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PloS One 2024Pain in conjunction with surgery for ulnar nerve entrapment at the elbow is seldom highlighted in the literature. This study aimed to explore patients' experiences of...
PURPOSE
Pain in conjunction with surgery for ulnar nerve entrapment at the elbow is seldom highlighted in the literature. This study aimed to explore patients' experiences of living with chronic pain (≥3 months duration) in conjunction with surgery for ulnar nerve entrapment at the elbow, the consequences and the coping strategies applied.
MATERIAL AND METHODS
In-depth interviews were conducted with 10 participants aged 18-60 years. The narratives were analyzed using an inductive approach and content-analysis.
RESULTS
The analysis revealed seven main categories: "Physical symptoms/impairments" and "Mood and emotions"comprise symptoms caused by ulnar nerve entrapment at the elbow and chronic pain; "Consequences in daily life" includes challenges and obstacles in every-day life, impact on leisure activities and social life; "Struggling with self-image" embraces experiences closely related to identity; "Coping strategies" covers adaptive resources; "Experience of relief "describes perceived improvements; "Key message for future care" comprises important aspects for healthcare providers to consider.
CONCLUSIONS
The results clarify the need for healthcare personnel to adopt a biopsychosocial approach when treating patients with ulnar nerve entrapment at the elbow. Emotional symptoms and sleep disturbances should be identified and treated properly since they contribute to the heavy burden experienced by the individual.
Topics: Humans; Adult; Female; Male; Middle Aged; Ulnar Nerve Compression Syndromes; Adolescent; Chronic Pain; Elbow; Young Adult; Qualitative Research; Adaptation, Psychological; Ulnar Nerve
PubMed: 38941288
DOI: 10.1371/journal.pone.0306327 -
Nutrients Jun 2024Carpal tunnel syndrome (CTS) is the most common cause of peripheral compressive neuropathy and consists of compression of the median nerve in the wrist. Although there...
Carpal tunnel syndrome (CTS) is the most common cause of peripheral compressive neuropathy and consists of compression of the median nerve in the wrist. Although there are several etiologies, idiopathic is the most prevalent origin, and among the forms of treatment for CTS, conservative is the most indicated. However, despite the high prevalence in and impact of this syndrome on the healthcare system, there are still controversies regarding the best therapeutic approach for patients. Therefore, noting that some studies point to vitamin D deficiency as an independent risk factor, which increases the symptoms of the syndrome, this study evaluated the role of vitamin D supplementation and its influence on pain control, physical examination and response electroneuromyography to conservative treatment of carpal tunnel syndrome. For this, the sample consisted of 14 patients diagnosed with CTS and hypovitaminosis D, who were allocated into two groups. The control group received corticosteroid treatment, while the experimental group received corticosteroid treatment associated with vitamin D. Thus, from this study, it can be concluded that patients who received vitamin D, when compared to those who did not receive it, showed improvement in the degree of pain intensity, a reduction in symptom severity and an improvement in some electroneuromyographic parameters.
Topics: Humans; Carpal Tunnel Syndrome; Vitamin D; Female; Vitamin D Deficiency; Male; Middle Aged; Electromyography; Adult; Treatment Outcome; Dietary Supplements; Adrenal Cortex Hormones; Median Nerve; Aged
PubMed: 38931299
DOI: 10.3390/nu16121947 -
Military Medicine Jun 2024Injury epidemiology research with military populations typically utilizes data obtained through medical chart review (MCR) or injury self-reports (ISRs). MCR data will...
INTRODUCTION
Injury epidemiology research with military populations typically utilizes data obtained through medical chart review (MCR) or injury self-reports (ISRs). MCR data will not capture musculoskeletal injury (MSKI) data for which medical care was not sought, which is common during military recruit training. Injury self-report is affected by issues with recall, especially for MSKIs perceived as less severe. U.S. Marine Corps (USMC) recruits participate in an intense 13-week recruit training program during which they are susceptible to MSKIs. The purpose of the current analysis was to utilize a novel statistical method, the capture-recapture (CRC) technique, to account for the undercounting inherent in MSKI data sources and estimate the ascertainment-corrected cumulative incidence of MSKIs during USMC recruit training.
