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181. AHA/ASA Guidelines for Adult Stroke Rehabilitation and Recovery

include regular turning (at least every 2 hours), good hygiene, and the use of special mattresses and proper wheelchair seating to prevent skin injury. After stroke with hemiparesis, 60% of patients will develop joint contracture on the affected side within the first year, with wrist contractures occurring most commonly in patients who do not recover functional hand use. , The occurrence of elbow contractures within the first year after stroke is associated with the presence of spasticity within (...) external rotation for 30 minutes each day either in bed or in a chair can be useful for preventing shoulder contracture. , Applying serial casting or static adjustable splints may be beneficial in preventing elbow or wrist contractures, although data are conflicting. , , , Surgical release of the brachialis, brachioradialis, and biceps muscles is a reasonable option to treat pain and range-of-motion limitations in patients with substantial established elbow flexor contractures. Ankle plantarflexion

2016 American Heart Association

182. CRACKCast E051 – Wrist and Forearm Injuries

– and a point for wrist arthrocentesis. Also where the lunate shows up with volar flexion Ulnar to this is the DRUJ and the triquetrum Volar structures: Scaphoid tubercle is distal to the radial styloid Pisiform is distal to the ulnar styloid (by the hypothenars) Distal and radial to the pisiform is the hook of the hamate Nerve and vascular exam 1) Describe normal radiographic relationships: Should get these views: PA, lateral, oblique Anatomy to identify: the ulnar styloid, the extensor carpi ulnaris (...) /instability/# Take home: memory aids: 22 volar tilt – 22 radial inclination – 11 radial length – 1-2 mm carpal bone spacing. Just remembers 1”s and 2”s in some combination. 2) Describe X-Ray findings and management of: Scaphoid fracture Most commonly #’d carpal bone (15-40 yr. Olds with a FOOSH), high complication rate (5-40%) of AVN/non-union Anatomy: 1) tuberosity and distal pole 2) waist 3) proximal pole Physical exam: Dorsal wrist pain – distal to radius Limited ROM of wrist and thumb Snuffbox

2016 CandiEM

183. CRACKCast E053 – Shoulder

means that it accounts for more than 50% of ED dislocations The first method of reduction described was the hippocratic (leg in axilla) technique, but even the egyptians had accurate drawings of shoulder reductions The type of injury is dependant on the strength of bones v. ligaments; children tend to fracture whereas adults tend to sprain or dislocate Anatomy : 3 bones: humerus, scapula Clavicle S shaped strut that pushes arm away from axial skeleton Rosens notes: ‘provides the neck with acceptable (...) on forearm Traction-counter traction Folded sheet in axilla providing counter traction Snowbird – first described in Skiers in Utah Seated patient with elbow at 90. Physician places foot in stockinette tied around elbow for traction External rotation method of leidelmeyer Supine, elbow at 90, slow gentle external rotation Milch Supine, HOB 20-30, slow abduction with ext. rotation. If 90 abduct and 90 ext. rotation, then gentle traction Scapular manipulation Repositioning of glenoid fossa. First obtain

2016 CandiEM

184. TREKK Series | Pediatric Multisystem Trauma

is the insertion site. Distal tibia: Identify the medial malleolus, the flat part of distal tibia 1-2 cm superior to medial malleolus is the insertion site. Proximal humerus: Position the patient so their hand is resting on their abdomen and their elbow is adducted, palpate up the humerus to greater tubercle approx. 1 cm superior to surgical neck of the humerus. Distal femur: Identify patella by palpation, the insertion site is just proximal to patella (max 1 cm) and approximately 1-2 cm medial to the midline (...) important take home message when it comes to managing pediatric trauma – the principles, approach and goals of resuscitation are the same in children as they are in adults, but there are pediatric nuances that clinicians need to be aware of! Wide differences in pediatric anatomy, physiology and developmental maturation account for specific injury patterns in children that are not seen in adults, and for high energy mechanisms, polytrauma is the rule. Traumatic brain injury is the leading cause of injury

2016 CandiEM

185. Distal pronator teres motor branch transfer for wrist extension restoration in radial nerve paralysis. Full Text available with Trip Pro

