1/9. Entrapment of the index flexor digitorum profundus tendon after fracture of both forearm bones in a child.Entrapment of the index FDP tendon in a radius fracture callus occurred after fracture of both forearm bones in a 4-year-old boy. Surgical release of the FDP tendon, three months after fracture, resulted in normal index finger motion. This clinical problem can be avoided by a detailed physical examination of children with forearm fractures, verifying full passive range-of-motion of the hand after cast immobilization. Prompt supervised active range-of-motion should be done to prevent adhesions at the fracture site.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/9. Management of a patient with a forearm fracture and median nerve injury.STUDY DESIGN: Case report. OBJECTIVES: patients with peripheral nerve injury may demonstrate long-lasting impairments and functional limitations. In this case report, we describe the diagnosis of a patient with a peripheral nerve injury and a conventional plan of care, along with the novel intervention of neuromuscular electrical stimulation (NMES). We feel that the additional NMES intervention was instrumental in achieving more rapid functional improvements than the more traditional interventions that are reported in the literature. BACKGROUND: The patient was a 21-year-old male who sustained a forearm fracture that was complicated by injury to the anterior interosseous branch of the median nerve. He was unable to flex the interphalangeal (IP) joint of his thumb, had decreased strength of thenar eminence musculature, and was unable to perform fine motor activities with his hand. methods AND MEASURES: Electrophysiological tests revealed partial denervation of the flexor pollicis longus and pronator quadratus muscles. In the fifth physical therapy session, NMES to the flexor pollicis longus and thenar muscles was added to the patient's conventional plan of care. RESULTS: With a conventional ROM and strengthening plan of care, no improvement was seen in thumb IP joint flexion over a period of 2 weeks. After 3 sessions of NMES and conventional interventions, gains in active ROM were made in thumb IP joint flexion. After 9 sessions of NMES and conventional interventions, force of thumb IP flexion was registered on a pinch dynamometer. Twenty weeks after initial examination, strength and ROM measures had improved and the patient reported no functional deficits. CONCLUSIONS: The patient showed gains in strength of the thumb IP joint after a few NMES sessions, which suggests that NMES was a helpful adjunct to the plan of care, even though the precise mechanism underlying the functional gains are not known.- - - - - - - - - - ranking = 0.10837712515096keywords = physical (Clic here for more details about this article) |
3/9. 'Wristlock restraint' and physeal injuries of the distal radius.Wristlock is a commonly used physical restraining manoeuvre to control aggressive and violent persons in penal and medical institutions. We report three cases of similar physeal injuries to the distal radius sustained consequent to a wristlock restraint. There may be a higher morbidity involved when wristlock restraint is used on those with an immature skeleton. We recommend that caution must be exercised whenever a wristlock restraint is used on individuals under 16 years of age.- - - - - - - - - - ranking = 0.10837712515096keywords = physical (Clic here for more details about this article) |
4/9. Stress fracture at the junction of the middle and distal third of the ulnar diaphysis in a spinner bowler: a case report and a review of the literature.Stress fractures of the ulnar shaft are uncommon injuries, which have been documented in a variety of sports. The location of the fracture is influenced by the activity and mechanism of injury with which it is associated. The combined traditional approach of clinical history, physical examination, plain radiographs and nuclear scintigraphy for unusual stress fracture may be troublesome. This report is the first to describe a stress fracture at the junction of the middle and distal third of the ulnar diaphysis in a bowler due to chronic torsional stress. We discuss the possible mechanism of injury and describe the diagnostic imaging. A review of the literature is also given and compared with the findings and data of this case.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
5/9. Compartmental syndrome complicating Salter-Harris type II distal radius fracture.Distal radius fractures are common in children, yet complications are rare. A rarely described complication, acute volar compartmental syndrome, occurred in a 15-year-old boy. An accurate physical examination and awareness of the syndrome are essential for diagnosis. Compartmental pressures can be obtained easily and afford a rapid means of corroboration. Once the diagnosis is established, adequate decompression of all involved compartments, including carpal tunnel release, is essential. The literature is unclear regarding the etiology of this complication. There is nothing structurally intrinsic to the distal radius that should lead to a compartmental syndrome. Both the amount of soft tissue damage at the time of fracture and the mode of immobilization (excessive elevation, constricting splint, etc.) are the ultimate determinants of a successful (or unsuccessful) outcome.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
6/9. Posterior dislocation of the radial head without fracture of the ulna. A case report.Posterior radial head dislocation without fracture of the ulna in an adult is extremely rare. A case is presented in which immediate closed reduction, a short period of immobilization, and early active range of motion resulted in a very good outcome. Early detection by thorough physical examination and careful radiographic analysis is crucial for a good final result.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
7/9. pseudarthrosis of the forearm bones. (Clinical and radiographic survey of 112 operated cases).There are two aims in the surgery of pseudarthrosis in the forearm; consolidation of the fracture, and restoration of function as nearly normal as possible in a part of the musculo-skeletal system which is mechanically controlled by extremely delicate, interdependent, structural units. These aims are, of course, the same as those in the treatment of fresh fractures. The following conclusions emerge from a clinical and radiographic study of 112 operated cases: (a) Sherman's plate has been shown to be an ideal means of synthesis, because of its metallurgical and physical qualities, which enable it to adapt excellently to an irregular bone surface. (b) Plate fixation is supplemented by an appositional cortical transplant. This also plays a definite mechanical role, both because of the firm grip that it affords to the screws when the bone stumps are atrophic, which they often are, and because it is isoelastic with the recipient's tissue. Two cortical grafts are sometimes used instead of a plate and graft. (c) The best functional results are obtained when the leverage of the forearm has been anatomically restored.- - - - - - - - - - ranking = 0.10837712515096keywords = physical (Clic here for more details about this article) |
8/9. brachial artery laceration with closed posterior elbow dislocation in an eight year old.elbow dislocations are relatively uncommon in children. rupture of the brachial artery associated with closed elbow dislocations in children is rare. This is a report of an 8-year-old boy, the youngest patient ever to be reported to have a closed posterior dislocation of the elbow associated with a brachial artery laceration. The boy incurred a closed elbow dislocation after a fall onto his outstretched arm. On physical examination, both radial and ulnar (ulnar) pulses were absent. Radiographs showed a posterolateral dislocation of the right elbow and distal fractures of the radius and ulna. Operative exploration of the antecubital fossa showed complete transection of the brachial artery. Repair of the vessel was performed using an interposition vein graft. The distal forearm fractures were managed by closed reduction. At the two-year postoperative follow-up examination, the patient had a normal neurovascular examination with full range of motion of his elbow and wrist. Surgical treatment should include exploration of the antecubital fossa and reconstruction of the injured vessels.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
9/9. A 9-year-old girl with a bowed right forearm 6 months after a fracture.The following case is presented to illustrate the roentgenographic and clinical findings of a condition of interest to the orthopedic surgeon. Initial history, physical findings, and roentgenographic examinations are found on the first page. The final clinical and roentgenographic differential diagnoses are presented on the following pages.- - - - - - - - - - ranking = 0.10837712515096keywords = physical (Clic here for more details about this article) |