MATERIALS AND METHODS
Data for the current study were derived from a larger study, the USMC Gender-Integrated Recruit Training Study, which was initiated to provide data-driven recommendations to increase gender integration in USMC recruit training. The estimated cumulative incidence of MSKIs during 13-weeks of USMC recruit training was calculated from the 2 sources of MSKI data (MCR, ISR) and using CRC analysis. Medical charts were reviewed to extract data about MSKIs that occurred during recruit training. Self-reported MSKI data for the same period were obtained from recruits at the end of recruit training. MSKIs were classified according to their anatomical location and type. The Chapman modification of the Lincoln-Peterson estimator was utilized to conduct the CRC analysis.
RESULTS
Medical chart review and ISR MSKI data were available for 464 USMC recruits (age: 19.1 ± 1.9 years; gender: men 70.0%). The observed 13-week cumulative incidence of MSKI in the sample was 21.8% in the MCR and 28.4% in the ISR, while the CRC incidence was much higher (62.0%). The MCR and ISR ascertainment were 35.1% and 45.9%, respectively, while the overall ascertainment or completeness of MSKI data when 2 sources were used was moderate (65.0%). When stratified by MSKI anatomical location, the overall ascertainment varied by anatomical location of the MSKI. It was highest for lower extremity MSKIs (64.8%), but lower for upper extremity (38.9%) and spine (33.3%) MSKIs. The overall ascertainment also varied by MSKI type; it was highest for sprain (55.1%), followed by strain (54.8%), and the pain/spasm/ache (43.3%).
CONCLUSIONS
This was the first study to utilize the CRC technique to access the ascertainment-corrected incidence of MSKIs among USMC recruits. There was significant undercounting in both sources of the data analyzed, and the extent of undercounting varied by both MSKI anatomical location and type. When 2 sources of data were utilized simultaneously, the percent of CRC-estimated MSKIs observed from 2 sources of data was more complete. There is a need for further application of the CRC technique to MSKI data in military populations to provide a more complete assessment of MSKIs. Identification of modifiable factors that influence completeness of MSKI data obtained during military recruit training is also warranted.
Topics: Humans; Military Personnel; Incidence; Male; Female; United States; Musculoskeletal System; Adult; Musculoskeletal Diseases; Young Adult; Self Report
PubMed: 38920034
DOI: 10.1093/milmed/usae129 -
The Iowa Orthopaedic Journal 2024Patients often access online resources to educate themselves prior to undergoing elective surgery such as carpal tunnel release (CTR). The purpose of this study was to...
BACKGROUND
Patients often access online resources to educate themselves prior to undergoing elective surgery such as carpal tunnel release (CTR). The purpose of this study was to evaluate available online resources regarding CTR on objective measures of readability (syntax reading grade-level), understandability (ability to convey key messages in a comprehensible manner), and actionability (providing actions the reader may take).
METHODS
The study conducted two independent Google searches for "Carpal Tunnel Surgery" and among the top 50 results, analyzed articles aimed at educating patients about CTR. Readability was assessed using six different indices: Flesch-Kincaid Grade Level Index, Flesch Reading Ease, Gunning Fog Index, Simple Measure of Gobbledygook (SMOG) Index, Coleman Liau Index, Automated Readability Index. The Patient Education Materials Assessment Tool evaluated understandability and actionability on a 0-100% scale. Spearman's correlation assessed relationships between these metrics and Google search ranks, with p<0.05 indicating statistical significance.
RESULTS
Of the 39 websites meeting the inclusion criteria, the mean readability grade level exceeded 9, with the lowest being 9.4 ± 1.5 (SMOG index). Readability did not correlate with Google search ranking (lowest p=0.25). Mean understandability and actionability were 59% ± 15 and 26% ± 24, respectively. Only 28% of the articles used visual aids, and few provided concise summaries or clear, actionable steps. Notably, lower grade reading levels were linked to higher actionability scores (p ≤ 0.02 in several indices), but no readability metrics significantly correlated with understandability. Google search rankings showed no significant association with either understandability or actionability scores.
CONCLUSION
Online educational materials for CTR score poorly in readability, understandability, and actionability. Quality metrics do not appear to affect Google search rankings. The poor quality metric scores found in our study highlight a need for hand specialists to improve online patient resources, especially in an era emphasizing shared decision-making in healthcare. .
Topics: Humans; Comprehension; Patient Education as Topic; Carpal Tunnel Syndrome; Internet; Health Literacy; Reading
PubMed: 38919356
DOI: No ID Found -
The Iowa Orthopaedic Journal 2024The aim of this case report is to present a case of chronic cervical ligament tear and instability, which occurred by an unusual work injury with an...
