30 patients with supraspinatus or bicipital tendonitis were randomly allocated to active infrared laser therapy at 904 nm three times weekly for 2 weeks, dummy laser or drug treatment for 2 weeks. Objectively maximum active extension, flexion and abduction of the shoulder, and subjectively pain stiffness movement and function were measured at 0 and 2 weeks. Significant improvement of active over dummy laser was noted for all seven assessments. Active laser therapy produced significant improvement over drug therapy for all three objective measures and pain. Naproxen sodium significantly improved only movement and function compared to dummy laser. These results demonstrate the effectiveness of laser therapy in tendonitis of the shoulder.
Compression of the ulnar nerve in Guyon's canal is an uncommon phenomenon. Reports of ulnar nerve palsy secondary to ulnar artery pseudoaneurysm at this anatomical location are very rare and equivalent pathology just distal to this site is unheard of.Here we present such a case, which featured a delayed onset of symptoms. This followed penetrating trauma to the hand. Our methods for diagnosis, operative planning and surgical treatment are included.Compression of the ulnar nerve in Guyon's canal is an uncommon phenomenon, described as early as 1908 by Hunt. 1Reports of ulnar nerve palsy secondary to ulnar artery pseudoaneurysm at this anatomical location are very rare. Case historyA 33-year-old man presented to our clinic 3 weeks after a penetrating glass laceration to the hypothenar eminence of his non-dominant right hand. He had attended casualty at the time of his injury while on holiday abroad where the wound was treated with adhesive strips. He reported that there were no functional problems with the hand at the time of the injury but motor and sensory symptoms developed progressively over the subsequent weeks.At the time of our assessment, ulnar clawing of the hand was apparent; the ring and little metacarpophalangeal joints were held in hyperextension with flexion at the interphalangeal joints of the corresponding fingers. Clinically, a sensory deficit was apparent (light touch, 2 point discrimination) in a well demarcated medial one and a half digit ulnar distribution. There was weakness of the interosseous muscles, abductor digiti minimi and lumbricals to the ring and little fingers (Medical Research Council score 3/5). Froment's sign was positive. A pulsatile mass was palpable over the hypothenar eminence. A clinical diagnosis of pseudoaneurysm of the ulnar artery causing neurapraxia of the ulnar nerve was made. The patient underwent ultrasonography and magnetic resonance angiography provided further clarity, demonstrating a pseudoaneurysm measuring 24mm of the ulnar artery as it coursed into the palm, immediately prior to its continuation as the superficial palmar arch (Fig 1).There was no evidence of ulnar nerve transection. Maximal ulnar nerve compression was at a site just distal and
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