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Unilateral, trifocal, diaphyseal fracture of the radius with ipsilateral mid-shaft ulna fracture in an adult: a case report
Mazin Ibrahim, Jenny Cwilewicz, Osman H Khan, Anthony Gibbon
Journal of Medical Case Reports , 2011, DOI: 10.1186/1752-1947-5-123
Abstract: We report a case of trifocal, diaphyseal fracture of the radius with a mid-diaphyseal fracture of the ulna in a 53-year-old Caucasian, British, right-hand dominant woman involved in a head-on collision with another vehicle. The management of this rare fracture configuration is described and alternative treatment options discussed.We describe an unusual, complex fracture, which with prompt surgical treatment resulted in a rapid, full and satisfactory functional recovery for our patient.Both bone forearm, diaphyseal fractures are commonly encountered in clinical practice. Segmental radius shaft fractures are, however, less commonly seen. We report a case of trifocal, complex diaphyseal fracture of the radius with ipsilateral mid-shaft fracture of the ulna. Our review of the scientific literature revealed no evidence of any previous reports relating to the surgical treatment of such a fracture. However, the management of a trifocal ulna fracture with bifocal radius fracture in a child has been described previously.A 53-year-old Caucasian British, right-hand dominant woman was involved in a road traffic accident while driving a car, involving a head-on collision with another vehicle at approximately 30 miles/hour. She sustained a closed injury to the left forearm against the steering wheel, resulting in obvious clinical deformity. No neurovascular deficit was evident.Radiographs revealed a displaced and angulated trifocal fracture of the radial shaft in combination with a displaced two-part mid-shaft ulna fracture (Figure 1). Within 24 hours an open reduction and internal fixation of the fracture was performed.Under general anesthesia, using a direct subcutaneous approach to the ulna, the ulna was reduced and fixed with a seven-hole titanium dynamic compression plate (DCP; Figure 2); 1 mm compression was applied.The radius was exposed using Henry's approach. The distal radius fracture was fixed using a five-hole titanium DCP while applying 1 mm compression. The proximal
Prediction of grip and key pinch strength in 978 healthy subjects
Felix Angst, Susann Drerup, Stephan Werle, Daniel B Herren, Beat R Simmen, J?rg Goldhahn
BMC Musculoskeletal Disorders , 2010, DOI: 10.1186/1471-2474-11-94
Abstract: A representative population survey was used as the basis for prediction analyses (n = 978). Bivariate relationships between grip/pinch strengths of the dominate hand were explored by means of all relevant mathematical functions to maximize prediction. The resulting best functions were combined into a multivariate regression.Polynoms (up to the third degree) were the best predictive functions. On the bivariate level, height was best correlated to grip (46.2% explained variance) and pinch strength (37.7% explained variance) in a linear relationship, followed by sex, age, weight, and occupational demand on the hand. Multivariate regression provided predicted values close to the empirical ones explaining 76.6% of the variance for grip strength and 67.7% for pinch strength.The five easy-to-measure cofactors sex, age, body height, categorized occupational demand on the hand, and body weight provide a highly accurate prediction of normative grip and pinch strength.The hand represents the most sophisticated and differentiated musculoskeletal tool in the human being, demanding the largest capacity of the nervous system in relation to its size. Full function and adequate strength of the hand are preconditions for dealing with the demands of daily life. Hand strength has been identified as an important factor predicting not only disability in musculoskeletal diseases such as rheumatoid arthritis [1], but also bone mineral density [2,3], and the likelihood of falls and fractures in osteoporosis [4,5]. It even predicts complications and general morbidity after surgical interventions [6], general disability and future outcome in older age [7-9], economic consequences of diseases [10] as well as cause-specific and overall mortality in elderly people [5,11-13]. Arteriosclerosis is the most frequent cause of morbidity and mortality and grip strength is one of the strongest predictors of its consequences, e.g. myocardial infarction or stroke and post-event recovery [12,14,15]. In con
Optimal Cutoffs of Grip Strength for Definition as Weakness in the Elderly  [PDF]
