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1/22. Save that arm: a study of problems in the remaining arm of unilateral upper limb amputees.

    A study has been made by questionnaire, personal examination and telephone interview of unilateral upper limb amputees seen at the Prince Henry Hospital, australia between 1994 and 1997. There were 60 questionnaires posted. Replies were received from 46. Problems were noted in the remaining arm of 23 (50%). The respondents' problems not only consisted of overuse symptoms, but also of an exacerbation of pre-existing arthritis and injury due to trauma to the remaining arm during the accident. Case histories are given in 3 typical cases. Treating professionals are warned about the hazards that one arm amputations present to the remaining arm.
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ranking = 1
keywords = upper
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2/22. Case report: reduction of low back pain in a professional golfer.

    Previous research agrees that the majority of injuries that affect male golfers are located in the lower back and that they are related to improper swing mechanics and/or the repetitive nature of the swing. This study describes the trunk motion and paraspinal muscle activity during the swing of a golfer with related low back pain (LBP) and assesses the effect of a 3-month period of muscle conditioning and coaching on these variables. motion of the trunk was measured using three-dimensional video analysis and electromyograms (EMGs) were recorded from the same six sites of the erector spinae at the start and end of the 3-month period. At the end of the period, the golfer was able to play and practice without LBP. Coaching resulted in an increase in the range of hip turn and a decrease in the amount of shoulder turn, which occurred during the swing. In addition, a reduction in the amount of trunk flexion/lateral flexion during the downswing occurred in conjunction with less activity in the left erector spinae. These changes may serve to reduce the torsional and compressive loads acting on the thoracic and lumbar spine, which in turn may have contributed to the cessation of the LBP and would reduce the risk of reoccurrence in the future. In conclusion, further research with more subjects would now be warranted in order to test the findings of this program for the prevention of low back in golfers as piloted in this case report.
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ranking = 5.8294728486028
keywords = back pain, back
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3/22. Industrial medicine and acute musculoskeletal rehabilitation. 3. cumulative trauma disorders of the upper limb in computer users.

    This self-directed learning module highlights various cumulative trauma disorders of the upper limb that may be seen in computer users. The biomechanics and ergonomics of computer users are addressed in relationship to specific neurologic and musculoskeletal conditions within the neck and upper limbs. In addition to a general overview of these conditions, a case presentation is used to show the evaluation and treatment of a computer user who has carpal tunnel syndrome and concomitant de Quervain tenosynovitis. overall ARTICLE OBJECTIVES: (a) To review the important anatomic and ergonomic basis for upper limb cumulative trauma disorders in computer users and (b) to provide an example of evaluation and treatment.
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ranking = 1.4
keywords = upper
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4/22. Longitudinal tibial fatigue fracture: an uncommon stress fracture with characteristic features.

    PURPOSE: The author reports three cases of longitudinal tibial fatigue fractures, reviews the literature, and discusses characteristic features that suggest the diagnosis may be made by bone scintigraphy. methods: Radiographs and two- or three-phase bone scintigraphs with Tc-99m MDP were obtained in three runners who had exercise-related leg pain and whose clinical symptoms suggested either stress fractures or shin splints. The literature was reviewed and previously reported scintigraphic findings were compared with those seen in these three cases. RESULTS: In contrast to the focal, elliptical, cortex-based abnormal activity usually seen in the upper or middle tibia in patients with tibial stress fractures, all three patients had a long area of abnormal diffusely increased tibial activity that extended from the tibiotalar region proximally. This finding was seen on the 3-hour delayed static images of all three patients and was suggested on the blood-pool (tissue phase) images. The literature also contained reports of these same scan characteristics. Radiographs subsequently disclosed a longitudinal tibial stress fracture in one patient, computed tomography was positive in the second patient, and findings of clinical follow-up and radiographs were consistent with this diagnosis in the third patient. CONCLUSION: In the appropriate clinical setting and with normal or nondiagnostic radiographs, the presence of a long area of diffusely increased activity in the distal tibia extending proximally from the tibiotalar junction is indicative of a longitudinal fatigue fracture.
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ranking = 0.2
keywords = upper
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5/22. Scintigraphic assessment of "effort" axillary-subclavian vein thrombosis.

