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Neal C Chen - One of the best experts on this subject based on the ideXlab platform.
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mri findings in patients undergoing triangular fibrocartilage complex repairs versus patients without ulnar sided Wrist Pain
Hand, 2020Co-Authors: Svenna H W L Verhiel, Julia Blackburn, Marco J P F Ritt, Frank J Simeone, Neal C ChenAbstract:Background: The clinical picture of ulnar-sided Wrist Pain is oftentimes confusing because various pathologies may be coexistent. In this study, we aimed: (1) to compare the prevalence of potential causes of ulnar-sided Wrist Pain on magnetic resonance imaging (MRI) in patients who underwent triangular fibrocartilage complex (TFCC) repair and control subjects: and (2) to evaluate whether inferior clinical results were associated with specific patient characteristics or other potential causes of ulnar-sided Wrist Pain. Methods: We included 67 patients who underwent a TFCC repair and 67 control subjects. The MRI scans were examined for sources of ulnar-sided Wrist Pain. After TFCC repair, 42 patients (63%) completed surveys, including Quick Disabilities of the Arm, Shoulder and Hand and Pain scores. Bivariate analysis was performed to compare our groups and to identify factors associated with our outcomes. Results: We found significantly higher rates of distal radioulnar joint (DRUJ) arthritis (P = .033), extensor carpi ulnaris (ECU) pathology (P = .028), and ulnar styloid fractures (P = .028) in patients with TFCC repairs. With increasing age, increasing pathology in the pisotriquetral joint (P = .040), more ulnocarpal abutment (P = .0081), and more degenerative tears (P < .001) were seen in both groups. No demographic characteristics or MRI findings were significantly associated with our outcomes. Conclusions: We observed higher rates of DRUJ arthritis and ECU pathology in patients with TFCC tears undergoing repair compared with age- and sex-matched controls. This may be due to damage to the TFCC itself altering relationships of the DRUJ and the ECU subsheath, or it may reflect various pathologies that cause ulnar-sided Wrist Pain and drive patients toward surgery.
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incidental flexor carpi radialis tendinopathy on magnetic resonance imaging
Hand, 2019Co-Authors: Nicky Stoop, Bonheur A T D Van Der Gronde, Stein J Janssen, Michael T Kuntz, David Ring, Neal C ChenAbstract:Background: Wrist Pain is often nonspecific. Magnetic resonance imaging (MRI) is regularly obtained to evaluate Wrist Pain. Variations and pathophysiology identified on MRI may not account for patient's clinical symptoms. This study aims to quantify the prevalence of flexor carpi radialis (FCR) tendinopathy on MRI and the coexistence of trapeziometacarpal (TMC) or scaphotrapeziotrapezoid (STT) osteoarthritis. Methods: Using an institutional research database, we identified 3631 adult patients who obtained an MRI of the Wrist during a 15-year period. Text search in the radiology reports identified 302 patients with possible FCR signal abnormalities. After reviewing the medical records, 98 patients were identified with FCR tendinopathy. Furthermore, medical records were used to identify Pain located on the volar radial part of the Wrist. In the absence of a documented examination consistent with FCR tendinopathy, we considered any signal change in the FCR incidental. Results: We identified 55 patients (55%) with incidental FCR tendinopathy. In a bivariate analysis, we found FCR signal changes on the MRI were associated with older age, white race, clinically suspected FCR tendinopathy, volar-radial sided Wrist Pain, and TMC and STT arthritis. Using multivariable logistic regression to account for confounding, older age and volar-radial sided Wrist Pain were independently associated with FCR signal changes on MRI. Conclusions: Signal changes in the FCR are infrequent and often incidental (asymptomatic) or associated with peritrapezial osteoarthritis.
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Diagnostic Wrist Arthroscopy for Nonspecific Wrist Pain.
Hand (New York N.Y.), 2016Co-Authors: Amin Mohamadi, David Ring, Femke M.a.p. Claessen, Sezai Özkan, Gregory P. Kolovich, Neal C ChenAbstract:Background: This study addresses the prevalence of discrete pathophysiology accounting for patients’ symptoms during diagnostic Wrist arthroscopy in individuals with Wrist Pain without a specific p...
John P Difiori - One of the best experts on this subject based on the ideXlab platform.
