Clinical Summary and Recommendations Patient History Complaints The utility of the patient history has been studied only in the context of identifying cervical radiculopathy. Subjective reports of symptoms were generally not helpful, with diagnoses including complaints of “weakness,” “numbness,” “tingling,”…
Clinical Summary and Recommendations Patient History Questions Screening instruments have been shown to be very good at identifying temporomandibular disorder (TMD) pain (+LR [likelihood ratio] of 33). A subject complaint of “periodic restriction” (the inability to open the mouth as…
The health sciences and medical professions continue to focus on evidence-based practice defined as the integration of the best available research evidence and clinical expertise with the patient’s values. , Evidence should be incorporated into all aspects of physical therapy…
Introduction Over the years, advances in upper extremity amputation management have included improved surgical techniques, preoperative management, postoperative management, and prosthetic management. In the past decade the greatest advances have occurred in prosthetic technologies, fabrication techniques, and components to more…
Introduction Elbow resection arthroplasty involves removal of the articulating ends of the distal part of the humerus, the proximal part of the ulna, and occasionally the radial head, and letting the soft tissue structures heal around the resected bone segments,…
Cerebral Palsy Cerebral palsy (CP) is a nonprogressive perinatal injury to the developing central nervous system (CNS) causing abnormalities of movement and posture. The incidence of CP is 1 to 7 per 1000 children worldwide, and 2 to 3 per…
Introduction Flaccid paralysis of the elbow severely limits a patient's ability to position and stabilize the hand for function. Paralysis of elbow flexors (biceps, brachialis, and brachioradialis) makes reaching the face impossible. Most other extremity functions require frequently changing levels…
Introduction Difficult-to-manage soft tissue defects about the elbow occur as a result of trauma, infection, extravasation of chemotherapeutic agents, cutaneous ulceration or necrosis, and limb-sparing tumor surgery (see Chapter 58 ). Treatment options are many, and appropriate management requires careful…
Introduction/Indications There is little accommodation for the loss of elbow motion from adjacent joints, and extremity function is severely compromised after elbow fusion. As such, elbow arthrodesis is a procedure that is largely avoided even in the most complex clinical…
Introduction In my practice, interposition arthroplasty continues to be an essential option as salvage for end-stage arthritis of the elbow in the young patient. Selection and technique have changed little in the last 10 years. We have found no additional…