid war indicate that reamputations are more often associated with amputations at the level of the upper limb, but are less often diagnosed in patients with amputation of the lower extremity. Reamputations are more often performed with trauma of one limb. Clinical features in patients injured in the ATO zone in the East Ukraine demonstrate the frequency and characteristics of re-arrests that are different from other armed conflicts.

Computed tomography angiography and microsurgical flaps for traumatic wounds: What is the added value?

2021 ◽  
pp. 1-9
Author(s):  
Lucas Sousa Macedo ◽  
Renato Polese Rusig ◽  
Gustavo Bersani Silva ◽  
Alvaro Baik Cho ◽  
Teng Hsiang Wei ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Upper Limb ◽  
Computed Tomography Angiography ◽  
Lower Limb ◽  
High Energy ◽  
Lower Limbs ◽  
Added Value ◽  
Vascular Lesions ◽  
Limb Injuries ◽  
Significant Difference

BACKGROUND: Microsurgical flaps are widely used to treat complex traumatic wounds of upper and lower limbs. Few studies have evaluated whether the vascular changes in preoperative computed tomography angiography (CTA) influence the selection of recipient vessel and type of anastomosis and the microsurgical flaps outcomes including complications. OBJECTIVE: The aim of this study was to evaluate if preoperative CTA reduces the occurrence of major complications (revision of the anastomosis, partial or total flap failure, and amputation) of the flaps in upper and lower limb trauma, and to describe and analyze the vascular lesions of the group with CTA and its relationship with complications. METHODS: A retrospective cohort study was undertaken with all 121 consecutive patients submitted to microsurgical flaps for traumatic lower and upper limb, from 2014 to 2020. Patients were divided into two groups: patients with preoperative CTA (CTA+) and patients not submitted to CTA (CTA–). The presence of postoperative complications was assessed and, within CTA+, we also analyzed the number of patent arteries on CTA and described the arterial lesions. RESULTS: Of the 121 flaps evaluated (84 in the lower limb and 37 in the upper limb), 64 patients underwent preoperative CTA. In the CTA+ group, 56% of patients with free flaps for lower limb had complete occlusion of one artery. CTA+ patients had a higher rate of complications (p = 0.031), which may represent a selection bias as the most complex limb injuries and may have CTA indicated more frequently. The highest rate of complications was observed in chronic cases (p = 0.034). There was no statistically significant difference in complications in patients with preoperative vascular injury or the number of patent arteries. CONCLUSIONS: CTA should not be performed routinely, however, CTA may help in surgical planning, especially in complex cases of high-energy and chronic cases, since it provides information on the best recipient artery and the adequate level to perform the microanastomosis, outside the lesion area.

scholarly journals Utility of mangled extremity severity score in severely injured lower limbs

2017 ◽  
Vol 18 (1) ◽  
pp. 23-25
Author(s):  
Toya Raj Bhatta ◽  
B Gyawali ◽  
R Tamrakar ◽  
BK Acharya ◽  
SK Shrestha ◽  
...  
Keyword(s):  
Decision Making ◽  
Lower Extremity ◽  
Severity Score ◽  
Treatment Protocol ◽  
Lower Limbs ◽  
Common Mechanism ◽  
Severely Injured ◽  
Injured Limb ◽  
Mangled Extremity ◽  
Significant Difference

