| 1. |
- Ekblom, Anna Gerber, et al.
(författare)
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Hand Function in Adults with Radial Longitudinal Deficiency.
- 2014
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Ingår i: Journal of Bone and Joint Surgery. American Volume. - 1535-1386 .- 0021-9355. ; 96:14, s. 1178-1184
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Tidskriftsartikel (refereegranskat)abstract
- Functional impairment in individuals with radial longitudinal deficiency can be influenced by several factors, including a short and bowed forearm, radial deviation of the wrist, a non-functional or absent thumb, limited finger motion, and impaired grip strength, but their relationship with activity and participation in adults with radial deficiency is not known.METHODS: Twenty individuals, eighteen to sixty years of age, who had Bayne type-II to V radial longitudinal deficiency, were examined in the context of the International Classification of Functioning, Disability and Health. Body function and structure were evaluated by measures of range of motion, grip strength, key pinch, sensibility, and radiographic parameters. Activity was evaluated by the Box and Block Test and the Sollerman test, and participation was evaluated by QuickDASH (the short form of the Disabilities of Arm, Shoulder and Hand outcome measure) and by the Medical Outcomes Study 12-Item Short Form Health Survey. Statistical correlations among assessments of body function and structure, activity, and participation were examined.RESULTS: The mean total active motion of the wrist (43°) and mean total active motion of the digits (377°) were less than the norms. The mean radial deviation of the wrist was 31°. The mean grip strength (4.0 kg), key pinch (1.4 kg), and scores for the Box and Block Test (55 blocks per minute) and the Sollerman test on hand function (56 points) were considerably lower than the norms. The mean scores were 18 points for QuickDASH, 51 points for Short Form-12 physical component summary, and 53 points for Short Form-12 mental component summary. Significant relationships were found between the Box and Block Test and grip strength (p = 0.012), key pinch (p < 0.001), and total active motion of digits (p < 0.001); between the Sollerman test and the total active motion of elbow (p < 0.001) and the total active motion of digits (p < 0.001); between the QuickDASH and forearm length (p < 0.001), the total active motion of elbow (p = 0.001), and the total active motion of digits (p < 0.001); between the Short Form-12 physical component summary and grip strength (p = 0.016), forearm length (p < 0.001), total active elbow motion (p < 0.001), and total active digit motion (p < 0.001); and between the Short-Form-12 mental component summary and radial deviation of the wrist (p = 0.019). No significant correlations were found between the radiographic measurement of the radial deviation of the wrist (total forearm angle) and the Box and Block Test (p = 0.244), the Sollerman test (p = 0.775), QuickDASH (p = 0.156), Short Form-12 physical component summary (p = 0.107), or Short Form-12 mental component summary (p = 0.129).CONCLUSIONS: In individuals with radial longitudinal deficiency, grip strength, key pinch, forearm length, and elbow and digital motion seem to be more important for the individual's activity and participation than the radial angulation of the wrist.LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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| 2. |
- Ekblom, Anna Gerber, et al.
(författare)
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Hand function in children with radial longitudinal deficiency
- 2013
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: In children with hypoplasia or aplasia of the radius (radial longitudinal deficiency) manual activity limitations may be caused by several factors; a short and bowed forearm, radial deviation of the wrist, a non-functional or absent thumb, limited range of motion in the fingers and impaired grip strength. The present study investigates the relation between these variables and activity and participation in children with radial dysplasia. Methods: Twenty children, age 4-17 years, with radial longitudinal dysplasia Bayne type II-IV were examined with focus on the International Classification of Functioning and Health, version for Children and Youth (ICF-CY) context. Body function/structure was evaluated by measures of range of motion, grip strength, sensibility and radiographic parameters. Activity was examined by Box and Block Test and Assisting Hand Assessment (AHA). Participation was assessed by Children's Hand-use Experience Questionnaire (CHEQ). Statistical correlations between assessments of body function/structure and activity as well as participation were examined. Results: The mean total active motion of wrist (49.6 degrees) and digits (447 degrees) were less than norms. The mean hand forearm angle was 34 degrees radially. Ulnar length ranged from 40 to 80% of age-related norms. Grip strength (mean 2.7 kg) and Box and Block Test (mean 33.8 blocks/minute) were considerably lower than for age-related norms. The mean score for the AHA was 55.9 and for CHEQ Grasp efficiency 69.3. The AHA had significant relationship with the total range of motion of digits (p = 0.042). Self-experienced time of performance (CHEQ Time) had significant relationship with total active motion of wrist (p = 0.043). Hand forearm angle did not show any significant relationship with Box and Block Test, AHA or CHEQ. Conclusion: In radial longitudinal deficiency total range of motion of digits and wrist may be of more cardinal importance to the child's activity and participation than the angulation of the wrist.
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| 3. |
- Eriksson, Martin, et al.