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overuse injury and the young athlete the case of chronic Wrist Pain in gymnasts
Current Sports Medicine Reports, 2006Co-Authors: John P DifioriAbstract:Chronic Wrist Pain in young gymnasts is an example of an overuse injury that can affect the physis. Yet, it remains unclear the extent to which this injury results in altered growth of the Wrist leading to positive ulnar variance and its sequelae. Although these findings are unique to young gymnasts, there are several other examples of similar overuse injuries involving the physis including those of the proximal humerus, proximal tibia, and distal femur. In addition to these clinical descriptions, basic science studies have also described the negative effects of high intensity loading on immature bone.
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Wrist Pain distal radial physeal injury and ulnar variance in the young gymnast
American Journal of Sports Medicine, 2006Co-Authors: John P Difiori, Dennis Caine, Robert M MalinaAbstract:In gymnastics, the Wrist joint is subjected to repetitive loading in a weightbearing fashion. In this setting, chronic Wrist Pain is quite common. Because gymnasts ordinarily enter the sport at very young ages and train for several years before skeletal maturity is attained, the growth plates of the Wrist are at risk for injury. In addition, imaging studies have identified evidence of injury to the distal radial physis and the development of positive ulnar variance. Recent studies provide more information on the relationships between these findings, as well as factors that may predispose some gymnasts to Wrist Pain. This article provides a comprehensive review of these issues and offers suggestions for management, preventive measures, and future research.
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Wrist Pain in young gymnasts frequency and effects upon training over 1 year
Clinical Journal of Sport Medicine, 2002Co-Authors: John P Difiori, James C Puffer, Bassil Aish, Frederick J DoreyAbstract:Objective To determine the frequency and characteristics of Wrist Pain in young, nonelite gymnasts over a 1-year training period, and to describe the effects of chronic Wrist upon gymnastics training. Design Prospective cohort study. Setting Los Angeles-based gymnastics club. Participants Forty-seven nonelite female and male gymnasts between 5 and 16 years of age. Assessments Each subject completed an interview-based questionnaire and received a physical exam at the study onset and at the end of 1 year of training. The questionnaire detailed training habits and elicited a history and description of Wrist Pain. Main outcome measures The frequency of Wrist Pain and several measures of training were reported at the study onset and at 1 year. Gymnasts with Wrist Pain were compared with those who were Pain-free. Main results Wrist Pain was reported by 57% (27 of 47) of subjects at the study onset. Eighty-nine percent (24 of 27) reported Wrist Pain both at the study onset and 1 year later. Nineteen gymnasts (40%) were Pain-free at each collection. The floor exercise, the pommel horse, and the balance beam were most frequently associated with Wrist Pain symptoms. Multivariate analysis revealed that adolescent gymnasts between 10 and 14 years of age were significantly more likely to report Wrist Pain at each survey than those who were either above or below this age range (p = 0.03). Forty-two percent of subjects with Wrist Pain at each survey reported that the symptoms interfered with training. Only five gymnasts with Wrist Pain were seen by physicians. Training intensity increased in gymnasts with and without Wrist Pain. The relative increase within each group was statistically significant among Pain-free gymnasts (p = 0.003), but was not for those with Wrist Pain (p = 0.08). Conclusions Wrist Pain among young, nonelite gymnasts is common, and appears to persist with continued training in the vast majority of those who report symptoms. Adolescent gymnasts between 10 and 14 years of age training at this level are significantly more likely to have Wrist Pain. Wrist Pain appears to have a negative effect upon training, based upon both self-report and training intensity measures; however, more study is needed with respect to this issue.
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Wrist Pain distal radial physeal injury and ulnar variance in young gymnasts does a relationship exist
American Journal of Sports Medicine, 2002Co-Authors: John P Difiori, James C Puffer, Bassil Aish, Frederick J DoreyAbstract:BackgroundChronic Wrist Pain affects up to 79% of young gymnasts. Distal radial growth plate injury and positive ulnar variance have also been reported in this population.HypothesisThere is a relationship between Wrist Pain, radiographic findings of distal radial growth plate injury, and ulnar variance in skeletally immature young gymnasts.Study DesignCross-sectional study.MethodsFifty-nine gymnasts (28 girls and 31 boys; average age, 9.3 years) completed a questionnaire detailing training and Wrist Pain symptoms. Each received a Wrist examination, grip strength measurement, and bilateral Wrist radiographs.ResultsWrist Pain was reported by 56% of the gymnasts (33 of 59), with 45% (15 of 33) describing Pain of at least 6 months’ duration. Factors significantly associated with Wrist Pain included higher skill level, older age, and more years of training. For those between 10 and 14 years of age, 83% had Wrist Pain, compared with 44% for those outside of that age range. Fifty-one percent of the gymnasts (30 ...