Renwei Dong, Qi Guo, Jiazhong Wang
Journal of Biosciences and Medicines (JBM) , 2014, DOI: 10.4236/jbm.2014.29003

Objective: To indentify Optimal cutoffs of grip strength for definition as weakness in the elderly. Methods: Our study population comprised 1317 subjects (mean ± SD age: 67.6 ± 6.0 years; 44.3% men) from the Hangu area of Tianjin, China. Data collection includes general physical examination, biochemical indicators and questionnaire. Mobility limitation was defined as a 4-m walking speed < 0.8 m/s and grip strength represents muscle strength. According to the ROC curve model, the cut-off point of grip strength was calculated, when mobility limitation was selected as the target variables. Results: According to the results of ROC curve, In man, grip strength is lower than 32.45 kg, the strength is weaker, Sensitivity is 79.7% and Specificity is 64.9%, the AUC is 0.764 (p < 0.001); In women, grip strength is lower than 18.20 kg, the strength is weaker, Sensitivity is 53.3% and Specificity is78.1%, the AUC is 0.703 (p < 0.001). Conclusions: Cut points for weakness derived from this large, diverse sample of older adults may be useful to identify populations who may benefit from interventions to improve muscle strength and function.

Prediction of Grip Strength in Iranian Young Healthy Population
Taher Afsharnezhad,Farzaneh Saki,Sadegh Rafei,Mina Mallaei
Modern Rehabilitation , 2012,
Abstract: Background and aim: Grip strength (GS) is an important measure of general health to predict mortality, disability and function of the hand. The purpose of this study was to develop equations to predict grip strength based on several anthropometric measurements using a multiple regression analysis.Materials and Methods: Four hundred and eleven males and 671 females college students, ages 18-30 years, in good health, participated voluntarily in this study. This sample was randomly assigned to the model-development (n=867) and cross-validation (n=215) groups. Four equations were developed by using data from the model development group, then cross-validated on the second group. A hand-held dynamometer was used to measure grip strengths. All anthropometric measurements such as hand anthropometry, forearm circumference (FC), lean body mass, skeletal muscle mass and arm muscle area were taken according to standard techniques. Results: It was found that grip strength has a significant correlation with all anthropometric measurements. Forearm length (FL) was correlated to grip (68% explained variance) in a linear relationship, followed by upper limb length and SM. All four equations were confirmed by cross-validation. Because of simplicity and easy-to-measure the following equations were selected for prediction grip: Dominant hand, A) 0.464×Age(yr)+0.392×Height(cm)+0.681×BMI-13.035×Sex(0 for men and 1 for women)-46.160, B) 0.029×FC×FL-8.634×sex+13.872; Non-dominant hand: C) 0.347×Age+0.386× Height+0.657×BMI-13.313×Sex-44.243, D) 0.029×FC×FL-8.752×sex+13.788.Conclusion: The six easy-to-measure cofactors sex, age, height, BMI, forearm length and forearm circumference provide a highly accurate prediction of normative grip strength.
Yogita Verma,Manu Goyal,Dr. Narkeesh
International Journal of Physiotherapy and Research , 2013,
Abstract: Background:Joint mobilisations in the spine are used as an integral part of the treatment and rehabilitation toalleviate pain and reduce stiffness. Mobilisation has also been used to improve muscle strength as described inthe literature. However, there is dearth of data exploring the effect of mobilisation on muscle strength in CLBP.Purpose:To investigate the effects of lumbar mobilisation on pain, range of motion and back strength chronicmechanical low back pain patients.Materials and Methods:Thirty subjects with chronic back pain partici-pated in the randomized clinical trial. The effects of lumbar mobilisation & exercises were comparedwith theexercises alone. Pain levels were measured using visual analog scale, lumbar extension range of motion usingmodified Schobers test and strength by back-leg-chest dynamometer. Measurements were done before & after2 and 4 weeks respectively.Results:A significantly greater improvement in pain (p=0.001); ROM (p=0.002);strength (p=0.001) after 4 weeks in experimental group than the control group.Conclusion:This study there-fore provides experimental evidence to support the use of lumbar mobilization along with the exercises for themanagement of patients with chronic mechanical low back pain, who responded favourably to the interven-tion.