Distal pronator teres motor branch transfer for wrist extension restoration in radial nerve paralysis. The authors describe the anatomy of the motor branches of the pronator teres (PT) as it relates to transferring the nerve of the extensor carpi radialis brevis (ECRB) to restore wrist extension in patients with radial nerve paralysis. They describe their anatomical cadaveric findings and report the results of their nerve transfer technique in several patients followed for at least 24 months (...) postoperatively.The authors dissected both upper limbs of 16 fresh cadavers. In 6 patients undergoing nerve surgery on the elbow, they dissected the branches of the median nerve and confirmed their identity by electrical stimulation. Of these 6 patients, 5 had had a radial nerve injury lasting 7-12 months, underwent transfer of the distal PT motor branch to the ECRB, and were followed for at least 24 months.The PT was innervated by two branches: a proximal branch, arising at a distance between 0 and 40 mm distal

2020 Journal of Neurosurgery

186. Isolated tears of the sternocostal head of the pectoralis major muscle: surgical technique, clinical outcomes, and a modification of the Tietjen and Bak classification. (Abstract)

. The isokinetic strength deficit averaged 8% compared with the contralateral arm, whereas the average preinjury bench-press weight of 134 kg (range 88-227 kg) was restored to 117 kg (range 61-250 kg) postoperatively.We propose a new classification of pectoralis major injury. In addition, we present a biomechanically sound repair technique for isolated tears of the sternocostal head of the pectoralis with favorable outcomes. The technique takes the specific anatomy of the sternocostal and clavicular heads (...) into account for the approach.Copyright © 2019 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

2020 Journal of Shoulder and Elbow Surgery

187. Cortical suture button fixation vs. bicortical screw fixation in the Latarjet procedure: a biomechanical comparison. (Abstract)

to the surrounding anatomy was more extensive in screw fixation than button fixation. In the event of unanticipated loading, this could place a patient at higher risk of graft migration, which could lead to unintended early outcomes. These results support the need for implants and techniques specifically tailored to the Latarjet procedure and should bring into question the adoption of a cortical button and technique not specific to the procedure.Copyright © 2019 Journal of Shoulder and Elbow Surgery Board (...) displacement was significantly less for screw fixation vs. cortical suture button fixation (3.1 ± 1.3 mm vs. 8.9 ± 2.1 mm, P < .0001). The total load at failure was 481.1 ± 88.8 N for screws and 175.5 ± 95.8 N for cortical suture buttons (P < .0001). Bony damage to the surrounding anatomy was more extensive at failure in the screw-fixation group.At time zero, the cortical button fixation and technique did not resist direct loads to the graft as much as traditional screw fixation, although bony damage

2020 Journal of Shoulder and Elbow Surgery

188. Pectoralis major tendon and enthesis: anatomic, magnetic resonance imaging, ultrasonographic, and histologic investigation. (Abstract)

Pectoralis major tendon and enthesis: anatomic, magnetic resonance imaging, ultrasonographic, and histologic investigation. This study evaluates the pectoralis major (PM) tendon humeral insertion, using imaging and histologic assessment in cadaveric specimens. Current descriptions of the pectoralis major tendon depict a bilaminar enthesis, and clarification of the anatomy is important for diagnostic and surgical considerations.Fourteen fresh-frozen whole upper extremity specimens were used (...) originate from a location other than the enthesis.Copyright © 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

2020 Journal of Shoulder and Elbow Surgery

189. Structural glenoid allograft reconstruction during reverse total shoulder arthroplasty. (Abstract)

preoperatively vs. 10 ± 8 postoperatively, P = .002), the average American Shoulder and Elbow Surgeons score (31 ± 19 preoperatively vs. 70 ± 25 postoperatively, P < .001), and average active forward elevation (71° ± 41° preoperatively vs. 128° ± 28° postoperatively, P < .001) were noted. Coronal-plane radiographic correction was 29° ± 12° as measured with the reverse shoulder arthroplasty angle (P < .001) and 14° ± 11° as measured with the β angle (P < .001). Postoperatively, of 17 patients with a minimum 1 (...) -year radiographic follow-up, 14 (82%) had complete radiographic incorporation of the graft. Acromial fracture nonunions developed in 2 patients and loosening and migration of the baseplate were found in 2 patients, although no patients elected to undergo further surgery.RTSA with allograft reconstruction of severe glenoid defects allows restoration of glenoid anatomy and leads to high rates of bony incorporation with low rates of glenoid loosening or requirement for revision. Structural allograft