Introduction: Massive lower extremity trauma,in particular open tibial fractures with associated vascular injuries, present an immediate and complex decision-making challenge between a limb salvage attempt and primary amputation. Medical and surgical advances of the past two decades have improved the ability to reconstruct severely injured limb. Limbs that once would have been amputated are now routinely managed with complex reconstruction protocol. Mangled extremity severity score is one of the scoring systems to predict the fate of limbs after severe limb injuries.Methods: Patients fulfilling the inclusion criteria were evaluated with MESS, at the same time treatment protocol for management of injuries of lower limb were followed independently by attending orthopedic surgeon. Mean MESS for salvaged and amputated limbs were calculated and its reliability for prediction of fate of injured limb was assessed using software SPSS v16.Result: The age of patient ranges from 10 to 65 yrs with mean age 35.83. The most common mechanism of injury was Road Traffic Accident followed by fall from height. The mean MESS score for salvaged limbs was 4.18 and for amputated limbs was 8.12 suggesting significant difference in mean scores. The sensitivity (the probability that limbs requiring amputation will have MESS at or above 7) was found to be 75%. The specificity of MESS (the probability that salvage limbs will have MESS < 7) was 95.45%.Conclusion: MESS is a reliable indicator in decision making process whether a limb can be salvaged or needs amputation. The mangled lower extremity with the score of less than 7 may be salvaged and 7 or more may need amputation.JSSN 2015; 18 (1), Page: 23-25

Prótesis neurales y amputados

2019 ◽  
Vol 24 (3) ◽  
pp. 25-36
Author(s):  
S Lamas-Figueira ◽  
Y González-González ◽  
I Da Cuña-Carrera
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Upper Limb ◽  
Lower Limb ◽  
Web Of Science ◽  
Neural Prostheses ◽  
Palabras Clave

Introducción: Los pacientes amputados pueden portar una prótesis, lo que permite al usuario seguir realizando sus actividades diarias. Podemos definir las prótesis como un elemento artificial dotado de autonomía para realizar la función de la extremidad faltante. Dentro de las prótesis, las neurales son un sistema de transducción bidireccional entre el organismo y la propia prótesis, que registran las señales biológicas mediante electrodos. Objetivo: Conocer la evidencia científica actual acerca del posible uso de las prótesis neurales en amputados. Material y métodos: se llevó a cabo una revisión de la literatura científica entre diciembre de 2018 y enero de 2019 en las bases de datos Medline, Cinahl, Web of Science y Scopus así como en el buscador Pubmed, con las palabras clave “amputation”, “neural prostheses”, “upper extremity” y “lower extremity” y se amplió la búsqueda con “upper limb” y “lower limb”, quedando 15 resultados válidos tras aplicar los criterios de inclusión y exclusión. Resultados: Se observó que el uso de estas prótesis neurales permitía mayor funcionalidad a los usuarios de las mismas, así como mejoras a la hora de realizar los movimientos. Conclusión: Podemos concluir que las prótesis neurales en amputados tienen una evidencia científica comprobada actualmente, pudiendo aportar grandes beneficios a su vida diaria. Sin embargo; debido a que son elementos tecnológicos que en la actualidad se encuentran en vías de desarrollo, no es posible aprovechar al máximo su rendimiento. Por lo tanto, su optimización iría ligada a un mayor desarrollo científico y tecnológico.

scholarly journals MILITARY PHYSICAL TRAINING, MUSCULAR STRENGTH, AND BODY COMPOSITION OF BRAZILIAN MILITARY PERSONNEL

2018 ◽  
Vol 24 (2) ◽  
pp. 153-156 ◽  
Author(s):  
Samir Ezequiel da Rosa ◽  
Eduardo Camillo Martinez ◽  
Runer Augusto Marson ◽  
Marcos de Sá Rego Fortes ◽  
José Fernandes Filho
Keyword(s):  
Body Composition ◽  
Body Mass ◽  
Upper Limb ◽  
Military Personnel ◽  
Physical Training ◽  
Muscular Strength ◽  
Fat Percentage ◽  
Level Of Evidence ◽  
Un Peacekeeping ◽  
Significant Difference