(författare)
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Economic consequences of accidents to hands and forearms by log splitters and circular saws: Cost of illness study
- 2011
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - 1651-2073. ; 45:1, s. 28-34
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Tidskriftsartikel (refereegranskat)abstract
- We estimated costs associated with injuries to hands from log splitters and circular saws used to cut up firewood and assessed the value of prevention. The study was carried out as a cost of illness study with an incidence approach based on 57 consecutive patients (median age 51; range 8--81) with injuries to the hand or forearm. Twenty-six of the 57 had an amputation which required microsurgery and 31/57 had various injuries. Median Hand Injury Severity Score (HISS) reflecting the severity of all injuries was 67 (range 6--332). Median DASH score after 2--7 years was 12.5 (0--73.3). Total cost (direct costs, costs of lost productivity, and lost quality of life) was estimated to roughly EUR 14 million (EUR 2.8 million/year), where the cost of lost quality of life is 82% of the total cost and loss of productivity and direct costs are 9% each. Injuries sustained from log splitters and circular saws account for considerable costs, but first and foremost human suffering.
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| 4. |
- Hazer, Derya Burcu, et al.
(författare)
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Technical Aspects on the Use of Ultrasonic Bone Shaver in Spine Surgery : Experience in 307 Patients
- 2016
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Ingår i: BioMed Research International. - : Hindawi Limited. - 2314-6133 .- 2314-6141. ; 2016
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Tidskriftsartikel (refereegranskat)abstract
- Aim. We discuss technical points, the safety, and efficacy of ultrasonic bone shaver in various spinal surgeries within our own series. Methods. Between June 2010 and January 2014, 307 patients with various spinal diseases were operated on with the use of an ultrasonic bone curette with microhook shaver (UBShaver). Patients' data were recorded and analyzed retrospectively. The technique for the use of the device is described for each spine surgery procedure. Results. Among the 307 patients, 33 (10.7%) cases had cervical disorder, 17 (5.5%) thoracic disorder, 3 (0.9%) foramen magnum disorder, and 254 (82.7%) lumbar disorders. Various surgical techniques were performed either assisted or alone by UBShaver. The duration of the operations and the need for blood replacement were relatively low. The one-year follow-up with Neck Disability Index (NDI) and Oswestry Disability Index (ODI) scores were improved. We had 5 cases of dural tears (1.6%) in patients with lumbar spinal disease. No neurological deficit was found in any patients. Conclusion. We recommend this device as an assistant tool in various spine surgeries and as a primary tool in foraminotomies. It is a safe device in spine surgery with very low complication rate.
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| 5. |
- Laurell, Tobias, et al.
(författare)
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Identification of three novel FGF16 mutations in X-linked recessive fusion of the fourth and fifth metacarpals and possible correlation with heart disease.
- 2014
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Ingår i: Molecular Genetics & Genomic Medicine. - : Wiley. - 2324-9269. ; 2:5, s. 402-411
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Tidskriftsartikel (refereegranskat)abstract
- Nonsense mutations in FGF16 have recently been linked to X-linked recessive hand malformations with fusion between the fourth and the fifth metacarpals and hypoplasia of the fifth digit (MF4; MIM#309630). The purpose of this study was to perform careful clinical phenotyping and to define molecular mechanisms behind X-linked recessive MF4 in three unrelated families. We performed whole-exome sequencing, and identified three novel mutations in FGF16. The functional impact of FGF16 loss was further studied using morpholino-based suppression of fgf16 in zebrafish. In addition, clinical investigations revealed reduced penetrance and variable expressivity of the MF4 phenotype. Cardiac disorders, including myocardial infarction and atrial fibrillation followed the X-linked FGF16 mutated trait in one large family. Our findings establish that a mutation in exon 1, 2 or 3 of FGF16 results in X-linked recessive MF4 and expand the phenotypic spectrum of FGF16 mutations to include a possible correlation with heart disease.
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| 6. |
- Ljungberg, Elinor, et al.
(författare)
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Hand injuries in young children.
- 2003
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Ingår i: Journal of Hand Surgery (British Volume). - 0266-7681. ; 28:4, s. 376-380
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Tidskriftsartikel (refereegranskat)
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| 7. |
- Nilsson, Jessica A, et al.
(författare)
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Treatment of proximal interphalangeal joint fractures by the pins and rubbers traction system: a follow-up.