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Wrist Pain distal radial physeal injury and ulnar variance in young gymnasts does a relationship exist
Annual meeting of the American College of Sports Medicine, 2002Co-Authors: John P Difiori, James C Puffer, Bassil Aish, Frederick J DoreyAbstract:Background: Chronic Wrist Pain affects up to 79% of young gymnasts. Distal radial growth plate injury and positive ulnar variance have also been reported in this population. Hypothesis: There is a relationship between Wrist Pain, radiographic findings of distal radial growth plate injury, and ulnar variance in skeletally immature young gymnasts. Study Design: Cross-sectional study. Methods: Fifty-nine gymnasts (28 girls and 31 boys; average age, 9.3 years) completed a questionnaire detailing training and Wrist Pain symptoms. Each received a Wrist examination, grip strength measurement, and bilateral Wrist radiographs. Results: Wrist Pain was reported by 56% of the gymnasts (33 of 59), with 45% (15 of 33) describing Pain of at least 6 months' duration. Factors significantly associated with Wrist Pain included higher skill level, older age, and more years of training. For those between 10 and 14 years of age, 83% had Wrist Pain, compared with 44% for those outside of that age range. Fifty-one percent of the gymnasts (30 of 59) had findings of stress injury to the distal radial physis of at least a grade 2; 7% (4) had frank widening of the growth plate. Wrist Pain prevalence was significantly related to the grade of radiographic injury. Mean ulnar variance was significantly more positive than established norms. Ulnar variance was not associated with Wrist Pain or radiographic injury of the distal radial physis. Conclusions: Radiographic findings of distal radial physeal injury are associated with Wrist Pain among young nonelite gymnasts.
Jeongyi Kwon - One of the best experts on this subject based on the ideXlab platform.
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effect of personalized Wrist orthosis for Wrist Pain with three dimensional scanning and printing technique a preliminary randomized controlled open label study
Prosthetics and Orthotics International, 2018Co-Authors: Sang Jun Kim, Sung Jae Kim, Yong Ho Cha, Keun Ho Lee, Jeongyi KwonAbstract:Background:Three-dimensional printer technology can produce the personalized orthosis in various forms.Objective:To develop a personalized Wrist orthosis using a three-dimensional scanner and three-dimensional printer for patients with Wrist Pain.Study design:A preliminary, prospective, randomized, open-label study.Methods:A total of 22 patients with Wrist Pain were randomly assigned to the control and experimental groups. The control group wore a cock-up orthosis and the experimental group wore a three-dimensional-printed Wrist orthosis for 1 week. The Patient-Rated Wrist Evaluation, Jebsen Hand Function Test, and Orthotics and Prosthetics Users’ Survey were checked before and 1 week after the application.Results:The Patient-Rated Wrist Evaluation showed significant Pain relief in both groups. Two items of the 28 Orthotics and Prosthetics Users’ Survey questions, “Put toothpaste on brush and brush teeth” and “Dial a touch tone phone,” showed high satisfaction scores, with statistically significant differ...