Value of Ultrasonography on Diagnosis and Assessment of Pain and Grip Strength in Patients with Lateral Epicondylitis
Serdar Tarhan,Zeliha ünlü,Gülgün Y?lmaz Oval?,Yüksel Pabu??u
Romatizma , 2009,
Abstract: Objective: Lateral epicondylitis (LE) is generally diagnosed clinically. Ultrasonography (US) can provide useful information about the location, extent, and severity of LE. Our objective was to use US to confirm LE and to investigate the relationships between pain, grip strength, physical examination, and disability in these patients.Material and Methods: Fifty-two patients with unilateral LE were examined by US. Pain and functional status were assessed using a visual analog scale (VAS), physical functioning and bodily pain scales of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and a patient-rated forearm evaluation questionnaire (PRFEQ). Grip strength and manual tests for LE were evaluated.Results: Clinical diagnosis of LE was confirmed by US in 28 (53.8%) patients. Our results showed close associations between clinical examination findings and SF-36 and PRFEQ assessments with pain in patients who had sonographic abnormalities. Grip strength was also correlated with clinical and functional evaluations in these cases. Conclusion: We concluded that evaluation of disability in LE requires methods different from those included in the traditional clinical examination. Pain and grip strength measurements provide numerical and quantitative data for evaluation of severity and disability in patients with sonographic findings of LE.
The Effect of Grip Strength on Bone Mineral Density Measurements in Postmenopausal Sedentary Women  [PDF]
Filiz Sivas,Fatma Yaz?c?,Kür?at ?zoran
Romatizma , 2009,
Abstract: Objective: The present study aimed to investigate the effect of grip strength on dominant and non-dominant forearm, hip and lumbar bone mineral density (BMD) measurements in postmenopausal women.Material and Methods: A total of 93 postmenopausal women (age range: 50-70 years) were included in the study. The dominant extremity was determined by querying patients regarding which hand they use while eating or performing a task. Following measurements regarding height and body weight for body mass index (BMI), grip strength was measured in all patients using the Jamar hand dynamometer device. BMD measurements were determined in the dominant and non-dominant forearm ultra-distal end (UDE), 1/3 radius distal end (RDE) and forearm total, and dominant and non-dominant side femur neck, total hip, and lumbar L1-4 regions. Results: When the hand grip strengths of dominant and non-dominant extremities were compared along with the forearm BMD values, only the hand grip strength of the dominant side was significantly higher than the non-dominant side. There was a significant correlation between the dominant and non-dominant extremity RDE, UDE, and forearm total BMD measurements and the grip strength of the same side. The multivariate regression analyses revealed that the determining effect of grip strength on the forearm BMD measurements of the dominant and non-dominant extremities was weak.There was also a correlation between L1-4 total, dominant and non-dominant extremity femur neck and total hip BMD values and the hand grip strengths. However, the regression analyses revealed that grip strength did not have a determining effect on L1-4 total and dominant and non-dominant extremity hip BMD values. The factors affecting BMD values of these regions were detected as BMI, age and duration of menopause.Conclusion: The present study concluded that the effect of muscle strength on BMD measurements in postmenopausal sedentary women was site-specific rather than systemic.
