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Scott P Steinmann - One of the best experts on this subject based on the ideXlab platform.
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Entrapment neuropathy of the ulnar nerve
Journal of The American Academy of Orthopaedic Surgeons, 2007Co-Authors: Bassem T Elhassan, Scott P SteinmannAbstract:Ulnar nerve Entrapment is the second most common nerve Entrapment syndrome of the upper extremity. Although it may occur at any location along the length of the nerve, it is most common in the cubital tunnel. Ulnar nerve Entrapment produces numbness in the ring and little fingers and weakness of the intrinsic muscles in the hand. Patient presentation and symptoms vary according to the site of Entrapment. Treatment options are often determined by the site of pathology. Many patients benefit from nonsurgical treatment (eg, physical therapy, bracing, injection). When these methods fail or when sensory or motor impairment progresses, surgical release of the nerve at the site of Entrapment should be considered. Surgical release may be done alone or with nerve transposition at the elbow. Most patients report symptomatic relief following surgery.
David G Kline - One of the best experts on this subject based on the ideXlab platform.
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management and outcomes of 42 surgical suprascapular nerve injuries and Entrapments
Neurosurgery, 2005Co-Authors: Daniel H Kim, Judith A Murovic, Robert L Tiel, David G KlineAbstract:OBJECTIVE: Retrospective chart reviews of 42 patients with surgical suprascapular nerve (SSN) injury/Entrapment were performed. Presenting symptoms, findings, operative approach, and results are documented. METHODS: Forty-two patients with SSN injuries/Entrapments underwent operations between 1970 and 2002. Charts were retrospectively reviewed for the presence of shoulder pain; spinati muscle function was evaluated with the Louisiana State University Health Sciences Center grading system. Side of lesion and sex were equally represented; mean follow-up was 18 months (range, 12-48 mo). SSN injuries/ Entrapments were associated with occupational overuse (19), sports-related injury (16), direct trauma (4) and ganglion cysts (3). Thirty-one (79%) of 39 patients with suprascapular notch SSN injuries/Entrapments, excluding ganglion cysts, presented with mild to moderate shoulder pain and spinati weakness. RESULTS: Motor function for these 31 patients was graded on a scale of 0 to 5. Preoperatively, patients had supraspinatus function Grades 0 to 2 and infraspinatus function Grades 0 to 2. Supraspinatus function improved postoperatively to Grade 4 or better in 28 patients (90%) and to Grades 2 to 3 in 3 patients (10%). Infraspinatus function improved to better than Grade 3 in 10 patients (32%), to Grades 2 to 3 in 14 patients (45%), and to Grade 1 in 7 patients (23%). Preoperatively, eight (21%) of 39 patients presenting with persistent severe pain had Grade 3 spinati strength. Of these eight patients, seven (88%) had an improvement in pain postoperatively. Strength in this group remained the same or improved to Grade 4. Postoperatively, three patients with ganglion cysts had good improvement in spinati function. CONCLUSION: Although SSN injury/Entrapment is rare, 42 patients are presented who responded well to SSN release. Supraspinatus muscle improvement was as good as or better than that achieved in the infraspinatus.
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surgical outcomes of 654 ulnar nerve lesions
Journal of Neurosurgery, 2003Co-Authors: Daniel H Kim, Judith A Murovic, Robert L Tiel, Kisoo Han, David G KlineAbstract:Object. In this article the authors present a retrospective analysis of 654 surgical outcomes in patients with ulnar nerve Entrapments, injuries, and tumors during a 30-year period. Methods. Data were gathered between 1968 and 1998 at Louisiana State University Health Sciences Center. Mechanisms of injuries or lesions included 460 Entrapments at the elbow level (70%), 76 lacerations (12%), 52 stretches/contusions (8%), 34 fractures/dislocations (5%), 12 gunshot wounds (2%), two injection-induced injuries (0.3%), and 13 nerve sheath tumors (2%). In cases of Entrapment, direct operative recordings uniformly demonstrated a slowing of conduction at the elbow, even in cases in which preoperative noninvasive studies had been nondiagnostic. Intraoperative electrical “inching” studies also demonstrated significant conduction abnormalities that lie just proximal to and through the olecranon notch rather than distal, beneath the flexor carpi ulnaris muscle. There were only eight exceptions to this. Lesions not in c...
Bruce E Rittmann - One of the best experts on this subject based on the ideXlab platform.