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effect of personalized Wrist brace for Wrist Pain with 3d scanning and printing technique a preliminary randomized controlled open label study
Annals of Physical and Rehabilitation Medicine, 2018Co-Authors: Sung Jae Kim, Yong Ho Cha, Kwang Hyuck Lee, Jeongyi KwonAbstract:Introduction/Background Three-dimensional (3D) printer technology can produce the personalized brace with low cost and less time. 3D printing data files are also advantageous for production of individualized products at no extra cost, even when different designs are used in consecutive production runs. In addition, because the 3D printer is controlled by a computer, it can make objects in various forms and is easy to use, as compared to other manufacturing techniques. The purpose of this study was to develop a personalized Wrist brace using a 3D scanner and 3D printer for patients with Wrist Pain caused by overuse syndrome, and to evaluate the improvement of Pain relief, work performance, and daily life satisfaction after wearing the brace. Material and method Twenty patients with Wrist Pain were randomly assigned to control and experimental groups. The control group wore the cock-up splint and the experimental group wore 3D printed Wrist brace for one week. Patient Rated Wrist Evaluation (PRWE), Jebsen Hand Function Test (JHFT), and Orthotics and Prosthetics User Survey (OPUS) were checked before and one week after the application. Results The PRWE showed significant Pain relief in both groups. Two items of the 28 OPUS questions, ‘Put toothpaste on brush and brush teeth’ and ‘Dial a touch tone phone’, showed high satisfaction scores, with statistically significant difference in the experimental group (P = 0.036 and 0.004). Conclusion 3D printed Wrist brace was superior to the cock-up splint in some items of the OPUS. Wrist Pain was reduced in the group wearing the 3D printed Wrist brace as well as the group wearing the cock-up splint, so 3D printed Wrist brace could possibly play the same role as the cock-up splint.
Mark E Baratz - One of the best experts on this subject based on the ideXlab platform.
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failure of a retinacular flap to prevent dorsal Wrist Pain after titanium pi plate fixation of distal radius fractures
Journal of Hand Surgery (European Volume), 2002Co-Authors: Peter P Chiang, Stephanie S Roach, Mark E BaratzAbstract:Patients with distal radius fractures that had been treated with a dorsal Pi plate and retinacular flap covering the transverse limb of the Pi plate were evaluated clinically and radiographically. Nine of 20 patients (45%) required plate removal for dorsal Wrist Pain. Three of the remaining 11 who retained the plate had dorsal tenderness over the Wrist extensors. There were no differences evident between the 2 groups in plate size, position, or number of screws used. In addition there were no significant differences between the groups in either radial height or inclination. The palmar tilt did show a trend toward statistical significance: those patients who required plate removal had an average of 4.1 degrees of dorsal tilt, patients whose plate was not removed averaged 2.8 degrees of palmar tilt. Our results show that the retinacular flap covering the distal transverse limb of the Pi plate did not prevent the occurrence of dorsal Wrist Pain. Dorsal Wrist Pain remained a problem with dorsal plating of distal radius fractures.
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failure of a retinacular flap to prevent dorsal Wrist Pain after titanium pi plate fixation of distal radius fractures
Journal of Hand Surgery (European Volume), 2002Co-Authors: Peter P Chiang, Stephanie S Roach, Mark E BaratzAbstract:Abstract Patients with distal radius fractures that had been treated with a dorsal Pi plate and retinacular flap covering the transverse limb of the Pi plate were evaluated clinically and radiographically. Nine of 20 patients (45%) required plate removal for dorsal Wrist Pain. Three of the remaining 11 who retained the plate had dorsal tenderness over the Wrist extensors. There were no differences evident between the 2 groups in plate size, position, or number of screws used. In addition there were no significant differences between the groups in either radial height or inclination. The palmar tilt did show a trend toward statistical significance: those patients who required plate removal had an average of 4.1° of dorsal tilt, patients whose plate was not removed averaged 2.8° of palmar tilt. Our results show that the retinacular flap covering the distal transverse limb of the Pi plate did not prevent the occurrence of dorsal Wrist Pain. Dorsal Wrist Pain remained a problem with dorsal plating of distal radius fractures. (J Hand Surg 2002;27A:724–728. Copyright © 2002 by the American Society for Surgery of the Hand.)
Frederick J Dorey - One of the best experts on this subject based on the ideXlab platform.