Somatotype Components, Aerobic Fitness and Grip Strength in Kuwaiti Males and Females  [PDF]
Jasem Ramadan Alkandari, Mario Barac Nieto
Health (Health) , 2016, DOI: 10.4236/health.2016.813135
Abstract: Introduction and Objective: We investigated the association of endo-, meso- and ecto-morphic components of somatotype with aerobic power, mid-trunk flexibility and grip strength. Methods: Healthy male (n = 226) and female (n = 86) subjects, aged 9 - 55 years, sedentary (n = 154) or participating in sports (n = 158) were studied. Anthro-pometrics (height, weight, 8 skin folds, arm and calf circumferences, elbow and knee diameters), maximal exercise O2 uptake, mid trunk flexibility, right and left grip strength were measured. Results: Sedentary adult females were endomorphic with mesomorph tendency, and had low aerobic power (27.8 ± 0.6 ml/Kg·min) and low (48.7 ± 1 Kg) grip strength. Sedentary males (young and adults) and Sports adult males were mesomorph with endomorphic tendency. Sports junior males were balanced mesomorph. Aerobic power was 54.1 ± 0.9 ml/Kg·min in sports young males, 53.8 ± 0.9 ml/Kg·min in sports adult males, 41.2 ± 4.3 ml/Kg·min in sedentary young males, and 39.5 ± 1 ml/Kg·min in sedentary adult males. Grip strength was 89.9 ± 1.7 Kg in sports adult males, 86.7 ± 2 Kg in sedentary adult males, 75.6 ± 2.2 Kg in sports junior males and 52 ± 9.1 Kg in young sedentary males. Step-wise multiple regression analysis of somatotype components on aerobic power revealed dominant negative contribution (P < 0.001) of endomorphy (r2 = 0.57, 57%), and small but significant positive contributions of mesomorphy (0.6%) and ectomorphy (0.6%): Aerobic power = [56.1 - 4.3 (endomorphy) + (mesomorphy) + 1.4 (ectomorphy)] ± 9.1 SEE. Height and somatotype components accounted for 69% of the variance (R2) in grip strength; height had greatest contribution (60%): Grip Strength = [1.7 (Height) - 6.5 (ectomorphy) - 3.4 (endomorphy) - 2 (mesomorphy) - 200] ± 12.9 SEE. Measured variables accounted for <2% of flexibility variance. Conclusion: Endomorphy contributes greatly and negatively to variance in aerobic power. Body height was the anthropometric variable with the greatest positive association with the variance in grip strength. Flexibility appears to be unrelated to somatotype components.
Analysis of the Grip Strength Data Using Anti-Diagonal Symmetry Models  [PDF]
Kiyotaka Iki
Open Journal of Statistics (OJS) , 2016, DOI: 10.4236/ojs.2016.64049
Abstract: For the analysis of square contingency tables with the same row and column ordinal classifications, this article proposes new models which indicate the structures of symmetry with respect to the anti-diagonal of the table. Also, this article gives a simple decomposition in 3 3 contingency table using the proposed models. The proposed models are applied to grip strength data.
Hand grip strength: evaluation methods and factors influencing this measure
Jonathan Ache Dias,Angélica Cristiane Ovando,Wladymir Külkamp,Noé Gomes Borges Junior
Revista Brasileira de Cineantropometria e Desempenho Humano , 2010,
Abstract: The evaluation of hand grip strength (HGS) is commonly used, especially in physiotherapy and sports. The establishment of reference values has been the focus of some studies, but the different instruments and protocols used impair generalization of the results. Moreover, several factors influence HGS, such as gender, age, dominance, time of assessment, body position, sincerity of effort, anthropometric characteristics, and grip span. The objective of this study was to review the current state of the art regarding HGS measures and some aspects related to their interpretation. According to the literature, the use of a dynamometer that allows the construction of force vs. time curves and the continuous adjustment of grip span according to hand dimensions seems to be essential for the evaluation of HGS. Additional recommenda-tions are the standardization of the time of evaluation, assessment of both hands, a minimum number of three trials for each hand, adoption of a standard body position, use of verbal and/or visual encouragement, and the correction of muscle strength according to body weight. The standardization of evaluation methods and interpretation of the results permits the establishment of reliable and universally accepted reference values of HGS.
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