- 2014
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X. ; 48:4, s. 259-264
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Tidskriftsartikel (refereegranskat)abstract
- Abstract A fracture of the proximal interphalangeal (PIP) joint at the base of the middle phalanx is rare, but is a challenge to treat. Posttraumatic osteoarthritis is a known complication causing impaired hand function and disability. The aim of the present retrospective study was to evaluate characteristics and outcome of complex PIP joint fractures treated by the pins and rubbers traction system (PRTS). Medical records of 42 patients with fractures treated with a PRTS in 1999-2010 were reviewed, and followed-up by questionnaires (QuickDASH, CISS, self-composed questionnaire). Eighteen of the 42 were clinically examined. The fractures were divided into three types of fractures: volar lip, dorsal lip, and pilon fractures. The volar lip fracture was most frequent (26/42; dorsal lip 3/42; pilon 13/42). Most fractures were sport-related (19/42; 45%) and males predominated (M:F ratio = 1.8). All fractures united. Infection occurred in 17/41 (41%) cases. Radiological signs of posttraumatic osteoarthritis were found in 25/41 (61%) patients. In 18/42 patients, where a clinical evaluation was performed, 66% of contralateral total active range of motion (TAM), 93% grip strength, and 100% pinch strength were achieved. The volar lip fracture had the best outcome according to the self-reported QuickDASH and CISS score and regained 77% of contralateral TAM. Fractures of the PIP joint in the middle phalanx can be treated with the PRTS, but reduced mobility, grip strength, infection, and osteoarthritis are seen. The device is well tolerated by the patients, easy to apply, and with ready accessible materials for the surgeon.
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| 8. |
- Rosberg, HansE, et al.
(författare)
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Costs and outcome for serious hand and arm injuries during the first year after trauma - a prospective study
- 2013
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: To study costs and outcome for serious hand and arm injuries during the first year after the trauma. Methods: In patients with a Hand Injury Severity Score (HISS) > 50, DASH and EQ-5D scores as well as factors related to costs within the health care sector, costs due to lost production and total costs were evaluated. Coxregression analysis stratifying for mechanism of injury was used to analyse return to work. Results: The majority of the 45 included patients (median 42 years 16-64) were men with severe (n = 9) or major (n = 36) injuries with different type of injuries (amputations n = 13; complex injuries n = 18; major nerve injuries/full house n = 13; burn injury n = 1). DASH and EQ-5D decreased and increased, respectively, significantly over time during one year. Total costs (+ 34%) and costs of lost production were highest for persons injured at work. Factors associated with higher health care costs were age > 50 years (+ 52%), injury at work (+ 40%) and partial labour market activity (+ 66%). Costs of lost production had a significant role in total costs of injury. Patients with major injuries had longer duration of sick leave. Patients with severe injuries were more likely to return to work [(RR 3.76 (95% CI 1.38-10.22) from Cox regression, controlling for age, gender and presence of nerve injury]. Conclusions: Despite the fact that work environments have constantly improved over the last decades, we found that hand injuries at work were most costly both in terms of health care and costs of lost production, although the severity, i.e. HISS, did not differ from injuries occurring at home or during leisure.
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| 9. |
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| 10. |
- Rosberg, HansE
(författare)
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Hand injuries - epidemiology, costs and outcome
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Hand injuries have a profound impact not only on the patient’s activity of daily living and during leisure time but also on working capability. Such injuries may therefore also generate substantial costs for society in terms of sick-leave and treatment. In the present thesis, the panorama, costs (within the health-care system, due to lost production and total costs), outcome and health status of patients with hand injuries in Malmö, Sweden and in Southern Sweden for especially flexor tendon injuries (zone II) and median and ulnar nerve injuries in the forearm as well as other hand injuries were investigated retro- and prospectively. Descriptive epidemiology, health economic methods, and health questionnaires (DASH & SF-36) were used to describe and analyse these factors. The incidence was around 7 hand injuries/1000 inhabitants/year in Malmö, representing 12% of the workload at an Acute & Emergency Unit. Most injuries occurred during leisure time (2/3), mainly affecting young men, and the majority of the injuries were minor, although causing sick leave but usually low costs (< EUR 2500). Only 22% of the injuries in the age group 18-65 years were work related, but such injuries increased the risk of admission to hospital. A decrease in the number of days for sick leave, an increased risk for children to get hand injuries as well as a slight change in type of injuries were observed between 1989 and 1997 (an 8-year interval). There was a reduced risk of injury during July, November and December and on Tuesdays. The median total cost for a nerve injury in the forearm was EUR 45 800 and for a flexor tendon injury EUR 15 600, mainly due to lost production (87% and 65% of total costs, respectively). Factors, such as complications during rehabilitation and more than four concomitant tendon injuries, influenced the costs for repair and rehabilitation of flexor tendon and median and ulnar nerve injuries, respectively. Mobilization regimes, such as active mobilization and rubber band mobilization, after flexor tendon repair increased the costs, but improved the outcome. The costs and sick leave for hand injuries of different severity, analysed in a prospective study, was associated with the score for severity (HISS) of the injury. The DASH-score was not found to be significant in the analysis of the length of sick leave but DASH-score at one year was associated with variation in age, HISS and health care costs. SF36 was not useful as a method to study health status after a hand injury. The data in the present thesis can be used to optimise the treatment and rehabilitation of hand injuries, reallocate resources as well as to improve prevention of such injuries, which usually affect young persons in a productive age.
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