ABSTRACT Introduction: Since 1965, the Brazilian Army (BA) has participated in peacekeeping missions of the United Nations (UN), sending large contingents to various parts of the world, such as Angola, Mozambique, East Timor and Haiti. To do so, the military must be in a minimum physical condition to face any obstacles in the course of action in the theater of operations. Objective: To verify the effects of Military Physical Training (MPT) on muscular strength of upper limbs, anthropometric variables and body composition of Brazilian military personnel of the 24th UN peacekeeping mission in Haiti. Methods: The sample consisted of 192 male soldiers with mean age of 23.2 ± 3 6 years. They observed a weekday residential regime, with a defined schedule of meals and activities and time off on weekends. The MPT was applied four times a week, 90 minutes long for 14 weeks and involved aerobic and resisted exercises. In the pre- and post-MPT period, body mass (MC), height, waist circumference (WC) and abdomen circumference (AC) were measured to calculate body mass index (BMI) and fat percentage (%F) through the protocol of Salem.. In addition, 12-minute run tests, push-ups, pull up and abdominal flexions were performed to calculate the Rogers Index (RI). Results: When comparing pre- and post-MPT, a significant difference was observed in all anthropometric variables and body composition (BM, BMI and %F) and in the RI for the upper limb muscle strength. Conclusion: The 14-week MPT indicates an improvement in the anthropometric and body composition variables, as well as an increase in upper limb muscular strength in Brazilian soldiers of the UN peacekeeping contingents in Haiti. This study concluded that RI could be an effective tool for assessing military muscular strength. Level of Evidence II; Therapeutic studies - Investigating the results of treatment.

scholarly journals The Value of Bedside Ultrasound in the Diagnosis and Treatment of Pulmonary Embolism in Severe Patients

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Qing Wang
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Lower Extremity ◽  
Upper Extremity ◽  
Transthoracic Echocardiography ◽  
Compliance Rate ◽  
Spiral Ct ◽  
Diagnostic Value ◽  
Lower Limbs

Objective — To explore the diagnostic value of bedside transthoracic echocardiography combined with bedside lower extremity venous ultrasonography in patients with venous thromboembolism. Methods — Select 97 patients with high-risk Caprini scores and high-risk Padua scores from December 2019 to April 2021 in the Second Affiliated Hospital of Shandong First Medical University as the research objects, all of whom completed bedside transthoracic echocardiography combined with bedside lower limbs or upper extremity venous ultrasound examination; compare the results of different ultrasound examinations with spiral CT pulmonary angiography (CTPA); analyze the diagnostic value of bedside transthoracic echocardiography combined with bedside lower extremity venous ultrasound in patients with pulmonary embolism. Results — 97 patients with high-risk Caprini score and high-risk Padua score were confirmed by CTPA in 41 cases of pulmonary embolism; bedside transthoracic echocardiography, bedside lower extremity or upper extremity venous ultrasonography for venous thromboembolism were all positive in 35 cases; among them, 32 cases were confirmed by CTPA as pulmonary embolism, and the diagnostic compliance rate with the gold standard was 87.63%; bedside transthoracic echocardiography combined with bedside lower extremity venous ultrasonography had a diagnostic sensitivity of 78.05% and a diagnostic specificity of 94.64%; Conclusion — Bedside transthoracic echocardiography and bedside lower extremity venous ultrasonography combined for venous thromboembolism can improve the specificity of diagnosis, and it is worthy of popularization and application.

scholarly journals Comparison of Upper Limb Disability in Overhead Women Athletes of Handball, Volleyball, Softball, and Swimming

2021 ◽  
pp. 103-110
Author(s):  
Elmira Arabi ◽  
◽  
Gholam Hossein Nazemzadegan ◽  
Keyword(s):  
Women Athletes ◽  
Upper Limb ◽  
Study Groups ◽  
High Rate ◽  
Joint Disease ◽  
Overhead Athletes ◽  
Study Results ◽  
Significant Difference ◽  
The Difference ◽  
Post Hoc

