The aim of this study was to obtain the ultrasonographical reference values of ulnar nerve cross-sectional areas at the common areas of nerve entrapment as well as any differences related to age, sex, weight, height, dominant arm. Cross-sectional areas of the ulnar nerves of 72 healthy volunteers were measured bilaterally at the level of the epicondyle, 2 cm proximal to and 2 cm distal to the epicondyle, just at the entrance of cubital tunnel, at arterial split, at Guyon's canal. Age, sex, body weight, height, body mass index, and dominant extremity were recorded. The mean ulnar nerve cross-sectional area was 5.8 ± 1.1 mm(2) at 2 cm proximal to medial epicondyle, 6.2 ± 1.1 mm(2) at the medial epicondyle, 5.6 ± 0.9 mm(2) at the entrance of the cubital tunnel, 5.6 ± 1.0 mm(2) at 2 cm distal to medial epicondyle (inside the flexor carpi ulnaris), 5.0 ± 0.6 mm(2) at arterial split, and 4.9 ± 0.6 mm(2) at Guyon's canal. There was statistically no difference between the dominant and nondominant sides (p > 0.05). Females had statistically smaller nerves than males (p < 0.05). There was a significant correlation with height at all levels; also, weight was significantly correlated with cross-sectional areas except at two levels: tip of medial epicondyle and 2 cm distal. This study provides normative data of ulnar nerve ultrasonography and as well as any differences related to age, sex, height, weight, and dominant arm.

We aimed to evaluate the relation between the severity of carpal tunnel syndrome and metabolic syndrome. One hundred and fifty patients who had a clinical and electrophysiologically confirmed diagnosis of carpal tunnel syndrome (CTS), were included in this study. The patients were divided into two groups (with or without metabolic syndrome) according to the criteria of National Cholesterol Education Program. Eighty one (73.5 %) of the patients with CTS had metabolic syndrome. The patients with metabolic syndrome the severity of CTS was found 22.2 % had mild CTS, 56.8 % had moderate CTS, and 21 % had severe CTS. The patients without metabolic syndrome the severity of CTS was found 44.9 % had mild CTS, 40.6 % had moderate CTS, and 14.5 % had severe CTS. The severity of CTS between both groups was found to be statistically significant (p = 0.0009). While a correlation was found between the severity of CTS and high level of LDL with the presence of metabolic syndrome (correlation coefficient 0.209). In conclusion metabolic syndrome that appears to be a risk factor for CTS. At the same time, the presence of metabolic syndrome increases the severity of the disease.

Objective: The detailed assessment of soft tissues over bony prominences and identification of methods of predicting pressure sores would improve the quality of care for patients with spinal cord injury (SCI). Comparing skin thicknesses on bony prominences in patients with SCI to those in healthy individuals will represent, to our knowledge, the first study aimed at determining whether differences in skin thicknesses between these groups can be detected by ultrasound. Design: In both patients and controls, skin thicknesses on the sites at risk for pressure ulcers -sacrum, greater trochanter, and ischium -were evaluated using high-frequency ultrasound. The waist was also evaluated by the same method for control as it was considered to be a pressure-free region. Participants: Thirty-two patients with complete thoracic SCI and 34 able-bodied individuals. Results: The skin was significantly thinner over the sacrum and ischial tuberosity in individuals with SCI compared with healthy individuals. No significant differences were observed in skin thicknesses over the greater trochanter or the waist between the two groups. Conclusions: Protecting skin integrity in patients with paraplegia is challenging due to many contributing factors, such as prolonged pressure, frictional/shearing forces, and poor nutrition. Thinning of the skin can increase the risk of soft tissue damage, leading to pressure ulcers. The significant differences in skin thickness at the sacrum and ischium provide the basis for establishing the early signs of pressure damage. Measuring skin thickness by ultrasound is a reliable non-invasive method that could be a promising tool for predicting pressure ulcers.

the time of surgery. Seven nerves recovered. By final follow up (7 months) only three nerves (1%) remained abnormal.Patients' responses on the visual analogue satisfaction score ranged from one to ten points with a mean value of seven. From the questionnaire responses ten patients (9%) disliked the injections of local anaesthetic. The tourniquet was not a source of major complaint, with only two patients stating discomfort. Both had tourniquet times of more than 30 minutes. Only three patients (2%) found the overall experience particularly unpleasant, and would prefer a general anaesthetic next time.Overall we achieved good deformity correction and a low complication rate. These short-term results compare well with published results for surgery under general anaesthetic or regional nerve block (Anwar et al., 2007;Dias and Braybrooke, 2006;Misra et al., 2007).This study demonstrates that the technique is practical to use in day-case theatre, is well tolerated by patients, and yields comparable results to those under GA or proximal regional anaesthetic. This avoids the cost of a dedicated anaesthetist and potentially shortens anaesthetic time. We recommend limited fasciectomy for Dupuytren's contracture using local anaesthetic wrist block and an upper arm tourniquet as a day-case procedure.

Study Design An experimental design.Objectives The aim of this study was to determine the latencies of vibration-induced reflexes in individuals with and without spinal cord injury (SCI), and to compare these latencies to identify differences in reflex circuitries. SettingA tertiary rehabilitation centre in Istanbul Methods Seventeen individuals with chronic SCI (SCI group) and 23 participants without SCI (Control group) were included in this study. Latency of tonic vibration reflex (TVR), and whole body vibration-induced muscular reflex (WBV-IMR) of the left soleus muscle were tested for estimating the reflex origins. The local tendon vibration was applied at six different vibration frequencies (50, 85, 140, 185, 235 and 265 Hz), each lasting for 15 s with 3-s rest intervals. The whole body vibration was applied at six different vibration frequencies (35, 37, 39, 41, 43 and 45 Hz), each lasting for 15 s with 3-s rest intervals.Results Mean (SD) TVR latency was 39.7 (5.3) milliseconds in the SCI group and 35.9 (2.7) milliseconds in the Control group with a mean (95% CI) difference of -3.8 (-6.7 to -0.9) milliseconds. Mean (SD) WBV-IMR latency was 45.8 (7.4) milliseconds in the SCI group and 43.3 (3.0) milliseconds in the Control group with a mean (95% CI) difference of -2.5 (-6.5 to 1.4) milliseconds. There were significant differences between TVR latency and WBV-IMR latency in both the groups (mean (95% CI) difference; -6.2 (-9.3 to -3.0) milliseconds p = 0.0001 for SCI group and -7.4 (-9.3 to -5.6) milliseconds p = 0.011 for Control group). ConclusionsThe results suggests that the receptor of origin of TVR and WBV-IMR may be different.