BACKGROUND
The aim of this case report is to present a case of chronic cervical ligament tear and instability, which occurred by an unusual work injury with an eversion/hyper-pronation mechanism in contrast to the usual mechanism of inversion. The ligament was reconstructed using an allograft with satisfactory results up to 30 months after surgery. A new magnetic resonance imaging protocol (MRI) was developed to better evaluate the cervical ligament/graft.
CONCLUSION
In diagnosis of foot sprains, a specific ligament injury should always be sought. In this case, physical examination producing tenderness at the location of the cervical ligament and correlating this with an oblique intercolumn stress test that reproduced pain with apprehension and gross instability supported the diagnosis. Retrospectively applying anatomic knowledge to the earlier MRI findings of bone marrow edema at the insertion points of the cervical ligament on the talus and calcaneus was important in confirming the diagnosis. To better evaluate the cervical ligament allograft tendon reconstruction, a novel volumetric MRI sequence was developed which may prove helpful to also diagnose cervical ligament injuries in future cases. Anatomic reconstruction of the cervical ligament provided satisfactory clinical and radiographic results at 30-month follow-up. V.
Topics: Humans; Magnetic Resonance Imaging; Ligaments, Articular; Rupture; Plastic Surgery Procedures; Male; Adult; Female; Treatment Outcome; Joint Instability; Cervical Vertebrae
PubMed: 38919347
DOI: No ID Found -
The Journal of Sports Medicine and... Jul 2024Interventions on ankle motor control are important to prevent recurrent ankle sprains. Training using whole-body vibration may easily and effectively improve ankle motor... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Interventions on ankle motor control are important to prevent recurrent ankle sprains. Training using whole-body vibration may easily and effectively improve ankle motor control, but the effects have not been investigated. Therefore, this study aimed to clarify the effects of 6 weeks of training with whole-body vibration on ankle motor control in a dynamic movement task among healthy participants.
METHODS
Twenty healthy university students (6 males and 14 females) were randomly allocated to whole-body vibration training and control groups, with 10 participants in each group. The training was performed twice a week for 6 weeks in both groups. Primary outcome was mean ankle angular jerk cost in the star excursion balance test. Secondary outcomes were maximum ankle motion angle and maximum reach distance in the star excursion balance test, ankle proprioception, and range of ankle dorsiflexion motion in the loaded position.
RESULTS
There was a significant group × period (pre- and postintervention) interaction for mean ankle angular jerk cost in the direction of ankle abduction/adduction during posterolateral reaching, which was significantly lower at postintervention than that at preintervention in the whole-body vibration group In the whole-body vibration group, the maximum ankle dorsiflexion motion angle during anterior and posterolateral reaching was significantly higher at postintervention than that at preintervention.
CONCLUSIONS
Training with whole-body vibration improves ankle motor control in dynamic movement tasks, although the direction of reach and plane of motion are limited. Additionally, training with whole-body vibration is also effective in increasing the ankle dorsiflexion angle during dynamic movement tasks.
Topics: Humans; Vibration; Female; Male; Young Adult; Proprioception; Range of Motion, Articular; Ankle Injuries; Postural Balance; Ankle Joint; Adult; Ankle
PubMed: 38916091
DOI: 10.23736/S0022-4707.24.15788-X -
Orthopaedic Journal of Sports Medicine Jun 2024While prevention protocols have been implemented, skiing-related musculoskeletal injuries and concussions continue to present to emergency departments in the United...
BACKGROUND
While prevention protocols have been implemented, skiing-related musculoskeletal injuries and concussions continue to present to emergency departments in the United States. Previous literature has suggested the pediatric population may constitute up to 40% of skiing-related injuries.
PURPOSE
To assess injury trends and the underlying mechanisms of skiing injuries in pediatric patients seen at emergency departments in the United States.
STUDY DESIGN
Descriptive epidemiology study.
METHODS
The National Electronic Injury Surveillance System (NEISS) was queried for pediatric (age ≤18 years) skiing injuries between January 1, 2012, and December 31, 2022. Injury mechanism, location, disposition, and diagnosis were recorded, and the statistical sample weight assigned by NEISS by hospital was used to calculate national estimates (NEs). Injury trends were evaluated with linear regression analysis.
