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Surgery of the Peripheral Nerve
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Ravikiran Shenoy, Gorav Datta, Max Horowitz, Mike Fox
History and clinical examination remain the mainstay of diagnosis. It is essential to examine the entire limb as well as the cervical spine to exclude a ‘double-crush’ lesion. Nerve conduction studies are useful and should be available on the day of surgery. They are considered essential in cases of recurrent carpal tunnel syndrome and complex upper limb lesions. Prolonged sensory latency is the earliest and most reliable nerve conduction abnormality. Magnetic resonance imaging (MRI) is rarely indicated, unless there is clinical evidence of a space-occupying lesion causing the symptoms. Conventional radiography is not generally indicated. Consideration should be given to extraneous causes such as diabetes mellitus, rheumatoid and other arthritides, amyloidosis and thyroid dysfunction; where appropriate these may also require investigation prior to operation.
Upper Limb
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
The upper limb is divided into the shoulder, arm (between shoulder and elbow), forearm (between elbow and wrist) and hand. The axilla, cubital fossa and carpal tunnel are important areas of transition in the upper limb.
Plastic Surgery
Published in Gozie Offiah, Arnold Hill, RCSI Handbook of Clinical Surgery for Finals, 2019
➣ Carpal tunnel syndromeMost common mononeuropathy of upper limbMechanical compression in the fixed rigid space of the carpal tunnel
Influence of an armrest support on handgrip strength in different arm and shoulder flexion angles in overhead postures
Published in International Journal of Occupational Safety and Ergonomics, 2023
Jorge-Hernán Restrepo-Correa, Juan-Luis Hernández-Arellano, Carlos Alberto Ochoa-Ortiz, Aidé-Aracely Maldonado-Macías
The task consisted of applying the maximum handgrip strength with the MicroFET hand dynamometer with a fixed aperture of 4.76 cm. while the right hand was raised above the shoulder level. The arm adhered itself against the based structure that supports the AAAS to avoid abduction of the shoulder (see Figure 2). Tasks were performed with and without AAAS for three combinations of shoulder–elbow flexion angles: 90°–90°, 135°–45° and 160°–20° (see Figure 2). The upper limb was held with the shoulder flexed, without abduction (0°), the forearm in a vertical and neutral position, and the wrist in a neutral position as well. The maximum handgrip strength was recorded by keeping the maximum handgrip strength for 5 s according to the Caldwell protocol [31]. The participants performed three repetitions for each combination of shoulder–elbow flexion angles. Each handgrip strength test was randomly assigned to each participant to eliminate order dependency. Table 1 presents the coding used to identify the six levels considered in the study.
Evidence of rotator cuff disease after breast cancer treatment: scapular kinematics of post-mastectomy and post-reconstruction breast cancer survivors
Published in Annals of Medicine, 2022
Angelica E. Lang, Stephan Milosavljevic, Clark R. Dickerson, Catherine M. Trask, Soo Y. Kim
Upper limb morbidities are common after breast cancer treatment. Limitations such as reduced range of motion, reduced strength, swelling or loss of sensation are commonly reported for several years after treatment [1,2]. Additionally, breast cancer survivors may be more likely to have secondary upper limb conditions [3–5], possibly as a result of the side effects of treatment or secondary to the above-mentioned limitations. One secondary morbidity that breast cancer survivors may experience is rotator cuff disease [3,6]. Rotator cuff disease, which for the purpose of this paper will encompass all tendinitis, tendinopathy and tears of the rotator cuff, is associated with upper limb disability [7]. For breast cancer survivors who may already experience physical limitations after cancer treatment, pain and reduced range of motion associated with rotator cuff disease [8] could lead to additional limitations that interfere with activities of daily living and occupational tasks if left untreated. Although this relationship is posited, there is actually very little research specifically on rotator cuff pathology among breast cancer survivors.
Effects of an active intervention based on myofascial release and neurodynamics in patients with chronic neck pain: a randomized controlled trial
Published in Physiotherapy Theory and Practice, 2022
Irene Cabrera-Martos, Janet Rodríguez-Torres, Laura López-López, Esther Prados-Román, María Granados-Santiago, Marie Carmen Valenza
In the last two weeks, patients performed active neurodynamic exercises. They were taught how to slide the nerve tissue. They performed three series of 10 repetitions alternating the right and left limbs. Neurodynamic exercises followed the same sequence used in the neurodynamic tests, but patients were positioned sitting in front of a mirror to have visual feedback of their movements and posture. The program was individually adapted to each patient in the first session. Exercises were also adapted according to the levels of pain assessed with the VAS and the feedback of patients. They involved different combinations of neck, elbow, and wrist movements in varying angles of shoulder abduction. Upper limb neurodynamic techniques were performed for the radial, median, and ulnar nerves following a standardized sequence (Butler, 2000). A cinch was placed at the shoulder to help participants lower it.