2020 Journal of Shoulder and Elbow Surgery

190. Three-dimensional geometry of the normal shoulder: a software analysis. (Abstract)

Three-dimensional geometry of the normal shoulder: a software analysis. Three-dimensional (3D) geometry of the normal glenohumeral bone anatomy and relations is poorly documented. Our aims were (1) to determine the 3D geometry of the normal glenohumeral joint (GHJ) with reference to the scapular body plane and (2) to identify spatial correlations between the orientation and direction of the humeral head and the glenoid.Computed tomographies (CTs) of the normal, noninjured GHJ were collected (...) in daily practice: version and inclination are -6° and 7°, respectively, and humeral posterior subluxation is 59%; interindividual variations, regardless of the size, are relative to the scapular plane. There exists a strong correlation between the position of the humeral head and the glenoid orientation and direction.Copyright © 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

2020 Journal of Shoulder and Elbow Surgery

191. Using Machine Learning to Predict Clinical Outcomes After Shoulder Arthroplasty with a Minimal Feature Set. (Abstract)

and Elbow Surgeons (ASES) (full model = ±11.7 vs. abbreviated model = ±12.0), Constant (±8.9 vs. ±9.8), Global Shoulder Function (±1.4 vs. ±1.5), Visual Analog Scale (VAS) pain (±1.3 vs. ±1.4), active abduction (±20.4º vs. ±21.8º), forward elevation (±17.6º vs. ±19.2º), and external rotation (±12.2º vs. ±12.6º). Marginal improvements in MAE were observed for each outcome measure prediction when the abbreviated model was supplemented with implant size/type data and measurements of native glenoid anatomy

2020 Journal of Shoulder and Elbow Surgery

192. Radiographic humeral head restoration after total shoulder arthroplasty: does the stem make a difference? Full Text available with Trip Pro

between 2007 and 2017 with complete operative reports and adequate radiographs. Surgical data including stem design were collected. Preoperative and postoperative radiographic measurements of the center of rotation (COR), humeral head height (HH), and neck-shaft angle were performed. Restoration of the native humeral anatomy was deemed "acceptable" based on postoperative differences in the COR ≤ 3 mm, HH ≤ 5 mm, and neck-shaft angle > 130°. Deviations between preoperative and postoperative (...) %) compared with short-stem (7.0%) and standard-stem (3.7%) designs (P < .001).Restoration of humeral anatomic parameters occurred significantly less with stemless implants than with short- and standard-stem implants. The stem of a shoulder arthroplasty implant aids surgeons in accurately restoring patient-specific anatomy.Copyright © 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

2020 Journal of Shoulder and Elbow Surgery

193. Anatomic factors influencing the anterior stability of reverse total shoulder arthroplasty. (Abstract)

Anatomic factors influencing the anterior stability of reverse total shoulder arthroplasty. Several factors affect the stability of the reverse shoulder arthroplasty. The influence of bony anatomy on anterior stability remains unclear. This study aimed to identify the correlations between bony anatomy and anterior dislocation forces.The differences in anterior dislocation force in reverse total shoulder arthroplasty reported in a previous biomechanical study were used to analyze the anatomic (...) rotation (r = -0.542, P = .025; r = -0.497, P = .042).The distance between the coracoid tip and glenoid in 2 planes had a significant negative correlation with the anterior stability of the reverse shoulder arthroplasty with a lateralized glenosphere and 155° humeral inclination. The findings suggest that only glenoid lateralization is influenced by the bony anatomy.Copyright © 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