Purpose: The shoulder joint is one of the most commonly injured joints in sports and may lead to disability, especially in the upper extremities of overhead players (handball, volleyball, softball, and swimming). Methods: This research is a causal-comparative study. After the approval of the Ethics Committee of the Medical University of Tehran, this study was conducted on 120 overhead athletes (Mean±SD height: 1.69±0.07 m, Mean±SD weight: 63.54±7.79 kg, Mean±SD age: 21.96±2.94 years, Mean±SD body mass index: 22.11±2.32 kg/m2). The inclusion criteria were elite female players in overhead sports with at least three years of experience in one of these sports (handball, volleyball, softball, and swimming). Samples with a history of surgery or cervical nerve problems, fractures in the shoulder area, and inflammatory joint disease were excluded from the study. The demographic information was obtained through a researcher-made questionnaire, and the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire was used to measure the degree of upper limb disability in daily activities. Results: In comparison between the study groups, a significant difference was observed between the dependent variable (DASH) and the research groups (F=6.067, df=3, P=0.002, Eta=0.342). Using the Bonferroni post hoc tests, the difference between volleyball and softball (P=0.44), volleyball and swimming (P=0.009), and handball and swimming players (P=0.022) were reported. In the next step, BMI characteristics, weekly training hours, and the number of training sessions per week were entered into the data analysis process as covariate variables (F=8.099, df=0.3, P=0.000, Eta=0.432). The Bonferroni post hoc test indicates the difference between volleyball and swimming athletes (P=0.001) and handball and swimming (P=0.002). Conclusion: The present study results indicate a high rate of upper limb disability in elite women athletes. The present study results showed no difference between volleyball and handball due to the nature of these two disciplines and handball, softball, and swimming.

Analysis and prediction of upper extremity movements by cyclograms

Open Medicine ◽  
2014 ◽  
Vol 9 (6) ◽  
pp. 814-820 ◽  
Author(s):  
Patrik Kutilek ◽  
Vladimir Socha ◽  
Karel Hana
Keyword(s):  
Upper Extremity ◽  
Upper Limb ◽  
Assistive Robotics ◽  
Lower Limbs ◽  
Upper Limb Movements ◽  
Scope Of Application ◽  
Prosthesis Control ◽  
The Right ◽  
Changes Over Time ◽  
The Relationship

AbstractQuantification of upper extremity movement is a common objective in both research and clinical practice. Currently, methods based on angle-angle diagrams, also called cyclograms, seem to be promising. Nevertheless, compared to the study of lower limbs, the concept of angle-angle diagrams has not been systematically used to study upper limb movements during walking. The paper describes two examples of new methods based on angle-angle diagrams for application in rehabilitation and assistive robotics. The cyclograms represent information about the relationship between the angles and their changes over time. We used cyclograms as patterns for learning artificial neural networks and predicting the movement of upper-limb. Together with artificial intelligence, cyclograms offer wide scope of application in prosthesis control systems. Using bilateral cyclogram, the information about the relationship between the right and left arm joint angles is used to evaluate the symmetry of movements. The method based on the orientation of the bilateral cyclogram can be used as an additional method for determining the symmetry of movements of the upper limbs or exo-prosthesis.

scholarly journals A Rare Case of Primary Upper Extremity Varicose Veins

2019 ◽  
Vol 04 (01) ◽  
pp. 029-031
Author(s):  
Ramisertti Bhargavi ◽  
Tammiraju Iragavarapu ◽  
A Aswini Kumar
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Upper Limb ◽  
Rare Case ◽  
Varicose Veins ◽  
Case Reports ◽  
Vascular Surgeon ◽  
Doppler Study ◽  
Lost To Follow Up

AbstractThe incidence of varicosities of upper extremity is far most uncommon from that of lower extremity varicose veins for varied reasons even though the causes are almost the same. Here, the authors present a case of right upper limb varicose veins in a 55-year-old female who is a housewife. After ruling out all the secondary and congenital causes on clinical and Doppler study, the authors diagnosed it as a case of primary upper extremity varicose veins. They referred the case to a vascular surgeon but the patient denied the surgery, and is lost to follow-up. Hence, the authors report this case of primary upper limb varicosities as the incidence is very low when compared with lower extremity, and not much of literature is available except for a few case reports.

