Hand & Wrist – Pubmed Results

Icon for Georg Thieme Verlag Stuttgart, New York Related Articles

Injury Incidence Rates and Profiles in Elite Taekwondo during Competition and Training.

Int J Sports Med. 2020 Jan;41(1):54-58

Authors: Geßlein M, Rüther J, Bail HJ, Schuster P, Krutsch W, Wolpert AK

Abstract
This study aimed to investigate exposure adjusted injury incidence rates and profiles associated with training and competition in an elite taekwondo athlete population. 82 athletes were investigated for injuries over a period of 5 years. Individual fight time exposure for training and competition was recorded. The type and location of the injuries were classified and exposure-adjusted injury incidence rates (IIR) were calculated per 1000 h for training and competition. 66 athletes with a mean age of 19.3±4.2 years and 172 injuries were included in the final data assessment. The exposure adjusted IIR was significantly higher during competition (p<0.001) with a rate ratio of 6.33 (95% CI 4.58-8.69). Ankle and foot region as well as hand and wrist were most affected with significant higher IIR in competition (p<0.001). Joint injuries, fractures, and bruising occurred the most. Fractures occurred mainly to the hand and wrist region. Future investigations should focus on exposure adjusted injury data including analyses of the detailed mechanism leading to especially severe injuries to improve specific injury prevention in competition and promote evolution of protective gear.

PMID: 31747701 [PubMed - indexed for MEDLINE]

Related Articles

Is there an association of hematopoietic stem cell and endothelial progenitor cell markers with maturation in forearm arterial repair?

Eklem Hastalik Cerrahisi. 2019 Dec;30(3):289-95

Authors: Karaman İ, Günay AE, Doğan S, Kafadar İH, Karaman ZF

Abstract
OBJECTIVES: This study aims to assess the effects of the hematopoietic stem cells and endothelial progenitor cells in peripheral blood and monocyte cluster of differentiation (CD) 34, CD133 and CD309 expression levels on maturation at the repair site in patients who underwent forearm arterial repair.
PATIENTS AND METHODS: This prospective study included 30 patients (23 males, 7 females; mean age 28.9±1.8 years; range, 18 to 49 years) with a well-defined cut at the wrist due to a stabbing injury but no comorbid condition who presented to the emergency department of our hospital between November 2014 and November 2017. Vascular patency was assessed by Doppler sonography in patients who underwent forearm arterial repair via micro-vascular techniques. The relationships between patency and hematopoietic stem and endothelial progenitor cell markers such as CD34, CD133 and CD309 were assessed by flow cytometry.
RESULTS: The patients were divided into two groups according to presence of sufficient flow in the arteries repaired. The mean CD34 expression level was 72.09±3.00 in the group with maturation whereas it was 54.64±7.34 in the group without maturation, indicating a statistically significant difference (p<0.05). In addition, the likelihood of sufficient flow was increased by 1.075 per one unit increase in CD34 level. Resistive index values were significantly lower in the group with maturation and CD34 level was predictive for maturation of arterial repair.
CONCLUSION: In the present study, the findings demonstrated that high CD34 expression level has favorable effects on maturation after arterial repair.

PMID: 31650927 [PubMed - indexed for MEDLINE]

Icon for BioMed Central Icon for PubMed Central Related Articles

Nickel-titanium arched shape-memory alloy connector combined with bone grafting in the treatment of scaphoid nonunion.

Eur J Med Res. 2019 Jul 27;24(1):27

Authors: Zhou PY, Jiang LQ, Xia DM, Wu JH, Ye Y, Xu SG

Abstract
PURPOSE: To summarize the techniques and clinical effectiveness in treating scaphoid nonunion with nickel-titanium (Ni-Ti) arched shape-memory alloy connector in combination with autologous iliac bone grafts.
METHODS: This study retrospectively analyzed 18 scaphoid nonunion cases treated with arched connectors with autologous iliac bone grafts. Based on scaphoid nonunion, 2 cases were classified as type II (fibrous union), 4 cases as type III (mild sclerotic union), 6 cases as type IV (moderate resorption and sclerosis), 5 cases as type V (severe bone resorption and sclerosis), and 1 case as type VI (pseudarthrosis formation). At the first 4, 8 and 12 weeks after the surgery, wrist anteroposterior, lateral X-ray were obtained, respectively, to evaluate bone healing. Patients who had not yet reached the standard of healing at 12 weeks after surgery would continue to receive additional appointments for follow-up visits, such as 14 weeks, 16 weeks, 18 weeks after surgery, until their imaging studies had achieved satisfactory bone healing. Clinical effectiveness was evaluated comprehensively, based on bone union time, Mayo wrist score, and visual analog pain score.
RESULTS: All 18 patients achieved satisfactory reduction and fixation with a mean union time of 4.2 months. Preoperative Mayo wrist score averaged 57.4 and average final postoperative follow-up was 91.4. On the other hand, mean preoperative VAS score was 6.8, and final postoperative follow-up average was 1.6. Mayo wrist score of the overall treatment effectiveness was excellent (90-100) in 12 cases, good (80-90) in 5 cases, and acceptable (60-80) in 1 case with zero poor (below 60) cases observed. Statistical analysis suggested that a statistically significant improvement in fracture healing, wrist function recovery and visual analog pain after surgery when compared to the scores of the patients before surgery.
CONCLUSION: Using Ni-Ti arched shape-memory alloy connector in combination with autologous bone grafting provided a new modality to treat scaphoid nonunions in a less traumatic, convenient to operate and satisfactory manner in treatment outcomes, and thus is worthy of further application.