    "Effort" axillary-subclavian vein thrombosis (Paget-Schroetter syndrome) is an uncommon deep venous thrombosis due to repetitive activity of the upper limb. Clinical suspicion is usually confirmed by contrast venography. This report describes a case where the diagnosis was made by radionuclide venography (Tc-99m DTPA). The examination was carried out in the acute phase and clearly demonstrated the presence and the site of the obstruction as well as the collateral vessels. Despite a complete clinical recovery, obtained by medical therapy, further examinations performed in the follow-up period showed persistence of the thrombotic obstruction and a rich development of collateral vessels. In the authors' opinion, radionuclide venography is worth considering as a first-choice procedure when an axillary-subclavian vein thrombosis is suspected, and contrast venography should be performed only when surgical treatment is indicated.
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ranking = 0.2
keywords = upper
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6/22. Relief of internal snapping hip syndrome in a marathon runner after chiropractic treatment.

    OBJECTIVE: To discuss the assessment, diagnosis and chiropractic management of a patient with sacroiliac joint dysfunction (SIJ) complicated by psoas major snapping hip syndrome (coxa saltans interna). CLINICAL FEATURES: A 32-year-old male marathon runner experienced low-back and left hip pain without radiation accompanied by a "popping" in the anterior hip. He ran approximately 100 to 150 km/wk for the prior 3 years. He had stopped running for the previous 3 weeks because of worsening and consistent pain. INTERVENTION AND OUTCOME: Treatment consisted of side posture SIJ "diversified" manipulation and myofascial release to the psoas muscle twice weekly for 2 weeks. The patient was also taught proprioceptive neuromuscular facilitation exercises of the psoas and iliotibial band muscles. He was instructed to substitute swimming instead of running on a daily basis. Reassessment at 3 weeks found the patient without pain in his hip or back and no clicking or popping in his left hip. CONCLUSION: Clinicians should consider that runners who present with coexisting SIJ dysfunction and internal snapping hip syndrome may benefit from the combined management of both conditions.
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ranking = 0.22268517627663
keywords = back
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7/22. Extensor tendon impingement in a gymnast.

    wrist injuries in the gymnast are due to the transformation of the upper extremity into a weight bearing entity. Gymnast wrist pain presents a difficult diagnostic and therapeutic challenge. Here, we present a new case of extensor tendon impingement in an elite gymnast. To our knowledge, there is no similar report in the literature.
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ranking = 0.2
keywords = upper
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8/22. Hypothenar Hammer Syndrome: rare or underdiagnosed?

    Hypothenar hammer Syndrome (HHS) is a condition characterised by digital ischaemia as a result of repetitive trauma to the hypothenar eminence of the hand. It occurs in people who repeatedly use the palm of the hand as a hammer to push, grind or twist objects. It is a curable and a preventable cause of upper digital ischemia. In this report we present a case of HHS and discuss the causes and pathogenesis of this syndrome. We review the incidence, clinical characteristics, differential diagnosis, investigation and treatment.
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ranking = 0.2
keywords = upper
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9/22. An unusual stress fracture in a multiple sport athlete.

    Most overuse injuries are a direct result of repetitive stresses which may create a condition of maltraining. Young athletes are no exception to this rule. swimming and baseball both create stresses to the humerus which may result in injuries to the shoulder and upper extremity. Stress fractures (fatigue fractures) are usually limited to the lower extremity (i.e., tibia or metatarsal). upper extremity stress fractures, especially of the humerus, are very uncommon. precipitating factors include repetitive stresses, low grade external forces, rapid application of muscular force to the bone, or an underlying disease or pathologic weakness of the bone. The majority of these fractures are primarily due to abnormal and repetitive stresses to bones. This case study examines the mechanism of injury, clinical presentation, and treatment of a clinically apparent stress fracture which ultimately converted to an overt humerus fracture in a 14-yr-old cross-trained athlete.
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ranking = 0.2
keywords = upper
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10/22. Repetitive strain injuries. How to deal with 'the epidemic of the 1990s'.

    Occupational trends, especially the mushrooming of computer use in the united states, have brought with them a virtual epidemic of repetitive strain injury of the upper limb. What can you as a primary care physician do to stem the tide? In this article, the authors fill you in on treatment of the most common injuries as well as remark on the ramifications for business and industry.
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ranking = 0.2
keywords = upper
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