scholarly journals The Effect of a 6-Week Core Stability Training Program on the Stroke Index and Front Crawl Record of Male Swimmers

2019 ◽  
Vol 5 (2) ◽  
pp. 124-133
Author(s):  
Mohsenali Darchini ◽  
◽  
Teimor Darzabi ◽  
Mohsen Mofrad Moghadam ◽  
Mahdi Nabavinik ◽  
...  
Keyword(s):  
Study Groups ◽  
The Body ◽  
Core Stability ◽  
Lower Limbs ◽  
Stroke Index ◽  
Front Crawl ◽  
Significance Level ◽  
The Core ◽  
Significant Difference ◽  
Stability Training

Objective For optimal performance of swimmers, it is necessary to determine a level for the functional interaction of upper and lower limbs. This level, created by more than 20 pairs of muscles, is the core of the body. The aim of this study was to investigate the effects of six weeks of core stability exercise on the stroke index and front crawl record of male swimmers. Methods In this quasi-experimental study, 24 male swimmers were selected by a convenience sampling method and randomly assigned into control (n=12) and exercise (n=12) groups. The core stability training was performed for 6 weeks, 3 sessions per week, each for 45-50 minutes. Before and after training, the stroke index and 100-m front crawl records of subjects were evaluated. For the within-group and between-group comparisons, the student t-test and ANCOVA were used, respectively. The significance level was set at P<0.05. Results Six weeks of core stability exercise led to significant improvement in 100-m front crawl record in the exercise group. There was no significant difference in the mean scores of stroke index and 100-meter front crawl record between and within the two study groups. Conclusion Core stability exercise is recommended for dryland training of swimmers.

scholarly journals The influence of ergonomic breastfeeding training on some health parameters in infants and mothers: a randomized controlled trial

2019 ◽  
Vol 77 (1) ◽  
Author(s):  
Raha Afshariani ◽  
Marjan Kiani ◽  
Zahra Zamanian
Keyword(s):  
Musculoskeletal Disorders ◽  
Visual Analog Scale ◽  
Upper Limb ◽  
Protective Factor ◽  
Controlled Trial ◽  
Intervention Group ◽  
Study Groups ◽  
Analog Scale ◽  
Significant Difference ◽  
Block Sampling

Abstract Background Breastfeeding is considered as a protective factor against non-communicable diseases in infants and mothers. The first aim of this study was to assess the influence of ergonomic breastfeeding training on the infants’ growth. The second aim was to investigate the effectiveness of this training for improving musculoskeletal disorders in mothers. Methods In this randomized control trial, 104 participants who were referred to the health centers in Shiraz for breastfeeding care were randomly allocated into the intervention or comparison group using a size-four block sampling method. At birth, 2, 4, and 6 months later childbirth, Rapid Upper Limb Assessment was used to assess musculoskeletal disorders in participants, and the severity of their discomfort was measured with the Visual Analog Scale. During the 6 months of the study (March to September, 2017), the weight and height of the neonates were measured every 2 months. Results Significant differences were found between groups in the priority level for corrective action in mothers’ postures determined by Rapid Upper Limb Assessment at 2, 4 and 6 months after childbirth (p < 0.001). Based on the Visual Analog Scale results in mothers at 6 months after childbirth, fewer back pain was reported by the intervention group (p = 0.03). No significant difference were found in the infants’ weights and heights in boys and girls at all growing stages between the two study groups (p > 0.05). However, the mean height for age of the girl infants at age of 6 months was higher among intervention groups compared to the controls (p = 0.01). Conclusion This study demonstrated that ergonomic breastfeeding training reduced the incidence of musculoskeletal disorders in mothers but seems not to have any significant and consistent impact on the infants’ growth. Trial registration fa.irct.ir IRCT2014042317398N1.

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