2020 Journal of Shoulder and Elbow Surgery

194. Clinical and radiographic outcomes of a transosseous suture technique for displaced lateral clavicle fractures. (Abstract)

for the surgical treatment of unstable fractures. The paucity of lateral clavicular bone and the unique anatomy of this area of the shoulder makes surgical treatment of these injuries challenging. This article reports a single-surgeon experience with a transosseous suture fixation technique for the treatment of unstable lateral clavicle fractures.A retrospective review of all patients with unstable lateral clavicle fractures treated with a transosseous suture technique from 2015-2018 was performed (...) . The indication for surgery was significant displacement between the main medial and lateral clavicle fragments. The surgical technique used was a modification of the technique as described by Levy. Patients were followed postoperatively with active and passive range of motion (ROM) measurements, strength testing, and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form score, visual analog scale score, and standard radiographs. Patients were followed to radiographic union.Twelve

2020 Journal of Shoulder and Elbow Surgery

195. Optimal activation ratio of the scapular muscles in closed kinetic chain shoulder exercises: A systematic review Full Text available with Trip Pro

(shoulder at 90 a horizontal abduction and 90 ∘ elbow flexion) Puhringer (2017) [ ] 0.15 – 0.08 – 0.27 – 5.5 Unstable Supine Pull Up. The participant performed a pull up grasping an elastic sling (suspended) or supporting heels on a bosu. De Mey (2014) [ ] (suspended) – 0.77 – 0.80 – 1.76 Youdas (2018) [ ] (bosu) – 0.97 – 1.90 – 4.70 6.1 Modified Plank. The participant performs a plank with elbows slightly flexed, and with their lower extremities supported on the knees. Ashnagar (2016) [ ] – – – – 0.28 (...) , Isometric Pull Up, Modified Plank, Unstable Plank, and One Hand Plank (Table ). 3.3.1 Push Up The starting position is prone, shoulder at 90 ∘ flexion, elbow and legs fully extended, with the weight distributed over the hands and feet. The elbows are flexed until the thorax almost touches the floor [ , , , , , ]. Three studies presented an optimal UT/SA ratio (0.07–0.48) [ , , ]. In contrast, three studies presented a non-optimal UT/SA ratio (0.74–0.80) [ , , ]. Four studies presented a non-optimal UT

2020 Journal of back and musculoskeletal rehabilitation

196. Effects of teriparatide and bisphosphonate on spinal fusion procedure: A systematic review and network meta-analysis Full Text available with Trip Pro

, fusion levels, fusion methods, fusion devices, graft selection, surgical indications and surgical methods all show heterogeneity which would influence fusion rate. Cervical spine surgery is not included in the analysis due to fundamental difference in anatomy, surgical approach, endplate area and implant design in cervical spine, which should be discussed separately. Regarding diagnostic tools, there are different imaging modalities and grading systems for evaluating pseudoarthrosis [ , ]. Currently (...) . Alendronate increases bone strength by increasing the mean degree of mineralization of bone tissue in osteoporotic women. Bone. 2000;27(5):687–94. Epub 2000/11/04. pmid:11062357. 33. Oteo-Alvaro A, Moreno E. Atrophic humeral shaft nonunion treated with teriparatide (rh PTH 1–34): a case report. J Shoulder Elbow Surg. 2010;19(7):e22–8. Epub 2010/09/18. pmid:20846618. 34. Tamai K, Takamatsu K, Kazuki K. Successful treatment of nonunion with teriparatide after failed ankle arthrodesis for Charcot arthropathy

2020 PloS one

197. Systematic review of combined functional near-infrared spectroscopy and transcranial direct-current stimulation studies Full Text available with Trip Pro

a significant influence on research findings with contributing factors including electrical field distribution, stimulation intensity, type of stimulation, and participant factors, such as age, anatomy, and presence of brain injury. These aspects are adding to the growing understanding of underlying neural mechanisms underpinning tDCS-led improvements. Current knowledge of tDCS-induced neural changes stems from animal studies in which surface-positive current was observed to enhance neuronal firing (...) Wrist flexion—50% of MIVC ✓ Active/reverse polarity (two session crossover) 2 mA, 0.08 mA / cm 2 , 15 min Bilateral M1 84 channels, 32 emitters, 16 detectors Bilateral SMC ↑ interhemispheric connectivity and ↑ activation under anodal electrode during and post-tDCS Muthalib et al., 2013 15 Elbow flexion—30% of MIVC — Active/sham(two session crossover) 2 mA, 0.083 mA / cm 2 , 2 × 10 min R-M1+ R shoulder 3 emitters, 2 detectors R PFC ↑ HbO 2 and ↓ HHb postactive and sham tDCS—no difference between