PMID: 31351486 [PubMed - indexed for MEDLINE]

Icon for IEEE Engineering in Medicine and Biology Society Related Articles

Automatic Age Estimation and Majority Age Classification From Multi-Factorial MRI Data.

IEEE J Biomed Health Inform. 2019 07;23(4):1392-1403

Authors: Stern D, Payer C, Giuliani N, Urschler M

Abstract
Age estimation from radiologic data is an important topic both in clinical medicine as well as in forensic applications, where it is used to assess unknown chronological age or to discriminate minors from adults. In this paper, we propose an automatic multi-factorial age estimation method based on MRI data of hand, clavicle, and teeth to extend the maximal age range from up to 19 years, as commonly used for age assessment based on hand bones, to up to 25 years, when combined with clavicle bones and wisdom teeth. Fusing age-relevant information from all three anatomical sites, our method utilizes a deep convolutional neural network that is trained on a dataset of 322 subjects in the age range between 13 and 25 years, to achieve a mean absolute prediction error in regressing chronological age of 1.01±0.74 years. Furthermore, when used for majority age classification, we show that a classifier derived from thresholding our regression-based predictor is better suited than a classifier directly trained with a classification loss, especially when taking into account that those cases of minors being wrongly classified as adults need to be minimized. In conclusion, we overcome the limitations of the multi-factorial methods currently used in forensic practice, i.e., dependence on ionizing radiation, subjectivity in quantifying age-relevant information, and lack of an established approach to fuse this information from individual anatomical sites.

PMID: 31059459 [PubMed - indexed for MEDLINE]

Icon for Elsevier Science Related Articles

Lunate subchondral cysts: Are there specific radiologic findings for patients with symptomatic ulnocarpal impaction?

J Orthop Sci. 2019 Jul;24(4):636-642

Authors: Rhee SM, Lee JY, Song KS, Lee GY, Lee JS

Abstract
BACKGROUND: There are few clinical studies evaluating the relationship between lunate cysts and symptomatic ulnar impaction syndrome (UIS). The purpose of this study was to investigate the prevalence and relationship between lunate cysts and UIS by comparing data from patients with UIS against those without.
MATERIALS AND METHODS: From March 2012 to January 2015, 375 patients who had undergone MRI or CT for reasons other than ulnar-sided wrist pain were classified into the 'asymptomatic group' (Group I). Thirty three patients who had been diagnosed with UIS were classified in the 'UIS group' (Group II). We determined whether any differences were present between the two groups and evaluated prognostic factors for lunate cysts.
RESULTS: The prevalence of lunate cysts was significantly higher in Group II but only reached just above 50% (10.4% vs. 57.6%, p < 0.001]. Dorsal-side lunate cysts were more frequent than palmar side in Group I, while Group II had more cysts on the palmar side (74.4% vs. 52.6%, p = 0.001). Logistic regression analysis revealed that UIS and patient age was a significant factor for the presence of lunate cysts (odds ratio: 11.692, p < 0.001; odds ratio: 1.063, p < 0.001, respectively). However, positive ulnar variance or duration of symptom in Group II was not a predisposing factor for lunate cysts (odds ratio: 1.035, p = 0.598; odds ratio: 1.007, p = 0.877, respectively).
CONCLUSION: Since positive ulnar variance or duration of symptom did not affect the formation of the lunate cyst and only slightly more than 50% (57.6%) of patients with UIS had a lunate cyst, it seems unlikely that these cysts are a pathognomonic finding. Surgeons can obtain some evidence from lunate cysts on radiographic exams, but care must be taken that this diagnosis is not made hastily or without due consideration.

PMID: 30606647 [PubMed - indexed for MEDLINE]

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