Elbow and wrist injuries in sports.
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Any disabling injury of the elbow or wrist should be studied roentgenographically for evidence of fracture which may not be otherwise evident but which may cause permanent disability unless the joint is immobilized for healing."Tennis elbow" may be treated with physical therapy and analgesic injection but may require splinting or tendon stripping. Elbow sprain can occur in the growing epiphysis but is rare in adults. A jarring fall on the hand may cause fracture or dislocation at the elbow. Full extension of the joint should be restored gradually by active exercise rather than passive or forcible stretching. Fracture at the head of the radius may cause joint hemorrhage with severe pain which can be relieved by aspiration. A displacing fracture at the head of the radius requires removal of the head to prevent arthritic changes. Myositis ossificans contraindicates operation until after it has cleared. Healing of wrist fractures may be facilitated by exercise of the shoulder and elbow while the wrist is still in a cast. Fractures of the navicular bone are difficult to detect even roentgenographically and splinting may have to be done on clinical evidence alone. (+info)
Cumulative trauma disorders of the hand and wrist in the auto industry.
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Surveillance for cumulative trauma disorders (CTDs) of the hand and wrist was carried out in five US automotive plants from 1985 to 1986, using Occupational Safety and Health Administration (OSHA) Form 200 injury and illness logs and medical insurance claims. Results using both record sources indicated that hand and wrist disorders may be more common in foundries than in other types of automotive plants. Similarly, in assembly plants, employees in certain departments appeared to be at higher risk for CTDs. Although our results are based on small numbers of cases, they suggest plants and departments that might be targeted for more detailed investigation. (+info)
Osteoarthritis of the knee is associated with vertebral and nonvertebral fractures in the elderly: the Rotterdam Study.
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OBJECTIVE: To study the association between prevalent radiographic osteoarthritis (ROA) of the knee and incident vertebral and nonvertebral fractures. METHODS: A sample of 2,773 subjects was drawn from the Rotterdam Study, a prospective population-based cohort study of the elderly. Status on knee ROA was assessed at baseline using the Kellgren score. Incident nonvertebral fractures were scored for all subjects, and for 1,466 subjects additional data on incident vertebral fractures were available. RESULTS: Although people with ROA had a higher bone mineral density (BMD), their incident fracture risk was increased as compared with those without ROA. After adjustment for potential confounding factors, including parameters of postural stability, the relative risks for incident vertebral and nonvertebral fractures in the presence of knee ROA were 2.0 (95% confidence interval [95% CI] 1.1-3.4) and 1.5 (95% CI 1.1-2.0), respectively. CONCLUSIONS: Knee ROA is associated with an increased risk of incident vertebral and nonvertebral fractures, independent of BMD and parameters of postural stability. (+info)
Palmar divergent dislocation of scaphoid and lunate.
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A 28-year-old man presented with a palmar divergent dislocation of the scaphoid and lunate. He was treated with an open reduction and an internal fixation with two Kirschner's wires after the 25th day of trauma due to a neurological injury. The results were satisfactory after 18 months follow up without any evidence of avascular necrosis and traumatic arthritis of the scaphoid and lunate. The patient had no limitation in motion or intermittent wrist pain. We reported this case with a brief review of relevant literatures. (+info)
Associations of birth weight and length, childhood size, and smoking with bone fractures during growth: evidence from a birth cohort study.
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Little information exists on risk factors associated with bone fractures during childhood and adolescence. This 1972/1973-1990/1991 New Zealand study examined the influence of birth size, height and weight throughout growth, smoking, breastfeeding, and sports participation on the risk of fracture in participants of the Dunedin Multidisciplinary Health and Development Study. Information on height, weight, fracture status, and lifestyle was collected at birth and at ages 3, 5, 7, 9, 11, 13, 15, and 18 years from parents and/or participants. Study members sustained 229 (girls) and 393 (boys) fractures between birth and age 18 years. Fracture risk was elevated (per standard deviation unit increase) in relation to birth length (prepubertal fractures only) (risk ratio (RR) = 1.28, 95% confidence interval (CI): 1.04, 1.58), weight at age 3 years (RR = 1.14, 95% CI: 1.03, 1.27), weight from ages 5 to 18 years (RR = 1.15, 95% CI: 1.03, 1.28), height at age 3 years (RR = 1.13, 95% CI: 1.01, 1.26), and height from ages 5 to 18 years (RR = 1.13, 95% CI: 1.02, 1.24). Birth weight, maternal smoking, breastfeeding, and sports participation had no significant effect on fracture risk. However, for teenagers, personal daily smoking increased the risk of fracture (RR = 1.43, 95% CI: 1.05, 1.95). The authors concluded that tall and heavy children had an increased risk of fracture, as did adolescents who smoked regularly. (+info)
Dhaga syndrome: a previously undescribed entity.
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Three children between the ages of 18 months and four years presented with a discharging sinus or sinuses at the wrist due to a 'sacred' thread (the Moli Dhaga) which had been tied around it. This thread had been forgotten by the parents and had become embedded in the soft tissues of the wrist. Plain radiographs showed a circumferential constriction in the soft tissue shadow in all three. In two, there was a periosteal reaction in the distal radius or ulna with an indentation which we have called the constriction sign. Surgical removal of the buried thread was successful in all cases. (+info)
Failure to diagnose--fractures.
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'Failure to diagnose' claims are the most common cause of medical negligence claims in general practice. This article examines a claim involving a failure to diagnose a fracture and outlines some risk management strategies for general practitioners to minimise the possibility of a claim arising from a failure to diagnose orthopaedic problems. Case histories are based on actual medical negligence claims, however, certain facts have been omitted or changed by the author to ensure the anonymity of the parties involved. (+info)
Hand and wrist injuries: Part I. Nonemergent evaluation.
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Diagnosis of upper extremity injuries depends on knowledge of basic anatomy and biomechanics of the hand and wrist. The wrist is composed of two rows of carpal bones. Flexor and extensor tendons cross the wrist to allow function of the hand and digits. The ulnar, median, and radial nerves provide innervation of the hand and wrist. A systematic primary and secondary examination of the hand and wrist includes assessment of active and passive range of motion of the wrist and digits, and dynamic stability testing. The most commonly fractured bone of the wrist is the scaphoid, and the most common ligamentous instability involves the scaphoid and lunate. (+info)