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Digital Deformities in Rheumatoid Arthritis
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
An extensive and thorough physical examination is required:The wrist should be positioned in alignment to assess its impact on the ulnar deviation of the digital chains. Before performing a direct gesture of realignment at the MCP level, it is imperative to first correct the radial deviation of the carpus which only aggravates the dislocation of the extensor muscle-tendons [5,18,28,29,36,41,51,57].The localization of the different synovitis is evaluated, joint by joint. The spontaneously painful joints are most often on the lateral side (squeeze test).Instability and joint dislocation.The function of the extensor apparatus; the sub-dislocation or the dislocation of the extensor tendons in the intermetacarpal grove must be systematically corrected because they contribute to the deficit of extension of the digit chain, in the “ulnar side” and promote the palmar subluxation of the first phalanx.The function of the wrist and finger flexors.The intrinsic muscles: The interosseous retraction is assessed by the Finochietto test.
Introduction to the clinical stations
Published in Sukhpreet Singh Dubb, Core Surgical Training Interviews, 2020
Joint dislocation occurs when there is separation between two articulating bony surfaces following traumatic force; joints commonly affected include the shoulder, finger, patella, hip and elbow. Anterior shoulder dislocations are typically held in an externally rotated and abducted position. Conversely, posterior shoulder dislocations are held in adduction and internal rotation. Dislocations are characterised by pain, immobility, tenderness and swelling. Treatment involves analgesic and a safe method of reduction for which there are many techniques including Kocher's, Milch's, Cunningham's, and so forth.
The Musculoskeletal System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Joint dislocation is treated with reduction or relocation to prevent muscle spasm, swelling, and further damage to surrounding tissues. Immobilization may also be required. Treatment of joint damage has traditionally been by immobilization; however, a technique called continuouspassive motion (CPM) is now being utilized following surgical procedures to stimulate the flow of synovial fluid and prevent adhesion of cartilage to the synovial membrane.
Does double calibration coupled with a closed loop multibody kinematic optimization improve scapular kinematic estimates?
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Y. Blache, M. Degot, M. Begon, S. Duprey, I. Rogowski
A first approach consists of using an acromion-marker-cluster method coupled with a single calibration to identify scapulo-thoracic kinematics. This method has been extended with double (Brochard et al. 2011) calibrations to improve scapular kinematics accuracy. Although these approaches are easy to use, they may lead to joint dislocation when considering the whole kinematic chain. Multibody kinematic optimization has then been developed to address this issue. Especially, closed loop kinematic chain has gained interest for the last decade in order to improve scapulo-thoracic kinematic estimates (Duprey et al. 2017). This approach consists of optimizing joint angles by minimizing the distance between the positions of experimental markers and the virtual markers of the kinematic model, with the latter being obtained from a single calibration usually performed while the participant hold an anatomic pose. The closed loop is ensured by constraining the scapula to slide along the thorax. Nevertheless, scapular misorientation are still observed especially for high degrees of arm elevation (Michaud et al. 2017), which are far from the calibration pose. Combining double calibrations with multibody kinematic optimization may be innovative and a promising approach to address current issues when computing scapular kinematics.
The Tight-Rope Technique versus Clavicular Hook Plate for Treatment of Acute Acromioclavicular Joint Dislocation: A Systematic Review and Meta-Analysis
Published in Journal of Investigative Surgery, 2021
Weihui Qi, Yunyun Xu, Zijian Yan, Jingdi Zhan, Jian Lin, Xiaoyun Pan, Xinghe Xue
The Review Manager 5.3 software (Revman the Cochrane Collaboration; Oxford, England) was used to convert all outcome measurements, and the review of all surgeries was based on the methods contained within Cochrane’s handbook. The relative risk (RR) was used for dichotomous data and the weighted mean difference for continuous data. A Chi-squared test on N-1 degrees of freedom was used to calculate the statistical heterogeneity, with the level of significance set at 0.05. I2 (I2 = [(Q-df)/Q] × 100%) was used to calculate the percentage of variability in effect estimates according to the heterogeneity. Q is the χ2 statistic and df is the degree of freedom. A fixed effects model was used if I2 was no more than 50%; otherwise, a random effects model was used. If substantial heterogeneities across studies (I2 > 50%) were detected in the index three main meta-analyses in terms of constant score, VAS pain score, and complication rate, post hoc sensitivity analyses, or subgroup analyses were performed to determine the sources of heterogeneity. The outliers were determined as those studies in which the CI of the estimated effect size did not overlap greatly with the pooled overall effect size. A funnel plot was used to assess publication bias. In the case of asymmetrical plots, trim and fill analyses were used to assess the stability. When appropriate, subgroup analyses of supplementary fixation were performed for AC joint dislocation. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was also used to evaluate the quality of evidence according to each outcome [23, 24].
Simultaneous bilateral shoulder dislocation during pilates reformer exercise: A case report
Published in Physiotherapy Theory and Practice, 2023
Metin Ergün, İhsan Yörük, Ogün Köyağasioğlu
Major joint dislocations can be the consequence of unsupervised exercises, even low-impact ones such as Pilates Reformer, due to inadequate muscle control and joint stabilization. In addition to effective trauma care, it is important to design personalized rehabilitation programs with supervision and to follow-up closely in order to ensure that these rare cases can ameliorate with daily comfort and return to sport performance at the pre-injury or nearest level.