RESULTS
Overall, 2951 pediatric skiing injuries were included (NE = 123,386). The mean age of the patients was 12.4 ± 3.5 years, with 61.3% of the injuries occurring in male patients. Impact with the ground was the most common injury mechanism (NE = 87,407; 70.8%). Fractures were the most common diagnosis (NE = 38,527, 31.2%), followed by strains/sprains (NE = 22,562, 18.3%), contusions/abrasions (NE = 16,257, 13.2%), and concussions (NE = 12,449, 10.1%). The lower leg was the most common fracture site (NE = 9509, 24.7%), followed by the shoulder (NE = 7131, 18.5%) and lower arm (NE = 5876, 15.3%). Analysis of annual injuries revealed no significant trend between 2012 and 2022 ( = .17), with fluctuations apparent throughout the study period. Significant decreases were seen in strains/sprains ( < .01) and contusions/abrasions ( < .01), but not in concussions ( = .57) or fractures ( = .70).
CONCLUSION
Impacts with the snow/ground made up 70.8% of all injuries. Fractures were the most common injury diagnosis, followed by strains/sprains, with the lower leg being most frequently fractured. While strains/sprains and contusions/abrasions showed a significant decline, there were no significant trends in fractures and concussions between 2012 and 2022.
PubMed: 38911123
DOI: 10.1177/23259671241255704 -
Cureus May 2024Several large longitudinal studies on myotonic dystrophy type 1 (DM1) patients have revealed that proximal muscles show more gradual muscle weakness than distal muscles...
Several large longitudinal studies on myotonic dystrophy type 1 (DM1) patients have revealed that proximal muscles show more gradual muscle weakness than distal muscles and that the progression of muscle weakness might differ between the sexes. However, these longitudinal studies were based on two follow-up time points. The present report aimed to verify the longitudinal characteristics of muscle strength and various movement abilities in a case of DM1 by examining the results of 44 repeated evaluations for approximately two years. A 40-year-old male patient with DM1 could walk independently without any aid. We recorded the longitudinal changes in his muscle strength and movement ability during outpatient rehabilitation. During follow-up, he had a fall and was diagnosed with a right ankle sprain. To evaluate the effects of the fall, we examined his recorded data. He had a significant decrease in right knee extensor muscle strength after the fall, suggesting muscle weakness due to disuse syndrome. Although his right knee extensor muscle strength and walking speed decreased, the timed up-and-go test score was improved, and walking endurance in the 2-minute walk test was maintained. In the present case, there were some motor tasks in which the movement ability was maintained or improved, likely due to the use of compensation by residual function, even when muscle weakness was present. Regular and repeated evaluations of patients with DM1 lead to reveal longitudinal characteristics of their dysfunction and movement ability.
PubMed: 38910617
DOI: 10.7759/cureus.60818 -
American Family Physician Jun 2024
Topics: Humans; Carpal Tunnel Syndrome
PubMed: 38905558
DOI: No ID Found -
International Orthopaedics Jun 2024Lesions of the peroneal tendons are frequently overseen after ankle sprain. The symptoms consist of stress-dependent pain that extends from the inframalleolar to the...
PURPOSE
Lesions of the peroneal tendons are frequently overseen after ankle sprain. The symptoms consist of stress-dependent pain that extends from the inframalleolar to the proximal part along the course of the peroneal tendons as well as ankle instability and soft-tissue swelling. In case of unsuccessful conservative treatment, surgical therapy is recommended. The aim of the study was to evaluate the clinical and functional outcome after open reconstruction of the peroneus brevis tendon.
METHODS
13 patients were included in this retrospective study. All of them received a single reconstruction of the peroneus brevis tendon in open technique. Postoperative results were evaluated with the AOFAS score, a functional and perdobargraphic analysis as well as measuring postural stability with the Biodex balance system. The participants were matched with a healthy control group according to age, sex and BMI.
RESULTS
The results of the AOFAS score showed significantly convincing results in all subscores postoperatively. A bilateral comparison of the postural stability showed that the affected side had become functionally similar to the healthy side. No statistical significant difference was detected concerning both one-legged and two-legged standing with the control group. Pedobarographic results revealed no difference between the affected and contralateral side, as well as between the patients and the healthy control group.
CONCLUSION
Open reconstruction of the peroneus brevis tendon leads to significant better postoperative results and can be recommended after unsuccessful conservative treatment as promising option.
PubMed: 38904764
DOI: 10.1007/s00264-024-06239-9