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Wrist Pain in young gymnasts frequency and effects upon training over 1 year
Clinical Journal of Sport Medicine, 2002Co-Authors: John P Difiori, James C Puffer, Bassil Aish, Frederick J DoreyAbstract:Objective To determine the frequency and characteristics of Wrist Pain in young, nonelite gymnasts over a 1-year training period, and to describe the effects of chronic Wrist upon gymnastics training. Design Prospective cohort study. Setting Los Angeles-based gymnastics club. Participants Forty-seven nonelite female and male gymnasts between 5 and 16 years of age. Assessments Each subject completed an interview-based questionnaire and received a physical exam at the study onset and at the end of 1 year of training. The questionnaire detailed training habits and elicited a history and description of Wrist Pain. Main outcome measures The frequency of Wrist Pain and several measures of training were reported at the study onset and at 1 year. Gymnasts with Wrist Pain were compared with those who were Pain-free. Main results Wrist Pain was reported by 57% (27 of 47) of subjects at the study onset. Eighty-nine percent (24 of 27) reported Wrist Pain both at the study onset and 1 year later. Nineteen gymnasts (40%) were Pain-free at each collection. The floor exercise, the pommel horse, and the balance beam were most frequently associated with Wrist Pain symptoms. Multivariate analysis revealed that adolescent gymnasts between 10 and 14 years of age were significantly more likely to report Wrist Pain at each survey than those who were either above or below this age range (p = 0.03). Forty-two percent of subjects with Wrist Pain at each survey reported that the symptoms interfered with training. Only five gymnasts with Wrist Pain were seen by physicians. Training intensity increased in gymnasts with and without Wrist Pain. The relative increase within each group was statistically significant among Pain-free gymnasts (p = 0.003), but was not for those with Wrist Pain (p = 0.08). Conclusions Wrist Pain among young, nonelite gymnasts is common, and appears to persist with continued training in the vast majority of those who report symptoms. Adolescent gymnasts between 10 and 14 years of age training at this level are significantly more likely to have Wrist Pain. Wrist Pain appears to have a negative effect upon training, based upon both self-report and training intensity measures; however, more study is needed with respect to this issue.
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Wrist Pain distal radial physeal injury and ulnar variance in young gymnasts does a relationship exist
American Journal of Sports Medicine, 2002Co-Authors: John P Difiori, James C Puffer, Bassil Aish, Frederick J DoreyAbstract:BackgroundChronic Wrist Pain affects up to 79% of young gymnasts. Distal radial growth plate injury and positive ulnar variance have also been reported in this population.HypothesisThere is a relationship between Wrist Pain, radiographic findings of distal radial growth plate injury, and ulnar variance in skeletally immature young gymnasts.Study DesignCross-sectional study.MethodsFifty-nine gymnasts (28 girls and 31 boys; average age, 9.3 years) completed a questionnaire detailing training and Wrist Pain symptoms. Each received a Wrist examination, grip strength measurement, and bilateral Wrist radiographs.ResultsWrist Pain was reported by 56% of the gymnasts (33 of 59), with 45% (15 of 33) describing Pain of at least 6 months’ duration. Factors significantly associated with Wrist Pain included higher skill level, older age, and more years of training. For those between 10 and 14 years of age, 83% had Wrist Pain, compared with 44% for those outside of that age range. Fifty-one percent of the gymnasts (30 ...
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Wrist Pain distal radial physeal injury and ulnar variance in young gymnasts does a relationship exist
Annual meeting of the American College of Sports Medicine, 2002Co-Authors: John P Difiori, James C Puffer, Bassil Aish, Frederick J DoreyAbstract:Background: Chronic Wrist Pain affects up to 79% of young gymnasts. Distal radial growth plate injury and positive ulnar variance have also been reported in this population. Hypothesis: There is a relationship between Wrist Pain, radiographic findings of distal radial growth plate injury, and ulnar variance in skeletally immature young gymnasts. Study Design: Cross-sectional study. Methods: Fifty-nine gymnasts (28 girls and 31 boys; average age, 9.3 years) completed a questionnaire detailing training and Wrist Pain symptoms. Each received a Wrist examination, grip strength measurement, and bilateral Wrist radiographs. Results: Wrist Pain was reported by 56% of the gymnasts (33 of 59), with 45% (15 of 33) describing Pain of at least 6 months' duration. Factors significantly associated with Wrist Pain included higher skill level, older age, and more years of training. For those between 10 and 14 years of age, 83% had Wrist Pain, compared with 44% for those outside of that age range. Fifty-one percent of the gymnasts (30 of 59) had findings of stress injury to the distal radial physis of at least a grade 2; 7% (4) had frank widening of the growth plate. Wrist Pain prevalence was significantly related to the grade of radiographic injury. Mean ulnar variance was significantly more positive than established norms. Ulnar variance was not associated with Wrist Pain or radiographic injury of the distal radial physis. Conclusions: Radiographic findings of distal radial physeal injury are associated with Wrist Pain among young nonelite gymnasts.
