1/7. superior mesenteric artery syndrome as a complication in hip spica application for immobilization: report of a case.A 10-year-old girl who had a pelvic and femoral osteotomy for congenital dislocation of her right hip was immobilized with a hip spica. On the 28th postoperative day, she had upper abdominal pain, distention and bilious vomiting. An upper GI series demonstrated complete obstruction of the duodenum at the third portion of the duodenum in a supine position; however, the barium passed the obstruction site slowly when the patient assumed a lateral or prone position. She was successfully treated conservatively with nasogastric decompression, fluid replacement, proper positioning and hyperalimentation. superior mesenteric artery syndrome is a rare complication in patients immobilized in a body cast or hip spica. early diagnosis and proper treatment usually leads to an uneventful convalescence.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
2/7. Prosthetic restoration in congenital lower limb deficiency. A case study.We presented a synopsis of a young girl with congenitally deficient limb who underwent seven corrective surgical procedures and fabrication of a specially designed and constructed prosthesis. The surgical procedures are detailed as in the total rehabilitation approach. We have provided plastic laminated orthoses and prostheses to many patients with congenitally deficient upper and lower limbs. An additional paper will detail our experience with a series of plastic laminated orthoses and prostheses in patients with congentally deficient upper and lower extremities.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
3/7. coxa vara in spina bifida.In spina bifida the femoral neck can develop either the well-known coxa valga or the hitherto unreported coxa vara. Twenty-three cases of coxa vara in spina bifida are reported. These result from spontaneous separation of the upper femoral epiphysis (10 cases), spontaneous fracture of the femoral neck (three cases) and iatrogenic avascular necrosis of the upper femoral epiphysis (10 cases).- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
4/7. Traumatic partial arrest of tibial physis.Two children with premature partial arrest of the tibial physis, one proximal and the other distal, were treated by resection of the bony bar and by the Langenskiold method of interposition of fat. In one child the arrest was the result of an open fracture and bony loss of the upper tibia. In the other child the arrest was caused by a Salter IV fracture. Preservation of the fat implant 20 months after operation was observed histologically. Correction of the deformity was accomplished in one case but not in the other.- - - - - - - - - - ranking = 0.5keywords = upper (Clic here for more details about this article) |
5/7. Unilateral lower limb hypoplasia in arterial fibromuscular dysplasia.Hypoplasia or hyperplasia of limbs can be unilateral or bilateral and can involve the upper or lower extremities in any combination. The etiology is varied, and the presentation, clinical features, and investigative pathway differ to some extent among patients. Reported here is a child, referred for limb lengthening, with claudicating unilateral leg pain and unilateral hypoplasia of the same limb. Investigations revealed multiple arterial stenoses consistent with fibromuscular dysplasia. In such cases, early diagnosis and intervention with angioplasty may enhance subsequent growth of the limb, thus avoiding the need for limb lengthening procedures.- - - - - - - - - - ranking = 0.5keywords = upper (Clic here for more details about this article) |
6/7. A further case of vertical transmission of proximal femoral focal deficiency?We report on a newborn boy with congenital asymmetrically hypoplastic fibulae, lateral oligodactyly, and mild left ectrodactyly. The patient's grandfather had a short femoral shaft with a slightly smaller collodiaphyseal angle on the left as compared to the right side, probably a proximal focal femoral deficiency (PFFD). The upper limbs were not affected in either patient. PFFD in the grandfather and hypoplastic fibulae with lateral ray defects in the grandson raise the possibility of genetic transmission, specifically autosomal-dominant inheritance with variable penetrance and expressivity. This case gives further support to the fibular developmental field concept postulated by Lewin und Opitz [1986: Am J Med Genet (Suppl) 2:215-238].- - - - - - - - - - ranking = 0.5keywords = upper (Clic here for more details about this article) |
7/7. Thermal asymmetry of the upper extremity in scalenus anticus syndrome, leg-length inequality and response to chiropractic adjustment.OBJECTIVE: To describe a case of a vasomotor, vascular form of thoracic outlet syndrome that causes upper extremity thermal asymmetry, and to discuss a single subject case study (N-of-1) comparing the correlation of a subjective test for putative atlas vertebral subluxation complex (supine leg-length inequality) with a single blinded objective measurement [temperature differential (delta degree T)] on the dorsum of the hands. CLINICAL FEATURES: A 71-yr-old woman with a cold, painful right hand and chronic neck pain sought chiropractic evaluation. There was a left head tilt and muscular hypertonicity with fibrous bands in the opposite scalenes and sternocleidomastoid. Thermographic examination revealed a large temperature differential (12 degrees F) between the dorsum of the right and left hands, with the superficial veins on the dorsum of the cold hand collapsed. Thoracic outlet provocation tests were negative. A left-side leg-length inequality potentially indicative of putative upper cervical subluxation was also noted. A diagnosis of presumptive thoracic outlet syndrome with vasomotor vascular complications subsequent to altered cervical biomechanics was made. INTERVENTION AND OUTCOME: Treatment was limited to chiropractic, upper cervical, vectored, linear adjustment of the atlas vertebra. temperature differential between the hands improved significantly after individual atlas adjustment(s) and in the long term. CONCLUSION: Scalenus anticus syndrome and upper extremity thermal asymmetry may result from altered cervical biomechanics caused by atlas vertebral subluxation complex. Furthermore, the supine leg check may be of value in determining the necessity of atlas adjustment.- - - - - - - - - - ranking = 4keywords = upper (Clic here for more details about this article) |