2020 Neurophotonics

198. The 100 Top-Cited Systematic Reviews/Meta-Analyses on Diabetic Research Full Text available with Trip Pro

at: | GBD 2015 Eastern Mediterranean Region Diabetes and Chronic Kidney Disease Collaborators, “Diabetes mellitus and chronic kidney disease in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study,” International Journal of Public Health , vol. 63, Supplement 1, pp. 177–186, 2018. View at: | W. Shuaib and J. L. Costa, “Anatomy of success: 100 most cited articles in diabetes research,” Therapeutic Advances in Endocrinology and Metabolism , vol. 6, no. 4, pp. 163–173 (...) -decade bibliographic perspective,” Asian Journal of Anesthesiology , vol. 55, no. 1, pp. 3–8, 2017. View at: | L. M. Chen, Y. Q. Liu, J. N. Shen et al., “The 100 top-cited tuberculosis research studies,” The International Journal of Tuberculosis and Lung Disease , vol. 19, no. 6, pp. 717–722, 2015. View at: | Y. Q. Huo, X. H. Pan, Q. B. Li et al., “Fifty top-cited classic papers in orthopedic elbow surgery: a bibliometric analysis,” International Journal of Surgery , vol. 18, pp. 28–33, 2015. View

2020 Journal of diabetes research

199. A systematic review on diagnostic test accuracy of magnetic resonance neurography versus clinical neurosensory assessment for post-traumatic trigeminal neuropathy in patients reporting neurosensory disturbance Full Text available with Trip Pro

. AJNR Am J Neuroradiol 2018 ; 39 : 162 – 9 . doi: , , , 24. Wang X , Harrison C , Mariappan YK , Gopalakrishnan K , Chhabra A , Lenkinski RE , et al. Mr neurography of brachial plexus at 3.0 T with robust fat and blood suppression . Radiology 2017 ; 283 : 538 – 46 . doi: , , , 25. Bäumer P , Dombert T , Staub F , Kaestel T , Bartsch AJ , Heiland S , et al. Ulnar neuropathy at the elbow: MR neurography--nerve T2 signal increase and caliber . Radiology 2011 (...) , et al. Three-Dimensional isotropic Fat-Suppressed proton Density-Weighted MRI at 3 tesla using a T/R-Coil can replace multiple plane two-dimensional sequences in knee imaging . Fortschr Röntgenstr 2016 ; 188 : 949 – 56 . doi: , 39. von Arx T , Lozanoff S . Clinical oral anatomy . Switzerland: Springer International Publishing 2017 ;561 p. 40. Dietrich O , Raya JG , Reeder SB , Reiser MF , Schoenberg SO . Measurement of signal-to-noise ratios in Mr images: influence of multichannel coils, parallel

2020 Dentomaxillofacial Radiology

200. Risk Factors for Canine Osteoarthritis and Its Predisposing Arthropathies: A Systematic Review Full Text available with Trip Pro

occurring in the hip or elbow, describes failure of normal joint formation during development and can lead to well-recognized and described joint conditions which cause pain and lameness in their own right, and can progress to osteoarthritis ( ). Consequently, it is important to understand the risk factors for these complex diseases when considering the epidemiology of canine osteoarthritis. A critical evaluation of the existing published evidence on risk factors for osteoarthritis and its predisposing (...) diseases were discussed, the primary disease of interest) for 20 (32%) papers was hip or elbow dysplasia, 17 (27%) focused on cruciate ligament disease, 16 (26%) on osteoarthritis, 6 (10%) on patellar luxation, and 3 (5%) on osteochondritis dissecans. Study Characteristics and Reporting Quality Evaluation Regarding study design, 31 (50%) studies were retrospective cross-sectional, 16 (26%) were retrospective case-control, 11 (18%) were prospective cohort studies, three (5%) were prospective cross

2020 Frontiers in veterinary science

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