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n acyl homoserine lactones signaling as a critical control point for phosphorus Entrapment by multi species microbial aggregates
Water Research, 2021Co-Authors: Thomas P Curtis, Jan Dolfing, Bruce E RittmannAbstract:Abstract Quorum sensing (QS) has been extensively studied in pure stains of microorganisms, but the ecological roles of QS in multi-species microbial aggregates are poorly understood due to the aggregates’ heterogeneity and complexity, in particular the phosphorus (P) Entrapment, a key aspect of element cycling. Using periphytic biofilm as a microbial-aggregate model, we addressed how QS signaling via N-acyl-homoserine-lactones (AHLs) regulated P Entrapment. The most-abundant AHLs detected were C8-HSL, 3OC8-HSL, and C12-HSL, are the primary regulator of P Entrapment in the periphytic biofilm. QS signaling-AHL is a beneficial molecule for bacterial growth in periphytic biofilm and the addition of these three AHLs optimized polyphosphate accumulating organisms (PAOs) community. Growth promotion was accompanied by up-regulation of pyrimidine, purine and energy metabolism. Both intra- and extra-cellular P Entrapment were enhanced in the addition of AHLs. AHLs increased extracellular polymeric substances (EPS) production to drive extracellular P Entrapment, via up-regulating amino acids biosynthesis and amino sugar/nucleotide sugar metabolism. Also, AHLs improved intracellular P Entrapment potential by regulating genes involved in inorganic-P accumulation (ppk, ppx) and P uptake and transport (pit, pstSCAB). This proof-of-concept evidence about how QS signaling regulates P Entrapment by microbial aggregates paves the way for managing QS to enhance P removal by microbial aggregates in aquatic environments.
Ravi Bhaskar - One of the best experts on this subject based on the ideXlab platform.
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Rare case of median nerve and brachial artery Entrapment by an abnormal musculo-fascial tunnel in the arm: possible cause of neurovascular compression syndrome.
Anatomy & Cell Biology, 2019Co-Authors: Naveen Kumar, Ashwini Aithal Padur, Gayathri Prabhu, Swamy Ravindra Shanthakumar, Ravi BhaskarAbstract:Entrapment neuropathies of the peripheral nervous system are frequently encountered due to anatomical variations.Median nerve is the most vulnerable nerve to undergo Entrapment neuropathies. The clinical complications are mostly manifested by median nerve impingement in forearm and wrist areas. Median nerve Entrapment could also occur at the arm,due to the presence of ligament of Struthers. Here we report a rare case of proximal Entrapment of median nerve and brachial artery in the arm by an abnormally formed musculo-fascial tunnel. The tunnel was formed by the muscle fibers of brachialis and medial intermuscular septum in the lower part of arm. Due to this, the median nerve coursed deep, below the tunnel and continued distally into the forearm, underneath the pronator teres muscle and hence did not appear as a content of cubital fossa.The present Entrapment of neurovascular structures in the tunnel might lead to pronator syndromes or other neurovascular compression syndromes.
Henk J Coert - One of the best experts on this subject based on the ideXlab platform.
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validity of the tinel sign and prevalence of tibial nerve Entrapment at the tarsal tunnel in both diabetic and nondiabetic subjects a cross sectional study
Plastic and Reconstructive Surgery, 2018Co-Authors: Willem D Rinkel, Manuel Castro Cabezas, Johan W Van Neck, Erwin Birnie, Steven E R Hovius, Henk J CoertAbstract:BACKGROUND: Nerve Entrapments like carpal tunnel syndrome are more prevalent in patients with diabetes, especially in those with diabetic polyneuropathy. Our study aims were to investigate the validity of the Tinel sign in diagnosing tibial neuropathy and determine the prevalence of tibial nerve Entrapment in both a diabetic and nondiabetic population. METHODS: Two hundred forty nonneuropathic subjects with diabetes and 176 diabetic subjects with neuropathy participating in the prospective Rotterdam Diabetic Foot Study and 196 reference subjects without diabetes and without neuropathy complaints were evaluated. All subjects underwent sensory testing of the feet, and complaints were assessed using the Michigan Neuropathy Screening Instrument. The Tinel sign was defined as discriminative and valid for diagnosing tibial nerve Entrapment when the nerve-related Michigan Neuropathy Screening Instrument subscore of neuropathic symptoms differed at least 5 percent between the Tinel-positive and Tinel-negative subjects. When the sign was valid, prevalence estimates of tibial nerve Entrapment at the tarsal tunnel were calculated. RESULTS: Significantly more neuropathic symptoms (p < 0.002) and higher sensory thresholds (p < 0.0005) were observed in (compressed) tibial nerve-innervated areas, indicating that a positive Tinel sign at the tarsal tunnel is a valid measure of tibial nerve abnormality. The prevalence of tibial nerve Entrapment in diabetic patients was 44.9 percent (95 percent CI, 40.1 to 49.7 percent) versus 26.5 percent (95 percent CI, 20.3 to 32.7 percent) in healthy controls (p < 0.0001). CONCLUSIONS: Tibial nerve Entrapment is more prevalent in diabetic subjects than in controls. The significantly more frequently reported neuropathic complaints and concomitant sensory disturbances provide evidence for the role of superimposed Entrapment neuropathy in diabetes-related neuropathy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, IV.
